Methods of enhancing delivery of drugs using ultrasonic waves and systems for performing the same
Methods and systems for inducing and passively detecting stable cavitation and/or inertial cavitation for targeted drug delivery across a biological membrane are disclosed. Such methods include administering vesicles having a nucleating agent and a therapeutic drug to a vascular system of a patient, and providing an active interval of ultrasonic exposure substantially throughout a targeted treatment zone. The ultrasonic exposure is produced by a source transducer at a specified fundamental frequency, amplitude, duty cycle, and duration. The methods also include detecting a scattered ultrasonic wave, where the scattered ultrasonic wave is received by a detection transducer. Detection of the scattered ultrasonic wave is indicative of stable and/or inertial cavitation. The ultrasonic exposure is provided intermittently in the active intervals separated by rest periods, and substantially less ultrasonic exposure is provided during the rest period than during the active interval.
1. A method for inducing and passively detecting stable cavitation for targeted drug delivery across a biological membrane, comprising:
administering vesicles comprising a nucleating agent and a therapeutic drug to a target vascular system of a patient;
providing intermittent active intervals of ultrasonic exposure substantially throughout a targeted treatment zone within the vascular system of the patient, said active intervals each lasting an active interval duration and being separated by rest periods, each rest period lasting a rest period duration during which no ultrasonic energy is provided, wherein the ultrasonic exposure is produced by a source transducer at a specified fundamental frequency, amplitude, duty cycle, and duration;
detecting a scattered ultrasonic wave, wherein the scattered ultrasonic wave is received by a detection transducer and the scattered ultrasonic wave comprises a derivative frequency of the fundamental ultrasonic frequency comprising at least one of a subharmonic frequency and an ultraharmonic frequency, wherein detection of the derivative frequency is indicative of stable cavitation; and
modifying the active interval duration and rest period duration to maintain stable cavitation by leaving the source transducer on when scattered ultrasonic waves of the derivative frequency are detected, and initiating a rest period when scattered ultrasonic waves of the derivative frequency decrease or are not detected.
2. The method for inducing and passively detecting stable cavitation of claim 1 , wherein the method increases permeability of an endothelium of the patient to passage of the therapeutic drug across the endothelium.
3. The method for inducing and passively detecting stable cavitation of claim 1 , wherein the source transducer and the detection transducer is selected from the group consisting of an annular transducer array, a linear transducer array, and a two-dimensional transducer array.
4. The method for inducing and passively detecting stable cavitation of claim 1 , wherein the detection transducer comprises a passive cavitation detector selected from the group consisting of a hydrophone and a transducer array.
5. The method for inducing and passively detecting stable cavitation of claim 1 , wherein the source transducer produces a fundamental ultrasonic frequency from about 100-kHz to about 15-MHz.
6. The method for inducing and passively detecting stable cavitation of claim 1 , wherein the vesicles are echogenic liposomes.
7. The method for inducing and passively detecting stable cavitation of claim 1 , further comprising monitoring the scattered ultrasonic waves received by the detection transducer and adjusting the pressure amplitude, duty cycle, duration of the ultrasonic exposure produced by the source transducer and duration of the rest period in order to maintain stable cavitation.
8. The method for inducing and passively detecting stable cavitation of claim 1 , wherein the targeted treatment zone comprises atheromatous plaques accumulated subendothelially by the patient.
9. The method for inducing and passively detecting stable cavitation of claim 1 , wherein the fundamental frequency, amplitude, duty cycle, and duration of the ultrasonic exposure is predetermined based on the excitation properties of the nucleating agent and the permeability of the biological membrane.
10. The method according to claim 1 wherein the rest period durations are between 100 milliseconds and 5 minutes and the active interval durations are between 10 milliseconds and five minutes.
11. The method according to claim 1 wherein the rest period durations are between 1 second and 60 seconds and the active interval durations are between 10 milliseconds and 10 seconds.
12. The method according to claim 1 wherein the rest period durations are between 1 second and 30 seconds.
13. The method according to claim 1 wherein the active interval durations are 8.5 seconds.
14. The method for inducing and passively detecting stable cavitation of claim 1 further comprising providing an active interrogation ultrasound pulse after the duration of one of the rest periods, wherein if the scattered ultrasonic wave comprising the derivative frequency is detected, then the vesicles comprising the nucleating agent and the therapeutic drug are positioned proximate to the targeted treatment zone of the patient and an active interval is resumed, and if the scattered ultrasonic wave comprising the derivative frequency is not detected, a rest period is re-initiated.
15. The method for inducing and passively detecting stable cavitation of claim 14 , wherein the scattered ultrasonic wave includes a plurality of ultraharmonic frequencies of the fundamental ultrasonic frequency.
16. The method for inducing and passively detecting stable cavitation of claim 14 , wherein the scattered ultrasonic wave includes a plurality of ultraharmonic frequencies of the fundamental ultrasonic frequency.
17. The method for inducing and passively detecting stable cavitation of claim 1 , wherein the nucleating agent is selected from the group consisting of nanobubbles, microbubbles, and ultrasound contrast agents.
18. The method for inducing and passively detecting stable cavitation of claim 17 , wherein the ultrasound contrast agent is perflutren-lipid microspheres.