Minimally invasive intraventricular ultrasound: design and instrumentation towards a miniaturized ultrasound-guided focused ultrasound probe.

Neurosurgery typically requires craniectomy and meticulous dissection to achieve sufficient exposure for subsequent surgical intervention. This highly invasive process requires hours of operating time, long recovery periods and leaves patients with visible surgical scars. Non-invasive high-intensity focused ultrasound (HIFU) has shown some promise yet remains challenged by the attenuation of ultrasonic waves while passing through the skull. Consequently, the clinical impact of this technology remains limited, particularly in the treatment of neuro-oncology. In order to compensate for acoustic attenuation, excessive use of power for HIFU devices has been investigated, although it is undesirable from a regulatory and patient safety standpoint. Here, we report the design and development of a novel HIFU device prototype for neurologic lesion ablation. This device concept is envisioned to access the ventricular space via a minimally invasive ventriculostomy, allowing ultrasound to reach targets deep in the brain, while eliminating the need for high power to penetrate the skull.