Catheter for intravascular ultrasound and photoacoustic imaging

A design and a fabrication method for an intravascular imaging and therapeutic catheters for combined ultrasound, photoacoustic, and elasticity imaging and for optical and/or acoustic therapy of hollow organs and diseased blood vessels and tissues are disclosed in the present invention. The invention comprises both a device—optical fiber-based intravascular catheter designs for combined IVUS/IVPA, and elasticity imaging and for acoustic and/or optical therapy—and a method of combined ultrasound, photoacoustic, and elasticity imaging and optical and/or acoustic therapy. The designs of the catheters are based on single-element catheter-based ultrasound transducers or on ultrasound array-based units coupled with optical fiber, fiber bundles or a combination thereof with specially designed light delivery systems. One approach uses the side fire fiber, similar to the one utilized for biomedical optical spectroscopy. The second catheter design uses the micro-optics in the manner of a probe for optical coherent tomography.Board of Regents, University of Texas Syste

Image-Guided Robot-Assisted Techniques with Applications in Minimally Invasive Therapy and Cell Biology

There are several situations where tasks can be performed better robotically rather than manually. Among these are situations (a) where high accuracy and robustness are required, (b) where difficult or hazardous working conditions exist, and (c) where very large or very small motions or forces are involved. Recent advances in technology have resulted in smaller size robots with higher accuracy and reliability. As a result, robotics is fi nding more and more applications in Biomedical Engineering. Medical Robotics and Cell Micro-Manipulation are two of these applications involving interaction with delicate living organs at very di fferent scales.Availability of a wide range of imaging modalities from ultrasound and X-ray fluoroscopy to high magni cation optical microscopes, makes it possible to use imaging as a powerful means to guide and control robot manipulators. This thesis includes three parts focusing on three applications of Image-Guided Robotics in biomedical engineering, including: Vascular Catheterization: a robotic system was developed to insert a catheter through the vasculature and guide it to a desired point via visual servoing. The system provides shared control with the operator to perform a task semi-automatically or through master-slave control. The system provides control of a catheter tip with high accuracy while reducing X-ray exposure to the clinicians and providing a more ergonomic situation for the cardiologists. Cardiac Catheterization: a master-slave robotic system was developed to perform accurate control of a steerable catheter to touch and ablate faulty regions on the inner walls of a beating heart in order to treat arrhythmia. The system facilitates touching and making contact with a target point in a beating heart chamber through master-slave control with coordinated visual feedback. Live Neuron Micro-Manipulation: a microscope image-guided robotic system was developed to provide shared control over multiple micro-manipulators to touch cell membranes in order to perform patch clamp electrophysiology. Image-guided robot-assisted techniques with master-slave control were implemented for each case to provide shared control between a human operator and a robot. The results show increased accuracy and reduced operation time in all three cases

Comparative ergonomic workflow and user experience analysis of MRI versus fluoroscopy-guided vascular interventions:an iliac angioplasty exemplar case study

Purpose A methodological framework is introduced to assess and compare a conventional fluoroscopy protocol for peripheral angioplasty with a new magnetic resonant imaging (MRI)-guided protocol. Different scenarios were considered during interventions on a perfused arterial phantom with regard to time-based and cognitive task analysis, user experience and ergonomics. Methods Three clinicians with different expertise performed a total of 43 simulated common iliac angioplasties (9 fluoroscopic, 34 MRI-guided) in two blocks of sessions. Six different configurations for MRI guidance were tested in the first block. Four of them were evaluated in the second block and compared to the fluoroscopy protocol. Relevant stages’ durations were collected, and interventions were audio-visually recorded from different perspectives. A cued retrospective protocol analysis (CRPA) was undertaken, including personal interviews. In addition, ergonomic constraints in the MRI suite were evaluated. Results Significant differences were found when comparing the performance between MRI configurations versus fluoroscopy. Two configurations [with times of 8.56 (0.64) and 9.48 (1.13) min] led to reduce procedure time for MRI guidance, comparable to fluoroscopy [8.49 (0.75) min]. The CRPA pointed out the main influential factors for clinical procedure performance. The ergonomic analysis quantified musculoskeletal risks for interventional radiologists when utilising MRI. Several alternatives were suggested to prevent potential low-back injuries. Conclusions This work presents a step towards the implementation of efficient operational protocols for MRI-guided procedures based on an integral and multidisciplinary framework, applicable to the assessment of current vascular protocols. The use of first-user perspective raises the possibility of establishing new forms of clinical training and education

In-Suit Doppler Technology Assessment

The objective of this program was to perform a technology assessment survey of non-invasive air embolism detection utilizing Doppler ultrasound methodologies. The primary application of this technology will be a continuous monitor for astronauts while performing extravehicular activities (EVA's). The technology assessment was to include: (1) development of a full understanding of all relevant background research; and (2) a survey of the medical ultrasound marketplace for expertise, information, and technical capability relevant to this development. Upon completion of the assessment, LSR was to provide an overview of technological approaches and R&D/manufacturing organizations

Doctor of Philosophy

dissertationDiabetes mellitus affects 5% of the world's population and requires constant monitoring to avoid fatality. Tight control of blood glucose levels has shown to reduce the long-term effects of diabetes. Finger-stick blood glucose measurements are the gold standard for glucose monitoring that are painful and only provide intermittent glucose values. Continuous glucose monitoring (CGM) is an improvement in this technology but is severely limited in its performance abilities beyond the currently approved implantation time lasting up to a week. CGM is still performed as an adjunct to finger-stick measurements since they are unreliable even during the approved usage durations. Implantation of a biomaterial induces a wound (catheter, hernia meshes, etc.) or disturbance in local tissue (contact lens, etc.). Wound healing response in the host mediates the formation of scar tissue and healing of the injury site. Host foreign body response (FBR) deviates from its healing response in the presence of a foreign body i.e, an implant, and tries to isolate it from the host via fibrous encapsulation. FBR is considered as one of the primary reasons for CGM sensor failure. FBR encapsulates the sensor implant, creating a barrier between the sensing electrode and essential analytes (glucose, oxygen, etc.) required for measuring glucose levels. This phenomenon results in painful and expensive CGM sensor replacements. Work described in this dissertation focuses on improving the clinical performance of CGM sensors by extending their functional lifetimes. Combination device strategies involving the use of a drug (dexamethasone, etc.), or a biologic (VEGF, siRNA, etc.), or a combination of these have been studied to reduce implant-associated FBR. In this dissertation, we targeted mast cells that are believed to orchestrate the FBR by secreting several key granules containing inflammatory cytokines, vasodilators, chemokines, etc. that result in an increased influx of inflammatory cells to the wound site. A novel tyrosine kinase inhibitor- masitinib was used to target the c-KIT receptor on the cell surface of mast cells. Stem cell factor and its ligand c-KIT are considered critical for mast cell survival, proliferation, and degranulation and the hypothesis driving this research is that targeting mast cell degranulation via the c-KIT pathway results in a reduced foreign body response. To test our hypothesis, we developed a local drug delivery formulation comprised of PLGA microsphere drug carriers embedded in a PEG matrix around implants. The effect of the drug was initially evaluated in wild-type (mast cell competent) and sash (mast cell-deficient) mice for up to 28 days. The results from these studies confirmed previous claims that mast cells play an important role in mediating FBR-associated fibrosis around implanted biomaterials and that the use of a mast cell stabilizing tyrosine kinase inhibitor reduced fibrous capsule thickness around implants in wild-type mice but had no effect in sash mice. The drug-releasing coating was then tested in CGM sensors in a wild-type murine percutaneous model for 21 days. Results from the CGM study indicate that drug-releasing coated sensors exhibit relatively stable response compared to control implants, suggesting that reduced fibrosis resulting from stabilizing mast cells results in improving CGM performance. The translation of these results to human subjects would enable better control of diabetes and provide the ability to better diagnose long-term effects of diabetes through long-term continuous glucose monitoring

Real-time laser speckle contrast imaging for intraoperative neurovascular blood flow assessment: animal experimental study

The use of various blood flow control methods in neurovascular interventions is crucial for reducing postoperative complications. Neurosurgeons worldwide use different methods, such as contact Dopplerography, intraoperative indocyanine videoangiography (ICG) video angiography, fluorescein angiography, flowmetry, intraoperative angiography, and direct angiography. However, there is no noninvasive method that can assess the presence of blood flow in the vessels of the brain without the introduction of fluorescent substances throughout the intervention. The real-time laser-speckle contrast imaging (LSCI) method was studied for its effectiveness in controlling blood flow in standard cerebrovascular surgery cases in rat common carotid arteries, such as proximal occlusion, trapping, reperfusion, anastomosis, and intraoperative vessel thrombosis. The real-time LSCI method is a promising method for use in neurosurgical practice. This approach allows timely diagnosis of intraoperative disturbance of blood flow in vessels in cases of clip occlusion or thrombosis. Additionally, LSCI allows us to reliably confirm the functioning of the anastomosis and reperfusion after removal of the clips and thrombolysis in real time. An unresolved limitation of the method is noise from movements, but this does not reduce the value of the method. Additional research is required to improve the quality of the data obtained

Focal Spot, Spring/Summer 1980

https://digitalcommons.wustl.edu/focal_spot_archives/1026/thumbnail.jp

ADVANCED INTRAVASCULAR MAGNETIC RESONANCE IMAGING WITH INTERACTION

Intravascular (IV) Magnetic Resonance Imaging (MRI) is a specialized class of interventional MRI (iMRI) techniques that acquire MRI images through blood vessels to guide, identify and/or treat pathologies inside the human body which are otherwise difficult to locate and treat precisely. Here, interactions based on real-time computations and feedback are explored to improve the accuracy and efficiency of IVMRI procedures. First, an IV MRI-guided high-intensity focused ultrasound (HIFU) ablation method is developed for targeting perivascular pathology with minimal injury to the vessel wall. To take advantage of real-time feedback, a software interface is developed for monitoring thermal dose with real-time MRI thermometry, and an MRI-guided ablation protocol developed and tested on muscle and liver tissue ex vivo. It is shown that, with cumulative thermal dose monitored with MRI thermometry, lesion location and dimensions can be estimated consistently, and desirable thermal lesions can be achieved in animals in vivo. Second, to achieve fully interactive IV MRI, high-resolution real-time 10 frames-per-second (fps) MRI endoscopy is developed as an advance over prior methods of MRI endoscopy. Intravascular transmit-receive MRI endoscopes are fabricated for highly under-sampled radial-projection MRI in a clinical 3Tesla MRI scanner. Iterative nonlinear reconstruction is accelerated using graphics processor units (GPU) to achieve true real-time endoscopy visualization at the scanner. The results of high-speed MRI endoscopy at 6-10 fps are consistent with fully-sampled MRI endoscopy and histology, with feasibility demonstrated in vivo in a large animal model. Last, a general framework for automatic imaging contrast tuning over MRI protocol parameters is explored. The framework reveals typical signal patterns over different protocol parameters from calibration imaging data and applies this knowledge to design efficient acquisition strategies and predicts contrasts under unacquired protocols. An external computer in real-time communication with the MRI console is utilized for online processing and controlling MRI acquisitions. This workflow enables machine learning for optimizing acquisition strategies in general, and provides a foundation for efficiently tuning MRI protocol parameters to perform interventional MRI in the highly varying and interactive environments commonly in play. This work is loosely inspired by prior research on extremely accelerated MRI relaxometry using the minimal-acquisition linear algebraic modeling (SLAM) method