Novel use of noninvasive high-intensity focused ultrasonography for intercostal nerve neurolysis in a swine model Journal Article


Authors: Gulati, A.; Loh, J.; Gutta, N. B.; Ezell, P. C.; Monette, S.; Erinjeri, J. P.; Maybody, M.; Solomon, S.
Article Title: Novel use of noninvasive high-intensity focused ultrasonography for intercostal nerve neurolysis in a swine model
Abstract: Background: High-intensity focused ultrasound (HIFU) is a noninvasive thermal ablation technique. High-intensity focused ultrasound has been used in small-animal models to lesion neural tissue selectively. This study aimed to evaluate the efficacy of HIFU in a large-animal model for ablation of nerves similar in size to human nerves. METHODS: Twelve acute magnetic resonance-guided HIFU ablation lesions were created in intercostal nerves in a swine model. In a second pig, as a control, 4 radiofrequency ablation and 4 alcohol lesions were performed on intercostal nerves under ultrasound guidance. Preprocedural and postprocedural magnetic resonance imaging was then performed to evaluate radiologically the lesion size created by HIFU. Animals were euthanized 1 hour postprocedure, and necropsy was performed to collect tissue samples for histopathologic analysis. RESULTS: On gross and histological examination of the intercostal nerve, acute HIFU nerve lesions showed evidence of well-demarcated, acute, focally extensive thermal necrosis. Four intercostal nerves ablated with HIFU were sent for histopathologic analysis, with 2 of 4 lesions showing pathologic damage to the intercostal nerve. Similar results were shown with radiofrequency ablation technique, whereas the intercostal nerves appeared histologically intact with alcohol ablation. CONCLUSIONS: High-intensity focused ultrasound may be used as a noninvasive neurolytic technique in swine. High-intensity focused ultrasound may have potential as a neuroablation technique for patients with chronic and cancer pain. Copyright © 2013 by American Society of Regional Anesthesia and Pain Medicine.
Journal Title: Regional Anesthesia and Pain Medicine
Volume: 39
Issue: 1
ISSN: 1098-7339
Publisher: BMJ Publishing Group Ltd.  
Date Published: 2014-01-01
Start Page: 26
End Page: 30
Language: English
DOI: 10.1097/aap.0000000000000028
PROVIDER: scopus
PUBMED: 24317231
DOI/URL:
Notes: Export Date: 3 February 2014 -- CODEN: RAPMF -- Source: Scopus
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Citation Impact
MSK Authors
  1. Amitabh Gulati
    124 Gulati
  2. Majid Maybody
    96 Maybody
  3. Stephen Solomon
    399 Solomon
  4. Joseph Patrick Erinjeri
    172 Erinjeri
  5. Sebastien Monette
    138 Monette
  6. Narendra Babu Gutta
    7 Gutta