"Quality over quantity:" smaller, targeted lesions optimize quality of life outcomes after MR-guided focused ultrasound thalamotomy for essential tremor.

Introduction: MRI-guided focused ultrasound (MRgFUS) thalamotomy of the nucleus ventralis intermedius (VIM) has emerged as a powerful and safe treatment modality for refractory essential tremor. While the efficacy of this technique has been extensively described, much remains unclear about how to optimize MRgFUS for patient quality of life (QoL), which may depend as much on a patient's adverse effect profile as on the magnitude of tremor suppression. Diffusion tensor imaging (DTI) has been used to help guide targeting strategies but can pose certain challenges for scalability.

A rapid beam simulation framework for transcranial focused ultrasound.

Transcranial focused ultrasound is a non-invasive therapeutic modality that can be used to treat essential tremor. Beams of energy are focused into a small spot in the thalamus, resulting in tissue heating and ablation. Here, we report on a rapid 3D numeric simulation framework that can be used to predict focal spot characteristics prior to the application of ultrasound.