Beyond Imaging
The Amazing Power of Ultrasound: from Destroying Tumors to Healing the Brain, and More!
by
Book Cover & Preview Text
“At the time I was reviewing this chapter, after finishing the first complete draft of the manuscript, the Emmy Award-winning prime time news program 60 Minutes aired a half-hour segment on the recent advances in Alzheimer’s disease (AD) treatment employing MRI-guided focused ultrasound (MRgFUS). A study out of one of the top focused ultrasound (FUS) research centers in the United States reported that the clinical investigators were able to effectively deliver an antibody-based agent designed specifically for treating AD. They were also able to identify a reduction in the levels of beta-amyloid plaques, which can be imaged with MRI, and which have been identified as playing a major role in the pathogenesis of AD. The beta-amyloid peptide comprised of approximately forty amino acids is the main component of the amyloid plaques that form in the brain of people suffering with AD. The plaques appear as small clumps that can block or inhibit cell-to-cell signaling at the synapses that link the neurons together. These new, recently FDA-approved agents function by targeting the beta-amyloid at different stages of plaque formation in order to slow down the progression of the disease. In patients in this new study treated with FUS and the agents, an increase in delivery was observed when compared to the administration of them on their own. Like so many other new generation drugs, the agents (as described earlier in this chapter) are too large to effectively cross the blood-brain barrier (BBB) at levels that can be deemed therapeutic without some type of adjuvant treatment. The enhancement observed in the delivery of the agents with FUS was also found to be associated with an improvement (i.e., mitigation) of the AD symptoms. These results are especially encouraging because the ability to lower beta-amyloid levels in the brain has been shown to slow the progression of the disease. A type of dementia, AD can affect memory and thinking as well as a person’s behavior. If symptoms become especially severe, they can interfere with the person’s most basic daily tasks. Today, as human populations are living longer, AD has become especially problematic, and greater numbers of the elderly are being diagnosed with this debilitating condition. For years now, AD has become an ever-increasing burden on the families who must care for their aging loved ones. Like so many other medical advancements directly linked to the use of FUS, there is finally hope that major improvements in the prognosis of AD patients may soon be realized in our own lifetimes. Parallel to advancements for treating neurological disorders, there is also renewed hope regarding the potential of using MRgFUS for treating brain tumors. This is undoubtedly the result of a surplus of published studies demonstrating that BBB opening with FUS can now be carried out routinely in a safe and effective manner. This includes multiple treatments with increasing accuracy, and in comparatively larger regions of the brain. Perhaps by the time this book is published, the first applications using this approach will also be approved and employed in the clinic for treating various types of brain tumors. This will be especially important for the most deadly of all primary brain cancers, glioblastoma (GBM). Patients diagnosed with GBM, for which there is no cure, will typically die within six months following diagnosis. Even after aggressive treatment that includes surgery and radiotherapy, survival is generally around eighteen months. A number of chemotherapeutic agents and immunotherapy options presently exist for slowing down the growth of GBM. However, again, because of the BBB, they typically can’t reach the tumors at sufficient and uniform levels to be efficacious. This situation is similar for metastatic brain tumors, a well-known example being those derived from primary breast cancer. The results of clinical studies continue to be published in peer-reviewed, scientific journals on an almost weekly basis, mirroring those for treating neurological disorders. These include encouraging results (including for GBM) that demonstrate how increased survival and reduced tumor burden is directly correlated with improved delivery of a range of chemotherapeutics using MRgFUS.”
Formats
Book Details
About the Book
When most of us hear the word ultrasound, we typically think of diagnostic imaging; especially in regard to its use in obstetrics. Ultrasound, however, can also be used for a wide variety of therapeutic applications, which the author has chosen as the theme of this book. The book begins with a primer on sound waves, which are followed with some basics on imaging. Next are descriptions of the evolving technology, with a specific emphasis on medical applications. Examples are given of the different procedures that are carried out using sophisticated, non-invasive, image-guided devices. Each procedure is carefully explained with the help of many detailed illustrations. Examples of these include the destruction of tumors deep within the body using highly focused ultrasound beams. Especially impressive are the treatments that are guided with realtime MRI. One in particular is employed for opening barriers in the brain to facilitate the delivery of a range of agents for treating conditions such as Alzheimer’s disease. For almost thirty years, Victor Frenkel has worked as a teacher, mentor, and research scientist at medical schools, engineering departments, and government institutions. Along the way he made his own contributions in the field of therapeutic ultrasound. These include the development of novel treatment protocols, and also designing and building the devices used to carry them out. Told with easy-to-follow language, including key historical and cultural perspectives, this book is meant for anyone who loves cutting edge technology, especially pertaining to medical treatments.
About the Author
Victor Frenkel, PhD (Author) was born in Montreal, Canada in 1960. After receiving an associate degree in physics, he moved to Israel. For many years, he lived on a kibbutz in the southern desert, served in the military, and completed his undergraduate and graduate studies. He first began working with ultrasound during his dissertation research at the Technion, Israel Institute of Technology. He came to Baltimore for a postdoctoral fellowship in 1999 at the University of Maryland Biotechnology Institute. He then moved on to work as a staff scientist at the National Institutes of Health, applying his expertise and knowledge for translational applications in human health. For three years, he taught biomedical engineering to undergraduate and graduate students at Catholic University of America in Washington, DC. After that, he accepted a position as Associate Professor of Radiology at the University of Maryland School of Medicine in Baltimore and took on the role of founding director of the Translational Focused Ultrasound Research program. He is currently on the faculty at the Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine. For almost thirty years, he has investigated how ultrasound can be used to enhance the delivery of therapeutics in various treatment applications. He has published over one hundred peer-reviewed original research articles, invited review papers, conference proceedings, editorials, book chapters, and books. He lives in central Maryland with his two teenage sons and his twelve-year-old rescue lab, Grover.