High-intensity focused ultrasound: past, present, and future in neurosurgery

Quadri, Syed A.; Waqas, Muhammad; Khan, Inamullah; Khan, Muhammad Adnan; Suriya, Sajid; Farooqui, Mudassir; Fiani, Brian

doi:10.3171/2017.11.focus17610

Cited by 123 publications

(87 citation statements)

References 82 publications

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“…4E and Movie S4). HIFU-based triggering of polymer mechanochemistry through a mouse skull demonstrates the potential for in vitro/in vivo applications (23,25,26). With the capability to spatiotemporally control the acoustic pressure, HIFU enables the activation of mechanophore-functionalized biocompatible polymers (3,38), potentially facilitating mechanochemical phenomena such as mechanoluminescence in vivo through intervening tissues such as bone.…”

Section: Hifu Sonication Through the Skull: Potential For Biomedicalmentioning

confidence: 99%

“…By focusing an ultrasonic wave onto the target location, the high intensity of irradiation affects mechanical deformation and cavitation in response to the acoustic pressure wave, as well as localized heating from energy dissipation. HIFU has demonstrated clinical success in applications including tumor ablation (23,24), pain management (25), neurosurgery (26)(27)(28)(29),…”

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confidence: 99%

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High-intensity focused ultrasound-induced mechanochemical transduction in synthetic elastomers

Kim

Lau

Halmes

et al. 2019

Proc. Natl. Acad. Sci. U.S.A.

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While study in the field of polymer mechanochemistry has yielded mechanophores that perform various chemical reactions in response to mechanical stimuli, there is not yet a triggering method compatible with biological systems. Applications such as using mechanoluminescence to generate localized photon flux in vivo for optogenetics would greatly benefit from such an approach. Here we introduce a method of triggering mechanophores by using high-intensity focused ultrasound (HIFU) as a remote energy source to drive the spatially and temporally resolved mechanicalto-chemical transduction of mechanoresponsive polymers. A HIFU setup capable of controlling the excitation pressure, spatial location, and duration of exposure is employed to activate mechanochemical reactions in a cross-linked elastomeric polymer in a noninvasive fashion. One reaction is the chromogenic isomerization of a naphthopyran mechanophore embedded in a polydimethylsiloxane (PDMS) network. Under HIFU irradiation evidence of the mechanochemical transduction is the observation of a reversible color change as expected for the isomerization. The elastomer exhibits this distinguishable color change at the focal spot, depending on ultrasonic exposure conditions. A second reaction is the demonstration that HIFU irradiation successfully triggers a luminescent dioxetane, resulting in localized generation of visible blue light at the focal spot. In contrast to conventional stimuli such as UV light, heat, and uniaxial compression/tension testing, HIFU irradiation provides spatiotemporal control of the mechanochemical activation through targeted but noninvasive ultrasonic energy deposition. Targeted, remote light generation is potentially useful in biomedical applications such as optogenetics where a light source is used to trigger a cellular response.high-intensity focused ultrasound | mechanochromism | mechanophores | mechanoluminescence | spatiotemporal control M echanical force exerted on a covalent bond acts as an energetic stimulus to drive specific chemical reactivity (mechanochemistry) (1). Particularly, mechanophores, i.e., mechanically sensitive molecules, have attracted attention due to their role in eliciting various chemical transformations in polymers (2). Extensive work in molecular design has revealed a rich library of mechanophores, which when subjected to mechanical stress undergo selective bond cleavage to unveil color change (3, 4), fluorescence (5), new reactive functionality (6), catalytic activity (7), light emission (8), and small-molecule release (9), among other responses. The ability of mechanochromic mechanophores to "visualize" the mechanical response to applied force provides insight for identifying the damage location and the material state in polymeric materials. Of particular importance to extending functionality of these mechanophores is the development of novel force-control tools capable of noninvasively triggering their activation. Mechanochemical responses have been observed when mechanical energy is applied to bulk-phase m...

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Section: Hifu Sonication Through the Skull: Potential For Biomedicalmentioning

confidence: 99%

mentioning

confidence: 99%

High-intensity focused ultrasound-induced mechanochemical transduction in synthetic elastomers

Kim

Lau

Halmes

et al. 2019

Proc. Natl. Acad. Sci. U.S.A.

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“…Different from high-intensity focused ultrasound (HIFU) [4], low-intensity tFUS can achieve reversible neural effects while complying with the Food and Drug Administration’s (FDA) [5] safety requirements, thus ensuring safety of human subjects.…”

Section: Introductionmentioning

confidence: 99%

On the neuromodulatory pathways of the in vivo brain by means of transcranial focused ultrasound

Niu

2018

Current Opinion in Biomedical Engineering

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For last decade, low-intensity transcranial focused ultrasound (tFUS) has been rapidly developed for a myriad of successful applications in neuromodulation. tFUS possesses high spatial resolution, focality and depth penetration as a noninvasive neuromodulation tool. Despite the promise, confounding activation can be observed in rodents when stimulation parameters are not selected carefully. Here we summarize the existing classes of observations for ultrasound neuromodulation: ultrasound directly activates a localized area, or ultrasound indirectly activates auditory pathways, which further propagates to other cortical networks. We also present control in vivo animal studies, which suggest that underlying tFUS brain modulation is characterized by localized activation independent of auditory networks activations.

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“…(Credit: Image courtesy and permission INSIGHTEC Ltd.) (B) Inside of a transcranial magnetic resonance imaging‐guided high‐intensity focused ultrasound set‐up. (Credit: Image published with permission from Neurosurgical Focus, Quadri et al)…”

Section: The Apparatus and Setupmentioning

confidence: 99%

“…[10][11][12][13] In the current era of modern minimal invasive techniques, magnetic resonance imaging-guided high-intensity focused ultrasound (MRgHIFU) is a new emerging modality that promises therapeutic utilities for multiple neurological pathologies. 14,15 Minimally invasive techniques used to destroy deep tissue for example laser photocoagulation, microwave ablation, and radio frequency ablation use a probe or an antenna for delivering electromagnetic waves. High-intensity focused ultrasound (HIFU) causes thermal heating as the tissue absorbs the mechanical energy transmitted by the ultrasonic waves.…”

Section: Introductionmentioning

confidence: 99%

MRI‐Guided High‐Intensity Focused Ultrasound as an Emerging Therapy for Stroke: A Review

Zafar

Quadri

Farooqui

et al. 2018

Journal of Neuroimaging

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Stroke, either ischemic or hemorrhagic, accounts for significantly high morbidity and mortality rates around the globe effecting millions of lives annually. For the past few decades, ultrasound has been extensively investigated to promote clot lysis for the treatment of stroke, myocardial infarction, and acute peripheral arterial occlusions, with or without the use of tPA or contrast agents. In the age of modern minimal invasive techniques, magnetic resonance imaging‐guided high‐intensity focused ultrasound is a new emerging modality that seems to promise therapeutic utilities for both ischemic and hemorrhagic stroke. High‐intensity focused ultrasound causes thermal heating as the tissue absorbs the mechanical energy transmitted by the ultrasonic waves leading to tissue denaturation and coagulation. Several in‐vitro and in‐vivo studies have demonstrated the viability of this technology for sonothrombolysis in both types of stroke and have warranted clinical trials. Apart from safety and efficacy, initiation of trials would further enable answers regarding its practical application in a clinical setup. Though this technology has been under study for treatment of various brain diseases for some decades now, relatively very few neurologists and even neurosurgeons seem to be acquainted with it. The aim of this review is to provide basic understanding of this powerful technology and discuss its clinical application and potential role as an emerging viable therapeutic option for the future management of stroke.

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High-intensity focused ultrasound: past, present, and future in neurosurgery

Cited by 123 publications

References 82 publications

High-intensity focused ultrasound-induced mechanochemical transduction in synthetic elastomers

High-intensity focused ultrasound-induced mechanochemical transduction in synthetic elastomers

On the neuromodulatory pathways of the in vivo brain by means of transcranial focused ultrasound

MRI‐Guided High‐Intensity Focused Ultrasound as an Emerging Therapy for Stroke: A Review

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