Magnetic Resonance guided Focused Ultrasound (MRgFUS)

MRgFUS stands for Magnetic Resonance-guided Focused Ultrasound. This non-invasive technique uses an MRI thermal imaging system to continuously measure temperature changes inside the body, pinpointing and guiding the treatment. This is a relatively new, FDA-approved, treatment for uterine fibroids.

MR guided Focused Ultrasound combines two proven technologies - High intensity focused ultrasound and Magnetic Resonance Imaging (MRI).

INSIGHTEC and MRgFUS

INSIGHTEC’s MRgFUS uses focused ultrasound to ablate the target tissue under the image and temperature guidance of the Magnetic Resonance. This enables the physician to perform a safe and effective non-invasive treatment with little to no harm to the surrounding tissue and with minimal side effects.

Applications:

• Neurosurgery

• Women’s Health

• Oncology

mrgfus
NEUROSURGERY

NEUROSURGERY

• Essential Tremor
• Parkinsons

Essential Tremor

Exablate uses MR guided Focused Ultrasound to perform a “non-invasive” thalamotomy to relieve medication refractory tremor in patients with Essential Tremor or tremor dominant Parkinsons Disease. The effect of MRgFUS is based on tissue destruction within the Vim nucleus of the thalamus which enables a highly accurate and controlled thermal effect. Ultrasound energy is delivered across the skull, without an incision or craniotomy, heating the targeted tissue above the protein denaturation threshold at temperatures near 60°C. Prior to the delivery of high temperatures, destructive sonication delivery of lower energy focused ultrasound allows for proper anatomic localization, as well as physiologic evaluation of symptom relief and/or any unwanted side effects. This process allows for adjustments before making a permanent lesion. Treatment effects are immediate and the several hour treatment is generally well tolerated with mild sedatives.

Parkinsons

Exablate uses MR guided Focused Ultrasound to perform a “non-invasive” thalamotomy to relieve medication refractory tremor in patients with Essential Tremor or tremor dominant Parkinsons Disease. The effect of MRgFUS is based on tissue destruction within the Vim nucleus of the thalamus which enables a highly accurate and controlled thermal effect. Ultrasound energy is delivered across the skull, without an incision or craniotomy, heating the targeted tissue above the protein denaturation threshold at temperatures near 60°C. Prior to the delivery of high temperatures, destructive sonication delivery of lower energy focused ultrasound allows for proper anatomic localization, as well as physiologic evaluation of symptom relief and/or any unwanted side effects. This process allows for adjustments before making a permanent lesion. Treatment effects are immediate and the several hour treatment is generally well tolerated with mild sedatives.

WOMEN’S HEALTH

• Uterine Fibroid
• Adenomyosis

UTERINE FIBROID

INSIGHTEC uses MR guided Focused (MRgFUS) as a non-invasive thermal ablation technique to relieve symptoms caused by uterine fibroids. MRgFUS destroys uterine fibroid tissue using a thermal effect.

Ultrasound energy is focused onto the fibroid, heating the targeted tissue at a temperature above 55ºC for a few seconds. This heating of the tissue results in local coagulation and necrosis of the heated cells. A single application of the energy is called ‘sonication’ and a typical treatment is comprised of multiple ’sonications’. Sonications are repeated until the entire volume of the fibroid has been treated. Immediately post treatment, the physician can evaluate the treatment results by using a contrast agent which indicates the extent of the volume of fibroid that was successfully treated.

ADENOMYOSIS

INSIGHTEC’s Women’s Health treatment option provides a non-invasive solution for symptomatic Uterine Fibroids and Adenomyosis. This non-invasive option spares the uterus, enabling future fertility. Focused ultrasound waves, guided by magnetic resonance imaging are used to safely ablate tumor tissue, ensuring a high rate of effectiveness with minimal side effects. Performed on an outpatient basis, patients can return to work and normal activity within days. Prevalence of uterine fibroids increases with age. In the US, 40% of 35 year old women suffer from uterine fibroids, while almost 70% by the age of 50. Many patients tend to wait more than 3 years from discovery to treatment, while in the meantime fibroids are growing. Today’s most common procedure for treating symptomatic, large uterine fibroids is Hysterectomy. This treatment option leaves women with no uterus and no option of having children in the future. Hysterectomy is also known to have some post procedure chronic side effects such as changes in hormonal balance, heart problems and more. That’s why having a uterus preserving treatment option, such as MRgFUS, is so critical.

WOMEN’S HEALTH
ONCOLOGY

ONCOLOGY

INSIGHTEC’s MR guided Focused Ultrasound technology, Exablate, can treat painful bone metastases, providing prompt pain relief and significant improvement in patients’ quality of life. This non-invasive, non-ionizing treatment uses focused ultrasound waves, guided by magnetic resonance imaging (MRI), to ablate the target, ensuring an effective, highly accurate treatment with minimal damage to surrounding tissue:

• High intensity focused ultrasound generates 65-85 degrees Celsius of heat at the ablated targeted tissue.

• Magnetic resonance imaging system (MRI) allows the physician to identify and target tumors while providing temperature monitoring of the treated tissue and surrounding areas in real time.

The focused ultrasound energy is focused on and around the osteoid osteoma bone lesion itself, heating the region to around 65-85ºC for a few seconds. This heating causes damage to the targeted periosteum (covering of the bone) and damages the local nerve network, causing nerve denervation. Damaging the nerves means they can no longer conduct pain signals, therefore reducing the pain from this type of lesion. A single application of the energy is called a ‘sonication’ and a treatment comprises multiple repetitions to cover the lesions. The goal of the treatment is to provide total pain relief from these lesions. However, one or two focally directed sonications may also be directed at the nidus of the lesion and may result in complete ablation of the lesion providing not only pain control but also soft tissue death of the lesion itself.