Minimally invasive therapeutic ultrasound: Ultrasound-guided ultrasound ablation in neuro-oncology

Micah Belzberg, Smruti Mahapatra, Alexander Perdomo‐Pantoja, Francisco Chavez, Kyle Morrison, Kah Timothy Xiong, Nao J. Gamo, Stephen Restaino, Nitish Thakor, Youseph Yazdi, Rajiv Iyer, Betty Tyler, Nicholas Theodore, Mark G. Luciano, Henry Brem, Mari Groves, Alan R. Cohen, Amir Manbachi

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: To improve patient outcomes (eg, reducing blood loss and infection), practitioners have gravitated toward noninvasive and minimally invasive surgeries (MIS), which demand specialized toolkits. Focused ultrasound, for example, facilitates thermal ablation from a distance, thereby reducing injury to surrounding tissue. Focused ultrasound can often be performed noninvasively; however, it is more difficult to carry out in neuro-oncological tumors, as ultrasound is dramatically attenuated while propagating through the skull. This shortcoming has prompted exploration of MIS options for intracranial placement of focused ultrasound probes, such as within the BrainPath™ (NICO Corporation, Indianapolis, IN). Herein, we present the design, development, and in vitro testing of an image-guided, focused ultrasound prototype designed for use in MIS procedures. This probe can ablate neuro-oncological lesions despite its small size. Materials & Methods: Preliminary prototypes were iteratively designed, built, and tested. The final prototype consisted of three 8-mm-diameter therapeutic elements guided by an imaging probe. Probe functionality was validated on a series of tissue-mimicking phantoms. Results: Lesions were created in tissue-mimicking phantoms with average dimensions of 2.5 × 1.2 × 6.5 mm and 3.4 × 3.25 × 9.36 mm after 10- and 30-second sonification, respectively. 30 s sonification with 118 W power at 50% duty cycle generated a peak temperature of 68 °C. Each ablation was visualized in real time by the built-in imaging probe. Conclusion: We developed and validated an ultrasound-guided focused ultrasound probe for use in MIS procedures. The dimensional constraints of the prototype were designed to reflect those of BrainPath trocars, which are MIS tools used to create atraumatic access to deep-seated brain pathologies.

Original languageEnglish (US)
Article number106210
JournalUltrasonics
Volume108
DOIs
StatePublished - Dec 2020

Keywords

  • Ablation
  • Acoustic probes
  • Engineering design
  • Focused ultrasound
  • Minimally invasive surgery
  • Neurosurgery
  • Oncology
  • Therapeutic ultrasound
  • Transducer design
  • Ultrasound

ASJC Scopus subject areas

  • Acoustics and Ultrasonics

Fingerprint Dive into the research topics of 'Minimally invasive therapeutic ultrasound: Ultrasound-guided ultrasound ablation in neuro-oncology'. Together they form a unique fingerprint.

Cite this