Israeli Doctors Treat ET With MRI


Doctors at Haifa’s Rambam Medical Center are now among the first in the world to treat essential tremor (ET) using MRI-guided ultrasound rather than surgery, The Jerusalem Post reported.

A 73-year-old man, who was unable to sign his name clearly or even hold a cup of tea without spilling it, showed dramatic improvement after undergoing the painless procedure.

The results are achieved through “ablating” — the removal of tissue by vaporization — of a dysfunctional part of the brain. The therapy integrated MRI guidance and the heating of the tissue using focused ultrasound.

The first Israeli patient, a hardware store owner named Sami Zangi, who has suffered from ET for years, underwent the procedure for three hours while fully conscious in an MRI scanner.

Rambam senior neurologist Dr. Ilana Schlesinger, head of the movement disorders and Parkinson’s center, ran the MRI, while Prof. Menashe Zaaroor of the neurosurgery department used a computer mouse to direct 1,000 ultrasonic beams to the thalamic focal point that had been targeted for thermal ablation.

The treatment, known as ExAblate Neuro, was developed by InSightec at the Technion and at Sheba Medical Center at Tel Hashomer.

Rambam hopes to apply the technology to treatment of Parkinson’s patients in the near future.

However, there is no clear consensus yet within the medical profession on its efficacy.

Prof. Shlomo Constantini, a senior neurosurgeon who heads the pediatric neurosurgery unit at Dana Hospital of Tel Aviv Sourasky Medical Center, is one expert who expressed doubts. He told the Post that his own hospital had been trying it but was unsure as to its usefulness.

“It will take a long time, if ever, [before] the U.S. Food and Drug Administration approves it to ablate tumors or for use on children,” Constantini said. “[ExAblate Neuro] is a promising technology, but the future will determine whether conventional surgery or non-invasive ablation will be better. I can’t predict now, but I am rather skeptical that it will be widely used. Perhaps it will find a use in treating epilepsy.”