What is MR Guided Focused Ultrasound?

MR Guided Focused Ultrasound (or MRgFUS for short) is an incisionless surgical procedure which is used in Queen Square to treat Essential Tremor.  The aim of treatment is to produce a significant and durable improvement in upper limb tremor on side of the body, in a single treatment visit.  The treatment does not require a general anaesthetic or hospital admission and is usually performed as an outpatient procedure.

How can I be assessed for Focused Ultrasound Treatment?

Patients who are interested in MRgFUS treatment are assessed in Queen Square using a combination of specialist consultations and diagnostic tests.  The aim of these assessments is to ensure that there is maximum potential for a significant improvement in tremor, but a minimal risk of side effects from treatment, before the patient commits. 

We hope the following guide provides some useful information about the process we follow, from first assessment to treatment and beyond.  It is important to note that you are under no obligation to commit to every stage of this process from the outset – you can take it one step at a time.

Currently, we have no waiting list for private treatment, and can usually start the process as soon as you wish.

Stage 1 – The Initial Neurology Consultation

The first stage of our assessment process is a consultation with a Consultant Neurologist from the Movement Disorders Group here in Queen Square. This is consultation usually lasts between 45 to 60 minutes, and is essentially a review of the patient’s history, current symptoms and diagnosis.  The neurologist will discuss the patient’s experiences and expectations, and would review the treatments offered so far. They will then be able to advise whether any other treatments might be suitable, which may include focused ultrasound treatment.

This consultation can either take place in person, or via video consultation if you do not live close by.

Stage 2 – The Multi-Disciplinary Assessment (MDT)

If the consultant neurologist feels that there could be a significant benefit from surgical treatment, we will then arrange an appointment for the patient to attend a clinic in Queen Square to meet with a Consultant Neurologist and a Consultant Neurosurgeon from the functional neurosurgery team. 

During this appointment, further assessments are made of the patient’s tremor and general health, to ensure that focused ultrasound treatment is the most appropriate treatment.  Queen Square is the only centre in the UK capable of offering a choice of all four forms of surgical treatment for Essential Tremor.  As part of this assessment, all possible options are presented so that the patient can make an informed choice about which treatment is most suitable for them.

If MRgFUS is appropriate, the consultants will then request several tests which we aim to perform on the same day.  This will typically involve:

• an MRI scan of the brain – This is used to create a detailed ‘map’ of the brain which is used for treatment planning. The imaging technique used in Queen Square has been developed by our specialist to provide more accurate targeting for improved treatment outcomes. You can read and watch more about how we use MRI to guide treatment here.
• a CT scan of the skull – This is used to evaluate skull density, an essential measurement which allows us to ensure that the ultrasound waves can reach the part of the brain responsible for the tremor. more information about the role of the skull density ratio is available in our article here.

Some general blood tests will also be needed which can organised at convenient time and place for the patient.

Stage 3 – Treatment

Once a patient has been assessed and approved for treatment, we are then able to arrange a treatment date.  Our Patient Information Leaflet here provides a full explanation of what happens on the day of treatment.

Treatment is performed on a day case basis and take around 4 hours in total. The treatment requires only local anaesthetic (for the fitting of a stereotactic frame) and is completely incision-less.  Most patients do not need to stay in hospital following the procedure and will just be with us for an hour after the treatment to recover.  We typically arrange a local hotel stay for the night of the treatment so that we can arrange to see the patient for a brief follow up the next day before they head home.

Stage 4 – Post-treatment follow-up

Following treatment, the patient is then be discharged back under the care of their own neurologist or GP.  However, the treatment team will arrange follow up appointments at 3 months (by telephone), 6 months and 12 months (ideally in-person) after the procedure to monitor progress.  The cost of these follow up consultations is included in the treatment package price.

How much does MR-guided focused ultrasound cost?

As a private service, we offer fixed package prices for each stage of the process, from the initial consultation through to treatment and follow up. Currently, these prices are as follows:

• Stage 1 – Initial consultation – This appointment is typically around £300 (although it may vary depending on the specific consultant you see).
• Stage 2 – MDT assessment – The package price for the MDT consultation and all associated tests is £1750
• Stages 3 and 4 – Treatment and post treatment follow up – The package price for treatment, including all fees associated with the treatment itself and follow up appointment for 1 year is £25,000.

We are pleased that our service is recognised by some private medical insurers. If you have a policy and would like to discuss whether you may be able to get coverage, please do get in touch.

Please note that these prices apply to patients who are normally resident in the United Kingdom. Enquiries from international patients are welcome, and bespoke quotations can be provided based on specific circumstances.

How to begin your Journey

If you would be interested in arranging an initial consultation to explore your options, or if you have any further questions, please contact our treatment coordinators at treatment@queensquare.com or by phone on 020 7833 2513. 

For more information, download our guide to assessment and treatment at Queen Square.