Focused ultrasound in pediatric neurosurgery: a scoping review of opportunities and challenges

Authors

Andrew M. Hersh, Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Ritvik Jillala, Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Patrick Kramer, Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Robert F. Keating, Department of Neurosurgery, Children's National Hospital, Washington, DC, USA.
Hasan R. Syed, Department of Neurosurgery, Children's National Hospital, Washington, DC, USA.
Chima O. Oluigbo, Department of Neurosurgery, Children's National Hospital, Washington, DC, USA.
Mari L. Groves, Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Amir Manbachi, Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Nicholas Theodore, Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Graeme F. Woodworth, Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA.
Evan Cantor, Division of Hematology and Oncology, Connecticut Children's, Hartford, CT, USA.
Patrick B. Senatus, Department of Neurosurgery, Hartford Hospital, Hartford, CT, USA.
David S. Hersh, Division of Neurosurgery, Connecticut Children's, Hartford, CT, USA. dhersh@connecticutchildrens.org.

Document Type

Journal Article

Publication Date

6-11-2025

Journal

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

Volume

41

Issue

1

DOI

10.1007/s00381-025-06863-9

Keywords

Brain; DMG; Focused ultrasound; Neurosurgery; Pediatrics; Tumor

Abstract

BACKGROUND: Transcranial focused ultrasound (FUS) non-invasively transmits acoustic energy across the skull, resulting in biological effects. Although early studies focused on adult movement disorders, transcranial FUS is now being explored for pediatric patients as well. Here, we review the emerging applications of transcranial FUS in pediatric neurosurgery and explore the unique considerations for this patient population. METHODS: A scoping review was conducted using PRISMA-ScR guidelines. RESULTS: A total of 20 studies were included. Six clinical investigations reported the outcomes of 22 individual patients, ten of whom underwent thermal ablation of brain tumors or lesions. Eleven patients underwent sonodynamic therapy of brainstem tumors without adverse effects, and one patient underwent blood-brain barrier (BBB) opening prior to the infusion of doxorubicin. Preclinical studies further explored the use of low-intensity FUS to transiently disrupt the BBB and improve the delivery of therapeutic agents to diffuse midline gliomas or medulloblastomas. CONCLUSIONS: This review highlights the growing interest in expanding transcranial FUS to pediatric neurosurgical patients. In parallel to ongoing work in the adult neurosurgical community, pediatric neurosurgical applications of this novel technology will continue to expand, but will require conscious and intentional efforts to optimize its use given the unique features of the pediatric population.

APA Citation

Hersh, Andrew M.; Jillala, Ritvik; Kramer, Patrick; Keating, Robert F.; Syed, Hasan R.; Oluigbo, Chima O.; Groves, Mari L.; Manbachi, Amir; Theodore, Nicholas; Woodworth, Graeme F.; Cantor, Evan; Senatus, Patrick B.; and Hersh, David S., "Focused ultrasound in pediatric neurosurgery: a scoping review of opportunities and challenges" (2025). GW Authored Works. Paper 7427.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/7427

Department

Neurological Surgery