ABSTRACT

Described as the ideal surgery, 1 magnetic resonance (MR)- guided focused ultrasound surgery (MRgFUS) completely destroys targeted tissue without causing structural or functional damage to adjacent tissue. Magnetic resonance imaging (MRI) identifies targeted tissue and detects suitable access routes for the acoustic waves. The ultrasound energy penetrates normal tissue with minimal interference, reaching targeted tissue in sufficiently high energy levels, inducing cell death. MRI contrast scans then verify effective therapeutic treatment. Thus, an effective, safe, non-invasive, closed-loop procedure eradicates circumscribed tissue with minimal discomfort and recovery time. So effective and novel, the first table approved for MRgFUS (ExAblate 2000) topped the list of the US FDA’s (Food and Drug Administration’s) Office of Device Evaluation Annual Report Fiscal Year 2005 for new devices approved the previous year. 2

Since 1935, researchers have known thermal energy created by focused ultrasound acoustic beams results in localized heating. 3,4 This thermal ablation causes a coagulative necrosis, destroying all structural and enzymatic proteins sensitive to short-term temperatures >54°C. All mammalian cells, regardless of function and structure, are destroyed above this temperature.