Noninvasive Repositioning of Kidney Stone Fragments with Acoustic Forceps

项目摘要/摘要 肾结石很普遍，也是最昂贵的泌尿系疾病之一。可用的治疗方案 如输尿管镜或冲击波碎石术将结石粉碎成小碎片，可通向未来 生长和症状复发。这项提案调查了使用声学技术的潜在机制 超声波多元素阵列产生的辐射力，可以捕获结石，将其引导出肾脏 收集空间，并将其存放在肾盆或UPJ，以促进其自然清除。该项目旨在 回答基本的科学障碍，瞄准并操纵石头通向通道。 目标1开发分析框架，以优化脉冲机制，以捕获和操纵自然 石头。提出了一种用球函数近似计算散射的半解析方法 作用在天然石头上的力。预测将与脉冲参数的调查相结合，以优化 诱捕稳健性，实现天然石材的稳定诱捕。脉冲参数，例如脉冲长度， 控制光束形状和均匀性的重复频率、频率和相位激励将被调整到 消除旋转和不对称力的不稳定性，以实现对天然石头的稳定捕获。其目的是 成功是通过沿着预定的路径操纵天然石头来衡量的。 在目标2中，石头充当一个目标，可以反射和散射接收回来的超声波。 通过多元素数组。校正算法使用接收的信号来计算元件的激励度 有必要校正来自组织异质性的光束像差。水听器测量将 将校正前后的光束与无像差的光束进行比较。最后，对石头的处理 进行肾脏模型和体外实验是为了模拟体内的条件。 在目标3中，将评估声学钳操作的安全性和有效性。第一，不同 声强暴露将在体外研究猪肾脏的热损伤和机械损伤。 随后，生猪的肾脏采集空间将实施各种大小的天然结石。这个 结石将成为目标，被困住，并被从肾脏收集空间引导到肾脏出口 声学钳子。治疗组将与未治疗的对照组进行评估，以评估疗效。 组织损伤机制将通过组织学分析进行评估。 除了我的研究，我还会在导师的指导下从事其他活动，以实现我的职业目标 成为一名独立调查员。这些活动包括与研究人员、行业合作伙伴、 和临床医生通过研讨会和会议；参加关于负责任的行为的研讨会 研究，拨款建议和管理，这样我就能够寻求独立的R级资金 在K25大奖即将结束的时候。应用物理实验室提供的设施和跨部门 翻译研究的成功职业发展所必需的合作。

Project Summary/Abstract Kidney stones are prevalent and one of the costliest urologic diseases. The available treatment options such as ureteroscopy or shockwave wave lithotripsy break the stone into small fragments that can lead to future growth and recurrence of symptoms. This proposal investigates the underlying mechanisms to use acoustic radiation force produced by an ultrasound multi-element array that can trap a stone, steer it out of the kidney collecting space, and deposit it in the renal pelvis or UPJ to facilitate its natural clearance. The project seeks to answer the fundamental scientific hurdles to target and maneuver the stone toward passage. Aim 1 develops the analytical framework to optimize pulsing mechanisms to trap and manipulate natural stones. A proposed semi-analytical approach approximates the scattering with spherical functions to calculate the forces on natural stones. Predictions will be combined with the investigation of pulsing parameters to optimize trap robustness and achieve stable trapping of natural stones. Pulsing parameters such as pulse length, repetition rate, frequency, and phase excitation that control beam shape and uniformity will be adjusted to eliminate instabilities from rotation and asymmetric forces to achieve stable trapping of natural stones. The aim success is measured by performing manipulation maneuver natural stones along predetermined paths. In Aim 2, the stone acts as a target that can reflect and scatter ultrasound waves which are received back by the multi-element array. Correction algorithms use the received signal to calculate the element excitations necessary to correct for beam aberrations from the tissue heterogeneity. Hydrophone measurements will compare the beams before and after corrections with the unaberrated beam. Finally, manipulation of stones in kidney phantoms and ex vivo are performed to mimic in vivo conditions. In Aim 3, the safety and efficacy of acoustic forceps manipulation will be evaluated. First, different acoustic intensity exposures will be investigated in ex vivo porcine kidneys for thermal and mechanical injury. Afterward, natural stones of various sizes will be implemented in the kidney collecting space of live pigs. The stone will be targeted, trapped, and steered from the kidney collecting space toward the kidney exit using the acoustic forceps. The treated group will be evaluated against an untreated control group to evaluate efficacy. Tissue injury mechanisms will be assessed through histological analysis. In addition to my research, I will also pursue other activities guided by my mentors toward my career goal of becoming an independent investigator. These activities include interacting with researchers, industry partners, and clinicians through seminars and conferences; and participating in workshops on the responsible conduct of research, and grant proposals and management so that I will be able to pursue independent R-level funding toward the end of the K25 award. The Applied Physics Laboratory offers the facilities and inter-departmental collaboration necessary for successful career development in translational research.