High-intensity ultrasound allows U of C team to perform incision-free brain surgery
New ultrasound technology allows doctors to penetrate the skull to perform brain surgery without drilling
By Lucie Edwardson, CBC News Posted: Dec 06, 2017 8:39 PM MT Last Updated: Dec 06, 2017 8:39 PM MT
For five years Elias Pharon suffered from uncontrollable essential tremors in his hands.
He struggled to eat, drink and write.
"I like to work with my hands and it was for me, almost impossible," he said. "I am determined person. I refused help."
But thanks to a team of scientists from the Hotchkiss Brain Institute and the University of Calgary's Cumming School of Medicine, with a little help from a new technology they acquired last year, Pharon can again do many things he struggled to do for a long time.
"My hands are steady — like a rock," he said.
Earlier this year, Pharon underwent a procedure to treat his essential tremor using a machine called magnetic resonance guided focused ultrasound (MRgFUS), which fits right inside an MRI machine.
The MRI provides real-time visuals of the patient's brain, while the MRgFUS's highly focused ultrasound waves target a specific area of the brain, essentially burning away the problem spot.
Bruce Pike, a professor of radiology and clinical neuroscience, said ultrasound technology isn't new, but figuring out how to use it to penetrate the skull is.
"The innovation that's happened over the past decade is a very large array of ultrasound transducers," he said. "In this case, about a 1,024 of them in a helmet-sort configuration all focused towards a central point."
A rubber layer surrounding the helmet is filled with water before being placed around the head of the patient.
Pike said this acts in the same way as the amniotic sack of a baby and helps the ultrasound waves penetrate the skull.
First procedure in Calgary
Dr. Zelma Kiss performed the first procedure using the technology in Calgary on Pharon earlier this year. Since then, six others have been completed.
According to Kiss, the previous procedure to fix this sort of tremor would've require a small hole to be drilled through the patients skull, allowing a probe to pass through and burn the target area.
"The new part of this is the fact that we can do it without making an opening in the skull, without making an incision in the skin," she said. "So far more people are potentially willing to undergo this kind of procedure that has lower risk."
A big perk of the new procedure, according to Kiss, is that it's day surgery.
She said generally the patient experiences instant results and can go home within 24 hours.
"I'm a million times better. Maybe exaggerated to you, but that's how I feel," he said.
Kiss said the hope is to one day use this technology to treat things like Parkinson's disease and epilepsy.
There are two other magnetic resonance guided focused ultrasound machines in Canada, both in Toronto.
Kiss said so far there have been approximately 1,000 procedures of this kind world-wide.
Her team plans to do two procedures per-month beginning in the New Year.
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