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1438: Thermal Ablation System Using High Intensity Focused Ultrasound (HIFU) and Guided by MRI
S218
Ultrasound in Medicine and Biology
Volume 35, Number 8S, 2009
assurance for therapeutic ultrasound such as HIFU tumor surgery where thermal mechanisms are important.
Keywords: vulval white lesions; T lymph cell; vascular endothelial cells; focused ultrasonic treatment
1438
1440
Thermal Ablation System Using High Intensity Focused Ultrasound (HIFU) and Guided by MRI Christis Damianou, Frederick University, Cyprus K Ioannides, Frederick University, Cyprus V HadjiSavas, Frederick University, Cyprus N Milonas, Frederick University, Cyprus A Couppis, Frederick University, Cyprus D Iosif, Frederick University, Cyprus M Komodromos, Frederick University, Cyprus F Vrionides, Frederick University, Cyprus
High Intensity Focused Ultrasound (HIFU) Therapy with Nano Droplets and Microbubbles Ken-Ichi Kawabata, Hitachi, Ltd., Japan Rei Asami, Hitachi, Ltd, Japan Takashi Azuma, Hitachi, Ltd, Japan Hideki Yoshikawa, Hitachi, Ltd., Japan Shin-Ichiro Umemura, Tohoku University, Japan
Introduction: In this paper magnetic resonance imaging (MRI) is investigated for monitoring lesions created by high intensity focused ultrasound (HIFU) in kidney, liver, heart and brain in vitro and in vivo. Materials and Methods: Spherically focused transducers of 3-5 cm diameter, focusing at 10 cm and operating from 2-4 MHz were used. An MRI compatible positioning device was developed in order to scan the HIFU transducer. Results: The MRI compatibility of the system was successfully demonstrated in a clinical high-field MRI scanner. The ability of the positioning device to accurately move the transducer thus creating discrete and overlapping lesions in biological tissue was tested successfully. Conclusions: Both T1-w FSE and T1-w FSE imaged successfully lesions in kidney, heart and liver. T1-w FSE and T2-w FSE and FLAIR shows better anatomical details in brain than T1-w FSE, but with T1-w FSE the contrast between lesion and brain is higher for both thermal and bubbly lesion. With this system we were able to create large lesions (by producing overlapping lesions). The length of the lesions in vivo brain was much higher than the length in vitro, proving that the penetration in the in vitro brain is limited by reflection due to trapped bubbles in the blood vessels. 1439 Study of the Effect on T-lymphocytes and Vascular Endothelial Cell in the White Lesion of Vulva when Treated with Focused Ultrasound Luxia Jiao, General Hospital of PLA, China Objective: To study the significance of the T lymph cells and vascular endothelial cells in the patients with vulva white lesion before and after the treatment with focused ultrasound. Methods: The quantity of CD4 and CD8 T lymph cells and the vascular endothelial cells which expressed CD34 were observed with immunohistochemistry stain in the specimen taken from the 20 patients with white lesion of the vulva before and after the treatment of focused ultrasound, meanwhile the number of the micro-vessels was counted. 20 normal vulvar skin were also observed as control. Results: The number of CD4⫹,CD8⫹ T lymph cells and CD34⫹ endothelial cells and micro-vessels decreased in the group of the white lesion compared with the control group. Compared with the group before treatment, the number of CD4⫹,CD8⫹ T lymph cells and CD34⫹ vascular endothelial cells and micro-vessels increased in the group of patients after the treatment with focused ultrasound. Conclusions: T lymph cells and vascular endothelial cells may take part in the pathogenesis of vulval white lesions. Focused ultrasonic treatment may play an important roles by increasing and activating the lymph cells and vascular endothelial cells of the lesion skin.
Although HIFU therapy is very low invasive method for tumor treatment, its time inefficiency and the absence of focus detecting mechanism of current systems limit the number of applicable cases. For an improved HIFU tumor treatment system, we propose to utilize a nonechogenic liquid nano droplet which turns into highly echogenic microbubbles upon non-therapeutic ultrasound pulses. Such a nano droplet would give echographic information on the focus of HIFU when exposed to the pulse and accelerate HIFU treatment by enhancing the ultrasonic energy deposition as microbubble As such a nanoparticle system, we developed a phase change nano droplet (PCND) which consists of superheated perfluorocarbon nano droplet coated with PEGylated phospholipids. Microbubbles generation from PCND in tumor tissues was investigated by using mice, rats, and rabbits. It was found that 4 cycles of ultrasound pulses in the range of 3-8 MHz with negative peak pressure of about 3 MPa can generate microbubbles at tumor tissues in each animal 5 minutes after PCND was administered intravenously. Significance of PCND to enhance ultrasonically induced therapeutic effects was also investigated. At frequency of 2 and 3 MHz, it was found that the presence of PCND (and generated microbubbbles) halved the intensity threshold for inducing thermal damage in murine tumor tissues. At frequency around 1 MHz, it was also found that the presence of PCND halved the threshold for inducing damage in murine tumor and the damage was induced both by thermal and cavitational effects of ultrasound.
1441 Efficacy of Real Time US Guided ESWL for Bile Duct Stones Katsuyuki Koichi, Department of Internal Medicine, Asanogawa General Hospital, Japan Ichiro Araki, Department of Internal Medicine, Asanogawa General Hospital, Japan Naomichi Hamano, Department of Internal Medicine, Asanogawa General Hospital, Japan Toshio Ueno, Department of Internal Medicine, Asanogawa General Hospital, Japan Susumu Motoji, Unit of Clinical Ultrasound, Asanogawa General Hospital, Japan Purpose: Real time US guided ESWL was performed in patients with bile duct stones to evaluate its efficacy and safety. Methods: 100 patients with bile duct stones were treated with real time US guided ESWL. Before ESWL, conventional ultrasonic examinations were performed on prone position to see the number, the size and the character of stones. To visualize common bile duct more easily on US, a small amount of water (50-100ml) was taken to patients. Using machines were HDI-3000 (ATL) and EUB-8500 (HITACHI) for observation, and MPL-9000 (Dornier) for ESWL.
Ultrasound in Medicine and Biology
Volume 35, Number 8S, 2009
assurance for therapeutic ultrasound such as HIFU tumor surgery where thermal mechanisms are important.
Keywords: vulval white lesions; T lymph cell; vascular endothelial cells; focused ultrasonic treatment
1438
1440
Thermal Ablation System Using High Intensity Focused Ultrasound (HIFU) and Guided by MRI Christis Damianou, Frederick University, Cyprus K Ioannides, Frederick University, Cyprus V HadjiSavas, Frederick University, Cyprus N Milonas, Frederick University, Cyprus A Couppis, Frederick University, Cyprus D Iosif, Frederick University, Cyprus M Komodromos, Frederick University, Cyprus F Vrionides, Frederick University, Cyprus
High Intensity Focused Ultrasound (HIFU) Therapy with Nano Droplets and Microbubbles Ken-Ichi Kawabata, Hitachi, Ltd., Japan Rei Asami, Hitachi, Ltd, Japan Takashi Azuma, Hitachi, Ltd, Japan Hideki Yoshikawa, Hitachi, Ltd., Japan Shin-Ichiro Umemura, Tohoku University, Japan
Introduction: In this paper magnetic resonance imaging (MRI) is investigated for monitoring lesions created by high intensity focused ultrasound (HIFU) in kidney, liver, heart and brain in vitro and in vivo. Materials and Methods: Spherically focused transducers of 3-5 cm diameter, focusing at 10 cm and operating from 2-4 MHz were used. An MRI compatible positioning device was developed in order to scan the HIFU transducer. Results: The MRI compatibility of the system was successfully demonstrated in a clinical high-field MRI scanner. The ability of the positioning device to accurately move the transducer thus creating discrete and overlapping lesions in biological tissue was tested successfully. Conclusions: Both T1-w FSE and T1-w FSE imaged successfully lesions in kidney, heart and liver. T1-w FSE and T2-w FSE and FLAIR shows better anatomical details in brain than T1-w FSE, but with T1-w FSE the contrast between lesion and brain is higher for both thermal and bubbly lesion. With this system we were able to create large lesions (by producing overlapping lesions). The length of the lesions in vivo brain was much higher than the length in vitro, proving that the penetration in the in vitro brain is limited by reflection due to trapped bubbles in the blood vessels. 1439 Study of the Effect on T-lymphocytes and Vascular Endothelial Cell in the White Lesion of Vulva when Treated with Focused Ultrasound Luxia Jiao, General Hospital of PLA, China Objective: To study the significance of the T lymph cells and vascular endothelial cells in the patients with vulva white lesion before and after the treatment with focused ultrasound. Methods: The quantity of CD4 and CD8 T lymph cells and the vascular endothelial cells which expressed CD34 were observed with immunohistochemistry stain in the specimen taken from the 20 patients with white lesion of the vulva before and after the treatment of focused ultrasound, meanwhile the number of the micro-vessels was counted. 20 normal vulvar skin were also observed as control. Results: The number of CD4⫹,CD8⫹ T lymph cells and CD34⫹ endothelial cells and micro-vessels decreased in the group of the white lesion compared with the control group. Compared with the group before treatment, the number of CD4⫹,CD8⫹ T lymph cells and CD34⫹ vascular endothelial cells and micro-vessels increased in the group of patients after the treatment with focused ultrasound. Conclusions: T lymph cells and vascular endothelial cells may take part in the pathogenesis of vulval white lesions. Focused ultrasonic treatment may play an important roles by increasing and activating the lymph cells and vascular endothelial cells of the lesion skin.
Although HIFU therapy is very low invasive method for tumor treatment, its time inefficiency and the absence of focus detecting mechanism of current systems limit the number of applicable cases. For an improved HIFU tumor treatment system, we propose to utilize a nonechogenic liquid nano droplet which turns into highly echogenic microbubbles upon non-therapeutic ultrasound pulses. Such a nano droplet would give echographic information on the focus of HIFU when exposed to the pulse and accelerate HIFU treatment by enhancing the ultrasonic energy deposition as microbubble As such a nanoparticle system, we developed a phase change nano droplet (PCND) which consists of superheated perfluorocarbon nano droplet coated with PEGylated phospholipids. Microbubbles generation from PCND in tumor tissues was investigated by using mice, rats, and rabbits. It was found that 4 cycles of ultrasound pulses in the range of 3-8 MHz with negative peak pressure of about 3 MPa can generate microbubbles at tumor tissues in each animal 5 minutes after PCND was administered intravenously. Significance of PCND to enhance ultrasonically induced therapeutic effects was also investigated. At frequency of 2 and 3 MHz, it was found that the presence of PCND (and generated microbubbbles) halved the intensity threshold for inducing thermal damage in murine tumor tissues. At frequency around 1 MHz, it was also found that the presence of PCND halved the threshold for inducing damage in murine tumor and the damage was induced both by thermal and cavitational effects of ultrasound.
1441 Efficacy of Real Time US Guided ESWL for Bile Duct Stones Katsuyuki Koichi, Department of Internal Medicine, Asanogawa General Hospital, Japan Ichiro Araki, Department of Internal Medicine, Asanogawa General Hospital, Japan Naomichi Hamano, Department of Internal Medicine, Asanogawa General Hospital, Japan Toshio Ueno, Department of Internal Medicine, Asanogawa General Hospital, Japan Susumu Motoji, Unit of Clinical Ultrasound, Asanogawa General Hospital, Japan Purpose: Real time US guided ESWL was performed in patients with bile duct stones to evaluate its efficacy and safety. Methods: 100 patients with bile duct stones were treated with real time US guided ESWL. Before ESWL, conventional ultrasonic examinations were performed on prone position to see the number, the size and the character of stones. To visualize common bile duct more easily on US, a small amount of water (50-100ml) was taken to patients. Using machines were HDI-3000 (ATL) and EUB-8500 (HITACHI) for observation, and MPL-9000 (Dornier) for ESWL.