Principal Component Analysis to Identify Parameters in MRgFUS Treatment

Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) is a relatively new treatment which combines the precision of radiological imaging with the therapeutic potential of focused ultrasound, promis-ing a non-invasive treatment for different conditions. The objective of this work was to apply Principal Component Analysis (PCA) to identify the main factors that influence the efficacy of MRgFUS treatment.Thirty-six neurological patients with medication-refractory tremor (n=19 Parkinson’s Disease (PD); n=17 Essential Tremor (ET)) were treated with a commercial MRgFUS brain system (ExAblate Neuro 4000, InSightec) integrated with a 1.5T Magnetic Resonance Imaging (MRI) unit (Sigma HDxt; GE Medical System). We applied PCA, using Kaiser’s criterion, to guide principal component maintenance. The most significant variables for these components, based on the magnitude of their loadings, were maximum energy delivered (Joule) for PC1 (eigenvalues=3.85), indicat-ing the influence of energy delivery; Cerebrospinal Fluid Volume (CSV) normalized for PC2 (eigenvalues=2.55), highlighting CSF; White Matter Volume (WMV) normalized for PC3 (eigenvalues=1.50), reflecting WMV; and active elements for PC4 (eigenvalues=1.18). Few studies has highlighted the influence of energy delivery on treatment outcomes, aligning with our results where maximum energy delivered (PC1) demonstrated a predominant impact. In conclusion, the application of PCA, as guided by Kaiser’s rule, has not only facilitated a robust analysis of MRgFUS treatment variables but also set a benchmark for future research in this field. This study contributes to support the clinical value of PCA as a powerful analytical tool to personalize, precision-focused neurological treatment.