RT Journal Article SR Electronic T1 Neuronavigation-Guided Focused Ultrasound-Induced Blood-Brain Barrier Opening: A Preliminary Study in Swine JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology DO 10.3174/ajnr.A3150 A1 K.-C. Wei A1 H.-C. Tsai A1 Y.-J. Lu A1 H.-W. Yang A1 M.-Y. Hua A1 M.-F. Wu A1 P.-Y. Chen A1 C.-Y. Huang A1 T.-C. Yen A1 H.-L. Liu YR 2012 UL http://www.ajnr.org/content/early/2012/06/21/ajnr.A3150.abstract AB BACKGROUND AND PURPOSE: FUS-induced BBB opening is a promising technique for noninvasive and local delivery of drugs into the brain. Here we propose the novel use of a neuronavigation system to guide the FUS-induced BBB opening procedure and investigate its feasibility in vivo in large animals. MATERIALS AND METHODS: We developed an interface between the neuronavigator and FUS to allow guidance of the focal energy produced by the FUS transducer. The system was tested in 29 swine by more than 40 sonication procedures and evaluated by MR imaging. Gd-DTPA concentration was quantitated in vivo by MR imaging R1 relaxometry and compared with ICP-OES assay. Brain histology after FUS exposure was investigated using H&E and TUNEL staining. RESULTS: Neuronavigation could successfully guide the focal beam, with precision comparable to neurosurgical stereotactic procedures (2.3 ± 0.9 mm). A FUS pressure of 0.43 MPa resulted in consistent BBB opening. Neuronavigation-guided BBB opening increased Gd-DTPA deposition by up to 1.83 mmol/L (a 140% increase). MR relaxometry demonstrated high correlation with ICP-OES measurements (r2 = 0.822), suggesting that Gd-DTPA deposition can be directly measured by imaging. CONCLUSIONS: Neuronavigation provides sufficient precision for guiding FUS to temporally and locally open the BBB. Gd-DTPA deposition in the brain can be quantified by MR relaxometry, providing a potential tool for the in vivo quantification of therapeutic agents in CNS disease treatment. Abbreviations CEcontrast-enhancedFUSfocused sonographyGd-DTPAgadolinium-diethylene-triamine pentaacetic acidICP-OESinductively coupled plasma optical emission spectroscopyMRgFUSMR-guided FUSSIsignal intensityTUNELterminal deoxynucleotidyl transferase biotin-dUTP nick end-labeling