Diagnostics & Devices:
Transcranial Focused Ultrasound: Next-Generation Image-Guided Therapy
Bhavya Shah, M.D.
- Associate Professor of Radiology at UT Southwestern Medical Center
- Neuroradiology Division. Associate Professor of Neurosurgery, the Advanced Imaging Research Center, and the Center for Alzheimer's and Neurodegenerative Diseases
- Director of the Transcranial-Focused Ultrasound Lab.
Focused ultrasound thalamotomy for tremor works best when the treatment hits the correct brain fiber bundle, but standard coordinate targeting can put nearby “do-not-hit” pathways at risk. PICASSO is a precision imaging software approach that identifies patient-specific tract anatomy and returns actionable targeting coordinates for therapy planning. It is built around four-tract targeting that focuses on both components of the dentato-rubro-thalamic tract while avoiding the corticospinal tract and medial lemniscus, which are linked to weakness and sensory side effects. PICASSO also incorporates a convolutional neural network that can generate tract maps directly on structural imaging, reducing dependence on time-consuming diffusion workflows. The result is a more standardized, faster, and potentially safer planning workflow that can be integrated into existing MRgHIFU targeting operations.
