Welcome to this month's issue of the Focused Ultrasound Surgery Foundation newsletter, offering the latest developments in focused ultrasound as well as news of the Foundation and its programs.
The FUS Foundation has recently implemented an online research award submission system. To use the system for submitting an MRgFUS or focused ultrasound related research project proposal, please visit our website.
To keep up with the Foundation's activities and the latest news in the world of Focused Ultrasound Surgery, visit our Web site at http://www.fusfoundation.org.
FUSF Research Award Recipient - Rich Price, Ph.D.
Dr. Rich Price is an Associate Professor of Biomedical Engineering at the University of Virginia. Dr. Price’s research training was primarily in the field of microvascular biomechanics, and he currently serves as an Associate Editor for the journal Microcirculation and as a member of the Executive Council of the Microcirculatory Society. Dr. Price’s research interests center on the basic molecular mechanisms of capillary sprouting dynamics during angiogenesis, the role of bone-marrow derived cells in regulating arteriogenesis, and the development of contrast agent microbubble technologies for targeted nanomedicine delivery. His work on the therapeutic potential of contrast agent microbubbles has been published in Circulation and the Journal of the American College of Cardiology, and it has received research grants from the Whitaker Foundation, the American Heart Association, and the National Institutes of Health.
Dr. Price’s FUSF-supported research project is based on observations and technologies derived from his research on the use of contrast ultrasound for stimulating pro-arteriogenic nanoparticle delivery. Dr. Price’s research team has previously demonstrated that ultrasonic microbubble destruction by low frequency ultrasound creates pores in capillaries, which, in turn, permit the transport of nanoparticles to tissue. Based on these observations, the researchers have now begun to develop injectable microbubble-based composite drug delivery agents capable of transporting controlled-release polymer nanoparticles to ultrasound-targeted regions.
Working in collaboration with Dr. Jason Sheehan in the Department of Neurosurgery at the University of Virginia, Price and his team plan to load the controlled-release nanoparticles on these composite agents with chemotherapeutic drugs, study the transport of these nanoparticles to and within brain tumors in small animal models following activation of the agents with ultrasound, and then test the ability of these agents to elicit tumor regression. Ultimately, the goal of this work is to develop a therapeutic regimen in which these agents enhance the effectiveness of brain tumor ablation with low power HIFU via the creation of additional mechanical and thermal damage, the cessation of tumor blood flow through capillary occlusion, and the targeted delivery of controlled-release chemotherapeutic nanoparticles.
FUSF Research Award Recipient - Nathan McDannold, Ph.D.
Nathan McDannold, Assistant Professor in the Department of Radiology at Brigham and Women's Hospital in Boston, has pursued focused ultrasound research since 1996 and has published more than 50 articles and book chapters on the subject. His work to date has focused largely on developing MRI techniques to guide and monitor focused ultrasound procedures and developing methods for targeted drug delivery in the brain using ultrasound to temporarily disrupt the blood-brain barrier. Dr. McDannold is particularly interested in using focused ultrasound ablation as a noninvasive alternative to surgical resection or radiotherapy for brain tumors.
The FUSF has awarded Dr. McDannold a grant to begin work that will test the effects of focused ultrasound heating on nerve structures in the brain. The ultimate goal is to gain the ability to ablate tumors at the skull base near nerve structures, which are particularly difficult to treat currently because the skull bone is preferentially heated. Dr. McDannold will examine the effects of different thermal exposures on nerve tracts in the brain using both histological and functional approaches. Once the safe levels of nerve heating can be determined, MRI-based thermal imaging can then be employed to guide the procedure and ensure that the nerve structures are not damaged.
AdMeTech Conference Features Strong Focused Ultrasound Presence
Advances in diagnostic imaging and minimally invasive surgery such as MRgFUS are set to revolutionize management of prostate cancer, the second most common cancer in men, according to an eminent group of clinicians and scientists who met at a conference in Washington, D.C., September 16-18, 2007. Prostate cancer was described as “an epidemic affecting one in six men,” by Faina Shtern M.D., Director of Radiology Research at Harvard Children’s Hospital and President of the AdMeTech Foundation.
A broad consensus emerged during presentations from the multi-disciplinary faculty, which included representation from the fields of radiology, urology, oncology, surgery, imaging, and research. Most presenters agreed that too many patients receive radical prostatectomy, which can have a profoundly negative impact on quality of life by impacting sexual function and continence. Also, the procedure is frequently used in circumstances where alternative approaches would provide better outcomes. However, in the absence of a dependable diagnostic system that provides conclusive imaging and accurate biopsy site guidance, too many patients with rising PSA levels receive radical surgery to avoid the risk of possible aggressive disease. Maximizing the possibility of a cure can come with a high price in terms of subsequent quality of life.
In fact, as many as 30 percent of post-operative biopsy samples reveal indolent tumors with low Gleason scores, indicating that these patients could have received minimally-invasive alternatives. John Frangioni M.D., Ph.D. stated, “seeing is curing, and too often we are making decisions in the dark.” The lack of a conclusive diagnosis is the major issue that prevents the selection of focal therapy and other alternatives to radical prostatectomy, of which 19 different treatment modalities already exist.
“We have a unique opportunity to apply focal therapy to prostate cancer,” stated Clare Tempany, M.D., Director of clinical MRI at Harvard, as she discussed the potential role of MRgFUS as a treatment option for prostate, breast, and liver cancers. Referencing the ongoing paradigm shift from global to focal treatment illustrated by breast lumpectomy replacing mastectomy and uterine fibroid ablation or embolization offering alternatives to hysterectomy, Dr. Tempany pointed out the need for imaging research to pinpoint biological activity at the molecular level. Using MR imaging and thermometry, MRgFUS already has the potential to provide highly accurate focal ablation of malignant tissue while mapping the nerve tissues that should be avoided to preserve sexual function and without the dose or frequency limitations associated with radiation based treatments.
Dr. Shtern was optimistic about advances in the field and called for a systematic “manogram” to replace over-reliance on PSA testing. Further research into imaging technology is required to yield a conclusive diagnostic test which makes a “manogram” as accurate as breast imaging. That is the goal of new funding legislation, the PRIME Act 1734, which was announced at a press conference on Capitol Hill. Sponsored by both Democratic and Republican representatives, PRIME will allocate $650M to research imaging technologies for the detection and treatment of prostate cancer. “The commitment of the federal government is a crucial step in the development of the highly-accurate, non-invasive technology that we need to save lives and to improve lives of our men,” said Dr. Shtern. “We salute Senators Boxer, Lautenberg, and Kerry for their leadership, and we will do everything possible to help ensure that the right tools are made available to put an end to the fear, pain, suffering, and costs that prostate cancer causes men and their families.”
Study indicates MRgFUS is a cost effective treatment for uterine fibroids A comparison of MRgFUS to other treatment modalities for uterine fibroids shows favorable results for cost effectiveness and quality of life after the procedure.Ability of focused ultrasound to open the blood brain barrier This study demonstrates the ability of focused ultrasound to reversibly open the blood brain barrier (BBB) and allow pharmaceuticals to be selectively targeted on specific brain tissue regions, without causing other harmful effects to the targeted or surrounding tissues. The study also indicates that larger vessels within the brain tissue are more susceptible to the increased BBB permeability.
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