Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Characteristics of Focused Ultrasound Mediated Blood-Brain Barrier Opening in Magnetic Resonance Images

  • Kyung Won Chang (Brain Research Institute, Department of Neurosurgery, Yonsei University College of Medicine) ;
  • Seung Woo Hong (Brain Research Institute, Department of Neurosurgery, Yonsei University College of Medicine) ;
  • Won Seok Chang (Brain Research Institute, Department of Neurosurgery, Yonsei University College of Medicine) ;
  • Hyun Ho Jung (Brain Research Institute, Department of Neurosurgery, Yonsei University College of Medicine) ;
  • Jin Woo Chang (Brain Research Institute, Department of Neurosurgery, Yonsei University College of Medicine)
  • Received : 2022.11.08
  • Accepted : 2022.12.19
  • Published : 2023.03.01
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Abstract

Objective : The blood-brain barrier (BBB) is an obstacle for molecules to pass through from blood to the brain. Focused ultrasound is a new method which temporarily opens the BBB, which makes pharmaceutical delivery or removal of neurodegenerative proteins possible. This study was demonstrated to review our BBB opening procedure with magnetic resonance guided images and find specific patterns in the BBB opening. Methods : In this study, we reviewed the procedures and results of two clinical studies on BBB opening using focused ultrasound regarding its safety and clinical efficacy. Magnetic resonance images were also reviewed to discover any specific findings. Results : Two clinical trials showed clinical benefits. All clinical trials demonstrated safe BBB opening, with no specific side effects. Magnetic resonance imaging showed temporary T1 contrast enhancement in the sonication area, verifying the BBB opening. Several low-signal intensity spots were observed in the T2 susceptibility-weighted angiography images, which were also reversible and temporary. Although these spots can be considered as microbleeding, evidence suggests these are not ordinary microbleeding but an indicator for adequate BBB opening. Conclusion : Magnetic resonance images proved safe and efficient BBB opening in humans, using focused ultrasound.

Keywords

Acknowledgement

We would like to thank Itay Rachmilevitch, E.J. Kwon and our radiologists for their contribution.

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