The long-term goal of this project is to develop a noninvasive treatment for hypertrophic obstructive cardiomyopathy (HOCM). Focused ultrasound (FUS) is a promising technique for noninvasive thermal ablation. The effort proposed here addresses the main technical challenges to using focused ultrasound therapy in the heart. Specifically, we aim to 1) evaluate the efficacy of magnetic resonance (MR) guided phased array focused ultrasound (FUS) therapy to non-invasively ablate the myocardium, including strategies to target the heart in the presence of beam path obstruction by ribcage and lungs and to synchronize the ablation to the rhythm of the heart, 2) develop robust real-time targeting and temperature monitoring in the heart using magnetic resonance imaging, and 3) perform initial testing and evaluation ofthe system. My immediate career goal is to develop the necessary FUS ablation and MR imaging strategies to make MRguided FUS ablation a noninvasive alternative for the treatment of HOCM. During the mentored phase, I have participated in interdisciplinary collaboration between the Departments of Radiology, Cardiology, and Electrical Engineering at Stanford University. I was able to gain an understanding of cardiac physiology and ofthe principles of therapeutic ultrasound, in addition to further developing my expertise in cardiac magnetic resonance imaging and MR-thermometry. I have accepted a faculty position at University of California San Francisco in the Department of Radiology and Biomedical Imaging where I can independently research and develop MR-guided focused ultrasound techniques with potential clinical applications. My long-term career goal is to continually contribute to the field of MR-guided focused ultrasound therapy and to make a fundamental impact on patient care_by exploring new, less invasive treatment options.

Public Health Relevance

(See inslructions): Hypertrophic obstructive cardiomyopathy (HOCM) has high mortality and morbidity rates. Current treatments are invasive and have limited success rates. Focused ultrasound therapies are showing promising results, but there are technical challenges in applying the method to cardiac ablation. The work proposed here addresses these challenges and if successful, will represent a major advance in the noninvasive treatment of HOCM.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Transition Award (R00)
Project #
5R00HL097030-05
Application #
8823814
Study Section
Special Emphasis Panel (NSS)
Program Officer
Lee, Albert
Project Start
2010-04-01
Project End
2016-11-30
Budget Start
2014-12-01
Budget End
2016-11-30
Support Year
5
Fiscal Year
2015
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94118
Ozhinsky, Eugene; Han, Misung; Bucknor, Matthew et al. (2016) T2-based temperature monitoring in bone marrow for MR-guided focused ultrasound. J Ther Ultrasound 4:26
Han, Misung; Rieke, Viola; Scott, Serena J et al. (2015) Quantifying temperature-dependent T1 changes in cortical bone using ultrashort echo-time MRI. Magn Reson Med 74:1548-55
Bucknor, Matthew D; Rieke, Viola; Do, Loi et al. (2014) MRI-guided high-intensity focused ultrasound ablation of bone: evaluation of acute findings with MR and CT imaging in a swine model. J Magn Reson Imaging 40:1174-80
Salgaonkar, Vasant A; Prakash, Punit; Rieke, Viola et al. (2014) Model-based feasibility assessment and evaluation of prostate hyperthermia with a commercial MR-guided endorectal HIFU ablation array. Med Phys 41:033301
Rieke, Viola; Instrella, Ron; Rosenberg, Jarrett et al. (2013) Comparison of temperature processing methods for monitoring focused ultrasound ablation in the brain. J Magn Reson Imaging 38:1462-71
Scott, Serena J; Prakash, Punit; Salgaonkar, Vasant et al. (2013) Approaches for modelling interstitial ultrasound ablation of tumours within or adjacent to bone: theoretical and experimental evaluations. Int J Hyperthermia 29:629-42
Ellis, Samantha; Rieke, Viola; Kohi, Maureen et al. (2013) Clinical applications for magnetic resonance guided high intensity focused ultrasound (MRgHIFU): present and future. J Med Imaging Radiat Oncol 57:391-9