The World Society of Stereotactic and Functional Neurosurgery (WSSFN) had its 15th Quadrennial Meeting in Toronto, Canada May 24-27, 2009 (Detailed program).  More than 500 functional neurosurgeons from around the world convened to discuss their latest findings.  As a group, functional neurosurgeons have the highest percentage of interest in MRgFUS of any group of clinical physicians (virtually 100%).

There has been a surge in interest using deep brain stimulation (DBS) for neuromodulation in functional neurosurgery over the last decade.  The main limitations of DBS for movement disorders, pain and behavioral disorders are cost in both money and time, and the necessity of a neurosurgical operation that entails some risk of hemorrhage, infection, mechanical failure, neurologic damage, etc. One tremendous advantage of MRgFUS is the non-invasive nature of the technique. Any form of lesioning, including MRgFUS, gains significant advantage through targeting techniques that assure a safe, effective lesion location.  MRgFUS offers distinct advantages over other techniques through MR thermometry (visualization of the actual energy focus prior to lesioning) and neurophysiological assessment through transient neuromodulation effects.  This counters the main advantage of DBS, which is its reversibility in the face of a misplaced lead (with adverse neurologic symptoms.)

The University Children’s Hospital in Zurich, Switzerland recently celebrated treating its tenth neurosurgery patient with focused ultrasound.  The patient had suffered for almost ten years from neuropathic pain – pain that originated when a benign brain tumor damaged nerve fibers in his brain which led to extreme pain and cramping in his right arm.

By having the errant cells targeted with magnetic resonance image guided focused ultrasound, the patient was able to have the condition treated without opening up the skull, which would typically be required for such a treatment.

After the procedure, the patient was able to experience full relief from the pain he had endured for so long.  "It is really something else when someone stands up from the bed and reports that the pain has gone," says Ernst Martin, Director of the Magnetic Resonance Centre at University Children's Hospital.

Google translation of the news article can be found here 

Translated PDF of the article is also available here

The Christian Broadcasting Network (CBN) recently ran a feature on its telecast and web site about focused ultrasound surgery and the role of the FUS Foundation in accelerating the development and adoption of FUS technology.

Entitled "The Sonic Miracle," the piece highlights the exciting current uses of the technology and some of the revolutionary possibilities the future holds.
Featured in the article are use of the InSightec ExAblate system by Dr. Suzanne LeBlange of University MRI in Boca Raton, the experiences of two patients being treated for uterine fibroids, and commentaries by Dr. Neal Kassell and Dr. Joy Polefrone of the FUS Foundation and Pat Robertson of CBN.

This feature represents significant media exposure for focused ultrasound. The CBN is broadcast in 95 percent of US viewing markets and is seen daily by about 1 million viewers. In addition, 650,000 people view CBN's web site each month. The response of patients and clinicians to this feature has been overwhelming with scores calling and emailing for more information. The web site article and accompanying video can be seen on the CBN web site here

Kyoshi Namba M.D. (Breastopia Namba Hospital, Japan) presented a very comprehensive and optimistic review of the clinical trials investigating breast cancer treatment with MRgFUS. He started by applauding the remarkable progress in breast conserving treatments for breast cancer, and predicted that focused ultrasound would be the ultimate minimally invasive treatment which avoids scarring, a possibility which he, as a breast surgeon, is keen to embrace.

Dr Namba described the importance of ongoing monitoring of disease using MRI during the pre-operative phase during which chemotherapy and radiation are utilized. The great benefit of the MRI modality is that it allows the rapid identification of non-responders and switching to other treatments. (References given: Lehman and Furusawa).

Like MRI, focused ultrasound is seen as a conservative treatment as it does not use ionizing radiation and does not preclude other more aggressive therapy to follow. Since 2002 it has been studied as comparison to lumpectomy in breast cancer, and integrated into the breast healthcare system in his hospital in Japan.