On September 1st, we announced that researchers at the University of Maryland and the University of Virginia performed the first focused ultrasound treatments in the United States for dyskinesia associated with Parkinson’s disease. These treatments are part of an international pilot study of 40 patients to assess the feasibility, safety, and preliminary efficacy of MR-guided focused ultrasound pallidotomy for treatment of dyskinesia.
Investigators are using MR imaging to guide ultrasound waves through the intact skin and skull to reach the globus pallidus, a structure deep in the brain. If successful, focused ultrasound could offer an alternative approach for certain patients with Parkinson’s disease who have failed medical therapy or become disabled from medication-induced dyskinesia. In addition to the US patients, seven patients in Korea and one patient in Canada have been treated in studies to date.
This Parkinson’s study is being co-funded with the Michael J Fox Foundation. Read their blog post about Maryland patient, Kimberly Spletter’s treatment.
Kimberly also shared her experience with the Foundation. Her Parkinson’s had limited her movement and quality of life, but following the experimental treatment, she was able to regain some of her favorite activities and “turn back the clock."
I’ve shuffled for so long. Now, for the first time in three years, I can take big steps and walk with a purpose. – Kimberly
Parkinson's Patient No Longer Just Spinning Her Wheels
For Kimberly Spletter, bike rides had always been a source of relaxation, until she was diagnosed with Parkinson’s disease and could no longer safely balance on her bike. For the last couple years, she had turned to riding a stationary bike instead, as the uncontrollable movements associated with the illness even compromised her ability to walk.
Fortunately, Kimberly was referred to neurologist Dr. Paul Fishman at the University of Maryland, who suggested she consider a new study using focused ultrasound. The procedure would be non-invasive and could offer symptom relief, which would be life-changing for Kimberly. But, it was experimental; she would be one of the first patients in the US to try it for her dyskinesia.
Twenty-five experts attended from 12 institutions.
Alzheimer's Workshop to Develop Research Roadmap
The Foundation hosted a workshop in Bethesda September 17-18 to discuss the state of the field, current challenges, and future research directions for using focused ultrasound to treat Alzheimer’s disease. The meeting was an ideal forum for advanced collaboration in which an invited group of experts reviewed past studies, presented current data, and shared new ideas. Participants included focused ultrasound technical experts, leading Alzheimer’s neurosurgeons, neurologists, neuroscientists, neuroradiologists, and representatives from FDA, medical research foundations, and industry. A white paper outlining the workshop's specific outcomes will be available soon.
Cancer & The Elephant: The Unfortunate Consequence of Cancer as a Metaphor will be hosted by the Focused Ultrasound Foundation and the University of Virginia Cancer Center Tuesday, October 6, 2015.
Featured speaker Samuel Hellman, MD, is the former Dean of the University of Chicago School of Medicine and former Physician-in-Chief at Memorial Sloan-Kettering Cancer Center. A supporter and advocate of multidisciplinary therapy, Dr. Hellman’s research on breast cancer, prostate cancer, and lymphoma among others has been published in more than 250 scientific articles.
The Charlottesville event will begin at 5:30 pm, and those interested in attending should contact Catherine Zimmerman via email.
RESEARCH NEWS
The late Ferenc Jolesz
Brigham and Women's: A Hub for FUS Research
As many as 50 researchers in three laboratories span the Boston campus of Brigham and Women’s Hospital where, in conjunction with Harvard Medical School, they are pioneering innovative uses of focused ultrasound from bench to bedside.
The Focused Ultrasound Laboratory was created in the early 1990’s when Ferenc Jolesz invited Kullervo Hynynen to join him and GE Medical Systems to develop MRI-guided focused ultrasound. This collaboration between Dr. Hynynen, an experienced researcher of therapeutic ultrasound, Dr. Jolesz, who developed MRI-guided laser ablation, and the MR/ultrasound engineers at GE (and later from Insightec) established a program that has produced important contributions for more than two decades.
With the unexpected death of their mentor, Dr. Ferenc Jolesz, in December 2014, the programs that grew under his tutelage at Brigham & Women's continue, and his legacy of progress endures through the focused ultrasound scientists and clinicians he trained and inspired. With teams led by Clare Tempany, MD, Nathan McDannold, PhD, and Seung-Schik Yoo, PhD, MBA, the innovations created by the “Father of MR-Guided Focused Ultrasound” continue to flourish.
We interviewed these BWH research leaders to find out more about their current projects and future plans. Each profile includes a Q & A session with the investigator.
Radiosurgery of children carries significant risk of causing secondary tumors. Therefore, the Foundation has a strong interest in bringing focused ultrasound to pediatric patients. – Matt Eames
Foundation Research Award Update: Pediatric Neurological Disorders
After performing acoustic characterization of pediatric skulls, the group studied sound propagation near the skulls to develop a corresponding refocusing algorithm. They then designed an in vivo neonate setup for FUS treatment of pediatric intraventricular hemorrhage.
“Dr. Drake’s project takes a large step toward realizing focused ultrasound as a treatment option for pediatric patients," said Matt Eames, PhD, the Foundation’s Director of Extramural Research. The study was co-funded by the Canadian government at the level of $1.5 million.
James Drake and George Schade
3rd Quarter Research Awards
Two projects have been selected for funding for the 3rd quarter of 2015. The first is Dr. James Drake’s work at the Hospital for Sick Children in Toronto. His group will establish an international database for pediatric focused ultrasound treatment. In urology, Dr. George Schade at the University of Washington will be assessing the use of histotripsy for treating renal tumors.
Abstracts are now being accepted for the 16th annual meeting of the International Society of Therapeutic Ultrasound (ISTU), to be held March 14-16, 2016 in Tel Aviv, Israel. The conference will include talks on advances in focused ultrasound technology and clinical practice. In addition, for the first time, a brain treatment taking place at Rambam Hospital will be broadcast live during the second day of the conference.
Abstract submission is now open, and papers are encouraged on modelling, physics, and technology in the field of therapeutic ultrasound, as well as its pre-clinical and clinical applications.
Advances in focused ultrasound brain treatment are ongoing. Efforts to expand the treatment envelope in the brain are addressed in this month’s research roundup. New arrays for transcranial sonication, efficiency of acoustic energy delivery through the skull, and thalamotomy for treating Parkinson’s disease are included. In hypertension, a Chinese group has begun clinical trials for renal denervation.
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INDUSTRY NEWS
Christopher Busch
The platform for focused ultrasound is very fragmented. We can talk about it being one technology, but when you look at applications to reach various targets, it requires discrete systems to address different technology challenges arising from different clinical requirements. – Christopher Busch
Philips Strategically Invests in Focused Ultrasound
Philips is reorganizing into a pure health technology company, with focused ultrasound as an important offering in their range of solutions throughout the health continuum of prevention, diagnosis, and treatment. As part of this evolution, they are becoming more strategic with how they invest in the technology.
Christopher Busch, PhD, General Manager of Philips Radiation Oncology Solutions & MR Therapy, met with the Foundation in August to review their current focused ultrasound program, vision for the future, and some of the challenges and opportunities for an established global company in this emerging field. Busch explains that they are shifting their focus from technical development to evidence building and commercial success for a sustainable value proposition for focused ultrasound.
“We continue to support the commercialization of our Sonalleve systems for bone and fibroids,” says Busch. “When it comes to expanding to new applications, our preferred approach is to partner with organizations that have compelling proprietary technology and expertise within their segment and offer them an opportunity to accelerate required technology and clinical developments and to leverage our penetration in imaging suites around the world.”
As announced this summer by Philips and Toronto-based Profound Medical, the two companies will integrate Profound’s TULSA (Transurethral Ultrasound Ablation) technology onto Philips’ 3T MRI systems. TULSA is designed to provide minimally invasive, single session whole gland ablation for patients with prostate cancer.
Theraclion to Begin Commercial Thyroid Treatments in Europe
Theraclion announced that its echotherapy treatment for thyroid nodules will soon be available at three sites in Germany. Because Germany is a traditionally low iodine region, it results in 100,000 surgeries and 50,000 radioiodine procedures annually. Theraclion is hoping to replace these procedures—and many of the thyroidectomies—with the non-invasive Echopulse therapy.
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