Using Focused Ultrasound to Treat Hypothalamic Hamartomas
Interview with Dr. Travis Sean Tierney, Pediatric Neurosurgeon Nicklaus Children’s Hospital
- You recently used Focused Ultrasound to treat a hypothalamic hamartoma. What is FUS and how does it work? Has it been used to treat other diseases?
Focused Ultrasound is a surgical method that uses highly focused acoustic energy to destroy diseased tissue inside the body without an incision. It has been in development for over 50 years, but only recently have technical imaging and computing innovations allowed its routine clinical use. It is FDA approved for a number of body applications and for the treatment of essential tremor. Our study (University of Miami/Nicklaus Children’s Hospital) is one of several ongoing investigations aimed at using focused ultrasound to treat brain tumors as a potential alternative to radiation or open surgery. The procedure is performed in an MRI suite.
- Are ALL HH patients good candidates? If not, who is?
All patients over age 8 with HH are candidates to consider, except for perhaps those with Delalande and Fohlen class IV lesions, the so called “giant” hamartomas, because they are larger than 8cm3. This is a technical exclusion in our current study. Type II lesions are particularly ideal as the disconnect plane lies in a favorable orientation for delivery of acoustic energy. Patients with gelastic seizures and precocious puberty are not excluded from our trial.
- What can patients expect before or after the surgery? What tests are recommended prior to surgery? Are there any side effects? What is the recommended follow up?
Patients can expect a complete neurological evaluation, which includes an MRI and CT scan, and some basic blood work to exclude bleeding abnormalities and to evaluate endocrine function. They will be admitted to the hospital on the morning of the procedure and likely discharged to home the following day. Minor side effects have included headache and those associated with general anesthesia, but no stroke or intracranial bleeding or other major side effect such as cognitive decline or weight gain have occurred. The head must be shaved completely to avoid heating small air bubbles trapped on the skin surface, but no incisions are made. We will see the patient back in clinic at 2 weeks, 3 months, 6 months and one year.
- Your surgery was part of a clinical trial. Who is eligible to participate? Are international patients eligible as well?
International patients are eligible, and the study is free. However, patients are not paid to be a part of our study, but support for travel to Miami may be possible. For a complete list of inclusion and exclusion criteria click here.
- What questions should a patient ask their doctor if they are considering surgery for an HH?
The most important question to ask your doctor is whether the hamartoma requires an operation and to discuss the risk of various standard surgical approaches including radiosurgery. Only those patients that require surgery are eligible for our study.
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Editors Note: For more information on Focused Ultrasound, visit additional Hope for HH videos, Blogs and Clinical trials information.
- You Tube Focused Ultrasound Videos
- Other Related Blogs:
- Two Clinical Trials on FUS: