Biomedical subjects

Robin O Cleveland

Publications and source records attributed to Robin O Cleveland.

14 recordsLinked to original sources

PubMed2006

Derivation of elastic stiffness from site-matched mineral density and acoustic impedance maps.

200 MHz acoustic impedance maps and site-matched synchrotron radiation micro computed tomography (SR-muCT) maps of tissue degree of mineralization of bone (DMB) were used to derive the elastic coefficient c(33) in cross sections of human cortical bone. To accomplish this goal, a model was developed to relate the DMB accessible with SR-muCT to mass density. The formulation incorporates the volume fractions and densities of the major bone tissue components (collagen, mineral and water), and accounts for tissue porosity. We found that the mass density can be well modelled by a second-order polynomial fit to DMB (R(2) = 0.999) and appears to be consistent with measurements of many different types of mineralized tissues. The derived elastic coefficient c(33) correlated more strongly with the acoustic impedance (R(2) = 0.996) than with mass density (R(2) = 0.310). This finding suggests that estimates of c(33) made from measurements of the acoustic impedance are more reliable than those made from density measurements. Mass density and elastic coefficient were in the range between 1.66 and 2.00 g cm(-3) and 14.8 and 75.4 GPa, respectively. Although SAM inspection is limited to the evaluation of carefully prepared sample surfaces, it provides a two-dimensional quantitative estimate of elastic tissue properties at the tissue level.

Acoustics↗

PubMed2006

Producing diffuse ultrasound reflections from medical instruments using a quadratic residue diffuser.

Simultaneous visualization of tissue and surgical instruments is necessary during ultrasound-guided medical procedures. Standard minimally invasive instruments are typically metallic and act as strong specular scatterers. As a result, such instruments saturate the image or disappear according to the angle of incidence, obscuring nearby tissue and making it difficult to determine the instrument's precise location. The objective of this study was to produce diffusive reflections from the surface of surgical instruments for improved visualization in ultrasound. A surface profile based on a 2D quadratic residue diffuser (QRD) was employed, which has been demonstrated to reduce specular reflection in other acoustic applications. The backscattered echo amplitude from the diffusive surface at various angles of insonation was measured and compared to that from unmodified metal surfaces and heart tissue surfaces. The QRD resulted in an 8 dB reduction of the specular signal. Furthermore, the dynamic range for angles up to 75 degrees was less than 20 dB for the QRD and more than 65 dB for a flat surface. The QRD surface produces two beneficial results for the simultaneous imaging of instruments and tissue. First, the conspicuity of diffusive surfaces in ultrasound images is markedly improved in comparison with unmodified metal surfaces. Secondly, the echo amplitude of diffusive metal surfaces differs in mean and standard deviation from that of tissue facilitating image enhancement and segmentation.

Acoustics↗

PubMed2006

Effects of frequency-dependent attenuation and velocity dispersion on in vitro ultrasound velocity measurements in intact human femur specimens.

Numerous studies have shown that ultrasonic velocity measured in bone provides a good assessment of osteoporotic fracture risk. However, a lack of standardization of signal processing techniques used to compute the speed of sound (SOS) complicates the comparison between data obtained with different commercial devices. In this study, 38 intact femurs were tested using a through-transmission technique and SOS determined using different techniques. The resulting difference in measured SOS was determined as functions of the attenuation and the velocity dispersion. A numerical simulation was used to explain how attenuation and dispersion impact two different SOS measurements (group velocity, velocity based on the first zero crossing of the signal). A new method aimed at compensating for attenuation was devised and led to a significant reduction in the difference between SOS obtained with both signal processing techniques. A comparison between SOS and X-ray density measurements indicated that the best correlation was reached for SOS based on the first zero crossing apparently because it used a marker located in the early part of the signal and was less sensitive to multipath interference. The conclusion is that first zero crossing velocity may be preferred to group velocity for ultrasonic assessment at this potential fracture site.

Aged↗

PubMed2006

Ultrasonic contrast agent shell rupture detected by inertial cavitation and rebound signals.

Determining the rupture pressure threshold of ultrasound contrast agent microbubbles has significant applications for contrast imaging, development of therapeutic agents, and evaluation of potential bioeffects. Using a passive cavitation detector, this work evaluates rupture based on acoustic emissions from single, encapsulated, gas-filled microbubbles. Sinusoidal ultrasound pulses were transmitted into weak solutions of Optison at different center frequencies (0.9, 2.8, and 4.6 MHz), pulse durations (three, five, and seven cycles of the center frequencies), and peak rarefactional pressures (0.07 to 5.39 MPa). Pulse repetition frequency was 10 Hz. Signals detected with a 13-MHz, center-frequency transducer revealed postexcitation acoustic emissions (between 1 and 5 micros after excitation) with broadband spectral content. The observed acoustic emissions were consistent with the acoustic signature that would be anticipated from inertial collapse followed by "rebounds" when a microbubble ruptures and thus generates daughter/free bubbles that grow and collapse. The peak rarefactional pressure threshold for detection of these emissions increased with frequency (e.g., 0.53, 0.87, and 0.99 MPa for 0.9, 2.8, and 4.6 MHz, respectively; five-cycle pulse duration) and decreased with pulse duration. The emissions identified in this work were separated from the excitation in time and spectral content, and provide a novel determination of microbubble shell rupture.

Albumins↗

PubMed2006

Quantitative measurements of acoustic emissions from cavitation at the surface of a stone in response to a lithotripter shock wave.

Measurements are presented of acoustic emissions from cavitation collapses on the surface of a synthetic kidney stone in response to shock waves (SWs) from an electrohydraulic lithotripter. A fiber optic probe hydrophone was used for pressure measurements, and passive cavitation detection was used to identify acoustic emissions from bubble collapse. At a lithotripter charging voltage of 20 kV, the focused SW incident on the stone surface resulted in a peak pressure of 43 +/- 6 MPa compared to 23 +/- 4 MPa in the free field. The focused SW incident upon the stone appeared to be enhanced due to the acoustic emissions from the forced cavitation collapse of the preexisting bubbles. The peak pressure of the acoustic emission from a bubble collapse was 34 +/- 15 MPa, that is, the same magnitude as the SWs incident on the stone. These data indicate that stresses induced by focused SWs and cavitation collapses are similar in magnitude thus likely play a similar role in stone fragmentation.

Acoustics↗

PubMed2005

Ultracal-30 gypsum artificial stones for research on the mechanisms of stone breakage in shock wave lithotripsy.

Artificial stones are used in research on the mechanisms of stone breakage in shock wave lithotripsy (SWL) and in assessing lithotripter performance. We have adopted Ultracal-30 gypsum as a model, finding it suitable for SWL studies in vitro, acute animal experiments in which stones are implanted in the kidney, and as a target to compare the in vitro performance of intracorporeal lithotripters. Here we describe the preparation of U-30 stones, their material properties, shock wave (SW) breakage characteristics, and methods used for quantitation of stone fragmentation with this model. Ultracal-30 gypsum cement was mixed 1:1 with water, cast in plastic multi-well plates, then, the stones were liberated by dissolving the plastic with chloroform and stored under water. Stone breakage in SWL was assessed by several methods including measures of the increase in projected surface area of SW-treated stones. Breakage of hydrated stones showed a linear increase in fragment area with increased SW-number and SW-voltage. Stones stored in water for an extended time showed reduced fragility. Dried stones could be rehydrated so that breakage was not different from stones that had never been dry, but stones rehydrated for less than 96 h showed increased fragility to SWs. The physical properties of U-30 stones place them in the range reported for natural stones. U-30 stones in vitro and in vivo showed equivalent response to SW-rate, with approximately 200% greater fragmentation at 30 SW/min compared to 120 SW/min, suggesting that the mechanisms of SW action are similar under both conditions. U-30 stones provide a convenient, reproducible model for SWL research.

Calcium Sulfate↗

PubMed2005

Cavitation detection during shock-wave lithotripsy.

A system was built to detect cavitation in pig kidney during shock-wave lithotripsy (SWL) with a Dornier HM3 lithotripter. Active detection using echo on B-mode ultrasound, and passive cavitation detection using coincident signals on confocal orthogonal receivers, were used to interrogate the renal collecting system (urine) and the kidney parenchyma (tissue). Cavitation was detected in urine immediately upon shock-wave (SW) administration in urine or urine plus X-ray contrast agent but, in native tissue, cavitation required hundreds of SWs to initiate. Localization of cavitation was confirmed by fluoroscopy, sonography and by thermally marking the kidney using the passive cavitation detection receivers as high-intensity focused ultrasound sources. Cavitation collapse times in tissue and native urine were about the same, but less than in urine after injection of X-ray contrast agent. The finding that cavitation occurs in kidney tissue is a critical step toward determining the mechanisms of tissue injury in SWL.

Animals↗

PubMed2005

Time domain simulation of nonlinear acoustic beams generated by rectangular pistons with application to harmonic imaging.

A time-domain numerical code (the so-called Texas code) that solves the Khokhlov-Zabolotskaya-Kuznetsov (KZK) equation has been extended from an axis-symmetric coordinate system to a three-dimensional (3D) Cartesian coordinate system. The code accounts for diffraction (in the parabolic approximation), nonlinearity and absorption and dispersion associated with thermoviscous and relaxation processes. The 3D time domain code was shown to be in agreement with benchmark solutions for circular and rectangular sources, focused and unfocused beams, and linear and nonlinear propagation. The 3D code was used to model the nonlinear propagation of diagnostic ultrasound pulses through tissue. The prediction of the second-harmonic field was sensitive to the choice of frequency-dependent absorption: a frequency squared f2 dependence produced a second-harmonic field which peaked closer to the transducer and had a lower amplitude than that computed for an f1.1 dependence. In comparing spatial maps of the harmonics we found that the second harmonic had dramatically reduced amplitude in the near field and also lower amplitude side lobes in the focal region than the fundamental. These findings were consistent for both uniform and apodized sources and could be contributing factors in the improved imaging reported with clinical scanners using tissue harmonic imaging.

Acoustics↗

PubMed2005

Modeling elastic wave propagation in kidney stones with application to shock wave lithotripsy.

A time-domain finite-difference solution to the equations of linear elasticity was used to model the propagation of lithotripsy waves in kidney stones. The model was used to determine the loading on the stone (principal stresses and strains and maximum shear stresses and strains) due to the impact of lithotripsy shock waves. The simulations show that the peak loading induced in kidney stones is generated by constructive interference from shear waves launched from the outer edge of the stone with other waves in the stone. Notably the shear wave induced loads were significantly larger than the loads generated by the classic Hopkinson or spall effect. For simulations where the diameter of the focal spot of the lithotripter was smaller than that of the stone the loading decreased by more than 50%. The constructive interference was also sensitive to shock rise time and it was found that the peak tensile stress reduced by 30% as rise time increased from 25 to 150 ns. These results demonstrate that shear waves likely play a critical role in stone comminution and that lithotripters with large focal widths and short rise times should be effective at generating high stresses inside kidney stones.

Elasticity↗

PubMed2004

Three-dimensional echocardiography-guided beating-heart surgery without cardiopulmonary bypass: a feasibility study.

BACKGROUND: There is no current acceptable approach for intracardiac beating-heart interventions. We have adapted real-time 3-dimensional echocardiography with specialized instrumentation to facilitate beating-heart repair of atrial septal defects and mitral valve plasty to investigate the feasibility of real-time 3-dimensional echocardiography-guided cardiac surgery. METHODS: In experiment I a modified real-time 3-dimensional echocardiography system with x4 matrix transducer was compared with 2-dimensional echocardiography in the performance of common surgical tasks. Completion times, deviation from an ideal trajectory, and an echogenic target were measured. In experiment II porcine atrial septal defects were closed with an original semiautomatic suturing device (n = 4) and with a 5-mm endoscopic stapler and a pericardial or polytetrafluoroethylene patch (n = 4). In experiment III a pulsatile porcine mitral valve model was developed, and suture placement through the anterior and posterior mitral leaflets was performed (n = 8). During all experiments, the operator was blinded to the target and operated on only with ultrasonic guidance. RESULTS: In experiment I, compared with 2-dimensional echocardiographic guidance, completion times improved by 21% ( P <.01) with high-trajectory accuracy, and suture deviation was significantly smaller (2-dimensional echocardiography, 5.4 +/- 2.7 mm; 3-dimensional echocardiography, 1.7 +/- 0.7 mm; P <.05) in real-time 3-dimensional echocardiography-guided tasks. In experiments II and III in both atrial septal defect closure and mitral valve plasty, real-time 3-dimensional echocardiography provided satisfactory images and sufficient anatomic detail for suturing and patch deployment. All surgical tasks were successfully performed with accuracy. CONCLUSIONS: Real-time 3-dimensional echocardiography provides adequate imaging and anatomic detail to act as a sole guide for surgical task performance. These initial experiments demonstrate the feasibility of beating-heart direct or patch closure of atrial septal defects and mitral valve plasty without cardiopulmonary bypass.

Animals↗

PubMed2004

Effect of stone motion on in vitro comminution efficiency of Storz Modulith SLX.

BACKGROUND AND PURPOSE: During SWL, stone motion secondary to ventilatory motion can be as much as 50 mm. This is much larger than the 4- to 15-mm diameter of the focal regions on most clinical machines. The goal of this study was to determine the effect of stone motion on the fragmentation efficiency of a clinical lithotripter with a small (4-mm) focal spot. MATERIALS AND METHODS: A model stone (6.5 x 7.5 mm) made of gypsum cement was used as an in vitro target for a Storz Modulith SLX lithotripter with a custom-designed waterbath. A motorized positioner was used to translate the stone in order to simulate ventilatory motion. The excursion was variable up to 48 mm (+/- 24 mm about the focus). After treatment by 400 shockwaves, the remnants (> 2 mm) were dried and weighed. RESULTS: Fragmentation efficiency was reduced (P < 0.05) for motion of > or = 10 mm. Similar results were found with different energy levels and firing rates. The reduction in fragmentation efficiency was consistent with calculations of the time the stone was outside the focal region. CONCLUSIONS: Clinically relevant stone motion has a dramatic effect on in vitro comminution. Motion of 10 mm led to a significant reduction in comminution, and for motion > 20 mm, it appeared that three-quarters of the shockwaves missed the stone. These data imply that ventilatory gating or stone tracking may result in fewer shockwaves being required for successful treatment with this lithotripter.

Electromagnetic Phenomena↗

PubMed2004

Experimental validation of a tractable numerical model for focused ultrasound heating in flow-through tissue phantoms.

Heating from high intensity focused ultrasound (HIFU) can be used to control bleeding, both from individual blood vessels as well as from gross damage to the capillary bed. The presence of vascularity can limit one's ability to elevate the temperature owing to convective heat transport. In an effort to better understand the heating process in tissues with vascular structure we have developed a numerical simulation that couples models for ultrasound propagation, acoustic streaming, ultrasound heating and blood cooling in a Newtonian viscous medium. The 3-D simulation allows for the study of complicated biological structures and insonation geometries. We have also undertaken a series of in vitro experiments employing non-uniform flow-through tissue phantoms and designed to provide verification of the model predictions. We show that blood flow of 2 cm/s (6.4 ml/min through a 2.6 mm 'vessel') can reduce peak temperature in a vessel wall by 25%. We also show that HIFU intensities of 6.5 x 10(5) W/m2 can induce acoustic streaming with peak velocities up to 5 cm/s and this can reduce heating near a vessel wall by more than 10%. These results demonstrate that convective cooling is important in HIFU and can be accounted for within simulation models.

Algorithms↗

PubMed2003

Cavitation bubble cluster activity in the breakage of kidney stones by lithotripter shockwaves.

BACKGROUND AND PURPOSE: There is strong evidence that cavitation bubble activity contributes to stone breakage and that shockwave-bubble interactions are involved in the tissue trauma associated with shockwave lithotripsy. Cavitation control may thus be a way to improve lithotripsy. MATERIALS AND METHODS: High-speed photography was used to analyze cavitation bubble activity at the surface of artificial and natural kidney stones during exposure to lithotripter shockwaves in vitro. RESULTS: Numerous individual bubbles formed on the surfaces of stones, but these bubbles did not remain independent but rather combined to form clusters. Bubble clusters formed at the proximal and distal ends and at the sides of stones. Each cluster collapsed to a narrow point of impact. Collapse of the proximal cluster eroded the leading face of the stone, and the collapse of clusters at the sides of stones appeared to contribute to the growth of cracks. Collapse of the distal cluster caused minimal damage. CONCLUSION: Cavitation-mediated damage to stones is attributable, not to the action of solitary bubbles, but to the growth and collapse of bubble clusters.

Calcium Sulfate↗

PubMed2002

Effect of overpressure and pulse repetition frequency on cavitation in shock wave lithotripsy.

Cavitation appears to contribute to tissue injury in lithotripsy. Reports have shown that increasing pulse repetition frequency [(PRF) 0.5-100 Hz] increases tissue damage and increasing static pressure (1-3 bar) reduces cell damage without decreasing stone comminution. Our hypothesis is that overpressure or slow PRF causes unstabilized bubbles produced by one shock pulse to dissolve before they nucleate cavitation by subsequent shock pulses. The effects of PRF and overpressure on bubble dynamics and lifetimes were studied experimentally with passive cavitation detection, high-speed photography, and B-mode ultrasound and theoretically. Overpressure significantly reduced calculated (100-2 s) and measured (55-0.5 s) bubble lifetimes. At 1.5 bar static pressure, a dense bubble cluster was measured with clinically high PRF (2-3 Hz) and a sparse cluster with clinically low PRF (0.5-1 Hz), indicating bubble lifetimes of 0.5-1 s, consistent with calculations. In contrast to cavitation in water, high-speed photography showed that overpressure did not suppress cavitation of bubbles stabilized on a cracked surface. These results suggest that a judicious use of overpressure and PRF in lithotripsy could reduce cavitation damage of tissue while maintaining cavitation comminution of stones.

Equipment Design↗