Noninvasive fragmentation of urinary calculi with focused ultrasound bursts

聚焦超声脉冲无创碎裂泌尿系结石

• 批准号: 9069839
• 负责人: Adam Douglas Maxwell
• 金额: $ 13.7万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-06-01 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9069839
• 关键词: Acoustics; Adopted; Affect; Area; Attention; Biomedical Engineering; Characteristics; Clinical; Clinical Treatment; Data; Development; Devices; Disease; Exposure to; Family suidae; Feedback; Focused Ultrasound; Focused Ultrasound Therapy; Fracture; Frequencies; Generations; Goals; Health; Healthcare; Histology; In Vitro; Individual; Injury; Injury to Kidney; Institution; Investigation; K-Series Research Career Programs; Kidney; Kidney Calculi; Laboratories; Lead; Lithotripsy; Measurement; Measures; Mechanics; Mentors; Methods; Modeling; Outpatients; Output; Patients; Percutaneous Nephrolithotomy; Physics; Physiologic pulse; Procedures; Research; Research Personnel; Resources; Retreatment; Science; Shock; Source; Staging; Stress; Surface; Technology; Tissues; Transducers; Translating; Treatment Protocols; Ultrasonic Therapy; Ultrasonic Transducer; Ultrasonography; Universities; Ureteroscopy; Urinary Calculi; Urology; Washington; Width; Work; base; career development; common treatment; design; experience; improved; in vivo; novel; novel strategies; pressure; prototype; research and development; research study; standard of care; success; systems research; technology development; urolithiasis; urologic

 DESCRIPTION (provided by applicant): The candidate of the proposed Career Development Award is Dr. Adam Maxwell, a biomedical engineer with over 10 years of experience in medical ultrasound research, particularly shock wave lithotripsy and high- intensity focused ultrasound therapy. He has investigated physical interactions of acoustic waves with tissues, developed research and clinical prototype systems, and researched new applications for ultrasound therapies. The purpose of applying for this Career Development Award is for Dr. Maxwell to cultivate the qualities and abilities necessary to be a successful independent researcher and obtain expertise in urolithiasis under the guidance of three experienced mentors, Drs. Michael Bailey, Jonathan Harper, and Hunter Wessells. The University of Washington is a leading research institution at which Dr. Maxwell plans to pursue his research and career development. He will be supported by a collaborative team with expertise in stone management within the Department of Urology and medical ultrasound in the Center for Industrial and Medical Ultrasound at the Applied Physics Laboratory. His proposed research will investigate a potential new treatment for urolithiasis. Urolithiasis is a common disease that affects approximately 1 in 11 individuals during their lifetime and presents a large burden on U.S. healthcare resources. In the last 30 years, management of urinary tract stones has seen the introduction of several novel approaches, including shock wave lithotripsy (SWL), ureteroscopy, and percutaneous nephrolithotomy. SWL is the only noninvasive procedure for stones, but the likelihood of rendering patients stone-free in a single session is considerably lower than other methods, and has declined in newer lithotripters. Development of a more effective lithotripter remains an unmet clinical challenge. While the physical interactions between shocks and stones were not well understood during this technology's clinical introduction, recent research has established the mechanisms of stone fracture in SWL. Based on this work, a novel type of lithotripsy using widely focused bursts of ultrasound rather than shock waves is proposed. Preliminary data shows that burst wave lithotripsy (BWL) is capable of disintegrating stones in as little as 10 seconds. Furthermore, the size of fragments generated during the procedure can be controlled by the ultrasound frequency, potentiating a therapy that produces small fragments easily passed by patients. The goal of this proposal is to create a scientific rationale that will guide the development of burst wave lithotripsy. In particular, this project proposes to investigate the physical interactions of ultrasound bursts with stones and tissue, and use this information to determine therapy parameters. The specific aims of the proposal are: 1) Develop and characterize a suitable ultrasound source for BWL research, 2) Determine the mechanistic interactions leading to stone fracture by BWL, and 3) Identify the mechanical effects of BWL leading to tissue damage. Dr. Maxwell's long-term research goal is to translate this technology into a clinically useful treatment that improves the standard of care for stone management.

 描述（由适用提供）：拟议的职业发展奖的候选人是亚当·麦克斯韦（Adam Maxwell）博士，他是一名生物医学工程师，拥有超过10年的医学超声研究经验，尤其是冲击波岩石疗法和高强度的超声疗法。他研究了声波与组织，开发研究和临床原型系统的身体相互作用，并研究了超声疗法的新应用。申请这一职业发展奖的目的是麦克斯韦博士在三种经验的指导下培养成为成功的独立研究人员所需的素质和能力，并获得尿石病的专业知识，即迈克尔·贝利博士，乔纳森·哈珀和亨特·韦塞尔。华盛顿大学是麦克斯韦博士计划从事研究和职业发展的领先研究机构。他将得到一个合作团队的支持，该团队在应用物理实验室的工业和医疗超声中心的泌尿外科和医疗超声部门内拥有石材管理专业知识。他提出的研究将调查潜在的尿石病新治疗方法。尿石病是一种常见疾病，一生中影响11个人中的大约1个人，并对美国的医疗保健资源产生了巨大的影响。在过去的30年中，尿路结石的管理已经引入了几种新型方法，包括冲击波岩石碎屑（SWL），输尿管镜检查和经皮肾化学切开术。 SWL是石头唯一的非侵入性程序，但是在一次疗程中渲染不含石头的患者的可能性比其他方法低，并且在较新的岩石纤维中有所下降。更有效的岩石纤维的发展仍然是未经满足的临床挑战。虽然在这项技术的临床介绍中，减震与结石之间的物理相互作用尚不清楚，但最近的研究确定了SWL中石材裂缝的机制。基于这项工作，提出了一种新型的岩石疗法，使用广泛聚焦的超声波爆发而不是冲击波。初步数据表明，爆发波写的（BWL）能够在短短10秒内分解石头。此外，手术过程中产生的片段的大小可以通过超声频率控制，从而使患者很容易通过的疗法产生一种小碎片。该提案的目的是建立一个科学的理由，以指导爆发岩石术的发展。特别是，该项目提出了研究超声爆发与石头和组织的物理相互作用的建议，并使用此信息来确定治疗参数。该提案的具体目的是：1）开发和表征BWL研究的合适的超声源，2）确定导致BWL结石裂缝的机械相互作用，以及3）确定BWL的机械作用，导致组织损伤。麦克斯韦博士的长期研究目标是将这项技术转化为一种临床上有用的治疗方法，以改善石材管理的护理标准。