Magnetic resonance image–guided focused ultrasound robotic system for transrectal prostate cancer therapy

Giannakou, Marinos; Drakos, Theocharis; Menikou, Georgios; Evripidou, Nikolas; Filippou, Antria; Spanoudes, Kyriakos; Ioannou, Leonidas; Damianou, Christakis

doi:10.1002/rcs.2237

Cited by 15 publications

(13 citation statements)

References 34 publications

(73 reference statements)

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“…This damage is caused by ultrasonic thermal coagulation and destructive mechanical effects, including acoustic cavitation [ 2 ]. HIFU devices rely mostly upon ultrasonic heating under continuous or long pulse irradiation [ 3 ]. In thermal ablation, the focal intensity needs to be high enough to denature protein and cause coagulative necrosis [ 4 5 ].…”

Section: Resultsmentioning

confidence: 99%

“…Ultrasonic methods or X-ray fluoroscopy [ 2 ] are limited in monitoring HIFU treatment process since these cannot provide information about temperature rises. Thus, HIFU can be combined with magnetic resonance imaging (MRI) to permit relative thermometry [ 3 ]. An MRI-guided HIFU device has proven to better visualize target tissues with temperature changes during the treatment procedure and confirm the surgical efficacy following treatment [ 4 ].…”

Section: Resultsmentioning

confidence: 99%

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Clinical application of the therapeutic ultrasound in urologic disease: Part II of therapeutic ultrasound in urology

Choi

et al. 2022

Investig Clin Urol

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This article aimed to review the clinical application and evidence of the therapeutic ultrasound in detail for urological diseases such as prostate cancer, kidney tumor, erectile dysfunction, and urolithiasis. We searched for articles about high-intensity focused ultrasound (HIFU), extracorporeal shock wave therapy, ultrasound lithotripsy, and extracorporeal shockwave lithotripsy (ESWL) in the MEDLINE and Embase. HIFU may be indicated as a primary treatment for low- or intermediate-risk prostate cancer, and salvage therapy for local recurrence as a promising way to address the limitations of current standard therapies. The application of HIFU in treating kidney tumors has scarcely been reported with unsatisfactory results. Evidence indicates that low-intensity shockwave therapy improves subjective and objective erectile function in patients with erectile dysfunction. Regarding the application of ultrasound in stone management, the novel combination of ultrasound lithotripsy and other energy sources in a single probe promises to be a game-changer in efficiently disintegrating large kidney stones in percutaneous nephrolithotomy. ESWL is losing its role in managing upper urinary tract calculi worldwide. The burst-wave lithotripsy and ultrasound propulsion could be the new hope to regain its position in the lithotripsy field. According to our investigations and reviews, cavitation bubbles of the therapeutic ultrasound are actively being used in the field of urology. Although clinical evidence has been accumulated in urological diseases such as prostate cancer, kidney tumor, erectile dysfunction, and lithotripsy, further development is needed to be a game-changer in treating these diseases.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Clinical application of the therapeutic ultrasound in urologic disease: Part II of therapeutic ultrasound in urology

Choi

et al. 2022

Investig Clin Urol

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“…Note that this type of motors was widely used in the development of MRI compatible FUS devices. 27 , 34 , 44 , 45 , 46 , 47 , 48 The angular motion of the motors is transmitted inside the water container via sealed shafts.…”

Section: Discussionmentioning

confidence: 99%

Preclinical robotic device for magnetic resonance imaging guided focussed ultrasound

Giannakou

Antoniou

Damianou

2022

Robotics Computer Surgery

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Background: A robotic device featuring three motion axes was manufactured for preclinical research on focussed ultrasound (FUS). The device comprises a 2.75 MHz single element ultrasonic transducer and is guided by Magnetic Resonance Imaging (MRI). Methods:The compatibility of the device with the MRI was evaluated by estimating the influence on the signal-to-noise ratio (SNR). The efficacy of the transducer in generating ablative temperatures was evaluated in phantoms and excised porcine tissue.Results: System's activation in the MRI scanner reduced the SNR to an acceptable level without compromising the image quality. The transducer demonstrated efficient heating ability as proved by MR thermometry. Discrete and overlapping thermal lesions were inflicted in excised tissue. Conclusions:The FUS system was proven effective for FUS thermal applications in the MRI setting. It can thus be used for multiple preclinical applications of the emerging MRI-guided FUS technology. The device can be scaled-up for human use with minor modifications.

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“… (1) The mechanism of HIFU devices is referred to as ultrasonic ablation , and it mostly relies on ultrasonic heating under continuous or long-pulse irradiation [ 16 ]. A piezoelectric transducer is used as the HIFU source, and a transducer or lens in front of a transducer focuses the energy onto the target [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Understanding cavitation-related mechanism of therapeutic ultrasound in the field of urology: Part I of therapeutic ultrasound in urology

et al. 2022

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Shock waves are commonly used in the field of urology. They have two phases, positive and negative, and the bubble generation is roughly classified into acoustic cavitation (AC) and laser-induced cavitation (LIC). We evaluated the occurrence of cavitation, its duration, the area of interest, and the maximal diameter of the cavitation bubbles. Changes in AC occurred at 0.2 ms with the highest number of bubbles and disappeared at 0.6 ms. The bubble size was 2 mm in diameter. Changes in LIC bubbles were observed in three pulse modes. The short pulse showed an initial bubble starting at 0.005 ms, which reached its largest size at 0.4 to 0.6 ms. The long pulse showed an initial bubble starting at 0.005 ms, which reached its largest size at 0.4 ms with the formation of an additional lagena-shaped bubble at 0.6 ms. The distance mode of MOSES showed two signal peaks with the formation of two consecutive bubbles at 0.2 and 0.6 ms. The main difference in the laser beams between the long-pulse and the MOSES modes was the continuity and the peak power of the laser beam. The diameters parallel to the laser direction were 6.8, 8.6, and 9.7 mm at 1, 2, and 3 J, respectively, in the short pulse. While the cavitation bubbles rupture, ejectile force occurs in numerous directions, transmitting high enough energy to break the targets. Cavitation bubbles should be regarded as energy and the mediators of energy for stone fragmentation and tissue destruction.

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Magnetic resonance image–guided focused ultrasound robotic system for transrectal prostate cancer therapy

Cited by 15 publications

References 34 publications

Clinical application of the therapeutic ultrasound in urologic disease: Part II of therapeutic ultrasound in urology

Clinical application of the therapeutic ultrasound in urologic disease: Part II of therapeutic ultrasound in urology

Preclinical robotic device for magnetic resonance imaging guided focussed ultrasound

Understanding cavitation-related mechanism of therapeutic ultrasound in the field of urology: Part I of therapeutic ultrasound in urology

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