Department of Biomedical Engineering, The George Washington University, Washington, DC, USA.
Department of Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
J Ultrasound Med. 2023 Aug;42(8):1699-1707. doi: 10.1002/jum.16189. Epub 2023 Feb 1.
Our previous published studies have focused on safety and effectiveness of using therapeutic ultrasound (TUS) for treatment of type 2 diabetes mellitus (T2DM) in preclinical models. Here we present a set of simulation studies to explore potential ultrasound application schemes that would be feasible in a clinical setting.
Using the multiphysics modeling tool OnScale, we created two-dimensional (2D) models of the human abdomen from CT images captured from one normal weight adolescent patient, and one obese adolescent patient. Based on our previous studies, the frequency of our TUS was 1 MHz delivered from a planar unfocused transducer. We tested five different insonation angles, as well as four ultrasound intensities combined with four different duty factors and five durations of application to explore how these variables effect the peak pressure and temperature delivered to the pancreas as well as surrounding tissue in the model.
We determined that ultrasound applied directly from the anterior of the patient abdomen at 5 W/cm delivered consistent acoustic pressures to the pancreas at the levels which we have previously found to be effective at inducing an insulin release from preclinical models.
Our modeling work indicates that it may be feasible to non-invasively apply TUS in clinical treatment of T2DM.
我们之前的研究主要集中在使用治疗性超声(TUS)治疗 2 型糖尿病(T2DM)的临床前模型的安全性和有效性上。在这里,我们提出了一系列模拟研究,以探索在临床环境中可行的潜在超声应用方案。
我们使用多物理场建模工具 OnScale,根据从一名正常体重青少年患者和一名肥胖青少年患者采集的 CT 图像,创建了人体腹部的二维(2D)模型。基于我们之前的研究,TUS 的频率为 1MHz,由平面非聚焦换能器发出。我们测试了五个不同的照射角度,以及四个超声强度与四个不同的占空比和五个应用持续时间相结合,以探讨这些变量如何影响模型中胰腺和周围组织的峰值压力和温度。
我们确定,从患者腹部的前侧以 5W/cm 的功率直接施加超声,可将一致的声压传递到胰腺,我们之前的研究发现,这种声压水平可有效地从临床前模型中诱导胰岛素释放。
我们的建模工作表明,非侵入性地应用 TUS 可能在临床治疗 T2DM 中是可行的。