Focused Ultrasound Surgery Foundation

The Focused Ultrasound Surgery Foundation (FUSF) is a medical foundation based in Charlottesville, Virginia, United States, whose adopted mission is to shorten the time from technology development to patient treatment, develop new applications and accelerates the worldwide adoption of magnetic resonance guided focused ultrasound (MRgFUS), which uses high intensity focused ultrasound (HIFU).

Foundation Activities

The Focused Ultrasound Surgery Foundation was established to increase the pace of research into the core technology of MRgFUS (MRI-guided Focused Ultrasound Surgery). It has four primary activities: funding translational and clinical research, funding fellowships, providing educational resources, and facilitating collaboration within the community of scientists and clinicians interested in MRgFUS.

FUSF funds fellowships Verify source|date=July 2007 to train surgeons, radiologists, and radiation oncologists and other specialists in the discipline of focused ultrasound surgery. It also intends to sponsor training courses, conferences, symposia, and workshops, and is developing online communication among patients, physicians and researchers.

It also helps design, organize and conduct pre-clinical and clinical studies Verify source|date=July 2007 in a collaborative, site-independent manner through a network of investigators, facilities, and funding sources.

FUSF is in the process of creating a network of research and development centers that will facilitate boundary-less collaboration between investigators and facilities Verify source|date=July 2007.

The first International Symposium exclusively dedicated to MRgFUS is taking place in Washington DC on October 6-7 (www.fusfoundation.org/symposium)

About MR guided Focused Ultrasound

Focused Ultrasound Surgery has been described as “one of the most important medical innovations since the invention of the scalpel”, and is projected to revolutionize a remarkable spectrum of clinical applications spanning oncology, surgery, radiology, and neurology, whilst also addressing many important men’s and women’s health issues.

In many ways Focused Ultrasound Surgery is a therapy of the digital age. The underlying phenomenon has been understood for decades, but it has been the more recent advances in computational science and imaging technology that have made it possible to apply this approach to medical therapy, and especially to the non-invasive treatment of benign and malignant tumors.

Thermal Ablation

Focused Ultrasound Surgery takes advantage of the phenomenon of energy transformation that takes place when high intensity ultrasound is focused on a single point within the body. Each pulse of focused ultrasound energy is termed a sonication. The focal point experiences significant energy deposition leading to a rise in temperature which can be controlled with great precision through sophisticated computational modeling. Ultrasound used for imaging, by comparison, is low intensity and is not focused.

Energy deposition leads to a significant temperature rise which causes necrotic changes to the target tissue and coagulation of the blood within the tissue. This process is termed thermal ablation and is the primary goal of Focused Ultrasound Surgery for solid tumors, resulting in cell death in the target tissue. After the procedure, the body’s immune system removes the ablated tissue naturally over time. This is in contrast to traditional surgical resection, where the target tissue is cut away and removed. Focused Ultrasound Surgery has a distinct advantage over standard radiation therapy and radiosurgery in that it avoids the toxicity of ionizing radiation (including the induction of secondary tumors).

Ultrasound travels readily through water, and the soft tissue in the body is mainly fluid (about 80% - this varies from organ to organ). The focused ultrasound source can be relatively distant from the target site, thus enabling a non-invasive treatment approach. In some cases, the focused ultrasound source is housed in a probe which is inserted via an orifice to gain access to a specific location. For example, the prostate may be accessed via a transrectal or transurethral probe because of its close proximity to the pelvis and bowel.

MRI Guidance and Control

Magnetic resonance imaging (MRI) is the essential partner to precise Focused Ultrasound Surgery. MRI is used to guide the deposition of energy to the target site (a tumor, for example) with great precision (+/- 1mm) and to monitor the temperature levels at that site. The MRI machine creates a strong magnetic field within which the patient is placed during the procedure. Radiofrequency stimulation within this magnetic field allows generation of detailed internal images of the patient through a complex computational process. Diagnostic MR images are derived by measuring the different resonance signals of the organs and tissue, and can produce detailed anatomical images of the patient’s body.

A second form of MR imaging is derived from measuring differences in temperature, a process termed MR thermometry. This allows for the measurement of energy deposition during a sonication in Focused Ultrasound Surgery. Using these two imaging modalities together results in the precise identification of the target site, and accurate monitoring of the thermal ablation process.

ummary

In summary, Magnetic Resonance Guided Focused Ultrasound Surgery (MRgFUS) can thus be described as an elegant integration of diagnostic and therapeutic science made possible by advanced technology. MRgFUS provides the physician with a safe and non-invasive “virtual scalpel”, where energy deposition resulting in thermal ablation and cell death of target tissue replaces traditional surgical resection, and thus avoids traditional surgical trauma. Both MRI and ultrasound have relatively benign safety profiles, compared to traditional surgery, X-ray imaging, CT scans, and radiation therapy.

Focused Ultrasound Surgery also holds much promise in enabling the precise localization of drug delivery (including gene therapy) to target organs. In addition, it may provide an excellent means of functional lesioning within the brain in the treatment of chronic pain, Parkinson’s Disease, tremor, depression, and other neuropsychiatric conditions.

Annual Symposium

[http://www.fusfoundation.org/symposium] MRgFUS 2008 Symposium website with program,registration, accommodation details.

Links

[http://www.fusfoundation.org] Official website with details of funding application process

[http://www.fusfoundation.org/symposium] MRgFUS 2008 Symposium website with program,registration, accommodation details.