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Singh R, Yang X. A review on photo-mediated ultrasound therapy. Exp Biol Med (Maywood) 2023; 248:775-786. [PMID: 37452726 PMCID: PMC10468643 DOI: 10.1177/15353702231181191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Abstract
Photo-mediated ultrasound therapy (PUT) is a novel therapeutic technique based on the combination of ultrasound and laser. The underlying mechanism of PUT is the enhanced cavitation effect inside blood vessels. The enhanced cavitation activity can result in bio-effects such as reduced perfusion in microvessels. The reduced perfusion effect in microvessels in the eye has the potential to control the progression of eye diseases such as diabetic retinopathy and age-related macular degeneration. Several in vivo studies have demonstrated the feasibility of PUT in removing microvasculature in the eye using rabbit eye model and vasculature in the skin using rabbit ear model. Numerical studies using a bubble dynamics model found that cavitation is enhanced during PUT due to the dramatic increase in size of air/vapor nuclei in blood. In addition, the study conducted to model cavitation dynamics inside a blood vessel during PUT found stresses induced on the vessel wall during PUT are higher than that at normal physiological levels, which may be responsible for bio-effects. The concentration of vasodilators such as nitric oxide and prostacyclin were also found to be affected during PUT in an in vitro study, which may limit blood perfusion in vessels. The main advantage of PUT over conventional techniques is non-invasive, precise, and selective removal of microvessels with high efficiency at relatively low energy levels of ultrasound and laser, without affecting the nearby structures. However, the main limitation of vessel rupture/hemorrhage needs to be overcome through the development of real-time monitoring of treatment effects during PUT. In addition to the application in removing microvessels, PUT-based techniques were also explored in treating other diseases. Studies have found a combination of ultrasound and laser to be effective in removing blood clots inside veins, which has the potential to treat deep-vein thrombosis. The disruption of atherosclerotic plaque using combined ultrasound and laser was also tested, and the feasibility was demonstrated.
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Affiliation(s)
- Rohit Singh
- Department of Mechanical Engineering, Institute for Bioengineering Research, The University of Kansas, Lawrence, KS 66045, USA
| | - Xinmai Yang
- Department of Mechanical Engineering, Institute for Bioengineering Research, The University of Kansas, Lawrence, KS 66045, USA
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Singh R, Yang X. A 3D finite element model to study the cavitation induced stresses on blood-vessel wall during the ultrasound-only phase of photo-mediated ultrasound therapy. AIP ADVANCES 2022; 12:045020. [PMID: 35465057 PMCID: PMC9020880 DOI: 10.1063/5.0082429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/28/2022] [Indexed: 06/14/2023]
Abstract
Photo-mediated ultrasound therapy (PUT) is a novel technique utilizing synchronized ultrasound and laser to generate enhanced cavitation inside blood vessels. The enhanced cavitation inside blood vessels induces bio-effects, which can result in the removal of micro-vessels and the reduction in local blood perfusion. These bio-effects have the potential to treat neovascularization diseases in the eye, such as age-related macular degeneration and diabetic retinopathy. Currently, PUT is in the preclinical stage, and various PUT studies on in vivo rabbit eye models have shown successful removal of micro-vessels. PUT is completely non-invasive and particle-free as opposed to current clinical treatments such as anti-vascular endothelial growth factor therapy and photodynamic therapy, and it precisely removes micro-vessels without damaging the surrounding tissue, unlike laser photocoagulation therapy. The stresses produced by oscillating bubbles during PUT are responsible for the induced bio-effects in blood vessels. In our previous work, stresses induced during the first phase of PUT due to combined ultrasound and laser irradiation were studied using a 2D model. In this work, stresses induced during the third or last phase of PUT due to ultrasound alone were studied using a 3D finite element method-based numerical model. The results showed that the circumferential and shear stress increased as the bubble moves from the center of the vessel toward the vessel wall with more than a 16 times increase in shear stress from 1.848 to 31.060 kPa as compared to only a 4 times increase in circumferential stress from 211 to 906 kPa for a 2 µm bubble placed inside a 10 µm vessel on the application of 1 MHz ultrasound frequency and 130 kPa amplitude. In addition, the stresses decreased as the bubble was placed in smaller sized vessels with a larger decrease in circumferential stress. The changes in shear stress were found to be more dependent on the bubble-vessel wall distance, and the changes in circumferential stress were more dependent on the bubble oscillation amplitude. Moreover, the bubble shape changed to an ellipsoidal with a higher oscillation amplitude in the vessel's axial direction as it was moved closer to the vessel wall, and the bubble oscillation amplitude decreased drastically as it was placed in vessels of a smaller size.
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Affiliation(s)
| | - Xinmai Yang
- Author to whom correspondence should be addressed:
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Effect of Photo-Mediated Ultrasound Therapy on Nitric Oxide and Prostacyclin from Endothelial Cells. APPLIED SCIENCES-BASEL 2022; 12. [PMID: 35983461 PMCID: PMC9384428 DOI: 10.3390/app12052617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Several studies have investigated the effect of photo-mediated ultrasound therapy (PUT) on the treatment of neovascularization. This study explores the impact of PUT on the release of the vasoactive agents nitric oxide (NO) and prostacyclin (PGI2) from the endothelial cells in an in vitro blood vessel model. In this study, an in vitro vessel model containing RF/6A chorioretinal endothelial cells was used. The vessels were treated with ultrasound-only (0.5, 1.0, 1.5 and 2.0 MPa peak negative pressure at 0.5 MHz with 10% duty cycle), laser-only (5, 10, 15 and 20 mJ/cm2 at 532 nm with a pulse width of 5 ns), and synchronized laser and ultrasound (PUT) treatments. Passive cavitation detection was used to determine the cavitation activities during treatment. The levels of NO and PGI2 generally increased when the applied ultrasound pressure and laser fluence were low. The increases in NO and PGI2 levels were significantly reduced by 37.2% and 42.7%, respectively, from 0.5 to 1.5 MPa when only ultrasound was applied. The increase in NO was significantly reduced by 89.5% from 5 to 20 mJ/cm2, when only the laser was used. In the PUT group, for 10 mJ/cm2 laser fluence, the release of NO decreased by 76.8% from 0.1 to 1 MPa ultrasound pressure. For 0.5 MPa ultrasound pressure in the PUT group, the release of PGI2 started to decrease by 144% from 15 to 20 mJ/cm2 laser fluence. The decreases in NO and PGI2 levels coincided with the increased cavitation activities in each group. In conclusion, PUT can induce a significant reduction in the release of NO and PGI2 in comparison with ultrasound-only and laser-only treatments.
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Abstract
PURPOSE OF REVIEW This review highlights indications and evidence on laser therapy in the management of diabetic retinopathy and diabetic macular edema. Particular focus is placed upon the benefits and limitations of conventional laser photocoagulation versus more modern laser photocoagulation techniques, as well as the role of laser photocoagulation in treatment of diabetic retinopathy and diabetic macular edema with the frequent utilization of pharmacologic, including anti-vascular endothelial growth factor (VEGF), therapy. RECENT FINDINGS Laser photocoagulation remains the gold-standard therapy for the effective, definitive treatment of PDR, and also is highly effective in the management of DME. However, numerous recent studies have demonstrated the clinical efficacy and improved functional and anatomic outcomes of combination therapy with pharmacologic treatment. Continuing innovations in laser technology and improved understanding of laser-retinal interactions and pathophysiology demonstrate that laser therapy will continue to play a critical role in the treatment of diabetic retinopathy and diabetic macular edema for many years to come.
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Affiliation(s)
- Lesley A. Everett
- grid.214458.e0000000086837370Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, 1000 Wall Street, Ann Arbor, MI 48105 USA
| | - Yannis M. Paulus
- grid.214458.e0000000086837370Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, 1000 Wall Street, Ann Arbor, MI 48105 USA
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Singh R, Jo J, Riegel M, Forrest ML, Yang X. The feasibility of ultrasound-assisted endovascular laser thrombolysis in an acute rabbit thrombosis model. Med Phys 2021; 48:4128-4138. [PMID: 34214203 DOI: 10.1002/mp.15068] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/27/2021] [Accepted: 06/21/2021] [Indexed: 12/31/2022] Open
Abstract
PURPOSE This study aimed to test the feasibility of combined ultrasound and laser technique, namely, ultrasound-assisted endovascular laser thrombolysis (USELT), for thrombolysis by conducting in vivo tests in a rabbit thrombosis model. MATERIALS AND METHODS An acute thrombus was created in the right jugular vein of rabbit and then was treated with ultrasound only, laser only, and USELT to dissolve the blood clot. A total of 20 rabbits were used. Out of which, the first three rabbits were used to titrate the laser and ultrasound parameters. Then, five rabbits were treated with ultrasound only, five rabbits were treated with laser only, and seven rabbits were treated with USELT. During USELT, 532-nm laser pulses were delivered endovascularly directly to the clot through a fiber optic, and 0.5 MHz ultrasound pulses were applied noninvasively to the same region. A laser fluence of 4 to 12 mJ/cm2 and ultrasound amplitude of 1 to 2 MPa were used. Recanalization of the jugular vein was assessed by performing ultrasound Doppler imaging immediately after the treatment. The maximum blood flow speed after the treatment as compared to its value before the treatment was used to calculate the blood flow recovery in vessel. RESULTS The blood flow was fully recovered (100%) in three rabbits, partially recovered in two rabbits (more than 50% and less than 100%) with mean percentage recovery of 69.73% and poorly recovered in two rabbits (<50%) with mean percentage recovery of 6.2% in the USELT group. In contrast, the treatment group with ultrasound or laser alone did not show recanalization of vein in any case, all the five rabbits were poorly/not recovered with a mean percentage recovery of 0%. CONCLUSIONS The USELT technology was shown to effectively dissolve the blood clots in an acute rabbit jugular vein thrombosis model.
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Affiliation(s)
- Rohit Singh
- Institute for Bioengineering Research and Department of Mechanical Engineering, University of Kansas, Lawrence, Kansas, USA
| | - Janggun Jo
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA.,Vesarex LLC, Lawrence, Kansas, USA
| | - Matthew Riegel
- Animal Care Unit, University of Kansas, Lawrence, Kansas, USA
| | - M Laird Forrest
- Department of Pharmaceutical Chemistry, University of Kansas, Lawrence, Kansas, 66045, USA
| | - Xinmai Yang
- Institute for Bioengineering Research and Department of Mechanical Engineering, University of Kansas, Lawrence, Kansas, USA
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Jo J, Forrest ML, Yang X. Ultrasound-assisted laser thrombolysis with endovascular laser and high-intensity focused ultrasound. Med Phys 2020; 48:579-586. [PMID: 33280145 DOI: 10.1002/mp.14636] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/15/2020] [Accepted: 11/29/2020] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The combination of laser and ultrasound can significantly improve the efficiency of thrombolysis through an enhanced cavitation effect. We developed a fiber optics-based laser-ultrasound thrombolysis device and tested the feasibility and efficiency of this technology for restoring blood flow in an in vitro blood clot model. METHODS An in vitro blood flow-clot model was setup, and then an endovascular laser thrombolysis system was combined with high-intensity focused ultrasound to remove the clot. The laser and ultrasound pulses were synchronized and delivered to the blood clot concurrently. The laser pulses of 532 nm were delivered to the blood clot endovascularly through an optical fiber, whereas the ultrasound pulses of 0.5 MHz were applied noninvasively to the same region. Effectiveness of thrombolysis was evaluated by the ability to restore blood flow, which was monitored by ultrasound Doppler. RESULTS As laser powers increased, the ultrasound threshold pressures for effective thrombolysis decreased. For laser fluence levels of 0, 2, and 4 mJ/cm2 , the average negative ultrasound threshold pressures were 1.26 ± 0.114, 1.05 ± 0.181, and 0.59 ± 0.074 MPa, respectively. The periods of time needed to achieve effective thrombolysis were measured at 0.8, 2, and 4 mJ/cm2 laser fluence levels and 0.42, 0.70, and 0.98 MPa negative ultrasound pressures. In general, thrombolysis could be achieved more rapidly with higher laser powers or ultrasound pressures. CONCLUSIONS Effective thrombolysis can be achieved by combining endovascular laser with noninvasive ultrasound at relatively low power and pressure levels, which can potentially improve both the treatment efficiency and safety.
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Affiliation(s)
- Janggun Jo
- Vesarex LLC, Lawrence, KS, 66047, USA.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, 48109, USA
| | - M Laird Forrest
- Department of Pharmaceutical Chemistry, the University of Kansas, Lawrence, Kansas, 66045, USA
| | - Xinmai Yang
- Institute for Bioengineering Research and Department of Mechanical Engineering, the University of Kansas, Lawrence, Kansas, 66045, USA
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Qin Y, Yu Y, Fu J, Xie X, Wang T, Woodward MA, Paulus YM, Yang X, Wang X. Photo-Mediated Ultrasound Therapy for the Treatment of Corneal Neovascularization in Rabbit Eyes. Transl Vis Sci Technol 2020; 9:16. [PMID: 33344060 PMCID: PMC7726583 DOI: 10.1167/tvst.9.13.16] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/24/2020] [Indexed: 12/05/2022] Open
Abstract
Purpose Corneal neovascularization (CNV) is the invasion of new blood vessels into the avascular cornea, leading to reduced corneal transparency and visual acuity, impaired vision, and even blindness. Current treatment options for CNV are limited. We developed a novel treatment method, termed photo-mediated ultrasound therapy (PUT), that combines laser and ultrasound, and we tested its feasibility for treating CNV in a rabbit model. Methods A suture-induced CNV model was established in New Zealand White rabbits, which were randomly divided into two groups: PUT and control. For the PUT group, the applied light fluence at the corneal surface was estimated to be 27 mJ/cm2 at 1064-nm wavelength with a pulse duration of 5 ns, and the ultrasound pressure applied on the cornea was 0.43 MPa at 0.5 MHz. The control group received no treatment. Red-free photography and fluorescein angiography were utilized to evaluate the efficiency of PUT. Safety was evaluated by histology and immunohistochemistry. For comparison with the PUT safety results, conventional laser photocoagulation (LP) treatment was performed with standard clinical parameters: 532-nm continuous-wave (CW) laser with 0.1-second pulse duration, 450-mW power, and 75-µm spot size. Results In the PUT group, only 1.8% ± 0.8% of the CNV remained 30 days after treatment. In contrast, 71.4% ± 7.2% of the CNV remained in the control group after 30 days. Safety evaluations showed that PUT did not cause any damage to the surrounding tissue. Conclusions These results demonstrate that PUT is capable of removing CNV safely and effectively in this rabbit model. Translational Relevance PUT can remove CNV safely and effectively.
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Affiliation(s)
- Yu Qin
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, China.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Yixin Yu
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA.,Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan Province, China.,Hunan Key Laboratory of Ophthalmology, Changsha, Hunan Province, China
| | - Julia Fu
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Xinyi Xie
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Tao Wang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Maria A Woodward
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Yannis M Paulus
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.,Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Xinmai Yang
- Institute for Bioengineering Research and Department of Mechanical Engineering, University of Kansas, Lawrence, KS, USA
| | - Xueding Wang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
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Wang M, Qin Y, Wang T, Orringer JS, Paulus YM, Yang X, Wang X. Removing Subcutaneous Microvessels Using Photo-Mediated Ultrasound Therapy. Lasers Surg Med 2020; 52:984-992. [PMID: 32394475 PMCID: PMC7655656 DOI: 10.1002/lsm.23260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND OBJECTIVES We have developed a novel anti-vascular technique, termed photo-mediated ultrasound therapy (PUT), which utilizes nanosecond duration laser pulses synchronized with ultrasound bursts to remove the microvasculature through cavitation. The objective of the current study is to explore the potential of PUT in removing subcutaneous microvessels. STUDY DESIGN/MATERIALS AND METHODS The auricular blood vessels of two New Zealand white rabbits were treated by PUT with a peak negative ultrasound pressure of 0.45 MPa at 0.5 MHz, and a laser fluence of 0.056 J/cm2 at 1064 nm for 10 minutes. Blood perfusion in the treated area was measured by a commercial laser speckle imaging (LSI) system before and immediately after treatment, as well as at 1 hour, 3 days, 2 weeks, and 4 weeks post-treatment. Perfusion rates of 38 individual vessels from four rabbit ears were tracked during this time period for longitudinal assessment. RESULTS The measured perfusion rates of the vessels in the treated areas, as quantified by the relative change in perfusion rate, showed a statistically significant decrease for all time points post-treatment (P < 0.001). The mean decrease in perfusion is 50.79% immediately after treatment and is 32.14% at 4 weeks post-treatment. Immediately after treatment, the perfusion rate decreased rapidly. Following this, there was a partial recovery in perfusion rate up to 3 days post-treatment, followed by a plateau in the perfusion from 3 days to 4 weeks. CONCLUSIONS This study demonstrated that a single PUT treatment could significantly reduce blood perfusion by 32.14% in the skin for up to 4 weeks. With unique advantages such as low laser fluence as compared with photothermolysis and agent-free treatment as compared with photodynamic therapy, PUT holds the potential to be developed into a new tool for the treatment of cutaneous vascular lesions. Lasers Surg. Med. © 2020 Wiley Periodicals, LLC.
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Affiliation(s)
- Mingyang Wang
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd, Ann Arbor, Michigan, 48109
| | - Yu Qin
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd, Ann Arbor, Michigan, 48109
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, No.1239, Siping Road, Shanghai, 200092, China
| | - Tao Wang
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd, Ann Arbor, Michigan, 48109
- Institution of Biomedical Engineering, Chinese Academy of Medical Science & Peking Union Medical College, 236 Baidi Road, Tianjin, 300192, China
| | - Jeffrey S Orringer
- Department of Dermatology, University of Michigan, 1910 Taubman Center, 1500 E. Medical Center Drive, Ann Arbor, Michigan, 48109
| | - Yannis M Paulus
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd, Ann Arbor, Michigan, 48109
- Department of Ophthalmology and Visual Sciences, University of Michigan, W.K. Kellogg Eye Center, 1000 Wall Street, Ann Arbor, Michigan, 48109
| | - Xinmai Yang
- Institute for Bioengineering Research and Department of Mechanical Engineering, University of Kansas, 1530 W.15th Street, 3138 Learned Hall, Lawrence, Kansas, 66045
| | - Xueding Wang
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd, Ann Arbor, Michigan, 48109
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Qin Y, Yu Y, Xie X, Zhang W, Fu J, Paulus YM, Yang X, Wang X. The Effect of Laser and Ultrasound Synchronization in Photo-Mediated Ultrasound Therapy. IEEE Trans Biomed Eng 2020; 67:3363-3370. [PMID: 32275582 PMCID: PMC8183568 DOI: 10.1109/tbme.2020.2985648] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Photo-mediated ultrasound therapy (PUT) is a novel, non-invasive, agent-free, highly selective, and precise anti-vascular technique. PUT removes microvessels through promoting cavitation activity precisely in targeted microvessels by applying synchronized nanosecond laser pulses and ultrasound bursts. The synchronization between laser and ultrasound is critical to the outcome of PUT. METHODS Through theoretical simulation and experimental study, the effect of synchronization between laser pulses and ultrasound bursts on cavitation activity during PUT is evaluated. RESULTS By using a theoretical model, we found that cavitation activity was enhanced when laser pulses and ultrasound bursts were synchronized such that the produced photoacoustic wave overlaid the rarefactional phase of the ultrasound wave. This finding was then verified through in vitro studies where cavitation was monitored by using a passive cavitation detector. Furthermore, we demonstrated that the in vivo treatment outcome of PUT in rabbits was directly related to the synchronization between laser and ultrasound. The anti-vascular effect could only be observed when laser and ultrasound were properly synchronized in vivo. CONCLUSION PUT is more efficient when the laser-induced photoacoustic wave overlays the rarefactional phase of the ultrasonic wave. SIGNIFICANCE This is a systematic study to investigate the synchronization effect of PUT, which would be significant for further understanding the mechanism and further improving the treatment efficiency of PUT.
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Affiliation(s)
- Yu Qin
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, P. R. China
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Yixin Yu
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Xinyi Xie
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, P.R. China
| | - Wei Zhang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Julia Fu
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Yannis M Paulus
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Xinmai Yang
- Institute for Bioengineering Research and Department of Mechanical Engineering, University of Kansas, Lawrence, KS, USA
| | - Xueding Wang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
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Paulus YM, Qin Y, Yu Y, Fu J, Wang X, Yang X. Photo-mediated Ultrasound Therapy to Treat Retinal Neovascularization. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:5244-5247. [PMID: 33019167 DOI: 10.1109/embc44109.2020.9175882] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This report describes a novel therapeutic technique called photo-mediated ultrasound therapy (PUT). PUT applies synchronized short pulse duration (nanosecond) laser and ultrasound burst on targeted tissue, offering high-precision localized treatment. PUT is based on controlled induction and promotion of micro-cavitation activity in the target tissue. PUT is able to safely and effectively treat retinal neovascularization in rabbits with persistent nonperfusion up to 4 weeks after PUT in the choroidal vasculature.Clinical Relevance- PUT can selectively remove retinal angiogenesis in clinically-relevant disease models in humansized eyes (rabbit) without damaging surrounding tissue.
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He Y, Yu M, Wang J, Xi F, Zhong J, Yang Y, Jin H, Liu J. Improving the Therapeutic Effect of Ultrasound Combined With Microbubbles on Muscular Tumor Xenografts With Appropriate Acoustic Pressure. Front Pharmacol 2020; 11:1057. [PMID: 32760276 PMCID: PMC7373785 DOI: 10.3389/fphar.2020.01057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 06/29/2020] [Indexed: 01/08/2023] Open
Abstract
Ultrasound combined with microbubbles (USMB) is a promising antitumor therapy because of its capability to selectively disrupt tumor perfusion. However, the antitumor effects of repeated USMB treatments have yet to be clarified. In this study, we established a VX2 muscular tumor xenograft model in rabbits, and performed USMB treatments at five different peak negative acoustic pressure levels (1.0, 2.0, 3.0, 4.0, or 5.0 MPa) to determine the appropriate acoustic pressure. To investigate whether repeated USMB treatments could improve the antitumor effects, a group of tumor-bearing rabbits was subjected to one USMB treatment per day for three consecutive days for comparison with the single-treatment group. Contrast-enhanced ultrasonic imaging and histological analyses showed that at an acoustic pressure of 4.0 MPa, USMB treatment contributed to substantial cessation of tumor perfusion, resulting in severe damage to the tumor cells and microvessels without causing significant effects on the normal tissue. Further, the percentages of damaged area and apoptotic cells in the tumor were significantly higher, and the tumor growth inhibition effect was more obvious in the multiple-treatment group than in the single USMB treatment group. These findings indicate that with an appropriate acoustic pressure, the USMB treatment can selectively destroy tumor vessels in muscular tumor xenograft models. Moreover, the repeated treatments strategy can significantly improve the antitumor effect. Therefore, our results provide a foundation for the clinical application of USMB to treat solid tumors using a novel therapeutic strategy.
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Affiliation(s)
- Yan He
- Department of Medical Ultrasound, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Meiling Yu
- Department of Functional Examination, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, China
| | - Jie Wang
- Department of Medical Ultrasound, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Fen Xi
- Department of Medical Ultrasound, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Jiali Zhong
- Department of Medical Ultrasound, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Yuwen Yang
- Department of Medical Ultrasound, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Hai Jin
- Department of Medical Ultrasound, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Jianhua Liu
- Department of Medical Ultrasound, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
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Hazlewood D, Yang X. Enhanced cavitation activity in a slab-shaped optical absorber during photo-mediated ultrasound therapy. Phys Med Biol 2020; 65:055006. [PMID: 31715592 DOI: 10.1088/1361-6560/ab56f7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Recently, new studies have shown that combined laser and ultrasound, or photo-mediated ultrasound therapy (PUT), can enhance cavitation in optically absorptive targets to disrupt tissues through photoacoustic (PA) effect. These studies, including both experimental and theoretical investigations, have largely focused on blood vessels, which are modeled as cylindrically-shaped optical absorbers for PA wave generation and propagation. However, in many clinical situations, target tissues may not be cylindrically-shaped. In this paper we investigated the effect of PUT on a slab-shaped optical absorber, much larger than the size of the laser beam or the ultrasound focal point. Our results demonstrated that laser light could generate a PA wave that could enhance cavitation not only at the surface of a slab, but also at depths when combined with ultrasound, suggesting that PUT may be effective in enhancing cavitation in a large range of soft tissues. Our results also demonstrated that the cavitation enhancement was based on the optical absorption of the targeted tissue, allowing for self-targeting treatments when optical contrast is present. Additionally, we demonstrated that for the greatest cavitation enhancement in deeper layers a focused laser beam geometry would be most effective.
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Affiliation(s)
- David Hazlewood
- Bioengineering Program and Institute for Bioengineering Research, University of Kansas, Lawrence, KS, United States of America
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Zhang W, Qin Y, Xie X, Hu Z, Paulus YM, Yang X, Wang X. Real-time photoacoustic sensing for photo-mediated ultrasound therapy. OPTICS LETTERS 2019; 44:4063-4066. [PMID: 31415547 PMCID: PMC6907727 DOI: 10.1364/ol.44.004063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/10/2019] [Indexed: 06/01/2023]
Abstract
Photo-mediated ultrasound therapy (PUT) is a novel, noninvasive antimicrovascular approach that can treat neovascularization with high precision. We developed a photoacoustic (PA) sensing (PAS) system for PUT and achieved real-time PAS-guided PUT. Experiments performed on a chicken yolk sac membrane model demonstrated that PAS could monitor the treatment effect in a microvessel during PUT. Vessel shrinkage induced a decrease in the PA signal amplitude, while vessel rupture induced an abrupt increase in the PA signal amplitude. The integrated PUT and PAS system can significantly improve the safety and effectiveness of PUT, and may assist with clinical translation of this novel antimicrovascular technique.
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Affiliation(s)
- Wei Zhang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Yu Qin
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, P. R. China
| | - Xinyi Xie
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, P.R. China
| | - Zizhong Hu
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, P.R. China
| | - Yannis M Paulus
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Xinmai Yang
- Institute for Bioengineering Research and Department of Mechanical Engineering, University of Kansas, Lawrence, KS, USA
| | - Xueding Wang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
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