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Ultrasound is Ultra-Cool – The Health Care Blog

JONATHAN DESVERNEY by JONATHAN DESVERNEY
January 25, 2023
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BY KIM BELLARD

AI continues to amaze – ChatGPT is now passing Wharton Enterprise College exams, Microsoft and Google are doubling down of their AI efforts – and I’m as large a fan as anybody, however I wish to speak about a expertise that has been extra underneath the radar, so to talk: ultrasound.  

Sure, ultrasound.  Most of us have in all probability had an ultrasound sooner or later (particularly should you’ve been pregnant) and Dr. Eric Topol continues his years-long quest to interchange the traditional stethoscope expertise with ultrasound, however should you suppose ultrasound is simply one other nifty device within the imaging toolbox, you’ve missed quite a bit. 

Let’s begin with the best use I’ve seen: ultrasound can be utilized for 3D printing.  Inside the physique.  

This information on this dates again to final April, when researchers from Concordia College printed their findings in Nature (I discovered about it final week).  As a substitute of the extra frequent “Additive Manufacturing” (AM) method to 3D printing, these researchers use Direct Sound Printing (DSP).  

The paper summarizes their outcomes: “To point out distinctive future potentials of DSP, functions equivalent to RDP [Remote Distance Printing] for inside physique bioprinting and direct nanoparticle synthesizing and pattering by DSP for integrating localized floor plasmon resonance with microfluidics chip are experimentally demonstrated.”

As lead writer Mohsen Habibi defined it: 

We discovered that if we use a sure kind of ultrasound with a sure frequency and energy, we will create very native, very centered chemically reactive areas.  Principally, the bubbles can be utilized as reactors to drive chemical reactions to remodel liquid resin into solids or semi-solids.

The authors imagine that DSP can have functions the place AM can’t be used, significantly as a result of sound can penetrate objects that gentle can not (e.g., the human physique).  Bioprinting contained in the physique isn’t, in itself, new, however has required open surgical procedure, which DSP wouldn’t.  “DSP introduces the opportunity of noninvasive deep contained in the physique printing,” they explicitly level out.  

“Additionally we will do the repairing of inside bio-organs. That’s a future risk,” corresponding writer Muthukumaran Packirisamy stated.  Right here’s their video:

I’ve been fascinated with 3D printing for a very long time, particularly for its healthcare-related makes use of (e.g.., prescribed drugs, blood vessels, prosthetic gadgets, even organs), however inform me we’ll be capable of do these noninvasively, utilizing sound waves – effectively, take into account me entranced.  

————-

All that’s cool sufficient, however ultrasound is getting used for a lot of extra healthcare functions, equivalent to destruction of tumors.  In truth, that was one of many motivations for the Concordia efforts; Professor Packirisamy famous: “Ultrasonic frequencies are already being utilized in damaging procedures like laser ablation of tissues and tumours. We needed to make use of them to create one thing.” 

“Centered ultrasound” is the time period generally used; there’s truly a Centered Ultrasound Basis. “Centered ultrasound is a noninvasive therapeutic expertise,” Dr. Neal Kassell, founder and chairman of the Centered Ultrasound Basis, instructed CNN. “We’ve stated that centered ultrasound is probably the most highly effective sound you’ll by no means hear, however sound that sometime might save your life.”

A few of the makes use of embrace:

  • Earlier this month Canadian surgeons used ultrasound to ship chemotherapy to an inoperable mind tumor, the primary time this has been achieved.  “Centered ultrasound is an revolutionary and non-invasive method to extra successfully ship chemotherapy on to the tumour,” one of many researchers stated. “Our hope is that this continued analysis will carry us nearer to enhancing remedies to assist change the course of the illness.”
  • Centered ultrasound has been proven to be equally efficient in ache administration and high quality of life measures for painful bone metastases as exterior radiation beam remedy, with low opposed even charges.  
  • Late final 12 months the FDA accepted centered ultrasound to deal with the second aspect of sufferers with important tumors; use for the primary aspect was accepted in 2016.  New analysis confirmed the long run effectiveness of its use for important tremors.
  • Researchers at UT Southwestern are utilizing high-intensity centered ultrasound to deal with treatment refractory tremor in important tremor and tremor-dominant Parkinson’s Illness, which the researchers imagine “allows extra exact focusing on of the mind, decreases remedy instances, reduces unintended effects, and improves remedy response.”  
  • Researchers at West Virginia College Rockefeller Neuroscience Institute used Low-intensity centered ultrasound (LIFU) within the remedy of Alzheimer’s sufferers.  “This examine can also be a significant step ahead for the thrilling risk of mixing centered ultrasound with focused supply of medicines or antibodies that usually have restricted functionality to cross the blood mind barrier from the blood to the mind.” 
  • Equally, researchers at Yonsei College School of Drugs (South Korea) discovered that centered ultrasound improved the supply of Alzheimer’s medication by over eight instances.  “Whereas there isn’t a full treatment for dementia, we hope that open BBB [blood brain barrier] surgical procedure utilizing FUS surgical procedure may also help give hope to dementia sufferers,” the lead researcher stated.
  • LIFU is displaying “promising outcomes” for remedy of main depressive dysfunction, in line with a paper from Delft College.  The paper describes LIFU as “an rising neuromodulation methodology with disruptive potential because it permits for non-invasive stimulation throughout the entire mind with milimetre precision.”
  • Centered ultrasound has been discovered protected and efficient for intermediate danger prostate most cancers.  
  • A 2020 examine steered that centered ultrasound may very well be used for sufferers with melancholy or obsessive-compulsive dysfunction.  “We demonstrated that FUS is efficient in considerably enhancing signs of sufferers with treatment-resistant OCD and melancholy,” the lead writer stated.

That’s on no account a whole record. The Centered Ultrasound Basis claims that centered ultrasound is at present (at this writing) being utilized by 65 machine producers, for 170 medical indications, in 424 analysis websites and 895 remedy websites.  Spectacular numbers, however nonetheless small within the scheme of healthcare. It warns:

Sadly, the evolution of a brand new therapeutic medical machine from idea to straightforward of care can take many years. Difficult and inefficient, the method requires the interplay of many organizations with differing agendas and timelines. There are additionally quite a few expertise, financial, regulatory and reimbursement obstacles to beat.

Too usually, the mechanisms that healthcare has developed supposedly to guard us additionally work in opposition to us.  Because the Basis additionally warns: “Many years is just too lengthy for sufferers and their households to attend for medical breakthroughs.

———–

Clifford Marks, MD, writes in The New Yorker about ultrasound changing the stethoscope, citing miniaturization, decrease prices, and software of AI as components, however I believe he’s not being bold sufficient.  As Diku Mandavia, MD, instructed him, “However ultrasound—it’s low-cost, no radiation, has a lot worth for affected person care . . . it’s going to be ubiquitous.”  

Let’s hope so.  

Kim is a former emarketing exec at a significant Blues plan, editor of the late & lamented Tincture.io, and now common THCB contributor.



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