This unique volume is a comprehensive, well-illustrated study of the organization of the white matter pathways of the brain. Schmahmann and Pandya have analyzed and synthesized the corticocortical and corticosubcortical connections of the major areas of the cerebral cortex of the rhesus monkey. The result is a detailed understanding of the constituents of the cerebral white matter and the organization of the fiber tracts. The findings from the 36 cases studied are presented on a single template brain, facilitating comparison of the locations of the different fiber pathways. The summary diagrams provide a comprehensive atlas of the cerebral white matter. The text is enriched by close attention to functional aspects of the anatomical observations. The clinical relevance of the pathways is addressed throughout the text and a chapter is devoted to human white matter diseases. The introductory account gives a detailed historical background. Translations of seminal original observations by early investigators are presented, and when these are considered in the light of the authors' new observations, many longstanding conflicts and debates are resolved. This scholarly book is an important addition to systems and cognitive neuroscience that will be of lasting value to neurobiologists, anatomists, neurologists, neurosurgeons, neuroradiologists, psychiatrists, psychologists, and to their students and trainees.

Fiber Pathways of the Brain

An ablation electrode carries a temperature sensing element for measuring the temperature of the tissue being ablated. A thermal insulating element associated with the sensing element blocks the transfer of heat energy from between the temperature sensing element and the body. The temperature sensing element therefore measures temperature without being affected by the surrounding thermal mass of the electrode.

Electrode and associated systems using thermally insulated temperature sensing elements

An endometrial ablation method comprising passing sufficient RF current having a frequency of from 250 kHz to about 100 MHz through substantially the entire surface of the endometrium to heat the endometrium, in a single operation, to a temperature within the range of from 45 °C to 90 °C and preferably not above 70 °C for a time sufficient to destroy the cells of the lining while maintaining the average temperature of the myometrium at a temperature below 42 °C. The apparatus comprises an electroconductive expandable member such as a balloon (14) for extending the organ and effecting electrical contact with the endometrial lining to be destroyed. The balloon is connected to power source (30) adapted to provide radiofrequency electric power having the desired characteristics to selectively heat the endometrial lining to the desired temperature. The balloon (14) can be an electroconductive elastomer such as a mixture of a polymeric elastomer and electroconductive particles. Alternatively, it can be a non-extensible bladder having a shape and size, which will extend the organ and effecting contact with the endometrial lining to be destroyed.

Endometrial ablation apparatus and method

A device and method for ablating tissue is disclosed comprising the steps of acquiring an anatomical image of a patient, correlating the image to the patient, guiding an ablating member within the patient while tracking the position of the ablating member in the patient, positioning the ablating member in a desired position to ablate tissue, emitting ablating energy from the ablating member to form an ablated tissue area and removing the ablating member from the patient.

Methods of using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions

Antibody-based anticancer agents are promising chemotherapeutic agents. Among these agents, Herceptin (trastuzumab), a humanized anti-human epidermal growth factor receptor 2 (HER2/c-erbB2) monoclonal antibody, has been used successfully in patients with breast cancer. However, in patients with brain metastasis, the blood–brain barrier limits its use, and a different delivery method is needed to treat these patients. Here, we report that Herceptin can be delivered locally and noninvasively into the mouse central nervous system through the blood–brain barrier under image guidance by using an MRI-guided focused ultrasound blood–brain barrier disruption technique. The amount of Herceptin delivered to the target tissue was correlated with the extent of the MRI-monitored barrier opening, making it possible to estimate indirectly the amount of Herceptin delivered. Histological changes attributable to this procedure were minimal. This method may represent a powerful technique for the delivery of macromolecular agents such as antibodies to treat patients with diseases of the central nervous system.

https://www.pnas.org/content/pnas/103/31/11719.full.pdf

Noninvasive localized delivery of Herceptin to the mouse brain by MRI-guided focused ultrasound-induced blood-brain barrier disruption.

An ultrasound hyperthermia applicator suitable for medical hyperthermia treatment, and method for using the same, includes two ultrasound sources (14, 16) producing focused ultrasound beams of frequencies f0 and f1. Aiming means direct the two ultrasound beams (20, 22) so that they cross each other confocally at the target. A controller (11) activates the two ultrasound sources so that the target is simultaneously irradiated by the two focused ultrasound beams. The two ultrasound sources provide acoustic energy sufficient to cause significant intermodulation products to be produced at the target due to the interaction of the two ultrasound beams. The intermodulation products are absorbed by the target to enhance heating of the target. In preferred embodiments the ultrasound sources include a pair of signal generators (34, 36) for producing gated ultrasound output signals driving single crystal ultrasound transducers (14, 16). In other embodiments the ultrasound sources include a pair of phased array ultrasound transducers for generating two steerable ultrasound beams. Aiming means are provided for electronically steering and focusing the two ultrasound beams so that they cross each other confocally at the target. Further embodiments employ pluralities of transducers, arrays, or both.

Apparatus and method for acoustic heat generation and hyperthermia

A system for delivering ultrasound hyperthermic therapy to a subject includes a plurality of piezoelectric ultrasound transducer elements arranged in a two-dimensional array to provide multiple sources of ultrasonic energy, and variable activation elements for activating the transducer elements individually and at variable electrical energy levels. A plurality of lens elements is provided for transmitting the multiple sources of ultrasonic energy to the subject, in conjunction with focusing elements which individually vary the attitude of the lens elements to change the focal regions of the individual lenses. The transducer elements and lens elements can be corresponding "pie-slice" sectors arranged in a circular array, in combination with a central circular transducer and lens.

Diffuse focus ultrasound hyperthermia system

A therapeutic ultrasound hyperthermia system utilizes a phased array of ultrasound transducer elements. By varying the phase delays in the excitation of individual transducer elements, the focal depth of the ultrasonic beam can be varied, without changing the distance between the transducer and the patient. The phased array of transducer elements can be an array of rectangular elements which are rotated about an axis to deliver ultrasound to the target region while minimizing overall heating effect in the treatment areas outside the target region.

Electronically-controlled variable focus ultrasound hyperthermia system

Methods and devices for characterizing tissues and the like utilize signals obtained from ultrasonic backscatter processes. The method accounts for frequency-dependent attenuation, spatially-varying media statistics, arbitrary beam geometries, and arbitrary pulse shapes. Statistical analysis is employed to estimate the scatterer number density (SND) of tissues. The method for estimating the scatterer number density incorporates measurements of both the statistical moments of the backscattered signals and the point spread function of the acoustic system.

Ultrasonic tissue characterization

A therapeutic hyperthermia system generates a line-focus beam of ultrasound which can be mechanically scanned across a treatment volume of tissue. The ultilization of a line-focus advantageously reduces the peak intensity of the ultrasonic beam. The system includes methods of scanning the line-focus beam to provide optimal treatment protocols for deep tumors and other pathological conditions while minimizing damage in overlying body tissues. The utilization of mechanical scanning reduces the number of transducers, amplifiers and associated electronics required.

Mechanically scanned line-focus ultrasound hyperthermia system

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