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The role of focused ultrasound for pediatric brain tumors: current insights and future implications on treatment strategies

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Abstract

Introduction

Focused ultrasound (FUS) is an innovative and emerging technology for the treatment of adult and pediatric brain tumors and illustrates the intersection of various specialized fields, including neurosurgery, neuro-oncology, radiation oncology, and biomedical engineering.

Objective

The authors provide a comprehensive overview of the application and implications of FUS in treating pediatric brain tumors, with a special focus on pediatric low-grade gliomas (pLGGs) and the evolving landscape of this technology and its clinical utility.

Methods

The fundamental principles of FUS include its ability to induce thermal ablation or enhance drug delivery through transient blood-brain barrier (BBB) disruption, emphasizing the adaptability of high-intensity focused ultrasound (HIFU) and low-intensity focused ultrasound (LIFU) applications.

Results

Several ongoing clinical trials explore the potential of FUS in offering alternative therapeutic strategies for pathologies where conventional treatments fall short, specifically centrally-located benign CNS tumors and diffuse intrinsic pontine glioma (DIPG). A case illustration involving the use of HIFU for pilocytic astrocytoma is presented.

Conclusion

Discussions regarding future applications of FUS for the treatment of gliomas include improved drug delivery, immunomodulation, radiosensitization, and other technological advancements.

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Data availability

No datasets were generated or analyzed during the current study.

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Authors and Affiliations

  1. Department of Neurosurgery, Children’s National Hospital, Washington, DC, USA

    Kelsi M. Chesney, Gregory F. Keating, Nirali Patel, Daniel A. Donoho, Chima Oluigbo, John S. Myseros, Robert F. Keating & Hasan R. Syed

  2. Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC, USA

    Kelsi M. Chesney, Gregory F. Keating & Nirali Patel

  3. Brain Tumor Institute, Children’s National Hospital, Washington, DC, USA

    Lindsay Kilburn, Adriana Fonseca, Javad Nazarian & Roger J. Packer

  4. Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY, USA

    Cheng-Chia Wu

  5. Department of Neurosurgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA

    Daniel A. Donoho, Chima Oluigbo, John S. Myseros, Robert F. Keating & Hasan R. Syed

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  1. Kelsi M. Chesney
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  2. Gregory F. Keating
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Contributions

K.C., G.K, and H.R.S. wrote the main manuscript text and prepared Figs. 1, 2, 3, 4 and 6, 8. N.P. prepared Fig. 5. L.K., A.F., C.W., D.D., C.O., and J.M. reviewed the manuscript. R.P. and R.K. critically reviewed and edited the manuscript. H.R.S. contributed to the conceptualization and critically reviewed and edited the manuscript. All authors reviewed and approved the manuscript for submission.

Corresponding author

Correspondence to Hasan R. Syed.

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Chesney, K.M., Keating, G.F., Patel, N. et al. The role of focused ultrasound for pediatric brain tumors: current insights and future implications on treatment strategies. Childs Nerv Syst (2024). https://doi.org/10.1007/s00381-024-06413-9

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