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Subramanian Karthikesh M, Martinez-Rivera N, Rosa-Molinar E, Wang X, Yang X. Ultrasound-assisted laser therapy for selective removal of melanoma cells. Exp Biol Med (Maywood) 2024; 249:10096. [PMID: 39170033 PMCID: PMC11338193 DOI: 10.3389/ebm.2024.10096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 07/26/2024] [Indexed: 08/23/2024] Open
Abstract
The current study explores the potential of ultrasound-assisted laser therapy (USaLT) to selectively destroy melanoma cells. The technology was tested on an ex vivo melanoma model, which was established by growing melanoma cells in chicken breast tissue. Ultrasound-only and laser-only treatments were used as control groups. USaLT was able to effectively destroy melanoma cells and selectively remove 66.41% of melanoma cells in the ex vivo tumor model when an ultrasound peak negative pressure of 2 MPa was concurrently applied with a laser fluence of 28 mJ/cm2 at 532 nm optical wavelength for 5 min. The therapeutic efficiency was further improved with the use of a higher laser fluence, and the treatment depth was improved to 3.5 mm with the use of 1,064 nm laser light at a fluence of 150 mJ/cm2. None of the laser-only and ultrasound-only treatments were able to remove any melanoma cells. The treatment outcome was validated with histological analyses and photoacoustic imaging. This study opens the possibility of USaLT for melanoma that is currently treated by laser therapy, but at a much lower laser fluence level, hence improving the safety potential of laser therapy.
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Affiliation(s)
- Madhumithra Subramanian Karthikesh
- Bioengineering Graduate Program, University of Kansas, Lawrence, KS, United States
- Institute for Bioengineering Research, University of Kansas, Lawrence, KS, United States
| | - Noraida Martinez-Rivera
- Microscopy and Analytical Imaging Laboratory, University of Kansas, Lawrence, KS, United States
| | - Eduardo Rosa-Molinar
- Bioengineering Graduate Program, University of Kansas, Lawrence, KS, United States
- Microscopy and Analytical Imaging Laboratory, University of Kansas, Lawrence, KS, United States
- Department of Pharmacology and Toxicology, and Neuroscience, University of Kansas, Lawrence, KS, United States
| | - Xueding Wang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Xinmai Yang
- Bioengineering Graduate Program, University of Kansas, Lawrence, KS, United States
- Institute for Bioengineering Research, University of Kansas, Lawrence, KS, United States
- Department of Mechanical Engineering, School of Engineering, University of Kansas, Lawrence, KS, United States
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Wang M, Singh R, Zhang W, Orringer JS, Paulus YM, Yang X, Wang X. Cutaneous Hypervascularization Treatment Using Photo-Mediated Ultrasound Therapy. JID INNOVATIONS 2023; 3:100237. [PMID: 38024557 PMCID: PMC10661455 DOI: 10.1016/j.xjidi.2023.100237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 12/01/2023] Open
Abstract
Photo-mediated ultrasound therapy (PUT) is a cavitation-based, highly selective antivascular technique. In this study, the effectiveness and safety of PUT on cutaneous vascular malformation was examined through in vivo experiments in a clinically relevant chicken wattle model, whose microanatomy is similar to that of port-wine stain and other hypervascular dermal diseases in humans. Assessed by optical coherence tomography angiography, the blood vessel density in the chicken wattle decreased by 73.23% after one session of PUT treatment in which 0.707 J/cm2 fluence laser pulses were applied concurrently with ultrasound bursts (n = 7, P < .01). The effectiveness of removing blood vessels in the skin at depth up to 1 mm was further assessed by H&E-stained histology at multiple time points, which included days 1, 3, 7, 14, and 21 after treatment. Additional immunohistochemical analyses with CD31, caspase-3, and Masson's trichrome stains were performed on day 3 after treatment. The results show that the PUT-induced therapeutic effect was confined and specific to blood vessels only, whereas unwanted collateral damage in other skin tissues such as collagen was avoided. The findings from this study demonstrate that PUT can efficiently and safely remove hypervascular dermal capillaries using laser fluence at a level that is orders of magnitude smaller than that used in conventional laser treatment of vascular lesions, thus offering a safer alternative technique for clinical management of cutaneous vascular malformations.
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Affiliation(s)
- Mingyang Wang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Rohit Singh
- PhotoSonoX LLC, Ann Arbor, Michigan, USA
- Institute for Bioengineering Research, University of Kansas, Lawrence, Kansas, USA
- Department of Mechanical Engineering, School of Engineering, University of Kansas, Lawrence, Kansas, USA
| | - Wei Zhang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Yannis M. Paulus
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Xinmai Yang
- Institute for Bioengineering Research, University of Kansas, Lawrence, Kansas, USA
- Department of Mechanical Engineering, School of Engineering, University of Kansas, Lawrence, Kansas, USA
| | - Xueding Wang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
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Wang M, Nguyen VP, Singh R, Mossallam B, Yang X, Wang X, Paulus YM. Choroidal neovascularization removal with photo-mediated ultrasound therapy. Med Phys 2023; 50:3661-3670. [PMID: 37029733 PMCID: PMC10330868 DOI: 10.1002/mp.16404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 02/16/2023] [Accepted: 03/01/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND Age-related macular degeneration (AMD) is a major cause of irreversible central vision loss. The main reason for lost vision due to AMD is choroidal neovascularization (CNV). In the clinic, current treatments for CNV include photodynamic therapy, laser photocoagulation, and anti-vascular endothelial growth factor (VEGF) therapy. PURPOSE This study evaluates a novel treatment technique combining synchronized nanosecond laser pulses and ultrasound bursts, namely photo-mediated ultrasound therapy (PUT) as a potential treatment method for CNV, for its efficacy and safety in the treatment of CNV via the experiments in a clinically-relevant rabbit model in vivo. METHODS CNV was created by subretinal injection of Matrigel and vascular endothelial growth factor (M&V) in 10 New Zealand white rabbits. Six rabbits were used in the PUT group. In the control groups, two rabbits were treated by laser-only, and two rabbits were treated by ultrasound-only. The treatment efficacy was evaluated through fundus photography and fluorescein angiography (FA) longitudinally for up to 4 weeks. Rabbits were sacrificed for histopathology 3 months after treatment to examine the safety of PUT. RESULTS The fluorescein leakage on FA was quantified to longitudinally evaluate treatment outcome. Compared with baseline, the relative intensity index was reduced by 26.57% ± 8.66% at 3 days after treatment, 27.24% ± 6.21% at 1 week after treatment, 27.79% ± 2.61% at 2 weeks after treatment, and 32.12% ± 3.23% at 4 weeks after treatment, all with a statistically significant difference of p < 0.01. The comparison between the relative intensity indexes from the two control groups (laser-only treatment and ultrasound-only treatment) did not show any statistically significant difference at all time points. Safety evaluation at 3 months with histopathology demonstrated that the PUT did not result in morphologic changes to the neurosensory retina. CONCLUSIONS This study introduces PUT for the first time for the treatment of CNV. The results demonstrated good efficacy and safety of PUT to treat CNV in a clinically-relevant rabbit model. With a single session of treatment, PUT can safely reduce the leakage of CNV for at least 1 month after treatment.
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Affiliation(s)
- Mingyang Wang
- Department of Biomedical Engineering, University of Michigan Ann Arbor, MI, 48109 USA
| | - Van Phuc Nguyen
- Department of Ophthalmology and Visual Sciences, University of Michigan Ann Arbor, MI, 48105 USA
| | - Rohit Singh
- Institute for Bioengineering Research and Department of Mechanical Engineering, University of Kansas, Lawrence, KS, 66045 USA
| | - Basheer Mossallam
- Department of Biomedical Engineering, University of Michigan Ann Arbor, MI, 48109 USA
| | - Xinmai Yang
- Institute for Bioengineering Research and Department of Mechanical Engineering, University of Kansas, Lawrence, KS, 66045 USA
| | - Xueding Wang
- Department of Biomedical Engineering, University of Michigan Ann Arbor, MI, 48109 USA
| | - Yannis M. Paulus
- Department of Biomedical Engineering, University of Michigan Ann Arbor, MI, 48109 USA
- Department of Ophthalmology and Visual Sciences, University of Michigan Ann Arbor, MI, 48105 USA
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Singh R, Yang X. A review on photo-mediated ultrasound therapy. Exp Biol Med (Maywood) 2023; 248:775-786. [PMID: 37452726 PMCID: PMC10468643 DOI: 10.1177/15353702231181191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Abstract
Photo-mediated ultrasound therapy (PUT) is a novel therapeutic technique based on the combination of ultrasound and laser. The underlying mechanism of PUT is the enhanced cavitation effect inside blood vessels. The enhanced cavitation activity can result in bio-effects such as reduced perfusion in microvessels. The reduced perfusion effect in microvessels in the eye has the potential to control the progression of eye diseases such as diabetic retinopathy and age-related macular degeneration. Several in vivo studies have demonstrated the feasibility of PUT in removing microvasculature in the eye using rabbit eye model and vasculature in the skin using rabbit ear model. Numerical studies using a bubble dynamics model found that cavitation is enhanced during PUT due to the dramatic increase in size of air/vapor nuclei in blood. In addition, the study conducted to model cavitation dynamics inside a blood vessel during PUT found stresses induced on the vessel wall during PUT are higher than that at normal physiological levels, which may be responsible for bio-effects. The concentration of vasodilators such as nitric oxide and prostacyclin were also found to be affected during PUT in an in vitro study, which may limit blood perfusion in vessels. The main advantage of PUT over conventional techniques is non-invasive, precise, and selective removal of microvessels with high efficiency at relatively low energy levels of ultrasound and laser, without affecting the nearby structures. However, the main limitation of vessel rupture/hemorrhage needs to be overcome through the development of real-time monitoring of treatment effects during PUT. In addition to the application in removing microvessels, PUT-based techniques were also explored in treating other diseases. Studies have found a combination of ultrasound and laser to be effective in removing blood clots inside veins, which has the potential to treat deep-vein thrombosis. The disruption of atherosclerotic plaque using combined ultrasound and laser was also tested, and the feasibility was demonstrated.
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Affiliation(s)
- Rohit Singh
- Department of Mechanical Engineering, Institute for Bioengineering Research, The University of Kansas, Lawrence, KS 66045, USA
| | - Xinmai Yang
- Department of Mechanical Engineering, Institute for Bioengineering Research, The University of Kansas, Lawrence, KS 66045, USA
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Singh R, Ebersole KC, Yang X. A feasibility study on removing lipid deposition in atherosclerotic plaques with ultrasound-assisted laser ablation. Phys Med Biol 2023; 68. [PMID: 36804803 DOI: 10.1088/1361-6560/acb9d1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 02/07/2023] [Indexed: 02/23/2023]
Abstract
Objective. Atherosclerosis is the buildup of fats, cholesterol, and other substances on the inner walls of arteries. It can affect arteries of heart, brain, arms, legs, pelvis and kidney, resulting in ischemic heart disease, carotid artery disease, peripheral artery disease and chronic kidney disease. Laser-based treatment techniques like laser atherectomy can be used to treat many common atherosclerostic diseases. However, the use of laser-based treatment remains limited due to the high risk of complications and low efficiency in removing atherosclerostic plaques as compared with other treatment methods. In this study, we developed a technology that used high intensity focused ultrasound to assist laser treatment in the removal of the lipid core of atherosclerotic plaques.Approach. The fundamental mechanism to disrupt atherosclerostic plaque was to enhance the mechanical effect of cavitation during laser/ultrasound therapy. To promote cavitation, spatiotemporally synchronized ultrasound bursts of 2% duty cycle at 0.5 MHz and nanosecond laser pulses at 532 nm wavelength were used. Experiments were first performed on pig belly fat samples to titrate ultrasound and laser parameters. Then, experiments were conducted on human plaque samples, where the lipid depositions of the plaques were targeted.Main results. Our results showed that fat tissue could be removed with an ultrasound peak negative pressure (PNP) of 2.45 MPa and a laser radiant exposure as low as 3.2 mJ mm-2. The lipid depositions on the atherosclerostic plaques were removed with laser radiant exposure of 16 mJ mm-2in synchronizing with an ultrasound PNP of 5.4 MPa. During all the experiments, laser-only and ultrasound-only control treatments at the same energy levels were not effective in removing the lipid.Significance. The results demonstrated that the addition of ultrasound could effectively reduce the needed laser power for atherosclerotic plaque removal, which will potentially improve treatment safety and efficiency of current laser therapies.
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Affiliation(s)
- Rohit Singh
- Institute for Bioengineering Research and Department of Mechanical Engineering, the University of Kansas, Lawrence, KS, 66045, United States of America
| | - Koji C Ebersole
- Department of Neurosurgery, the University of Kansas Medical Center, Kansas City, KS, 66160, United States of America
| | - Xinmai Yang
- Institute for Bioengineering Research and Department of Mechanical Engineering, the University of Kansas, Lawrence, KS, 66045, United States of America
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Singh R, Yang X. A 3D finite element model to study the cavitation induced stresses on blood-vessel wall during the ultrasound-only phase of photo-mediated ultrasound therapy. AIP ADVANCES 2022; 12:045020. [PMID: 35465057 PMCID: PMC9020880 DOI: 10.1063/5.0082429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/28/2022] [Indexed: 06/14/2023]
Abstract
Photo-mediated ultrasound therapy (PUT) is a novel technique utilizing synchronized ultrasound and laser to generate enhanced cavitation inside blood vessels. The enhanced cavitation inside blood vessels induces bio-effects, which can result in the removal of micro-vessels and the reduction in local blood perfusion. These bio-effects have the potential to treat neovascularization diseases in the eye, such as age-related macular degeneration and diabetic retinopathy. Currently, PUT is in the preclinical stage, and various PUT studies on in vivo rabbit eye models have shown successful removal of micro-vessels. PUT is completely non-invasive and particle-free as opposed to current clinical treatments such as anti-vascular endothelial growth factor therapy and photodynamic therapy, and it precisely removes micro-vessels without damaging the surrounding tissue, unlike laser photocoagulation therapy. The stresses produced by oscillating bubbles during PUT are responsible for the induced bio-effects in blood vessels. In our previous work, stresses induced during the first phase of PUT due to combined ultrasound and laser irradiation were studied using a 2D model. In this work, stresses induced during the third or last phase of PUT due to ultrasound alone were studied using a 3D finite element method-based numerical model. The results showed that the circumferential and shear stress increased as the bubble moves from the center of the vessel toward the vessel wall with more than a 16 times increase in shear stress from 1.848 to 31.060 kPa as compared to only a 4 times increase in circumferential stress from 211 to 906 kPa for a 2 µm bubble placed inside a 10 µm vessel on the application of 1 MHz ultrasound frequency and 130 kPa amplitude. In addition, the stresses decreased as the bubble was placed in smaller sized vessels with a larger decrease in circumferential stress. The changes in shear stress were found to be more dependent on the bubble-vessel wall distance, and the changes in circumferential stress were more dependent on the bubble oscillation amplitude. Moreover, the bubble shape changed to an ellipsoidal with a higher oscillation amplitude in the vessel's axial direction as it was moved closer to the vessel wall, and the bubble oscillation amplitude decreased drastically as it was placed in vessels of a smaller size.
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Affiliation(s)
| | - Xinmai Yang
- Author to whom correspondence should be addressed:
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Qin Y, Yu Y, Fu J, Wang M, Yang X, Wang X, Paulus YM. Photo-mediated ultrasound therapy for the treatment of retinal neovascularization in rabbit eyes. Lasers Surg Med 2022; 54:747-757. [PMID: 35320609 PMCID: PMC9314838 DOI: 10.1002/lsm.23539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/02/2022] [Accepted: 03/07/2022] [Indexed: 11/19/2022]
Abstract
Objectives Retinal neovascularization (RNV) is the growth of abnormal microvessels on the retinal surface and into the vitreous, which can lead to severe vision loss. By combining relatively low‐intensity ultrasound and nanosecond‐pulse‐duration laser, we developed a novel treatment method, namely photo‐mediated ultrasound therapy (PUT), which holds a potential to remove RNV with minimal or no damage to the adjacent tissues. Methods RNV was created in both albino and pigmented rabbits (n = 10) through a single intravitreal injection with DL‐α‐aminoadipic acid. RNV was treated with PUT 8 weeks postinjection. After PUT treatment, animals were evaluated longitudinally for up to 6 weeks. Treatment outcomes were evaluated through fundus photography, red‐free fundus photography, fluorescein angiography (FA), and histopathology. Results In both albino and pigmented rabbits, there were no leakage in the treatment area immediately after PUT treatment as demonstrated by FA, indicating the cessation of blood perfusion of the RNV in the treated area. The fluorescence leakage did not recover in albino rabbits during the 6‐week posttreatment monitoring period, and only 9.9 ± 9.8% of the neovascularization remained at the end of 6 weeks. In the pigmented rabbits, the fluorescence leakage partially returned, but the level of leakage decreased over time during the 6‐week posttreatment monitoring period, and only 10.8 ± 9.8% of the neovascularization remained at the end of 6 weeks. Histology demonstrated removal of vasculature without damage to the surrounding neurosensory retina. Conclusions These results demonstrate that PUT could precisely remove RNV without damage to the surrounding neurosensory retina in both rabbit strains.
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Affiliation(s)
- Yu Qin
- Department of Biomedical EngineeringUniversity of MichiganAnn ArborMichiganUSA
- Institute of Acoustics, School of Physics Science and EngineeringTongji UniversityShanghaiChina
| | - Yixin Yu
- Department of Ophthalmology and Visual SciencesUniversity of MichiganAnn ArborMichiganUSA
- Eye Center of Xiangya HospitalCentral South UniversityChangshaHunan ProvinceChina
- Hunan Key Laboratory of OphthalmologyChangshaHunan ProvinceChina
| | - Julia Fu
- Department of Ophthalmology and Visual SciencesUniversity of MichiganAnn ArborMichiganUSA
| | - Mingyang Wang
- Department of Biomedical EngineeringUniversity of MichiganAnn ArborMichiganUSA
| | - Xinmai Yang
- Institute for Bioengineering Research and Department of Mechanical EngineeringUniversity of KansasLawrenceKansasUSA
| | - Xueding Wang
- Department of Biomedical EngineeringUniversity of MichiganAnn ArborMichiganUSA
| | - Yannis M. Paulus
- Department of Biomedical EngineeringUniversity of MichiganAnn ArborMichiganUSA
- Department of Ophthalmology and Visual SciencesUniversity of MichiganAnn ArborMichiganUSA
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Effect of Photo-Mediated Ultrasound Therapy on Nitric Oxide and Prostacyclin from Endothelial Cells. APPLIED SCIENCES-BASEL 2022; 12. [PMID: 35983461 PMCID: PMC9384428 DOI: 10.3390/app12052617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Several studies have investigated the effect of photo-mediated ultrasound therapy (PUT) on the treatment of neovascularization. This study explores the impact of PUT on the release of the vasoactive agents nitric oxide (NO) and prostacyclin (PGI2) from the endothelial cells in an in vitro blood vessel model. In this study, an in vitro vessel model containing RF/6A chorioretinal endothelial cells was used. The vessels were treated with ultrasound-only (0.5, 1.0, 1.5 and 2.0 MPa peak negative pressure at 0.5 MHz with 10% duty cycle), laser-only (5, 10, 15 and 20 mJ/cm2 at 532 nm with a pulse width of 5 ns), and synchronized laser and ultrasound (PUT) treatments. Passive cavitation detection was used to determine the cavitation activities during treatment. The levels of NO and PGI2 generally increased when the applied ultrasound pressure and laser fluence were low. The increases in NO and PGI2 levels were significantly reduced by 37.2% and 42.7%, respectively, from 0.5 to 1.5 MPa when only ultrasound was applied. The increase in NO was significantly reduced by 89.5% from 5 to 20 mJ/cm2, when only the laser was used. In the PUT group, for 10 mJ/cm2 laser fluence, the release of NO decreased by 76.8% from 0.1 to 1 MPa ultrasound pressure. For 0.5 MPa ultrasound pressure in the PUT group, the release of PGI2 started to decrease by 144% from 15 to 20 mJ/cm2 laser fluence. The decreases in NO and PGI2 levels coincided with the increased cavitation activities in each group. In conclusion, PUT can induce a significant reduction in the release of NO and PGI2 in comparison with ultrasound-only and laser-only treatments.
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Arruda TR, Vieira P, Silva BM, Freitas TD, Amaral AJB, Vieira ENR, Leite Júnior BRDC. What are the prospects for ultrasound technology in food processing? An update on the main effects on different food matrices, drawbacks, and applications. J FOOD PROCESS ENG 2021. [DOI: 10.1111/jfpe.13872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | - Patty Vieira
- Department of Food Technology Federal University of Viçosa Viçosa Brazil
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Singh R, Jo J, Riegel M, Forrest ML, Yang X. The feasibility of ultrasound-assisted endovascular laser thrombolysis in an acute rabbit thrombosis model. Med Phys 2021; 48:4128-4138. [PMID: 34214203 DOI: 10.1002/mp.15068] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/27/2021] [Accepted: 06/21/2021] [Indexed: 12/31/2022] Open
Abstract
PURPOSE This study aimed to test the feasibility of combined ultrasound and laser technique, namely, ultrasound-assisted endovascular laser thrombolysis (USELT), for thrombolysis by conducting in vivo tests in a rabbit thrombosis model. MATERIALS AND METHODS An acute thrombus was created in the right jugular vein of rabbit and then was treated with ultrasound only, laser only, and USELT to dissolve the blood clot. A total of 20 rabbits were used. Out of which, the first three rabbits were used to titrate the laser and ultrasound parameters. Then, five rabbits were treated with ultrasound only, five rabbits were treated with laser only, and seven rabbits were treated with USELT. During USELT, 532-nm laser pulses were delivered endovascularly directly to the clot through a fiber optic, and 0.5 MHz ultrasound pulses were applied noninvasively to the same region. A laser fluence of 4 to 12 mJ/cm2 and ultrasound amplitude of 1 to 2 MPa were used. Recanalization of the jugular vein was assessed by performing ultrasound Doppler imaging immediately after the treatment. The maximum blood flow speed after the treatment as compared to its value before the treatment was used to calculate the blood flow recovery in vessel. RESULTS The blood flow was fully recovered (100%) in three rabbits, partially recovered in two rabbits (more than 50% and less than 100%) with mean percentage recovery of 69.73% and poorly recovered in two rabbits (<50%) with mean percentage recovery of 6.2% in the USELT group. In contrast, the treatment group with ultrasound or laser alone did not show recanalization of vein in any case, all the five rabbits were poorly/not recovered with a mean percentage recovery of 0%. CONCLUSIONS The USELT technology was shown to effectively dissolve the blood clots in an acute rabbit jugular vein thrombosis model.
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Affiliation(s)
- Rohit Singh
- Institute for Bioengineering Research and Department of Mechanical Engineering, University of Kansas, Lawrence, Kansas, USA
| | - Janggun Jo
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA.,Vesarex LLC, Lawrence, Kansas, USA
| | - Matthew Riegel
- Animal Care Unit, University of Kansas, Lawrence, Kansas, USA
| | - M Laird Forrest
- Department of Pharmaceutical Chemistry, University of Kansas, Lawrence, Kansas, 66045, USA
| | - Xinmai Yang
- Institute for Bioengineering Research and Department of Mechanical Engineering, University of Kansas, Lawrence, Kansas, USA
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Qin Y, Yu Y, Fu J, Xie X, Wang T, Woodward MA, Paulus YM, Yang X, Wang X. Photo-Mediated Ultrasound Therapy for the Treatment of Corneal Neovascularization in Rabbit Eyes. Transl Vis Sci Technol 2020; 9:16. [PMID: 33344060 PMCID: PMC7726583 DOI: 10.1167/tvst.9.13.16] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/24/2020] [Indexed: 12/05/2022] Open
Abstract
Purpose Corneal neovascularization (CNV) is the invasion of new blood vessels into the avascular cornea, leading to reduced corneal transparency and visual acuity, impaired vision, and even blindness. Current treatment options for CNV are limited. We developed a novel treatment method, termed photo-mediated ultrasound therapy (PUT), that combines laser and ultrasound, and we tested its feasibility for treating CNV in a rabbit model. Methods A suture-induced CNV model was established in New Zealand White rabbits, which were randomly divided into two groups: PUT and control. For the PUT group, the applied light fluence at the corneal surface was estimated to be 27 mJ/cm2 at 1064-nm wavelength with a pulse duration of 5 ns, and the ultrasound pressure applied on the cornea was 0.43 MPa at 0.5 MHz. The control group received no treatment. Red-free photography and fluorescein angiography were utilized to evaluate the efficiency of PUT. Safety was evaluated by histology and immunohistochemistry. For comparison with the PUT safety results, conventional laser photocoagulation (LP) treatment was performed with standard clinical parameters: 532-nm continuous-wave (CW) laser with 0.1-second pulse duration, 450-mW power, and 75-µm spot size. Results In the PUT group, only 1.8% ± 0.8% of the CNV remained 30 days after treatment. In contrast, 71.4% ± 7.2% of the CNV remained in the control group after 30 days. Safety evaluations showed that PUT did not cause any damage to the surrounding tissue. Conclusions These results demonstrate that PUT is capable of removing CNV safely and effectively in this rabbit model. Translational Relevance PUT can remove CNV safely and effectively.
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Affiliation(s)
- Yu Qin
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, China.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Yixin Yu
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA.,Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan Province, China.,Hunan Key Laboratory of Ophthalmology, Changsha, Hunan Province, China
| | - Julia Fu
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Xinyi Xie
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Tao Wang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Maria A Woodward
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Yannis M Paulus
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.,Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Xinmai Yang
- Institute for Bioengineering Research and Department of Mechanical Engineering, University of Kansas, Lawrence, KS, USA
| | - Xueding Wang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
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Qin Y, Yu Y, Xie X, Zhang W, Fu J, Paulus YM, Yang X, Wang X. The Effect of Laser and Ultrasound Synchronization in Photo-Mediated Ultrasound Therapy. IEEE Trans Biomed Eng 2020; 67:3363-3370. [PMID: 32275582 PMCID: PMC8183568 DOI: 10.1109/tbme.2020.2985648] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Photo-mediated ultrasound therapy (PUT) is a novel, non-invasive, agent-free, highly selective, and precise anti-vascular technique. PUT removes microvessels through promoting cavitation activity precisely in targeted microvessels by applying synchronized nanosecond laser pulses and ultrasound bursts. The synchronization between laser and ultrasound is critical to the outcome of PUT. METHODS Through theoretical simulation and experimental study, the effect of synchronization between laser pulses and ultrasound bursts on cavitation activity during PUT is evaluated. RESULTS By using a theoretical model, we found that cavitation activity was enhanced when laser pulses and ultrasound bursts were synchronized such that the produced photoacoustic wave overlaid the rarefactional phase of the ultrasound wave. This finding was then verified through in vitro studies where cavitation was monitored by using a passive cavitation detector. Furthermore, we demonstrated that the in vivo treatment outcome of PUT in rabbits was directly related to the synchronization between laser and ultrasound. The anti-vascular effect could only be observed when laser and ultrasound were properly synchronized in vivo. CONCLUSION PUT is more efficient when the laser-induced photoacoustic wave overlays the rarefactional phase of the ultrasonic wave. SIGNIFICANCE This is a systematic study to investigate the synchronization effect of PUT, which would be significant for further understanding the mechanism and further improving the treatment efficiency of PUT.
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Affiliation(s)
- Yu Qin
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, P. R. China
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Yixin Yu
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Xinyi Xie
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, P.R. China
| | - Wei Zhang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Julia Fu
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Yannis M Paulus
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Xinmai Yang
- Institute for Bioengineering Research and Department of Mechanical Engineering, University of Kansas, Lawrence, KS, USA
| | - Xueding Wang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
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Hazlewood D, Yang X. Enhanced cavitation activity in a slab-shaped optical absorber during photo-mediated ultrasound therapy. Phys Med Biol 2020; 65:055006. [PMID: 31715592 DOI: 10.1088/1361-6560/ab56f7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Recently, new studies have shown that combined laser and ultrasound, or photo-mediated ultrasound therapy (PUT), can enhance cavitation in optically absorptive targets to disrupt tissues through photoacoustic (PA) effect. These studies, including both experimental and theoretical investigations, have largely focused on blood vessels, which are modeled as cylindrically-shaped optical absorbers for PA wave generation and propagation. However, in many clinical situations, target tissues may not be cylindrically-shaped. In this paper we investigated the effect of PUT on a slab-shaped optical absorber, much larger than the size of the laser beam or the ultrasound focal point. Our results demonstrated that laser light could generate a PA wave that could enhance cavitation not only at the surface of a slab, but also at depths when combined with ultrasound, suggesting that PUT may be effective in enhancing cavitation in a large range of soft tissues. Our results also demonstrated that the cavitation enhancement was based on the optical absorption of the targeted tissue, allowing for self-targeting treatments when optical contrast is present. Additionally, we demonstrated that for the greatest cavitation enhancement in deeper layers a focused laser beam geometry would be most effective.
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Affiliation(s)
- David Hazlewood
- Bioengineering Program and Institute for Bioengineering Research, University of Kansas, Lawrence, KS, United States of America
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Zhang W, Qin Y, Xie X, Hu Z, Paulus YM, Yang X, Wang X. Real-time photoacoustic sensing for photo-mediated ultrasound therapy. OPTICS LETTERS 2019; 44:4063-4066. [PMID: 31415547 PMCID: PMC6907727 DOI: 10.1364/ol.44.004063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/10/2019] [Indexed: 06/01/2023]
Abstract
Photo-mediated ultrasound therapy (PUT) is a novel, noninvasive antimicrovascular approach that can treat neovascularization with high precision. We developed a photoacoustic (PA) sensing (PAS) system for PUT and achieved real-time PAS-guided PUT. Experiments performed on a chicken yolk sac membrane model demonstrated that PAS could monitor the treatment effect in a microvessel during PUT. Vessel shrinkage induced a decrease in the PA signal amplitude, while vessel rupture induced an abrupt increase in the PA signal amplitude. The integrated PUT and PAS system can significantly improve the safety and effectiveness of PUT, and may assist with clinical translation of this novel antimicrovascular technique.
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Affiliation(s)
- Wei Zhang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Yu Qin
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, P. R. China
| | - Xinyi Xie
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, P.R. China
| | - Zizhong Hu
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, P.R. China
| | - Yannis M Paulus
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Xinmai Yang
- Institute for Bioengineering Research and Department of Mechanical Engineering, University of Kansas, Lawrence, KS, USA
| | - Xueding Wang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
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