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A Prototype Therapy System for Transcutaneous Application of Boiling Histotripsy

机译:经皮应用煮沸组织学的原型治疗系统

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Boiling histotripsy (BH) is a method of focused ultrasound surgery that noninvasively applies millisecond-length pulses with high-amplitude shock fronts to generate liquefied lesions in tissue. Such a technique requires unique outputs compared to a focused ultrasound thermal therapy apparatus, particularly to achieve high in situ pressure levels through intervening tissue. This paper describes the design and characterization of a system capable of producing the necessary pressure to transcutaneously administer BH therapy through clinically relevant overlying tissue paths using pulses with duration up to 10 ms. A high-voltage electronic pulser was constructed to drive a 1-MHz focused ultrasound transducer to produce shock waves with amplitude capable of generating boiling within the pulse duration in tissue. The system output was characterized by numerical modeling with the 3-D Westervelt equation using boundary conditions established by acoustic holography measurements of the source field. Such simulations were found to be in agreement with directly measured focal waveforms. An existing derating method for nonlinear therapeutic fields was used to estimate in situ pressure levels at different tissue depths. The system was tested in ex vivo bovine liver samples to create BH lesions at depths up to 7 cm. Lesions were also created through excised porcine body wall (skin, adipose, and muscle) with 3–5 cm thickness. These results indicate that the system is capable of producing the necessary output for transcutaneous ablation with BH.
机译:沸腾组织变性(BH)是一种聚焦超声手术的方法,该方法以无创方式施加具有高幅冲击波前沿的毫秒级脉冲,以在组织中产生液化病变。与聚焦超声热疗仪相比,这种技术需要独特的输出,特别是要通过介入组织获得高的原位压力水平。本文描述了一种系统的设计和特性,该系统能够产生必要的压力,以使用持续时间长达10 ms的脉冲通过临床相关的上覆组织路径经皮进行BH疗法。构造了一个高压电子脉冲发生器,以驱动一个1-MHz聚焦超声换能器,以产生振幅能够在组织的脉冲持续时间内产生沸腾的冲击波。系统输出的特征是通过使用3-D Westervelt方程进行数值建模,并通过声场全息图测量声场建立边界条件。发现这种模拟与直接测量的聚焦波形一致。现有的用于非线性治疗领域的降额方法用于估计不同组织深度的原位压力水平。该系统在离体牛肝样本中进行了测试,以产生高达7 cm深度的BH损伤。切除的猪体壁(皮肤,脂肪和肌肉)的厚度为3-5厘米,也会造成病变。这些结果表明该系统能够产生必要的输出,以经BH经皮消融。

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