New and ongoing clinical and preclinical research is examining the use of focused ultrasound in initiating an anti-tumor immune response – either alone or in combination with immunotherapies – to treat cancer.
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The Foundation thanks Joan Vidal-Jové, MD, PhD, of the Interventional and Surgical Oncology department at the Comprehensive Tumor Center Barcelonain Barcelona, Spain, for providing this case report.
In November 2013, a 67-year-old male with stage 4 colon cancer underwent surgical resection of a part of his colon containing cancer. During the operation, he was noted to have hepatic metastases. After recovery from his colon surgery, the patient was started on chemotherapy. In 2014 and 2015, he underwent two separate open surgeries to remove liver masses, and chemotherapy was continued. From 2015 to 2018, his cancer was in remission, and he was maintained on adjuvant chemotherapy. In May 2018, during routine follow-up, the patient showed marked progression of his liver tumors in addition to new lung masses. Due to these findings, he was started on a different chemotherapy regimen plus an immunotherapy drug. In July 2018, three of the patient’s liver masses were treated with thermal ablation by ultrasound-guided, high-intensity focused ultrasound (HIFU). He had a partial response to this treatment, but, unfortunately, his disease continued to progress, and he was maintained on the chemotherapy plus immunotherapy regimen. In April 2019, an MRI of the patient’s abdomen revealed countless liver masses that had increased in number and size since his last evaluation (Figure 1). The patient received an evaluation by the Tumor Board at Comprehensive Tumor Center Barcelona, and his inclusion in a clinical trial – the THERESA study – was approved. The THERESA studyis a first-in-human clinical trial sponsored by HistoSonics, Inc. to establish the safety and efficacy of their histotripsy device to treat liver tumors. The patient was not considered a candidate for other surgical or locoregional therapies.On May 13, 2019, the patient underwent histotripsy-mediated ablation of a 1.2 cm x 1 cm lesion in his liver. No adverse events occurred during or after the procedure, including no pain. In the weeks following the procedure, lab tests revealed a significant decrease in the value of the tumor marker CEA (Figure 2), and the patient continued to feel well with no pain. Follow up MRI scans at one, four, and eight weeks showed a decrease in size of the targeted, treated lesion as well as a decrease in size of numerous other, non-treated lesions throughout the liver (Figure 3). Immune assessment (CD3, CD4, CD8, IL6, Complement) was equivocal. Following the advice of the patient’s oncologist, a new chemotherapy regime was initiated five weeks after the ablation procedure. After this, both tumor marker levels and the size of the liver lesions continued to decrease. In December 2019, there was progression of the liver metastases and appearance of a new tumor in the colon. New treatment options and clinical trials are still being explored. At present, one year after his treatment with histotripsy and evidence of an abscopal effect, the patient has slow progression of his disease.
Surgical resection is the established first-line treatment for primary and metastatic liver cancer. However, surgical removal with curative intent is only feasible for a minority of patients with liver metastases (10-25 percent) since only a small proportion of patients have tumors that are entirely resectable at presentation.1 Despite the survival advantage of hepatic resection on colorectal cancer liver metastases, relapse is common following curative resection.2 In addition, surgery is an invasive procedure associated with high rates of morbidity and mortality.3Ablation techniques are promising alternatives for those patients who are not eligible for surgical resection or who have failed other therapies. Current ablation methods include non-thermal ablation methods (e.g., percutaneous ethanol injection [PEI] and irreversible electroporation [IRE]) and thermal modalities (e.g., radiofrequency ablation [RFA, microwave ablation [MWA], and HIFU.)4Despite the efficacy of some of these local thermal ablation modalities, significant limitations exist due to their mode of action (thermal tissue destruction). Thermal ablation is inconsistent in tissue with non-uniform heat dissipation patterns, which is common in liver tumors.5 It often results in incomplete tumor necrosis in tissue that is located near major vessels.6, 7 Consequently, the shape and the size of the ablation zone may be unpredictable, and the efficacy of thermal ablation may be restricted.8 In addition, thermal ablation methods are often unsuitable for treating tumors larger than three centimeters due to excessive treatment time and practical ultrasound probe sizes.9-11 Most complications associated with RFA and MWA are consequences related to thermal injury.12 Another limitation of these methods is the lack of imaging feedback during treatment. Thus, CT or MRI evaluates the effect of ablation treatment after the application of thermal treatment while no real-time imaging provides monitoring during treatment.13HIFU is a noninvasive, image-guided, thermal ablation method. Unlike percutaneous thermal modalities, HIFU is completely extracorporeal and lacks the risks of bleeding and tumor seeding with the direct puncture of tumors. HIFU can improve upon other thermal ablation modalities due to its noninvasiveness, real-time feedback, and the ability to scan the focal zone over a large volume.13 As with the other thermal-based methods, HIFU is limited by the heat-sink effect, resulting in reduced efficacy in ablating tissue near major vessels and by extended treatment time for larger liver volumes.13 Another major challenge in the noninvasive treatment of liver tumors using HIFU is rib obstruction, which may result in secondary hot spots near the treatment main focal zone, inducing loss of therapeutic precision and collateral damage.14 Moreover, because of the high ultrasound absorption coefficient at the bone-tissue interface, overheating of ribs and surrounding tissue often results in unwanted tissue damage. Skin burns and subcostal edema have been reported with HIFU ablation cases.15, 16Therefore, developing new strategies in which a liver tumor can be ablated noninvasively and avoiding thermal-related collateral damage and inefficacy would be a major clinical advancement. To address this unmet clinical need, cavitation-based, ultrasound-guided treatment (histotripsy) is a promising option to destroy liver tumors and overcome the limitations of currently available ablation modalities.Histotripsy is a treatment technology that mechanically destroys targeted tissue through the precise targeting of acoustic cavitation.17-19 The ablation system is an image-guided device designed to deliver noninvasive, non-thermal histotripsy for local treatment that has the potential to overcome many limitations of other focal liver tumor treatment options.The Histotripsy Group in the Biomedical Engineering Department at University of Michigan invented and pioneered the development of focused ultrasound histotripsy more than 12 years ago. Starting with their earliest work with the use of microbubbles to cause tissue damage, this group developed histotripsy into a highly controlled and predictable tool to remove unwanted tissue with microscopic precision. In 2010, HistoSonics, Inc. entered into a worldwide exclusive license with the University of Michigan for exclusive rights to the entire portfolio of histotripsy patents and patent applications.Favorable characteristics of histotripsy treatment method include:
An additional potential benefit of histotripsy may be as immunogenic ablation20 if it can be used to stimulate tumor-specific immune responses capable of magnifying the impact of checkpoint inhibition immunotherapy. The characteristics of this cavitation-based ablation likely allow cytokines and metabolites – not destroyed in the tumor micro-environment – to become highly immunogenic and contribute to the abscopal effect, where shrinkage of untargeted tumors occurs secondary to an immune response. The abscopal – or “off target” – effect was first described in patients who were receiving radiation therapy that were noted to have regression of tumors that were in a non-irradiated zone. It describes the ability of localized radiation to initiate an antitumor response that kills cancer cells distant to the primary target. Similar to radiation, focused ultrasound has been shown to produce an abscopal effect in both preclinical and human cancers. When combined with immunotherapy, the abscopal effect could produce a durable treatment response to control or eradicate metastatic cancer.
This case report shows clear evidence of an immunologic relationship between histotripsy ablation and the abscopal effect. A patient with progressive and extensive metastatic disease with a short overall survival prognosis had noticeable shrinkage of non-targeted metastases and is still alive and considering new clinical trial options one year after the histotripsy procedure.In addition, this report highlights the differences between two focused ultrasound modalities. Thermal US guided HIFU was performed previously and obtained a substantial volume ablation but no immune effects. Less volume ablation with histotripsy generated a noticeable abscopal effect, and this data will influence future research assumptions.Histotripsy is a disruptive technology. The non-thermal and noninvasive characteristics of histotripsy offer patients the potential for a tumor treatment with fewer clinical complications and adverse events than currently available ablation methods and surgical procedures. The safety of histotripsy has been demonstrated through rigorous testing including benchtop and both acute and chronic disease preclinical studies. Future clinical trials with the objectives to evaluate technical performance, including acute technical success, while collecting safety-related data are forthcoming. In addition, further clinical trials should continue to explore histotripsy-mediated immune effects in detail. The THERESA Study used an investigative histotripsy device that is not yet commercially available. The THERESA Study is currently ongoing; therefore, data is not considered final.
The Foundation is seeking public comments on these guidelines to ensure that they are comprehensive and address challenges faced by the community. The public comment period is open until July 15, 2020.
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The scientific program for the Annual Meeting of the American Society of Clinical Oncology (ASCO)was held virtually from May 29–31, 2020.
The New York Academy of Sciences held “Frontiers in Cancer Immunotherapy 2020” as an online symposium May 11–12, 2020.
CarThera, a French ultrasound company, has announced the start of a new clinical trial in France. The “SoniMel” study has enrolled and treated its first patient diagnosed with brain metastases from a primary melanoma.
The Core Hub for Medical Research of UltraSound (CHORUS) is a focused ultrasound research facility located within the Department of Radiology at Seoul National University Hospital in Korea. The group’s incredibly wide breadth of applications combined with their multifaceted internal and external collaborations has created a highly productive environment for clinical and preclinical research. Importantly, CHORUS scientists recently discovered a potential mechanism for how focused ultrasound treatment clears amyloid plaques in Alzheimer’s disease. We interviewed Jae Young Lee, MD, PhD, to learn more about one of Seoul’s many impressive focused ultrasound centers.
A 15-year-old female diagnosed with a benign brain tumor called a hypothalamic hamartoma (HH) presented to Nicklaus Children’s Hospital in Miami, Florida, in 2019.
Kranion, an Open-source Environment for Planning Transcranial Focused Ultrasound Surgery: Technical Note
A collaborative group led by Gail ter Haar, PhD, and Elizabeth Respasky, PhD, recently completed a two-year pancreatic cancer immunotherapy project titled, “Defining Basic Properties of Physical Immunotherapy using HIFU and Immune Checkpoint Inhibition.”
Sonogenetic Modulation of Cellular Activities Using an Engineered Auditory-Sensing ProteinTaiwanese scientists recently engineered a biological system for using focused ultrasound to remotely control living cells.
The opioid epidemic is a national crisis. Every day, an estimated 130 people die in the United States from an opiate related overdose. Many of these deaths can be attributed to an initial or current misuse of prescription opioids, often prescribed to treat acute and chronic pain. The US Centers for Disease Control and Prevention (CDC) estimates that the annual economic burden of prescription opioid misuse in the United States alone is $78.5 billion, which includes the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement. About 80 percent of people who use heroin have misused a prescription opiate first. These types of staggering statistics go on, but the point is that the opioid epidemic is a real problem requiring realistic, effective, and timely solutions.
A Multi-faceted ApproachMany different areas need improvement when considering potential solutions to the opioid crisis, and it will likely be advancement in all of them that results in a real progress. Those who already suffer from an opioid misuse disorder need improved access to evidence-based treatment. It is imperative to advance research in overdose therapy, medication-assisted therapy, and opiate abuse risk reduction. Most relevant to the field of focused ultrasound is the establishment and promotion of alternatives to opiate-based medications for the treatment of pain. Another area that has the potential to use focused ultrasound is in the identification and development of new therapies to aid in abstinence from opiates.
The 12th International Symposium on Focal Therapy and Imaging in Prostate and Kidney Cancer was held February 9-11, 2020, in Washington, DC. The conference highlighted advances in the real-time image-guided diagnosis and treatment of prostate and kidney cancer. Its interactive scientific program included state-of-the art lectures, video demonstrations, and hands-on workshops delivered by a world-class faculty. The small sessions allowed ample opportunities for networking and exchanging opinions and experiences.
Improving the Trustworthiness, Usefulness, and Ethics of Biomedical Research through an Innovative and Comprehensive Institutional Initiative
An open science center based in Berlin recently published its experiences, approaches, and recommendations for institutions (as opposed to individual scientists) to create initiatives that improve rigor, reproducibility, and transparency in biomedical research. One such initiative pays researchers €1,000 to publish their null results.
The Sontag Foundation is offering a Distinguished Scientist Award (DSA)to an individual with projects that show potential to advance knowledge of causes, cure, or treatment of primary brain tumors and/or brain cancer.
New clinical trial data from a Phase I liver cancer study were recently presented at the Society of Interventional Oncology 2020 Annual Scientific Meeting. Timothy Ziemlewicz, MD, Associate Professor at the University of Wisconsin School of Medicine and Public Health, shared positive results from using the HistoSonics robotically positioned histotripsy system to destroy affected tissue in patients with primary and metastatic liver cancer.
A Case of Unresectable Pancreatic Cancer with Long-Term Survival in High-Intensity Focused Ultrasound (HIFU) TherapyA patient in Tokyo with pancreatic cancer survived more than four years while undergoing focused ultrasound in conjunction with standard systemic chemotherapy.
MRgFUS Pallidothalamic Tractotomy for Chronic Therapy-Resistant Parkinson's Disease in 51 Consecutive Patients: Single Center Experience
A new clinical trial using focused ultrasound to address Alzheimer’s disease has begun at Columbia University in New York. Researchers are investigating the safety and feasibility of using a novel focused ultrasound device in combination with microbubbles to temporarily open the blood-brain barrier (BBB) in patients with Alzheimer’s disease.
The Foundation has launched a multicenter, international registry to evaluate focused ultrasound as a treatment option for patients with pancreatic cancer.
Safety and Feasibility of Multiple Blood-brain Barrier Disruptions for the Treatment of Glioblastoma in Patients Undergoing Standard Adjuvant Chemotherapy
With 25 citations, a Todd Mainprize et al. paper in Scientific Reports was one of the most cited focused ultrasound peer-reviewed publications in 2019.
Beginning on November 20, 2019, the Society for Neuro-Oncology (SNO) sponsored a series of translational research-focused educational conferences in Phoenix, Arizona. Among others,the series included:
Neuromodulation is the reversible stimulation or suppression of neural brain activity and has been extensively studied with transcranial ultrasound stimulation (TUS). Instead of using high-intensity focused ultrasound for ablation of targets, a form of TUS can take neurons that are “sleeping” and wake them up – or take neurons that are firing too much, such as in epilepsy, and slow them down. Neuromodulation uses low-intensity, low-frequency ultrasound (LILFU) to create mild mechanical waves on cell membranes which are transmitted into electrical signals that regulate cellular functions. Until now, the exact underlying mechanisms were unclear.A recent publication by Lee and colleagues has elucidated a main mechanism describing how TUS alters neuronal function entitled, “Ultrasound Neuromodulation via Astrocytic TRPA1”. It details the pathway of how LILFU alters calcium permeability in the astrocytes, supporting cells of the brain, releasing chemical neurotransmitters that in turn activate adjacent neurons. Another publication by Fouragnan et al. published in Nature Neuroscience has expanded our understanding of how different brain areas influence decision making. A key difference that distinguishes this study from previous experiments is that the authors recorded neuronal activity from multiple brain areas simultaneously and during the decision making process. They found that some brain areas simply hold information, whereas others actually influence behavior. The results of this paper support individualized targeted therapy that can be tailored based on patients’ brain activity in various disease states, including anorexia nervosa, obsessive-compulsive disorder, and Tourette's syndrome.
Photo courtesy of Lee, et. al.
A groundbreaking clinical trialfor women with nonpalpable breast cancer is now underway at Institut Bergonié in Bordeaux, France. The pilot study is testing the safety and efficacy of a novel focused ultrasound device, called MUSE, that was designed at built by the Focused Ultrasound Laboratory at the University of Utah in collaboration with Image Guided Therapy in Bordeaux.
This 20-patient clinical trial is using Insightec’s Exablate Neuro device to temporarily and reversibly open the blood-brain barrier (BBB) in glioblastoma (GBM) patients undergoing standard chemotherapy treatment.
The cover of the journal Theranostics recently featured research led by Nathan McDannold, PhD, in the Department of Radiology at Brigham and Women’s Hospital and Harvard Medical School in collaboration with several other departments.
In “Acoustic Feedback Enables Safe and Reliable Carboplatin Delivery Across the Blood-brain Barrier with a Clinical Focused Ultrasound System and Improves Survival in a Rat Glioma Model,”the team used the Exablate Neuro low-frequency clinical transcranial focused ultrasound system to safely, repeatedly, and reliably disrupt the blood-brain barrier (BBB) in a rat model of aggressive glioma. While the BBB was open, the team delivered a non-neurotoxic chemotherapy agent, carboplatin, to the brain in dosages that slowed tumor growth and significantly prolonged survival as compared to treatment with the drug alone.See Theranostics >
Sacroiliac Joint Ablation Using MR-HIFU
French manufacturer, CarThera, recently announced that the FDA has granted approval to begin a US clinical trial of their SonoCloud-9 ultrasound device in patients with recurrent glioblastoma (GBM).
Boiling Histotripsy-induced Partial Mechanical Ablation Modulates Tumour Microenvironment by Promoting Immunogenic Cell Death of Cancers
The Neurovascular Response is Attenuated by Focused Ultrasound--mediated Disruption of the Blood-brain Barrier
Three of the Foundation's research award programs announced newly funded projects for the second quarter of the year. The Cancer Immunotherapy Program selected a project that will study a new method using a combination of focused ultrasound and immunotherapy for treating recurrent ovarian and cervical cancer. The Veterinary Program funded a study to determine "time to metastasis" as an initial index of focused-ultrasound-induced systemic antitumor immune effect. The External Awards Program selected two projects that use mechanical ablation to treat brain tumors and pancreatic tumors, and one project that seeks to develop a "needle-less nerve block" technique that would noninvasively deliver pain medication for local anesthesia. Each project is described below.
Delivering Focused Ultrasound to Intervertebral Discs Using Time-Reversal
Amelioration of the Nigrostriatal Pathway Facilitated by Ultrasound-mediated Neurotrophic Delivery in Early Parkinson's Disease
In May 2018, Foundation scientists released Kranion®, a highly visual and interactive, open-source transcranial focused ultrasound modeling system for conducting research. Kranion® allows scientists to “see” how the paths of focused ultrasound’s invisible sound waves behave as they pass through the skull while aiming for a particular target in the brain.
In early March, veteran researchers and students across the field of focused ultrasound convened in Les Houches, France, for the 2019 Winter School on Therapeutic Ultrasound.
Held biennially, the School offers an excellent opportunity for those early in their career to meet and connect with experts in focused ultrasound. The educational agenda included lectures from esteemed researchers in the field.
This year, the Foundation sponsored seven students to attend the Winter School. Learn more about each student, their research, and what they found most valuable about their experience at the workshop.Gadi Cohen, PhDPostdoctoral fellow in the Laboratory of Diagnostic Radiology Research, Clinical Center at the National Institutes of HealthCurrent research focus: Proteomic and transcriptomic changes in tumor microenvironment of murine melanoma and breast cancer models following pulsed ultrasound treatment Mentor: Joseph Frank, MD
“As a scientist in cancer research, I use ultrasound daily and examine its therapeutic benefits. However, until participating in the Winter School, I have yet to experience such a thorough and comprehensive seminar regarding the basics of the use and theory behind this technology. The variety of high quality speakers with an obvious passion for the field gave both fascinating and highly useful talks. The tools and insight I got from these lectures are invaluable. In addition to expanding my knowledge, I also expanded my worldwide network of collaborators and friends in the field. There are a few potential collaborations that may come out of these new connections. I thank the Focused Ultrasound Foundation for this wonderful opportunity, and I hope you continue to extend this opportunity to other young scientists in the field, so they can benefit as I did.” –Gadi Cohen
Jennifer M. Colón Mercado, PhDPost-doctoral IRTA fellow in the Laboratory of Diagnostic Radiology Research, Clinical Center at the National Institutes of HealthCurrent research focus: Inflammatory response after blood-brain barrier disruption using focused ultrasoundMentor: Joseph Frank, MD
“Participating in the Winter School 2019 allowed me to exchange ideas and future research directions with the leaders in the field of focused ultrasound. The Winter School provided an optimal environment to network with top researchers. The evening meetings and discussions allowed us to reflect on current and future investigations and the potential contributions to the field that could have great impact in the clinical setting. The sponsorship by the Focused Ultrasound Foundation allowed me to obtain a better understanding of ultrasound physics and the translational properties of this technology.” – Jennifer M. Colón Mercado
Delaney FisherPhD student in the Department of Biomedical Engineering at the University of VirginiaCurrent research focus: Using focused ultrasound to open the blood-brain barrier for the delivery of neurotrophic factors in models of Parkinson’s diseaseMentor: Richard Price, PhD
“As a first year PhD student, the extensive lectures offered during the Winter School greatly expanded my knowledge on the fundamentals of therapeutic ultrasound as well as the multitude of its applications. During the week, I was able to form connections with people from all over the world in differing areas of expertise and gain insights from them to improve our lab’s practices and considerations. Students are also encouraged to present their work at the workshop, which further fosters discussion and collaborations of those with overlapping research goals. I am incredibly grateful for the Focused Ultrasound Foundation’s sponsorship for me to attend this workshop. Winter School offers the opportunity to learn, demonstrate, and connect, which is important for the growth of all young researchers and, ultimately, the focused ultrasound field.” – Delaney Fisher
William GarrisonPhD student in the Department of Biomedical Engineering at the University of VirginiaCurrent research focus: MRI, primarily in the contexts of lung imaging and focused ultrasound treatment assessmentMentor: Wilson Miller, PhD
“Focused ultrasound medical research draws scientists from many different backgrounds, including biology, physics, engineering, and fields in between these. As trainees generally cannot be experts in all of these disciplines, it is extremely enriching for us to have the opportunity to meet and form connections with other trainees who have expertise in different fields related to focused ultrasound.” –William Garrison
Catherine GorickPhD student in the Department of Biomedical Engineering at the University of VirginiaCurrent research focus: Developing a platform for endothelial-selective transfection of the cerebral vasculature using focused ultrasoundMentor: Richard Price, PhD
“The Winter School program facilitated many networking connections with other students as well as post-docs and professors from around the world. It also provided me with a strong education in the various physical mechanisms of ultrasound and MRI and introduced me to some different applications of these technologies with which I was not otherwise familiar. I came away from the program with some new ideas about how best to monitor cavitation during preclinical brain FUS treatments.” –Catherine Gorick
Ying Meng, MDNeurosurgery resident at the University of Toronto Current research focus: Investigating the biological effect of focused ultrasound blood-brain barrier opening on the brain and systemicallyMentor: Nir Lipsman, MD, PhD
“The 2019 Winter School provided a comprehensive program from world experts in therapeutic ultrasound. Speakers from basic and clinical research, as well as industry, offered diverse perspectives. Sponsorship of young researchers by the FUS Foundation was an invaluable opportunity to expand our knowledge, accelerate research, and network with experts from across the world in a friendly environment. In particular, I was inspired with new insight on how to approach current research challenges.” –Ying Meng
Andrew ThimPhD student in the Department of Biomedical Engineering at the University of VirginiaCurrent research focus: Using focused ultrasound to promote anti-tumor therapeutic delivery, leukocyte adhesion and infiltrationMentor: Richard Price, PhD
“The Winter School allows us to gather with like-minded individuals and learn about our field, from the mechanical to biological, in a completely immersive environment. While at the Winter School, I was able to troubleshoot my in-house built FUS system with Erik Dumont, an expert in image-guided therapy. He was able to diagnose the problem immediately after I described it. It also made me want to focus more on the technical aspect of focused ultrasound in conjunction with the biological therapy so as to make more informed therapeutic hypotheses.” –Andrew Thim
Left to right: William Garrison, Andrew Thim, Catherine Gorick, Delaney Fisher
The Foundation’s External Awards Program has selected a new project to fund in the first quarter of 2019. John Eisenbrey, PhD, Associate Professor in the Department of Radiology at Thomas Jefferson University, will lead a study titled, “Microbubble cavitation sensitization of hepatocellular carcinoma to radioembolization therapy.”
A Foundation-funded project at the University of Michigan was recently completed. Jonathan Sukovich, PhD, sought to develop advanced methods for real-time monitoring and localization of histotripsy-generated bubble clouds during transcranial treatment.
Imperial College Healthcare National Health Service (NHS) Trust is the largest teaching and research trust in the United Kingdom. It includesfive hospitals in London: Charing Cross Hospital, Queen Charlotte’s and Chelsea Hospital, Hammersmith Hospital, St. Mary’s Hospital, and Western Eye Hospital.
NHS foundation trusts are not-for-profit, public benefit corporations that provide over half of all NHS hospital, mental health, and ambulance services in the United Kingdom. NHS foundation trusts were created to devolve decision making from central government to local organizations and communities. Read about Imperial Healthcare Trust.Imperial College Healthcare’s focused ultrasound facilities are located solely within the Department of Radiology at St. Mary’s Hospital. Professor Wladyslaw Gedroyc, MD, Consultant Radiologist, first brought focused ultrasound to St. Mary’s in 2000 after recognizing that it was an important emerging technology for image-guided MR therapy and a natural extension of the work that was already being done there.We interviewed Prof. Gedroyc to learn more about the program that he created and how it continues to expand. Read the following Q&A to learn about the past and see this visionary’s concept for the future, which includes exciting new neurological research that is now underway.
The first patient in the world’s first clinical trial using focused ultrasound to open the blood-brain barrier (BBB) and allow chemotherapeutic agents to more efficiently reach the tumors of patients with glioblastoma (GBM) has completed treatment at Severance Hospital, a part of Yonsei University Health System, in Seoul, Korea.
The University of Queensland (Brisbane, Australia) recently announced that an impressive $10 million of its latest capital campaign would be directed to its Queensland Brain Institute (QBI) to support the work of Dr. Jürgen Götz and his team of researchers at the Clem Jones Centre for Ageing and Dementia Research (CJCADR). As QBI completes the necessary steps toward initiating their first focused ultrasound-based phase 1 clinical safety trial for patients with Alzheimer’s disease, we interviewed Dr. Götz to learn more about CJCADR and the progress that he and his team have been making over the past several years.
An issue that limits precise visualization of the brain during focused ultrasound treatments—essential tremor and Parkinson’s tremor, for example—is that the coils that apply the focused ultrasound beam can interfere with the imaging coils within the MRI. Treating physicians could potentially gain faster and clearer view of the treatment area if this interference was reduced or eliminated. To address this problem, the Foundation awarded Kim Butts Pauly, PhD, and her team at Stanford University funding for their project titled “Neuro Focused Ultrasound MR Coil Fabrication and Testing.”
The 176th Meeting of the Acoustical Society of America (ASA) was held November 5–9, 2018, in Victoria, British Columbia, Canada. With an overall mission to generate, disseminate, and promote the knowledge and practical applications of acoustics, the meeting included several presentations of interest to the focused ultrasound community. Researchers from the Focused Ultrasound Foundation were invited to present their recent simulation study that developed and validated algorithms for how ultrasound propagates through the skull. Additional topics in the program included blood—spinal cord barrier opening, blood-brain barrier opening, droplet vaporization for mechanical brain tissue ablation, additional simulation work, and much more.
Dr. Dheeraj Gandhi has been involved in all aspects of clinical focused ultrasound work at the University of Maryland, with a specific focus on facilitating direct image-based targeting of brain structures using advanced MR techniques. He is Professor of Radiology, Neurology, and Neurosurgery Director of Interventional Neuroradiology. He is also the Clinical Director of the Center for Metabolic Imaging and Therapeutics (CMIT), the state-of-the-art facility where MR-guided focused ultrasound therapies take place. Dr. Gandhi has worked side-by-side with Dr. Howard Eisenberg, Dr. Elias Melhem, and Dr. Paul Fishman to develop the program into the Focused Ultrasound Center of Excellence that it has become. He has been involved in more than 65 focused ultrasound procedures and is now Principal Investigator for a new clinical trial that uses focused ultrasound to treat neuropathic pain. Furthermore, he is working with his imaging colleagues to develop a precision medicine-based approach to focused ultrasound treatment planning. We recently interviewed Dr. Gandhi to learn more about his new study, his career, and his work.
This month’s research highlights come from the 6th International Symposium on Focused Ultrasound, held this week in Reston, Virginia. Researchers from around the world presented the latest data on focused ultrasound applications for the brain, cancer immunotherapy, liver, lung, veterinary medicine, and more. Which presentations garnered the most attention?
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