With a donation as focused as the technology it seeks to advance, the Focused Ultrasound Surgery Foundation has pledged $3.1 million toward an MR-Guided Focused Ultrasound Surgery Center at the University of Virginia.

The Center will specialize in research, training and patient care using MR Guided Focused Ultrasound - a medical break-through that combines MRI (magnetic resonance imaging) with ultra-high frequency sound waves in a new kind of therapy.

Focused Ultrasound lets doctors treat tumors noninvasively, employing beams of ultrasound instead of a scalpel or radiation. Each of the high-frequency sound beams - up to one thousand of them - passes through healthy tissue harmlessly. But where they converge, at the site of the tumor, they generate just enough heat to destroy it. This is similar to using a magnifying glass to focus beams of sunlight and burn a hole in a leaf.

The UVA facility, one of three Centers of Excellence that the Foundation plans to establish in the next two years, will treat women with uterine fibroids - the first of this type of procedure to receive FDA approval.

In addition, the Center will be conducting research on the use of focused ultrasound surgery for other tumors - brain, breast, prostate, bone and liver. It will also explore using it on stroke, epilepsy, chronic pain, and Parkinson's disease and essential tremor.

More than four years in the making, the UVA Center is slated to be up and running by September of 2009. Its total cost will exceed $8 million. This includes the $3.1 million contribution by the foundation, plus its research and fellowship grants, and $4 million provided by the Commonwealth of Virginia.

Other contributions will include "in kind" giving by InSightec, the company that manufactures the focused ultrasound equipment; and GE Healthcare, the MRI maker.

"This remarkable center isn't just something that will offer real 21st century healthcare to our citizens", commented Bill Howell, speaker of the Commonwealth's House of Delegates. "It's a smart investment that puts Virginia at the head of the pack in a major new high-tech field."

A key goal of the Focused Ultrasound Surgery Foundation, according to Eben Alexander, MD, its Director of Research and Education, is to shorten the time it will take to get widespread use of focused ultrasound surgery. "This technology is too promising to let it languish for years while it proves its worth," Dr. Alexander added.

According to Steven T. DeKosky, MD, Dean of UVA's School of Medicine, "our new Focused Ultrasound Surgery Center will be a wonderful opportunity for physicians and scientists from a variety of specialties to collaborate in high-technology translational research -- the sophisticated application of what's learned in the laboratory to clinical studies and then into everyday use in treating patients. The Center is a great example of what UVA is doing to become a major research university."

"How big is Focused Ultrasound," rhetorically asks James Larner M.D., Chairman of UVA's Department of Radiation Oncology and Director of the Center. "It's possibly the biggest thing in therapy since the scalpel."

The Focused Ultrasound Surgery Foundation and Department of Neurosurgery at the University of Virginia hosted a Brain Workshop for Magnetic Resonance guided Focused Ultrasound Surgery (MRgFUS) March 23-25, 2009 at a retreat in Chantilly, VA. The primary objective of the workshop was to develop a comprehensive R&D roadmap that would fast-track the use of this technology to treat a variety of brain disorders including benign and malignant tumors, Parkinson's disease and essential tremor, stroke, and epilepsy.

Participation was by invitation only, and representatives from academia, industry, NIH, and the Focused Ultrasound Surgery Foundation were in attendance. Participants included 45 leading neurosurgeons, neurologists, neuroradiologists, neuroscientists, biomedical engineers, physicists, product-development managers and medical device company executives from around the world.

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A researcher whose study was initially funded by the Focused Ultrasound Surgery Foundation has been awarded the Young Investigator Award at the American Association of Neurological Surgeons. The young investigator award goes to Jason Sheehan, M.D., a neurosurgeon and assistant professor at the University of Virginia, and part of a research team that also includes Jason Price, Ph.D., and Caitlin Burke, B.S. The research shows that focused ultrasound can be used to activate chemotherapy agents at the site of glioblastoma multiforme tumors. After receiving an initial award from the Focused Ultrasound Surgery Foundation, the team went on to receive further funding from the Hartwell Foundation. Dr Sheehan is also the co-director the new Focused Ultrasound Surgery Center at the University of Virginia, which is due to become operational in September 2009.

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• "Treatment of chronic functional brain disorders using transcranial MR-guided focused ultrasound" Daniel Jeanmonod, MD, University of Zurich ($100,000)
• "Microbubble-Enhanced FUS for more Efficient Therapy for Uterine Fibroids" Terry Matsunaga, Pharm.D., PhD, University of Arizona ($102, 324)
• "Creation and validation of a clinically-relevant ultrasound-enhanced drug delivery strategy - finalize ultrasound parameters, quantify full body biodistribution and characterize tissue changes" Katherine Ferrara, PhD, University of California at Davis ($100,000)

For more details on these and other of our funded research projects, please see our website.

• Evan Weeks, MD (Anesthesiologist) - One-year fulltime fellowship to be carried out at St. Mary's Hospital, Imperial College London, under the mentorship of Professor Wady Gedroyc. Focus of fellowship will be on the use of MR-guided focused ultrasound for facet joint pain. ($100,000)
  
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Founded in 1986 by researchers in the area of thermal therapy, the Society for Thermal Medicine has facilitated a forum for discussion of research for more than 20 years. The Society's 2009 Annual Meeting was held in Tucson, Arizona, on April 3-7, with a program jam-packed with presentations on research topics that included Targeted Drug Delivery and Liposomes, Thermal Effects on the Immune System and the Tumor Microenvironment, and even a full session on MRI-guided Focused Ultrasound.

Targeted Drug Delivery is a research area the Foundation has consistently predicted will have tremendous potential when coupled with Focused Ultrasound. In fact, we recently funded a research project to support work by Katherine Ferrara's group at the University of California at Davis that aims to create and validate clinically relevant ultrasound-enhanced drug delivery. One of Dr. Ferrara's colleagues, Dustin Kruse, PhD, presented related work at STM, and we look forward to seeing continued success from Ferrara's lab, aided by Foundation resources.

In addition, thermo-sensitive liposomes were the focus of multiple presentations. These included talks by Matthew Dreher of the NIH, and Ashley Manzoor of Duke University, which described their collaborative work on lysolipid-containing temperature-sensitive liposomes (LTSLs) coupled with an image-guided hyperthermia device.

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At the recent International Society for Magnetic Resonance in Medicine (ISMRM), 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.

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The RAC is a scientific peer review group composed primarily of scientists with expertise in clinical and scientific disciplines relevant to the field of MR-guided focused ultrasound. Members of the committee are charged with the task of evaluating research funding proposals submitted to the Foundation under its Research Award Program and are therefore critical to the success of the program. For a complete list of all RAC members, please visit our website.

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