# Comprehensive MRI Guidance of Focused Ultrasound Neurosurgery

> **NIH NIH R01** · UNIVERSITY OF VIRGINIA · 2021 · $504,958

## Abstract

PROJECT SUMMARY/ABSTRACT
 Essential tremor (ET) is a debilitating, common movement disorder, with prevalence as high as 4% of the population.
ET is often disabling, with reduced ability to write, eat, or drink. People with the disorder often curtail their social interactions
because of embarrassment and are at risk for depression. There are medical therapies that can reduce symptoms, but
many patients have tremor that is not responsive to medical treatment. Deep brain stimulation can work well, but many
patients are not candidates for surgery or would prefer a non-surgical option.
 MR-guided Focused Ultrasound (MRgFUS) is a minimally invasive method of treating ET that works in patients who
are refractory to medical therapy. Focused ultrasound (FUS) delivers acoustic energy that focally heats lesions to ablative
temperatures of greater than 60C. The combination of FUS with MRI guidance (MRgFUS) enables precisely localized
tissue ablation, monitored by real-time MR thermometry. Transcranial MRgFUS has been used to treat ET with signiﬁcant
and durable reduction in symptoms.
 Through our clinical experience, we have identiﬁed several critical areas where improved treatment monitoring could
dramatically increase safety and effectiveness. The overall goal of this project is to provide comprehensive MRI feedback
for transcranial focused ultrasound to improve the safety, efﬁciency and efﬁcacy of treatment. Our speciﬁc aims are the
following:
Aim 1: Develop real-time volumetric thermometry techniques to monitor thermal treatment. MRgFUS treatments
are currently monitored using a 2D pulse sequence for temperature mapping. During ablation, the treatment can only be
monitored in a plane, and the location of peak temperature rise can occur outside of the plane. In this aim, we will develop
new methods for real-time volumetric MR thermometry and validate these techniques in pre-clinical and volunteer studies.
Aim 2: Develop methods to monitor unintended heating of the brain and skull. The skull absorbs energy from the
applied ultrasound, which results in heating of the skull and the nearby soft tissue, including the brain. There is currently no
direct monitoring of this heating, and the required wait time between sonications is only estimated using simple models. In
this aim, we will develop new, rapid, 3D ultrashort-echo-time methods for monitoring skull temperature changes combined
with whole-brain volumetric thermometry and test these methods in studies of patients undergoing FUS treatment for ET.
Aim 3: Develop real-time treatment monitoring techniques to give early assessment of viability. Critical MR moni-
toring functions include visualizing the lesion as it is created. We hypothesize that diffusion-weighted imaging can capture
clinically useful lesion contrast at early time points. In this aim, we will develop and validate new methods for diffusion
imaging in the challenging environment of a FUS transducer and test these methods in studies of patients...

## Key facts

- **NIH application ID:** 10242710
- **Project number:** 5R01EB028773-02
- **Recipient organization:** UNIVERSITY OF VIRGINIA
- **Principal Investigator:** CRAIG H MEYER
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $504,958
- **Award type:** 5
- **Project period:** 2020-09-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10242710

## Citation

> US National Institutes of Health, RePORTER application 10242710, Comprehensive MRI Guidance of Focused Ultrasound Neurosurgery (5R01EB028773-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10242710. Licensed CC0.

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