Feasibility study on MR-guided high-intensity focused ultrasound ablation of sciatic nerve in a swine model: Preliminary results Journal Article


Authors: Kaye, E. A.; Gutta, N. B.; Monette, S.; Gulati, A.; Loh, J.; Srimathveeravalli, G.; Ezell, P. C.; Erinjeri, J. P.; Solomon, S. B.; Maybody, M.
Article Title: Feasibility study on MR-guided high-intensity focused ultrasound ablation of sciatic nerve in a swine model: Preliminary results
Abstract: Introduction: Spastic patients often seek neurolysis, the permanent destruction of the sciatic nerve, for better pain management. MRI-guided high-intensity focused ultrasound (MRgHIFU) may serve as a noninvasive alternative to the prevailing, more intrusive techniques. This in vivo acute study is aimed at performing sciatic nerve neurolysis using a clinical MRgHIFU system. Methods: The HIFU ablation of sciatic nerves was performed in swine (n = 5) using a HIFU system integrated with a 3 T MRI scanner. Acute lesions were confirmed using T1-weighted contrast-enhanced (CE) MRI and histopathology using hematoxylin and eosin staining. The animals were euthanized immediately following post-ablation imaging. Results: Reddening and mild thickening of the nerve and pallor of the adjacent muscle were seen in all animals. The HIFU-treated sections of the nerves displayed nuclear pyknosis of Schwann cells, vascular hyperemia, perineural edema, hyalinization of the collagenous stroma of the nerve, myelin sheet swelling, and loss of axons. Ablations were visible on CE MRI. Non-perfused volume of the lesions (5.8–64.6 cc) linearly correlated with estimated lethal thermal dose volume (4.7–34.2 cc). Skin burn adjacent to the largest ablated zone was observed in the first animal. Bilateral treatment time ranged from 55 to 138 min, and preparation time required 2 h on average. Conclusion: The acute pilot study in swine demonstrated the feasibility of a noninvasive neurolysis of the sciatic nerve using a clinical MRgHIFU system. Results revealed that acute HIFU nerve lesions were detectable on CE MRI, gross pathology, and histology. © 2015, Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
Keywords: histopathology; nonhuman; nuclear magnetic resonance imaging; animal tissue; edema; animal experiment; histology; feasibility study; pilot study; contrast enhancement; nerve fiber; high intensity focused ultrasound; burn; stroma; schwann cell; non invasive procedure; mri; myelin; ultrasound therapy; neurolysis; nuclear magnetic resonance scanner; hyperemia; ablation; sciatic nerve; gadolinium pentetate meglumine; porcine model; hyaline degeneration; pallor; ultrasound transducer; priority journal; article; hifu; high intensity focused ultrasound device; nerve lesion; yorkshire pig
Journal Title: CardioVascular and Interventional Radiology
Volume: 38
Issue: 4
ISSN: 0174-1551
Publisher: Springer  
Date Published: 2015-08-01
Start Page: 985
End Page: 992
Language: English
DOI: 10.1007/s00270-015-1141-0
PROVIDER: scopus
PUBMED: 26040256
PMCID: PMC5502758
DOI/URL:
Notes: Export Date: 2 September 2015 -- Source: Scopus
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MSK Authors
  1. John Loh
    2 Loh
  2. Amitabh Gulati
    148 Gulati
  3. Majid Maybody
    98 Maybody
  4. Stephen Solomon
    424 Solomon
  5. Joseph Patrick Erinjeri
    203 Erinjeri
  6. Sebastien Monette
    149 Monette
  7. Paula Cherie Ezell
    19 Ezell
  8. Narendra Babu Gutta
    7 Gutta
  9. Elena Aleksandrovna Kaye
    16 Kaye