{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:48:22Z","timestamp":1789480102461,"version":"build-2803163510"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,2]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The goal of this study was to improve the predictability of lesion size during focused ultrasound (FUS) thalamotomy procedures.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Treatment profiles and T2-weighted MRI (T2 MRI) studies obtained in 63 patients who participated in 3 clinical trials of FUS thalamotomy from February 2011 to March 2015 were reviewed retrospectively. Four damage estimate models were compared with lesion sizes measured on postprocedural T2 MRI. Models were based on 54\u00b0C \u00d7 3 seconds, 240 cumulative equivalent minutes at 43\u00b0C, and simple thermal threshold analysis, which recorded the maximum diameter that reached a temperature of at least 51\u00b0C and 54\u00b0C. Energy requirements per \u00b0C thermal rise above 37\u00b0C were also recorded.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Lesion diameters from T2 MRI correlated poorly from the day of the procedure to day 1 postprocedure (mean increase 78% [SD 79%]). There was more predictability of lesion size from day 1 to day 30, with a mean reduction in lesion diameter of 11% (SD 24%). Of the 4 models tested, the most correlative model to day 1 findings on T2 MRI was a 51\u00b0C threshold. The authors observed an increase in the energy requirement for each subsequent treatment sonication, with the largest percentage increase from treatment sonication 1 to treatment sonication 2 (mean increase 20% in energy required per \u00b0C increase in temperature above 37\u00b0C).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n At the margins, 51\u00b0C temperature threshold diameters correlated best to lesion diameters measured at day 1 with T2 MRI. The lesion size from T2 MRI decreases from day 1 to day 30 in a predictable manner, much more so than from the day of the procedure to day 1 postprocedure. Energy requirements per \u00b0C rise above 37\u00b0C continuously increase with each successive sonication.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2017.11.focus17623","type":"journal-article","created":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T03:37:25Z","timestamp":1517456245000},"page":"E5","source":"Crossref","is-referenced-by-count":41,"title":["Predicting lesion size during focused ultrasound thalamotomy: a review of 63 lesions over 3 clinical trials"],"prefix":"10.3171","volume":"44","author":[{"given":"Aaron E.","family":"Bond","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Jeffrey","family":"Elias","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"Suppl 1","key":"b1","series-title":"Neurosurgery","first-page":"154","article-title":"A randomized, sham-controlled trial of transcranial magnetic resonance-guided focused ultrasound thalamotomy trial for the treatment of tremor-dominant, idiopathic Parkinson disease","volume":"63","author":"Bond AE","year":"2016","unstructured":"Bond AE, Dallapiazza R, Huss D, Warren AL, Sperling S, Gwinn R, : A randomized, sham-controlled trial of transcranial magnetic resonance-guided focused ultrasound thalamotomy trial for the treatment of tremor-dominant, idiopathic Parkinson disease. Neurosurgery 63 (Suppl 1):154, 2016 (Abstract)"},{"key":"b2","series-title":"J Neurol Neurosurg Psychiatry","first-page":"257","article-title":"Unilateral magnetic resonance guided focused ultrasound thalamotomy for essential tremor: practices and clinicoradiological outcomes","volume":"86","author":"Chang WS","year":"2015","unstructured":"Chang WS, Jung HH, Kweon EJ, Zadicario E, Rachmilevitch I, Chang JW: Unilateral magnetic resonance guided focused ultrasound thalamotomy for essential tremor: practices and clinicoradiological outcomes. J Neurol Neurosurg Psychiatry 86:257\u2013264, 2015"},{"key":"b3","series-title":"N Engl J Med","first-page":"640","article-title":"A pilot study of focused ultrasound thalamotomy for essential tremor","volume":"369","author":"Elias WJ","year":"2013","unstructured":"Elias WJ, Huss D, Voss T, Loomba J, Khaled M, Zadicario E, : A pilot study of focused ultrasound thalamotomy for essential tremor. N Engl J Med 369:640\u2013648, 2013"},{"key":"b4","series-title":"J Neurosurg","first-page":"307","article-title":"A magnetic resonance imaging, histological, and dose modeling comparison of focused ultrasound, radiofrequency, and Gamma Knife radiosurgery lesions in swine thalamus","volume":"119","author":"Elias WJ","year":"2013","unstructured":"Elias WJ, Khaled M, Hilliard JD, Aubry JF, Frysinger RC, Sheehan JP, : A magnetic resonance imaging, histological, and dose modeling comparison of focused ultrasound, radiofrequency, and Gamma Knife radiosurgery lesions in swine thalamus. J Neurosurg 119:307\u2013317, 2013"},{"key":"b5","series-title":"N Engl J Med","first-page":"730","article-title":"A randomized trial of focused ultrasound thalamotomy for essential tremor","volume":"375","author":"Elias WJ","year":"2016","unstructured":"Elias WJ, Lipsman N, Ondo WG, Ghanouni P, Kim YG, Lee W, : A randomized trial of focused ultrasound thalamotomy for essential tremor. 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Lancet Neurol 12:462\u2013468, 2013"},{"key":"b8","series-title":"Magn Reson Med","first-page":"913","article-title":"MRI investigation of the threshold for thermally induced blood-brain barrier disruption and brain tissue damage in the rabbit brain","volume":"51","author":"McDannold N","year":"2004","unstructured":"McDannold N, Vykhodtseva N, Jolesz FA, Hynynen K: MRI investigation of the threshold for thermally induced blood-brain barrier disruption and brain tissue damage in the rabbit brain. Magn Reson Med 51:913\u2013923, 2004"},{"key":"b9","series-title":"Mov Disord","first-page":"20","article-title":"The emerging role of transcranial magnetic resonance imaging-guided focused ultrasound in functional neurosurgery","volume":"32","author":"Weintraub D","year":"2017","unstructured":"Weintraub D, Elias WJ: The emerging role of transcranial magnetic resonance imaging-guided focused ultrasound in functional neurosurgery. Mov Disord 32:20\u201327, 2017"},{"key":"b10","series-title":"AJNR Am J Neuroradiol","first-page":"891","article-title":"Imaging findings in MR imaging-guided focused ultrasound treatment for patients with essential tremor","volume":"35","author":"Wintermark M","year":"2014","unstructured":"Wintermark M, Druzgal J, Huss DS, Khaled MA, Monteith S, Raghavan P, : Imaging findings in MR imaging-guided focused ultrasound treatment for patients with essential tremor. 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Mov Disord 32:20\u201327, 2017"},{"key":"b10","series-title":"AJNR Am J Neuroradiol","first-page":"891","article-title":"Imaging findings in MR imaging-guided focused ultrasound treatment for patients with essential tremor","volume":"35","author":"Wintermark M","year":"2014","unstructured":"Wintermark M, Druzgal J, Huss DS, Khaled MA, Monteith S, Raghavan P, : Imaging findings in MR imaging-guided focused ultrasound treatment for patients with essential tremor. 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