Magnetic resonance-guided focused ultrasound thalamotomy is an innovative minimally invasive treatment for medication-resistant tremor in patients with essential tremor and Parkinson disease. Sedation with common hypnotic agents is discouraged because the patient's cooperation is required during the procedure, and these drugs interact with the patient's tremor, interfering with the results of intraprocedural neurological evaluations. Dexmedetomidine may be the best choice for sedation during magnetic resonance-guided focused ultrasound thalamotomy, which can be prolonged and poorly tolerated by the awake patient. We report the first use of dexmedetomidine for sedation in magnetic resonance-guided focused ultrasound thalamotomy in 3 patients: none of them experienced relevant hemodynamic changes or apnea.
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http://dx.doi.org/10.1213/XAA.0000000000000946 | DOI Listing |
Mov Disord
January 2025
Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Background: Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy of ventral intermediate (Vim) nucleus is useful to treat drug-resistant tremor-dominant Parkinson's disease (TdPD), but tremor relapse may occur. Predictors of relapse have been poorly investigated so far.
Objective: The aim of this study is to evaluate the role of clinico-demographic, procedural, and neuroradiological variables in determining clinical response, relapse, and adverse events (AEs) in TdPD after MRgFUS Vim-thalamotomy.
Ann Transl Med
December 2024
Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK.
Phys Imaging Radiat Oncol
January 2025
Division of Cancer Sciences, University of Manchester, Manchester, UK.
Background And Purpose: Magnetic resonance imaging - linear accelerator (MRI-linac) systems permit imaging of tumours to guide treatment. Dynamic contrast enhanced (DCE)-MRI allows investigation of tumour perfusion. We assessed the feasibility of performing DCE-MRI on a 1.
View Article and Find Full Text PDFCancer Prev Detect Interv (2024)
October 2024
Magnetic resonance guided focused ultrasound (MRgFUS) is one of the most attractive emerging minimally invasive procedures for breast cancer, which induces localized hyperthermia, resulting in tumor cell death. Accurately assessing the post-ablation viability of all treated tumor tissue and surrounding margins immediately after MRgFUS thermal therapy residual tumor tissue is essential for evaluating treatment efficacy. While both thermal and vascular MRI-derived biomarkers are currently used to assess treatment efficacy, currently, no adequately accurate methods exist for the in vivo determination of tissue viability during treatment.
View Article and Find Full Text PDFBMJ Open
January 2025
Institute of Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
Background: Magnetic resonance-guided transurethral ultrasound ablation (MR-TULSA) is a new focal therapy for treating localised prostate cancer that is associated with fewer adverse effects (AEs) compared with established treatments. To support large-scale clinical implementation, information about cost-effectiveness is required.
Objective: To evaluate the cost-utility of MR-TULSA compared with robot-assisted radical prostatectomy (RARP), external beam radiation therapy (EBRT) and active surveillance (AS) for patients with low- to favourable intermediate-risk localised prostate cancer.
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