Brain Surgery Done With Sound

Focused ultrasound surgery has now been performed successfully on nine human patients, according to a preliminary study done in Switzerland. Thirty years ago, this kind of technique was science fiction; today, it is science fact.

The work was reported by MIT's Technology Review.

"The groundbreaking finding here is that you can make lesions deep in the brain--through the intact skull and skin--with extreme precision and accuracy and safety," says Neal Kassell, a neurosurgeon at the University of Virginia. Kassell, who was not directly involved in the study, is chairman of the Focused Ultrasound Surgery Foundation, a nonprofit based in Charlottesville, VA, that was founded to develop new applications for focused ultrasound.

The Swiss study tested the technique on nine patients with chronic debilitating pain. The traditional treatment involves destroying a small part of the thalamus, a structure that relays messages between different brain areas. In the past, this has been accomplished with radio frequency ablation, in which a probe is inserted into the skull, or with radio surgery which focuses radiation on the area. Surgeons believe that the new technique will be faster-acting and more precise than the current methods.

In the procedure, ultrasound beams are focused on a specific point in the brain; the exact location depends on the condition being treated. The small portion of brain tissue at the focus (about the size of a rice grain) absorbs the energy and converts it to heat; the temperature in this area rises to about 130 degrees Fahrenheit, killing the cells. The entire system is integrated with a magnetic resonance scanner, which allows neurosurgeons to make sure they target the correct piece of brain tissue (see illustration).

"Thermal images acquired in real time during the treatment allow the surgeon to see where and to what extent the rise in temperature is achieved," says Zadicario.

Fans of the 1983 movie Star Trek IV: The Voyage Home fondly remember that Dr. McCoy had a special device that allowed him to avoid cutting patients open and yet still perform surgery; he angrily locked 20th century physicians in a closet rather than let them touch crew member Pavel Chekov with their "butcher knives".

Medical devices shown on the fictional Star Trek series have a way of coming true in reality. For example, laser welding of body tissues (rather than sewing skin closed) is now a reality, thanks to researchers at Tel Aviv University, and the LifeBed monitoring system is just like the beds in the Star Trek sickbay.

This Science Fiction in the News story used with permission of Technovelgy.com.