Optimizing Volumetric Efficiency and Backscatter Communication in Biosensing Ultrasonic Implants

Enhancing Ultrasound Power Transfer: Efficiency, Acoustics, and Future Directions

Implantable medical devices (IMDs), like pacemakers regulating heart rhythm or deep brain stimulators treating neurological disorders, revolutionize healthcare. However, limited battery life necessitates frequent surgeries for replacements. Ultrasound power transfer (UPT) emerges as a promising solution for sustainable IMD operation. Current research prioritizes implantable materials, with less emphasis on sound field analysis and maximizing energy transfer during wireless power delivery. This review addresses this gap. A comprehensive analysis of UPT technology, examining cutting-edge system designs, particularly in power supply and efficiency is provided. The review critically examines existing efficiency models, summarizing the key parameters influencing energy transmission in UPT systems. For the first time, an energy flow diagram of a general UPT system is proposed to offer insights into the overall functioning. Additionally, the review explores the development stages of UPT technology, showcasing representative designs and applications. The remaining challenges, future directions, and exciting opportunities associated with UPT are discussed. By highlighting the importance of sustainable IMDs with advanced functions like biosensing and closed-loop drug delivery, as well as UPT's potential, this review aims to inspire further research and advancements in this promising field.

Towards A Wireless Image Sensor for Real-Time Fluorescence Microscopy in Cancer Therapy

We present a mm-sized, ultrasonically powered lensless CMOS image sensor as a progress towards wireless fluorescence microscopy. Access to biological information within the tissue has the potential to provide insights guiding diagnosis and treatment across numerous medical conditions including cancer therapy. This information, in conjunction with current clinical imaging techniques that have limitations in obtaining images continuously and lack wireless compatibility, can improve continual detection of multicell clusters deep within tissue. The proposed platform incorporates a 2.4×4.7 mm2 integrated circuit (IC) fabricated in TSMC 0.18 μm, a micro laser diode (μLD), a single piezoceramic and off-chip storage capacitors. The IC consists of a 36×40 array of capacitive trans-impedance amplifier-based pixels, wireless power management and communication via ultrasound and a laser driver all controlled by a Finite State Machine. The piezoceramic harvests energy from the acoustic waves at a depth of 2 cm to power up the IC and transfer 11.5 kbits/frame via backscattering. During Charge-Up, the off-chip capacitor stores charge to later supply a high-power 78 mW μLD during Imaging. Proof of concept of the imaging front end is shown by imaging distributions of CD8 T-cells, an indicator of the immune response to cancer, ex vivo, in the lymph nodes of a functional immune system (BL6 mice) against colorectal cancer consistent with the results of a fluorescence microscope. The overall system performance is verified by detecting 140 μm features on a USAF resolution target with 32 ms exposure time and 389 ms ultrasound backscattering.

Brave New Healthcare: A Narrative Review of Digital Healthcare in American Medicine

The digital revolution has had a profound effect on American and global healthcare, which was accelerated by the pandemic and telehealth applications. Digital health also includes popular and more esoteric forms of wearable monitoring systems and interscatter and other wireless technologies that facilitate their telemetry. The rise in artificial intelligence (AI) and machine learning (ML) may serve to improve interpretation from imaging technologies to electrocardiography or electroencephalographic tracings, and new ML techniques may allow these systems to scan data to discern and contextualize patterns that may have evaded human physicians. The necessity of virtual care during the pandemic has morphed into new treatment paradigms, which have gained patient acceptance but still raise issues with respect to privacy laws and credentialing. Augmented and virtual reality tools can facilitate surgical planning and "hands-on" clinical training activities. Patients are working with new frontiers in digital health in the form of "Dr. Google" and patient support websites to learn or share medical information. Patient-facing digital health information is both a blessing and curse, in that it can be a boon to health-literate patients who seek to be more active in their own care. On the other hand, digital health information can lead to false conclusions, catastrophizing, misunderstandings, and "cyberchondria." The role of blockchain, familiar from cryptocurrency, may play a role in future healthcare information and would serve as a disruptive, decentralizing, and potentially beneficial change. These important changes are both exciting and perplexing as clinicians and their patients learn to navigate this new system and how we address the questions it raises, such as medical privacy in a digital age. The goal of this review is to explore the vast range of digital health and how it may impact the healthcare system.

A Study on Ultrasonic Wireless Power Transfer With Phased Array for Biomedical Implants

This article presents the design, fabrication, and sensitivity analysis of an ultrasound (US) wireless power transfer (WPT) link using an external phased array. Optimal beam focusing and steering is needed for efficient, safe, and reliable US WPT to biomedical implants with millimeter (mm) dimensions. Therefore, the main contributions of this work include the investigation of the 1) performance of the US WPT link using different mm-sized US receivers, 2) effect of different types of errors in the delay profile of the beamforming system on the delivered power, and 3) implant's localization. In measurements, the fabricated 0.94 MHz, 32-element array (39.48 × 9.6 × 2 mm3) driven by 25 V pulses with beam focusing and steering capability up to 50 mm depth and ±60o angle could deliver power to different mm-sized US receivers within the FDA safety limit of 720 mW/cm2. Specifically, several US transducers with a 1 mm dimension (sphere, cubic, disc shape) and 2 mm dimension (disc shape) received 0.095 mW, 0.25 mW, 0.22 mW, and 0.53 mW, respectively, at a 30 mm depth (0o steering angle). Among these transducers, the sphere shape transducer featured less sensitivity to misalignments. A random error in the phased array delays had a more drastic effect on delivered power reduction. For implant's localization, the measurement results demonstrated comparable power delivery by measuring pulse delays of only 5 elements (out of 32 elements) using 4 different interpolation methods.

Phased Array Beamforming Methods for Powering Biomedical Ultrasonic Implants

Millimeter-scale implants using ultrasound (US) for power and communication have been proposed for a range of deep-tissue applications, including neural recording and stimulation. However, published implementations have shown high sensitivity to misalignment with the external US transducer. Ultrasonic beamforming using a phased array to these implants can improve tolerance to misalignment, reduce implant volume, and allow multiple implants to be operated simultaneously in different locations. This article details the design of a custom planar phased array US system, which is capable of steering and focusing US power within a 3-D volume. Analysis and simulation is performed to determine the choice of array element pitch, with special attention given to maximizing the power available at the implant while meeting FDA limits for diagnostic US. Time reversal (TR) is proposed as a computationally simple approach to beamforming that is robust despite scattering and inhomogeneity of the acoustic medium. This technique is demonstrated both in active drive and pulse-echo modes, and it is experimentally compared with other beamforming techniques by measuring energy transfer efficiency. Simultaneous power delivery to multiple implants is also demonstrated.

Design and Optimization of Ultrasonic Links With Phased Arrays for Wireless Power Transmission to Biomedical Implants

Ultrasound (US) is an attractive modality for wireless power transfer (WPT) to biomedical implants with millimeter (mm) dimensions. To compensate for misalignments in WPT to a mm-sized implant (or powering a network of mm-sized implants), a US transducer array should electronically be driven in a beamforming fashion (known as US phased array) to steer focused US beams at different locations. This paper presents the theory and design methodology of US WPT links with phased arrays and mm-sized receivers (Rx). For given constraints imposed by the application and fabrication, such as load (R_L) and focal distance (F), the optimal geometries of a US phased array and Rx transducer, as well as the optimal operation frequency (f_c) are found through an iterative design procedure to maximize the power transfer efficiency (PTE). An optimal figure of merit (FoM) related to PTE is proposed to simplify the US array design. A design example of a US link is presented and optimized for WPT to a mm-sized Rx with a linear array. In measurements, the fabricated 16-element array (10.9×9×1.7 mm³) driven by 100 V pulses at f_c of 1.1 MHz with optimal delays for focusing at F = 20 mm generated a US beam with a pressure output of 0.8 MPa. The link could deliver up to 6 mW to a ∼ 1 mm³ Rx with a PTE of 0.14% (R_L = 850 Ω). The beam steering capability of the array at -45^o to 45^o angles was also characterized.

Towards an Implantable Fluorescence Image Sensor for Real-Time Monitoring of Immune Response in Cancer Therapy

Real-time monitoring of cellular-level changes inside the body provides key information regarding disease progression and therapy assessment for critical care including cancer therapy. Current state-of-the-art oncological imaging methods impose unnecessary latencies to detect small cell foci. Invasive methods such as biopsies, on the other hand, cause disruption if deployed on a repeated basis. Therefore, they are not practical for real-time assessments of the tumor tissue. This work presents a proof-of-concept design for an implantable fluorescence lensless image sensor to address the pervasive challenge of real-time tracking of the immune response in immunotherapy. The 2.4x4.7 mm² integrated circuit (IC) prototype consists of a 36 by 40 pixel array, a laser driver and a power management unit harvesting power and transferring 11.5 kbits/frame through a wireless ultrasound link while implanted 2 cm deep inside the body. Compared to prior art, this is the first full-fledged wireless system implementing chip-scale fluorescence microscopy to the best of our knowledge.Clinical relevance- This prototype can be used to personalize immunotherapy for the 50% of cancer patients who do not initially respond to the therapy.

A Method and Analysis to Enable Efficient Piezoelectric Transducer-Based Ultrasonic Power and Data Links for Miniaturized Implantable Medical Devices

Acoustic links for implantable medical devices (implants) have gained attention primarily because they provide a route to wireless deep-tissue systems. The miniaturization of the implants is a key research goal in these efforts, nominally because smaller implants result in less acute tissue damage. Implant size in most acoustic systems is limited by the piezoelectric bulk crystal used for power harvesting and data communication. Further miniaturization of the piezocrystal can degrade system power transfer efficiency and data transfer reliability. Here, we present a new method for packaging the implant piezocrystal; the method maximizes power transfer efficiency ( η ) from the acoustic power at the piezo surface to the power delivered to the electrical load and information transfer across the acoustic link. Our method relies on placing piezo-to-substrate anchors to the piezo regions where the vibrational displacement of the mode of interest is zero. To evaluate our method, we investigated packaged 1×1×1 mm³ piezocrystals assembled with different sized anchors. Our results show that reducing the anchor size decreases anchor loss and thus improves piezo quality factor (Q). We also demonstrate that this method improves system electromechanical coupling. A strongly coupled, high-Q piezo with properly sized and located anchors is demonstrated to achieve significantly higher η and superior data transfer capability at resonance. Overall, this work provides an analysis and generic method for packaging the implant piezocrystal that enables the design of efficient acoustic power and data links, which provides a path toward the further miniaturization of ultrasonic implants to submillimeter scales.

Ultrasound-Powered Implants: A Critical Review of Piezoelectric Material Selection and Applications

Ultrasound-powered implants (UPIs) represent cutting edge power sources for implantable medical devices (IMDs), as their powering strategy allows for extended functional lifetime, decreased size, increased implant depth, and improved biocompatibility. IMDs are limited by their reliance on batteries. While batteries proved a stable power supply, batteries feature relatively large sizes, limited life spans, and toxic material compositions. Accordingly, energy harvesting and wireless power transfer (WPT) strategies are attracting increasing attention by researchers as alternative reliable power sources. Piezoelectric energy scavenging has shown promise for low power applications. However, energy scavenging devices need be located near sources of movement, and the power stream may suffer from occasional interruptions. WPT overcomes such challenges by more stable, on-demand power to IMDs. Among the various forms of WPT, ultrasound powering offers distinct advantages such as low tissue-mediated attenuation, a higher approved safe dose (720 mW cm^-2 ), and improved efficiency at smaller device sizes. This study presents and discusses the state-of-the-art in UPIs by reviewing piezoelectric materials and harvesting devices including lead-based inorganic, lead-free inorganic, and organic polymers. A comparative discussion is also presented of the functional material properties, architecture, and performance metrics, together with an overview of the applications where UPIs are being deployed.