Targeting Ultrasound Therapy to the Spine

针对脊柱的超声治疗

• 批准号: RGPIN-2016-06336
• 负责人: OReilly, Meaghan
• 金额: $ 1.97万
• 依托单位: University of Toronto
• 依托单位国家: 加拿大
• 项目类别: Discovery Grants Program - Individual
• 财政年份: 2018
• 资助国家: 加拿大
• 起止时间: 2018-01-01 至 2019-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=661238
• 关键词: Targeting; Ultrasound; Therapy; Spine

Ultrasound (US) can elicit a range of therapeutic effects on tissues, including stimulating cell proliferation, facilitating drug delivery and focally ablating tissue. Because US is non-ionizing and can be focused at depth in the body without damage to the intervening tissues, it is particularly well suited for targets in, or in close proximity to, sensitive structures, and has great potential for use in the spine. US-mediated drug, cell or gene delivery to the spinal cord could revolutionize the treatment of spinal cord injury and disease. Targeted to the intervertebral disc or facet joints, US could play an important role in the management of back pain.******A major limitation to the clinical realization of these treatments is the need to focus the US through the complex bony structures of the posterior spinal elements. Bone is highly attenuating and aberrating to sound, and treating through bony structures is only possible through the use of US transducer arrays that can correct the beam distortions caused by the bone, and which operate within an optimal frequency range. In the brain this technology is in-hand and has been investigated clinically. However, the spinal geometry is more complex than the skull. Acoustic windows such as the interlaminar spaces will facilitate access to some targets. In other regions, non-normal incidence angles will reflect and refract the US, and the narrow spinal canal may give rise to standing waves. Thus, the development of extracorporeal US transducer arrays that are capable of focusing in the spinal setting is necessary to advance this technology.******The overall goal of this research program is to use numerical simulations and bench-top measurements to test the hypothesis that extracorporeal ultrasound can be focused non-invasively to targets in the spinal cord and spinal column at therapeutically relevant exposures. The specific aims to achieve this are:******1. To develop acoustic simulation models of the human spine at cervical, thoracic and lumbar levels using computed tomography (CT)-derived geometry.***2. To experimentally validate the numerical models through comparison with acoustic and thermal measurements in cadaveric spine segments.***3. To use the validated models to assess the ability of ultrasound to safely target different structures in the spine.***4. To determine, through numerical optimization, the ultrasound transducer geometry that maximizes the treatment envelope.***5. To fabricate and characterize a prototype transducer for targeting the spine. ******This research will lay the groundwork for clinical-scale investigations in the spine using therapeutic US, and has immense potential to be a disruptive technology in this arena. By eliminating a major obstacle to clinical translation, establishing the technical feasibility of this approach will also encourage further research to identify new clinical applications in the spine.**

超声（US）可以引起对组织的一系列治疗作用，包括刺激细胞增殖，促进药物递送和局部消融组织。因为我们是非离子化的，并且可以集中在体内的深度，而不会损害中间组织，因此它特别适合于敏感结构的目标或紧邻靶标，并且具有在脊柱中使用的巨大潜力。美国介导的药物，细胞或基因递送到脊髓可能会彻底改变脊髓损伤和疾病的治疗。美国针对椎间盘或刻面关节，美国可能在背痛的管理中发挥重要作用。******对这些治疗方法的临床实现的主要局限性是需要通过后脊柱元素的复杂骨质结构将美国聚焦。骨骼高度衰减和畸变，并且只有通过使用美国传感器阵列来纠正骨骼引起的光束扭曲并在最佳频率范围内运行的美国传感器阵列才有可能通过骨结构进行处理。在大脑中，这项技术是掌握的，并且已经在临床上进行了研究。但是，脊柱几何形状比头骨更复杂。诸如层间空间之类的声窗将有助于进入某些目标。在其他地区，非正常的入射角将反射和折射美国，狭窄的脊柱管可能会导致站波。因此，必须在脊柱环境中专注的体外美国换能器阵列的发展是为了推进这项技术。****** ******这项研究计划的总体目标是使用数值模拟和基准测量测量来测试假说，即在脊柱和脊柱柱中均不在脊柱和脊柱上的靶标的靶标，可以将体外超声集中在脊柱和脊柱上。实现这一目标的具体目的是：****** 1。使用计算机断层扫描（CT）衍生的几何形状在颈椎，胸腔和腰部水平上开发人脊柱的声学模拟模型。*** 2。通过与尸体脊柱段中的声学和热测量进行比较，通过实验验证数值模型。*** 3。使用经过验证的模型评估超声安全靶向脊柱不同结构的能力。*** 4。为了通过数值优化确定最大化处理包膜的超声传感器几何形状。*** 5。制造和表征用于靶向脊柱的原型传感器。 *****这项研究将使用治疗性美国在脊柱中进行临床规模研究为基础，并具有在该领域成为一种破坏性技术的巨大潜力。通过消除临床翻译的主要障碍，建立这种方法的技术可行性还将鼓励进一步的研究确定脊柱的新临床应用。**