About this Research Topic
Recent technological advances have led to the development of Magnetic Resonance (MR)-guided Focused Ultrasound (FUS) (MRgFUS). This technique is increasingly gaining ground as an advantageous alternative to conventional treatment of a variety of conditions for which numerous clinical trials are currently ongoing. MRgFUS is completely non-invasive, can be administered in an outpatient setting, and regular every-day activities can be resumed on the day after treatment.
The enormous potential of this novel technique stems from a combination of the thermal and mechanical effects of ultrasound with the excellent image guidance provided by MR imaging. The combined focusing and real-time monitoring capability of MRgFUS allow unprecedented spatial specificity (as compared to, for example, radiation therapy) and hence better preservation of organs-at-risk surrounding lesions. Additionally, the ability to operate across a vast range of intensity levels endows MRgFUS with unprecedented application potential and a wide range of use cases. For example, MR-guided High Intensity- Focused Ultrasound (HIFU) can provide accurate and non-invasive thermal ablation as an alternative to surgical resection. Its clinical applications include uterine fibroid treatment, palliation of pain in bone metastases, as well as the treatment of medically refractory Essential Tremor and Parkinson Disease. Clinical trials for the treatment of breast, liver, prostate, and brain cancer are also in progress. At the other end of the spectrum, Low Intensity-Focused Ultrasound (LIFU) can elicit reversible effects, for example in brain tissue, effectively allowing both excitatory and inhibitory neuromodulation. In this context, MR-guided LIFU is being investigated for use in the treatment of consciousness disorders associated with acute brain injury as well as in deep brain stimulation. Other exciting applications include the use of microbubbles, which can be combined with LIFU, to temporarily modulate vascular permeability and hence greatly facilitate the targeted release compounds for local drug delivery or gene therapy.
The development of new therapies using MRgFUS requires a highly interdisciplinary effort, including modelling and optimization of the ultrasound beam, development and optimization of MR imaging techniques, characterization of the biological effects of FUS both at a cellular and at a molecular level, as well as refinement of safety guidelines and standardized protocols as more and more innovative applications are designed and tested.
This Research Topic calls for impactful contributions dealing with clinical and preclinical research in MRgFUS. Review articles focused on these topics are also welcome. Potential topics include, but are not limited to, the following:
· MRgFUS-based therapies
· MRI acquisition strategies for real-time monitoring of FUS-related energy deposition
· MRI acquisition strategies for evaluating outcomes of FUS treatment
· Development and characterization of MRI-compatible focused ultrasound systems
· Traditional and novel MRI biomarkers for the evaluation of biological effects of US
· Theranostic particles: delivery and excitation through FUS
· FUS-induced neuromodulation: techniques and applications
Keywords: MRgFUS, Magnetic Resonance Imaging, Focused Ultrasound, Therapeutic Ultrasound, Guided Therapies
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