A new era of non-invasive intracranial surgery

Since I joined the postdoctoral fellow at the Shenzhen Hospital of the University of Hong Kong, I haven’t published public articles and video accounts very often. The main reason is because my work focus has shifted to scientific research. The things I think about every day are a little different from the science of disease, and it is difficult to multitask with limited energy. Compared with clinical diseases, the content of scientific research work will be farther away from you and more inconclusive, so I don’t plan to mention it here.

However, a brand new clinical work that I have recently started makes me want to share it with you. Recently, at the Shenzhen Hospital of the University of Hong Kong, the team led by my teacher, Professor Li Yongjie, completed the first clinical application in China to treat essential tremor by “magnetic resonance guided transcranial focused ultrasound (also known as magnetic knife)” .

The reason why this technology makes me so emotional is because it breaks a lot of knowledge about neurosurgery. A “noninvasive” “intracranial surgery“, these two words are like a pair of antonyms and generally impossible to put together (and the gamma knife, here not detailed comparison).

Able to damage specific locations within the skull (like a scalpel) without craniotomy, without trauma to the head, and without other damage (such as ionizing radiation) . This is undoubtedly a new era of non-invasive surgery in neurosurgery.

Sounds amazing, but it’s done using common ultrasound. Ultrasound is a kind of mechanical wave, and its essence is the transmission of energy. Many people know that through a magnifying glass, light can be focused on a focal point and the paper can be ignited, which is to focus the energy of the light. When the ultrasound is controlled with sufficient precision, it can be operated at specific locations, such as heat damage, drug delivery, etc.

Applications of focused ultrasound in the brain: from thermoablation to drug delivery. Nat Rev Neurol, 2021. 17(1): p. 7-22.

It’s an understatement, but it’s very difficult to achieve, especially with intracranial surgery through the skull, and I’ll have a chance to go into more detail about how this technique works. The reason why it is called a magnetic wave knife, “magnetic” represents another key point of this technology, “magnetic resonance”, which can see the operation of ultrasound as accurately as the eye.

This technology began clinical research more than ten years ago abroad. In 2016, the US FDA confirmed the approval for intracranial treatment, and in 2021, the domestic NMPA also approved it. In 2022, under the leadership of Professor Li Yongjie, the first clinical service treatment in China finally began. Now domestic patients can also enjoy the benefits of this non-invasive technology. The first benefit is essential tremor and tremor patients with Parkinson’s disease.

In short, this is a short article with personal feelings. I will introduce this new technology and the diseases it is suitable for in the future.