Journal of therapeutic ultrasound最新文献

{"title":"Transcranial and pulsed focused ultrasound that activates brain can accelerate remyelination in a mouse model of multiple sclerosis.","authors":"T A Olmstead,&nbsp;P A Chiarelli,&nbsp;D J Griggs,&nbsp;A M McClintic,&nbsp;A N Myroniv,&nbsp;P D Mourad","doi":"10.1186/s40349-018-0119-1","DOIUrl":"10.1186/s40349-018-0119-1","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) impacts approximately 400,000 in the United States and is the leading cause of disability among young to middle aged people in the developed world. Characteristic of this disease, myelin within generally focal volumes of brain tissue wastes away under an autoimmune assault, either inexorably or through a cycle of demyelination and remyelination. This centrally located damage produces central and peripheral symptoms tied to the portion of brain within the MS lesion site. Interestingly, Gibson and colleagues noted that optical activation of transgenically tagged central neurons increased the thickness of the myelin sheath around those neurons. Since ultrasound, delivered transcranially, can also activate brain focally, we hypothesized that ultrasound stimulation that followed the temporal pattern of Gibson et al. applied to MS lesions in a mouse model might either decelerate the demyelination phase or accelerate its remyelination phase.</p><p><strong>Methods: </strong>We created a temporal pattern of ultrasound delivery that conformed to that of Gibson et al. and capable of activating mouse brain. We then applied ultrasound, transcranially, following that temporal pattern to separate cohorts of a mouse model of multiple sclerosis, using three different ultrasound carrier frequencies (0.625 MHz, 1.09 MHz, 2.0 MHz), during each of the demyelinating and remyelinating phases. After identifying the most promising protocol and MS brain state through qualitative analysis of myelin content, we performed additional studies for that condition then assayed for change in myelin content via quantitative analysis.</p><p><strong>Results: </strong>We identified one ultrasound protocol that significantly accelerated remyelination, without damage, as demonstrated with histological analysis.</p><p><strong>Conclusion: </strong>MRI-guided focused ultrasound systems exist that can, in principle, deliver the ultrasound protocol we successfully tested here. In addition, MRI, as the clinical gold standard, can readily identify MS lesions. Given the relatively low intensity values of our ultrasound protocol - close to FDA limits - we anticipate that future success with this approach to MS therapy as tested using more realistic MS mouse models may one day translate to clinical trials that help address this devastating disease.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"6 ","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2018-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40349-018-0119-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36789312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focused ultrasound for the treatment of bone metastases: effectiveness and feasibility.","authors":"Anne-Sophie Bertrand,&nbsp;Antoine Iannessi,&nbsp;Romain Natale,&nbsp;Hubert Beaumont,&nbsp;Sebastien Patriti,&nbsp;Jiang Xiong-Ying,&nbsp;Guillaume Baudin,&nbsp;Antoine Thyss","doi":"10.1186/s40349-018-0117-3","DOIUrl":"https://doi.org/10.1186/s40349-018-0117-3","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the effectiveness and feasibility of high-intensity focused ultrasound (HIFU) for the treatment of bone metastases.</p><p><strong>Methods: </strong>A single-center prospective study was made involving 17 consecutive patients with symptomatic bone metastases. Patients were treated by Focused Ultrasound (FUs) performed with magnetic resonance (MR) guidance. Surgical treatment or radiotherapy treatment was not indicated for patients who underwent FUs. Lesions were located in the appendicular and axial skeleton and consisted of secondary symptomatic lesions. The clinical course of pain was evaluated using the Visual Analog Scale (VAS) before treatment, at 1 week, and at 1 month after treatment and the Oral Morphine Equivalent Daily Dose (OMEDD) was also recorded. We used Wilcoxon signed rank test to assess change in patient pain (R CRAN software V 3.1.1).</p><p><strong>Results: </strong>We observed a significant decrease in the pain felt by patients between pre- procedure and 1 week post-procedure (<i>p</i> = 2.9.10-4), and pre-procedure and 1 month post-procedure (<i>p</i> = 3.10-4). The proportion of responders according to the International Bone Metastases Consensus Working Party was: Partial Response 50% (8/16) and Complete Response 37.5% (6/16).</p><p><strong>Conclusions: </strong>HIFU under MR-guidance seems to be an effective and safe procedure in the treatment of symptomatic bone lesions for patients suffering from metastatic disease. A significant decrease of patient pain was observed.</p><p><strong>Trial registration: </strong>NCT01091883. Registered 24 March 2010. Level of evidence: Level 3.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"6 ","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2018-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40349-018-0117-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36754239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wedged gel pad for bowel manipulation during MR-guided high-intensity focused ultrasound therapy to treat uterine fibroids: a case report.","authors":"Teija Sainio,&nbsp;Gaber Komar,&nbsp;Jani Saunavaara,&nbsp;Visa Suomi,&nbsp;Kirsi Joronen,&nbsp;Antti Perheentupa,&nbsp;Antti Viitala,&nbsp;Roberto Blanco Sequeiros","doi":"10.1186/s40349-018-0116-4","DOIUrl":"https://doi.org/10.1186/s40349-018-0116-4","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance guided high-intensity focused ultrasound (MR-HIFU) therapy is not feasible in all patients with uterine fibroids because of limiting anatomical factors such as scar tissue, bowel loops or other obstacles in the sonication path. These may prevent the treatment or limit the treatment window, and therefore, also the volume where HIFU therapy can be delivered. Bowel loops present a particular problem because of bowel gas bubbles and hard particles which may cause reflection or absorption of ultrasound energy, potentially leading to thermal damage and even bowel perforation. Most commonly used techniques for bowel repositioning are bladder and/or rectum filling but these are not always sufficient to reposition the bowel loops. With more efficient bowel repositioning technique, the number of eligible patients for MR-HIFU treatment could be increased, and therapy efficacy be improved in cases where bowel loops limit the treatment window.</p><p><strong>Case presentation: </strong>A wedged exterior gel pad was used in two patients presented with in total of four symptomatic fibroids undergoing MR-HIFU treatment when bladder and/or rectum filling was not sufficient to reposition the bowel loops. No severe adverse effects were observed in these cases. The non-perfused volume ratios (NPVs) immediately after treatment were 86% and 39% for the first patient, and 3% for the second patient.</p><p><strong>Conclusions: </strong>Our preliminary experience suggests that the use of a wedged gel pad during MR-HIFU treatment could be an effective tool to manipulate the bowels in cases where the bladder and/or rectum filling is not sufficient to reposition the bowel loops. A wedged gel pad could also be used in other situations to achieve better treatment coverage to the uterine fibroid.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"6 ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2018-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40349-018-0116-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36728518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The fine spatial and temporal control of ultrasonic neuromodulation is a necessary condition for discerning the accompanying subjective feelings, but is it sufficient?","authors":"Robert Muratore","doi":"10.1186/s40349-018-0118-2","DOIUrl":"https://doi.org/10.1186/s40349-018-0118-2","url":null,"abstract":"","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"6 ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2018-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40349-018-0118-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36768593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MR thermometry-guided ultrasound hyperthermia of user-defined regions using the ExAblate prostate ablation array.","authors":"Eugene Ozhinsky,&nbsp;Vasant A Salgaonkar,&nbsp;Chris J Diederich,&nbsp;Viola Rieke","doi":"10.1186/s40349-018-0115-5","DOIUrl":"https://doi.org/10.1186/s40349-018-0115-5","url":null,"abstract":"<p><strong>Background: </strong>Hyperthermia therapy (HT) has shown to be an effective adjuvant to radiation, chemotherapy, and immunotherapy. In order to be safe and effective, delivery of HT requires maintenance of target tissue temperature within a narrow range (40-44 °C) for 30-60 min, which necessitates conformal heat delivery and accurate temperature monitoring. The goal of this project was to develop an MR thermometry-guided hyperthermia delivery platform based upon the ExAblate prostate array that would achieve uniform stable heating over large volumes within the prostate, while allowing the user to precisely control the power deposition patterns and shape of the region of treatment (ROT).</p><p><strong>Methods: </strong>The HT platform incorporates an accelerated multi-slice real time MR thermometry pulse sequence and reconstruction pipeline. Temperature uniformity over a large contiguous area was achieved by multi-point temperature sampling with multi-focal feedback power control. The hyperthermia delivery system was based on an InSightec ExAblate 2100 prostate focused ultrasound ablation system, and HeartVista's RTHawk real-time MRI system integrated with a 3 T MRI scanner. The integrated system was evaluated in experiments with a tissue-mimicking phantom for prolonged exposures with a target temperature increase of 7 °C from baseline.</p><p><strong>Results: </strong>Five various shapes of the region of treatment, defined on a 5 × 5 grid (35 × 35 mm, 11-25 focal spots per shape), were implemented to evaluate the performance of the system. MR temperature images, acquired after steady state was reached, showed different patterns of heating that closely matched the prescribed regions. Temperature uncertainty of the thermometry acquisition was 0.5 °C. The time to reach the target temperature (2:58-7:44 min) depended on the chosen ROT shape and on the distance from transducer to focal plane. Pre-cooling with circulating water helped to reduce near-field heating.</p><p><strong>Conclusions: </strong>We have implemented a real-time MR thermometry-guided system for hyperthermia delivery within user-defined regions with the ExAblate prostate array and evaluated it in phantom experiments for different shapes and focal depths. Our results demonstrate the feasibility of using a commercially available endorectal FUS transducer to perform spatially-conformal hyperthermia therapy and could lead to a new set of exciting applications for these devices.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"6 ","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2018-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40349-018-0115-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36411191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Theory for acoustic streaming in soft porous matter and its applications to ultrasound-enhanced convective delivery.","authors":"Raghu Raghavan","doi":"10.1186/s40349-018-0114-6","DOIUrl":"https://doi.org/10.1186/s40349-018-0114-6","url":null,"abstract":"<p><p>This paper develops theory for <i>bulk</i> acoustic streaming in soft porous materials, with applications to biological tissue. The principal results of this paper are: (i) streaming equations for such porous media, which show interestingly significant differences from those that describe streaming in pure fluids; (ii) the Green functions obtained for these equations in isotropic, infinite media; and (iii) approximate evaluation of the sources in the streaming equations from acoustic wave forms often used, and the streaming velocities and particle trajectories resulting therefrom. People are now investigating acoustic enhancement of delivery of therapeutics such as drug molecules or other particulates, introduced directly into cellular tissue. A comparison of the predictions of the theory in this paper to available data is made and shown to be surprisingly good. Some macroscale effects of the ultrastructure of the tissue that are not contained in the current paper are pointed out for future studies.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"6 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2018-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40349-018-0114-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36374779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A convenient, reliable, and fast acoustic pressure field measurement method for magnetic resonance-guided high-intensity focused ultrasound systems with phased array transducers.","authors":"Satya V V N Kothapalli, Ari Partanen, Lifei Zhu, Michael B Altman, H Michael Gach, Dennis E Hallahan, Hong Chen","doi":"10.1186/s40349-018-0113-7","DOIUrl":"10.1186/s40349-018-0113-7","url":null,"abstract":"<p><strong>Background: </strong>With the expanding applications of magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU), there is an urgent need for a convenient, reliable, and fast acoustic pressure field measurement method to aid treatment protocol design, ensure consistent and safe operation of the transducer, and facilitate regulatory approval of new techniques. Herein, we report a method for acoustic pressure field characterization of MR-HIFU systems with multi-element phased array transducers. This method integrates fiber-optic hydrophone measurements and electronic steering of the ultrasound beam with MRI-assisted HIFU focus alignment to the fiber tip.</p><p><strong>Methods: </strong>A clinical MR-HIFU system (Sonalleve V2, Profound Medical Inc., Mississauga, Canada) was used to assess the proposed method. A fiber-optic hydrophone was submerged in a degassed water bath, and the fiber tip location was traced using MRI. Subsequently, the nominal transducer focal point indicated on the MR-HIFU therapy planning software was positioned at the fiber tip, and the HIFU focus was electronically steered around the fiber tip within a 3D volume for 3D pressure field mapping, eliminating the need for an additional, expensive, and MRI-compatible 3D positioning stage. The peak positive and negative pressures were measured at the focus and validated using a standard hydrophone measurement setup outside the MRI magnet room.</p><p><strong>Results: </strong>We found that the initial MRI-assisted HIFU focus alignment had an average offset of 2.23 ± 1.33 mm from the fiber tip as identified by the 3D pressure field mapping. MRI guidance and electronic beam steering allowed 3D focus localization within ~ 1 h, i.e., faster than the typical time required using the standard laboratory setup (~ 3-4 h). Acoustic pressures measured using the proposed method were not significantly different from those obtained with the standard laboratory hydrophone measurements.</p><p><strong>Conclusions: </strong>In conclusion, our method offers a convenient, reliable, and fast acoustic pressure field characterization tool for MR-HIFU systems with phased array transducers.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"6 ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2018-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6027582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36295790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of breast structure on high-intensity focused ultrasound focal error.","authors":"Kohei Okita,&nbsp;Ryuta Narumi,&nbsp;Takashi Azuma,&nbsp;Hidemi Furusawa,&nbsp;Junichi Shidooka,&nbsp;Shu Takagi,&nbsp;Yoichiro Matsumoto","doi":"10.1186/s40349-018-0111-9","DOIUrl":"https://doi.org/10.1186/s40349-018-0111-9","url":null,"abstract":"<p><strong>Background: </strong>The development of imaging technologies and breast cancer screening allowed early detection of breast cancers. High-intensity focused ultrasound (HIFU) is a non-invasive cancer treatment, but the success of HIFU ablation was depending on the system type, imaging technique, ablation protocol, and patient selection. Therefore, we aimed to determine the relationship between breast tissue structure and focal error during breast cancer HIFU treatment.</p><p><strong>Methods: </strong>Numerical simulations of the breast cancer HIFU ablation were performed using digital breast phantoms constructed using the magnetic resonance imaging data obtained from 12 patients.</p><p><strong>Results: </strong>The focal shapes were distorted despite breast tissue representing soft tissue. Focal errors are caused by the complex distribution of fibroglandular tissue, and they depend on the target position and the arrangement of the transducer. We demonstrated that the focusing ratio increases with the decrease in the local acoustic inhomogeneity, implying that it may be used as an indicator to reduce the HIFU focal error depending on the breast structure.</p><p><strong>Conclusions: </strong>The obtained results demonstrated that the focal error observed during the breast cancer HIFU treatment is highly dependent on the structure of fibroglandular tissue. The optimal arrangement of the transducer to the target can be obtained by minimizing the local acoustic inhomogeneity before the breast cancer HIFU treatment.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"6 ","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2018-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40349-018-0111-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36265710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meeting report: 2017 Winter School on Therapeutic Ultrasound","authors":"N. Sheybani","doi":"10.1186/s40349-018-0112-8","DOIUrl":"https://doi.org/10.1186/s40349-018-0112-8","url":null,"abstract":"","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40349-018-0112-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42905094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017","authors":"C. Arvanitis, V. Askoxylakis, Yutong Guo, Jonas Kloepper, Meenal Datta, M. Bernabeu, D. Fukumura, N. McDannold, R. Jain, Chenchen Bing, Debra Szczepanski, I. Munaweera, Yu Hong, I. Corbin, Rajiv Chopra","doi":"10.1186/s40349-018-0110-x","DOIUrl":"https://doi.org/10.1186/s40349-018-0110-x","url":null,"abstract":"","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40349-018-0110-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43008854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}