Endocrine Abstracts

JOINT1342

The invention relates to medicine, namely to endocrinology and neurosurgery, and can be used to treat patients with altered ultrasound conductivity of bone tissue who are planned to be treated with magnetic resonance imaging-guided focused ultrasound (MR-FUS) The MR-FUS method is most often used to treat movement disorders such as Parkinson’s disease, dystonia, and essential tremor. The method is based on two technologies – high-intensity focused ultrasound (HIFU) and MRI. Using heating or cavitation at a variable distance from the sensor, HIFU can cause selective thermal coagulation in a clearly defined volume. The error in the destruction of brain tissue with this method is extremely small and averages 0.50–0.75 mm, varying depending on the technical characteristics of the selected equipment. The arsenal of solutions to the problem associated with low CUPT is very limited, which in turn leads to numerous refusals to perform operations using focused ultrasound. The objective of the invention is to develop a method for increasing the ultrasound conductivity of the bone tissue of the skull for further surgical interventions in patients using MR-FUS in a short time and with a safer method. The technical result of using the invention is a significant increase in the skull UCCT in patients with an initial UCCT of less than 0.35, achieving the threshold value necessary for thalamotomy with MR-FUS. The proposed method for increasing the ultrasound conductivity of the cranial bone tissue is carried out as follows. The patient for whom MR-FUS is planned undergoes CT of the cranial bones to determine the UPCCT, as well as laboratory tests for ionized calcium and vitamin D. If the coefficient is less than 0.35, the patient is administered Bonviva (Ibandronic acid) 3 mg intravenously by bolus over 15-30 seconds once every 3 months, Aquadetrim (Cholecalciferol) at a dose of 1500-5500 IU per day and Calcium D3 Nycomed (Calcium carbonate + Cholecalciferol) at a dose of 500 mg + 200 IU 2 times a day. The course of treatment is 3-6 months. After 3 months, the patient undergoes a repeat CT of the cranial bones on the same device and with the same program to assess the ultrasound conductivity coefficient of bone tissue, and laboratory tests for vitamin D and ionized calcium. If the cranial CUPCT increases by more than 0.35, the patient is referred for surgery using focused ultrasound. If there is no effect after 3 months.