7T MRI quantitative susceptibility mapping for magnetic resonance-guided focused ultrasound thalamotomy : methodology and anatomo-clinical correlations in a retrospective pilot study

Article Article scientifique Article 7T MRI quantitative susceptibility mapping for magnetic resonance-guided focused ultrasound thalamotomy : methodology and anatomo-clinical correlations in a retrospective pilot study eng 2025-11-21 2025-12-01 author Botta Daniele Division of Neuroradiology, Diagnostic Department, University Hospitals of Geneva, Geneva, Switzerland. 417457 author Ndengera Martin Division of Radiology, Diagnostic Department, University Hospitals of Geneva, Geneva, Switzerland.,Image Guided Interventions Laboratory (GR-949), Faculty of Medicine, University of Geneva, Geneva, Switzerland. 774001 author Momjian Shahan Marc Division of Neurosurgery, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland. 84022 Département des neurosciences cliniques (OTONO) author Velarde Masiel Department of Physics, The University of Texas at El Paso, El Paso, TX, USA. author Jorge João Swiss Center for Electronics and Microtechnology (CSEM), Bern, Switzerland. author Delattre Bénédicte Division of Radiology, Diagnostic Department, University Hospitals of Geneva, Geneva, Switzerland. 134269 author Guillemin Pauline Coralie 0000-0003-2792-6543 Image Guided Interventions Laboratory (GR-949), Faculty of Medicine, University of Geneva, Geneva, Switzerland. 877140 Département de radiologie et informatique médicale (RADIO) author Bratanov Christo Division of Neurology, Diagnostic Department, University Hospitals of Geneva, Geneva, Switzerland. 418663 author Lingenberg Alma 0009-0009-1790-5205 Division of Neurology, Diagnostic Department, University Hospitals of Geneva, Geneva, Switzerland. 780228 SYNAPSY Centre de recherche translationnelle en neurosciences psychiatriques (CTNP) (SYNAPM) author Constanthin Paul Division of Neurosurgery, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland. 670446 author Lorton Orane Division of Neurosurgery, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland. 855324 author Stadelmann Joël Division of Radiology, Diagnostic Department, University Hospitals of Geneva, Geneva, Switzerland. 431801 author Courvoisier Sébastien Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland. 629128 Centre d'imagerie bio-médicale (CIBM) author Lövblad Karl-Olof Division of Neuroradiology, Diagnostic Department, University Hospitals of Geneva, Geneva, Switzerland. 135154 Département de radiologie et informatique médicale (RADIO) author Schaller Karl Lothard Division of Neurosurgery, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland. 658606 Département des neurosciences cliniques (OTONO) author Gallay Marc Division of Neurosurgery, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.,Neurological and Neurosurgical Institute (SIFUS) AG, Ostermundigen, Switzerland.,Division of Neurosurgery and Neurology, University Hospital of Berne, Berne, Switzerland. 804194 author Kurz Félix Tobias 0000-0001-7616-7147 Division of Neuroradiology, Diagnostic Department, University Hospitals of Geneva, Geneva, Switzerland. 419472 author Fleury Vanessa Division of Neurology, Diagnostic Department, University Hospitals of Geneva, Geneva, Switzerland. 840771 Département des neurosciences cliniques (OTONO) author Salomir Rares Vincent Division of Radiology, Diagnostic Department, University Hospitals of Geneva, Geneva, Switzerland.,Image Guided Interventions Laboratory (GR-949), Faculty of Medicine, University of Geneva, Geneva, Switzerland. 682178 Département de radiologie et informatique médicale (RADIO) 12836-12849 10.21037/qims-2025-713 41367782 2223-4306 PMC12682564 https://qims.amegroups.com/article/view/144160/html Ventral intermediate nucleus (VIM) thalamotomy is an effective treatment for essential tremor (ET). It can be performed incisionlessly by transcranial magnetic resonance-guided focused ultrasound (MRgFUS), aiming for accurate targeting and thermal dose control. Conventional magnetic resonance imaging (MRI) sequences performed at 1.5T or 3T provide limited case-specific information on the topology of intra-thalamic sub-nuclei. Quantitative susceptibility mapping (QSM) MRI enhances the visualization of subcortical structures by leveraging the magnetic properties of tissues, typically the iron content and the myelin microstructure. QSM may help depict the high-intensity focused ultrasound (HIFU) lesion's position and extent relative to the thalamic sub-nuclei, and correlate this information with clinical outcomes. To the best of our knowledge, this study addresses for the first time the integration of 7T MRI QSM into the clinical workflow of MRgFUS VIM thalamotomy. We retrospectively analyzed the radiological and clinical data of five patients undergoing routine MRgFUS VIM thalamotomy. A pre-operative multi-echo gradient-echo sequence was acquired at 7T MRI at 0.6 mm isotropic resolution. These data were processed to generate QSM images, which were combined with a paired T1-weighted (T1w) magnetization prepared rapid gradient echo (MPRAGE) dark-cerebrospinal fluid (CSF) sequence acquired both pre- and 6-week post-operatively. The MPRAGE data ensured the preservation of key anatomical references for indirect MRgFUS targeting, such as the commissures and ventricular wall. It also enabled sharp delineation of the ablative lesions, which were retro-projected "back-in-time" onto the paired pre-operative QSM. In this preliminary report, the enhanced intra-thalamic contrast provided by 7T MRI QSM supported a comprehensive correlation between the neuroradiological findings and the clinical outcomes, advocating for the interest in integrating 7T QSM MRI into the clinical workflow of MRgFUS VIM thalamotomy. 7T magnetic resonance imaging (7T MRI) Quantitative susceptibility mapping (QSM) Functional neurosurgery High-intensity focused ultrasound (HIFU) Ventral intermediate nucleus (VIM) Dewey 616.8 Dewey 616.0757 61 Département des neurosciences cliniques 226 62 Département de radiologie et informatique médicale 227 false 926 Imagerie per-opératoire multi-modalité en radiologie interventionnelle 949 513 Groupe Schaller Karl Lothard (neurochirurgie) 851 470 Ischémie cérébrale et connectivité 801 1470 Laboratoire de neuroimagerie quantitative et computationnelle 1078 Quantitative imaging in medicine and surgery 15 12 3c0f9972-5ea7-4f08-bd77-c7b827fbcd89 Article (Published version) Public Botta_2025_published.pdf 6719292 application/pdf CC BY-NC-ND-4.0 c6047e5a7bb299092e5ab9ba46fb07e0ad6c88cf8aa15dcc880ad3379849a327 openAccess Faculté de médecine / Section de médecine clinique / Département des neurosciences cliniques Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale

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7T MRI quantitative susceptibility mapping for magnetic resonance-guided focused ultrasound thalamotomy : methodology and anatomo-clinical correlations in a retrospective pilot study	Quantitative imaging in medicine and surgery			2025	22	21

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Stadelmann, Joël