Advanced
MRgFUS
Surgery in Hyderabad

MRgFUS: Pre-Op & Post-Op Care

MRgFUS treatment is conducted in three phases, as with any other invasive or non-invasive surgery. The 3 phases are pre-operative, intra-operative, and post-operative.

Before the start of the MRgFUS procedure

The pre-operative phase of MRgFUS is very important for the selection of appropriate patients, making them ready to undergo the MRgFUS procedure, and then planning the whole process, making sure that the process is accurately done.

Patient evaluation involves a complete examination that includes neurological and oncological testing (depending on the disease condition it treats, like essential tremor, uterine fibroids, and metastasis of bone.

Reviewing the results obtained from previous imaging techniques like computed tomography and magnetic resonance imaging to examine the size of the lesion, its location, and its accessibility. MRgFUS is suitable for well-defined and localized sutures. For treating brain conditions like tremors, patients with intact skull density are usually given preference.

MRgFUS should be avoided in patients with metal implants, pacemakers, or severe claustrophobia, as magnetic resonance imaging is utilized during the treatment procedure.

High-resolution magnetic resonance imaging helps determine the exact location of the target tissue, and planning images are utilized to determine where the beam needs to be targeted. Surrounding healthy tissues are generally avoided.

Patient-specific anatomical maps are used for MRgFUS to focus energy as accurately as a few millimeters in diameter on the target point.

Preparation of the patient before MRgFUS surgery involves an in-depth discussion with a specialist about every possible benefit and risk.

In neurological cases, MRgFUS treatment involves shaving of hair on the head for good transmission of ultrasound waves. The patient is advised to fast for several hours before the start of the procedure.

MRgFUS is done under mild sedition or local anesthesia, as the patient needs to be awake for monitoring in between the procedure.

Patient is placed on the MR table, with the body part that is to be treated in the transducer dome, which is then filled with degassed water for ultrasound coupling.

Intra-operative stage

This is the active phase of MRgFUS treatment, where magnetic resonance imaging is accurately combined with the ultrasound beams.

The entire MRgFUS setup is compatible with magnetic resonance imaging. This provides instant images required for targeted treatment and also management of temperature, carried out by magnetic resonance imaging thermometry.

During the complete MRgFUS treatment procedure, the patient stays awake so they can actually have a conversation about any untoward sensations or discomforts, especially during the MRgFUS procedure.

At first, the procedure is tested for accuracy and temperature rise at the point of focus with low-powered beams.

Once alignment is confirmed, high-intensity ultrasound beams are delivered to heat the target tissue, leading to coagulative necrosis.

Each sonication lasts from a few seconds to a minute, and depending upon the size of the lesion, the exact number of sonication cycles is determined. Adjustments are made in between each sonication to maintain safety, accuracy.

After each cycle of sonication, the magnetic resonance imaging checks for the size of the lesion and contrast changes, which confirm successful dismantling of the diseased part. Essential tremor patients are tested by asking them to perform simple tasks, such as holding an object or writing.

After the MRgFUS procedure

Post-operative care of the MRgFUS procedure involves the guarantee of a safe recovery and early detection of any problems.

Patients are shifted to the recovery area, where their vitals are carefully monitored, neurological function is evaluated, and kept under observation to see if they develop any not-so-usual complications.

A final magnetic resonance imaging scan is performed to ascertain that the diseased part is completely treated and the surrounding area is not harmed.

Any small amount of discomfort or appearance of a lesion is managed by mild analgesics or the use of anti-inflammatory medications.

MRgFUS is an outpatient or day-care procedure, with patients discharged within a few hours. This is coupled with a quick recovery that usually happens in 24-48 hours.

Patient is advised to avoid any stressful activity, maintain hydration, and report immediately if there are any unusual symptoms.

After 1 to 3 months of the MRgFUS procedure, there is complete dismantling of the diseased condition and no chance of any recurrence taking place.

Improvement in the state of symptoms is evaluated periodically over time. In neurological patients, relief from pain is almost immediate and gradually improves over time.

In comparison to other invasive surgeries like radio frequency ablation, cryoablation, stereotactic radiosurgery, Laser interstitial thermal therapy, High-Intensity focused ultrasound without magnetic resonance guidance, conventional surgery, and radiation therapy, MRgFUS causes minimal collateral damage and a low rate of complications.

Benefits of MRgFUS at Yashoda Hospitals

• Non-invasive treatment
• Magnetic resonance imaging guided accuracy
• Minimal trauma
• Faster recovery
• Lower risk of complications or infection
• Repeatability and Reproducibility
• Convenient as an outpatient technique
• Drug-free and radiation-free
• Effective cost