November 2014: Essential Tremor Enrollment Complete and More…


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Also in this issue:


Elekta Executive Offers Insights
Jane Batten Hosts Virginia Beach Event
Winter School Funding Awards Available

Focused Ultrasound Survey Findings
FUS Research Recognized at MRI Meeting
CarThera Study Opens the BBB
Research Roundup

Article of the Month: Brain Tumor Ablation

EDAP Receives FDA Guidance
Mark Carol Named CEO of SonaCare

FUS Tackles Brain Disorders and more…


November 30-December 5 RSNA
February 28-March 5 SIR
March 8-13 Therapeutic Ultrasound Winter School
Essential Tremor Pivotal Trial Enrollment Complete

Dr. Elias presenting the pivotal study design at the Focused Ultrasound Symposium

InSightec has completed enrollment in the pivotal study of their ExAblate Neuro system for the treatment of essential tremor. Physicians at eight sites worldwide have now treated 76 patients in the trial. The first randomized, controlled trial of unilateral MR-guided focused ultrasound thalamotomy with InSightec’s system began in August 2013 and completed enrollment in September 2014. Results will be submitted to the US Food and Drug Administration (FDA) for regulatory approval of the device. The pivotal study was designed based on the clinical outcome of the initial 15-patient pilot study that was conducted from 2011 to 2012 and published in an August 2013 issue of the New England Journal of Medicine.

"We all know someone with essential tremor; it's a common problem. Hopefully this study will lead to a treatment that might be applicable to many patients around the world."
– Jeff Elias, MD, associate professor of neurological surgery at the University of Virginia and principal investigator of the study

Patients with severe, medication-refractory essential tremor were enrolled after being assessed for tremor severity and disability and then randomized in a one-to-three fashion to receive either sham (pretend) procedure or the focused ultrasound treatment. Participating patients are now being followed for one year.

Treatment safety and efficacy are the study’s primary endpoints, with secondary endpoints including durability at 12 months, quality of life, functional improvement, and comparison between the sham and treatment groups. During the follow-up period, an independent, blinded corelab group of neurologists specializing in the management of essential tremor rate the clinical outcomes from videotaped assessments, and the patients will complete disease-specific quality of life questionnaires. Final results are expected to be submitted to the FDA by the end of 2015.




Tomas Puusepp

"As long as you capitalize on change and are ahead of the curve, you can succeed. "
– Tomas Puusepp

Elekta’s Executive Director Shares Insight, Praises the Role of the Focused Ultrasound Foundation

Tomas Puusepp, Executive Director of the Board of Elekta and its former CEO, recently visited the Foundation and shared his experience in providing an emerging technology (the Gamma Knife) to the patients who need it. His thoughts on taking risks, competition, and overcoming barriers provide many valuable insights that apply to focused ultrasound.

When Puusepp joined Elekta in 1988, it was a $5 million company with a staff of 22—today it has $1.5 billion in revenue and 4,000 employees. With a background in electrical engineering and physics, he advanced through the management ranks within Elekta to serve as President and CEO from 2005 through April 2014.

Puusepp recognizes the benefit of a foundation in supporting technology. "It took decades for the Gamma Knife to become a standard of care. However, after we established the Leksell Gamma Knife Society, we gained traction much faster. If an organization similar to the Focused Ultrasound Foundation existed for advancing stereotactic radiosurgery from the start, this time would have been much shorter."

Learn more about the parallels between the path of the Gamma Knife and the development of focused ultrasound, his top three tips for device companies, and his praise for the role of the Foundation.



Jane Batten

Council Co-Chair Jane Batten Hosts Virginia Beach Awareness Event

On November 3rd, Foundation Council co-chair Jane Batten and Vince Mastracco hosted a luncheon in Virginia Beach for 25 community leaders who were interested in learning about focused ultrasound and its potential to revolutionize medicine, save lives, and reduce suffering. During the program, Chairman Neal F. Kassell, MD, presented the Foundation’s history and a brief overview of the technology. A focused ultrasound patient then shared his story with the group.



Applicants should send a cover letter, CV, and letter of recommendation from their mentor to Matt Eames meames@

Student Funding Available for Winter School - Apply Now!


The Foundation is offering travel support for US students to attend the Winter School on Therapeutic Ultrasound in Les Houches, France, March 8-13, 2015.

The meeting is sponsored by the Focused Ultrasound Foundation, the European Society for Hyperthermic Oncology (ESHO), The International Society for Therapeutic Ultrasound (ISTU), the Acoustical Society of America (ASA), and the Society for Thermal Medicine (STM).

The Winter School explores the rapidly emerging field of therapeutic ultrasound. Participants will learn the physics behind the technology, the biophysical effects in the body, and the clinical applications of the therapy.


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Click to see a word cloud of the role respondents thought the Foundation should play

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FUS Experts Believe Brain and Cancer Applications Have Most Potential to Improve QOL

The Foundation conducted a survey of 150 members of the focused ultrasound community on the state of the field prior to the October 2014 Symposium.

Respondents were asked to identify which clinical indications were most likely to improve patients’ quality of life. Neurological and oncological indications are tied for the most votes, with brain tumors, essential tremor, and pancreatic cancer being rated as the top three individual indications. Similarly, respondents were asked to rank the top three bioeffects that are most likely to have long-term therapeutic value. Thermal ablation is ranked first, followed by drug delivery and neuromodulation.

Read more to find out about the community’s perspective on:

  • Which indications are most likely to be commercially successful
  • What the obstacles are to widespread use
  • Whether there are any differences between scientist and clinician views on the potential of FUS





Focused Ultrasound Research Broadly Recognized at the 10th Interventional MRI Symposium in Germany

A research group based at Kobe University in Japan received the magna cum laude poster award at the 10th Interventional MRI Symposium held last month in Leipzig, Germany. Their winning project featured work in analyzing liver deformation to obtain MR images prior to focused ultrasound (FUS) treatment. Of the 63 posters accepted at this technically oriented meeting, seven included FUS.



Image courtesy of CarThera



CarThera Opens the Blood-Brain Barrier with Ultrasound

Although they do not use focused ultrasound, one of the developmental companies that presented at last month’s Symposium is using low intensity ultrasound waves to temporarily open the blood-brain barrier (BBB) to allow drug delivery to brain tumors. CarThera researchers gained attention after reporting that they initiated a Phase 1/2a clinical trial to open the BBB in recurrent glioblastoma patients last July.

At the time of the presentation, four patients had been enrolled in the study. A tiny ultrasound transducer device is inserted into a standard burr hole, fixed to the surrounding skull bone, and covered with skin. The energy is delivered once a month when the device is connected to an external generator system via transdermal needle. The patient receives up to two minutes of pulsed ultrasound. At the same time, an ultrasound contrast agent is given and BBB disruption is monitored via MRI. As the BBB is opening with ultrasound, the chemotherapy is administered.

After the Symposium, New Scientist, i09, and China Topix reported the study.




Research Roundup

Three interesting papers have recently been published about the use of focused ultrasound (FUS) in the brain. Could 3D MR thermometry play a key role in understanding and expanding the FUS treatment envelope? Does skull thickness matter? What parameters are needed to begin using low-frequency FUS in the brain?

Read these manuscripts, and one about liver disease clinical trials. READ MORE ►




JTU Article of the Month – Brain Tumor Ablation

The first successful noninvasive thermal ablation of a brain tumor with MR-guided focused ultrasound is highlighted in the October issue of The Journal of Therapeutic Ultrasound.

This work from Switzerland supports the potential use of transcranial focused ultrasound for the noninvasive treatment of patients suffering from malignant brain tumors, especially in areas not amenable to conventional neurosurgical interventions.

Further treatments in the context of this ongoing pilot study will be needed to assess the feasibility and safety of the procedure. If the results are positive, then a larger study in the future will be needed to demonstrate safety and efficacy.



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EDAP Receives FDA Guidance for Ablatherm

EDAP-TMS received a letter from the US Food and Drug Administration (FDA) indicating that, although their premarket application for the Ablatherm device to treat localized prostate cancer was not approvable in its current form, a path forward is possible.

The letter provides specific guidance and recommendations for modifying the patient population to those prostate cancer patients with a greater risk of morbidity and/or mortality from their disease and for using the company's European registry along with the already existing safety data to support approval for the modified indication. EDAP’s press release provides additional details.

"This response from the FDA reflects the extensive and ongoing discussions between our team and agency staff…We appreciate their constructive and comprehensive recommendations."
– EDAP CEO Marc Oczachowski


Mark Carol, MD



Mark Carol Named CEO and President of ‏SonaCare Medical

SonaCare Medical has named Mark Carol, MD, CEO and President. According to the company’s press release, Carol plans to focus on further developing SonaCare’s HIFU technology while overseeing commercialization, manufacturing, and finance.

Dr. Carol, who joined SonaCare in 2011 as Chief Development Officer, has led the company’s clinical study program and the ongoing effort for US regulatory approval of the Sonablate 450.

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Focused Ultrasound Tackles Brain Disorders on Medical Physics Web 10/30/14
UVA Physicians are Using Focused Ultrasound as an Alternative to Brain Surgery on 10/18/14
Sound Waves Can Heal Brain Disorders on 10/16/14

BRIEF-Theraclion Presents Positive Thyroid Nodule Trial Results on 10/15/14

Women’s Health
High-Intensity Ultrasound OK for Cesarean Scar Pregnancy on 10/9/14

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November 30-December 5, 2014 Radiological Society of North America (RSNA) 100th Scientific Assembly and Annual Meeting, Chicago, IL

February 28-March 5, 2015 Society of Interventional Radiology (SIR) Annual Scientific Meeting, Atlanta, GA

March 8-13, 2015 Winter School on Therapeutic Ultrasound, Les Houches, France (see above article on travel awards)


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