Image guided high intensity focused ultrasound treatment of nerves

• US 8,211,017 B2
• Filed: 09/21/2010
• Issued: 07/03/2012
• Est. Priority Date: 12/16/2003
• Status: Active Grant

• Current Assignee: University of Washington
• Original Assignee: University of Washington
• Inventors: Foley, Jessica L., Vaezy, Shahram, Little, James W.
• Primary Examiner(s): Rozanski, Michael
• Application Number:
  US12/887,178
• Publication Number:
  US 20110040214A1
• Time in Patent Office: 651 Days
• Field of Search: 601/2, 600/411, 600/437, 600/439
• US Class Current: 600/439
• 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 a high intensity focused ultrasound (HIFU) probe to provide therapy to a peripheral nerve at a treatment site in a patient, the method comprising:

(a) moving an external ultrasound imaging probe and an external HIFU probe having a focal point to probe positions, wherein an image provided by the imaging probe includes the treatment site, and wherein the focal point of the HIFU probe is in proximity to the peripheral nerve,

(b) administering a dose of HIFU to the peripheral nerve to achieve a therapeutic effect, and

(c) during the administering, verifying in real time that the focal point of the HIFU probe remains positioned at the treatment site.

2. The method of claim 1, wherein the HIFU probe and ultrasound imaging probe are attached to a frame in a fixed spatial relationship to one another, and wherein moving the ultrasound imaging probe comprises placing the focal point of the HIFU probe at the treatment site.

3. The method of claim 2, further comprising providing an icon on the image corresponding to the position of the focal point of the HIFU probe, and wherein moving the ultrasound imaging probe comprises moving the ultrasound imaging probe until the icon is positioned at the treatment site.

4. The method of claim 1, further comprising tracking the positions of the imaging and HIFU probes independently by a tracking system.

5. The method of claim 4, wherein the position of the focal point of the HIFU probe is determined based on the known position of the HIFU probe'"'"'s focal point with respect to the HIFU probe.

6. The method of claim 1, wherein the therapeutic effect is partial blockage of nerve function.

7. The method of claim 1, wherein the therapeutic effect is complete blockage of nerve function.

8. The method of claim 1, wherein the therapeutic effect is temporary.

9. The method of claim 1, wherein the therapeutic effect is permanent.

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

11. The method of claim 10, wherein the blood soluble agent is an anesthetic.

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

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