Abstract #0554

White-Matter-Nulled MP-RAGE Predicts Clinical Outcome of Focused Ultrasound Thalamic Ablation for Essential Tremor

Jason Su¹, Christian Federau², Thomas Tourdias³, Manojkumar Saranathan⁴, Casey Halpern⁵, Jaimie Henderson⁵, Veronica Santini⁶, Kim Butts-Pauly², Pejman Ghanouni², and Brian Rutt²

¹Electrical Engineering, Stanford University, Stanford, CA, United States, ²Radiology, Stanford University, Stanford, CA, United States, ³Neuroradiology, Bordeaux University Hospital, Bordeaux, France, ⁴Radiology, University of Arizona, Tucson, AZ, United States, ⁵Neurosurgery, Stanford University, Stanford, CA, United States, ⁶Neurology, Stanford University, Stanford, CA, United States

This retrospective analysis of MR-guided focused ultrasound ablation for essential tremor (ET) treatment is centered on clinical outcome (CRST A+B) and segmentation of ablation lesions using the white-matter-nulled MP-RAGE contrast. There is no significant correlation between the volume of ablation and clinical outcome at 1 month. We identify a new potential target region based on the best-responding patient and compute the percent coverage of that region by each subject’s ablation via nonlinear registration. This measure correlates with the outcome after 1 month in 8 subjects with r²=0.8 and p=0.003, a remarkable association that may aid future targeting strategies in ET.

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