Laser enhanced high-intensity focused ultrasound thrombolysis: An <i>in vitro</i> study

Cui, Huizhong; Yang, Xinmai

doi:10.1121/1.4778375

Cited by 25 publications

(25 citation statements)

References 24 publications

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“…[6][7][8][9][10][11][12] However, pre-existing nucleation sites for cavitation are not omnipresent in most tissues in vivo. Many research efforts have been made to create nucleation sites for cavitation and reduce cavitation threshold.…”

mentioning

confidence: 99%

Laser-enhanced cavitation during high intensity focused ultrasound: An in vivo study

Cui

Zhang²,

Yang³

2013

Applied Physics Letters

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Laser-enhanced cavitation during high intensity focused ultrasound (HIFU) was studied in vivo using a small animal model. Laser light was employed to illuminate the sample concurrently with HIFU radiation. The resulting cavitation was detected with a passive cavitation detector. The in vivo measurements were made under different combinations of HIFU treatment depths, laser wavelengths, and HIFU durations. The results demonstrated that concurrent light illumination during HIFU has the potential to enhance cavitation effect by reducing cavitation threshold in vivo. High intensity focused ultrasound (HIFU) is a truly noninvasive thermal-ablation technique. HIFU works through rapidly depositing high intensity ultrasound energy into a small region to induce cell death primarily by hyperthermia after high intensity ultrasound is absorbed by soft tissue. [1][2][3][4][5] While the application of HIFU therapy is expanding, one concern related to HIFU treatment is the prolonged treatment time for large tumors because HIFU lesion is relatively small for each HIFU shot.Cavitation has been shown to yield elevated heating rate above those produced by classical acoustic absorption in tissue and can provide an effective method to improve the efficiency of HIFU treatment.6-12 However, pre-existing nucleation sites for cavitation are not omnipresent in most tissues in vivo. Many research efforts have been made to create nucleation sites for cavitation and reduce cavitation threshold. Both ultrasound contrast agents (UCAs) [13][14][15][16][17][18] and nanoparticles have been studied as methods to deliver cavitation nuclei into the targeted region.19,20 The use of UCA or nanoparticles, however, requires the systematic injection of foreign particles into the blood stream, and would have major concerns regarding toxicity, efficiency, etc. Cavitation bubbles can also be induced in presonication areas by using low frequency, high intensity ultrasound prior to HIFU treatments. 21,22 This technique can enhance cavitation and create larger size lesions in deep tissue without the injection of any contrast agents. However, this technique requires very high acoustic pressure (generally more than 10 MPa) to be delivered into soft tissues in order to induce cavitation in the beginning. In addition, the inception of cavitation is erratic and difficult to predict when induced by ultrasound alone.Laser light has been widely used as a reliable method to induce cavitation through optical breakdown. This procedure is generally performed with high intensity light, and mostly limited to clear media or sample surfaces. 23,24 Hence the application of this technique is limited in the in vivo applications, where treatments in a certain depth in turbid media are often desired.In a previous study, 25 we reported an enhanced heating effect during photoacoustic imaging-guided HIFU therapy. The results suggested that cavitation was enhanced when a diagnostic laser light beam illuminated the sample concurrently with HIFU radiation. Two features were highlighted...

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mentioning

confidence: 99%

Laser-enhanced cavitation during high intensity focused ultrasound: An in vivo study

Cui

Zhang²,

Yang³

2013

Applied Physics Letters

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“…9,17,57,67,76,85 FUS causes microbubble oscillation, leading to mechanical disruption of the ischemic clot and improving rates of recanalization. 20 Low-intensity ultrasound combined with systemic delivery of microbubble contrast agents has been shown to improve thrombolysis in the presence or absence of tissue plasminogen activator (tPA) in the past.…”

Section: Ischemic Strokementioning

confidence: 99%

“…1,18 HIFU as a stand-alone method for thrombolysis seems to be more advantageous, as it reduces the risk of hemorrhage by eliminating the side effects of thrombolytic drugs as well as adequately causing thrombolysis without damage to the targeted vessels. 9,57,85 Also, HIFU reduces the treatment time from hours to minutes, which may cause significant reductions in the size of infarct and lead to better clinical outcomes in stroke patients, 9,17,57,67,76,85 and therefore has the potential to revolutionize current treatment paradigms. Further investigations and clinical trials are warranted.…”

Section: Ischemic Strokementioning

confidence: 99%

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

Quadri¹,

Waqas

Khan

et al. 2018

Neurosurgical Focus

123

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Since Lynn and colleagues first described the use of focused ultrasound (FUS) waves for intracranial ablation in 1942, many strides have been made toward the treatment of several brain pathologies using this novel technology. In the modern era of minimal invasiveness, high-intensity focused ultrasound (HIFU) promises therapeutic utility for multiple neurosurgical applications, including treatment of tumors, stroke, epilepsy, and functional disorders. Although the use of HIFU as a potential therapeutic modality in the brain has been under study for several decades, relatively few neuroscientists, neurologists, or even neurosurgeons are familiar with it. In this extensive review, the authors intend to shed light on the current use of HIFU in different neurosurgical avenues and its mechanism of action, as well as provide an update on the outcome of various trials and advances expected from various preclinical studies in the near future. Although the initial technical challenges have been overcome and the technology has been improved, only very few clinical trials have thus far been carried out. The number of clinical trials related to neurological disorders is expected to increase in the coming years, as this novel therapeutic device appears to have a substantial expansive potential. There is great opportunity to expand the use of HIFU across various medical and surgical disciplines for the treatment of different pathologies. As this technology gains recognition, it will open the door for further research opportunities and innovation.

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“…The large area‐focused arrays apply US energy at a very small, predefined target site only without affecting the majority of brain tissue. Numerous preclinical studies have demonstrated HIFU to be a favorable option for thrombolysis with or without tPA, both in‐vitro and in‐vivo models …”

Section: Sonothrombolysis In Strokementioning

confidence: 99%

“…Cui et al studied the viability of laser‐enhanced cavitation HIFU treatment for thrombolysis of bovine blood clots without any thrombolytic agents or microbubbles . They found that thrombolytic efficacy increased with laser illumination as laser‐enhanced cavitation significantly reduced the cavitation threshold for alone HIFU sonothrombolysis.…”

Section: In‐vitro Hifu Studiesmentioning

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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Laser enhanced high-intensity focused ultrasound thrombolysis: An in vitro study

Cited by 25 publications

References 24 publications

Laser-enhanced cavitation during high intensity focused ultrasound: An in vivo study

Laser-enhanced cavitation during high intensity focused ultrasound: An in vivo study

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

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

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