MR-Guided Focused Ultrasound Ablation of Visceral Fat: A new treatment for metabolic syndrome

Abstract

I am writing to provide you and the Foundation the final report on the execution of the project entitled "MR-Guided Focused Ultrasound Ablation of Visceral Fat: A new treatment for metabolic syndrome". BackgroundThe overarching goal of the research is to develop a non-invasive approach for the treatment of metabolic syndrome. The main hypothesis of the project is that HIFU ablation of visceral fat can improve insulin action in obese rats and provide a non-invasive treatment for type 2 diabetes and other diseases associated with metabolic syndrome. The hypothesis is being tested with two specific aims that are centered on: 1) technique development, and 2) animal experiments.We estimate that the entire research program will cost approximately $500,000 to conduct, and we are grateful to the Focused Ultrasound Foundation for the grant of $100,000 which allowed us to purchase the equipment. At this point we are still seeking funds to cover the remainder of the metabolic syndrome project, but as you can see from the progress reported below, the hardware that has been acquired with the support from your foundation has given us a tremendous start. We have made significant progress on aim 1 and, the grant has enabled exciting new programs in other directions relevant to human disease. Progress1) We ordered a pre-clinical Sonalleve MR-guided HIFU system from Philips in early 2011. The system was delivered in late 2011. The system is now operational and being used on our 3T MR system. All animal experiments have been performed under animal use protocols.2) The HIFU system has been optimized for use on rats with the creation of a new stage and MR imaging coils.3) We have developed high-speed imaging approaches for monitoring temperature changes and thermal dose. One of the approaches we are investigating is the use of magnitude images for temperature monitoring. 4)We have used the system to support simple ablations in pig livers in collaboration with Dr. Rupak Banerjee at the University of Cincinnati. 7) The progress with the preclinical HIFU system has encouraged us to pursue human research opportunities. We have secured funding from our institution to purchase a clinical Sonalleve system from Philips to perform clinical HIFU treatments and related research. Our first clinical target will be bone ablation in pediatric patients. The preclinical and clinical systems will have common control software and we anticipate substantial benefit for translational studies.8) Several publications describing our HIFU experimental results are in preparation. This includes an abstract for presentation at next year's ISMRM.Additional details of our progress can be found in the attached documents. We at Cincinnati Children's Medical Center are very grateful for the support the FUS Foundation has provided and we look forward to the research opportunities it enables as we pursue our mission of improving the practice of healthcare for our patients.Please feel free to call me if you have any questions. Introduction: Magnetic Resonance (MR) is r...

Impact of Visceral Obesity on the Risk of Incident Metabolic Syndrome in Metabolically Healthy Normal Weight and Overweight Groups: A Longitudinal Cohort Study in Korea

“…Visceral fat and its resident macrophages produce pro-inflammatory cytokines (e.g., necrosis factor-alpha, leptin, and interleukin-6) that are implicated in chronic low-grade inflammation which can subsequently lead to MS in the obese. 25,27,28) Our study observed that VO and overweight were factors that were positively associated with the incidence of each component of MS. In the present study, both SBP and DBP were slightly positively associat-ed with weight compared to VO.…”

“…Previously, obesity-associated MS was considered to be related to the accumulation of visceral fat, rather than subcutaneous fat or total body fat. Visceral fat and its resident macrophages produce pro-inflammatory cytokines (e.g., necrosis factor-alpha, leptin, and interleukin-6) that are implicated in chronic low-grade inflammation which can subsequently lead to MS in the obese [ 25 , 27 , 28 ].…”