Operating rooms are aiming to change as Technion – the Israel Institute of Technology – has united with the leader in MR-guided focused ultrasound therapy, InSightec, to develop the first non-invasive outpatient procedure to replace traditional surgery.
InSightec has developed a breakthrough technology called ExAblate O.R. that allows for the treatment of human beings without invading the body. ExAblate is a new treatment modality that combines the non-invasive capabilities of focused ultrasound with the precision of Magnetic Resonance Imaging (MRgFUS) to ablate tissue deep in the body, for example uterine fibroids or bone metastases.
This MRgFUS technology is unique, requiring zero surgical intervention and is conducted under real-time monitoring and the control of treatment outcome. Whoever conducts the procedure may be therefore capable of changing treatment parameters on-the-fly rather than in retrospect, and may achieve the desired outcome instantaneously.
Barach Avruch (InSightec’s VP Operations) explains how the machine works: “The main part of the system is the transducer that transmits the ultrasound waves from the machine. This has thousands of elements in it and each one is electronically controlled by a complicated electronic system, together with mechanics and software that supports it. Each one of these elements is transmitting the ultrasound waves and focusing at the treatment point.” This means the technology allows for the treatment of almost any tumour in the body.
ExAblate’s application started with uterine fibroids, benign tumours that grow in the uterus. Approximately 25% of women of childbearing age experience uterine fibroids and may experience symptomatic effects. The usual treatment is a hysterectomy, where the patient may be hospitalised for three to five days and then sent home to recover for a number of weeks. With ExAblate, the patient may be able to return to their life, work and family immediately.
Following the treatment of uterine fibroids and the application of the technology to oncology and metastatic bone tumour is what InSightec calls the “holy grail” of the technology. This “holy grail” being brain treatments and the management of central nervous system conditions such as Parkinson’s and essential tremor. Kobi (Jackob) Vortman, President and Founder of InSightec, demonstrated the success of the procedure when he described seeing patients “that have for tens of years been challenged from these medical conditions leaving the table immediately post treatment without any tremor.”
Vortman also spent time advocating the progression of the technology and the prospects it holds. “We’ll definitely look at brain tumours as the next step, prostate cancer, liver tumours, breast cancer and so on,” he says. “Eventually we see it as the next generation operating room in the hospital.”
It appears that InSightec and Technion are moving in the right direction with ExAblate having been clinically proven on thousands of patients and in hundreds of peer-reviewed papers. The industry-transforming technology has also earned numerous awards and honours and as recently as yesterday, InSightec announced that its ExAblate system received approval of the Chinese Food and Drug Administration (CFDA) for non-invasive treatment of uterine fibroids.
Considering that the whole development stems from “lots of dreams” (as the creators put it) it is somewhat astonishing. As Vortman describes: “it’s a Star Trek system because the notion that you could place someone on a table and look at them using MRI and then three hours later this guy rides his bike back home is something that, at least in my generation, is still perceived as ‘guys send me a postcard when this will be ready, okay?’” In reality the system does exist and is in use today, and it look like it aims to move forward with Vortman naming strokes and targeted drug delivery as his next quest.
InSightec is essentially providing a non-invasive focused treatment requiring minimal hospitalization, preparation and after-care. MRgFUS therefore satisfies health economists and patients, whilst also providing consistent solutions to numerous medical challenges.
How may new treatments such as this one be developed further to benefit patients in the future?