Abstract #0823

Diffusion MRI Tractography for Improved MRI-guided Focused Ultrasound Thalamotomy Targeting for Essential Tremor

Qiyuan Tian^1,2, Max Wintermark², Kim Butts Pauly², Diane Huss³, W. Jeffrey Elias⁴, and Jennifer A. McNab²

¹Electrical Engineering, Stanford University, Stanford, CA, United States, ²Radiology, Stanford University, Stanford, CA, United States, ³Physical Therapy, University of Virginia, Charlottesville, VA, United States, ⁴Neurosurgery, University of Virginia, Charlottesville, VA, United States

We retrospectively studied 13 essential tremor patients treated with MRI-guided focused ultrasound. The purpose was to demonstrate the value of using diffusion MRI tractography to help localize the ventral intermediate (Vim) nucleus of the thalamus (the treatment target). Tractography between the thalamus and hand-knob region of the motor cortex was consistent from subject-to-subject and followed the expected anatomy. The thalamic voxels with high tractography streamline counts qualitatively matched the location of Vim as depicted on the Schaltenbrand-Wahren Atlas. A trend was found towards better treatment outcome scores with higher pre-treatment probabilistic tractography streamline counts within the visualized MRgFUS treatment-induced lesion.

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