A Prototype Therapy System for Transcutaneous Application of Boiling Histotripsy.
A Prototype Therapy System for Transcutaneous Application of Boiling Histotripsy.
复制标题
DOI：
10.1109/tuffc.2017.2739649
复制
发表时间：
2017-10
期刊：
影响因子：
--
通讯作者：
Khokhlova VA
中科院分区：
文献类型：
--
作者：
Maxwell AD;Yuldashev PV;Kreider W;Khokhlova TD;Schade GR;Hall TL;Sapozhnikov OA;Bailey MR;Khokhlova VA
沸腾组织摧毁术是一种聚焦超声手术方法，其非侵入性地应用具有高振幅冲击波阵面的毫秒长度脉冲以在组织中产生液化损伤。与聚焦超声热治疗设备相比，这种技术需要独特的输出，特别是为了通过介入组织实现高的原位压力水平。本文介绍了一个系统的设计和表征，能够产生必要的压力transmitting管理沸腾组织摧毁治疗，通过临床相关的覆盖组织路径，使用脉冲持续时间长达10 ms。高压电子脉冲发生器被构造为驱动1 MHz的聚焦超声换能器产生冲击波的幅度能够产生沸腾的脉冲持续时间内的组织。系统输出的特点是通过数值模拟与三维Westerpyrutone方程使用的边界条件建立的声全息测量的源场。这样的模拟被认为是在协议与直接测量的焦点波形。现有的非线性治疗领域的降额方法被用来估计在不同的组织深度的原位压力水平。该系统在离体牛肝样品中进行了测试，以在高达7 cm的深度处产生沸腾组织破坏损伤。还通过切除的猪体壁（皮肤、脂肪、肌肉）产生3- 5cm厚的损伤。这些结果表明，该系统能够产生必要的输出，用于经皮消融和沸腾组织摧毁术。
Boiling histotripsy is a method of focused ultrasound surgery that noninvasively applies millisecond-length pulses with high-amplitude shock fronts to generate liquefied lesions in tissue. Such a technique requires unique outputs compared to a focused ultrasound thermal therapy apparatus, particularly to achieve high in situ pressure levels through intervening tissue. This article describes the design and characterization of a system capable of producing the necessary pressure to transcutaneously administer boiling histotripsy therapy through clinically relevant overlying tissue paths using pulses with duration up to 10 ms. A high-voltage electronic pulser was constructed to drive a 1-MHz focused ultrasound transducer to produce shock waves with amplitude capable of generating boiling within the pulse duration in tissue. The system output was characterized by numerical modeling with the 3D Westervelt equation using boundary conditions established by acoustic holography measurements of the source field. Such simulations were found to be in agreement with directly measured focal waveforms. An existing derating method for nonlinear therapeutic fields was used to estimate in situ pressure levels at different tissue depths. The system was tested in ex vivo bovine liver samples to create boiling histotripsy lesions at depths up to 7 cm. Lesions were also created through excised porcine body wall (skin, adipose, muscle) with 3–5 cm thickness. These results indicate that the system is capable of producing the necessary output for transcutaneous ablation with boiling histotripsy.