INTRODUCTION To improve patient outcomes (eg, reducing blood loss and infection), practitioners have gravitated toward noninvasive and minimally invasive surgeries (MIS), which demand specialized toolkits. Focused ultrasound, for example, facilitates thermal ablation from a distance, thereby reducing injury to surrounding tissue. Focused ultrasound can often be performed noninvasively; however, it is more difficult to carry out in neuro-oncological tumors, as ultrasound is dramatically attenuated while propagating through the skull. This shortcoming has prompted exploration of MIS options for intracranial placement of focused ultrasound probes, such as within the BrainPath™ (NICO Corporation, Indianapolis, IN). Herein, we present the design, development, and in vitro testing of an image-guided, focused ultrasound prototype designed for use in MIS procedures. This probe can ablate neuro-oncological lesions despite its small size. MATERIALS & METHODS Preliminary prototypes were iteratively designed, built, and tested. The final prototype consisted of three 8-mm-diameter therapeutic elements guided by an imaging probe. Probe functionality was validated on a series of tissue-mimicking phantoms. RESULTS Lesions were created in tissue-mimicking phantoms with average dimensions of 2.5 × 1.2 × 6.5 mm and 3.4 × 3.25 × 9.36 mm after 10- and 30-second sonification, respectively. 30 s sonification with 118 W power at 50% duty cycle generated a peak temperature of 68 °C. Each ablation was visualized in real time by the built-in imaging probe. CONCLUSION We developed and validated an ultrasound-guided focused ultrasound probe for use in MIS procedures. The dimensional constraints of the prototype were designed to reflect those of BrainPath trocars, which are MIS tools used to create atraumatic access to deep-seated brain pathologies.

中文翻译：

---

微创治疗性超声：神经肿瘤学的超声引导超声消融

引言 为了改善患者的治疗效果（例如，减少失血和感染），从业者倾向于无创和微创手术 (MIS)，这需要专门的工具包。例如，聚焦超声有助于远距离进行热消融，从而减少对周围组织的伤害。聚焦超声通常可以无创进行；然而，在神经肿瘤肿瘤中进行比较困难，因为超声波在通过颅骨传播时会显着减弱。这一缺点促使人们探索用于颅内放置聚焦超声探头的 MIS 选项，例如在 BrainPath™ (NICO Corporation, Indianapolis, IN) 内。在此，我们介绍了图像引导的设计、开发和体外测试，聚焦超声原型设计用于 MIS 程序。尽管它的尺寸很小，但这种探针可以消融神经肿瘤病变。材料和方法 初步原型经过反复设计、建造和测试。最终原型由三个由成像探头引导的 8 毫米直径治疗元件组成。探针功能在一系列组织模拟模型上得到验证。结果 在 10 秒和 30 秒超声处理后，在组织模拟模型中产生了平均尺寸分​​别为 2.5 × 1.2 × 6.5 mm 和 3.4 × 3.25 × 9.36 mm 的损伤。在 50% 占空比下 118 W 功率的 30 秒声处理产生了 68 °C 的峰值温度。每次消融都通过内置的成像探头实时可视化。结论 我们开发并验证了一种用于 MIS 程序的超声引导聚焦超声探头。原型的尺寸限制旨在反映 BrainPath 套管针的尺寸限制，这是一种 MIS 工具，用于创建对深层脑部病变的无创伤访问。