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在金属植入物暴露于交变磁场时,远程声学感应作为一种安全机制。

Remote acoustic sensing as a safety mechanism during exposure of metal implants to alternating magnetic fields.

机构信息

Department of Radiology, UT Southwestern Medical Center, Dallas TX, United States of America.

Department of Internal Medicine, UT Southwestern Medical Center, Dallas TX, United States of America.

出版信息

PLoS One. 2018 May 10;13(5):e0197380. doi: 10.1371/journal.pone.0197380. eCollection 2018.

Abstract

Treatment of prosthetic joint infections often involves multiple surgeries and prolonged antibiotic administration, resulting in a significant burden to patients and the healthcare system. We are exploring a non-invasive method to eradicate biofilm on metal implants utilizing high-frequency alternating magnetic fields (AMF) which can achieve surface induction heating. Although proof-of-concept studies demonstrate the ability of AMF to eradicate biofilm in vitro, there is a legitimate safety concern related to the potential for thermal damage to surrounding tissues when considering heating implanted metal objects. The goal of this study was to explore the feasibility of detecting acoustic emissions associated with boiling at the interface between a metal implant and surrounding soft tissue as a wireless safety sensing mechanism. Acoustic emissions generated during in vitro and in vivo AMF exposures were captured with a hydrophone, and the relationship with surface temperature analyzed. The effect of AMF exposure power, surrounding media composition, implant location within the AMF transmitter, and implant geometry on acoustic detection during AMF therapy was also evaluated. Acoustic emissions were reliably identified in both tissue-mimicking phantom and mouse studies, and their onset coincided with the implant temperature reaching the boiling threshold. The viscosity of the surrounding medium did not impact the production of acoustic emissions; however, emissions were not present when the medium was oil due to the higher boiling point. Results of simulations and in vivo studies suggest that short-duration, high-power AMF exposures combined with acoustic sensing can be used to minimize the amount of thermal damage in surrounding tissues. These studies support the hypothesis that detection of boiling associated acoustic emissions at a metal/tissue interface could serve as a real-time, wireless safety indicator during AMF treatment of biofilm on metallic implants.

摘要

治疗人工关节感染通常需要多次手术和长时间使用抗生素,这给患者和医疗系统带来了巨大的负担。我们正在探索一种非侵入性的方法,利用高频交变磁场(AMF)来消灭金属植入物上的生物膜,这种磁场可以实现表面感应加热。虽然概念验证研究表明 AMF 有能力在体外消灭生物膜,但当考虑加热植入的金属物体时,周围组织热损伤的潜在风险是一个合理的安全问题。本研究的目的是探索检测金属植入物与周围软组织界面沸腾相关声发射的可行性,作为一种无线安全感应机制。使用水听器捕获体外和体内 AMF 暴露过程中产生的声发射,并分析其与表面温度的关系。还评估了 AMF 暴露功率、周围介质成分、植入物在 AMF 发射器中的位置以及植入物几何形状对 AMF 治疗期间声检测的影响。在组织模拟体和小鼠研究中可靠地识别出了声发射,并且它们的出现与植入物温度达到沸点相吻合。周围介质的粘度不影响声发射的产生;然而,当介质是油时,由于沸点较高,没有声发射。模拟和体内研究的结果表明,短时间、高功率 AMF 暴露与声感测相结合可以最小化周围组织的热损伤量。这些研究支持这样一种假设,即在金属/组织界面检测与沸腾相关的声发射可以作为 AMF 治疗金属植入物生物膜过程中的实时无线安全指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8838/5944992/a402909a7490/pone.0197380.g001.jpg

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