Thermal therapy with a fully electronically steerable HIFU phased array using ultrasound guidance and local harmonic motion monitoring

Aslani, Pegah; Drost, Leah; Huang, Yuexi; Lucht, Benjamin B. C.; Wong, Erin; Czarnota, Gregory J.; Yee, Caitlin; Wan, Bo; Ganesh, Vithusha; Gunaseelan, Samuel; David, Elizabeth; Chow, Edward; Hynynen, Kullervo

doi:10.1109/tbme.2019.2949478

Cited by 11 publications

(7 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A second limitation of our rabbit tumor experiments was the long treatment time associated with mechanically scanning a single-element transducer. Sophisticated phased-array transducers ( 25 ) could overcome the limitations of mechanically scanning a single-element transducer, providing the ability to uniformly heat larger areas of the tumor and reduce treatment times in the clinical context for human patients.…”

Section: Discussionmentioning

confidence: 99%

Novel fractionated ultrashort thermal exposures with MRI-guided focused ultrasound for treating tumors with thermosensitive drugs

Santos

Regenold

et al. 2020

Sci. Adv.

Self Cite

View full text Add to dashboard Cite

Thermosensitive liposomes represent an important paradigm in oncology, where hyperthermia-mediated release coupled with thermal bioeffects enhance the effectiveness of chemotherapy. Their widespread clinical adoption hinges upon performing controlled targeted hyperthermia, and a leading candidate to achieve this is temperature-based magnetic resonance imaging (MRI)–guided focused ultrasound (MRgFUS). However, the current approach to hyperthermia involves exposures lasting tens of minutes to hours, which is not possible to achieve in many circumstances because of blood vessel cooling and respiratory motion. Here, we investigate a novel approach to overcome these limitations: to use fractionated ultrashort (~30 s) thermal exposures (~41° to 45°C) to release doxorubicin from a thermosensitive liposome. This is first demonstrated in a dorsal chamber tumor model using two-photon microscopy. Thermal exposures were then conducted with a rabbit tumor model using a custom MRgFUS system incorporating temperature feedback control. Drug release was confirmed, and longitudinal experiments demonstrated profoundly enhanced tumor growth inhibition and survival.

show abstract

Section: Discussionmentioning

confidence: 99%

Novel fractionated ultrashort thermal exposures with MRI-guided focused ultrasound for treating tumors with thermosensitive drugs

Santos

Regenold

et al. 2020

Sci. Adv.

Self Cite

View full text Add to dashboard Cite

show abstract

“…To the best of our knowledge, this is the first study to optimize a clinical scanner and probe to produce the ultrasound conditions for cavitation treatment that are different from those of normal imaging. We chose the S5-1 array for two reasons: it allows the use of a low frequency (1.6 MHz was the lowest available for this probe) suitable for cavitation therapies and it produces collimated beams to cover a large area, like novel phased array HIFU devices currently being investigated ( Hand et al, 2009 ; Wang and Zhou, 2016 ; Aslani et al, 2019 ). We chose to implement parameters that were consistent with other studies investigating cavitation-induced vascular disruption, and therefore the MI of 2 that was used was only slightly higher than the FDA limit of 1.9.…”

Section: Discussionmentioning

confidence: 99%

“…use of a low frequency (1.6 MHz was the lowest available for this probe) suitable for cavitation therapies and it produces collimated beams to cover a large area, like novel phased array HIFU devices currently being investigated (Hand et al, 2009;Wang and Zhou, 2016;Aslani et al, 2019). We chose to implement parameters that were consistent with other studies investigating cavitation-induced vascular disruption, and therefore the MI of 2 that was used was only slightly higher than the FDA limit of 1.9.…”

Section: Use Of a Diagnostic Ultrasound Device For Ultrasound Cavitatmentioning

confidence: 99%

Image-Guided Treatment of Primary Liver Cancer in Mice Leads to Vascular Disruption and Increased Drug Penetration

et al. 2020

View full text Add to dashboard Cite

Despite advances in interventional procedures and chemotherapeutic drug development, hepatocellular carcinoma (HCC) is still the fourth leading cause of cancer-related deaths worldwide with a <30% 5-year survival rate. This poor prognosis can be attributed to the fact that HCC most commonly occurs in patients with pre-existing liver conditions, rendering many treatment options too aggressive. Patient survival rates could be improved by a more targeted approach. Ultrasound-induced cavitation can provide a means for overcoming traditional barriers defining drug uptake. The goal of this work was to evaluate preclinical efficacy of image-guided, cavitation-enabled drug delivery with a clinical ultrasound scanner. To this end, ultrasound conditions (unique from those used in imaging) were designed and implemented on a Philips EPIQ and S5-1 phased array probe to produced focused ultrasound for cavitation treatment. Sonovue ® microbubbles which are clinically approved as an ultrasound contrast agent were used for both imaging and cavitation treatment. A genetically engineered mouse model was bred and used as a physiologically relevant preclinical analog to human HCC. It was observed that imageguided and targeted microbubble cavitation resulted in selective disruption of the tumor blood flow and enhanced doxorubicin uptake and penetration. Histology results indicate that no gross morphological damage occurred as a result of this process. The combination of these effects may be exploited to treat HCC and other challenging malignancies and could be implemented with currently available ultrasound scanners and reagents.

show abstract

“…Aslani et al created an HMIFU system with a phased array therapeutic transducer that facilitates electronic beam steering. 179 The system was tested for treatment of bone metastases in a live porcine model and subsequently in a small clinical trial with nine patients. Although capable of detecting lesion formation, the system has not yet been utilized for real-time feedback and thus it is not clear if it will improve the ability to achieve predefined ablation zones.…”

Section: Harmonic Motion Imagingmentioning

confidence: 99%

“…Aslani et al. created an HMIFU system with a phased array therapeutic transducer that facilitates electronic beam steering 179 . The system was tested for treatment of bone metastases in a live porcine model and subsequently in a small clinical trial with nine patients.…”

Section: Techniques For Direct Tissue Assessmentmentioning

confidence: 99%

Methods of monitoring thermal ablation of soft tissue tumors – A comprehensive review

et al. 2022

View full text Add to dashboard Cite

Thermal ablation is a form of hyperthermia in which oncologic control can be achieved by briefly inducing elevated temperatures, typically in the range 50-80 • C, within a target tissue. Ablation modalities include high intensity focused ultrasound, radiofrequency ablation, microwave ablation, and laser interstitial thermal therapy which are all capable of generating confined zones of tissue destruction, resulting in fewer complications than conventional cancer therapies. Oncologic control is contingent upon achieving predefined coagulation zones; therefore, intraoperative assessment of treatment progress is highly desirable. Consequently, there is a growing interest in the development of ablation monitoring modalities. The first section of this review presents the mechanism of action and common applications of the primary ablation modalities. The following section outlines the state-of -the-art in thermal dosimetry which includes interstitial thermal probes and radiologic imaging. Both the physical mechanism of measurement and clinical or pre-clinical performance are discussed for each ablation modality. Thermal dosimetry must be coupled with a thermal damage model as outlined in Section 4. These models estimate cell death based on temperature-time history and are inherently tissue specific. In the absence of a reliable thermal model, the utility of thermal monitoring is greatly reduced. The final section of this review paper covers technologies that have been developed to directly assess tissue conditions. These approaches include visualization of non-perfused tissue with contrast-enhanced imaging, assessment of tissue mechanical properties using ultrasound and magnetic resonance elastography, and finally interrogation of tissue optical properties with interstitial probes. In summary, monitoring thermal ablation is critical for consistent clinical success and many promising technologies are under development but an optimal solution has yet to achieve widespread adoption.

show abstract

Thermal therapy with a fully electronically steerable HIFU phased array using ultrasound guidance and local harmonic motion monitoring

Cited by 11 publications

References 57 publications

Novel fractionated ultrashort thermal exposures with MRI-guided focused ultrasound for treating tumors with thermosensitive drugs

Novel fractionated ultrashort thermal exposures with MRI-guided focused ultrasound for treating tumors with thermosensitive drugs

Image-Guided Treatment of Primary Liver Cancer in Mice Leads to Vascular Disruption and Increased Drug Penetration

Methods of monitoring thermal ablation of soft tissue tumors – A comprehensive review

Contact Info

Product

Resources

About