Quantitative investigation of acoustic streaming in blood

Mechanistic Insights and Therapeutic Delivery through Micro/Nanobubble-Assisted Ultrasound

Ultrasound with low frequency (20–100 kHz) assisted drug delivery has been widely investigated as a non-invasive method to enhance the permeability and retention effect of drugs. The functional micro/nanobubble loaded with drugs could provide an unprecedented opportunity for targeted delivery. Then, ultrasound with higher intensity would locally burst bubbles and release agents, thus avoiding side effects associated with systemic administration. Furthermore, ultrasound-mediated destruction of micro/nanobubbles can effectively increase the permeability of vascular membranes and cell membranes, thereby not only increasing the distribution concentration of drugs in the interstitial space of target tissues but also promoting the penetration of drugs through cell membranes into the cytoplasm. These advancements have transformed ultrasound from a purely diagnostic utility into a promising theragnostic tool. In this review, we first discuss the structure and generation of micro/nanobubbles. Second, ultrasound parameters and mechanisms of therapeutic delivery are discussed. Third, potential biomedical applications of micro/nanobubble-assisted ultrasound are summarized. Finally, we discuss the challenges and future directions of ultrasound combined with micro/nanobubbles.

Quantitative assessment of parallel acoustofluidic device

The advantage of ultrasonic fields in harmless and label-free applications intrigued researchers to develop this technology. The capability of acoustofluidic technology for medical applications has not been thoroughly analyzed and visualized. Toward efficient design, in this research, flowing fluid in a microchannel excited by acoustic waves is fully investigated. To study the behavior of acoustic streaming, the main interfering parameters such as inlet velocity, working frequency, displacement amplitude, fluid buffer material, and hybrid effect in a rectangular water-filled microchannel actuated by standing surface acoustic waves are studied. Governing equations for acoustic field and laminar flow are derived employing perturbation theory. For each set of equations, appropriate boundary conditions are applied. Results demonstrate a parallel device is capable of increasing the inlet flow for rapid operations. Frequency increment raises the acoustic streaming velocity magnitude. Displacement amplitude amplification increases the acoustic streaming velocity and helps the streaming flow dominate over the incoming flow. The qualitative analysis of the hybrid effect shows using hard walls can significantly increase the streaming power without depleting excessive energy. A combination of several effective parameters provides an energy-efficient and fully controllable device for biomedical applications such as fluid mixing and cell lysis.

Nanoplatforms for Targeted Stimuli-Responsive Drug Delivery: A Review of Platform Materials and Stimuli-Responsive Release and Targeting Mechanisms

To achieve the promise of stimuli-responsive drug delivery systems for the treatment of cancer, they should (1) avoid premature clearance; (2) accumulate in tumors and undergo endocytosis by cancer cells; and (3) exhibit appropriate stimuli-responsive release of the payload. It is challenging to address all of these requirements simultaneously. However, the numerous proof-of-concept studies addressing one or more of these requirements reported every year have dramatically expanded the toolbox available for the design of drug delivery systems. This review highlights recent advances in the targeting and stimuli-responsiveness of drug delivery systems. It begins with a discussion of nanocarrier types and an overview of the factors influencing nanocarrier biodistribution. On-demand release strategies and their application to each type of nanocarrier are reviewed, including both endogenous and exogenous stimuli. Recent developments in stimuli-responsive targeting strategies are also discussed. The remaining challenges and prospective solutions in the field are discussed throughout the review, which is intended to assist researchers in overcoming interdisciplinary knowledge barriers and increase the speed of development. This review presents a nanocarrier-based drug delivery systems toolbox that enables the application of techniques across platforms and inspires researchers with interdisciplinary information to boost the development of multifunctional therapeutic nanoplatforms for cancer therapy.

Micro/nano-bubble-assisted ultrasound to enhance the EPR effect and potential theranostic applications

Drug delivery for tumor theranostics involves the extensive use of the enhanced permeability and retention (EPR) effect. Previously, various types of nanomedicines have been demonstrated to accumulate in solid tumors via the EPR effect. However, EPR is a highly variable phenomenon because of tumor heterogeneity, resulting in low drug delivery efficacy in clinical trials. Because ultrasonication using micro/nanobubbles as contrast agents can disrupt blood vessels and enhance the specific delivery of drugs, it is an effective approach to improve the EPR effect for the passive targeting of tumors. In this review, the basic thermal effect, acoustic streaming, and cavitation mechanisms of ultrasound, which are characteristics that can be utilized to enhance the EPR effect, are briefly introduced. Second, micro/nanobubble-enhanced ultrasound imaging is discussed to understand the validity and variability of the EPR effect. Third, because the tumor microenvironment is complicated owing to elevated interstitial fluid pressure and the deregulated extracellular matrix components, which may be unfavorable for the EPR effect, few new trends in smart bubble drug delivery systems, which may improve the accuracy of EPR-mediated passive drug targeting, are summarized. Finally, the challenging and major concerns that should be considered in the next generation of micro/nanobubble-contrast-enhanced ultrasound theranostics for EPR-mediated passive drug targeting are also discussed.

Spatially Specific Liposomal Cancer Therapy Triggered by Clinical External Sources of Energy

This review explores the use of energy sources, including ultrasound, magnetic fields, and external beam radiation, to trigger the delivery of drugs from liposomes in a tumor in a spatially-specific manner. Each section explores the mechanism(s) of drug release that can be achieved using liposomes in conjunction with the external trigger. Subsequently, the treatment's formulation factors are discussed, highlighting the parameters of both the therapy and the medical device. Additionally, the pre-clinical and clinical trials of each triggered release method are explored. Lastly, the advantages and disadvantages, as well as the feasibility and future outlook of each triggered release method, are discussed.

Cell agglomeration in the wells of a 24-well plate using acoustic streaming

Cell agglomeration is essential both to the success of drug testing and to the development of tissue engineering. Here, a MHz-order acoustic wave is used to generate acoustic streaming in the wells of a 24-well plate to drive particle and cell agglomeration. Acoustic streaming is known to manipulate particles in microfluidic devices, and even provide concentration in sessile droplets, but concentration of particles or cells in individual wells has never been shown, principally due to the drag present along the periphery of the fluid in such a well. The agglomeration time for a range of particle sizes suggests that shear-induced migration plays an important role in the agglomeration process. Particles with a diameter of 45 μm agglomerated into a suspended pellet under exposure to 2.134 MHz acoustic waves at 1.5 W in 30 s. Additionally, BT-474 cells also agglomerated as adherent masses at the center bottom of the wells of tissue-culture treated 24-well plates. By switching to low cell binding 24-well plates, the BT-474 cells formed suspended agglomerations that appeared to be spheroids, fully fifteen times larger than any cell agglomerates without the acoustic streaming. In either case, the viability and proliferation of the cells were maintained despite acoustic irradiation and streaming. Intermittent excitation was effective in avoiding temperature excursions, consuming only 75 mW per well on average, presenting a convenient means to form fully three-dimensional cellular masses potentially useful for tissue, cancer, and drug research.

Near-field acoustic streaming jet

A numerical and experimental investigation of the acoustic streaming flow in the near field of a circular plane ultrasonic transducer in water is performed. The experimental domain is a parallelepipedic cavity delimited by absorbing walls to avoid acoustic reflection, with a top free surface. The flow velocities are measured by particle image velocimetry, leading to well-resolved velocity profiles. The theoretical model is based on a linear acoustic propagation model, which correctly reproduces the acoustic field mapped experimentally using a hydrophone, and an acoustic force term introduced in the Navier-Stokes equations under the plane-wave assumption. Despite the complexity of the acoustic field in the near field, in particular in the vicinity of the acoustic source, a good agreement between the experimental measurements and the numerical results for the velocity field is obtained, validating our numerical approach and justifying the planar wave assumption in conditions where it is a priori far from obvious. The flow structure is found to be correlated with the acoustic field shape. Indeed, the longitudinal profiles of the velocity present a wavering linked to the variations in acoustic intensity along the beam axis and transverse profiles exhibit a complex shape strongly influenced by the transverse variations of the acoustic intensity in the beam. Finally, the velocity in the jet is found to increase as the square root of the acoustic force times the distance from the origin of the jet over a major part of the cavity, after a strong short initial increase, where the velocity scales with the square of the distance from the upstream wall.

State-of-the-art materials for ultrasound-triggered drug delivery

Ultrasound is a unique and exciting theranostic modality that can be used to track drug carriers, trigger drug release and improve drug deposition with high spatial precision. In this review, we briefly describe the mechanisms of interaction between drug carriers and ultrasound waves, including cavitation, streaming and hyperthermia, and how those interactions can promote drug release and tissue uptake. We then discuss the rational design of some state-of-the-art materials for ultrasound-triggered drug delivery and review recent progress for each drug carrier, focusing on the delivery of chemotherapeutic agents such as doxorubicin. These materials include nanocarrier formulations, such as liposomes and micelles, designed specifically for ultrasound-triggered drug release, as well as microbubbles, microbubble-nanocarrier hybrids, microbubble-seeded hydrogels and phase-change agents.

Simulation of nonlinear Westervelt equation for the investigation of acoustic streaming and nonlinear propagation effects

This study investigates the influence of blood flow on temperature distribution during high-intensity focused ultrasound (HIFU) ablation of liver tumors. A three-dimensional acoustic-thermal-hydrodynamic coupling model is developed to compute the temperature field in the hepatic cancerous region. The model is based on the nonlinear Westervelt equation, bioheat equations for the perfused tissue and blood flow domains. The nonlinear Navier-Stokes equations are employed to describe the flow in large blood vessels. The effect of acoustic streaming is also taken into account in the present HIFU simulation study. A simulation of the Westervelt equation requires a prohibitively large amount of computer resources. Therefore a sixth-order accurate acoustic scheme in three-point stencil was developed for effectively solving the nonlinear wave equation. Results show that focused ultrasound beam with the peak intensity 2470 W/cm(2) can induce acoustic streaming velocities up to 75 cm/s in the vessel with a diameter of 3 mm. The predicted temperature difference for the cases considered with and without acoustic streaming effect is 13.5 °C or 81% on the blood vessel wall for the vein. Tumor necrosis was studied in a region close to major vessels. The theoretical feasibility to safely necrotize the tumors close to major hepatic arteries and veins was shown.

Investigation of microbubble response to long pulses used in ultrasound-enhanced drug delivery

In current drug delivery approaches, microbubbles and drugs can be co-administered while ultrasound is applied. The mechanism of microbubble interaction with ultrasound, the drug and the cells is not fully understood. The aim of this study was to investigate microbubble response to long ultrasonic pulses used in drug delivery approaches. Two different in vitro set-ups were considered: with the microbubbles diluted in an enclosure and with the microbubbles flowing in a capillary tube. Acoustic streaming, which influences the observed bubble response, was observed in "typical" drug delivery conditions in the first set-up. With the capillary set-up, streaming effects were avoided and accurate bubble responses were recorded. The diffraction pattern of the source greatly influences the bubble response and in different locations of the field different bubble responses are observed. At low nondestructive pressures, microbubbles can oscillate for thousands of cycles repeatedly. At high acoustic pressures (at 1 MHz), most bubble activity disappeared within about 100 μs despite the length of the pulse, mainly due to violent bubble destruction and subsequent accelerated diffusion.

Enhancement of DNA hybridization under acoustic streaming with three-piezoelectric-transducer system

Recently, we have demonstrated that DNA hybridization using acoustic streaming induced by two piezoelectric transducers provides higher DNA hybridization efficiency than the conventional method. In this work, we refine acoustic streaming system for DNA hybridization by inserting an additional piezoelectric transducer and redesigning the locations of the transducers. The Comsol® Multiphysics was used to design and simulate the velocity field generated by the piezoelectric agitation. The simulated velocity vector followed a spiral vortex flow field with an average direction outward from the center of the transducers. These vortices caused the lower signal intensity in the middle of the microarray for the two-piezoelectric disk design. On the contrary, the problem almost disappeared in the three-piezoelectric-disk system. The optimum condition for controlling the piezoelectric was obtained from the dye experiments with different activation settings for the transducers. The best setting was to activate the side disks and middle disk alternatively with 1 second activating time and 3 second non-activating time for both sets of transducers. DNA hybridization using microarrays for the malaria parasite Plasmodium falciparum from the optimized process yielded a three-fold enhancement of the signal compared to the conventional method. Moreover, a greater number of spots passed quality control in the optimized device, which could greatly improve biological interpretation of DNA hybridization data.

Nonviral transfection of suspension cells in ultrasound standing wave fields

Ultrasound-induced cavitation has been widely used for delivering DNA vectors into cells. However, this approach may seriously disrupt cell membranes and cause lethal damage when cells are exposed to the inertial cavitation field. In this study, instead of using sonoporation, ultrasound standing wave fields (USWF) were explored for nonviral transfection of suspension cells. Acoustic resonance in a tubular chamber was generated from the interference of waves emitted from a piezoelectric transducer and consequently reflected from a borosilicate glass coverslip. The suspended K562 erythroleukemia cells were transfected by polyethyleneimine (PEI)/DNA complexes with and without exposure to 1-MHz USWF for 5 min. During USWF exposure, K562 cells moved to the pressure nodal planes first and formed cell bands by the primary radiation force. Nanometer-sized PEI/DNA complexes, circulated between nodal planes by acoustic microstreaming, then used the cell agglomerates as the nucleating sites on which to attach. After incubation at 37 degrees C for 48 h, the efficiency of nonviral transfection based on EGFP transgene expression was determined by fluorescent microscopy and fluorometry. Both studies showed that USWF brought suspended K562 cells and PEI/DNA complexes into close contact at the pressure nodal planes, yielding an approximately 10-fold increment of EGFP transgene expression compared with the group without ultrasonic treatment.

What is ultrasound?

This paper is based on material presented at the start of a Health Protection Agency meeting on ultrasound and infrasound. In answering the question 'what is ultrasound?', it shows that the simple description of a wave which transports mechanical energy through the local vibration of particles at frequencies of 20 kHz or more, with no net transport of the particles themselves, can in every respect be misleading or even incorrect. To explain the complexities responsible for this, the description of ultrasound is first built up from the fundamental properties of these local particle vibrations. This progresses through an exposition of the characteristics of linear waves, in order to explain the propensity for, and properties of, the nonlinear propagation which occurs in many practical ultrasonic fields. Given the Health Protection environment which framed the original presentation, explanation and examples are given of how these complexities affect issues of practical importance. These issues include the measurement and description of fields and exposures, and the ability of ultrasound to affect tissue (through microstreaming, streaming, cavitation, heating, etc.). It is noted that there are two very distinct regimes, in terms of wave characteristics and potential for bioeffect. The first concerns the use of ultrasound in liquids/solids, for measurement or material processing. For biomedical applications (where these two processes are termed diagnosis and therapy, respectively), the issue of hazard has been studied in depth, although this has not been done to such a degree for industrial uses of ultrasound in liquids/solids (sonar, non-destructive testing, ultrasonic processing etc.). However, in the second regime, that of the use of ultrasound in air, although the waves in question tend to be of much lower intensities than those used in liquids/solids, there is a greater mismatch between the extent to which hazard has been studied, and the growth in commercial applications for airborne ultrasound.

Annular phased-array high-intensity focused ultrasound device for image-guided therapy of uterine fibroids

An ultrasound (US), image-guided high-intensity focused ultrasound (HIFU) device was developed for noninvasive ablation of uterine fibroids. The HIFU device was an annular phased array, with a focal depth range of 30-60 mm, a natural focus of 50 mm, and a resonant frequency of 3 MHz. The in-house control software was developed to operate the HIFU electronics drive system for inducing tissue coagulation at different distances from the array. A novel imaging algorithm was developed to minimize the HIFU-induced noise in the US images. The device was able to produce lesions in bovine serum albumin-embedded polyacrylamide gels and excised pig liver. The lesions could be seen on the US images as hyperechoic regions. Depths ranging from 30 to 60 mm were sonicated at acoustic intensities of 4100 and 6100 W/cm2 for 15 s each, with the latter producing average lesion volumes at least 63% larger than the former. Tissue sonication patterns that began distal to the transducer produced longer lesions than those that began proximally. The variation in lesion dimensions indicates the possible development of HIFU protocols that increase HIFU throughput and shorten tumor treatment times.

Sub-micron particle behaviour and capture at an immuno-sensor surface in an ultrasonic standing wave

The capture of 200 nm biotinylated latex beads from suspensions of concentration 10(7) to 2.5 x 10(8) particle/ml on an immuno-coated surface of the acoustic reflector in an ultrasound standing wave (USW) resonator has been studied while the acoustic pathlength was less than one half wavelength (lambda/2). The particles were delivered to the reflector's surface by acoustically induced flow. The capture dependencies on suspension concentration, duration of experiments and acoustic pressure have been established at 1.09, 1.46 and 1.75 MHz. Five-fold capture increase has been obtained at 1.75 MHz in comparison to the control (no ultrasound) situation. The contrasting behaviours of 1, 0.5 and 0.2 mum fluorescent latex beads in a lambda/4 USW resonator at 1.46 MHz have been characterized. The particle movements were observed with an epi-fluorescent microscope and the velocities of the particles were measured by particle image velocimetry (PIV). The experiments showed that whereas the trajectories of 1 mum particles were mainly affected by the direct radiation force, 0.5 mum particles were influenced both by the radiation force and acoustic streaming. The 0.2 mum latex beads followed acoustic streaming in the chamber and were not detectably affected by the radiation force. The streaming-associated behaviour of the 200 nm particles has implications for enhanced immunocapture of viruses and macromolecules (both of which are also too small to experience significant acoustic radiation force).

Acoustic streaming in ovarian cysts

OBJECTIVE

The purpose of this study was to investigate the hypothesis that endometriomas do not show acoustic streaming and then to quantify the streaming velocity of the particles within ovarian cysts that do show acoustic streaming.

METHODS

Ovarian cysts greater than 2 cm in diameter, with internal echoes seen on B-mode sonography, were prospectively evaluated for the presence of acoustic streaming. If acoustic streaming was present, a 2-mm pulsed Doppler sample volume was then placed within the distal portion of the cyst, and the streaming velocity was recorded. Follow-up included review of subsequent sonographic examinations, surgical notes, and histopathologic reports, with the latter being considered the final results if available.

RESULTS

Acoustic streaming was detected in 10 (38%) of 26 ovarian cysts, but of the 10 endometriomas, none (0%) showed acoustic streaming (P = .002). Acoustic streaming was detected in 86% (n = 6) of cystadenomas. Four of these were serous cystadenomas, which all showed acoustic streaming, with a velocity range of 1.5 to 3.6 cm/s. Two mucinous cystadenomas showed acoustic streaming with velocities of 0.8 and 2.0 cm/s.

CONCLUSIONS

Endometriomas appear as cysts containing homogeneous, low-level, "ground glass" echoes on gray scale sonography. Other types of ovarian cysts can also have these appearances. Endometriomas do not show acoustic streaming. Cystadenomas may have streaming velocities within a defined range. Acoustic streaming assessment may therefore prove to be an additional useful tool in assessing ovarian cysts and in completely excluding endometrioma as a diagnosis if a cyst shows acoustic streaming.

Finite element modelling and simulations in cardiovascular mechanics and cardiology: A bibliography 1993–2004

The paper gives a bibliographical review of the finite element modelling and simulations in cardiovascular mechanics and cardiology from the theoretical as well as practical points of views. The bibliography lists references to papers, conference proceedings and theses/dissertations that were published between 1993 and 2004. At the end of this paper, more than 890 references are given dealing with subjects as: Cardiovascular soft tissue modelling; material properties; mechanisms of cardiovascular components; blood flow; artificial components; cardiac diseases examination; surgery; and other topics.

A bubble-driven microfluidic transport element for bioengineering

Microfluidics typically uses channels to transport small objects by actuation forces such as an applied pressure difference or thermocapillarity. We propose that acoustic streaming is an alternative means of directional transport at small scales. Microbubbles on a substrate establish well controlled fluid motion on very small scales; combinations ("doublets") of bubbles and microparticles break the symmetry of the motion and constitute flow transport elements. We demonstrate the principle of doublet streaming and describe the ensuing transport. Devices based on doublet flow elements work without microchannels and are thus potentially cheap and highly parallelizable.

Acoustic streaming: an in vitro study

The aims of this study were, first, to determine if cyst size and cyst-to-transducer distance have an impact upon acoustic streaming and, second, to investigate the effect of cyst content viscosity on acoustic streaming using an artificial ovarian cyst model. Artificial ovarian cysts were constructed and suspended in a tissue-mimicking bath. Although there was no subjective difference in acoustic streaming velocity between cyst sizes during B-mode insonation, with colour Doppler and pulsed Doppler examination, higher acoustic streaming scores were recorded for larger cysts. When the cyst-to-transducer distance was increased, the acoustic streaming velocity was noted to decrease in all scanning modalities. The second stage of the study demonstrated decreasing acoustic streaming velocity as the viscosity of the cyst content was increased. The finding of a clear association between cyst content viscosity and acoustic streaming velocity raises the exciting possibility that we may be able to make estimations of the viscosity of ovarian cyst contents, in the clinical setting, by sonographic means.