MR Imaging‐Guided High Intensity Focused Ultrasound in the Treatment of Neurologic Disease: Current Applications and Future Directions

Abstract

MR imaging‐guided focused ultrasound is a revolutionary noninvasive technique with a wide breadth of clinical potential. MR imaging‐guided focused ultrasound uses focused ultrasound energy delivered transcranially to treat a variety of neurologic disease processes. High-intensity focused ultrasound creates sufficient acoustic energy for targeted noninvasive thermal ablation of intracranial soft tissues, with sharply marginated treatment zones overall superior to the established percutaneous ablation techniques. The use of concurrent MR imaging allows highly accurate spatial and thermal guidance, with fine anatomic detail, high soft-tissue contrast, and real-time monitoring of the treatment zone. Here we review the current established applications of MR imaging‐guided focused ultrasound in the treatment of neurologic disease and the relevant anatomic targets for each discussed disease entity, with a focus on essential tremor, Parkinson disease, and neuropathic pain, along with investigative applications and future directions related to this innovative technology.Learning Objective: To provide a comprehensive review of the existing literature on current neurologic applications of MR imaging‐guided high-intensity focused ultrasound and the relevant anatomic targets for each disease entity, discuss investigative applications and future directions for MR imaging‐guided high-intensity focused ultrasound, and increase awareness among providers to promote safe informed use of this relatively newer technology