Initiating a Magnetic Resonance-Guided Focused Ultrasound Program: Comprehensive Workflow and Lessons Learned from the Initial 116 Cases.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Daniel Y Zhang, John J Pearce, Jacob Mazza, Edgar Petrosyan, Alireza Borghei, Neepa Patel, Sepehr Sani
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引用次数: 0

Abstract

Introduction: Magnetic resonance-guided focused ultrasound (MRgFUS) represents an incisionless treatment option for essential or parkinsonian tremor. The incisionless nature of this procedure has garnered interest from both patients and providers. As such, an increasing number of centers are initiating new MRgFUS programs, necessitating development of unique workflows to optimize patient care and safety. Herein, we describe establishment of a multi-disciplinary team, workflow processes, and outcomes for a new MRgFUS program.

Methods: This is a single-academic center retrospective review of 116 consecutive patients treated for hand tremor between 2020 and 2022. MRgFUS team members, treatment workflow, and treatment logistics were reviewed and categorized. Tremor severity and adverse events were evaluated at baseline, 3, 6, and 12 months post-MRgFUS with the Clinical Rating Scale for Tremor Part B (CRST-B). Trends in outcome and treatment parameters over time were assessed. Workflow and technical modifications were noted.

Results: The procedure, workflow, and team members remained consistent throughout all treatments. Technique modifications were attempted to reduce adverse events. A significant reduction in CRST-B score was achieved at 3 months (84.5%), 6 months (79.8%), and 12 months (72.2%) post-procedure (p < 0.0001). The most common post-procedure adverse events in the acute period (<1 day) were gait imbalance (61.1%), fatigue and/or lethargy (25.0%), dysarthria (23.2%), headache (20.4%), and lip/hand paresthesia (13.9%). By 12 months, the majority of adverse events had resolved with a residual 17.8% reporting gait imbalance, 2.2% dysarthria, and 8.9% lip/hand paresthesia. No significant trends in treatment parameters were found.

Conclusions: We demonstrate the feasibility of establishing an MRgFUS program with a relatively rapid increase in evaluation and treatment of patients while maintaining high standards of safety and quality. While efficacious and durable, adverse events occur and can be permanent in MRgFUS.

启动磁共振引导聚焦超声程序:综合工作流程和最初116例的经验教训。
简介:磁共振引导聚焦超声(MRgFUS)代表了原发性或帕金森性震颤的无切口治疗选择。这种手术的无切口性质已经引起了患者和提供者的兴趣。因此,越来越多的中心正在启动新的MRgFUS项目,需要开发独特的工作流程来优化患者护理和安全。在这里,我们描述了一个多学科团队的建立,工作流程,以及一个新的MRgFUS项目的结果。方法:这是一项针对2020年至2022年间连续116例手部震颤患者的单学术中心回顾性研究。对MRgFUS团队成员、治疗工作流程和治疗后勤进行了回顾和分类。使用震颤部分临床评定量表(CRST-B)在mrgfus后的基线、3,6和12个月评估震颤严重程度和不良事件。评估结果和治疗参数随时间的变化趋势。注意到工作流程和技术修改。结果:在所有治疗过程中,程序、工作流程和团队成员保持一致。我们尝试改进技术以减少不良事件的发生。CRST-B评分在术后3个月(84.5%)、6个月(79.8%)和12个月(72.2%)显著降低(p < 0.0001)。结论:我们证明了建立MRgFUS项目的可行性,在保持高安全性和高质量的同时,对患者的评估和治疗相对快速地增加。虽然MRgFUS有效且持久,但不良事件的发生和可能是永久性的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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