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Advances in Image-Guided Focused Ultrasound Applications

B Denis de Senneville1*, A Payne2*, C Lafon3*, H Chen4*, (1) Universite de Bordeaux, Cedex, France, (2) University of Utah Hospitals, Provo, UT, (3) INSERM U281, Lyon, Cedex, France,(4) Washington University in St.Louis, University City, MO


(Tuesday, 7/16/2019) 1:45 PM - 3:45 PM

Room: 303

Advances in Image-Guided Focused Ultrasound Applications
Baudouin Denis de Senneville¹, Allison Payne², Cyril Lafon³, Hong Chen�
¹1Université Bordeaux, Bordeaux, France & UMC Utrecht, The Netherlands
²2University of Utah, Salt Lake City, Utah, USA
³LabTAU, INSERM, Centre Léon Bérard, Université Lyon, Lyon, France
â?´4Washington University, St. Louis, MO, USA

Motion management and adaptive control for treating abdominal tumors – Baudouin Denis de Senneville, Presenting Author
Volumetric real-time magnetic resonance imaging in breast focused ultrasound treatments – Allison Payne, Presenting Author
High speed ultrasound imaging for targeting and monitoring trans oesophageal HIFU during cardiac procedures – Cyril Lafon, Presenting Author
Image-guided focused ultrasound-mediated brain drug delivery – Hong Chen, Presenting Author

Image guidance plays a critical role in managing the safety and efficacy of focused ultrasound treatments. This session’s four presentations highlight several advanced monitoring techniques that utilize different imaging modalities.

High-speed ultrasound imaging can be used to guide and monitor focused ultrasound treatments. When applied with a transesophageal approach, focused ultrasound can be used to treat atrial fibrillation and ventricular tachycardia. Electromechanical Wave Imaging provides global mapping of mechanical activation into the myocardium and passive elastography can image stiffness changes in order to assess the quality of treatment.

The use of focused ultrasound combined with microbubbles for blood-brain barrier disruption (FUS-BBBD) is a promising technique for noninvasive and localized brain drug delivery that will also be discussed. Passive cavitation imaging (PCI) can predict the location and concentration of radio-labeled nanoclusters delivered by FUS-BBBD, a technique that we named as cavitation dose painting. This PCI-based cavitation dose painting technique in combination with FUS-BBBD opens new horizons in spatially targeted and modulated brain drug delivery.

Magnetic resonance imaging is an excellent tool to plan and monitor focused ultrasound ablative treatments. Two presentations will address the role of magnetic resonance imaging guidance to control the heat deposition within the targeted pathological area. First, the challenges associated with abdominal organs such as kidney and liver will be addressed. Both therapy guidance and energy deposition must be rendered compatible with physiological abdominal motions in order to provide an effective treatment with an increased level of patient safety and a reduced duration. Second, it will be presented that volumetric magnetic resonance imaging tools can be used to streamline a focused ultrasound protocol workflow to allow for more rapid treatment in the clinic. Advanced 3D magnetic resonance imaging sequences and hardware innovations will be demonstrated in a breast cancer application.

Learning Objectives
1. Understand the basics of conformal ultrasonic device design, specifically for a transesophageal approach.
2. Understand the use of high speed ultrasound imaging for tracking motion and follow electromechanical activity or stiffness changes.
3. Understand the physical mechanisms of focused ultrasound-induced blood-brain barrier disruption.
4. Understand the importance of imaging in focused ultrasound-mediated brain drug delivery.
5. Differentiate between the sources and the time-scale of the different types of physiological motion in magnetic resonance imaging.
6. Understand challenges of abdominal focused ultrasound on moving organs and appropriate solutions.
7. Understand the benefits and drawbacks of volumetric magnetic resonance imaging in focused ultrasound applications
8. Become acquainted with recent efforts that use imaging solutions to streamline a focused ultrasound ablation procedure, potentially improving the patient experience.

Funding Support, Disclosures, and Conflict of Interest: Dr. Chen is supported by NIH R01MH116981 and R01EB027223. Dr. Lafon is supported by the Focused Ultrasound Foundation and the French National Research Agency under the project CHORUS. Dr. Payne is supported by NIH R37CA224141.



Image-guided Therapy, Ultrasonics, MRI


Education: Knowledge of principles and generalizations

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