Clinically Feasible Patient-Specific Targeting Method for Improved Quality-of-Life Outcomes from MRgFUS Treatment of Essential Tremor

MRI-guided focused-ultrasound (MRgFUS) is an FDA-approved treatment for essential tremor. Unfortunately, the target to be ablated cannot be directly visualized on standard imaging, and its location varies interindividually. Since suboptimal lesion location can lead to side effects that impair quality of life, a method that locates personalized ablative targets that correlate with better quality-of-life outcomes (and not just with tremor reduction) could provide significant benefit. We present a clinically-feasible patient-specific probabilistic-tractography-based method for personalized targeting of MRgFUS treatment and show that similarity between the target it generates and the ablated lesion predicts QoL outcome in a dataset of 36 patients.