MRI-Guided Focused Ultrasound Surgery will be the first publication on this new technology, and will present a variety of current and future clinical applications in tumor ablation treatment. This source helps surgeons and specialists evaluate, analyze, and utilize MRI-guided focused ultrasound surgery - bridging the gap between phase 3 clinical tr

MRI-Guided Focused Ultrasound Surgery will be the first publication on this new technology, and will present a variety of current and future clinical applications in tumor ablation treatment. This source helps surgeons and specialists evaluate, analyze, and utilize MRI-guided focused ultrasound surgery - bridging the gap between phase 3 clinical trials and the expansion to the clinical practice - by exploring fundamental principles and future clinical applications using this new therapeutic method.

Ultrasound has been widely used in diagnostic imaging for a long time. In the past 10 years, image-guided focused ultrasound therapy has seen rapid growth, in biomedical science and engineering, and in clinical medicine. The purpose of this book is to bring internationally renowned authorities and experts in this field together to provide up-to-date and comprehensive reviews of basic physics, biomedical engineering, and clinical applications of focused ultrasound therapy in a widely accessible fashion. Focusing on applications in cancer treatment, this book covers basic principles, practical aspects, and clinical applications of focused ultrasound therapy. It reviews the medical physics and bio-effects of focused ultrasound beams on living tissues, dosimetric methods and measurements, transducer engineering, image guidance and monitoring (including magnetic resonance imaging -- MRI -- and ultrasound), treatment delivery systems, and clinical applications. The book also gives practical guidelines on patient setup, target localisation, treatment planning and image-guided procedures for the treatment in various sites, including the prostate, liver, pancreas, breast, kidney, uterus, bone, and brain. The book discusses major challenges for the use of focused ultrasound energy on living tissues and explores the cellular and physiological responses that can be employed in the fight against cancer from biological, physics and engineering perspectives. It also highlights recent advances, including the treatment of solid tumours using image-guided drug delivery, and the exploitation of microbubbles, nanoparticles, and other cutting-edge techniques. Readers who are interested in learning more about the technique and the clinical applications described in each chapter can find more information in the comprehensive bibliographies provided. This book is suitable for anyone involved in, or looking to become involved in, the research and clinical applications of focused ultrasound therapy, including medical professionals, physicists, biomedical engineers, graduate students and others working in this multidisciplinary field. It offers a balanced and critical assessment of state-of-the-art technologies, major challenges, and an outlook on the future of focused ultrasound therapy. It presents a thorough introduction for those new to the field while providing helpful, up-to-date information and guidelines for readers already using this therapy in clinical and pre-clinical settings. Key Features: Brings together a wide range of world-leading experts in this new field, presenting the latest clinical outcomes of using focused ultrasound for the treatment of benign and malignant diseases Covers the fundamental physics of focused ultrasound therapy and ultrasound-mediated drug delivery, including chapters on the mechanism of sonoporation, microbubble and ultrasound interaction, and their potential clinical applications Introduces clinical guidelines for focused ultrasound therapy, including indications and contraindications, treatment goals, the selection of patients, clinical observation during treatment procedure and follow-up, and characteristics of image changes after treatment

John Grisham says THE TUMOR is the most important book he has ever written. In this short book, he provides readers with a fictional account of how a real, new medical technology could revolutionize the future of medicine by curing with sound. THE TUMOR follows the present day experience of the fictional patient Paul, an otherwise healthy 35-year-old father who is diagnosed with a malignant brain tumor. Grisham takes readers through a detailed account of Paul’s treatment and his family’s experience that doesn’t end as we would hope. Grisham then explores an alternate future, where Paul is diagnosed with the same brain tumor at the same age, but in the year 2025, when a treatment called focused ultrasound is able to extend his life expectancy. Focused ultrasound has the potential to treat not just brain tumors, but many other disorders, including Parkinson’s, Alzheimer’s, hypertension, and prostate, breast and pancreatic cancer. For more information or to order a free hardcopy of the book, please visit The Focused Ultrasound Foundation’s website www.fusfoundation.org. Here you will find a video of Grisham on the TEDx stage with the Foundation’s chairman and a Parkinson’s patient who brings the audience to its feet sharing her incredible story of a focused ultrasound “miracle.” Readers will get a taste of the narrative they expect from Grisham, but this short book will also educate and inspire people to be hopeful about the future of medical innovation.

Magnetic resonance imaging (MRI) guided focused ultrasound (MRgFUS) is a promising non-invasive and non-ionizing therapy in which the acoustic energy penetrates to the target through the intact surrounding tissue without causing any significant bioeffects and without any incisions. At the target, ultrasound energy is converted to heat, causing tissue coagulation and necrosis. MRI guidance is used with FUS to provide high quality tumor margin definition as well as the ability to monitor the temperature of the tissue and assess the treatment. Among the MRgFUS applications are treatments of tumors in the prostate, breast, uterine fibroids, liver and brain. To make these applications widely acceptable and available to patients, improvement of image guidance is essential. The goal of this work was to develop novel MRI tools for visualization of the focal spot and for adaptive focusing of ultrasound. Visualization of the ultrasound focus is performed to con rm that the beam's focus is placed on the target anatomy. Currently, it is achieved by producing a small temperature rise in a test spot, which is detected using MRI temperature monitoring techniques. Focus localization often relies on multiple applications of ultrasound, the cumulative effects of which can lead to potentially irreversible changes in healthy tissue. In addition, visualization of the temperature rise with MRI is problematic in tissue with high fat content such as breast. The thesis addresses the challenges of focus visualization by introducing novel imaging methods, that image displacement of tissue due to acoustic radiation force: 2D Fourier Transform (2DFT) spin-echo and single-shot echo planar imaging (EPI) MR guided acoustic radiation force imaging (MR-ARFI). The new pulse sequences are demonstrated ex vivo and optimized for in vivo brain applications. One of the challenges of using FUS to treat brain pathology is overcoming the phase aberrations of ultrasound caused by heterogeneous acoustic properties of the skull bone. These aberrations result in partial or complete destruction of the focal spot, and therefore prevent the delivery of sufficient energy to the targeted volume, and cause heating where it was not intended. The current correction method estimates the aberrations from the thickness and density of the skull bone obtained from pre-operative computerized tomography (CT) images of the patient's head. Recently introduced alternative methods use adaptive focusing approach combined with MR-ARFI. The transducer elements' emissions are manipulated until the acoustic intensity, which is proportional to tissue displacement, is maximized. Promising, but very time consuming, these methods do not o er a practical solution. In this work, it is shown how using Zernike polynomials, actively utilized in optics, can increase the efficiency of MR-ARFI-based adaptive focusing, making it a more suitable technique for clinical applications.

Image-guided therapy (IGT) uses imaging to improve the localization and targeting of diseased tissue and to monitor and control treatments. During the past decade, image-guided surgeries and image-guided minimally invasive interventions have emerged as advances that can be used in place of traditional invasive approaches. Advanced imaging technologies such as magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET) entered into operating rooms and interventional suites to complement already-available routine imaging devices like X-ray and ultrasound. At the same time, navigational tools, computer-assisted surgery devices, and image-guided robots also became part of the revolution in interventional radiology suites and the operating room. Intraoperative Imaging and Image-Guided Therapy explores the fundamental, technical, and clinical aspects of state-of the-art image-guided therapies. It presents the basic concepts of image guidance, the technologies involved in therapy delivery, and the special requirements for the design and construction of image-guided operating rooms and interventional suites. It also covers future developments such as molecular imaging-guided surgeries and novel innovative therapies like MRI-guided focused ultrasound surgery. IGT is a multidisciplinary and multimodality field in which teams of physicians, physicists, engineers, and computer scientists collaborate in performing these interventions, an approach that is reflected in the organization of the book. Contributing authors include members of the National Center of Image-Guided Therapy program at Brigham and Women’s Hospital and international leaders in the field of IGT. The book includes coverage of these topics: - Imaging methods, guidance technologies, and the therapy delivery systems currently used or in development. - Clinical applications for IGT in various specialties such as neurosurgery, ear-nose-and-throat surgery, cardiovascular surgery, endoscopies, and orthopedic procedures. - Review and comparison of the clinical uses for IGT with conventional methods in terms of invasiveness, effectiveness, and outcome. - Requirements for the design and construction of image-guided operating rooms and interventional suites.