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Damara FA, Wolfers M, Kirksey L. Successful use of lithoplasty for re-expansion of covered iliac stents with unilateral occlusion. Vascular 2024:17085381241280458. [PMID: 39212171 DOI: 10.1177/17085381241280458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
BACKGROUND Vessel wall calcification is associated with stent under-expansion and in-stent restenosis. The traditional approaches to treat peripheral artery calcification are percutaneous transluminal angioplasty (PTA) and atherectomy. Shockwave intravascular lithotripsy (IVL) uses sonic wave pressure to disrupt calcium of the severely calcified lesions. Published reports of IVL to treat in-stent restenosis are limited to coronary interventions and bare metal platforms. METHODS We describe the case of a 55-year-old male with extremely compressed under-expanded covered stents associated with severe wall calcification that resulted in stent occlusion. RESULTS The IVL system balloon was deployed uneventfully, in a phased manner. Bilateral bare metal stents were also placed in a kissing fashion to further re-expand the arterial segments. Reintervention with IVL facilitated successful revascularization and the stent remained patent at 24 months. CONCLUSION Our case highlights the use of IVL as an effective tool in the management of vessel wall calcification both for primary and secondary interventions.
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Affiliation(s)
- Fachreza A Damara
- Department of Vascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Matthew Wolfers
- Department of Vascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Lee Kirksey
- Department of Vascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
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Biasiori-Poulanges L, Lukić B, Supponen O. Cavitation cloud formation and surface damage of a model stone in a high-intensity focused ultrasound field. ULTRASONICS SONOCHEMISTRY 2024; 102:106738. [PMID: 38150955 PMCID: PMC10765487 DOI: 10.1016/j.ultsonch.2023.106738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 12/29/2023]
Abstract
This work investigates the fundamental role of cavitation bubble clouds in stone comminution by focused ultrasound. The fragmentation of stones by ultrasound has applications in medical lithotripsy for the comminution of kidney stones or gall stones, where their fragmentation is believed to result from the high acoustic wave energy as well as the formation of cavitation. Cavitation is known to contribute to erosion and to cause damage away from the target, yet the exact contribution and mechanisms of cavitation remain currently unclear. Based on in situ experimental observations, post-exposure microtomography and acoustic simulations, the present work sheds light on the fundamental role of cavitation bubbles in the stone surface fragmentation by correlating the detected damage to the observed bubble activity. Our results show that not all clouds erode the stone, but only those located in preferential nucleation sites whose locations are herein examined. Furthermore, quantitative characterizations of the bubble clouds and their trajectories within the ultrasonic field are discussed. These include experiments with and without the presence of a model stone in the acoustic path length. Finally, the optimal stone-to-source distance maximizing the cavitation-induced surface damage area has been determined. Assuming the pressure magnitude within the focal region to exceed the cavitation pressure threshold, this location does not correspond to the acoustic focus, where the pressure is maximal, but rather to the region where the acoustic beam and thereby the acoustic cavitation activity near the stone surface is the widest.
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Affiliation(s)
- Luc Biasiori-Poulanges
- Institute of Fluid Dynamics, Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, Zurich 8092, Switzerland
| | - Bratislav Lukić
- European Synchrotron Radiation Facility, CS 40220, Grenoble F-38043, France
| | - Outi Supponen
- Institute of Fluid Dynamics, Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, Zurich 8092, Switzerland.
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Ruiter NV, Kripfgans OD. Medical ultrasound: Time-honored method or emerging research frontier? Z Med Phys 2023; 33:251-254. [PMID: 37302938 PMCID: PMC10517395 DOI: 10.1016/j.zemedi.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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Jeong MK, Choi MJ, Kwon SJ. High-spatial-resolution, instantaneous passive cavitation imaging with temporal resolution in histotripsy: a simulation study. Ultrasonography 2022; 41:566-577. [PMID: 35535468 PMCID: PMC9262664 DOI: 10.14366/usg.21153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 02/22/2022] [Indexed: 11/08/2022] Open
Abstract
Purpose In histotripsy, a shock wave is transmitted, and the resulting inertial bubble cavitation that disrupts tissue is used for treatment. Therefore, it is necessary to detect when cavitation occurs and track the position of cavitation occurrence using a new passive cavitation (PC) imaging method. Methods An integrated PC image, which is constructed by collecting the focused signals at all times, does not provide information on when cavitation occurs and has poor spatial resolution. To solve this problem, we constructed instantaneous PC images by applying delay and sum beamforming at instantaneous time instants. By calculating instantaneous PC images at all data acquisition times, the proposed method can detect cavitation when it occurs by using the property that when signals from the cavitation are focused, their amplitude becomes large, and it can obtain a high-resolution PC image by masking out side lobes in the vicinity of cavitation. Results Ultrasound image simulation confirmed that the proposed method has higher resolution than conventional integrated PC imaging and showed that it can determine the position and time of cavitation occurrence as well as the signal strength. Conclusion Since the proposed novel PC imaging method can detect each cavitation separately when the incidence of cavitations is low, it can be used to monitor the treatment process of shock wave therapy and histotripsy, in which cavitation is an important mechanism of treatment.
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Affiliation(s)
- Mok Kun Jeong
- Department of Electronic Engineering, Daejin University, Pocheon, Korea
| | - Min Joo Choi
- Department of Medicine, Jeju National University, Jeju, Korea
| | - Sung Jae Kwon
- Division of IT Convergence Engineering, Daejin University, Pocheon, Korea
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5
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Coiado OC, Lowe J, O'Brien WD. Therapeutic Ultrasound in Cardiovascular Medicine. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 40:1061-1076. [PMID: 32964505 DOI: 10.1002/jum.15493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 07/20/2020] [Accepted: 08/08/2020] [Indexed: 06/11/2023]
Abstract
An advantage of therapeutic ultrasound (US) is the ability to cause controlled biological effects noninvasively. Depending on the magnitude and frequency of exposure parameters, US can interact in different ways with a variety of biological tissues. The development and clinical utility of therapeutic US techniques are now rapidly growing, especially with regard to the application of US pulses for cardiac pacing and the potential treatment of cardiovascular diseases. This review outlines the basic principles of US-based therapy in cardiology, including the acoustic properties of the cardiovascular tissue, and the use of US in therapeutic cardiovascular medicine.
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Affiliation(s)
- Olivia C Coiado
- Department of Biomedical and Translational Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Jacques Lowe
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - William D O'Brien
- Bioacoustics Research Laboratory, Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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6
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Aziz A, Bhatia G, Pitt M, Choudhury A, Hailan A, Upadhyaya S, Lee L, Testa L, Casenghi M, Ielasi A, Cortese B, Rides H, Basavarajaiah S. Intravascular lithotripsy in calcified‐coronary lesions: A real‐world observational, European multicenter study. Catheter Cardiovasc Interv 2020; 98:225-235. [PMID: 32936532 DOI: 10.1002/ccd.29263] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/12/2020] [Accepted: 08/31/2020] [Indexed: 01/17/2023]
Affiliation(s)
- Amir Aziz
- Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust Sutton Coldfield, Birmingham UK
| | - Gurbir Bhatia
- Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust Sutton Coldfield, Birmingham UK
| | - Michael Pitt
- Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust Sutton Coldfield, Birmingham UK
| | | | | | | | - Leong Lee
- City Hospital Birmingham, Sandwell and West Birmingham NHS Trust Birmingham UK
| | - Luca Testa
- Institution Policlinico San Donato Milan Italy
| | | | | | | | - Hannah Rides
- Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust Sutton Coldfield, Birmingham UK
| | - Sandeep Basavarajaiah
- Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust Sutton Coldfield, Birmingham UK
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Duck F, Leighton T. Frequency bands for ultrasound, suitable for the consideration of its health effects. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2018; 144:2490. [PMID: 30404482 DOI: 10.1121/1.5063578] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 09/05/2017] [Indexed: 06/08/2023]
Abstract
It is proposed that the ultrasound frequency spectrum should be divided into three bands in order to facilitate a more rational assessment of its health effects. Whilst statement of the frequencies at the borders of these bands facilitates their definition, it is recognized that these observables vary continuously with frequency and consequently these border frequencies should not be used to rule out the possibility of a given effect occurring. The lowest band, US(A), lies between 17.8 and 500 kHz. In this band acoustic cavitation and its associated forces form the dominant process resulting in biological effects in liquids and soft tissues, whereas health effects from airborne ultrasound have been reported but are far less researched. In the middle band, US(B), between 500 kHz and 100 MHz, temperature rise in tissues becomes the most important biological effect of exposure. The highest band, US(C), covers frequencies above 100 MHz, for which the radiation force becomes an increasingly important biophysical mechanism. A justification for the selection of 17.8 kHz in preference to any other threshold for the lower frequency limit for ultrasound is given.
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Affiliation(s)
- Francis Duck
- Department of Physics, University of Bath, Claverton Down, Bath, BA2 7AY, United Kingdom
| | - Timothy Leighton
- Institute of Sound and Vibration Research, Faculty of Engineering and the Environment, University of Southampton, Highfield, Southampton SO17 1BJ, United Kingdom
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Turangan CK, Ball GJ, Jamaluddin AR, Leighton TG. Numerical studies of cavitation erosion on an elastic–plastic material caused by shock-induced bubble collapse. Proc Math Phys Eng Sci 2017. [DOI: 10.1098/rspa.2017.0315] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We present a study of shock-induced collapse of single bubbles near/attached to an elastic–plastic solid using the free-Lagrange method, which forms the latest part of our shock-induced collapse studies. We simulated the collapse of 40 μm radius single bubbles near/attached to rigid and aluminium walls by a 60 MPa lithotripter shock for various scenarios based on bubble–wall separations, and the collapse of a 255 μm radius bubble attached to aluminium foil with a 65 MPa lithotripter shock. The coupling of the multi-phases, compressibility, axisymmetric geometry and elastic–plastic material model within a single solver has enabled us to examine the impingement of high-speed liquid jets from the shock-induced collapsing bubbles, which imposes an extreme compression in the aluminium that leads to pitting and plastic deformation. For certain scenarios, instead of the high-speed jet, a radially inwards flow along the aluminium surface contracts the bubble to produce a ‘mushroom shape’. This work provides methods for quantifying which parameters (e.g. bubble sizes and separations from the solid) might promote or inhibit erosion on solid surfaces.
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Affiliation(s)
- C. K. Turangan
- Department of Fluid Dynamics, Institute of High Performance Computing, , Singapore 138632
| | - G. J. Ball
- Atomic Weapons Establishment, Aldermaston, Reading RG7 4PR, UK
| | - A. R. Jamaluddin
- Faculty of Engineering and the Environment, University of Southampton, Highfield, Southampton SO17 1BJ, UK
| | - T. G. Leighton
- Faculty of Engineering and the Environment, University of Southampton, Highfield, Southampton SO17 1BJ, UK
- Institute of Sound and Vibration Research, University of Southampton, Highfield, Southampton SO17 1BJ, UK
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9
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Zhang Y, Nault I, Mitran S, Iversen ES, Zhong P. Effects of Stone Size on the Comminution Process and Efficiency in Shock Wave Lithotripsy. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:2662-2675. [PMID: 27515177 PMCID: PMC5048526 DOI: 10.1016/j.ultrasmedbio.2016.06.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 06/03/2016] [Accepted: 06/10/2016] [Indexed: 05/11/2023]
Abstract
The effects of stone size on the process and comminution efficiency of shock wave lithotripsy (SWL) were investigated in experiments, numerical simulations and scale analysis. Cylindrical BegoStone phantoms with approximately equal height and diameter of either 4, 7 or 10 mm, in a total aggregated mass of about 1.5 g, were treated in an electromagnetic shock wave lithotripter field. The resultant stone comminution was found to correlate closely with the average peak pressure, P+(avg), incident on the stones. The P+(avg) threshold necessary to initiate stone fragmentation in water increased from 7.9 to 8.8 to 12.7 MPa, respectively, as stone size decreased from 10 to 7 to 4 mm. Similar changes in the P+(avg) threshold were observed for the 7- and 10-mm stones treated in 1,3-butanediol, in which cavitation is suppressed, suggesting that the observed size dependency is due to changes in stress distribution within stones of different size. Moreover, the slope of the correlation curve between stone comminution and ln(P¯+(avg)) in water increased with decreasing stone size, whereas the opposite trend was observed in 1,3-butanediol. The progression of stone comminution in SWL exhibited size-dependence: the 7- and 10-mm stones fragmented into progressively smaller pieces, whereas a significant portion (>30%) of the 4-mm stones reached a stalemate within the size range of 2.8 ∼ 4 mm, even after 1000 shocks. Analytical scaling considerations suggest size-dependent fragmentation behavior, a hypothesis further supported by numerical model calculations that reveal changing patterns of constructive and destructive wave interference and, thus, variations in the maximum tensile stress or stress integral produced in cylindrical and spherical stone of different sizes.
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Affiliation(s)
- Ying Zhang
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina, USA
| | - Isaac Nault
- Department of Mathematics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sorin Mitran
- Department of Mathematics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Edwin S Iversen
- Department of Statistical Science, Duke University, Durham, North Carolina, USA
| | - Pei Zhong
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina, USA.
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10
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Dogan H, Popov V. Numerical simulation of the nonlinear ultrasonic pressure wave propagation in a cavitating bubbly liquid inside a sonochemical reactor. ULTRASONICS SONOCHEMISTRY 2016; 30:87-97. [PMID: 26611813 DOI: 10.1016/j.ultsonch.2015.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 10/28/2015] [Accepted: 11/12/2015] [Indexed: 05/03/2023]
Abstract
We investigate the acoustic wave propagation in bubbly liquid inside a pilot sonochemical reactor which aims to produce antibacterial medical textile fabrics by coating the textile with ZnO or CuO nanoparticles. Computational models on acoustic propagation are developed in order to aid the design procedures. The acoustic pressure wave propagation in the sonoreactor is simulated by solving the Helmholtz equation using a meshless numerical method. The paper implements both the state-of-the-art linear model and a nonlinear wave propagation model recently introduced by Louisnard (2012), and presents a novel iterative solution procedure for the nonlinear propagation model which can be implemented using any numerical method and/or programming tool. Comparative results regarding both the linear and the nonlinear wave propagation are shown. Effects of bubble size distribution and bubble volume fraction on the acoustic wave propagation are discussed in detail. The simulations demonstrate that the nonlinear model successfully captures the realistic spatial distribution of the cavitation zones and the associated acoustic pressure amplitudes.
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Affiliation(s)
- Hakan Dogan
- Institute of Sound and Vibration Research, University of Southampton, Southampton, UK.
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11
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Ramaswamy K, Marx V, Laser D, Kenny T, Chi T, Bailey M, Sorensen MD, Grubbs RH, Stoller ML. Targeted microbubbles: a novel application for the treatment of kidney stones. BJU Int 2015; 116:9-16. [PMID: 25402588 DOI: 10.1111/bju.12996] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Kidney stone disease is endemic. Extracorporeal shockwave lithotripsy was the first major technological breakthrough where focused shockwaves were used to fragment stones in the kidney or ureter. The shockwaves induced the formation of cavitation bubbles, whose collapse released energy at the stone, and the energy fragmented the kidney stones into pieces small enough to be passed spontaneously. Can the concept of microbubbles be used without the bulky machine? The logical progression was to manufacture these powerful microbubbles ex vivo and inject these bubbles directly into the collecting system. An external source can be used to induce cavitation once the microbubbles are at their target; the key is targeting these microbubbles to specifically bind to kidney stones. Two important observations have been established: (i) bisphosphonates attach to hydroxyapatite crystals with high affinity; and (ii) there is substantial hydroxyapatite in most kidney stones. The microbubbles can be equipped with bisphosphonate tags to specifically target kidney stones. These bubbles will preferentially bind to the stone and not surrounding tissue, reducing collateral damage. Ultrasound or another suitable form of energy is then applied causing the microbubbles to induce cavitation and fragment the stones. This can be used as an adjunct to ureteroscopy or percutaneous lithotripsy to aid in fragmentation. Randall's plaques, which also contain hydroxyapatite crystals, can also be targeted to pre-emptively destroy these stone precursors. Additionally, targeted microbubbles can aid in kidney stone diagnostics by virtue of being used as an adjunct to traditional imaging methods, especially useful in high-risk patient populations. This novel application of targeted microbubble technology not only represents the next frontier in minimally invasive stone surgery, but a platform technology for other areas of medicine.
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Affiliation(s)
- Krishna Ramaswamy
- Department of Urology, University of California, San Francisco, CA, USA
| | - Vanessa Marx
- Department of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA, USA
| | | | - Thomas Kenny
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA
| | - Thomas Chi
- Department of Urology, University of California, San Francisco, CA, USA
| | - Michael Bailey
- Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
| | - Mathew D Sorensen
- Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
| | - Robert H Grubbs
- Department of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA, USA
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12
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Ding T, Zhang S, Fu Q, Xu Z, Wan M. Ultrasound line-by-line scanning method of spatial-temporal active cavitation mapping for high-intensity focused ultrasound. ULTRASONICS 2014; 54:147-55. [PMID: 23673346 DOI: 10.1016/j.ultras.2013.04.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 03/12/2013] [Accepted: 04/14/2013] [Indexed: 05/15/2023]
Abstract
This paper presented an ultrasound line-by-line scanning method of spatial-temporal active cavitation mapping applicable in a liquid or liquid filled tissue cavities exposed by high-intensity focused ultrasound (HIFU). Scattered signals from cavitation bubbles were obtained in a scan line immediately after one HIFU exposure, and then there was a waiting time of 2 s long enough to make the liquid back to the original state. As this pattern extended, an image was built up by sequentially measuring a series of such lines. The acquisition of the beamformed radiofrequency (RF) signals for a scan line was synchronized with HIFU exposure. The duration of HIFU exposure, as well as the delay of the interrogating pulse relative to the moment while HIFU was turned off, could vary from microseconds to seconds. The feasibility of this method was demonstrated in tap-water and a tap-water filled cavity in the tissue-mimicking gelatin-agar phantom as capable of observing temporal evolutions of cavitation bubble cloud with temporal resolution of several microseconds, lateral and axial resolution of 0.50 mm and 0.29 mm respectively. The dissolution process of cavitation bubble cloud and spatial distribution affected by cavitation previously generated were also investigated. Although the application is limited by the requirement for a gassy fluid (e.g. tap water, etc.) that allows replenishment of nuclei between HIFU exposures, the technique may be a useful tool in spatial-temporal cavitation mapping for HIFU with high precision and resolution, providing a reference for clinical therapy.
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Affiliation(s)
- Ting Ding
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
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13
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Leighton TG, Turangan CK, Jamaluddin AR, Ball GJ, White PR. Prediction of far-field acoustic emissions from cavitation clouds during shock wave lithotripsy for development of a clinical device. Proc Math Phys Eng Sci 2013. [DOI: 10.1098/rspa.2012.0538] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study presents the key simulation and decision stage of a multi-disciplinary project to develop a hospital device for monitoring the effectiveness of kidney stone fragmentation by shock wave lithotripsy (SWL). The device analyses, in real time, the pressure fields detected by sensors placed on the patient's torso, fields generated by the interaction of the incident shock wave, cavitation, kidney stone and soft tissue. Earlier free-Lagrange simulations of those interactions were restricted (by limited computational resources) to computational domains within a few centimetres of the stone. Later studies estimated the far-field pressures generated when those interactions involved only single bubbles. This study extends the free-Lagrange method to quantify the bubble–bubble interaction as a function of their separation. This, in turn, allowed identification of the validity of using a model of non-interacting bubbles to obtain estimations of the far-field pressures from 1000 bubbles distributed within the focus of the SWL field. Up to this point in the multi-disciplinary project, the design of the clinical device had been led by the simulations. This study records the decision point when the project's direction had to be led by far more costly clinical trials instead of the relatively inexpensive simulations.
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Affiliation(s)
- T. G. Leighton
- Institute of Sound and Vibration Research, University of Southampton, Highfield, Southampton SO17 1BJ, UK
- Faculty of Engineering and the Environment, University of Southampton, Highfield, Southampton SO17 1BJ, UK
| | - C. K. Turangan
- Faculty of Engineering and the Environment, University of Southampton, Highfield, Southampton SO17 1BJ, UK
- Fluid Dynamics, Institute of High Performance Computing, Singapore 138632, Republic of Singapore
| | - A. R. Jamaluddin
- Faculty of Engineering and the Environment, University of Southampton, Highfield, Southampton SO17 1BJ, UK
| | - G. J. Ball
- Atomic Weapons Establishment, Aldermaston, Reading RG7 4PR, UK
| | - P. R. White
- Institute of Sound and Vibration Research, University of Southampton, Highfield, Southampton SO17 1BJ, UK
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Pishchalnikov YA, McAteer JA, Williams JC, Connors BA, Handa RK, Lingeman JE, Evan AP. Evaluation of the LithoGold LG-380 lithotripter: in vitro acoustic characterization and assessment of renal injury in the pig model. J Endourol 2013; 27:631-9. [PMID: 23228113 DOI: 10.1089/end.2012.0611] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Conduct a laboratory evaluation of a novel low-pressure, broad focal zone electrohydraulic lithotripter (TRT LG-380). METHODS Mapping of the acoustic field of the LG-380, along with a Dornier HM3, a Storz Modulith SLX, and a XiXin CS2012 (XX-ES) lithotripter was performed using a fiberoptic hydrophone. A pig model was used to assess renal response to 3000 shockwaves (SW) administered by a multistep power ramping protocol at 60 SW/min, and when animals were treated at the maximum power setting at 120 SW/min. Injury to the kidney was assessed by quantitation of lesion size and routine measures of renal function. RESULTS SW amplitudes for the LG-380 ranged from (P(+)/P(-)) 7/-1.8 MPa at PL-1 to 21/-4 MPa at PL-11 while focal width measured ~20 mm, wider than the HM3 (8 mm), SLX (2.6 mm), or XX-ES (18 mm). For the LG-380, there was gradual narrowing of the focal width to ~10 mm after 5000 SWs, but this had negligible effect on breakage of model stones, because stones positioned at the periphery of the focal volume (10 mm off-axis) broke nearly as well as stones at the target point. Kidney injury measured less than 0.1% FRV (functional renal volume) for pigs treated using a gradual power ramping protocol at 60 SW/min and when SWs were delivered at maximum power at 120 SW/min. CONCLUSIONS The LG-380 exhibits the acoustic characteristics of a low-pressure, wide focal zone lithotripter and has the broadest focal width of any lithotripter yet reported. Although there was a gradual narrowing of focal width as the electrode aged, the efficiency of stone breakage was not affected. Because injury to the kidney was minimal when treatment followed either the recommended slow SW-rate multistep ramping protocol or when all SWs were delivered at fast SW-rate using maximum power, this appears to be a relatively safe lithotripter.
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Affiliation(s)
- Yuri A Pishchalnikov
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, 635 Barnhill Dr., Indianapolis, IN 46202-5120, USA
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Chew BH, Zavaglia B, Sutton C, Masson RK, Chan SH, Hamidizadeh R, Lee JK, Arsovska O, Rowley VA, Zwirewich C, Afshar K, Paterson RF. Twenty-year prevalence of diabetes mellitus and hypertension in patients receiving shock-wave lithotripsy for urolithiasis. BJU Int 2012; 109:444-449. [DOI: 10.1111/j.1464-410x.2011.10291.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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16
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Obreschkow D, Tinguely M, Dorsaz N, Kobel P, de Bosset A, Farhat M. Universal scaling law for jets of collapsing bubbles. PHYSICAL REVIEW LETTERS 2011; 107:204501. [PMID: 22181734 DOI: 10.1103/physrevlett.107.204501] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Indexed: 05/31/2023]
Abstract
Cavitation bubbles collapsing and rebounding in a pressure gradient ∇p form a "microjet" enveloped by a "vapor jet." This Letter presents unprecedented observations of the vapor jets formed in a uniform gravity-induced ∇p, modulated aboard parabolic flights. The data uncover that the normalized jet volume is independent of the liquid density and viscosity and proportional to ζ ≡ |∇p|R(0)/Δp, where R(0) the maximal bubble radius and Δp is the driving pressure. A derivation inspired by "Kelvin-Blake" considerations confirms this law and reveals its negligible dependence of surface tension. We further conjecture that the jet only pierces the bubble boundary if ζ ≳ 4 × 10(-4).
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Affiliation(s)
- D Obreschkow
- Laboratoire des Machines Hydrauliques, EPFL, Lausanne, Switzerland
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