IMAGE GUIDED HIGH INTENSITY FOCUSED ULTRASOUND TREATMENT OF NERVES

• US 20110009734A1
• Filed: 09/21/2010
• Published: 01/13/2011
• Est. Priority Date: 12/16/2003
• Status: Active Grant

• Current Assignee: University of Washington
• Original Assignee: University of Washington
• Inventors: Little, James W., Vaezy, Shahram, Foley, Jessica L.
• Granted Patent: US 8,206,299 B2
• Time in Patent Office: Days
• US Class Current: 600/411
• CPC Class Codes: A61B 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 5/0035 adapted for acquisition of images from more than one imaging mode, e.g. combining MRI and optical tomography
• CPC Class Codes: A61B 8/0808 for diagnosis of the brain
• CPC Class Codes: A61B 8/13 Tomography A61B8/10, A61B8/12 take precedence; tomography for radiation diagnosis A61B6/02
• CPC Class Codes: A61B 8/4209 by using holders, e.g. positioning frames
• CPC Class Codes: A61B 8/4254 using sensors mounted on the probe
• CPC Class Codes: A61B 8/4272 involving the acoustic interface between the transducer and the tissue
• CPC Class Codes: A61B 8/4281 characterised by sound-transmitting media or devices for coupling the transducer to the tissue
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

A method for using high intensity focused ultrasound (HIFU) to treat neurological structures to achieve a desired therapeutic effect. Depending on the dosage of HIFU applied, it can have a reversible or irreversible effect on neural structures. For example, a relatively high dose of HIFU can be used to permanently block nerve function, to provide a non-invasive alternative to severing a nerve to treat severe spasticity. Relatively lower doses of HIFU can be used to reversibly block nerve function, to alleviate pain, to achieve an anesthetic effect, or to achieve a cosmetic effect. Where sensory nerves are not necessary for voluntary function, but are involved in pain associated with tumors or bone cancer, HIFU can be used to non-invasively destroy such sensory nerves to alleviate pain without drugs. Preferably, ultrasound imaging synchronized to the HIFU therapy is used to provide real-time ultrasound image guided HIFU therapy of neural structures.

Claims

1. A method for using high intensity focused ultrasound (HIFU) to provide therapy to a peripheral nerve of a patient, the method comprising the steps of:

(a) positioning a HIFU therapy device comprising a HIFU transducer in proximity to the peripheral nerve;

(b) verifying a position of the focal point of the HIFU transducer relative to the peripheral nerve using imaging technology; and

(c) administering a dose of HIFU to the peripheral nerve to achieve a therapeutic effect.

2. The method of claim 1, wherein the step of verifying the position of the focal point of the HIFU transducer relative to the peripheral nerve using imaging technology comprises the step of using imaging ultrasound.

3. The method of claim 2, wherein a source of the imaging ultrasound is disposed external to the patient.

4. The method of claim 2, wherein a source of the imaging ultrasound is disposed inside a body of the patient.

5. The method of claim 2, wherein a source of the imaging ultrasound comprises an ultrasound imaging transducer, and wherein both the HIFU transducer and the ultrasound imaging transducer are incorporated into the HIFU therapy device.

6. The method of claim 2, wherein the imaging ultrasound comprises three dimensional (3D) ultrasound.

7. The method of claim 2, wherein the imaging ultrasound comprises two dimensional (2D) ultrasound.

8. The method of claim 1, wherein the step of verifying the position of the focal point of the HIFU transducer relative to the peripheral nerve using imaging technology comprises the step of using magnetic resonance imaging (MRI).

9. The method of claim 1, wherein the step of verifying the position of the focal point of the HIFU transducer relative to the peripheral nerve using imaging technology comprises the steps of:

(a) energizing the HIFU transducer using a relatively lower power level, the relatively low power level being sufficient to change an echogenicity of tissue proximate the focal point, but insufficient to achieve a therapeutic effect; and

(b) using imaging ultrasound to detect the change in echogenicity, thereby verifying the position of the focal point.

10. The method of claim 1, wherein the HIFU transducer is disposed external to the patient.

11. The method of claim 1, wherein the HIFU transducer is disposed inside a body of the patient.

12. The method of claim 1, wherein the step of verifying the position of the focal point of the HIFU transducer relative to the peripheral nerve using imaging technology is performed in real-time.

13. The method of claim 1, further comprising the step of delivering a blood soluble agent to the patient prior to administering the dose of HIFU.

14. The method of claim 13, wherein the blood soluble agent is an anesthetic.

15. The method of claim 1, wherein the step of administering the dose of HIFU to the peripheral nerve comprises the step of using a HIFU power output level ranging from about 50 to about 2000 W/cm².

16. The method of claim 1, wherein the step of administering the dose of HIFU to the peripheral nerve comprises the step of using a HIFU power output level ranging from about 1480 to about 1850 W/cm².