1. Focused Ultrasound

2. DisclosureInSightec board member and shareholder 3. 3Focused UltrasoundNew, revolutionary, noninvasive therapeutic technologyAlternative or adjunct Surgery Radiation therapy Drug deliveryEarly stage, MR 25 years ago, additional R&DAs important to therapy as MR is to diagnosesTransform treatment of a variety of serious medical disorders Benign and malignant tumors Metastatic cancer Parkinsons disease & epilepsy Back pain, hypertensionReal today, infancy 4. Essential Tremor 5. Essential Tremor 6. Essential Tremor 7. Essential Tremor 8. Functional TestingBefore Procedure After Procedure 9. Thalamic Lesion Created to Treat Essential Tremor 10. Uterine Fibroid Treatment Pre-treatment MR scan of fibroid 11. Uterine Fibroid Treatment ComparisonHysterectomy Focused UltrasoundMajor surgeryNoninvasive, no incisionGeneral anesthesia Conscious sedationPainfulMinimal discomfortHospitalizationOutpatient6 weeks recovery 1 day recoverySide effects No side effectsNo more children Preserved fertility 12. Uterine Fibroid TreatmentPre-treatment9 months post-treatment Nine months after treatment, the fibroid has been absorbed 13. Breast CancerPre treatment 2 weeks post treatment 14. What is Focused Ultrasound? 15. Marriage of Two Breakthrough TechnologiesFocused Ultrasound: therapy Treat tissue deep in body Noninvasively Accurately and preciselyMagnetic Resonance (MR) or Ultrasound (US) Imaging Identify and target tissue to be treated Guide and control treatment in real time Immediate confirmation of effectiveness 16. Focused UltrasoundAnalogous to a magnifying glass focusing rays of the sun 17. Focused UltrasoundMultiple intersectingbeams of ultrasound Focused with extreme accuracy Point: 1 mm diameter Deep in bodyIndividual beams pass harmlessly through tissuePoint of convergence: profound effectAdjacent tissue unaffected 18. Effects at Focal PointDestroy tissue: thermal ablation, cavitationDeliver drugsDissolve clots: sonothrombolysisRadiation sensitizationDrug activity enhancementCoagulate blood vesselsAmplification of cancer biomarkersImmunomodulationNeuromodulationVasodilationVariety of effects, variety of disordersAbundant research opportunities 19. Destroy Tissue: Thermal AblationHeating any tissue to 130 F (56 C) for one secondDestroys any tissue, normal or abnormal. 20. Focal Drug DeliveryDeliver drugs in high concentrations Precisely where needed Minimizing systemic toxicityDrugs Chermotherapeutic agents Antibotics Genes Growth factors 21. Drugs contained in microbubbles released by ultrasoundonly at the target 1/5 22. Drugs contained in microbubbles released by ultrasoundonly at the target 2/5 23. Drugs contained in microbubbles released by ultrasoundonly at the target 3/5 24. Drugs contained in microbubbles released by ultrasoundonly at the target 4/5 25. Drugs contained in microbubbles released by ultrasoundonly at the target 5/5 26. Focused Ultrasound ProcedureSteps in procedure Targeting Planning Treating Confirming 27. Procedure: Targeting Structures to be avoidedRegion tobe treated 28. Procedure: PlanningAutomatic planning 29. Procedure: TreatmentReal time guidance Temperature measurement 30. FUS Advantages vs Radiation Single treatment Immediate and verifiable effect Greater precision and accuracy Real time localization No cumulative dose No limitations on lesion size No limitations on number of treatments No secondary tumors 100% cell death Sharp margins 31. Global Development Landscape 32. Imagine the Future: 2020Advances in technology Imaging Focused ultrasound Focal drug deliveryUndreamed-of applications 33. SNAKE OIL: CURE-ALL33 34. Limitations: Cannot be used for all conditions ScoliosisLeukemiaTraumatic InjuriesLung Tumors 35. Potential Impact, Urgent NeedTechnology widely available Delay = unnecessary death, disability, suffering Countless individuals: friends, family, you!Focused Ultrasound Foundation Shorten time to wide-spread use Saving time, saving lives 36. Focused UltrasoundFoundationIts all about the patients