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Focused ultrasound

Sunnybrook Health Sciences Centre is a Centre of Excellence in focused ultrasound (FUS). The Focused Ultrasound Foundation, the leading organization for research and advocacy in the field, announced the honour Nov. 17, 2016. Sunnybrook is the first centre in Canada to receive this honour.

The designation recognizes the pioneering work of our research and clinical teams, united under the scientific leadership of Dr. Kullervo Hynynen.

Researchers at Sunnybrook are making groundbreaking advances in FUS, from discovery research, to technology development, to clinical trials. One area in which we lead in particular is the brain, in which we have achieved notable firsts. Our neurosurgery expertise has positioned us at the forefront of clinical translation in FUS research, an effort that is intensifying under the clinical directorship of Dr. Nir Lipsman.

In 2012, Sunnybrook was the site of the first published study to use FUS to treat essential tremor, the most common movement disorder. We subsequently played a key role in the first international, randomized controlled trial for FUS in essential tremor. Results from that study led the U.S. Food and Drug Administration and Health Canada to grant regulatory approval to FUS as a treatment option for essential tremor.

In 2015, Sunnybrook researchers were the first in the world to use FUS to open the blood-brain barrier and deliver chemotherapy directly into the brain of a woman with brain cancer, completely noninvasively.

In 2016, they have set their sights on a new frontier: Alzheimer’s disease. Sunnybrook is the first centre in the world to obtain regulatory approval to use FUS to open the blood-brain barrier to treat this devastating disorder.

Other current clinical research projects in neurosciences include the first North American trials to harness FUS for neuromodulation therapy in treatment-refractory obsessive-compulsive disorder and major depression; and using FUS to deliver therapeutic proteins in Parkinson’s disease.

These historic milestones are paving the way for tackling some of the most difficult-to-treat diseases, including those with few or no treatment options. Our researchers are internationally recognized experts in medical biophysics, biology and the clinical sciences. Together, they are pioneering the development of focused ultrasound and its application not only to conditions affecting the brain, but also to diverse clinical domains, including urology, oncology, orthopedics and gynecology.

Timeline of milestones achieved by Sunnybrook researchers

Focused Ultrasound at Sunnybrook, timeline of events

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Timeline of milestones achieved by Sunnybrook researchers

1991:

  • Drs. Kullervo Hynynen and Arthur Guthkelch first to report treatment of brain tumours with focused ultrasound (FUS) in combination with radiation.

1992:

  • Hynynen first to combine FUS with MRI to guide and monitor treatment.

1995:

  • Hynynen and team first to show that FUS could be used selectively for controlled opening of the blood-brain barrier for therapeutic purposes.

1997:

  • Hynynen and Dr. Ferenc Jolesz first to use a large, phased-array applicator for through-skull focusing and ablation.

1999:

  • Hynynen spins off high-intensity FUS technology with GE Healthcare.
  • InSightec founded.

2001:

  • Hynynen and team first to show that FUS paired with microbubbles can locally, transiently and reversibly disrupt the blood-brain barrier under MRI guidance.

2010:

  • Hynynen and Dr. Isabelle Aubert first to show that antibodies delivered with MRI-guided FUS can reduce amyloid in mice with Alzheimer's disease.

2012:

  • Sunnybrook leads first trial in Canada using high-intensity FUS to treat essential tremor.
  • Centre for Research in Image- Guided Therapeutics opens.

2013:

  • Hynynen and Aubert first to show MRI-guided FUS, alone–with no therapeutics–reduces plaque in mice with Alzheimer’s disease.

2014:

  • Hynynen and Aubert first to show MRI-guided FUS alone increases neurogenesis and improves cognitive function in a mouse model of Alzheimer’s disease.
  • First pediatric patient in North America treated at Sunnybrook using our high-intensity FUS technology to destroy a painful bone tumour.

2015:

  • Sunnybrook team launches world’s first trial of MRI-guided FUS to treat head and neck cancer.
  • Sunnybrook team first to use FUS to open the blood-brain barrier successfully to deliver chemotherapy into the brain of a patient with brain cancer.

2016:

  • Health Canada and the U.S. Food and Drug Administration approve focused ultrasound brain surgery to treat essential tremor.
  • Sunnybrook is designated a Centre of Excellence in focused ultrasound.

2017:

  • Sunnybrook team leads world’s first trial using FUS to open the blood-brain barrier in people with Alzheimer’s disease.
  • Sunnybrook researchers launch first North American trial of FUS surgery in people with obsessive-compulsive disorder.

2018:

  • Sunnybrook team launches first North American trial of FUS surgery in people with treatment-resistant major depression.
  • Sunnybrook team completes world’s first clinical trial using FUS to open the blood-brain barrier of patients with Alzheimer’s disease noninvasively and repeatedly, showing it is safe and feasible.
  • Sunnybrook team launches world’s first clinical trial using FUS to open the blood-brain barrier of patients with amyotrophic lateral sclerosis.

2019:

  • Sunnybrook team completes world’s first clinical trial using FUS to open the blood-brain barrier of patients with brain cancer noninvasively, showing it is safe and feasible.
  • Sunnybrook team completes world’s first trial using FUS to open the blood-brain barrier of patients with amyotrophic lateral sclerosis noninvasively. Show that the technique can open the barrier in the motor cortex safely and reversibly.