This is my last week here at Weill, and over the immersion thus far I have gotten to see many, many... many different types of surgeries and medical-clinical procedures. With my little blue note book and cell-phone camera I have been taking notes and jotting down ideas.
The above image shows the enhancing effects of ultrasound on non-invasive drug delivery into tissue. Shown in yellow is the drug perfusion by diffusion mechanisms alone, shown in green is the enhanced delivery of drug with ultrasound The image x-axis is distance into the tissue and y-axis is the amount of drug potentially delivered.
POTENTIAL USES OF THERAPEUTIC ULTRASOUND
My experience from watching surgeries, talking with clinicians, and reviewing literature on PubMed, has created many potential uses for enhanced drug delivery using ultrasound in the clinical setting.
a.) After tumor removal drugs are delivered locally, or the space is filled with a gliadel BCNU wafer. The application of ultrasound may potentially enhance drug diffusion from the locally delivered chemotherapy, thus increasing the chemo's effectiveness.
b.) In trying to fix neural aneurysms the most common techniques are either to pinch it off, or filling it with a coil. The use of ultrasound may be able to activate a locally delivered filling agent, or it may be used to target drugs to reduce the growth and shrink the aneurysm.
Things that must be considered to apply this technique are the following: getting the acoustic energy to the specific location, not damaging the tissue in its pathway and developing a re-usable minimally invasive mechanism.
Possible solutions are:
I. To produce an array that attaches to the head and is able to target the specific location (Like the acoustic version of the gamma knife). Existing mapping technology with MRI/image guided procedures could be used to simplify development
II. Use a high-power catheter based acoustic probe e.g. intravenous ultrasound, that may be guided to the place of interest. This however requires the development of new piezoelectric materials, that can produce large acoustic outputs with small surface area.
The above image is a potential acoustic therapeutic helmet.
2. Prostate Surgery:
Removal of the prostate may be