超声治癌研究

文章简要回顾超声治癌的发展和作者20年来相关的研究.阐明超声高热治疗(UHT)和高强度聚焦超声(HIFU)的原理、方法、仪器和治疗机理,重点论述关于凹球面多元相控阵(CSSMEPA)高热和高强度聚焦超声(HIPFU)治癌机的首创和发展.     

空化现象在新型超声波治癌中的作用

西方国家的临床试验表明:高强度聚焦超声(HIFU)能够杀死癌细胞,但很少有HIFU被应用于临床。在澳大利亚、日本和法国,临床应用也只局限于前列腺癌。然而,从1998～2002年,中国应用HIFU技术已经成功地治疗了10000多个癌症患者。这些患者有骨癌、肝癌、胰腺癌、皮肤癌等。目前,至少有三家厂商生产HIFU设备(有些已出口)。2002年8月,西雅图时报以“中国在HIFU方面的医疗优势”为题,介绍了第二届国际医疗超声研讨会(ISTU2),从中得出的结论是:“不要害怕气泡”。     

腔内高强度聚焦超声肿瘤治疗的实验研究

本文作者对于利用高强度聚焦超声（ＨＩＦＵ）进行肿瘤腔内治疗作了许多理论计算和试验工作,比较了两种换能器的聚焦特性并研制了一种既能监视又能治疗的高强度聚焦超声换能器,利用此换能器对人工模及活体肿瘤进行了一系列加热实验,验证了高强度聚焦超声治疗肿瘤的可行性。为加热治疗机的开发提供了依据。     

高强度聚焦超声肿瘤治疗系统专项技术研究

本文通过对高强度聚焦超声治疗基本原理介绍,对HY2900聚焦超声肿瘤治疗系统实际工作几项特色专项技术HIFU声场分布参数测量、HIFU温度场测量、三维重建技术中任意方位切面图像浏览及边界轮廓的实现方法等进行讨论,介绍相关技术及方法.     

高强度聚焦超声换能器的新型设计

采用高强度聚焦超声（HIFU）治疗局部肿瘤，如何增强对病变区域的辐照效果，而尽量减少对健康区域的辐照损伤是一个很重要的问题。文章基于目前常用的凹球面自聚焦换能器，提出了解决上述问题的方案，设计了新型的换能器，对其工作方式及声场特性进行了研究。结果表明：采用多换能器轮流发射的方式进行治疗是一种行之有效的解决方案。     

HIFU技术的研究

高强度聚焦超声技术起源于４０年代,当时由于缺乏高精的成像和定位技术,影响其发展,该项技术在许多方面优越于传统外科手术,具有极大的潜在临床应用价值。高强度聚焦超声对组织切换除有很高的精确性,换能器探头的选择也为灵活。该技术在对机体的生物效应包括：热效应,空化效应,与药物的相互作用和提高机体免疫机能等。该技术的应用已深入到社会科,泌尿科,等领域。     

双频高强度聚焦超声换能器应用研究进展

高强度聚焦超声(High Intensity Focused Ultrasound,HIFU)消融实体肿瘤已在临床治疗中展示出良好的应用前景。HIFU消融肿瘤技术由于其使靶区肿瘤组织瞬时升温至60℃以上,产生不可逆性凝固性坏死,同时不影响靶区外正常组织而被广泛应用。目前治疗用超声主要使用单频率高强度聚焦超声,但其临床应用的主要限制是靶区组织消融时间较长,靶区外正常组织损伤风险较大。缩短靶区组织消融时间,对于提高HIFU治疗效率,更好地应用于临床较为关键。在总结HIFU换能器的特性和影响HIFU治疗因素的基础上,综述了应用不同类型的双频HIFU换能器强空化和缩短靶区组织消融时间等方面的研究进展。     

高强度聚焦超声(HIFU)技术迅速发展的五年

自2001年“首届高强度聚焦超声(HIFU)在医学中应用的国际学术交流会议”在我国重庆召开并同时成立了“国际超声治疗学会”五年来,HIFU技术得到了蓬勃发展!本文首先讨论了HIFU外科与传统超声热疗技术的本质区别,继而从HIFU工程研究、超声生物物理基础研究和HIFU技术的临床应用及国际学术发展等方面扼要地予以介绍以此展示我国科技工作者对国际HIFU发展的卓越贡献和面临的巨大挑战。     

高强度聚焦超声联合全氟戊烷液滴在乳腺癌治疗增效中的实验研究

目的:探讨高强度聚焦超声(High-Intensity Focused Ultrasound,HIFU)联合全氟戊烷液滴(Perfluoropentane droplets,PFP),对小鼠乳腺癌4T1细胞治疗的增效作用。方法:制备PFP,检测其平均粒径及形态结构。试验设立三组:HIFU假照组,单纯HIFU治疗组,HIFU联合PFP治疗组。流式细胞仪检测HIFU分组治疗乳腺癌细胞后细胞存活率及死亡率;体内动物试验分组处理后,二维超声观察HIFU辐照前后肿瘤回声灰度变化情况,超声造影剂灌注缺损面积占总面积百分比评价不同治疗方式对裸鼠皮下移植瘤的消融能力。结果:所制备的PFP平均粒径为1.2μm,形态呈规则球形。细胞试验显示,HIFU联合PFP治疗组乳腺癌细胞死亡率(23.50±1.34)%显著高于单纯HIFU治疗组(14.34±0.55)%和HIFU假照组(11.76±0.62)%(P<0.05);动物试验显示HIFU联合PFP治疗组肿瘤消融面积占总面积百分比(84.03±4.47)%显著高于单纯HIFU治疗组(41.23±4.24)%(P<0.05),HIFU假照组无明显灌注缺损区域。结论:HIFU联合PFP可显著增强对乳腺癌细胞及组织的消融能力。     

A cylindrical-section ultrasound phased-array applicator for hyperthermia cancer therapy

A phased-array applicator geometry for deep localized hyperthermia is presented. The array consists of rectangular transducer elements forming a section of a cylinder that conforms to the body portals in the abdominal and pelvic regions. Focusing and scanning properties of the cylindrical-section array are investigated in homogeneous lossy media using appropriate computer simulations. The characteristic focus of this array is shown to be spatially limited in both transverse and longitudinal directions with intensity gain values suitable for deep hyperthermia applications. The ability of the cylindrical-section phased array to generate multiple foci using the field conjugation method is examined. The effect of the grating lobes on the power deposition pattern of the scanned field is shown to be minimal. Steady-state temperature distributions are simulated using a three-dimensional thermal model of the normal tissue layers surrounding a tumor of typical volume. The advantages and the limitations of this array configuration are discussed.     

Evolution of bubble clouds induced by pulsed cavitational ultrasound therapy - histotripsy

Mechanical tissue fractionation can be achieved using successive, high-intensity ultrasound pulses in a process termed histotripsy. Histotripsy has many potential clinical applications where noninvasive tissue removal is desired. The primary mechanism for histotripsy is believed to be cavitation. Using fast-gated imaging, this paper studies the evolution of a cavitating bubble cloud induced by a histotripsy pulse (10 and 14 cycles) at peak negative pressures exceeding 21MPa. Bubble clouds are generated inside a gelatin phantom and at a tissue-water interface, representing two situations encountered clinically. In both environments, the imaging results show that the bubble clouds share the same evolutionary trend. The bubble cloud and individual bubbles in the cloud were generated by the first cycle of the pulse, grew with each cycle during the pulse, and continued to grow and collapsed several hundred microseconds after the pulse. For example, the bubbles started under 10 microm, grew to 50 microm during the pulse, and continued to grow 100 microm after the pulse. The results also suggest that the bubble clouds generated in the two environments differ in growth and collapse duration, void fraction, shape, and size. This study furthers our understanding of the dynamics of bubble clouds induced by histotripsy.     

Shape calibration of a conformal ultrasound therapy array

A conformal ultrasound phased array prototype with 96 elements was previously calibrated for electronic steering and focusing in a water tank. The procedure for calibrating the shape of this 2D therapy array consists of two steps. First, a least squares triangulation algorithm determines the element coordinates from a 21×21 grid of time delays. The triangulation algorithm also requires temperature measurements to compensate for variations in the speed of sound. Second, a Rayleigh-Sommerfeld formulation of the acoustic radiation integral is aligned to a second grid of measured pressure amplitudes in a least squares sense. This shape calibration procedure, which is applicable to a wide variety of ultrasound phased arrays, was tested on a square array panel consisting of 7-×7-mm elements operating at 617 kHz. The simulated fields generated by an array of 96 equivalent elements are consistent with the measured data, even in the fine structure away from the primary focus and sidelobes. These two calibration steps are sufficient for the simulation model to predict successfully the pressure field generated by this conformal ultrasound phased array prototype     

Multifrequency ultrasound transducers for conformal interstitial thermal therapy

Control over the pattern of thermal damage generated by interstitial ultrasound heating applicators can be enhanced by changing the ultrasound frequency during heating. The ability to change transmission frequency from a single transducer through the use of high impedance front layers was investigated in this study. The transmission spectrum of multifrequency transducers was calculated using the KLM equivalent circuit model and verified with experimental measurements on prototype transducers. The addition of a quarter-wavelength thick PZT (unpoled) front layer enabled the transmission of ultrasound at two discrete frequencies, 4.7 and 9.7 MHz, from a transducer with an original resonant frequency of 8.4 MHz. Three frequency transmission at 3.3, 8.4, and 10.8 MHz was possible for a transducer with a half-wavelength thick front layer. Calculations of the predicted thermal lesion size at each transmission frequency indicated that the depth of thermal lesion could be varied by a factor of 1.6 for the quarter-wavelength front layer. Heating experiments performed in excised liver tissue with a dual-frequency applicator confirmed this ability to control the shape of thermal lesions during heating to generate a desired geometry. Practical interstitial Designs that enable the generation of shaped thermal lesions are feasible.     

超声治疗中耦合液对声聚焦影响的研究

本文推导了凹球面聚焦换能器产生的声波经耦合液进入软组织后的声场计算公式，并对不同耦合液，耦合层厚度，温度对声聚焦的影响进行了研究，得到一一些对超声热疗具有指导意义的结果。     

Synergetic lethal energy depletion initiated by cancer cell membrane camouflaged nano-inhibitor for cancer therapy

Mitochondrial bioenergy plays a vital role in the occurrence and development of cancer.Although strategies to impede mitochondrial energy supply have been rapid...     

Stone fragmentation by ultrasound

The presence of kidney stone in the kidney causes discomfort to patients. Hence, removal of such stones is important which is commonly done these days, non-destructively, with lithotripters without surgery. Commercially, lithotripters like extra-corporeal shock wave lithotripters (ESWL) made by Siemens etc are in routine use. These methods are very cumbersome and expensive. Treatment of the patients also takes comparatively more time because of more number of sittings. Some delicate nerves and fibres in the surrounding areas of the stones present in the kidney are also damaged by high ultrasonic intensity used in such systems. In the present work, enhancement of the kidney stone fragmentation by using ultrasound is studied. The cavitation bubbles are found to implode faster, with more disintegration efficiency of the lithotripters, which give better treatment to the patients.     

超声消融动脉粥样硬化斑块的研究

超声消融动脉粥样硬化斑块是一种介入式超声治疗方法，通过金属丝将超声能量入因斑块所致的血管狭窄或完全堵塞处，使斑块消融实现血管内腔扩大或再通，消融斑块的碎片不会造成远端血管的再堵塞。     

The use of ultrasound and micelles in cancer treatment

The high toxicity of potent chemotherapeutic drugs like Doxorubicin (Dox) limits the therapeutic window in which they can be applied. This window can be expanded by controlling the drug delivery in both space and time such that non-targeted tissues are not adversely affected. Recent research has shown that ultrasound (US) can be used to control the release of Dox and other hydrophobic drugs from polymeric micelles in both time and space. It has also been shown using an in vivo rat tumor model that Dox activity can be enhanced by ultrasound in one region, while in an adjacent region there is little or no effect of the drug. In this article, we review the in vivo and in vitro research being conducted in the area of using ultrasound to enhance and target micellar drug delivery to cancerous tissues. Additionally, we summarize our previously published mathematical models that attempt to represent the release and re-encapsulation phenomena of Dox from Pluronic P105 micelles upon the application of ultrasound. The potential benefits of such controlled chemotherapy compels a thorough investigation of the role of ultrasound (US) and the mechanisms by which US accomplishes drug release and/or enhances drug potency. Therefore we will summarize our findings related to the mechanism involved in acoustically activated micellar drug delivery to tumors.