Focused ultrasound surgery uses high-intensity focused ultrasound guided by MRI to heat and destroy targeted tissue, such as uterine fibroids, without the need for invasive surgery. MRI is used to identify the target tissue and guide the ultrasound beams to heat small spots within the tissue to ablate cells. The procedure is repeated around 50 times to treat the required volume, taking around 3 hours. It provides symptom relief as the body removes the treated tissue over months without impacting surrounding areas.

1. FOCUSED ULTRASOUND SURGERY
SUBMITTED BY:
PRANEETH KUMAR

2. OUTLIN
E
• MRI (MAGNETIC RESONANCE IMAGING)
• US (ULTRA SOUND WAVE)
• PROCEDURE
• EXAMPLE USING FIBROID
• SIDE EFFECTS
• DIFFERENT APPLICATION

3. MRI :
• MAGNETIC RESONANCE IMAGING (MRI) IS A TEST THAT USES A
MAGNETIC FIELD AND PULSES OF RADIO WAVE ENERGY TO MAKE
PICTURES OF ORGANS AND STRUCTURES INSIDE THE BODY.
• MRI GIVES DIFFERENT INFORMATION ABOUT STRUCTURES IN THE
BODY THAN CAN BE SEEN WITH AN X-RAY, ULTRASOUND,
OR COMPUTED TOMOGRAPHY (CT) SCAN

4. ULTRASOUN
D :
• PIEZO CRYSTAL
• AN ULTRASOUND WAVE IS GENERATED WHEN AN ELECTRIC FIELD IS
APPLIED TO AN ARRAY OF PIEZOELECTRIC CRYSTALS LOCATED ON
THE TRANSDUCER SURFACE. ELECTRICAL STIMULATION CAUSES
MECHANICAL DISTORTION OF THE CRYSTALS RESULTING IN
VIBRATION AND PRODUCTION OF SOUND WAVES

5. WHAT DOES THE MR GUIDANCE PROVIDE ?
• MAGNETIC RESONANCE IMAGING (MRI) IS ADVANCED DIAGNOSTIC
TECHNOLOGY WHICH PROVIDES 3D IMAGING OF INTERNAL ORGANS WITHOUT
RADIATION. THE MR GUIDED FUS TREATMENT USES THE MR IMAGES TO
IDENTIFY WHERE THE FIBROID IS AND WHAT PORTION HAS BEEN TREATED.

6. WHAT HAPPENS DURING THE
PROCEDURE ?
• HIGH ENERGY FOCUSED ULTRASOUND WAVES HEAT A SMALL SPOT IN THE
FIBROID TO A TEMPERATURE OF UP TO 85 C TO CAUSE THERMAL ABLATION
(KILLING OF THE CELLS) WITHOUT IMPACTING OTHER TISSUES.

7. • SO YOU CAN CHANGE THE INTENSITY, THE FREQUENCY, THE
DURATION, THE PULSE SHAPE OF THE ULTRASOUND TO CREATE
ANYTHING FROM AN AIRBRUSH TO A HAMMER
• THIS PROCESS WILL BE REPEATED UNTIL THE REQUIRED VOLUME IS
TREATED, TYPICALLY ABOUT 50 TIMES. THE PROCEDURE LASTS
ABOUT 3 HOURS DEPENDING UPON THE SIZE AND NUMBER OF
FIBROIDS TREATED.
• USING THE TREATMENT, THE BODY GRADUALLY REMOVES THE
TREATED TISSUE OVER A PERIOD OF MONTHS, PROVIDING
SYMPTOM RELIEF

8. THE PROCEDURE: TARGETING
Structures
to be avoided
Region to
be
treated

9. THE PROCEDURE: PLANNING

10. THE PROCEDURE: TREATMENT
Temperature
measurement
Point by point or volumetric

11. THE PROCEDURE
Move to
next target

12. FOCUSED ULTRASOUND FOR UTERINE
FIBROIDS

13. EVOLUTION OF
TECHNOLOGY :
• IN 2004, THE FDA HAS APPROVED MR-GUIDED FOCUSED
ULTRASOUNDS FOR THE TREATMENT OF SYMPTOMATIC UTERINE
FIBROIDS.
• TECHNOLOGY ADVANCEMENTS ALLOW
• LARGER FIBROIDS
• TREATMENT ENVELOPE FOR DEEPER FIBROIDS

14. EXPECTED SIDE-
EFFECTS :
• 30% PATIENTS MAY EXPERIENCE NAUSEA,
VOMITING, LEG AND BUTTOCK PAIN, ABDOMINAL
TENDERNESS.
• LESS FREQUENT, < 10% PATIENTS MAY EXPERIENCE
SWELLING, ABDOMINAL CRAMPING, VAGINAL
BLEEDING, URINARY DIFFICULTY.

15. APPLICATIONS:
• NEUROPATHIC PAIN
• BRAIN TUMOURS
• LOWER-BACK PAIN
• BREAST CANCER