CT and ultrasound guided stereotactic high intensity focused ultrasound (HIFU)

Bradford J. Wood, J. Yanof, V. Frenkel, A. Viswanathan, S. Dromi, K. Oh, J. Kruecker, C. Bauer, R. Seip, A. Kam, K. C.P. Li

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

To demonstrate the feasibility of CT and B-mode Ultrasound (US) targeted HIFU, a prototype coaxial focused ultrasound transducer was registered and integrated to a CT scanner. CT and diagnostic ultrasound were used for HIFU targeting and monitoring, with the goals of both thermal ablation and non-thermal enhanced drug delivery. A 1 megahertz coaxial ultrasound transducer was custom fabricated and attached to a passive position-sensing arm and an active six degree-of-freedom robotic arm via a CT stereotactic frame. The outer therapeutic transducer with a 10 cm fixed focal zone was coaxially mounted to an inner diagnostic US transducer (2-4 megahertz, Philips Medical Systems). This coaxial US transducer was connected to a modified commercial focused ultrasound generator (Focus Surgery, Indianapolis, IN) with a maximum total acoustic power of 100 watts. This pre-clinical paradigm was tested for ability to heat tissue in phantoms with monitoring and navigation from CT and live US. The feasibility of navigation via image fusion of CT with other modalities such as PET and MRI was demonstrated. Heated water phantoms were tested for correlation between CT numbers and temperature (for ablation monitoring). The prototype transducer and integrated CT/US imaging system enabled simultaneous multimodality imaging and therapy. Pre-clinical phantom models validated the treatment paradigm and demonstrated integrated multimodality guidance and treatment monitoring. Temperature changes during phantom cooling corresponded to CT number changes. Contrast enhanced or non-enhanced CT numbers may potentially be used to monitor thermal ablation with HIFU. Integrated CT, diagnostic US, and therapeutic focused ultrasound bridges a gap between diagnosis and therapy. Preliminary results show that the multimodality system may represent a relatively inexpensive, accessible, and simple method of both targeting and monitoring HIFU effects. Small animal pre-clinical models may be translated to large animals and humans for HIFU-induced ablation and drug delivery. Integrated CT-guided focused ultrasound holds promise for tissue ablation, enhancing local drug delivery, and CT thermometry for monitoring ablation in near real-time.

Original languageEnglish (US)
Title of host publicationTHERAPEUTIC ULTRASOUND
Subtitle of host publication5th International Symposium on Therapeutic Ultrasound
PublisherAmerican Institute of Physics Inc.
Pages122-126
Number of pages5
ISBN (Print)073540321X, 9780735403215
DOIs
StatePublished - May 8 2006
Externally publishedYes
EventTHERAPEUTIC ULTRASOUND: 5th International Symposium on Therapeutic Ultrasound - Boston, MA, United States
Duration: Oct 27 2005Oct 29 2005

Publication series

NameAIP Conference Proceedings
Volume829
ISSN (Print)0094-243X
ISSN (Electronic)1551-7616

Other

OtherTHERAPEUTIC ULTRASOUND: 5th International Symposium on Therapeutic Ultrasound
CountryUnited States
CityBoston, MA
Period10/27/0510/29/05

Keywords

  • CT intervention
  • Drug delivery
  • Image guided therapy
  • Pulsed-HIFU

ASJC Scopus subject areas

  • Physics and Astronomy(all)

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