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 diseaseWe interviewed Jae Young Lee, MD, PhD, to learn more about one of Seoul’s many impressive focused ultrasound centers.

Background Information

logo Seoul National University HospitalWhen was CHORUS started, who started it, and why?
I (Dr. Lee) opened the facility in 2008. My intention then, and now, was to conduct academic research in the areas of diagnostic and therapeutic ultrasound.

Describe CHORUS’s facilities, space, and equipment?
We conduct both preclinical and clinical focused ultrasound experiments using the ALPIUS 900 (a human focused ultrasound device), a VIFU 2000 (an animal focused ultrasound device), and three custom experimental setups.

What is CHORUS’s vision and mission?
Our mission is to make a better world using ultrasound.

Where does your funding come from, and what is your annual budget?
Our annual budget is 300,000 dollars, which is 80 percent from government funding and 20 percent from industry.

Investigators

Seoul National CHORUS team captionsHow many staff do you have in each position?
Our laboratory employs eight professionals, including one MD Professor, one PhD Professor, one research nurse, two biology researchers, one research radiation technician, and two doctorate MD students.

Who are your key investigators?
Along with myself, our other lead investigator is Eun-Joo Park, PhD. I (Jae Young Lee) graduated from Seoul National University College of Medicine in 1992. I then earned a Master of Medicine degree from Seoul National University College of Medicine in 1995 and became certified by the Korean Board of Radiology in 1997. After working as a radiologist for several years, I earned my PhD in Medicine from Seoul National University College of Medicine in 2008. I became a full Professor of Radiology (with tenure) at Seoul National University College of Medicine in 2016 and was named Vice Dean of Research Affairs at Seoul National University College of Medicine in 2018.

Eun-Joo Park, PhD, received her Bachelor of Science in Physics from Sungkyunkwan University in Seoul in 1996 followed by a Master of Science in Physics from Sungkyunkwan University in 1998. A few years later, in 2003, she completed her Master of Science in Mechanical Engineering at Boston University followed by a PhD in Bioengineering from Pennsylvania State University in 2010. Since 2014, she has served as a Research Professor in the Biomedical Research Institute and Department of Radiology at Seoul National University Hospital.

Who are your internal and external collaborators?
Internally, we work with Sang Hyup Lee, MD, Professor in Gastroenterology (pancreas); Jin Young Jang, MD, Professor in Pancreato-biliary surgery (pancreas); Hyun Hoon Chung, MD, Professor in OBGYN (uterus); Maria Lee, MD, Professor in OBGYN (uterus); Seung-June Oh, MD, Professor in Urology (prostate); Dong Soo Lee, MD, Professor in Nuclear medicine (Alzheimer’s disease); Eun Jung Lee, MD, Assistant Professor in Neurosurgery (brain and BBB opening); and Sun Ha Paek, MD, Professor in Neurosurgery (brain and BBB opening).

Externally, our collaborators are Kidong Kim, MD, Professor in OBGYN at SNBUH; Keonho Son, PhD, Executive Director at IMGT Co., Ltd.; Hak Jong Lee, MD, Professor in Radiology at SNBUH and Head of IMGT Co., Ltd.; Ki Joo Park, PhD, Senior Research Scientist at the Center for Bionics, Biomedical Research Institute, Korea Institute of Science and Technology (Seoul); Min Joo Choi, PhD, Professor in Medical engineering at Jeju National University; Hyuncheol Kim, PhD, Professor in the Department of Chemical & Biomolecular Engineering at Sogang University (Seoul); Jin Woo Chang, MD, Professor in Neurosurgery at Yonsei University College of Medicine (Seoul); and Eunah Kang, PhD, assistant professor, School of Chemical Engineering & Material Sciences at Chung-Ang University (Seoul).

Projects

Seoul National pancreatic treatment captionWhich focused ultrasound applications and biomechanisms does your group study?
Our research interests cover a wide range of applications, including pancreatic cancer and Alzheimer’s disease. We conduct clinical trials for thermal ablation of uterine diseases, such as adenomyosis and myomas.

Besides thermal ablation, we conduct both preclinical and clinical studies using various drug delivery mechanisms of focused ultrasound. Our preclinical work in opening the blood-brain barrier and using sonodynamic therapy has been promising. Finally, we study focused ultrasound—induced immunotherapy.

How many different focused ultrasound studies are being conducted at this site?
Our current studies include:

  • Studying sonodynamic therapy for the brain (animal studies)
  • Developing nanoparticles for sonodynamic therapy (cell and animal studies)
  • Evaluating the focused ultrasound—induced immune response in pancreatic cancer (animal studies)
  • Understanding focused ultrasound treatment of Alzheimer’s disease (animal studies)
  • Investigating the mechanism of combined therapy of ultrasound and microbubbles (cell study)
  • Evaluating the thermal effects of focused ultrasound (phantom studies)

What are your successes?
Commercially, we collaborated with Alpinion to develop both the first Korean commercial focused ultrasound device (ALPIUS 900) and the first Korean small animal focused ultrasound device (VIFU). We achieved Korean FDA approval of the ALPIUS 900 for the treatment of uterine myoma and uterine adenomyosis after successful prospective clinical trials. Our pilot prospective clinical trial for the treatment of pancreatic cancer produced excellent results, and we have also had promising results using focused ultrasound to enhance drug delivery for the treatment of pancreatic cancer in many animal studies. As mentioned above, our recent publication about the mechanism of focused ultrasound for the treatment of Alzheimer’s diseases in an animal study has been a nice success.

What’s next?
We are planning a randomized clinical trial to prove the efficacy of focused ultrasound for enhancing drug delivery in patients with unresectable pancreatic cancer. Preclinically, we are working on well-designed animal studies that measure immune system changes after focused ultrasound treatment. Our Alzheimer’s research will be ongoing, and our continued work on uterine diseases will focus on ways to decrease treatment time.

What is the role of the Foundation in your work, if any?
The Foundation is supporting our randomized clinical trial to prove the efficacy of focused ultrasound for enhancing drug delivery in patients with unresectable pancreatic cancer.

What is your wish list to increase your impact?
The main item on our wish list is increased funding for more studies.

Education

What is your role in education?
We provide basic science education about therapeutic ultrasound to graduate students, MDs, and other members of the research center. We also provide consulting on research projects for MDs and graduate students (phantom studies to preclinical studies).

Key Publications

Lee YS, Choi Y, Park EJ, Kwon S, Kim H, Lee JY, Lee DS. Improvement of glymphatic-lymphatic drainage of beta-amyloid by focused ultrasound in Alzheimer’s disease model.  bioRxiv 2020.01.24.918607; doi: https://doi.org/10.1101/2020.01.24.918607

Lee JY, Chung HH, Kang SY, Park EJ, Park DH, Son K, Han JK. Portable ultrasound-guided high-intensity focused ultrasound with functions for safe and rapid ablation: prospective clinical trial for uterine fibroids-short-term and long-term results. Eur Radiol 2020 Mar;30(3):1554-1563. doi: 10.1007/s00330-019-06468-2. Epub 2019 Nov 8. PMID: 31705252

Park EJ, Ahn YD, Lee JY. In vivo study of enhanced chemotherapy combined with ultrasound image-guided focused ultrasound (USgFUS) treatment for pancreatic cancer in a xenograft mouse model. Eur Radiol 2018 Sep;28(9):3710-3718. doi: 10.1007/s00330-018-5355-9. Epub 2018 Mar 29.PMID: 29600477

Yu MH, Lee JY, Kim HR, Kim BR, Park EJ, Kim HS, Han JK, Choi BI. Therapeutic Effects of Microbubbles Added to Combined High-Intensity Focused Ultrasound and Chemotherapy in a Pancreatic Cancer Xenograft Model. Korean J Radiol 2016 Sep-Oct;17(5):779-88. doi: 10.3348/kjr.2016.17.5.779. Epub 2016 Aug 23. PMID: 27587968

Kim JH, Kim H, Kim YJ, Lee JY, Han JK, Choi BI. Dynamic contrast-enhanced ultrasonographic (DCE-US) assessment of the early response after combined gemcitabine and HIFU with low-power treatment for the mouse xenograft model of human pancreatic cancer. Eur Radiol 2014 Sep;24(9):2059-68. doi: 10.1007/s00330-014-3260-4. Epub 2014 Jun 25.PMID: 24962825

Kang KM, Lee JY, Kim H, Han JK, Choi BI. Gel phantom study with high-intensity focused ultrasound: influence of metallic stent containing either air or fluid. Ultrasound Med Biol 2014 Dec;40(12):2851-6. doi: 10.1016/j.ultrasmedbio.2014.07.009. Epub 2014 Oct 11.PMID: 25308944

Lee ES, Lee JY, Kim H, Choi Y, Park J, Han JK, Choi BI. Pulsed high-intensity focused ultrasound enhances apoptosis of pancreatic cancer xenograft with gemcitabine. Ultrasound Med Biol 2013 Nov;39(11):1991-2000. doi: 10.1016/j.ultrasmedbio.2013.06.004. Epub 2013 Aug 22.PMID: 23972483

Lee JY, Choi BI, Ryu JK, Kim YT, Hwang JH, Kim SH, Han JK. Concurrent chemotherapy and pulsed high-intensity focused ultrasound therapy for the treatment of unresectable pancreatic cancer: initial experiences. Korean J Radiol 2011 Mar-Apr;12(2):176-86. doi: 10.3348/kjr.2011.12.2.176. Epub 2011 Mar 3. PMID: 21430934

Past Coverage

Alzheimer’s Disease: Preclinical Study Explores Impact of Focused Ultrasound March 2020
Meeting Report: TAITU 2018 December 2018
Meeting Report: RSNA 2017 December 2017
Focused Ultrasound Presence Grows at RSNA 2016 December 2016
Merkin Fellow Attends IEEE Ultrasound Symposium November 2015

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