経頭蓋MRガイド下集束超音波治療 (MRgFUS) の現状と可能性
ExAblate Neuro 4000®は, 約1,000本の超音波ビームを凝固部位と温度をリアルタイムにモニターしながら標的に集束し, 切らずに脳の病気を治療できる画期的な装置である. 精度の高い凝固手術ができるが, 頭蓋骨の性状 (SDR) と標的の位置に影響される. 本態性振戦では, 凝固温度55℃以上で高い効果が得られ, 両側凝固手術も期待できる. パーキンソン病のジスキネジアに淡蒼球手術が有効であるが, 手術標的には議論がある. 脳腫瘍, 脳卒中, 強迫神経症, 過誤腫などにも臨床応用され, さらに血液脳関門の可逆的開放が可能で, マイクロバブルとの組み合わせにより神経難病治療のブレ...
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| Published in | 脳神経外科ジャーナル Vol. 31; no. 7; pp. 454 - 463 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人日本脳神経外科コングレス
2022
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0917-950X 2187-3100 |
| DOI | 10.7887/jcns.31.454 |
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| Abstract | ExAblate Neuro 4000®は, 約1,000本の超音波ビームを凝固部位と温度をリアルタイムにモニターしながら標的に集束し, 切らずに脳の病気を治療できる画期的な装置である. 精度の高い凝固手術ができるが, 頭蓋骨の性状 (SDR) と標的の位置に影響される. 本態性振戦では, 凝固温度55℃以上で高い効果が得られ, 両側凝固手術も期待できる. パーキンソン病のジスキネジアに淡蒼球手術が有効であるが, 手術標的には議論がある. 脳腫瘍, 脳卒中, 強迫神経症, 過誤腫などにも臨床応用され, さらに血液脳関門の可逆的開放が可能で, マイクロバブルとの組み合わせにより神経難病治療のブレークスルーとなることが期待されている. |
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| AbstractList | ExAblate Neuro 4000®は, 約1,000本の超音波ビームを凝固部位と温度をリアルタイムにモニターしながら標的に集束し, 切らずに脳の病気を治療できる画期的な装置である. 精度の高い凝固手術ができるが, 頭蓋骨の性状 (SDR) と標的の位置に影響される. 本態性振戦では, 凝固温度55℃以上で高い効果が得られ, 両側凝固手術も期待できる. パーキンソン病のジスキネジアに淡蒼球手術が有効であるが, 手術標的には議論がある. 脳腫瘍, 脳卒中, 強迫神経症, 過誤腫などにも臨床応用され, さらに血液脳関門の可逆的開放が可能で, マイクロバブルとの組み合わせにより神経難病治療のブレークスルーとなることが期待されている. |
| Author | 福留, 賢二 大西, 英之 平林, 秀裕 小坂田, 陽介 |
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| Copyright | 2022 日本脳神経外科コングレス |
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| References | 12) Haubenberger D, Hallett M : Essential Tremor. N Engl J Med 378 : 1802-1810, 2018. 15) Hynynen K, Freund WR, Cline HE, Chung AH, Watkins RD, Vetro JP, Jolesz FA : A clinical, noninvasive, MR imaging-monitored ultrasound surgery method. Radiographics 16 : 185-195, 1996. 20) Martin E, Jeanmonod D, Morel A, Zadicario E, Werner B : High-intensity focused ultrasound for noninvasive functional neurosurgery. Ann Neurol 66 : 858-61, 2009. 23) McDannold N, Clement G, Black P, Jolesz F, Hynynen K : Transcranial MRI-guided focused ultrasound surgery of brain tumors : Initial findings in three patients. Neurosurgery 66 : 323-332, 2010. 29) Schlesinger I, Sinai A, Zaaroor M : MRI-guided focused ultrasound in Parkinson's disease : a review. Parkinsons Dis 2017 : 8124624, 2017. 9) Fukutome K, Kuga Y, Ohnishi H, Hirabayashi H, Nakase H : What factors impact the clinical outcome of magnetic resonance imaging-guided focused ultrasound thalamotomy for essential tremor? J Neurosurg 134 : 1618-1623, 2020. 31) Wright C, Hynynen K, Goertz D : In vitro and in vivo high intensity focused ultrasound thrombolysis. Invest Radiol 47 : 217-225, 2012. 2) Alvarez L, Macias R, Lopez G, Alvarez E, Pavon N, Rodriguez-Oroz MC, Juncos JL, Maragoto C, Guridi J, Litvan I, Tolosa ES, Koller W, Vitek J, DeLong MR, Obeso JA : Bilateral subthalamotomy in Parkinson's disease : initial and long-term response. Brain 128 (Pt 3) : 570-583, 2005. 10) Fukutome K, Hirabayashi H, Osakada Y, Kuga Y, Ohnishi H : Bilateral magnetic resonance imaging-guided focused ultrasound thalamotomy for essential tremor. Stereotact Funct Neurosurg 100 : 44-52, 2022. 30) Spiegel EA, Wycis HT, Szekely EG, Adams DJ, Flanagan M, Baird HW 3rd : Campotomy in various extrapyramidal disorders. J Neurosurg 20 : 871-884, 1963. 3) Bhatia KP, Bain P, Bajaj N, Elble RJ, Hallett M, Louis ED, Raethjen J, Stamelou M, Testa CM, Deuschl G ; Tremor Task Force of the International Parkinson and Movement Disorder Society : Consensus statement on the classification of tremors : from the task force on tremor of the International Parkinson and Movement Disorder Society. Mov Disord 33 : 75-87, 2018. 21) Martínez-Fernández R, Máñez-Miró JU, Rodríguez-Rojas R, Del Álamo M, Shah BB, Hernández-Fernández F, Pineda-Pardo JA, Monje MHG, Fernández-Rodríguez B, Sperling SA, Mata-Marín D, Guida P, Alonso-Frech F, Obeso I, Gasca-Salas C, Vela-Desojo L, Elias WJ, Obeso JA : Randomized trial of focused ultrasound subthalamotomy for parkinson's disease. N Engl J Med 383 : 2501-2513, 2020. 5) Chang WS, Jung HH, Zadicario E, Rachmilevitch I, Tlusty T, Vitek S, Chang JW : Factors associated with successful magnetic resonance-guided focused ultrasound treatment : efficiency of acoustic energy delivery through the skull. J Neurosurg 124 : 411-416, 2016. 6) Eisenberg HM, Krishna V, Elias WJ, Cosgrove GR, Gandhi D, Aldrich CE, Fishman PS : MR-guided focused ultrasound pallidotomy for Parkinson's disease : safety and feasibility J Neurosurg, 2020 [Online ahead of print] . 13) 花島律子, 宇川義一 : I疫病, 病因, 病態機序. 日本神経治療学会治療指針作成委員会編 : 標準的神経治療 : 本態性振戦. 神経治療 28 : 300-303, 2011. 25) Merello M, Tenca E, Pérez Lloret S, Martín ME, Bruno V, Cavanagh S, Antico J, Cerquetti D, Leiguarda R : Prospective randomized 1-year follow-up comparison of bilateral subthalamotomy versus bilateral subthalamic stimulation and the combination of both in Parkinson's disease patients : a pilot study. Br J Neurosurg 22 : 415-422, 2008. 26) Mohammed N, Patra D, Nanda A : A meta-analysis of outcomes and complications of magnetic resonance-guided focused ultrasound in the treatment of essential tremor. Neurosurg Focus 44 : E4, 2018. 27) Ohl, CD, Philipp A, Lauterborn W : Cavitation bubble collapse studied at 20 million frames per second. Ann Physik 4 : 26-34, 1995. 1) Alomar S, King NK, Tam J, Bari AA, Hamani C, Lozano AM : Speech and language adverse effects after thalamotomy and deep brain stimulation in patients with movement disorders : A meta-analysis. Mov Disord 32 : 53-63, 2017. 8) Fahn S, Tolosa E, Conceppcion M : Clinical rating scale for tremor. in Jankovic J, Tolosa E (eds) : Parkinson's Disease and Movement Disorders. Baltimore, Williams and Wilkins, 1993, pp.271-280. 11) Hariz MI : Complications of movement disorder surgery and how to avoid them. Lozano AM (ed) : Movement Disorder Surgery. Basel, Karger, 2000 pp.246-265. 14) Harnof S, Zibly Z, Hananel A, Monteith S, Grinfeld J, Schiff G, Kulbatski I, Kassell N : Potential of magnetic resonance-guided focused ultrasound for intracranial hemorrhage : an in vivo feasibility study. J Stroke Cerebrovasc Dis 23 : 1585-1591, 2014. 18) Jung NY, Park CK, Kim M, Lee PH, Sohn YH, Chang JW : The efficacy and limits of magnetic resonance-guided focused ultrasound pallidotomy for Parkinson's disease : a Phase Ⅰ clinical trial. J Neurosurg 2018 [Online ahead of print] . 22) Martínez-Fernández R, Mahendran S, Pineda-Pardo JA, Imbach LL, Máñez-Miró JU, Büchele F, Del Álamo M, Rodriguez-Rojas R, Hernández-Fernández F, Werner B, Matarazzo M, Obeso I, Gonzalez-Quarante LH, Deuschl G, Stieglitz L, Baumann CR, Obeso JA : Bilateral staged magnetic resonance-guided focused ultrasound thalamotomy for the treatment of essential tremor : a case series study. J Neurol Neurosurg Psychiatry 92 : 927-931, 2021. 32) Yamaguchi T, Hori T, Hori H, Takasaki M, Abe K, Taira T, Ishii K, Watanabe K : Magnetic resonance-guided focused ultrasound ablation of hypothalamic hamartoma as a disconnection surgery : a case report. Acta Neurochir (Wien) 162 : 2513-2517, 2020. 19) Laitinen LV, Bergenheim AT, Hariz MI : Leksell's posteroventral pallidotomy in the treatment of Parkinson's disease. J Neurosurg 76 : 53-61, 1992. 24) Medel R, Monteith SJ, Elias WJ, Eames M, Snell J, Sheehan JP, Wintermark M, Jolesz FA, Kassell NF : Magnetic resonance-guided focused ultrasound surgery : Part 2 : A review of current and future applications. Neurosurgery 71 : 755-763, 2012. 16) Jagannathan J, Sanghvi NT, Crum LA, Yen CP, Medel R, Dumont AS, Sheehan JP, Steiner L, Jolesz F, Kassell NF : High-intensity focused ultrasound surgery of the brain : part 1―A historical perspective with modern applications. Neurosurgery. 64 : 201-210, 2009. 28) Quadri SA, Waqas M, Khan I, Khan MA, Suriya SS, Farooqui M, Fiani B : High-intensity focused ultrasound : past, present, and future in neurosurgery. Neurosurg Focus 44 : E16, 2018. 17) Jung HH, Kim SJ, Roh D, Chang JG, Chang WS, Kweon EJ, Kim CH, Chang JW : Bilateral thermal capsulotomy with MR-guided focused ultrasound for patients with treatment-refractory obsessive-compulsive disorder : a proof-of-concept study. Mol Psychiatry 20 : 1205-1211, 2015. 7) Elias WJ, Lipsman N, Ondo WG, Ghanouni P, Kim YG, Lee W, Schwartz M, Hynynen K, Lozano AM, Shah BB, Huss D, Dallapiazza RF, Gwinn R, Witt J, Ro S, Eisenberg HM, Fishman PS, Gandhi D, Halpern CH, Chuang R, Butts Pauly K, Tierney TS, Hayes MT, Cosgrove GR, Yamaguchi T, Abe K, Taira T, Chang JW : A randomized trial of focused ultrasound thalamotomy for essential tremor. N Engl J Med 375 : 730-739, 2016. 4) Blomstedt P, Sandvik U, Fytagoridis A, Tisch S : The posterior subthalamic area in the treatment of movement disorders : past, present, and future. Neurosurgery 64 : 1029-1042, 2009. |
| References_xml | – reference: 1) Alomar S, King NK, Tam J, Bari AA, Hamani C, Lozano AM : Speech and language adverse effects after thalamotomy and deep brain stimulation in patients with movement disorders : A meta-analysis. Mov Disord 32 : 53-63, 2017. – reference: 9) Fukutome K, Kuga Y, Ohnishi H, Hirabayashi H, Nakase H : What factors impact the clinical outcome of magnetic resonance imaging-guided focused ultrasound thalamotomy for essential tremor? J Neurosurg 134 : 1618-1623, 2020. – reference: 32) Yamaguchi T, Hori T, Hori H, Takasaki M, Abe K, Taira T, Ishii K, Watanabe K : Magnetic resonance-guided focused ultrasound ablation of hypothalamic hamartoma as a disconnection surgery : a case report. Acta Neurochir (Wien) 162 : 2513-2517, 2020. – reference: 3) Bhatia KP, Bain P, Bajaj N, Elble RJ, Hallett M, Louis ED, Raethjen J, Stamelou M, Testa CM, Deuschl G ; Tremor Task Force of the International Parkinson and Movement Disorder Society : Consensus statement on the classification of tremors : from the task force on tremor of the International Parkinson and Movement Disorder Society. Mov Disord 33 : 75-87, 2018. – reference: 10) Fukutome K, Hirabayashi H, Osakada Y, Kuga Y, Ohnishi H : Bilateral magnetic resonance imaging-guided focused ultrasound thalamotomy for essential tremor. Stereotact Funct Neurosurg 100 : 44-52, 2022. – reference: 8) Fahn S, Tolosa E, Conceppcion M : Clinical rating scale for tremor. in Jankovic J, Tolosa E (eds) : Parkinson's Disease and Movement Disorders. Baltimore, Williams and Wilkins, 1993, pp.271-280. – reference: 23) McDannold N, Clement G, Black P, Jolesz F, Hynynen K : Transcranial MRI-guided focused ultrasound surgery of brain tumors : Initial findings in three patients. Neurosurgery 66 : 323-332, 2010. – reference: 20) Martin E, Jeanmonod D, Morel A, Zadicario E, Werner B : High-intensity focused ultrasound for noninvasive functional neurosurgery. Ann Neurol 66 : 858-61, 2009. – reference: 11) Hariz MI : Complications of movement disorder surgery and how to avoid them. Lozano AM (ed) : Movement Disorder Surgery. Basel, Karger, 2000 pp.246-265. – reference: 25) Merello M, Tenca E, Pérez Lloret S, Martín ME, Bruno V, Cavanagh S, Antico J, Cerquetti D, Leiguarda R : Prospective randomized 1-year follow-up comparison of bilateral subthalamotomy versus bilateral subthalamic stimulation and the combination of both in Parkinson's disease patients : a pilot study. Br J Neurosurg 22 : 415-422, 2008. – reference: 2) Alvarez L, Macias R, Lopez G, Alvarez E, Pavon N, Rodriguez-Oroz MC, Juncos JL, Maragoto C, Guridi J, Litvan I, Tolosa ES, Koller W, Vitek J, DeLong MR, Obeso JA : Bilateral subthalamotomy in Parkinson's disease : initial and long-term response. Brain 128 (Pt 3) : 570-583, 2005. – reference: 4) Blomstedt P, Sandvik U, Fytagoridis A, Tisch S : The posterior subthalamic area in the treatment of movement disorders : past, present, and future. Neurosurgery 64 : 1029-1042, 2009. – reference: 30) Spiegel EA, Wycis HT, Szekely EG, Adams DJ, Flanagan M, Baird HW 3rd : Campotomy in various extrapyramidal disorders. J Neurosurg 20 : 871-884, 1963. – reference: 24) Medel R, Monteith SJ, Elias WJ, Eames M, Snell J, Sheehan JP, Wintermark M, Jolesz FA, Kassell NF : Magnetic resonance-guided focused ultrasound surgery : Part 2 : A review of current and future applications. Neurosurgery 71 : 755-763, 2012. – reference: 15) Hynynen K, Freund WR, Cline HE, Chung AH, Watkins RD, Vetro JP, Jolesz FA : A clinical, noninvasive, MR imaging-monitored ultrasound surgery method. Radiographics 16 : 185-195, 1996. – reference: 26) Mohammed N, Patra D, Nanda A : A meta-analysis of outcomes and complications of magnetic resonance-guided focused ultrasound in the treatment of essential tremor. Neurosurg Focus 44 : E4, 2018. – reference: 28) Quadri SA, Waqas M, Khan I, Khan MA, Suriya SS, Farooqui M, Fiani B : High-intensity focused ultrasound : past, present, and future in neurosurgery. Neurosurg Focus 44 : E16, 2018. – reference: 17) Jung HH, Kim SJ, Roh D, Chang JG, Chang WS, Kweon EJ, Kim CH, Chang JW : Bilateral thermal capsulotomy with MR-guided focused ultrasound for patients with treatment-refractory obsessive-compulsive disorder : a proof-of-concept study. Mol Psychiatry 20 : 1205-1211, 2015. – reference: 21) Martínez-Fernández R, Máñez-Miró JU, Rodríguez-Rojas R, Del Álamo M, Shah BB, Hernández-Fernández F, Pineda-Pardo JA, Monje MHG, Fernández-Rodríguez B, Sperling SA, Mata-Marín D, Guida P, Alonso-Frech F, Obeso I, Gasca-Salas C, Vela-Desojo L, Elias WJ, Obeso JA : Randomized trial of focused ultrasound subthalamotomy for parkinson's disease. N Engl J Med 383 : 2501-2513, 2020. – reference: 13) 花島律子, 宇川義一 : I疫病, 病因, 病態機序. 日本神経治療学会治療指針作成委員会編 : 標準的神経治療 : 本態性振戦. 神経治療 28 : 300-303, 2011. – reference: 27) Ohl, CD, Philipp A, Lauterborn W : Cavitation bubble collapse studied at 20 million frames per second. Ann Physik 4 : 26-34, 1995. – reference: 7) Elias WJ, Lipsman N, Ondo WG, Ghanouni P, Kim YG, Lee W, Schwartz M, Hynynen K, Lozano AM, Shah BB, Huss D, Dallapiazza RF, Gwinn R, Witt J, Ro S, Eisenberg HM, Fishman PS, Gandhi D, Halpern CH, Chuang R, Butts Pauly K, Tierney TS, Hayes MT, Cosgrove GR, Yamaguchi T, Abe K, Taira T, Chang JW : A randomized trial of focused ultrasound thalamotomy for essential tremor. N Engl J Med 375 : 730-739, 2016. – reference: 6) Eisenberg HM, Krishna V, Elias WJ, Cosgrove GR, Gandhi D, Aldrich CE, Fishman PS : MR-guided focused ultrasound pallidotomy for Parkinson's disease : safety and feasibility J Neurosurg, 2020 [Online ahead of print] . – reference: 12) Haubenberger D, Hallett M : Essential Tremor. N Engl J Med 378 : 1802-1810, 2018. – reference: 14) Harnof S, Zibly Z, Hananel A, Monteith S, Grinfeld J, Schiff G, Kulbatski I, Kassell N : Potential of magnetic resonance-guided focused ultrasound for intracranial hemorrhage : an in vivo feasibility study. J Stroke Cerebrovasc Dis 23 : 1585-1591, 2014. – reference: 5) Chang WS, Jung HH, Zadicario E, Rachmilevitch I, Tlusty T, Vitek S, Chang JW : Factors associated with successful magnetic resonance-guided focused ultrasound treatment : efficiency of acoustic energy delivery through the skull. J Neurosurg 124 : 411-416, 2016. – reference: 19) Laitinen LV, Bergenheim AT, Hariz MI : Leksell's posteroventral pallidotomy in the treatment of Parkinson's disease. J Neurosurg 76 : 53-61, 1992. – reference: 22) Martínez-Fernández R, Mahendran S, Pineda-Pardo JA, Imbach LL, Máñez-Miró JU, Büchele F, Del Álamo M, Rodriguez-Rojas R, Hernández-Fernández F, Werner B, Matarazzo M, Obeso I, Gonzalez-Quarante LH, Deuschl G, Stieglitz L, Baumann CR, Obeso JA : Bilateral staged magnetic resonance-guided focused ultrasound thalamotomy for the treatment of essential tremor : a case series study. J Neurol Neurosurg Psychiatry 92 : 927-931, 2021. – reference: 29) Schlesinger I, Sinai A, Zaaroor M : MRI-guided focused ultrasound in Parkinson's disease : a review. Parkinsons Dis 2017 : 8124624, 2017. – reference: 16) Jagannathan J, Sanghvi NT, Crum LA, Yen CP, Medel R, Dumont AS, Sheehan JP, Steiner L, Jolesz F, Kassell NF : High-intensity focused ultrasound surgery of the brain : part 1―A historical perspective with modern applications. Neurosurgery. 64 : 201-210, 2009. – reference: 31) Wright C, Hynynen K, Goertz D : In vitro and in vivo high intensity focused ultrasound thrombolysis. Invest Radiol 47 : 217-225, 2012. – reference: 18) Jung NY, Park CK, Kim M, Lee PH, Sohn YH, Chang JW : The efficacy and limits of magnetic resonance-guided focused ultrasound pallidotomy for Parkinson's disease : a Phase Ⅰ clinical trial. J Neurosurg 2018 [Online ahead of print] . |
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| Snippet | ExAblate Neuro 4000®は, 約1,000本の超音波ビームを凝固部位と温度をリアルタイムにモニターしながら標的に集束し, 切らずに脳の病気を治療できる画期的な装置である. 精... |
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| SubjectTerms | ablation surgery blood-brain barrier (BBB) essential tremor (ET) MRI-guided focused ultrasound (MRgFUS) Parkinson's disease (PD) |
| Title | 経頭蓋MRガイド下集束超音波治療 (MRgFUS) の現状と可能性 |
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| ispartofPNX | 脳神経外科ジャーナル, 2022, Vol.31(7), pp.454-463 |
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