Real-time feedback of histotripsy thrombolysis using bubble-induced color Doppler.
Real-time feedback of histotripsy thrombolysis using bubble-induced color Doppler.
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DOI：
10.1016/j.ultrasmedbio.2014.12.006
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发表时间：
2015-05
影响因子：
2.9
通讯作者：
Xu, Zhen
中科院分区：
文献类型：
--
作者：
Zhang, Xi;Miller, Ryan M.;Lin, Kuang-Wei;Levin, Albert M.;Owens, Gabe E.;Gurm, Hitinder S.;Cain, Charles A.;Xu, Zhen
组织破坏溶栓是一种非侵入性、无药物和图像引导的治疗方法，仅使用控制良好的声空化来分离血凝块。实时定量反馈是非常需要在组织碎石溶栓治疗监测凝块分离的进展。气泡诱导彩色多普勒（BCD）监测每个组织碎石术脉冲产生的空化后的运动，这在凝胶和离体肝组织中已显示与组织碎石术分级相关。在本文中，我们探讨了BCD的潜力，定量监测组织碎石溶栓实时。为了可视化凝块分级，开发了透明的三层纤维蛋白凝块。结果显示，相干运动遵循由具有推动和回弹模式的每个组织破碎脉冲产生的空化。随着治疗的进行，这种运动的时间轮廓扩大并饱和。组织破碎凝块分离程度与从BCD提取的两个指标之间存在很强的相关性：峰值反弹速度时间（tPRV）和固定延迟时的局灶平均速度（Vf，延迟）。凝块分离的饱和度（即，治疗完成）与使用tPRV和Vf，delay检测的饱和度匹配良好。血凝块分级进展与两个BCD指标之间的平均Pearson相关系数分别为93.1%和92.6%。为了验证BCD反馈在体外凝块中的作用，在不同的治疗剂量下获得了组织碎石术溶栓的碎片体积，并与Vf，延迟进行了比较。碎片体积的增长和饱和趋势与Vf、延迟也有很好的一致性。最后，开发并测试了一种实时BCD反馈算法，用于预测组织碎石术溶栓过程中的完全凝块分离。这项工作证明了BCD实时监测组织碎石溶栓治疗的潜力。
Histotripsy thrombolysis is a noninvasive, drug-free and image-guided therapy that fractionates blood clots using well-controlled acoustic cavitation alone. Real-time quantitative feedback is highly desired during histotripsy thrombolysis treatment to monitor the progress of clot fractionation. Bubble-induced color Doppler (BCD) monitors the motion following cavitation generated by each histotripsy pulse, which has been shown in gel and ex vivo liver tissue to be correlated with histotripsy fractionation. In this paper we investigate the potential of BCD to quantitatively monitor histotripsy thrombolysis in real-time. To visualize clot fractionation, transparent three-layered fibrin clots were developed. Results show a coherent motion follows the cavitation generated by each histotripsy pulse with a push and rebound pattern. The temporal profile of this motion expanded and saturated as the treatment progressed. A strong correlation existed between the degree of histotripsy clot fractionation and two metrics extracted from BCD: time of peak rebound velocity (tPRV) and focal mean velocity at a fixed delay (Vf,delay). The saturation of clot fractionation (i.e., treatment completion) matched well with the saturations detected using tPRV and Vf,delay. The mean Pearson correlation coefficients between the progressions of clot fractionation and the two BCD metrics were 93.1% and 92.6% respectively. To validate the BCD feedback in in vitro clots, debris volume from histotripsy thrombolysis were obtained at different therapy doses and compared with Vf,delay. The increasing and saturation trends of debris volume and Vf,delay also had good agreement. Finally, a real-time BCD feedback algorithm to predict complete clot fractionation during histotripsy thrombolysis was developed and tested. This work demonstrated the potential of BCD to monitor histotripsy thrombolysis treatment in real-time.
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影响因子：
8.3
作者：
Culp WC;Flores R;Brown AT;Lowery JD;Roberson PK;Hennings LJ;Woods SD;Hatton JH;Culp BC;Skinner RD;Borrelli MJ
通讯作者：
Borrelli MJ
影响因子：
2.9
作者：
Everbach, EC;Makin, IRS;Meltzer, RS
通讯作者：
Meltzer, RS
影响因子：
2.9
作者：
Maxwell, Adam D.;Owens, Gabe;Gurm, Hitinder S.;Ives, Kimberly;Myers, Daniel D., Jr.;Xu, Zhen
通讯作者：
Xu, Zhen
影响因子：
7.5
作者：
Holland, Christy K.;Vaidya, Sampada S.;Shaw, George J.
通讯作者：
Shaw, George J.
影响因子：
4
作者：
Janis, AD;Buckley, LA;Gregory, K
通讯作者：
Gregory, K