Focused ultrasound technology has emerged as a successful noninvasive neurosurgical treatment. The FDA approved it in July 2016. With advancements in healthcare technology, Ultrasound has evolved from just a diagnostic method of medical imaging to a therapeutic one.
This MRI-guided focused ultrasound technology now offers ample opportunities for patients on whom medications and radiation treatment did not work. Recent clinical trials have shown that focused ultrasound technology can effectively treat neurological disorders such as Parkinson's disease, essential tremor, and epilepsy that cause involuntary and rhythmic shaking.
As per BIS Research, next-generation ultrasound systems are currently in demand. The global next-generation ultrasound systems market was valued at $8.24 billion in 2020 and is anticipated to reach $21.07 billion by 2031, growing at a CAGR of 9.3% during the forecast period 2021–2031.
Focused ultrasound technology has enabled safe and effective treatments. It utilizes a transducer with an acoustic lens to concentrate sound waves on one point, raising the temperature and destroying the targeted tissue with high precision and accuracy while leaving the surrounding tissue unaffected.
The patient's brain is scanned using MRI to identify the target area and plan the treatment. With MRI scanning, doctors can locate specific regions in the brain with an accuracy of less than one millimeter. A specialized helmet is placed over the patient's head with the assistance of a frame that keeps the head immobilized. The helmet has a continuous flow of water, which actively cools the patient's skull and suppresses any kind of discomfort.
The patient is given a local anesthetic to help them relax during the procedure. The ultrasound transducers in the helmet are then activated, delivering focused ultrasound waves to the target area in the brain. Firstly, light doses of ultrasound are applied to identify the right spot in the brain for treatment, and then total intensity ultrasound energy is used in that area.
The ultrasound waves heat the targeted area to around 85 degrees Celsius, causing the cells to die, thereby reducing the tremors. The patient is monitored throughout the procedure using MRI to ensure that the ultrasound reaches the correct target area and that the proper amount of energy is delivered. The doctors get real-time information about the treatment's location and patient condition during the procedure.
Patients are conscious during the procedure, and its effectiveness is monitored along with the patient response, which includes drawing inside spirals writing, and replicating hand gestures. The treatment results in decreased tremors, which can also be observed during the patient's treatment, as well as improved functionality after the treatment. After the procedure, the patient is monitored for any side effects and will be discharged once they are stable.
Although the focused ultrasound technology is in nascent stages, there are more than a hundred clinical applications of the technology such as treatment of neurodegenerative disorders, brain tumors, breast and prostate cancer.
Focused ultrasound technology can potentially treat epilepsy by ablative treatment in the epileptogenic foci or by disrupting the neural network of epilepsy. Moreover, MRI guided focused ultrasound technology is currently being tested for mental disorders such as obsessive-compulsive disorders and depression.
According to Dr. Neal Kassell, founder and chairman of the Focused Ultrasound Foundation, "Focused ultrasound is a noninvasive therapeutic technology," that will replace invasive procedures such as open brain surgeries and develop as a new approach in functional neurosurgery.
For instance, Insightec, an Israel-based healthcare company, launched a focused ultrasound platform for the treatment of Essential Tremor and Parkinson's Disease, known as Exablate Neuro in 2016, which has been recently approved by the FDA for treating motor symptoms associated with the diseases. Insightec claims that their technology can deliver up to 1024 ultrasound waves across the skull to precisely treat a target deep in the brain. The treatment eliminates incisions on the skull or drilling holes into the brain.
A major limitation to the technology is that of the different size and densities of human skulls which restricts the ultrasound waves to pass through, is currently under research and development.
Along with treating neurological disorders, focused ultrasound can also assist in progressive cancer treatments such as radiation and chemotherapy. It is making significant strides in fertility clinics to treat infertility by destroying small fibroids, adhesions in the uterus, and by creating small holes in the ovary to allow for the release of eggs.
Adoption of focused ultrasound technology as a mainstream standard of care would bring a revolution in medical therapy as well as transform drug delivery. With reduction in costs and complexity of the devices involved in the focused ultrasound treatment, the technology could become more accessible and be used worldwide including developing nations.
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