Maurice R. Ferre

MR-guided focused ultrasound: A game-changing innovation that is redefining surgery

April 18, 2017
By Maurice R. Ferré

Modern surgery has become extremely advanced. Over the last several decades, we have made great strides in combating life-threatening diseases due to significant improvements in both imaging and technology. At the same time, the health care system is bearing a heavy burden with lengthy hospitalization and increased risks of infection.

Ultrasound technology, past and present
Since the 1950s, ultrasound waves were used for safe diagnostic imaging of a developing fetus. The first time we saw noninvasive surgery was on “Star Trek” and it seemed unattainable back then. We have caught up with that futuristic “Star Trek” technology with the development of focused ultrasound for treating inside the body without making any cuts.

When ultrasound energy is raised to high temperatures and focused on a target, a noninvasive treatment of tissue within the body can be performed, while minimizing damage to adjacent healthy tissue. MRI is ideal for imaging and is necessary in order to plan the treatment, identify the target area and monitor the procedure in real time. Procedures can be performed in a single treatment and have been proven to be both safe and effective. The risks of bleeding and infections are reduced or eliminated, hospitalization is minimized or avoided altogether and patients can quickly return to their lives.

Treating essential tremor
Essential tremor is a neurological condition that causes shaking of the hands and other parts of the body, affecting up to 10 million Americans. Medication is used as a first line of treatment, but as there are no medications specifically designed to treat essential tremor, they can have serious side effects or provide little to no improvement.

Invasive procedures are the next line of treatment, including thalamotomy and deep brain stimulation (DBS), which involves placing electrodes in the brain, as well as fitting a pacemaker-like device into the patient’s chest. MRgFUS allows neurosurgeons to noninvasively target and ablate the Vim nucleus of the thalamus in a treatment that typically lasts three to four hours. Data from a multi-center clinical study published in the New England Journal of Medicine showed that patients generally experience an immediate and significant reduction in their tremor following the procedure. Neurosurgeons at leading U.S. treatment centers are treating essential tremor patients with this technology.

Treating uterine fibroids
Uterine fibroids are noncancerous growths in the uterus that cause extremely serious side effects and greatly impede on daily function. Many patients tend to avoid invasive procedures and opt for watchful waiting, which results in continued growth of the fibroid. Today’s standard of care for treating large fibroids is hysterectomy, an invasive surgery that results in the complete removal of a woman’s uterus, leaving no option for having children in the future. MRgFUS offers patients a treatment option that spares the uterus and it may be considered in patients who seek fertility-sparing options. Furthermore, there are no scars, no risks associated with surgery and patients have a quick recovery. This treatment is available at leading hospitals around the world.

Treating bone metastases
Bone metastases (bone mets) occur when cancer cells from a primary tumor spread to the bone. Prostate, breast and lung are the cancers that most commonly spread to the bone. When a person has bone metastases, the most common symptom is pain, which may be severe enough to impair daily living. To relieve the pain from bone mets, the main treatment options are opioids and the standard form of care is radiation therapy. Focused ultrasound provides non-toxic pain palliation of bone metastases, and has been shown to provide pain relief within days providing substantial improvement in patient quality of life.

Transforming patient lives
Noninvasive surgery places the patient in the center of care and holds the potential to safely treat millions of patients. MRgFUS has already been adopted and is in use by physicians in more than 80 leading medical facilities around the world. As the treatment becomes more widespread, it presents an opportunity for physicians to access new patients who desire noninvasive treatment options.

Focused ultrasound shows promise in becoming a new era for the way we look at surgical procedures and patient care. All of us, and the health care system at large, would opt for undergoing a surgical procedure that is incisionless, without lengthy hospital stays or succumbing ourselves to the risk of infection. We are quickly beginning to realize the enormous potential of focused ultrasound and we are constantly researching treatments for a variety of clinical indications that many thought were impossible to treat.

About the author: Maurice R. Ferré, M.D., is INSIGHTEC CEO and chairman of the board of directors.