Image-guided intensive focused ultrasound: Simulation, development, and applications

在治疗性超声领域一个很有前途的研究领域是应用高强度聚焦超声(IFUS)来治疗脑、脊髓和周围神经等各种神经组织和结构中的神经疾病。在IFUS能够在医学和生物学领域占据一席之地之前，仍有许多科学和/或技术挑战必须解决。IFUS波束与神经组织和结构的复杂相互作用以及由此产生的生物效应是一个仍然需要重大研究的重要领域。超声作为一种非侵入性、实时、便携和经济实惠的成像手段也非常有吸引力。任何新的治疗技术(包括IFUS)的主要组成部分必须包括指导和准确监测治疗的能力。因此，成功的治疗需要可靠的基于超声的定量指导和监测，通过测量射束焦点处组织的热机械变化来监测治疗进展。该提案的目的是在非侵入性图像引导超声手术领域建立和维持一个高级研究计划，以进一步提高当前技术的有效性和安全性，并在神经外科和疼痛管理领域开发新的应用程序。研究提案包括以下主要领域的调查。(A)开发新的非线性超声模型，以准确和有效地模拟IFUS波束与组织的相互作用，并预测由此产生的热和机械生物效应。(B)设计和开发一种新的体外成像引导双模治疗性超声技术，该技术利用IFUS的机械和热效应来提高治疗效果和安全性。(C)将所开发的技术作为神经外科和疼痛管理中的一种非侵入性影像引导手术方式进行定制和应用。该提案具有很强的潜力，可以在非侵入性图像引导超声手术领域实现科技突破。

A promising area of research within the field of therapeutic ultrasound is the application of intensive focused ultrasound (IFUS) to treat neurological disorders in various neural tissues and structures such as brain, spinal cord, and peripheral nerves. There are still a number of scientific and/or technical challenges that must be resolved before IFUS could find an established place in medicine and biology. An important area that still needs significant investigation is the complicated interaction of the IFUS beam with neural tissues and structures and the resulting bioeffects. Ultrasound is also very attractive as a non-invasive, real-time, portable, and cost-effective imaging modality. Primary components of any new therapeutic technology (including IFUS) must include its ability for guidance and accurate monitoring of the treatment. Reliable quantitative ultrasound-based guidance and monitoring of the progression of treatment by measuring the thermo-mechanical changes in tissue at the beam focus is therefore needed for a successful therapy. The objective of the proposal is to establish and maintain an advanced research program in the area of non-invasive image-guided ultrasound surgery toward further improving efficacy and safety of the current technology and developing new applications in the areas of neurosurgery and pain management. The research proposal consists investigations in the following main areas. (a) Development of novel nonlinear ultrasound models to accurately and efficiently simulate the interaction of the IFUS beam with tissue and to predict the resulting thermal and mechanical bioeffects. (b) Design and development of a novel extra-corporeal image-guided dual-mode therapeutic ultrasound technology that makes use of combined mechanical and thermal effects of IFUS to improve treatment efficacy and safety. (c) Customization and application of the developed technology as a non-invasive image-guided surgery modality in neurosurgery and pain management. The proposal has strong potential to lead to scientific and technological breakthroughs in the field of non-invasive image-guided ultrasound surgery.