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Song M, Sapozhnikov OA, Khokhlova VA, Khokhlova TD. Dynamic Mode Decomposition for Transient Cavitation Bubbles Imaging in Pulsed High-Intensity Focused Ultrasound Therapy. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2024; 71:596-606. [PMID: 38598407 PMCID: PMC11141145 DOI: 10.1109/tuffc.2024.3387351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Pulsed high-intensity focused ultrasound (pHIFU) can induce sparse de novo inertial cavitation without the introduction of exogenous contrast agents, promoting mild mechanical disruption in targeted tissue. Because the bubbles are small and rapidly dissolve after each HIFU pulse, mapping transient bubbles and obtaining real-time quantitative metrics correlated with tissue damage are challenging. Prior work introduced Bubble Doppler, an ultrafast power Doppler imaging method as a sensitive means to map cavitation bubbles. The main limitation of that method was its reliance on conventional wall filters used in Doppler imaging and its optimization for imaging blood flow rather than transient scatterers. This study explores Bubble Doppler enhancement using dynamic mode decomposition (DMD) of a matrix created from a Doppler ensemble for mapping and extracting the characteristics of transient cavitation bubbles. DMD was first tested in silico with a numerical dataset mimicking the spatiotemporal characteristics of backscattered signal from tissue and bubbles. The performance of DMD filter was compared to other widely used Doppler wall filter-singular value decomposition (SVD) and infinite impulse response (IIR) high-pass filter. DMD was then applied to an ex vivo tissue dataset where each HIFU pulse was immediately followed by a plane wave Doppler ensemble. In silico DMD outperformed SVD and IIR high-pass filter and ex vivo provided physically interpretable images of the modes associated with bubbles and their corresponding temporal decay rates. These DMD modes can be trackable over the duration of pHIFU treatment using k-means clustering method, resulting in quantitative indicators of treatment progression.
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Song M, Sapozhnikov OA, Khokhlova VA, Khokhlova TD. Dynamic Mode Decomposition for Transient Cavitation Bubbles Imaging in Pulsed High Intensity Focused Ultrasound Therapy. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.26.582222. [PMID: 38464326 PMCID: PMC10925276 DOI: 10.1101/2024.02.26.582222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Pulsed high-intensity focused ultrasound (pHIFU) can induce sparse de novo inertial cavitation without the introduction of exogenous contrast agents, promoting mild mechanical disruption in targeted tissue. Because the bubbles are small and rapidly dissolve after each HIFU pulse, mapping transient bubbles and obtaining real-time quantitative metrics correlated to tissue damage are challenging. Prior work introduced Bubble Doppler, an ultrafast power Doppler imaging method as a sensitive means to map cavitation bubbles. The main limitation of that method was its reliance on conventional wall filters used in Doppler imaging and optimized for imaging blood flow rather than transient scatterers. This study explores Bubble Doppler enhancement using dynamic mode decomposition (DMD) of a matrix created from a Doppler ensemble for mapping and extracting the characteristics of transient cavitation bubbles. DMD was first tested in silico with a numerical dataset mimicking the spatiotemporal characteristics of backscattered signal from tissue and bubbles. The performance of DMD filter was compared to other widely used Doppler wall filters - singular value decomposition (SVD) and infinite impulse response (IIR) highpass filter. DMD was then applied to an ex vivo tissue dataset where each HIFU pulse was immediately followed by a plane wave Doppler ensemble. In silico DMD outperformed SVD and IIR high pass filter and ex vivo provided physically interpretable images of the modes associated with bubbles and their corresponding temporal decay rates. These DMD modes can be trackable over the duration of pHIFU treatment using k-means clustering method, resulting in quantitative indicators of treatment progression.
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Affiliation(s)
- Minho Song
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195 USA
| | - Oleg A Sapozhnikov
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA 98195 USA
- Physics Faculty, Moscow State University, 119991 Moscow, Russia
| | - Vera A Khokhlova
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA 98195 USA
- Physics Faculty, Moscow State University, 119991 Moscow, Russia
| | - Tatiana D Khokhlova
- Division of Gastroenterology, University of Washington School of Medicine, Seattle, WA 98195 USA
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Lyons B, Balkaran JPR, Dunn-Lawless D, Lucian V, Keller SB, O’Reilly CS, Hu L, Rubasingham J, Nair M, Carlisle R, Stride E, Gray M, Coussios C. Sonosensitive Cavitation Nuclei-A Customisable Platform Technology for Enhanced Therapeutic Delivery. Molecules 2023; 28:7733. [PMID: 38067464 PMCID: PMC10708135 DOI: 10.3390/molecules28237733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
Ultrasound-mediated cavitation shows great promise for improving targeted drug delivery across a range of clinical applications. Cavitation nuclei-sound-sensitive constructs that enhance cavitation activity at lower pressures-have become a powerful adjuvant to ultrasound-based treatments, and more recently emerged as a drug delivery vehicle in their own right. The unique combination of physical, biological, and chemical effects that occur around these structures, as well as their varied compositions and morphologies, make cavitation nuclei an attractive platform for creating delivery systems tuned to particular therapeutics. In this review, we describe the structure and function of cavitation nuclei, approaches to their functionalization and customization, various clinical applications, progress toward real-world translation, and future directions for the field.
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Affiliation(s)
- Brian Lyons
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK; (J.P.R.B.); (D.D.-L.); (V.L.); (S.B.K.); (L.H.); (J.R.); (M.N.); (R.C.); (E.S.); (M.G.)
| | - Joel P. R. Balkaran
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK; (J.P.R.B.); (D.D.-L.); (V.L.); (S.B.K.); (L.H.); (J.R.); (M.N.); (R.C.); (E.S.); (M.G.)
| | - Darcy Dunn-Lawless
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK; (J.P.R.B.); (D.D.-L.); (V.L.); (S.B.K.); (L.H.); (J.R.); (M.N.); (R.C.); (E.S.); (M.G.)
| | - Veronica Lucian
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK; (J.P.R.B.); (D.D.-L.); (V.L.); (S.B.K.); (L.H.); (J.R.); (M.N.); (R.C.); (E.S.); (M.G.)
| | - Sara B. Keller
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK; (J.P.R.B.); (D.D.-L.); (V.L.); (S.B.K.); (L.H.); (J.R.); (M.N.); (R.C.); (E.S.); (M.G.)
| | - Colm S. O’Reilly
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford OX1 3PJ, UK;
| | - Luna Hu
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK; (J.P.R.B.); (D.D.-L.); (V.L.); (S.B.K.); (L.H.); (J.R.); (M.N.); (R.C.); (E.S.); (M.G.)
| | - Jeffrey Rubasingham
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK; (J.P.R.B.); (D.D.-L.); (V.L.); (S.B.K.); (L.H.); (J.R.); (M.N.); (R.C.); (E.S.); (M.G.)
| | - Malavika Nair
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK; (J.P.R.B.); (D.D.-L.); (V.L.); (S.B.K.); (L.H.); (J.R.); (M.N.); (R.C.); (E.S.); (M.G.)
| | - Robert Carlisle
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK; (J.P.R.B.); (D.D.-L.); (V.L.); (S.B.K.); (L.H.); (J.R.); (M.N.); (R.C.); (E.S.); (M.G.)
| | - Eleanor Stride
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK; (J.P.R.B.); (D.D.-L.); (V.L.); (S.B.K.); (L.H.); (J.R.); (M.N.); (R.C.); (E.S.); (M.G.)
| | - Michael Gray
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK; (J.P.R.B.); (D.D.-L.); (V.L.); (S.B.K.); (L.H.); (J.R.); (M.N.); (R.C.); (E.S.); (M.G.)
| | - Constantin Coussios
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK; (J.P.R.B.); (D.D.-L.); (V.L.); (S.B.K.); (L.H.); (J.R.); (M.N.); (R.C.); (E.S.); (M.G.)
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Williams RP, Karzova MM, Yuldashev PV, Kaloev AZ, Nartov FA, Khokhlova VA, Cunitz BW, Morrison KP, Khokhlova TD. Dual-Mode 1-D Linear Ultrasound Array for Image-Guided Drug Delivery Enhancement Without Ultrasound Contrast Agents. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:693-707. [PMID: 37074881 PMCID: PMC10712801 DOI: 10.1109/tuffc.2023.3268603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Pulsed high-intensity focused ultrasound (pHIFU) uses nonlinearly distorted millisecond-long ultrasound pulses of moderate intensity to induce inertial cavitation in tissue without administration of contrast agents. The resulting mechanical disruption permeabilizes the tissue and enhances the diffusion of systemically administered drugs. This is especially beneficial for tissues with poor perfusion such as pancreatic tumors. Here, we characterize the performance of a dual-mode ultrasound array designed for image-guided pHIFU therapies in producing inertial cavitation and ultrasound imaging. The 64-element linear array (1.071 MHz, an aperture of 14.8×51.2 mm, and a pitch of 0.8 mm) with an elevational focal length of 50 mm was driven by the Verasonics V-1 ultrasound system with extended burst option. The attainable focal pressures and electronic steering range in linear and nonlinear operating regimes (relevant to pHIFU treatments) were characterized through hydrophone measurements, acoustic holography, and numerical simulations. The steering range at ±10% from the nominal focal pressure was found to be ±6 mm axially and ±11 mm azimuthally. Focal waveforms with shock fronts of up to 45 MPa and peak negative pressures up to 9 MPa were achieved at focusing distances of 38-75 mm from the array. Cavitation behaviors induced by isolated 1-ms pHIFU pulses in optically transparent agarose gel phantoms were observed by high-speed photography across a range of excitation amplitudes and focal distances. For all focusing configurations, the appearance of sparse, stationary cavitation bubbles occurred at the same P- threshold of 2 MPa. As the output level increased, a qualitative change in cavitation behavior occurred, to pairs and sets of proliferating bubbles. The pressure P- at which this transition was observed corresponded to substantial nonlinear distortion and shock formation in the focal region and was thus dependent on the focal distance of the beam ranging within 3-4 MPa for azimuthal F -numbers of 0.74-1.5. The array was capable of B-mode imaging at 1.5 MHz of centimeter-sized targets in phantoms and in vivo pig tissues at depths of 3-7 cm, relevant to pHIFU applications in abdominal targets.
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Song M, Thomas GPL, Khokhlova VA, Sapozhnikov OA, Bailey MR, Maxwell AD, Yuldashev PV, Khokhlova TD. Quantitative Assessment of Boiling Histotripsy Progression Based on Color Doppler Measurements. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:3255-3269. [PMID: 36197870 PMCID: PMC9741864 DOI: 10.1109/tuffc.2022.3212266] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Boiling histotripsy (BH) is a mechanical tissue liquefaction method that uses sequences of millisecond-long high intensity focused ultrasound (HIFU) pulses with shock fronts. The BH treatment generates bubbles that move within the sonicated volume due to acoustic radiation force. Since the velocity of the bubbles and tissue debris is expected to depend on the lesion size and liquefaction completeness, it could provide a quantitative metric of the treatment progression. In this study, the motion of bubble remnants and tissue debris immediately following BH pulses was investigated using high-pulse repetition frequency (PRF) plane-wave color Doppler ultrasound in ex vivo myocardium tissue. A 256-element 1.5 MHz spiral HIFU array with a coaxially integrated ultrasound imaging probe (ATL P4-2) produced 10 ms BH pulses to form volumetric lesions with electronic beam steering. Prior to performing volumetric BH treatments, the motion of intact myocardium tissue and anticoagulated bovine blood following isolated BH pulses was assessed as two limiting cases. In the liquid blood the velocity of BH-induced streaming at the focus reached over 200 cm/s, whereas the intact tissue was observed to move toward the HIFU array consistent with elastic rebound of tissue. Over the course of volumetric BH treatments tissue motion at the focus locations was dependent on the axial size of the forming lesion relative to the corresponding size of the HIFU focal area. For axially small lesions, the maximum velocity after the BH pulse was directed toward the HIFU transducer and monotonically increased over time from about 20-100 cm/s as liquefaction progressed, then saturated when tissue was fully liquefied. For larger lesions obtained by merging multiple smaller lesions in the axial direction, the high-speed streaming away from the HIFU transducer was observed at the point of full liquefaction. Based on these observations, the maximum directional velocity and its location along the HIFU propagation axis were proposed and evaluated as candidate metrics of BH treatment completeness.
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Wang J, Li Z, Pan M, Fiaz M, Hao Y, Yan Y, Sun L, Yan F. Ultrasound-mediated blood-brain barrier opening: An effective drug delivery system for theranostics of brain diseases. Adv Drug Deliv Rev 2022; 190:114539. [PMID: 36116720 DOI: 10.1016/j.addr.2022.114539] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 09/04/2022] [Accepted: 09/11/2022] [Indexed: 01/24/2023]
Abstract
Blood-brain barrier (BBB) remains a significant obstacle to drug therapy for brain diseases. Focused ultrasound (FUS) combined with microbubbles (MBs) can locally and transiently open the BBB, providing a potential strategy for drug delivery across the BBB into the brain. Nowadays, taking advantage of this technology, many therapeutic agents, such as antibodies, growth factors, and nanomedicine formulations, are intensively investigated across the BBB into specific brain regions for the treatment of various brain diseases. Several preliminary clinical trials also have demonstrated its safety and good tolerance in patients. This review gives an overview of the basic mechanisms, ultrasound contrast agents, evaluation or monitoring methods, and medical applications of FUS-mediated BBB opening in glioblastoma, Alzheimer's disease, and Parkinson's disease.
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Affiliation(s)
- Jieqiong Wang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 201206, China
| | - Zhenzhou Li
- Department of Ultrasound, The Second People's Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University, Shenzhen 518061, China
| | - Min Pan
- Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen 518034, China
| | - Muhammad Fiaz
- Department of Radiology, Azra Naheed Medical College, Lahore, Pakistan
| | - Yongsheng Hao
- Center for Cell and Gene Circuit Design, CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Yiran Yan
- Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510282, China
| | - Litao Sun
- Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang 310014, China.
| | - Fei Yan
- Center for Cell and Gene Circuit Design, CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China.
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Landry TG, Gannon J, Vlaisavljevich E, Mallay MG, Woodacre JK, Croul S, Fawcett JP, Brown JA. Endoscopic Coregistered Ultrasound Imaging and Precision Histotripsy: Initial In Vivo Evaluation. BME FRONTIERS 2022; 2022:9794321. [PMID: 37850178 PMCID: PMC10521722 DOI: 10.34133/2022/9794321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/06/2022] [Indexed: 10/19/2023] Open
Abstract
Objective. Initial performance evaluation of a system for simultaneous high-resolution ultrasound imaging and focused mechanical submillimeter histotripsy ablation in rat brains. Impact Statement. This study used a novel combination of high-resolution imaging and histotripsy in an endoscopic form. This would provide neurosurgeons with unprecedented accuracy in targeting and executing nonthermal ablations in minimally invasive surgeries. Introduction. Histotripsy is a safe and effective nonthermal focused ablation technique. However, neurosurgical applications, such as brain tumor ablation, are difficult due to the presence of the skull. Current devices are too large to use in the minimally invasive approaches surgeons prefer. We have developed a combined imaging and histotripsy endoscope to provide neurosurgeons with a new tool for this application. Methods. The histotripsy component had a 10 mm diameter, operating at 6.3 MHz. Affixed within a cutout hole in its center was a 30 MHz ultrasound imaging array. This coregistered pair was used to ablate brain tissue of anesthetized rats while imaging. Histological sections were examined, and qualitative descriptions of ablations and basic shape descriptive statistics were generated. Results. Complete ablations with submillimeter area were produced in seconds, including with a moving device. Ablation progress could be monitored in real time using power Doppler imaging, and B-mode was effective for monitoring post-ablation bleeding. Collateral damage was minimal, with a 100 μm maximum distance of cellular damage from the ablation margin. Conclusion. The results demonstrate a promising hardware suite to enable precision ablations in endoscopic procedures or fundamental preclinical research in histotripsy, neuroscience, and cancer.
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Affiliation(s)
- Thomas G. Landry
- School of Biomedical Engineering, Dalhousie University, Canada
- Division of Surgery, Nova Scotia Health Authority, Canada
| | - Jessica Gannon
- Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Virginia, USA
| | - Eli Vlaisavljevich
- Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Virginia, USA
| | | | | | - Sidney Croul
- Department of Pathology & Laboratory Medicine, Dalhousie University, Canada
| | - James P. Fawcett
- Department of Pharmacology, Dalhousie University, Canada
- Department of Surgery, Dalhousie University, Canada
| | - Jeremy A. Brown
- School of Biomedical Engineering, Dalhousie University, Canada
- Division of Surgery, Nova Scotia Health Authority, Canada
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Jeong MK, Choi MJ. A Novel Approach for the Detection of Every Significant Collapsing Bubble in Passive Cavitation Imaging. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:1288-1300. [PMID: 35167448 DOI: 10.1109/tuffc.2022.3151882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Passive cavitation image (PCI) shows the power distribution of the acoustic emissions resulting from cavitation bubble collapses. The conventional PCI convolves the emitted cavitation signals with the point spread function of an imaging system, and it suffers from a low spatial resolution and contrast due to the increased sidelobe artifacts accumulated during the temporal integral process. To overcome the problems, the present study considers a 3-D time history of instantaneous PCIs where cavitation occurs at the local maxima of the main lobes of the beamformed cavitation field surrounded by the sidelobes largely spreading out in a time-space domain. A spatial and temporal gating technique was employed to detect the local maxima so that cavitation bubbles can be identified with their collapsing strength. The proposed approach was verified by the simulation for single and multiple cavitation bubbles, proving that it accurately detects the location and strength of the collapsing bubbles. An experimental test was also carried out for the cavitation bubbles produced by a clinical extracorporeal shock wave therapeutic device, which underpins that the proposed method successfully identifies every individual cavitation bubble.
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Jeong MK, Choi MJ, Kwon SJ. High-spatial-resolution, instantaneous passive cavitation imaging with temporal resolution in histotripsy: a simulation study. Ultrasonography 2022; 41:566-577. [PMID: 35535468 PMCID: PMC9262664 DOI: 10.14366/usg.21153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 02/22/2022] [Indexed: 11/08/2022] Open
Abstract
Purpose In histotripsy, a shock wave is transmitted, and the resulting inertial bubble cavitation that disrupts tissue is used for treatment. Therefore, it is necessary to detect when cavitation occurs and track the position of cavitation occurrence using a new passive cavitation (PC) imaging method. Methods An integrated PC image, which is constructed by collecting the focused signals at all times, does not provide information on when cavitation occurs and has poor spatial resolution. To solve this problem, we constructed instantaneous PC images by applying delay and sum beamforming at instantaneous time instants. By calculating instantaneous PC images at all data acquisition times, the proposed method can detect cavitation when it occurs by using the property that when signals from the cavitation are focused, their amplitude becomes large, and it can obtain a high-resolution PC image by masking out side lobes in the vicinity of cavitation. Results Ultrasound image simulation confirmed that the proposed method has higher resolution than conventional integrated PC imaging and showed that it can determine the position and time of cavitation occurrence as well as the signal strength. Conclusion Since the proposed novel PC imaging method can detect each cavitation separately when the incidence of cavitations is low, it can be used to monitor the treatment process of shock wave therapy and histotripsy, in which cavitation is an important mechanism of treatment.
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Affiliation(s)
- Mok Kun Jeong
- Department of Electronic Engineering, Daejin University, Pocheon, Korea
| | - Min Joo Choi
- Department of Medicine, Jeju National University, Jeju, Korea
| | - Sung Jae Kwon
- Division of IT Convergence Engineering, Daejin University, Pocheon, Korea
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Wu P, Wang X, Lin W, Bai L. Acoustic characterization of cavitation intensity: A review. ULTRASONICS SONOCHEMISTRY 2022; 82:105878. [PMID: 34929549 PMCID: PMC8799601 DOI: 10.1016/j.ultsonch.2021.105878] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 05/26/2023]
Abstract
Cavitation intensity is used to describe the activity of cavitation, and several methods are developed to identify the intensity of cavitation. This work aimed to provide an overview and discussion of the several existing characterization methods for cavitation intensity, three acoustic approaches for charactering cavitation were discussed in detail. It was showed that cavitation noise spectrum is too complex and there are some differences and disputes on the characterization of cavitation intensity by cavitation noise. In this review, we recommended a total cavitation noise intensity estimated via the integration of real cavitation noise spectrum over full frequency domain instead of artificially adding inaccurate filtering processing.
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Affiliation(s)
- Pengfei Wu
- State Key Laboratory of Acoustics, Institute of Acoustics, Chinese Academy of Sciences, Beijing 100190, China; University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Xiuming Wang
- State Key Laboratory of Acoustics, Institute of Acoustics, Chinese Academy of Sciences, Beijing 100190, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Weijun Lin
- State Key Laboratory of Acoustics, Institute of Acoustics, Chinese Academy of Sciences, Beijing 100190, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Lixin Bai
- State Key Laboratory of Acoustics, Institute of Acoustics, Chinese Academy of Sciences, Beijing 100190, China; University of Chinese Academy of Sciences, Beijing 100049, China
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Mallay MG, Woodacre JK, Landry TG, Campbell NA, Brown JA. A Dual-Frequency Lens-Focused Endoscopic Histotripsy Transducer. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:2906-2916. [PMID: 33961553 DOI: 10.1109/tuffc.2021.3078326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A forward-looking miniature histotripsy transducer has been developed that incorporates an acoustic lens and dual-frequency stacked transducers. An acoustic lens is used to increase the peak negative pressure through focal gain and the dual-frequency transducers are designed to increase peak negative pressure by summing the pressure generated by each transducer individually. Four lens designs, each with an f -number of approximately 1, were evaluated in a PZT5A composite transducer. The finite-element model (FEM) predicted axial beamwidths of 1.61, 2.40, 2.84, and 2.36 mm for the resin conventional, resin Fresnel, silicone conventional, and silicone Fresnel lenses, respectively; the measured axial beamwidths were 1.30, 2.28, 2.71, and 2.11 mm, respectively. Radial beamwidths from the model were between 0.32 and 0.35 mm, while measurements agreed to within 0.2 mm. The measured peak negative was 0.150, 0.124, 0.160, and 0.160 MPa/V for the resin conventional, resin Fresnel, silicone conventional, and silicone Fresnel lenses, respectively. For the dual-frequency device, the 5-MHz (therapy) transducer had a measured peak negative pressure of 0.136 MPa/V for the PZT5A composite and 0.163 MPa/V for the PMN-PT composite. The 1.2-MHz (pump) transducer had a measured peak negative pressure of 0.028 MPa/V. The pump transducer significantly lowered the cavitation threshold of the therapy transducer. The dual-frequency device was tested on an ex vivo rat brain, ablating tissue at up to 4-mm depth, with lesion sizes as small as [Formula: see text].
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Maxwell AD, Hunter C, Cunitz BW, Kreider W, Totten S, Wang YN. Factors Affecting Tissue Cavitation during Burst Wave Lithotripsy. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2286-2295. [PMID: 34078545 PMCID: PMC8259501 DOI: 10.1016/j.ultrasmedbio.2021.04.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/26/2021] [Accepted: 04/20/2021] [Indexed: 06/12/2023]
Abstract
Burst wave lithotripsy (BWL) is a technology under clinical investigation for non-invasive fragmentation of urinary stones. Under certain ranges of ultrasound exposure parameters, this technology can cause cavitation in tissue leading to renal injury. This study sought to measure the focal pressure amplitude needed to cause cavitation in vivo and determine its consistency in native tissue, in an implanted stone model and under different exposure parameters. The kidneys of eight pigs were exposed to transcutaneous BWL ultrasound pulses. In each kidney, two locations were targeted: the renal sinus and the kidney parenchyma. Each was exposed for 5 min at a set pressure level and parameters, and cavitation was detected using an active cavitation imaging method based on power Doppler ultrasound. The threshold was determined by incrementing the pressure amplitude up or down after each 5-min interval until cavitation occurred/subsided. The pressure thresholds were remeasured postsurgery, targeting an implanted stone or collecting space (in sham). The presence of a stone or sham surgery did not significantly impact the threshold for tissue cavitation. Targeting parenchyma instead of kidney collecting space and lowering the ultrasound pulse repetition frequency both resulted in an increased pressure threshold for cavitation.
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Affiliation(s)
- Adam D Maxwell
- Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA; Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA.
| | - Christopher Hunter
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Bryan W Cunitz
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Wayne Kreider
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Stephanie Totten
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Yak-Nam Wang
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
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13
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Kwon O, Pahk KJ, Choi MJ. Simultaneous measurements of acoustic emission and sonochemical luminescence for monitoring ultrasonic cavitation. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 149:4477. [PMID: 34241435 DOI: 10.1121/10.0005136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
In the present study, a novel hybrid method was considered to identify and measure inertial cavitation activity using acoustic and optical emissions from violent bubble collapses. A photomultiplier (PMT) tube and a calibrated cylindrical needle hydrophone were used to simultaneously detect sonochemical luminescence (SCL) signals and acoustic emissions, respectively, during sonication. A cylindrical focusing ultrasound transducer operating at 398.4 kHz was employed to produce a dense cavitation bubble cloud at the focus. The results clearly showed that a similar trend between the PMT output (i.e., the SCL results) and the broad band acoustic emissions started to appear at the frequencies considered above the fourth harmonic of the sonication frequency. The experimental observation suggests that the occurrence of inertial cavitation can be monitored using the high pass spectral acoustic power and the cut-off frequency can be effectively chosen with the aid of sonochemical luminescence measurement. The hybrid method is expected to be useful for cavitation dosimetry in various medical and industrial applications.
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Affiliation(s)
- Ohbin Kwon
- Interdisciplinary Postgraduate Program in Biomedical Engineering, Jeju National University, Jeju 63243, Republic of Korea
| | - Ki Joo Pahk
- Center for Bionics, Biomedical Research Institute, Korea Institute of Science and Technology KIST, Seoul 02792, Republic of Korea
| | - Min Joo Choi
- Interdisciplinary Postgraduate Program in Biomedical Engineering, Jeju National University, Jeju 63243, Republic of Korea
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14
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Deprez J, Lajoinie G, Engelen Y, De Smedt SC, Lentacker I. Opening doors with ultrasound and microbubbles: Beating biological barriers to promote drug delivery. Adv Drug Deliv Rev 2021; 172:9-36. [PMID: 33705877 DOI: 10.1016/j.addr.2021.02.015] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/01/2021] [Accepted: 02/17/2021] [Indexed: 12/13/2022]
Abstract
Apart from its clinical use in imaging, ultrasound has been thoroughly investigated as a tool to enhance drug delivery in a wide variety of applications. Therapeutic ultrasound, as such or combined with cavitating nuclei or microbubbles, has been explored to cross or permeabilize different biological barriers. This ability to access otherwise impermeable tissues in the body makes the combination of ultrasound and therapeutics very appealing to enhance drug delivery in situ. This review gives an overview of the most important biological barriers that can be tackled using ultrasound and aims to provide insight on how ultrasound has shown to improve accessibility as well as the biggest hurdles. In addition, we discuss the clinical applicability of therapeutic ultrasound with respect to the main challenges that must be addressed to enable the further progression of therapeutic ultrasound towards an effective, safe and easy-to-use treatment tailored for drug delivery in patients.
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Affiliation(s)
- J Deprez
- Ghent Research Group on Nanomedicines, Department of Pharmaceutics, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium; Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - G Lajoinie
- Physics of Fluids Group, MESA+ Institute for Nanotechnology and Technical Medical (TechMed) Center, University of Twente, P.O. Box 217, 7500 AE Enschede, Netherlands
| | - Y Engelen
- Ghent Research Group on Nanomedicines, Department of Pharmaceutics, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium; Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - S C De Smedt
- Ghent Research Group on Nanomedicines, Department of Pharmaceutics, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium; Cancer Research Institute Ghent (CRIG), Ghent, Belgium.
| | - I Lentacker
- Ghent Research Group on Nanomedicines, Department of Pharmaceutics, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium; Cancer Research Institute Ghent (CRIG), Ghent, Belgium
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15
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Li M, Sankin G, Vu T, Yao J, Zhong P. Tri-modality cavitation mapping in shock wave lithotripsy. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 149:1258. [PMID: 33639826 PMCID: PMC8329839 DOI: 10.1121/10.0003555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Shock wave lithotripsy (SWL) has been widely used for non-invasive treatment of kidney stones. Cavitation plays an important role in stone fragmentation, yet it may also contribute to renal injury during SWL. It is therefore crucial to determine the spatiotemporal distributions of cavitation activities to maximize stone fragmentation while minimizing tissue injury. Traditional cavitation detection methods include high-speed optical imaging, active cavitation mapping (ACM), and passive cavitation mapping (PCM). While each of the three methods provides unique information about the dynamics of the bubbles, PCM has most practical applications in biological tissues. To image the dynamics of cavitation bubble collapse, we previously developed a sliding-window PCM (SW-PCM) method to identify each bubble collapse with high temporal and spatial resolution. In this work, to further validate and optimize the SW-PCM method, we have developed tri-modality cavitation imaging that includes three-dimensional high-speed optical imaging, ACM, and PCM seamlessly integrated in a single system. Using the tri-modality system, we imaged and analyzed laser-induced single cavitation bubbles in both free field and constricted space and shock wave-induced cavitation clusters. Collectively, our results have demonstrated the high reliability and spatial-temporal accuracy of the SW-PCM approach, which paves the way for the future in vivo applications on large animals and humans in SWL.
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Affiliation(s)
- Mucong Li
- Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708, USA
| | - Georgy Sankin
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina 27708, USA
| | - Tri Vu
- Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708, USA
| | - Junjie Yao
- Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708, USA
| | - Pei Zhong
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina 27708, USA
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16
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Khokhlova TD, Schade GR, Wang YN, Buravkov SV, Chernikov VP, Simon JC, Starr F, Maxwell AD, Bailey MR, Kreider W, Khokhlova VA. Pilot in vivo studies on transcutaneous boiling histotripsy in porcine liver and kidney. Sci Rep 2019; 9:20176. [PMID: 31882870 PMCID: PMC6934604 DOI: 10.1038/s41598-019-56658-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 12/11/2019] [Indexed: 02/06/2023] Open
Abstract
Boiling histotripsy (BH) is a High Intensity Focused Ultrasound (HIFU) method for precise mechanical disintegration of target tissue using millisecond-long pulses containing shocks. BH treatments with real-time ultrasound (US) guidance allowed by BH-generated bubbles were previously demonstrated ex vivo and in vivo in exposed porcine liver and small animals. Here, the feasibility of US-guided transabdominal and partially transcostal BH ablation of kidney and liver in an acute in vivo swine model was evaluated for 6 animals. BH parameters were: 1.5 MHz frequency, 5–30 pulses of 1–10 ms duration per focus, 1% duty cycle, peak acoustic powers 0.9–3.8 kW, sonication foci spaced 1–1.5 mm apart in a rectangular grid with 5–15 mm linear dimensions. In kidneys, well-demarcated volumetric BH lesions were generated without respiratory gating and renal medulla and collecting system were more resistant to BH than cortex. The treatment was accelerated 10-fold by using shorter BH pulses of larger peak power without affecting the quality of tissue fractionation. In liver, respiratory motion and aberrations from subcutaneous fat affected the treatment but increasing the peak power provided successful lesion generation. These data indicate BH is a promising technology for transabdominal and transcostal mechanical ablation of tumors in kidney and liver.
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Affiliation(s)
- Tatiana D Khokhlova
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA, USA. .,Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA.
| | - George R Schade
- Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
| | - Yak-Nam Wang
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - Sergey V Buravkov
- Faculty of Fundamental Medicine, M.V. Lomonosov Moscow State University, Moscow, Russia
| | | | - Julianna C Simon
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - Frank Starr
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - Adam D Maxwell
- Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
| | - Michael R Bailey
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA.,Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
| | - Wayne Kreider
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - Vera A Khokhlova
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA.,Physics Faculty, M.V. Lomonosov Moscow State University, Moscow, Russia
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17
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Gray MD, Coussios CC. Compensation of array lens effects for improved co-registration of passive acoustic mapping and B-mode images for cavitation monitoring. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 146. [PMID: 31370617 PMCID: PMC7080234 DOI: 10.1121/1.5118238#suppl] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Passive acoustic mapping (PAM) techniques offer a simple means of spatio-temporal cavitation monitoring during therapeutic ultrasound procedures. Implementation with a conventional diagnostic ultrasound system allows natural integration of PAM with B-mode imaging. However, the refracting properties of diagnostic array lenses may introduce PAM image registration errors that could lead to inaccuracies in treatment monitoring and guidance. To address these concerns, this paper presents lens characterization of two different array designs, analytical estimation of lens-induced source mapping errors in simple media, and experimental demonstration and correction of lens effects, reducing the depth-averaged image co-registration errors to no more than 0.52 mm.
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Affiliation(s)
- Michael D Gray
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Old Road Campus Research Building, Oxford, OX3 7DQ, United ,
| | - Constantin C Coussios
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Old Road Campus Research Building, Oxford, OX3 7DQ, United ,
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18
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Gray MD, Coussios CC. Compensation of array lens effects for improved co-registration of passive acoustic mapping and B-mode images for cavitation monitoring. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 146:EL78. [PMID: 31370617 PMCID: PMC7080234 DOI: 10.1121/1.5118238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Passive acoustic mapping (PAM) techniques offer a simple means of spatio-temporal cavitation monitoring during therapeutic ultrasound procedures. Implementation with a conventional diagnostic ultrasound system allows natural integration of PAM with B-mode imaging. However, the refracting properties of diagnostic array lenses may introduce PAM image registration errors that could lead to inaccuracies in treatment monitoring and guidance. To address these concerns, this paper presents lens characterization of two different array designs, analytical estimation of lens-induced source mapping errors in simple media, and experimental demonstration and correction of lens effects, reducing the depth-averaged image co-registration errors to no more than 0.52 mm.
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Affiliation(s)
- Michael D Gray
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Old Road Campus Research Building, Oxford, OX3 7DQ, United ,
| | - Constantin C Coussios
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Old Road Campus Research Building, Oxford, OX3 7DQ, United ,
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19
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Maxwell AD, Wang YN, Kreider W, Cunitz BW, Starr F, Lee D, Nazari Y, Williams JC, Bailey MR, Sorensen MD. Evaluation of Renal Stone Comminution and Injury by Burst Wave Lithotripsy in a Pig Model. J Endourol 2019; 33:787-792. [PMID: 31016998 DOI: 10.1089/end.2018.0886] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Burst wave lithotripsy is an experimental technology to noninvasively fragment kidney stones with focused bursts of ultrasound (US). This study evaluated the safety and effectiveness of specific lithotripsy parameters in a porcine model of nephrolithiasis. Methods: A 6- to 7-mm human kidney stone was surgically implanted in each kidney of three pigs. A burst wave lithotripsy US transducer with an inline US imager was coupled to the flank and the lithotripter focus was aligned with the stone. Each stone was exposed to burst wave lithotripsy at 6.5 to 7 MPa focal pressure for 30 minutes under real-time image guidance. After treatment, the kidneys were removed for gross, histologic, and MRI assessment. Stone fragments were retrieved from the kidney to determine the mass comminuted to pieces <2 mm. Results: On average, 87% of the stone mass was reduced to fragments <2 mm. In three of five treatments, stones were completely comminuted to <2-mm fragments. In two of five treatments, stones were partially disintegrated, but larger fragments remained. One stone was not treated because no suitable acoustic window was identified. No injury was detected through gross, histologic, or MRI examination in the parenchymal tissue, although petechial damage and surface erosion were identified on the urothelium of the collecting system limited to the area around the stone. Conclusion: Burst wave lithotripsy can consistently produce stone fragments small enough to spontaneously pass by transcutaneous administration of US pulses. The data suggest that such exposures produce minimal injury to the kidney and urinary tract.
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Affiliation(s)
- Adam D Maxwell
- Department of Urology, University of Washington School of Medicine, Seattle, Washington.,Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington
| | - Yak-Nam Wang
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington
| | - Wayne Kreider
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington
| | - Bryan W Cunitz
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington
| | - Frank Starr
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington
| | - Donghoon Lee
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington
| | - Yasser Nazari
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington
| | - James C Williams
- Department of Anatomy and Cell Biology, Indiana University Purdue University at Indianapolis, Indianapolis, Indiana
| | - Michael R Bailey
- Department of Urology, University of Washington School of Medicine, Seattle, Washington.,Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington
| | - Mathew D Sorensen
- Department of Urology, University of Washington School of Medicine, Seattle, Washington.,Division of Urology, Department of Veterans Affairs Medical Center, Seattle, Washington
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20
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Bader KB, Vlaisavljevich E, Maxwell AD. For Whom the Bubble Grows: Physical Principles of Bubble Nucleation and Dynamics in Histotripsy Ultrasound Therapy. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:1056-1080. [PMID: 30922619 PMCID: PMC6524960 DOI: 10.1016/j.ultrasmedbio.2018.10.035] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/28/2018] [Accepted: 10/03/2018] [Indexed: 05/04/2023]
Abstract
Histotripsy is a focused ultrasound therapy for non-invasive tissue ablation. Unlike thermally ablative forms of therapeutic ultrasound, histotripsy relies on the mechanical action of bubble clouds for tissue destruction. Although acoustic bubble activity is often characterized as chaotic, the short-duration histotripsy pulses produce a unique and consistent type of cavitation for tissue destruction. In this review, the action of histotripsy-induced bubbles is discussed. Sources of bubble nuclei are reviewed, and bubble activity over the course of single and multiple pulses is outlined. Recent innovations in terms of novel acoustic excitations, exogenous nuclei for targeted ablation and histotripsy-enhanced drug delivery and image guidance metrics are discussed. Finally, gaps in knowledge of the histotripsy process are highlighted, along with suggested means to expedite widespread clinical utilization of histotripsy.
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Affiliation(s)
- Kenneth B Bader
- Department of Radiology and Committee on Medical Physics, University of Chicago, Chicago, Illinois, USA.
| | - Eli Vlaisavljevich
- Department of Biomedical Engineering and Mechanics, Virginia Tech University, Blacksburg, Virginia, USA
| | - Adam D Maxwell
- Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA
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21
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Wang M, Lei Y, Zhou Y. High-intensity focused ultrasound (HIFU) ablation by the frequency chirps: Enhanced thermal field and cavitation at the focus. ULTRASONICS 2019; 91:134-149. [PMID: 30146323 DOI: 10.1016/j.ultras.2018.08.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 08/14/2018] [Accepted: 08/20/2018] [Indexed: 06/08/2023]
Abstract
High-intensity focused ultrasound (HIFU) has become popular in the noninvasive ablation of a variety of solid tumors and cancers with promising clinical outcomes. Its ablation efficiency should be improved for the reduced treatment duration, especially for a large target. The frequency chirps were proposed and investigated for the enhanced lesion production and bubble cavitation at the focus during HIFU ablation. First, a nonlinear wave model was used to simulate the acoustic field using different excitation strategies (at the constant frequency excitation, downward and upward frequency chirps) and subsequently, the bubble dynamics and cavitation-enhanced temperature elevation were calculated by the Gilmore and Bioheat equations, respectively. Then the temperature rises and the produced lesion in the gel phantom were measured by the thermocouple and recorded photographically, respectively. Bubble activities at the focus were measured by passive cavitation detection (PCD) to quantify the scattering and inertial cavitation levels using short-time Fourier-transform (STFT). Finally, the enhanced temperature elevation, lesion production, and bubble cavitation were further confirmed in the ex vivo tissue samples. It is found that the frequency sweeping time plays a more important role in the enhancement of HIFU-produced lesion in the gel phantom while the frequency sweeping range seems more critical in the tissue. Altogether, large frequency sweeping range in a short time is preferable, and the frequency sweeping direction has little influence on the lesion enhancement.
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Affiliation(s)
- Mingjun Wang
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore
| | - Yisheng Lei
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore
| | - Yufeng Zhou
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore.
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22
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Gray MD, Coussios CC. Broadband Ultrasonic Attenuation Estimation and Compensation With Passive Acoustic Mapping. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2018; 65:1997-2011. [PMID: 30130184 DOI: 10.1109/tuffc.2018.2866171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Several active and passive techniques have been developed to detect, localize, and quantify cavitation activity during therapeutic ultrasound procedures. Much of the prior cavitation monitoring research has been conducted using lossless in vitro systems or small animal models in which path attenuation effects were minimal. However, the performance of these techniques may be substantially degraded by attenuation between the internal therapeutic target and the external monitoring system. As a further step toward clinical application of passive acoustic mapping (PAM), this paper presents methods for attenuation estimation and compensation based on broadband cavitation data measured with a linear ultrasound array. Soft tissue phantom experiment results are used to illustrate: 1) the impact of realistic attenuation on PAM; 2) the possibility of estimating attenuation from cavitation data; 3) cavitation source energy estimation following attenuation compensation; and 4) the impact of sound speed uncertainty on PAM-related processing. Cavitation-based estimates of attenuation were within 1.5%-6.2% of the values found from conventional through-transmission measurements. Tissue phantom attenuation reduced the PAM energy estimate by an order of magnitude, but array data compensation using the cavitation-based attenuation spectrum enabled recovery of the PAM energy estimate to within 2.9%-5.9% of the values computed in the absence of the phantom. Sound speed uncertainties were found to modestly impact attenuation-compensated PAM energies, inducing errors no larger than 28% for a 40-m/s path-averaged speed error. Together, the results indicate the potential to significantly enhance the quantitative capabilities of PAM for ensuring therapeutic safety and efficacy.
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23
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Gray MD, Lyka E, Coussios CC. Diffraction Effects and Compensation in Passive Acoustic Mapping. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2018; 65:258-268. [PMID: 29389657 DOI: 10.1109/tuffc.2017.2778509] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Over the last decade, a variety of noninvasive techniques have been developed to monitor therapeutic ultrasound procedures in support of safety or efficacy assessments. One class of methods employs diagnostic ultrasound arrays to sense acoustic emissions, thereby providing a means to passively detect, localize, and quantify the strength of nonlinear sources, including cavitation. Real array element diffraction patterns may differ substantially from those presumed in existing beamforming algorithms. However, diffraction compensation has received limited treatment in passive and active imaging, and measured diffraction data have yet to be used for array response correction. The objectives of this paper were to identify differences between ideal and real element diffraction patterns, and to quantify the impact of diffraction correction on cavitation mapping beamformer performance. These objectives were addressed by performing calibration measurements on a diagnostic linear array, using the results to calculate diffraction correction terms, and applying the corrections to cavitation emission data collected from soft tissue phantom experiments. Measured diffraction patterns were found to differ significantly from those of ideal element forms, particularly at higher frequencies and shorter distances from the array. Diffraction compensation of array data resulted in cavitation energy estimates elevated by as much as a factor of 5, accompanied by the elimination of a substantial bias between two established beamforming algorithms. These results illustrate the importance of using measured array responses to validate analytical field models and to minimize observation biases in imaging applications where quantitative analyses are critical for assessment of therapeutic safety and efficacy.
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24
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Simon JC, Sapozhnikov OA, Kreider W, Breshock M, Williams JC, Bailey MR. The role of trapped bubbles in kidney stone detection with the color Doppler ultrasound twinkling artifact. Phys Med Biol 2018; 63:025011. [PMID: 29131810 DOI: 10.1088/1361-6560/aa9a2f] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The color Doppler ultrasound twinkling artifact, which highlights kidney stones with rapidly changing color, has the potential to improve stone detection; however, its inconsistent appearance has limited its clinical utility. Recently, it was proposed stable crevice bubbles on the kidney stone surface cause twinkling; however, the hypothesis is not fully accepted because the bubbles have not been directly observed. In this paper, the micron or submicron-sized bubbles predicted by the crevice bubble hypothesis are enlarged in kidney stones of five primary compositions by exposure to acoustic rarefaction pulses or hypobaric static pressures in order to simultaneously capture their appearance by high-speed photography and ultrasound imaging. On filming stones that twinkle, consecutive rarefaction pulses from a lithotripter caused some bubbles to reproducibly grow from specific locations on the stone surface, suggesting the presence of pre-existing crevice bubbles. Hyperbaric and hypobaric static pressures were found to modify the twinkling artifact; however, the simple expectation that hyperbaric exposures reduce and hypobaric pressures increase twinkling by shrinking and enlarging bubbles, respectively, largely held for rough-surfaced stones but was inadequate for smoother stones. Twinkling was found to increase or decrease in response to elevated static pressure on smooth stones, perhaps because of the compression of internal voids. These results support the crevice bubble hypothesis of twinkling and suggest the kidney stone crevices that give rise to the twinkling phenomenon may be internal as well as external.
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Affiliation(s)
- Julianna C Simon
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40th St., Seattle, WA 98105, United States of America. Department of Mechanical Engineering, University of Washington, Stevens Way, Box 352600, Seattle, WA 98195, United States of America. Current address: Graduate Program in Acoustics, The Pennsylvania State University, 201E Applied Science Building, University Park, PA 16802, United States of America. Author to whom any correspondence should be addressed
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25
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Bai C, Xu S, Duan J, Jing B, Yang M, Wan M. Pulse-Inversion Subharmonic Ultrafast Active Cavitation Imaging in Tissue Using Fast Eigenspace-Based Adaptive Beamforming and Cavitation Deconvolution. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2017; 64:1175-1193. [PMID: 28796605 DOI: 10.1109/tuffc.2017.2710102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pulse-inversion subharmonic (PISH) imaging can display information relating to pure cavitation bubbles while excluding that of tissue. Although plane-wave-based ultrafast active cavitation imaging (UACI) can monitor the transient activities of cavitation bubbles, its resolution and cavitation-to-tissue ratio (CTR) are barely satisfactory but can be significantly improved by introducing eigenspace-based (ESB) adaptive beamforming. PISH and UACI are a natural combination for imaging of pure cavitation activity in tissue; however, it raises two problems: 1) the ESB beamforming is hard to implement in real time due to the enormous amount of computation associated with the covariance matrix inversion and eigendecomposition and 2) the narrowband characteristic of the subharmonic filter will incur a drastic degradation in resolution. Thus, in order to jointly address these two problems, we propose a new PISH-UACI method using novel fast ESB (F-ESB) beamforming and cavitation deconvolution for nonlinear signals. This method greatly reduces the computational complexity by using F-ESB beamforming through dimensionality reduction based on principal component analysis, while maintaining the high quality of ESB beamforming. The degraded resolution is recovered using cavitation deconvolution through a modified convolution model and compressive deconvolution. Both simulations and in vitro experiments were performed to verify the effectiveness of the proposed method. Compared with the ESB-based PISH-UACI, the entire computation of our proposed approach was reduced by 99%, while the axial resolution gain and CTR were increased by 3 times and 2 dB, respectively, confirming that satisfactory performance can be obtained for monitoring pure cavitation bubbles in tissue erosion.
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26
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May PC, Kreider W, Maxwell AD, Wang YN, Cunitz BW, Blomgren PM, Johnson CD, Park JSH, Bailey MR, Lee D, Harper JD, Sorensen MD. Detection and Evaluation of Renal Injury in Burst Wave Lithotripsy Using Ultrasound and Magnetic Resonance Imaging. J Endourol 2017; 31:786-792. [PMID: 28521550 DOI: 10.1089/end.2017.0202] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Burst wave lithotripsy (BWL) is a transcutaneous technique with potential to safely and effectively fragment renal stones. Preclinical investigations of BWL require the assessment of potential renal injury. This study evaluates the capabilities of real-time ultrasound and MRI to detect and evaluate BWL injury that was induced in porcine kidneys. MATERIALS AND METHODS Ten kidneys from five female farm pigs were treated with either a 170 or 335 kHz BWL transducer using variable treatment parameters and monitored in real-time with ultrasound. Eight kidneys were perfusion fixed and scanned with a 3-Tesla MRI scanner (T1-weighted, T2-weighted, and susceptibility-weighted imaging), followed by processing via an established histomorphometric technique for injury quantification. In addition, two kidneys were separately evaluated for histologic characterization of injury quality. RESULTS Observed B-mode hyperechoes on ultrasound consistent with cavitation predicted the presence of BWL-induced renal injury with a sensitivity and specificity of 100% in comparison to the histomorphometric technique. Similarly, MRI detected renal injury with a sensitivity of 90% and specificity of 100% and was able to identify the scale of lesion volumes. The injuries purposefully generated with BWL were histologically similar to those formed by shock wave lithotripsy. CONCLUSIONS BWL-induced renal injury can be detected with a high degree of sensitivity and specificity by real-time ultrasound and post-treatment ex vivo MRI. No injury occurred in this study without cavitation detected on ultrasound. Such capabilities for injury detection and lesion volume quantification on MRI can be used for preclinical testing of BWL.
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Affiliation(s)
- Philip C May
- 1 University of Washington Applied Physics Lab , Center for Industrial and Medical Ultrasound, Seattle, Washington.,2 Department of Urology, University of Washington School of Medicine , Seattle, Washington
| | - Wayne Kreider
- 1 University of Washington Applied Physics Lab , Center for Industrial and Medical Ultrasound, Seattle, Washington
| | - Adam D Maxwell
- 2 Department of Urology, University of Washington School of Medicine , Seattle, Washington
| | - Yak-Nam Wang
- 1 University of Washington Applied Physics Lab , Center for Industrial and Medical Ultrasound, Seattle, Washington
| | - Bryan W Cunitz
- 1 University of Washington Applied Physics Lab , Center for Industrial and Medical Ultrasound, Seattle, Washington
| | - Philip M Blomgren
- 3 Department of Anatomy and Cell Biology, Indiana University , Indianapolis, Indiana
| | - Cynthia D Johnson
- 3 Department of Anatomy and Cell Biology, Indiana University , Indianapolis, Indiana
| | - Joshua S H Park
- 4 Department of Radiology, University of Washington , Seattle, Washington
| | - Michael R Bailey
- 1 University of Washington Applied Physics Lab , Center for Industrial and Medical Ultrasound, Seattle, Washington.,2 Department of Urology, University of Washington School of Medicine , Seattle, Washington
| | - Donghoon Lee
- 4 Department of Radiology, University of Washington , Seattle, Washington
| | - Jonathan D Harper
- 2 Department of Urology, University of Washington School of Medicine , Seattle, Washington
| | - Mathew D Sorensen
- 2 Department of Urology, University of Washington School of Medicine , Seattle, Washington.,5 Division of Urology, Department of Veteran Affairs Medical Center , Seattle, Washington
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27
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Chevillet JR, Khokhlova TD, Giraldez MD, Schade GR, Starr F, Wang YN, Gallichotte EN, Wang K, Hwang JH, Tewari M. Release of Cell-free MicroRNA Tumor Biomarkers into the Blood Circulation with Pulsed Focused Ultrasound: A Noninvasive, Anatomically Localized, Molecular Liquid Biopsy. Radiology 2016; 283:158-167. [PMID: 27802108 DOI: 10.1148/radiol.2016160024] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Purpose To compare the abilities of three pulsed focused ultrasound regimes (that cause tissue liquefaction, permeabilization, or mild heating) to release tumor-derived microRNA into the circulation in vivo and to evaluate release dynamics. Materials and Methods All rat experiments were approved by the University of Washington Institutional Animal Care and Use Committee. Reverse-transcription quantitative polymerase chain reaction array profiling was used to identify candidate microRNA biomarkers in a rat solid tumor cell line. Rats subcutaneously grafted with these cells were randomly assigned among three pulsed focused ultrasound treatment groups: (a) local tissue liquefaction via boiling histotripsy, (b) tissue permeabilization via inertial cavitation, and (c) mild (<10°C) heating of tissue, as well as a sham-treated control group. Blood specimens were drawn immediately prior to treatment and serially over 24 hours afterward. Plasma microRNA was quantified with reverse-transcription quantitative polymerase chain reaction, and statistical significance was determined with one-way analysis of variance (Kruskal-Wallis and Friedman tests), followed by the Dunn multiple-comparisons test. Results After tissue liquefaction and cavitation treatments (but not mild heating), plasma quantities of candidate biomarkers increased significantly (P value range, <.0001 to .04) relative to sham-treated controls. A threefold to 32-fold increase occurred within 15 minutes after initiation of pulsed focused ultrasound tumor treatment, and these increases persisted for 3 hours. Histologic examination confirmed complete liquefaction of the targeted tumor area with boiling histotripsy, in addition to areas of petechial hemorrhage and tissue disruption by means of cavitation-based treatment. Conclusion Mechanical tumor tissue disruption with pulsed focused ultrasound-induced bubble activity significantly increases the plasma abundance of tumor-derived microRNA rapidly after treatment. © RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- John R Chevillet
- From the Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.C., E.N.G., M.D.G., M.T.); Institute for Systems Biology, Seattle, Wash (J.R.C., K.W.); Department of Medicine (T.D.K., J.H.H.), Department of Urology (G.R.S.), and Applied Physics Laboratory (F.S., Y.N.W.), University of Washington, Seattle, Wash; and Departments of Internal Medicine (M.D.G., M.T.) and Biomedical Engineering, Center for Computational Medicine and Bioinformatics, and the Biointerfaces Institute (M.T.), University of Michigan, 109 Zina Pitcher Pl, 1502 BSRB, SPC 2200, Ann Arbor, MI 48109
| | - Tatiana D Khokhlova
- From the Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.C., E.N.G., M.D.G., M.T.); Institute for Systems Biology, Seattle, Wash (J.R.C., K.W.); Department of Medicine (T.D.K., J.H.H.), Department of Urology (G.R.S.), and Applied Physics Laboratory (F.S., Y.N.W.), University of Washington, Seattle, Wash; and Departments of Internal Medicine (M.D.G., M.T.) and Biomedical Engineering, Center for Computational Medicine and Bioinformatics, and the Biointerfaces Institute (M.T.), University of Michigan, 109 Zina Pitcher Pl, 1502 BSRB, SPC 2200, Ann Arbor, MI 48109
| | - Maria D Giraldez
- From the Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.C., E.N.G., M.D.G., M.T.); Institute for Systems Biology, Seattle, Wash (J.R.C., K.W.); Department of Medicine (T.D.K., J.H.H.), Department of Urology (G.R.S.), and Applied Physics Laboratory (F.S., Y.N.W.), University of Washington, Seattle, Wash; and Departments of Internal Medicine (M.D.G., M.T.) and Biomedical Engineering, Center for Computational Medicine and Bioinformatics, and the Biointerfaces Institute (M.T.), University of Michigan, 109 Zina Pitcher Pl, 1502 BSRB, SPC 2200, Ann Arbor, MI 48109
| | - George R Schade
- From the Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.C., E.N.G., M.D.G., M.T.); Institute for Systems Biology, Seattle, Wash (J.R.C., K.W.); Department of Medicine (T.D.K., J.H.H.), Department of Urology (G.R.S.), and Applied Physics Laboratory (F.S., Y.N.W.), University of Washington, Seattle, Wash; and Departments of Internal Medicine (M.D.G., M.T.) and Biomedical Engineering, Center for Computational Medicine and Bioinformatics, and the Biointerfaces Institute (M.T.), University of Michigan, 109 Zina Pitcher Pl, 1502 BSRB, SPC 2200, Ann Arbor, MI 48109
| | - Frank Starr
- From the Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.C., E.N.G., M.D.G., M.T.); Institute for Systems Biology, Seattle, Wash (J.R.C., K.W.); Department of Medicine (T.D.K., J.H.H.), Department of Urology (G.R.S.), and Applied Physics Laboratory (F.S., Y.N.W.), University of Washington, Seattle, Wash; and Departments of Internal Medicine (M.D.G., M.T.) and Biomedical Engineering, Center for Computational Medicine and Bioinformatics, and the Biointerfaces Institute (M.T.), University of Michigan, 109 Zina Pitcher Pl, 1502 BSRB, SPC 2200, Ann Arbor, MI 48109
| | - Yak-Nam Wang
- From the Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.C., E.N.G., M.D.G., M.T.); Institute for Systems Biology, Seattle, Wash (J.R.C., K.W.); Department of Medicine (T.D.K., J.H.H.), Department of Urology (G.R.S.), and Applied Physics Laboratory (F.S., Y.N.W.), University of Washington, Seattle, Wash; and Departments of Internal Medicine (M.D.G., M.T.) and Biomedical Engineering, Center for Computational Medicine and Bioinformatics, and the Biointerfaces Institute (M.T.), University of Michigan, 109 Zina Pitcher Pl, 1502 BSRB, SPC 2200, Ann Arbor, MI 48109
| | - Emily N Gallichotte
- From the Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.C., E.N.G., M.D.G., M.T.); Institute for Systems Biology, Seattle, Wash (J.R.C., K.W.); Department of Medicine (T.D.K., J.H.H.), Department of Urology (G.R.S.), and Applied Physics Laboratory (F.S., Y.N.W.), University of Washington, Seattle, Wash; and Departments of Internal Medicine (M.D.G., M.T.) and Biomedical Engineering, Center for Computational Medicine and Bioinformatics, and the Biointerfaces Institute (M.T.), University of Michigan, 109 Zina Pitcher Pl, 1502 BSRB, SPC 2200, Ann Arbor, MI 48109
| | - Kai Wang
- From the Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.C., E.N.G., M.D.G., M.T.); Institute for Systems Biology, Seattle, Wash (J.R.C., K.W.); Department of Medicine (T.D.K., J.H.H.), Department of Urology (G.R.S.), and Applied Physics Laboratory (F.S., Y.N.W.), University of Washington, Seattle, Wash; and Departments of Internal Medicine (M.D.G., M.T.) and Biomedical Engineering, Center for Computational Medicine and Bioinformatics, and the Biointerfaces Institute (M.T.), University of Michigan, 109 Zina Pitcher Pl, 1502 BSRB, SPC 2200, Ann Arbor, MI 48109
| | - Joo Ha Hwang
- From the Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.C., E.N.G., M.D.G., M.T.); Institute for Systems Biology, Seattle, Wash (J.R.C., K.W.); Department of Medicine (T.D.K., J.H.H.), Department of Urology (G.R.S.), and Applied Physics Laboratory (F.S., Y.N.W.), University of Washington, Seattle, Wash; and Departments of Internal Medicine (M.D.G., M.T.) and Biomedical Engineering, Center for Computational Medicine and Bioinformatics, and the Biointerfaces Institute (M.T.), University of Michigan, 109 Zina Pitcher Pl, 1502 BSRB, SPC 2200, Ann Arbor, MI 48109
| | - Muneesh Tewari
- From the Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.C., E.N.G., M.D.G., M.T.); Institute for Systems Biology, Seattle, Wash (J.R.C., K.W.); Department of Medicine (T.D.K., J.H.H.), Department of Urology (G.R.S.), and Applied Physics Laboratory (F.S., Y.N.W.), University of Washington, Seattle, Wash; and Departments of Internal Medicine (M.D.G., M.T.) and Biomedical Engineering, Center for Computational Medicine and Bioinformatics, and the Biointerfaces Institute (M.T.), University of Michigan, 109 Zina Pitcher Pl, 1502 BSRB, SPC 2200, Ann Arbor, MI 48109
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Ding T, Hu H, Bai C, Guo S, Yang M, Wang S, Wan M. Spatial-temporal three-dimensional ultrasound plane-by-plane active cavitation mapping for high-intensity focused ultrasound in free field and pulsatile flow. ULTRASONICS 2016; 69:166-181. [PMID: 27111870 DOI: 10.1016/j.ultras.2016.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 03/22/2016] [Accepted: 04/11/2016] [Indexed: 06/05/2023]
Abstract
Cavitation plays important roles in almost all high-intensity focused ultrasound (HIFU) applications. However, current two-dimensional (2D) cavitation mapping could only provide cavitation activity in one plane. This study proposed a three-dimensional (3D) ultrasound plane-by-plane active cavitation mapping (3D-UPACM) for HIFU in free field and pulsatile flow. The acquisition of channel-domain raw radio-frequency (RF) data in 3D space was performed by sequential plane-by-plane 2D ultrafast active cavitation mapping. Between two adjacent unit locations, there was a waiting time to make cavitation nuclei distribution of the liquid back to the original state. The 3D cavitation map equivalent to the one detected at one time and over the entire volume could be reconstructed by Marching Cube algorithm. Minimum variance (MV) adaptive beamforming was combined with coherence factor (CF) weighting (MVCF) or compressive sensing (CS) method (MVCS) to process the raw RF data for improved beamforming or more rapid data processing. The feasibility of 3D-UPACM was demonstrated in tap-water and a phantom vessel with pulsatile flow. The time interval between temporal evolutions of cavitation bubble cloud could be several microseconds. MVCF beamformer had a signal-to-noise ratio (SNR) at 14.17dB higher, lateral and axial resolution at 2.88times and 1.88times, respectively, which were compared with those of B-mode active cavitation mapping. MVCS beamformer had only 14.94% time penalty of that of MVCF beamformer. This 3D-UPACM technique employs the linear array of a current ultrasound diagnosis system rather than a 2D array transducer to decrease the cost of the instrument. Moreover, although the application is limited by the requirement for a gassy fluid medium or a constant supply of new cavitation nuclei that allows replenishment of nuclei between HIFU exposures, this technique may exhibit a useful tool in 3D cavitation mapping for HIFU with high speed, precision and resolution, especially in a laboratory environment where more careful analysis may be required under controlled conditions.
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Affiliation(s)
- Ting Ding
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China; National Key Laboratory for Electronic Measurement Technology, Department of Biomedical Engineering, School of Information and Communication Engineering, North University of China, Taiyuan, Shanxi 030051, China
| | - Hong Hu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Chen Bai
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Shifang Guo
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Miao Yang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Supin Wang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Mingxi Wan
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China.
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29
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Miller RM, Zhang X, Maxwell A, Cain C, Xu Z. Bubble-Induced Color Doppler Feedback for Histotripsy Tissue Fractionation. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2016; 63:408-19. [PMID: 26863659 PMCID: PMC4838481 DOI: 10.1109/tuffc.2016.2525859] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Histotripsy therapy produces cavitating bubble clouds to increasingly fractionate and eventually liquefy tissue using high-intensity ultrasound pulses. Following cavitation generated by each pulse, coherent motion of the cavitation residual nuclei can be detected using metrics formed from ultrasound color Doppler acquisitions. In this paper, three experiments were performed to investigate the characteristics of this motion as real-time feedback on histotripsy tissue fractionation. In the first experiment, bubble-induced color Doppler (BCD) and particle image velocimetry (PIV) analysis monitored the residual cavitation nuclei in the treatment region in an agarose tissue phantom treated with two-cycle histotripsy pulses at [Formula: see text] using a 500-kHz transducer. Both BCD and PIV results showed brief chaotic motion of the residual nuclei followed by coherent motion first moving away from the transducer and then rebounding back. Velocity measurements from both PIV and BCD agreed well, showing a monotonic increase in rebound time up to a saturation point for increased therapy dose. In a second experiment, a thin layer of red blood cells (RBC) was added to the phantom to allow quantification of the fractionation of the RBC layer to compare with BCD metrics. A strong linear correlation was observed between the fractionation level and the time to BCD peak rebound velocity over histotripsy treatment. Finally, the correlation between BCD feedback and histotripsy tissue fractionation was validated in ex vivo porcine liver evaluated histologically. BCD metrics showed strong linear correlation with fractionation progression, suggesting that BCD provides useful quantitative real-time feedback on histotripsy treatment progression.
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Affiliation(s)
- Ryan M. Miller
- University of Michigan, Ann Arbor, MI 48109 USA. He is now with HistoSonics, Inc. Ann Arbor, MI 48103
| | - Xi Zhang
- University of Michigan, Ann Arbor, MI 48109 USA
| | - Adam Maxwell
- University of Michigan, Ann Arbor, MI 48109 USA. He is now with the University of Washington, Seattle, WA 98105
| | | | - Zhen Xu
- University of Michigan, Ann Arbor, MI 48109 USA
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30
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Khokhlova TD, Haider Y, Hwang JH. Therapeutic potential of ultrasound microbubbles in gastrointestinal oncology: recent advances and future prospects. Therap Adv Gastroenterol 2015; 8:384-94. [PMID: 26557894 PMCID: PMC4622285 DOI: 10.1177/1756283x15592584] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Microbubbles were initially invented as contrast agents for ultrasound imaging. However, lately more and more therapeutic applications of microbubbles are emerging, mostly related to drug and gene delivery. Ultrasound is a safe and noninvasive therapeutic modality which has the unique ability to interact with microbubbles and release their payload in situ in addition to permeabilizing the target tissues. The combination of drug-loaded microbubbles and ultrasound has been used in preclinical studies on blood-brain barrier opening, drug and gene delivery to solid tumors, and ablation of blood vessels. This review covers the basic principles of ultrasound-microbubble interaction, the types of microbubbles and the effect they have on tissue, and the preclinical and clinical experience with this approach to date in the field of gastrointestinal oncology.
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Affiliation(s)
- Tatiana D. Khokhlova
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Yasser Haider
- Department of Urology, University of Washington, Seattle, WA, USA
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31
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Li T, Wang YN, Khokhlova TD, D'Andrea S, Starr F, Chen H, McCune JS, Risler LJ, Mashadi-Hossein A, Hingorani SR, Chang A, Hwang JH. Pulsed High-Intensity Focused Ultrasound Enhances Delivery of Doxorubicin in a Preclinical Model of Pancreatic Cancer. Cancer Res 2015. [PMID: 26216548 DOI: 10.1158/0008-5472.can-15-0296] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Pancreatic cancer is characterized by extensive stromal desmoplasia, which decreases blood perfusion and impedes chemotherapy delivery. Breaking the stromal barrier could both increase perfusion and permeabilize the tumor, enhancing chemotherapy penetration. Mechanical disruption of the stroma can be achieved using ultrasound-induced bubble activity-cavitation. Cavitation is also known to result in microstreaming and could have the added benefit of actively enhancing diffusion into the tumors. Here, we report the ability to enhance chemotherapeutic drug doxorubicin penetration using ultrasound-induced cavitation in a genetically engineered mouse model (KPC mouse) of pancreatic ductal adenocarcinoma. To induce localized inertial cavitation in pancreatic tumors, pulsed high-intensity focused ultrasound (pHIFU) was used either during or before doxorubicin administration to elucidate the mechanisms of enhanced drug delivery (active vs. passive drug diffusion). For both types, the pHIFU exposures that were associated with high cavitation activity resulted in disruption of the highly fibrotic stromal matrix and enhanced the normalized doxorubicin concentration by up to 4.5-fold compared with controls. Furthermore, normalized doxorubicin concentration was associated with the cavitation metrics (P < 0.01), indicating that high and sustained cavitation results in increased chemotherapy penetration. No significant difference between the outcomes of the two types, that is, doxorubicin infusion during or after pHIFU treatment, was observed, suggesting that passive diffusion into previously permeabilized tissue is the major mechanism for the increase in drug concentration. Together, the data indicate that pHIFU treatment of pancreatic tumors when resulting in high and sustained cavitation can efficiently enhance chemotherapy delivery to pancreatic tumors. .
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Affiliation(s)
- Tong Li
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington
| | - Yak-Nam Wang
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington
| | - Tatiana D Khokhlova
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington
| | - Samantha D'Andrea
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington
| | - Frank Starr
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington
| | - Hong Chen
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington
| | - Jeannine S McCune
- Department of Pharmacy, University of Washington, Seattle, Washington. Department of Pharmaceutics, University of Washington, Seattle, Washington
| | - Linda J Risler
- Department of Pharmacy, University of Washington, Seattle, Washington. Department of Pharmaceutics, University of Washington, Seattle, Washington
| | | | | | | | - Joo Ha Hwang
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington.
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Abstract
In this review we present the current status of ultrasound thermometry and ablation monitoring, with emphasis on the diverse approaches published in the literature and with an eye on which methods are closest to clinical reality. It is hoped that this review will serve as a guide to the expansion of sonographic methods for treatment monitoring and thermometry since the last brief review in 2007.
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Affiliation(s)
- Matthew A. Lewis
- Department of Radiology, UT Southwestern Medical Center at Dallas
| | - Robert M. Staruch
- Department of Radiology, UT Southwestern Medical Center at Dallas
- Ultrasound Imaging & Interventions, Philips Research North America
| | - Rajiv Chopra
- Department of Radiology, UT Southwestern Medical Center at Dallas
- Advanced Imaging Research Center, UT Southwestern Medical Center at Dallas
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