Cavitation-enhanced targeted drug delivery and dosing
Various approaches for disrupting target tissue for treatment include identifying a target volume of the target tissue; causing disruption of the target tissue in a region corresponding to the target volume so as to increase tissue permeability therein; computationally generating a tissue permeability map of the target volume; and based on the tissue permeability map, computationally evaluating the disruption of the target tissue within the target volume.
1. A system for causing a disruption of a target tissue for treatment and evaluating the disruption of the target tissue, the system comprising a controller configured to:
prior to causing the disruption of the target tissue, cause an imaging device to acquire a digital representation of at least a portion of a target volume of the target tissue;
cause the disruption of the target tissue in a region corresponding to the target volume by causing an ultrasound transducer to generate and deliver at least one sonication of shaped energy beams to the target volume so as to increase tissue permeability therein;
subsequent to causing the disruption of the target tissue, generate a tissue permeability map indicating regions of increased tissue permeability and estimates of the tissue permeability due to the disruption of the target tissue and computationally evaluate, based on the tissue permeability map, the disruption of the target tissue within the target volume;
compare (i) a mapped region of the tissue permeability map having increased permeability due to the disruption of the target tissue to (ii) the digital representation of the target volume acquired using the imaging device prior to causing the disruption of the target tissue; and
determine that a therapeutic agent should be administered into the target volume only when, based on the comparing, there is a substantial match between (i) the mapped region of the tissue permeability map having increased permeability due to the disruption at the target tissue and (ii) the digital representation of the target volume acquired using the imaging device prior to causing the disruption of the target tissue.
2. The system of claim 1 , wherein the controller is further configured to computationally determine, based on the tissue permeability map, whether tissue within the target volume can admit the therapeutic agent.
3. The system of claim 2 , wherein the controller is further configured to determine that the therapeutic agent should only be administered when tissue within the target volume can admit the therapeutic agent.
4. The system of claim 2 , wherein the controller is further configured to computationally determine whether tissue within the target volume can admit the therapeutic agent based on a molecular size thereof and the estimates of the tissue permeability.
5. The system of claim 2 , wherein the controller is further configured to computationally verify, based on the tissue permeability map, that tissue outside the target volume cannot admit the therapeutic agent to a degree that would trigger an onset of damage.
6. The system of claim 2 , wherein the therapeutic agent comprises at least one of Busulfan, Thiotepa, CCNU (lomustine), BCNU (carmustine), ACNU (nimustine), Temozolomide, Methotrexate, Topotecan, Cisplatin, Etoposide, Irinotecan /SN-38, Carboplatin, Doxorubicin, Vinblastine, Vincristine, Procarbazine, Paclitaxel, Fotemustine, Ifosfamide /4-Hydroxyifosfamide /aldoifosfamide, Bevacizumab, 5-Fluorouracil, Bleomycin, Hydroxyurea, Docetaxel, or Cytarabine (cytosine arabinoside, ara-C)/ara-U.
7. The system of claim 1 , wherein the controller is further configured to cause the ultrasound transducer to generate and deliver at least a second sonication of shaped energy beams to the target volume after administering the therapeutic agent.
8. The system of claim 1 , wherein the tissue permeability map includes a plurality of permeability levels, each permeability level associated with a tissue region in the target volume and indicating a maximal size of molecules capable of entering the associated tissue region.
9. The system of claim 8 , wherein the controller is further configured to determine that the therapeutic agent should be administered into the target volume based on the permeability levels.
10. The system of claim 1 , wherein the controller is further configured to generate the tissue permeability map based at least in part on at least one of MRI contrast imaging, planning or simulation of the at least one sonication, or an acoustic response of the target volume during the disruption.
11. The system of claim 1 , wherein the controller is further configured to cause the imaging device to acquire an image of the target volume during delivery of the at least one sonication and the controller is further configured to adjust a parameter associated with a subsequent sonication based on the image.
12. The system of claim 1 , wherein the controller is further configured to cause the ultrasound transducer to generate a plurality of sonications each delivering shaped acoustic energy to one of a plurality of focal zones in the target volume, the focal zones collectively being coextensive with the target volume.
13. The system of claim 1 , wherein the at least one sonication causes generation and cavitation of microbubbles in the target volume.
14. The system of claim 13 , wherein the controller is further configured to determine that a microbubble seed should be administered to the target volume, wherein the at least one sonication and the microbubble seed cause generation of the microbubbles.
15. The system of claim 1 , wherein the controller is further configured to determine that microbubbles should be administered to the target volume, wherein the at least one sonication causes cavitation of the microbubbles.
16. The system of claim 1 , wherein the mapped region of the tissue permeability map having increased permeability substantially matches the digital representation of the target volume if the mapped region of the tissue permeability map having increased permeability and the digital representation of the target volume are substantially coextensive spatially.
17. The system of claim 1 , wherein the controller is further configured to, prior to determining that the therapeutic agent should be administered into the target volume, cause a subsequent disruption of the target tissue in the region corresponding to the target volume so as to further increase tissue permeability therein if the mapped region of the tissue permeability map having increased permeability is smaller than the digital representation of the target volume.
18. The system of claim 1 , wherein the controller is further configured to, prior to determining that the therapeutic agent should be administered into the target volume, require a rest period to reduce tissue permeability therein if the mapped region of the tissue permeability map having increased permeability is larger than the digital representation of the target volume.