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Neurosurgery targets in the thalamus can be challenging to identify duringtranscranial MRI-guided focused ultrasound (MRgFUS) thermal ablation due topoor image quality. They also neighbor structures that can result in sideeffects if damaged. Here we demonstrate that the phase data obtained duringMRgFUS for MR temperature imaging (MRTI) contains anatomic information thatcould be useful in guiding this procedure. This approach was evaluated in 68thalamotomies for essential tremor (ET). We found that we could readilyvisualize the red nucleus and subthalamic nucleus, and those nuclei wereconsistently aligned with the sonication target coordinates. We also couldconsistently visualize the internal capsule, which needs to be protected fromthermal damage to prevent side effects. Preliminary results from fourpallidotomies in Parkinson's disease patients suggest that this approach mightalso be useful in visualizing the optic tract in addition to the internalcapsule. Overall, this approach can visualize anatomic landmarks that may beuseful to refine atlas-based targeting for MRgFUS. Since the same data is usedfor MRTI and anatomic visualization, there are no errors induced byregistration to previously obtained planning images or image distortion, and noadditional time is needed.

Using phase data from MR temperature imaging to visualize anatomy during MRI-guided focused ultrasound neurosurgery