ExAblate: The Convergence between Clinical Needs and Technology Breakthrough InSightec Fibroid uterine-fibroids Insightec mrgfus uterine fibroid hifu MR guided focused ultrasound, focused ultrasound mri healthcare medical surgical womens' health, High Intensity Focused Ultrasound, Magnetic Resonance Imaging Guided Focused Ultrasound

1. 1
– the Convergence between Clinical Needs and
Technology Breakthrough

2. 2
Convergence Between Needs and Technology Breakthrough
Technical R&D
Technical
specificationsUpdated / modified
Clinical needs
Clinical needs
Specifications
Scalability
&flexibility
The breakthrough zone
Clinical R&D

3. 3
Conformal Energy Delivery
Conformal ablation - energy deposition is
performed along the acoustic beam where energy
density is the highest, utilizing the very large axial
electronic steering of the ExAblate; benefiting from
heat conduction as well as the absorption along the
beam to obtain significant treatment rate
enhancement
Conformal 3D packing – the conformal sonications
are of variable sizes: 0.03cc to 5cc per sonication
and are adjusted automatically by the 3D planner
to span the target in a single sonication.
The system packs the conformal sonications in 3D
to fully ablate the tumor in the shortest possible
treatment time

4. 4
Cooling Time – Interleaved Sonications
Cooling between sonications to allow tissue in
the acoustic beam path to cool down to
baseline temperature can significantly impact
treatment time.
Minimizing cooling time could be achieved by
reducing the overlap of acoustic beams so the
tissue in the path zone doesn’t accumulate
heat.
Interleaved sonication mode- sonications jump
from one treatment area to another so while
one beam path is cooling, treatment takes
place in another place, eliminating need to
wait for spot cooling before treating

5. 5
Acoustic Beam Shaping
The human anatomy generates a
complex medium through which the
acoustic beam needs to propagate to
reach the target.
Some of the organs are sensitive to
acoustic radiation and/or block it (bone,
air etc). The ability to treat the complete
tumor requires the ability to shape the
beam to conform to the anatomy
avoiding sensitive zones and transmitting
through “anatomic windows”
Combining conformal sonications, beam shaping, 3D
planning and interleaving into an optimized treatment

50. 50
Scalability - Very High Density Acoustic Beam Forming
Fully utilizing the potential of ultrasonic ablation one
would like to get the highest flexibility from this
“thermal scalpel”.
Ability to place the focus in the widest possible
anatomical envelop without the need to reposition the
patient requires large electronic steering.
Overcome obstacles in the anatomy by accurately
shaping the beam to conform with “anatomic
apertures”
Minimizing energy dispersion into the body that is not
propagating towards the target (focus) as is the case
in the use of sparse array
Current ExAblate systems range between 200
elements to 1,000 elements. The next step of
abdominal systems will be in the range of couple of
thousand of elements requiring the development of
miniaturized beam formers.
2nd
, 3rd
and 4th
generation beam
formers
100 channels
100 channels
64 channels

51. Optimizing Acoustic Beam Forming to Address Multiple Indications
Bone Tumors
Liver Tumors
Prostate Cancer
Breast Cancer
Uterine Fibroids
Brain diseases
200elements 200to 1,000 elements 1,000elements
200elements
1,000elements 200to thousands elements

52. The Future of MRgFUS –
Area ratio is 2.5
Fabric Like Arrays with Very high element count
Fast Treatments (very low intensity in beam
path(,
Extensive abdominal coverage (very high number
of small elements, large electronic steering(

53. Future of MRgFUS - Treatment of Dynamic Organs in Freely Breathing Patients