Abstract #3781

White matter fibre tract changes in patients treated with MR imaging-guided focused ultrasound are associated with lesion location and clinical outcome

Christian Thaler^1,2, Qiyuan Tian^1,3, Max Wintermark¹, Pejman Ghanouni¹, Casey H. Halpern⁴, Jamie M. Henderson⁴, Raag D. Airan¹, Michael Zeineh¹, Kim Butts Pauly^1,3, and Jennifer A. McNab¹

¹Department of Radiology, Stanford University, Stanford, CA, United States, ²Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, ³Department of Electrical Engineering, Stanford University, Stanford, CA, United States, ⁴Department of Neurosurgery, Stanford University, Stanford, CA, United States

DTI is sensitive to tract-specific FA changes and thereby can be used to inform on therapeutic mechanisms and optimal targeting strategies for MRI-guided high intensity–focused ultrasound. Here, we used probablilistic tractography to investigate white matter fibre tract changes in essential tremor patients treated with MRIgHIFU. On the treated side, a significant decrease in FA was detected in the tracts projecting between the thalamus and motor cortex and between the dentate nucleus and the thalamus (i.e. the dentato-rubro-thalamic tract). These decreases in FA were correlated with the degree of tract-lesion overlap. Additionally, the post-treatment FA decrease in the tracts projecting between the thalamus and the motor cortex were positively correlated with clinical improvement. Interestingly, tract changes were also observed in the medial lemniscus of the contralesional side, possibly indicating global changes in brain connectivity.

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