Practical tips for MRGFUS treatment (Online Book)


How to perform MRGFUS with remote supervision?

Hello, my name is Rezida.

I am a neurosurgeon and the director of Intelligent Neurosurgery clinic in Russia. We are the first clinic in our country adopting focused ultrasound neurosurgical treatment to help patients with movement disorders.

How we started the first in our country MRGFUS treatment center, despite COVID travel limitations?

We were ready to start on March 2020, but suddenly COVID-19 epidemic blocked everything globally, and Insightec company specialists could not come and start the project with us.

So the decision to treat the first patient remotely with the help of modern digital technology came spontaneously during the studying process with our clinic specialists and Insightec company specialists.

Our control room cameras

To organize the first remote treatment, we performed several new technological applications in our medical center. First, we applied secured access to every piece of equipment, remote desktop sharing, and port address translation, which allowed us to use the working station for all participants. And we installed 4 cameras in MRI room and in our control room to connect. We used Microsoft Teams software as an online communication tool. We could create supportive collaboration for both teams to work as one team.

Our control room camera number 3.

Remote telemedical proctorship is a solution.

We performed the first in the world remote treatment on May fifth 2020. We treated a sixty-eight-year-old patient with a drug-resistant tremor-dominant form of Parkinson’s disease with proctors who were online remotely.

The patient had suffered his symptoms for around four years. His skull score was forty-five, and his UPDRS-III was 46.

We used a GE MRI machine and Exablate 4000. The target we used was the left VIM nucleus. And we performed twelve total sonications, six of which were therapeutic.

The duration of the treatment was quite long, but it was our first experience. And it was more than two hours. But we got a good-looking lesion. Its size was five to five millimeters, and the patient had excellent clinical results in 2 years of follow-ups.

Here you can see the results of our patients before treatment and after the treatment.

And he showed significant improvement in his postural and rested tremors in his treated right hand.

It is possible to perform MRGFUS with remote supervision

Our experience shows that centers can perform such a complicated neurosurgical procedure remotely. If you thoroughly prepare the scores, your people are ready to work as one team. They’re prepared to show great support and help in every treatment step from the beginning.

This case was presented at 7th International Symposium on Focused ultrasound
Read more: what kind of neurologist you need in the operating room and how to deal with him

Rezida Galimova

The director of the first in Russia MRGFUS neurosurgery centre. Neurosurgeon. PhD. LSS black belt. The first woman MRgFUS neurosurgeon.

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