Synergistic effect of focused ultrasound and MRI for BBB theranostics. (A–C) BBB disruption in monkey brain tissue following focused ultrasound and microbubble targeting of a single tissue site (white circle; R, right and L, left). (D,E) After the interruption of the BBB presentation, an MR contrast agent was added, and this imaging agent penetrated the brain (white arrows). (F) Experimental design for the histological analysis of a rat brain treated with focused sonication. Targeted concentrated ultrasound on spots approximately 2 mm in diameter (red circles) and a Gd-enhanced T1-weighted image after using focused ultrasound. The white dashed line outlines the contrast-enhanced results, and no apparent damage was observed on H&E. (G) After the focused ultrasound and microbubble treatment, the white dashed rectangles indicate the accumulation of albumin occurring through the open exudative BBB. Adapted with permission from Refs. [99,100]. Copyright 2012 American Association for Cancer Research and 2016 Proceedings of the National Academy of Sciences of the United States of America.