Noninvasive Repositioning of Kidney Stone Fragments with Acoustic Forceps

用声学钳无创重新定位肾结石碎片

• 批准号: 10589666
• 负责人: Mohamed A Ghanem
• 金额: $ 19.27万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-11 至 2027-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10589666
• 关键词: 3-Dimensional; Acoustics; Address; Affect; Algorithms; American; Applications Grants; Award; Back; Bladder; Clinical Trials; Collaborations; Complex; Control Groups; Cutaneous; Data; Deposition; Devices; Educational workshop; Elements; Emergency department visit; Event; Family suidae; Feedback; Forcep; Frequencies; Funding; Future; Geometry; Glass; Goals; Growth; Heterogeneity; Histologic; Hospitalization; Human; Image; Implant; In Vitro; Injury; Intervention; Investigation; Kidney; Kidney Calculi; Knowledge; Laboratories; Length; Lithotripsy; Measurement; Measures; Mechanics; Mentors; Methods; Modeling; Motion; Operative Surgical Procedures; Patients; Pelvis; Phase; Physics; Physiologic pulse; Positioning Attribute; Protocols documentation; Radiation; Recurrence; Renal pelvis; Research; Research Personnel; Research Proposals; Residual state; Rotation; Safety; Shapes; Shock; Signal Transduction; Surface; Symptoms; System; Techniques; Technology; Testing; Time; Tissues; Transducers; Translational Research; Ultrasonic wave; Ultrasonics; Ureter; Ureteroscopy; Urinary tract; Urine; Urologic Diseases; Visualization; arm; career; career development; clinical implementation; common treatment; cost; efficacy evaluation; improved; in vivo; indexing; industry partner; novel strategies; object shape; particle; porcine model; predictive modeling; pressure; randomized, controlled study; reduce symptoms; responsible research conduct; success; symposium; technology development; tissue injury; tissue phantom; treatment arm; two-dimensional; ultrasound

Project Summary/Abstract Kidney stones are prevalent and one of the costliest urologic diseases. The available treatment options such as ureteroscopy or shockwave wave lithotripsy break the stone into small fragments that can lead to future growth and recurrence of symptoms. This proposal investigates the underlying mechanisms to use acoustic radiation force produced by an ultrasound multi-element array that can trap a stone, steer it out of the kidney collecting space, and deposit it in the renal pelvis or UPJ to facilitate its natural clearance. The project seeks to answer the fundamental scientific hurdles to target and maneuver the stone toward passage. Aim 1 develops the analytical framework to optimize pulsing mechanisms to trap and manipulate natural stones. A proposed semi-analytical approach approximates the scattering with spherical functions to calculate the forces on natural stones. Predictions will be combined with the investigation of pulsing parameters to optimize trap robustness and achieve stable trapping of natural stones. Pulsing parameters such as pulse length, repetition rate, frequency, and phase excitation that control beam shape and uniformity will be adjusted to eliminate instabilities from rotation and asymmetric forces to achieve stable trapping of natural stones. The aim success is measured by performing manipulation maneuver natural stones along predetermined paths. In Aim 2, the stone acts as a target that can reflect and scatter ultrasound waves which are received back by the multi-element array. Correction algorithms use the received signal to calculate the element excitations necessary to correct for beam aberrations from the tissue heterogeneity. Hydrophone measurements will compare the beams before and after corrections with the unaberrated beam. Finally, manipulation of stones in kidney phantoms and ex vivo are performed to mimic in vivo conditions. In Aim 3, the safety and efficacy of acoustic forceps manipulation will be evaluated. First, different acoustic intensity exposures will be investigated in ex vivo porcine kidneys for thermal and mechanical injury. Afterward, natural stones of various sizes will be implemented in the kidney collecting space of live pigs. The stone will be targeted, trapped, and steered from the kidney collecting space toward the kidney exit using the acoustic forceps. The treated group will be evaluated against an untreated control group to evaluate efficacy. Tissue injury mechanisms will be assessed through histological analysis. In addition to my research, I will also pursue other activities guided by my mentors toward my career goal of becoming an independent investigator. These activities include interacting with researchers, industry partners, and clinicians through seminars and conferences; and participating in workshops on the responsible conduct of research, and grant proposals and management so that I will be able to pursue independent R-level funding toward the end of the K25 award. The Applied Physics Laboratory offers the facilities and inter-departmental collaboration necessary for successful career development in translational research.

项目概要/摘要 肾结石很普遍，也是最昂贵的泌尿系统疾病之一。可用的治疗方案 例如输尿管镜检查或冲击波碎石术将结石打碎成小碎片，可以通向未来 症状的增长和复发。该提案研究了使用声学的基本机制 超声波多元件阵列产生的辐射力可以捕获结石，将其引导出肾脏 收集空间，并将其沉积在肾盂或UPJ中以利于其自然清除。该项目旨在 回答基本的科学障碍，以瞄准并操纵石头通行。 目标 1 开发分析框架来优化脉冲机制，以捕获和操纵自然 石头。提出的半解析方法用球函数来近似散射来计算 作用在天然石材上的力。预测将与脉冲参数的研究相结合以优化 捕获坚固性并实现对天然石材的稳定捕获。脉冲参数，例如脉冲长度、 控制光束形状和均匀性的重复率、频率和相位激励将被调整为 消除旋转和不对称力带来的不稳定性，以实现天然石材的稳定捕获。目的 成功与否是通过沿着预定路径对天然宝石进行操纵来衡量的。 在目标 2 中，石头充当目标，可以反射和散射接收回来的超声波 由多元素数组。校正算法使用接收到的信号来计算单元激励 有必要纠正组织异质性造成的光束像差。水听器测量将 将校正前后的光束与无畸变光束进行比较。最后，对石头进行处理 肾脏模型和离体模型是为了模拟体内条件而进行的。 在目标 3 中，将评估声学钳操作的安全性和有效性。一、不同 将在离体猪肾脏中研究声强度暴露的热损伤和机械损伤。 随后，将在生猪的肾脏收集空间内植入各种大小的天然结石。这 结石将被瞄准、捕获并使用以下装置从肾脏收集空间引导至肾脏出口 声学钳。将对照未治疗的对照组来评估治疗组以评估功效。 将通过组织学分析评估组织损伤机制。 除了我的研究之外，我还将在导师的指导下开展其他活动以实现我的职业目标 成为一名独立调查员。这些活动包括与研究人员、行业合作伙伴、 和临床医生通过研讨会和会议；并参加关于负责任行为的研讨会 研究、拨款提案和管理，以便我能够寻求独立的 R 级资助 K25 奖即将结束。应用物理实验室提供设施和跨部门 转化研究中成功的职业发展所必需的合作。