Acoustically Active Catheter for Ultrasound-Guided Intramyocardial Injections

用于超声引导心肌内注射的声学活性导管

• 批准号: 9110247
• 负责人: MAREK BELOHLAVEK
• 金额: $ 36.88万
• 依托单位: MAYO CLINIC ARIZONA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-15 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9110247
• 关键词: 3-Dimensional; Acoustics; Address; Anatomy; Animal Model; Autopsy; Biochemical; Cardiac; Cardiovascular Models; Catheters; Cell Therapy; Chemicals; Chest; Color; Deposition; Detection; Development; Diagnostic; Doppler Ultrasound; Dose; Dyes; Echocardiography; Endocardium; Exploratory/Developmental Grant for Diagnostic Cancer Imaging; Family suidae; Frequencies; Goals; Health; Heart; Image; Imagery; Imaging technology; In Situ; In Vitro; Infarction; Injection of therapeutic agent; Intervention; Investigation; Iodoacetamide; Left; Left Ventricular Function; Length; Maps; Measurable; Measurement; Measures; Mechanics; Medical; Methods; Modeling; Modification; Morphologic artifacts; Motion; Myocardial; Myocardium; Natural regeneration; Needles; Pattern; Perforation; Physiologic pulse; Principal Investigator; Procedures; Property; Publishing; Research; Safety; Sampling; Scanning; Signal Transduction; Source; System; Technology; Testing; Therapeutic Agents; Therapeutic Intervention; Time; Touch sensation; Ultrasonics; Ultrasonography; Ventricular; Visual; Work; attenuation; base; cost effective; design; efficacy testing; image guided; image guided intervention; imaging modality; in vitro testing; in vivo; innovation; instrumentation; method development; minimally invasive; novel; prototype; research study; response; signal processing; theories

 DESCRIPTION (provided by applicant): Minimally invasive interventions are rapidly emerging. In cell therapy of infarction by transendocardial injections, highly spatially accurate anatomical guidance towards an intramyocardial target, measurements of left ventricular (LV) wall motion, and identification of viable myocardium are required. While some imaging methods provide excellent anatomical depictions or electromechanical maps, echocardiography (echo) is the only one that could combine all the above requirements into a portable, nonionizing, and cost-effective guidance system. Such a comprehensive solution is highly desired, but currently does not exist. In response, we propose an innovative ultrasound navigation solution based on our acoustically active catheter (AAC) prototype, which has its tip fitted with a piezoelectric crystal The crystal vibrates at a specific frequency, and as a result, the AAC tip then acts as an acoustic "beacon," which is unambiguously identified and spatially localized by a pulsed-wave (PW) Doppler sample window. Thus, PW Doppler is used in a new application: It tracks the AAC tip within conventional (grayscale) scans and enables guidance of the tip to a desired anatomical target. There is no need to modify the conventional ultrasound imager. Our preliminary work has proven the proposed navigation principle and demonstrated its spatial targeting accuracy. In the current application, the existing functional AAC prototype will serve as a platform for further investigations of acoustic navigation of minimally invasive procedures, advancement of depth control of catheter-based intramyocardial injections, and determination of the efficacy of intramyocardial agent administrations. We will also capitalize on our theoretical work in acoustics, in vitro and in vivo (open-chest and closed-chest) pig experiments, sonometric instrumentation for reference measurements, and state of the art ultrasound technologies. The application is organized to the following aims. In aim 1, we will advance the navigation function by implementing a color Doppler marker of the AAC tip, allowing real-time biplane visualization and 3D tracking of the catheter tip. In aim 2, we will address intramyocardial injection accuracy and safety by developing and testing a sonometric approach for needle insertion depth measurement. In aim 3, we will use our previous model of local biochemical (nondestructive) inhibition of LV function and test efficacy of intramyocardial agent delivery by an injection AAC guided from within the heart. Our team and complementary expertise of the two principal investigators in cardiac interventions, echo, cardiovascular models, and vibroacoustics are conducive to accomplishing these aims. The research is significant because the combination of the specific localized acoustic source with Doppler tracking alleviates artifacts complicating image-guided intervention with conventional ultrasonography.

 描述（由申请人提供）：微创干预措施正在迅速兴起。在通过心内膜注射进行梗塞的细胞治疗中，需要对心肌内目标进行高度空间精确的解剖学引导、左心室（LV）壁运动的测量以及存活心肌的识别。虽然一些成像方法提供了出色的解剖描绘或机电图，但超声心动图 (echo) 是唯一一种可以将所有上述要求结合到便携式、非电离且经济高效的引导系统中的方法。人们非常希望有这样一个全面的解决方案，但目前还不存在。 为此，我们提出了一种基于声学活性导管 (AAC) 原型的创新超声导航解决方案，该原型的尖端装有压电晶体。晶体以特定频率振动，因此，AAC 尖端充当声学“信标”，由脉冲波 (PW) 多普勒样本窗口明确识别和空间定位。因此，PW 多普勒被用于新的应用：它在传统（灰度）扫描中跟踪 AAC 尖端，并能够将尖端引导至所需的解剖目标。无需修改传统的超声成像仪。 我们的前期工作证明了所提出的导航原理并证明了其空间瞄准精度。在当前的应用中，现有的功能AAC原型将作为 该平台用于进一步研究微创手术的声学导航、推进基于导管的心肌内注射的深度控制以及确定心肌内药剂给药的功效。我们还将利用我们在声学、体外和体内（开胸和闭胸）猪实验、用于参考测量的声波仪器以及最先进的超声技术方面的理论工作。该应用程序的组织目的如下。在目标 1 中，我们将通过实现 AAC 尖端的彩色多普勒标记来改进导航功能，从而实现导管尖端的实时双平面可视化和 3D 跟踪。在目标 2 中，我们将通过开发和测试用于针插入深度测量的声波测量方法来解决心肌内注射的准确性和安全性问题。在目标 3 中，我们将使用之前的左室功能局部生化（非破坏性）抑制模型，并测试通过心脏内引导注射 AAC 进行心肌内药物输送的功效。我们的团队和两位主要研究人员在心脏干预、回声、心血管模型和振动声学方面的互补专业知识有利于实现这些目标。这项研究意义重大，因为特定的局部声源与多普勒跟踪的结合减轻了使图像引导干预与传统超声检查复杂化的伪影。