Magnetic resonance-guided focused ultrasound for essential tremor:a prospective,single center,single-arm study

The safety and effectiveness of magnetic resonance-guided focused ultrasound thalamotomy has been broadly established and validated for the treatment of essential tremor.In 2018,the first magnetic resonance-guided focused ultrasound system in Chinese mainland was installed at the First Medical Center of the PLA General Hospital.This prospective,single center,open-label,single-arm study was part of a worldwide prospective multicenter clinical trial(ClinicalTrials.gov Identifier:NCT03253991)conducted to confirm the safety and efficacy of magnetic resonance-guided focused ultrasound for treating essential tremor in the local population.From 2019 to 2020,10 patients with medication refractory essential tremor were recruited into this open-label,single arm study.The treatment efficacy was determined using the Clinical Rating Scale for Tremor.Safety was evaluated according to the incidence and severity of adverse events.All of the subjects underwent a unilateral thalamotomy targeting the ventral intermediate nucleus.At the baseline assessment,the estimated marginal mean of the Clinical Rating Scale for Tremor total score was 58.3±3.6,and this improved after treatment to 23.1±6.4 at a 12-month follow-up assessment.A total of 50 adverse events were recorded,and 2 were defined as serious.The most common intraoperative adverse events were nausea and headache.The most frequent postoperative adverse events were paresthesia and equilibrium disorder.Most of the adverse events were mild and usually disappeared within a few days.Our findings suggest that magnetic resonance-guided focused ultrasound for the treatment of essential tremor is effective,with a good safety profile,for patients in Chinese mainland.

Neurosurgical and pharmacological management of dystonia

Dystonia characterizes a group of neurological movement disorders characterized by abnormal muscle movements,often with repetitive or sustained contraction resulting in abnormal posturing.Different types of dystonia present based on the affected body regions and play a prominent role in determining the potential efficacy of a given intervention.For most patients afflicted with these disorders,an exact cause is rarely identified,so treatment mainly focuses on symptomatic alleviation.Pharmacological agents,such as oral anticholinergic administration and botulinum toxin injection,play a major role in the initial treatment of patients.In more severe and/or refractory cases,focal areas for neurosurgical intervention are identified and targeted to improve quality of life.Deep brain stimulation(DBS)targets these anatomical locations to minimize dystonia symptoms.Surgical ablation procedures and peripheral denervation surgeries also offer potential treatment to patients who do not respond to DBS.These management options grant providers and patients the ability to weigh the benefits and risks for each individual patient profile.This review article explores these pharmacological and neurosurgical management modalities for dystonia,providing a comprehensive assessment of each of their benefits and shortcomings.

Creation of High Energy/Intensity Bremsstrahlung by a Multi-Target and Focusing of the Scattered Electrons by Small-Angle Backscatter at a Cone Wall and a Magnetic Field—Enhancement of the Outcome of Linear Accelerators in Radiotherapy

The yield of bremsstrahlung (BS) from collisions of fast electrons (energy at least 6 MeV) with a Tungsten target can be significantly improved by exploitation of Tungsten wall scatter in a multi-layered target. A simplified version of a previously developed principle is also able to focus on small angle scattered electrons by a Tungsten wall. It is necessary that the thickness of each Tungsten layer does not exceed 0.04 mm—a thickness of 0.03 mm is suitable for accelerators in medical physics. Further focusing of electrons results from suitable magnetic fields with field strength between 0.5 Tesla and 1.2 Tesla (if the cone with multi-layered targets is rather narrow). Linear accelerators in radiation therapy only need to be focused by wall scatter without further magnetic fields (a standard case: 31 plates with 0.03 mm thickness and 1 mm distance between the plates). We considered three cases with importance in medical physics: A very small cone with an additional magnetic field for focusing (the field diameter at 90 cm depth: 6 cm), a medium cone with an optional magnetic field (field diameter at 90 cm depth: 13 cm) and a broad cone without a magnetic field (the field diameter at 90 cm depth: 30 cm). All these cases can be positioned in a carousel. Measurements have been performed in the existing carousel positioned in the plane of the flattening filter and scatter foils for electrons.

An Innovative Scientific Theory to Create a “New Engine for Compressing and Transporting Matter and Creating an Independent Ultra-Gravitational Magnetic Field” for Flight on Earth and Space

This research proposes a new theory in the field of physics and space technology, based on several scientific hypotheses and conclusions, as it plans to manufacture a “new magnetic focus” by means of high-speed centrifugal engines, by equipping a group of them, and installing heavy, dense fans, not for the purpose of air pressure, Rather, it works to rotate at a speed of up to 1000 kilometers per hour at an angle of 45 degrees, and is lined up in front of each other in a circle, so that the final result is to transfer the effort and weight of the propellers to an upper point in their midst, and this point will reach a large degree of density, size and mass, causing the generation of a point independent magnetic attraction, which pulls the motors upward, as a result of the mutual gravitational effect created by the motors. These hypotheses need a large number of experiments, applications, and analyze the use of specialists in physics, technology, technology, engine engineers, and others, and the correct results will cause a major revolution in the field of space technology, and this theory will be relied upon in many means of land, air, and space transportation and different fields.

RECENT PROGRESS IN MULTI-BEAM KLYSTRON IN IECAS

Recent research progresses in Multi-Beam Klystron (MBK) in IECAS are briefly introduced in the letter. The S-band MBKs of IECAS have peak power of 120-250 kW, average power of 4-9 kW, efficiency of 35-45%, gain of 41-46 dB, beam voltage of 15-19 kV, and weight of 40-45 kg. Some key technical problems of MBK are also described and discussed. Among them,improving the design of MBK to obtain the required bandwidth, raising beam transmission to increase average power, eliminating oscillation and spray spectrum, overcoming window breakdown caused by magic mode, reducing breakdown times of electrongun, are most important things for the practical MBK. Besides, further research work in MBK in IECAS is commented.

Magnetic focusing of cold atomic beam with a 2D array of current-carrying wires

A new scheme to realize a two-dimensional （2D） array of magnetic micro-lenses for a cold atomic beam. formed by an array of square current-carrying wires, is proposed. We calculate the spatial distributions of the magnetic fields from the array of current-carrying wires and the magnetic focusing potential for cold rubidium atoms, and study the dynamic focusing processes of cold atoms passing through the mag- netic micro-lens array and its focusing properties by using Monte-Carlo simulations and trajectory tracing method. The result shows that the proposed micro-lens array can be used to focus effectively a cold atomic beam, even to load ultracold atoms or a BEC sample into a 2D optical lattice formed by blue detuned hollow beams.

Progress of research in the application of ultrasound technology for the treatment of Alzheimer’s disease

Alzheimer’s disease is a common neurodegenerative disorder defined by decreased reasoning abilities,memory loss,and cognitive deterioration.The presence of the blood-brain barrier presents a major obstacle to the development of effective drug therapies for Alzheimer’s disease.The use of ultrasound as a novel physical modulation approach has garnered widespread attention in recent years.As a safe and feasible therapeutic and drug-delivery method,ultrasound has shown promise in improving cognitive deficits.This article provides a summary of the application of ultrasound technology for treating Alzheimer’s disease over the past 5 years,including standalone ultrasound treatment,ultrasound combined with microbubbles or drug therapy,and magnetic resonance imaging-guided focused ultrasound therapy.Emphasis is placed on the benefits of introducing these treatment methods and their potential mechanisms.We found that several ultrasound methods can open the blood-brain barrier and effectively alleviate amyloid-βplaque deposition.We believe that ultrasound is an effective therapy for Alzheimer’s disease,and this review provides a theoretical basis for future ultrasound treatment methods.

Temperature stability of magnetic field for periodic permanent-magnet focusing system

In this study, finite element analysis based on an Ansoft Maxwell software was used to reveal the temperature stability of a magnet ring and the equivalent structural periodic permanent-magnet（PPM） focusing system. It is found that with the temperature increasing, the decrease rate of magnetic induction peak（Bz）maxof single magnet ring is greater than that of remanence Brof magnet in the range from room temperature to 200 °C, however,the PPM focusing system do have the same temperature characteristics of permanent-magnet materials. It indicates that the magnetic temperature properties of the PPM system can be effectively controlled by adjusting the temperature properties of the magnets. Moreover, the higher permeability of the magnets indicates the less Hcb, giving rise to lower magnetic induction peak （Bz）′max： Finally, it should be noted that the magnetic orientation deviation angle θ（／15°） of permanent magnets has little effect on the focusing magnetic field of the PPM system at different temperatures and the temperature stability. The obtained results are beneficial to the design and selection of permanent magnets for PPM focusing system.

Current applications for magnetic resonance-guided focused ultrasound in the treatment of Parkinson’s disease

Magnetic resonance-guided focused ultrasound(MRgFUS)is a novel and minimally invasive technology.Since the US Food and Drug Administration approved unilateral ventral intermediate nucleus-MRgFUS for medication-refractory essential tremor in 2016,studies on new indications,such as Parkinson’s disease(PD),psychiatric diseases,and brain tumors,have been on the rise,and MRgFUS has become a promising method to treat such neurological diseases.Currently,as the second most common degenerative disease,PD is a research hotspot in the field of MRgFUS.The actions of MRgFUS on the brain range from thermoablation,blood-brain barrier(BBB)opening,to neuromodulation.Intensity is a key determinant of ultrasound actions.Generally,high intensity can be used to precisely thermoablate brain targets,whereas low intensity can be used as molecular therapies to modulate neuronal activity and open the BBB in conjunction with injected microbubbles.Here,we aimed to summarize advances in the application of MRgFUS for the treatment of PD,with a focus on thermal ablation,BBB opening,and neuromodulation,in the hope of informing clinicians of current applications.

Universal Software Architecture of Magnetic Resonance-Guided Focused Ultrasound Surgery System and Experimental Study

Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is an emerging, non-invasive hyperthermia technology which can be used for the treatment of benign and malignant tumours, in conjunction with intracranial neurological diseases. To treat different indications, it is often necessary to design special focused ultrasound devices and treatment plans, which poses great challenges and results in substantial costs during software development. This article introduces a general software architecture that can be applied to three different focused ultrasound devices for the treatment of uterine fibroids, breast fibroids, and pain palliation of bone metastases, respectively, and can be integrated with GE Discovery or Signa MRI scanners and Xingaoyi BroadScan MRI scanners. Finally, the proposed software architecture was shown to possess desirable universality and safety through various tests and animal experimental studies.

Evaluation Value of Intravoxel Incoherent Motion Diffusion-Weighted Imaging on Early Efficacy of Magnetic Resonance-Guided High-Intensity Focused Ultrasound Ablation for Uterine Adenomyoma

To investigate the evaluation value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)on the early efficacy of magnetic resonance-guided high-intensity focused ultrasound(MRgFUS)ablation for uterine adenomyoma.The clinical and magnetic resonance imaging(MRI)data of 36 patients with uterine adenomyoma before and after MRgFUS treatment in our hospital from January 2018 to December 2018 were retrospectively analyzed.All the 36 patients underwent MRI examination one day before operation and immediately after operation using GE Discovery MR7503.0T MRI,including conventional sequences(T1WI,T2WI,and T2 fat suppression sequences)plain scan,IVIM-DWI sequences with 9 b values,and contrast enhanced-MRI sequences.The IVIM-DWI quantitative parameters(true diffusion coefficient D,perfusion related diffusion coefficient D*,and perfusion fraction f)of double-exponential model were obtained by using GE ADW 4.7 functool,a postprocessor.SPSS 24.0 software was used to analyze the difference in parameter between the ablation and non-ablation areas of uterine adenomyoma.DWI signal in the ablation area of uterine adenomyoma was increased,and manifested as heterogeneous diffuse high signal,with low central signal and high edge signal.Values of D,D*and f in the ablation area of uterine adenomyoma were significantly lower than those in the non-ablation area,and there was statistical difference between the two(P<0.05).The areas under receiver operating characteristic(ROC)curve of D,D*and f values in the ablation area of uterine adenomyoma were 0.854,0.898 and 0.924,respectively;the optimal thresholds for the diagnosis of ablation area of uterine adenomyoma were 0.81×10−3 mm2/s,4.99×10−3 mm2/s and 0.24,respectively;the diagnostic sensitivity was 80.6%,72.2%and 94.4%,respectively;and the specificity was 91.7%,97.2%and 94.4%,respectively.IVIM-DWI has a certain clinical value in the evaluation on early efficacy of MRgFUS ablation of uterine adenomyosis.

Design and implement of the signal generator in the magnetic focused conductivity tomography system

To improve stability and performance of the signal source and sweeping detection,as well as to extract abundant and reliable signal,the direct digital synthesis technology was employed to design the generator of the source which formed sweeping frequencies of sine wave output from 1 to 20 MHz.The planar spiral coil was con-nected as an amplitude modulation circuit.The same coil adopted differential architecture for signal detection and extraction.The MC1595 was utilized to compose a phase detector in which difference of phases varies with the change of frequencies.A low pass filter was designed to filter the carry waves of the sweeping source.Thereby the system gained abundant data and its stability was improved.Further,the spatial resolution of the system was enhanced.All of the above favors the use of software in the magnetic focused conductivity tomography system(MFCT)to reconstruct the image of conductivity within the human body.