Koninklijke Philips Corporation N.v.

Atl Ultrasound, Inc.

Other

Advanced Technology Laboratories, Inc.

Philips Ultrasound, Inc.

Michalakis Averkiou

Jeffry E Powers

David N Roundhill

Matthew Bruce

John Douglas Fraser

Danny M Skyba

Brent Stephen Robinson

Robert Randall Entrekin

Clifford R Cooley

Gary Allen Schwartz

Edward Lam Shang Leen

William Tao Shi

Juin-Jet Hwang

Peter N Burns

Thomas Gauthier

Damianos Christophides

Marios Lampaskis

Patrick Ren&eacute; Pesque

Konstantina Kyriakopoulou

Theodore J Browning

James Robertson Jago

Patrick G Rafter

Jeremy D Wiggins

Seth E Jensen

Patrick Rene' Pesque

Jeffrey E Powers

Edward J Browning

An ultrasonic therapy system delivers ultrasonic therapy energy to a therapy site in the body which is infused with microbubbles. A system without an image guidance capability has an array transducer which delivers therapy energy, a therapy transducer driver which causes the array transducer to deliver therapeutic energy, a control for controlling the intensity of the therapeutic energy, and a display of the sonotherapy signal strength of the energy and the concentration of microbubbles at the therapy site. A system with ultrasonic imaging capability will display an ultrasound image for therapeutic guidance and a measure of the microbubble concentration. The method of the present invention is performed as an adjunct to a standard drug therapy or other treatment regimen, following such treatment with an infusion of ultrasound and delivery of ultrasound therapy energy.

Method and apparatus for ultrasonic mediation of drug delivery using microbubbles

An ultrasound system and method are described for acquiring a sequence of ultrasound images of the carotid artery during the delivery of a contrast agent. Plaque in the images is identified and a time-intensity curve is calculated for pixels in the images. The intensity values before and after the arrival of contrast are compared to identify pixels or groups of pixels having perfusion. An anatomical image may be formed showing areas in an image of the plaque of the intensity and presence of perfusion, or the perfusion may be quantified by determining the percentage of pixels in the plaque image which exhibit perfusion. The extent and degree of perfusion is an indicator of the risk of plaque particulates in the blood stream which may lead to stroke-related symptoms.

Evaluation of carotid plaque using contrast enhanced ultrasonic imaging

An ultrasonic diagnostic imaging system is described which utilizes one or more transducer arrays affixed to the head of a patient to diagnose and treat stroke victims. The transducer headset produces a two or three dimensional image of the vasculature inside the cranium, preferably assisted by a microbubble contrast agent. A vascular flow map is produced by the system which may be diagnosed for signs of a blood clot. If a blood clot is detected, a therapeutic beam is transmitted while the contrast agent is present to break up the blood clot by the disruption of microbubbles. The headset may also be used in a monitoring application to detect the recurrence of blood clots in a stroke victim.

Ultrasound system for cerebral blood flow imaging and microbubble-enhanced blood clot lysis

A combined ultrasound imaging and therapy transducer () includes a linear array of imaging transducer elements (). First and second linear arrays of therapy transducer elements () extend longitudinally along respective first and second sides of the imaging transducer elements and are canted inwardly toward each other. The imaging and therapy transducer is used with an ultrasound imaging system to locate clots in a region of interest. After the region of interest has been perfused with a microbubble contrast agent, the therapy transducer elements are driven by an amplifier located in the transducer to dissolve the clot. The use of the imaging transducer elements and the therapy transducer elements can be interleaved so that the therapy can be conditioned on an ultrasound image showing substantial destruction of the contrast agent microbubbles, re-perfusion of microbubbles in the region of interest, or the continued presence of the clot.

Combination imaging and therapy transducer with therapy transducer amplifier

An ultrasonic diagnostic imaging system and method are described which produce tissue harmonic images containing both fundamental and harmonic frequency components. Such a blended image takes advantage of the performance possible with the two types of ultrasonic echo information and can advantageously reduce near field clutter while improving signal to noise performance in the far field of the image.

Ultrasonic diagnostic imaging with blended tissue harmonic signals

An ultrasonic imaging apparatus and method are described for monitoring the progress of therapy for pathology such as lesions, tumors, and metastases by means of contrast agent imaging. A sequence of images are acquired as a bolus of contrast agent infuses the tissue containing the pathology. Time-intensity curves of pathology and normal tissue are produced and used to measure perfusion in the pathology as affected by therapy. The motional effects of respiration can be taken into account during image acquisition by detecting the position of a landmark such as the diaphragm in each of the images of the sequence and discarding from processing those images which exhibit a change in the position of the landmark relative to the probe.

Respiratory-gated therapy assessment with ultrasonic contrast agents

An ultrasonic imaging apparatus and method are described for monitoring the progress of therapy for pathology such as lesions, tumors, and metastases by means of contrast agent imaging. A sequence of images are acquired as a bolus of contrast agent infuses the tissue containing the pathology. A contrast wash-in time parameter is calculated for both the tumor and normal tissue, and a ratio is calculated of the two wash-in time parameters (called WITR) which removes the effects of variations in the procedure from one therapy monitoring session to another. A difference curve of the time-intensity curves of the pathology and normal tissue is also produced, which is similarly immune to procedural variations.

Therapy assessment with ultrasound contrast agents

System and method for three dimensional harmonic ultrasound imaging

A combined ultrasound imaging and therapy transducer includes a linear array of imaging transducer elements. First and second linear arrays of therapy transducer elements extend longitudinally along respective first and second sides of the imaging transducer elements and are canted inwardly toward each other. The imaging and therapy transducer is used with an ultrasound imaging system to locate clots in a region of interest. After the region of interest has been perfused with a microbubble contrast agent, the therapy transducer elements are driven by an amplifier located in the transducer to dissolve the clot. The use of the imaging transducer elements and the therapy transducer elements can be interleaved so that the therapy can be conditioned on an ultrasound image showing substantial destruction of the contrast agent microbubbles, re-perfusion of microbubbles in the region of interest, or the continued presence of the clot.

Method of using a combination imaging and therapy transducer to dissolve blood clots

An ultrasound imaging system transmits a broad beam of ultrasound into tissues that are perfused with blood containing microbubbles. The ultrasound has an intensity that is sufficient to destroy the microbubbles in the tissues. A plurality of ultrasound imaging beams are then transmitted into the tissues over a sufficient period to allow the tissues to re-perfuse, and reflections from the transmitted imaging beams are processed to provide a perfusion image. The transmitted microbubble-destroying ultrasound may be in the form of a single beam or a plurality of beams that insonify a substantially larger area than the area insonified by the transmitted imaging beams. As a result, the microbubbles are all destroyed at substantially the same time, and the imaging ultrasound is transmitted only into regions of the tissues from which ultrasound reflections will be received.

Method for ultrasound perfusion imaging

An ultrasonic imaging apparatus and method are described for imaging nonlinear response objects such as contrast agents at greater depths. Transmit pulses include two fundamental frequency components, one of which is to produce harmonic components at the fundamental frequency of the other component. In the presence of a contrast agent these harmonic components are used for imaging the contrast agent. When the contrast agent is not present imaging is performed using the fundamental echoes of the other echo frequency. Preferably the harmonic frequency of the first fundamental component is aligned with the second fundamental frequency. The technique is especially useful when imaging contrast agents at low MI and at significant depths in the body.

Combined fundamental and harmonic ultrasonic imaging at low MI or deeper depths

An ultrasonic imaging method and apparatus are described for imaging the coronary arteries of the heart. The vascular system is infused with an ultrasonic contrast agent. A volumetric region of the heart wall including a coronary artery is three dimensionally scanned. A projection image of the volumetric region is produced from the scanning, providing a two dimensional contrast image of the coronary artery with the appearance of an angiogram. Preferably the coronary artery signals are segmented from contrast signals emanating from the myocardium and the heart blood pool so that the coronary arteries are clearly highlighted and distinct in the ultrasonic angiogram.

Ultrasonic diagnostic imaging transducer with hexagonal patches

Apparatus and methods are disclosed for the detection and imaging of ultrasonic contrast agents. Ultrasonic apparatus is provided for coherent imaging of ultrasonic contrast agents, and for detecting harmonic contrast agents. The inventive apparatus includes a dual display for simultaneously viewing a real time image which displays the location of the contrast agent and a triggered contrast image. Methods of contrast agent detection and imaging include the measurement of perfusion rate characteristics, multizone contrast imaging, multifrequency contrast imaging, tissue perfusion display, and high PRF contrast image artifact elimination.

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Kirkland, WA, United States of America

Michalakis Averkiou