Detection and control of cavitation during blood–brain barrier opening: Applications and clinical considerations

How is your doctor going to use this knowledge of how to cross the blood brain barrier to deliver therapeutic interventions?
http://scitation.aip.org/content/asa/journal/jasa/136/4/10.1121/1.4900320
Applications and clinical considerations

Meaghan A. O'Reilly¹, Ryan M. Jones¹, Alison Burgess¹, Cassandra Tyson¹ and Kullervo Hynynen¹
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J. Acoust. Soc. Am. 136, 2300 (2014); http://dx.doi.org/10.1121/1.4900320

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Microbubble-mediated opening of the blood–brain barrier (BBB) using ultrasound is a targeted technique that provides a transient time window during which circulating therapeutics that are normally restricted to the vasculature can pass into the brain. This effect has been associated with increases in cavitation activity of the circulating microbubbles, and our group has previously described a method to actively control treatments in pre-clinical rodent models based on acoustic emissions recorded by a single transducer. Recently, we have developed a clinical-scale receiver array capable of detecting bubble activity through ex vivo human skullcaps starting at pressure levels below the threshold for BBB opening. The use of this array to spatially map cavitation activity in the brain during ultrasound therapy will be discussed, including considerations for compensating for the distorting effects of the skull bone. Additionally, results from pre-clinical investigations examining safety and therapeutic potential will be presented, and receiver design considerations for both pre-clinical and clinical scale systems will be discussed.