Known as a luminary in medical imaging, Dennis L. Parker, PhD is currently devoting much of his time to focused ultrasound. Parker, a professor of Radiology at the University of Utah and Director of the Utah Center for Advanced Imaging Research (UCAIR), is co-leading the development of a high intensity focused ultrasound (HIFU) system for breast tumors.
The project’s origins trace back to 2003 when Utah purchased its first MRI scanner from Siemens. “Because the Siemens MRI scanner was very open as far as its software architecture, our students were able to very, very quickly establish a closed feedback loop feeding images out of the scanner into the ultrasound controlling computer that we had at the time,” Parker recalls. This led to the development of a closed-loop MRI guided focused ultrasound system.
“When Siemens came to visit in 2004, they actually decided to pick up that project and provided some funding,” he notes. At the time, Image Guided Therapy (IGT), a French medical device maker, had just designed a phased-array focused ultrasound transducer.
“Siemens purchased that device and placed it in Utah as IGT’s first large animal focused ultrasound system,” Parker adds. “Ever since that time, we’ve been working with them.”
By 2006, Parker and his collaborators decided that the best candidate site for their system would be the breast, and they applied for funding from the National Institutes of Health to develop a prototype. “It was an academic/industrial partnership,” he says. “We were very lucky. We were funded on the first submittal, which is very rare, but we were delighted.”
His collaborators on the project represent numerous disciplines and several departments at the University of Utah. In addition to Parker, the team includes Robert B. Roemer, PhD from Mechanical Engineering; Douglas Christensen, PhD from Bioengineering; Allison Payne, PhD, Rock Hadley, PhD, Emilee Minalga, PhD, Robb Merrill, PhD and Nick Todd, PhD from UCAIR; Leigh Neumayer, MD from Surgery/Oncology; and many students.
New breast system has unique features
Utah’s system, says Parker, “has a lot of capabilities not found in other breast HIFU systems.” Unique features include the placement of the focused ultrasound transducer. Mounted on flexible bellows made of PlastiDip (an idustrial grade fabrication material), the transducer can be moved into and out of the treatment cylinder as needed. Also unique is that the transducer shoots laterally. The system has a small water box in which the breast is suspended. That box has an array of radio frequency coils around it. According to Parker, this provides “image quality from the MR side [that] is actually very, very good.”
The system’s other major components are an MR-compatible ultrasound generator made by IGT and a Siemens MRI scanner.
Now in prototype form, the system has been tested on phantoms and samples. “From the standpoint of something that could ultimately be used to treat breast cancer, I think this is an excellent potential device,” Parker says. “The advantage of HIFU for breast cancer is that it’s totally noninvasive. It has the opportunity eventually to totally eradicate the disease without any surgical intervention at all.”
A patent application has been filed for the system and further improvements are planned. “There are many problems that still need to be solved,” he notes. “Measuring temperature in fat, which is a major component of breast tissue, has not been solved yet by others. We’ve got a good technique that is starting to work and we’re optimistic that with all these little pieces it’ll be a good system.”
The team, says Parker, will seek funding to develop modifications that improve image quality and enable the system to treat more aspects of breast disease. “Our new design should be able to treat much more of the disease, including many metastatic lesions,” he notes.
Written by Ellen C., McKenna
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While many cases of ET are mild, according to Neal Kassell, MD, chairman of the Focused Ultrasound Surgery Foundation, some patients suffer severely ... http://www.agingwellmag.com/news/ex_040312.shtml
In a recent email, Matthias Matzko, MD, head of Interventional and Diagnostic Radiology at Amper Kliniken AG in Dachau, Germany wrote, “We are proud to announce that we passed the 500th treatment in total for uterine fibroid ablation with MRgFUS last week. With the new ExAblate ONE System, we already have the experience of more than 230 treatments with a significant higher rate of success with this new technology in comparison to the old system ExAblate 2000.”
The last of 15 patients was treated in mid-December in the world’s first clinical trial using MR-guided focused ultrasound as a therapy for essential tremor. The single-site pilot study, which has been funded by the FUS Foundation, began in February 2011 at the University of Virginia with neurosurgeon W. Jeffrey Elias, MD serving as principal investigator.
All study participants are being followed for three-months, and final clinical trial data is expected to be available in March 2012. Elias will present that data at the 2012 American Association of Neurosurgeons meeting, scheduled for April 14-19.
Preliminary study data, which was presented by Elias at the 2011 Congress of Neurological Surgeons meeting in October, was highly promising. The study’s first 10 patients experienced a 78 percent improvement in contralateral tremor scores in their dominant hand, as assessed with the Clinical Rating Scale for Tremor (CRST). Patients’ functional activities scores improved by 92 percent, as measured in the ‘Disability’ subsection of the CRST. Elias said that outcomes and complications were comparable to other procedures for tremor, including stereotactic thalamotomy and deep brain stimulation.
Patient profile: John WattersonRecently, FUSF Director of Development Kimberly Skelly was delighted to receive the following unsolicited letter:
Fibroid Relief, the FUS Foundation's patient support initiative, has launched a renovated web site to improve its ability to educate women about MR-guided focused ultrasound as a non-invasive treatment option for uterine fibroids.
In October of 2008, the Foundation launched Fibroid Relief to fill an information void for patients with uterine fibroids. Through public events and its website, this initiative has become a vital and respected source of information about uterine fibroid treatment options, including MR-guided focused ultrasound.
A study recently published in the journal Academic Radiology shows positive outcomes up to three years following treatment of uterine fibroids with MR-guided focused ultrasound.
In the study, 40 women with fibroids were treated with focused ultrasound. Researchers followed up with the women at three and six months, as well as one, two and three years. They found that the largest decrease in fibroid size occurred within the first six months and continued to happen over the three-year period.
On June 14, 2011, GE Healthcare Korea and InSightec, Ltd. co-hosted a conference to recognize two important developments in the focused ultrasound community.
First was the attainment of the 500-patient mark by the focused ultrasound team at CHA Bundang Medical Center in Seoul. Under the leadership of Sang-Wook Yoon, MD, the team has been treating uterine fibroid patients for five years. CHA’s one-year follow up data shows that 95% of patients have experienced improvement and that 18 have either become pregnant or given birth.
The second development acknowledged at the event is the purchase of ExAblate brain and body systems by Yonsei University Medical Center. Jin Woo Chang, MD will use the new brain system to conduct the world’s first clinical trial in which patients with obsessive compulsive disorder (OCD) will receive MR-guided focused ultrasound therapy. Yonsei researchers are also planning clinical trials involving patients with metastatic bone tumors, low-risk and intermediate risk prostate cancers, essential tremor, and brain cancer.
On June 13, the Richmond Times Dispatch provided an update on the FUS Foundation-funded essential tremor trial at the University of Virginia and its first participant, Billy R. Williams. Written by Lifestyles reporter Tammie Smith, the story was prompted by a reader's inquiry about how Mr. Williams is doing.
Williams, who has completed the three-month study period, reports he is doing well. His UVA neurosurgeon, W. Jeffrey Elias, MD, says Williams has demonstrated excellent tremor control. Click the link below to read the full story.
Early results of essential tremor study promising - http://www2.timesdispatch.com/lifestyles/2011/jun/13/TDMET05-early-results-of-essential-tremor-study-pr-ar-1103913/
Mario Ries, Ph.D., a physicist at the Laboratory for Functional and Molecular Imaging in Bordeaux, France, has been intrigued with the notion of combining noninvasive ablation with MR guidance since 1997. Today, his key ambition is help the roughly one to one and a half million people globally diagnosed with breast cancer every year.
Ries has received a $100,000 research award from the Focused Ultrasound Surgery Foundation to pursue a project he believes will result in a safer and more effective treatment for breast cancer. His objective is to solve the technical drawbacks that cause existing high intensity focused ultrasound (HIFU) transducers – devices that convert energy into sound waves and focus the waves on a target – to damage tissue around the breast, including to the thoracic cage, heart and lungs. Click here to read full report.
Tracey Daniels of the FUS Foundation’s patient support organization, Fibroid Relief, reports that the April 27 Fibroid Relief event in Houston was a great success. She notes a few highlights:
The event marked the first time that Fibroid Relief worked in partnership with two focused ultrasound centers, each of which is using a different device to noninvasively treat uterine fibroids. The Methodist Hospital is performing treatments with the FDA-approved InSightec ExAblate System; St. Luke's is a clinical trial site for the Philips Sonalleve System.
The April issue of the FUS Foundation's e-newsletter features an excluvie video interview with Billy R. Williams, a patient with essential tremor who experienced dramatically positive results after being treated with MR-guided focused ultrasound. Williams is the first patient treated in a first in the world clinical trial funded by the FUS Foundation. Read more and view video.
The FUS Foundation's patient support organization, Fibroid Relief, has scheduled a free public education event for April 27, 2011 in Houston, Texas. The event is being organized in partnership with the focused ultrasound centers at the Methodist Hospital and at St. Luke's Episcopal Hospital.
"This is the first time that we have organized an event to support two focused ultrasound centers," said Tina Krall, Fibroid Relief executive director. "Each center uses a different device to noninvasively treat uterine fibroids. Methodist is using the FDA-approved InSightec ExAblate System, and St. Luke's is a clinical trial site for the Philips Sonalleve System."
The last ten years have been challenging for Billy R. Williams of Fort Valley, Virginia. The former Pentagon employee, who survived the 9/11 terrorist attack, has suffered from essential tremor, a progressive and debilitating neurological disorder.
Medications controlled his tremor for a while, but eventually the shaking became so severe that Williams found it impossible to do anything with his dominant right hand. He was unable to button his shirt, eat without spilling or fill in a crossword puzzle. An avid golfer, he even needed help teeing up his ball. Referred to the University of Virginia for evaluation, he learned about various treatment options and ultimately agreed to participate in a new clinical trial. Funded by the FUS Foundation, the study is assessing the safety and initial efficacy of noninvasive MR-guided focused ultrasound as a treatment for essential tremor.
On February 25, 2011, Williams became the first essential tremor patient in the world to receive MR-guided focused ultrasound therapy, and the results were dramatically positive.
- Written by Ellen C., McKenna
Study InformationClick here for study information posted on the National Institutes of Health website. Patient inquiries can be directed to UVA Neurosurgery Clinical Trials at 434-243-1435 or by emailing
Click here to read FUS Foundation newsletter coverage of this study >
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A front page story in the March 11, 2011 edition of the Richmond Times Dispatch featured an interview with Billy R. Williams, the first patient in a new clinical trial funded by the Focused Ultrasound Surgery Foundation. The first in the world clinical trial is asessing the safety and effectiveness of MR-guided focused ultrasound in treating essential tremor, a progressively debilitating condition that causes uncontrollable trembling in the hands and other areas of the body. Also interviewed was W. Jeffrey Elias, M.D., the University of Virginia neurosurgeon who performed the procedure and is the study's principal investigator.
In the report, Williams is quoted as saying, "I feel very good." He also explained, "I wanted these tremors taken care of so badly I really had no fear of having it done." Click below to read the full story.
Clinical trials using MR-guided focused ultrasound to treat uterine fibroids and pain from cancer that has metastasized to bones are enrolling patients at the University of Virginia Health System. Details of those studies are reported in the latest issue of the UVA edition of Physician’s Practice Magazine.Click below to view the full report.
UVA Physicians Practice Magazine Article
The FUS Foundation's patient-support organization, Fibroid Relief, is kicking off 2011 with a free educational event in Charlottesville, Virginia on February 3. The event will be the first held in conjunction with the Focused Ultrasound Center of Excellence at the University of Virginia.
According to Tina Krall, executive director of Fibroid Relief, confirmed speakers include Alan Matsumoto, M.D. (Focused Ultrasound and Uterine Fibroid Embolization); Elisa Trowbridge, M.D. (Robotic Myomectomy); Bruce Bateman, M.D. (Gynecology and Fertility); Annette Owens, M.D. (Sexual Health); Cindy Janechild, R.N. (Holistic Medicine) and three uterine fibroid patients, one of whom was successfully treated with MR-guided focused ultrasound at UVA.
Advancing a game-changing technology like MR-guided focused ultrasound from research bench to clinical reality requires the contribution of many stakeholders. One such group – first-to-be-treated patients – often goes unsung.
The January issue of the FUS Foundation newsletter provides an engaging profile of Doris McArdle, an indomitable 89-year-old who and recipient of the first MR-guided focused ultrasound treatment for a benign pancreatic tumor. Performed on a compassionate care basis at St. Mary’s Hospital in London, England, the treatment ablated about a fourth of Mrs. McArdle’s sizable tumor and has relieved about 75 percent of her persistent pain.
Click hereto read the complete details of Mrs. McArdles's treatment and recovery.
"What a difference a year makes!" exclaimed Doris McArdle and her daughter, Sharon Duffy, in a recent New Year’s greeting.
The recipients of that message – David Heller, Neal Kassell, M.D. and Wladyslaw Gedroyc, M.D. – made a difference that McArdle will never forget. In November 2010, the indomitable, 89-year-old McArdle boarded a trans-Atlantic flight from Chicago to London. There, she successfully underwent a noninvasive MR-guided focused ultrasound procedure to relieve acute pain and discomfort caused by a large benign tumor in her pancreas.
The Foundation’s patient support organization, Fibroid Relief, will conduct its second Coffee and Conversation event in London on Saturday, July 31.
Presented in partnership with St. Mary’s Hospital, the event will offer an intimate, safe and supportive environment where past and present uterine fibroid sufferers can talk freely about their experiences, share knowledge and learn from each other.
Erin, a blogger and patient advocate for the Foundation’s Patient Support Organization,Fibroid Relief, will be a guest on the hit daytime TV talk show, “The Doctors.”
Erin will appear on April 9, in a segment about uterine fibroids. She will share her story about living with the condition and being successfully treated with MR-guided FUS. The segment will be archived online on www.thedoctorstv.com.
A year after their procedures at the Mayo Clinic, 97 percent of the women who had MR-guided FUS treatments for uterine fibroids said their symptoms had improved. Ninety percent considered their improvement either “considerable” or “excellent.”
So reported Gina Hesley, M.D., an interventional radiologist at Mayo, who is studying the long-term effectiveness of MR-guided FUS treatments for uterine fibroids. She presented her findings at the Society of Interventional Radiology’s 35th Annual Scientific Meeting in Tampa.
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.
We met Beverly during her recent trip to Washington, DC to advocate for increased patient access to innovative treatments (see Patients and Physicians Advocate for Focused Ultrasound in Washington, DC). She is a 69-year-old family nurse practitioner in Western Montana whose essential tremor (ET) forced her to leave her beloved practice caring for American veterans.
The Centers for Medicare and Medicaid Services (CMS) have established a new billing code for focused ultrasound ablation of prostate tissue that will go into effect on July 1, 2017. The announcement was made by both EDAP-TMS and SonaCare Medical, the two companies whose devices are approved in the US.
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