Probability of Cavitation in a Custom Iron-Based Coupling Medium for Transcranial Magnetic Resonance-Guided Focused Ultrasound Procedures.

OBJECTIVE: A coupling bath of circulating, chilled, degassed water is essential to safe and precise acoustic transmittance during transcranial magnetic resonance-guided focused ultrasound (tMRgFUS) procedures, but the circulating water impairs the critical real-time magnetic resonance imaging (MRI). An iron-based coupling medium (IBCM) using iron oxide nanoparticles previously developed by our group increased the relaxivity of the coupling bath such that it appears to be invisible on MRI compared with degassed water. However, the nanoparticles also reduced the pressure threshold for cavitation. To address this concern for prefocal cavitation, our group recently developed an IBCM of electrosterically stabilized and aggregation-resistant poly(methacrylic acid)-coated iron oxide nanoparticles (PMAA-FeOX) with a similar capability to reduce the MR signal of degassed water. This study examines the effect of the PMAA-FeOX IBCM on the cavitation threshold. METHODS: Increasing concentrations of PMAA-FeOX nanoparticles in degassed, deionized water were placed at the focus of two different transducers to assess low and high duty-cycle pulsing parameters which are representative of two modes of focused ultrasound being investigated for tMRgFUS. Passive cavitation detection and high-speed optical imaging were used to measure cavitation threshold pressures. RESULTS: The mean cavitation threshold was determined in both cases to be indistinguishable from the degassed water control, between 6-8 MPa for high duty-cycle pulsing (CW) and between 25.5-26.5 MPa for very low duty-cycle pulsing. CONCLUSION: The findings of this study indicate that an IBCM of PMAA-FeOX nanoparticles is a possible solution to reducing MRI interference from the coupling bath without increasing the risk of prefocal cavitation.

Encapsulation of PI3K Inhibitor LY294002 within Polymer Nanoparticles Using Ion Pairing Flash Nanoprecipitation.

Flash nanoprecipitation (FNP) is a turbulent mixing process capable of reproducibly producing polymer nanoparticles loaded with active pharmaceutical ingredients (APIs). The nanoparticles produced with this method consist of a hydrophobic core surrounded by a hydrophilic corona. FNP produces nanoparticles with very high loading levels of nonionic hydrophobic APIs. However, hydrophobic compounds with ionizable groups are not as efficiently incorporated. To overcome this, ion pairing agents (IPs) can be incorporated into the FNP formulation to produce highly hydrophobic drug salts that efficiently precipitate during mixing. We demonstrate the encapsulation of the PI3K inhibitor, LY294002, within poly(ethylene glycol)-b-poly(D,L lactic acid) nanoparticles. We investigated how incorporating two hydrophobic IPs (palmitic acid (PA) and hexadecylphosphonic acid (HDPA)) during the FNP process affected the LY294002 loading and size of the resulting nanoparticles. The effect of organic solvent choice on the synthesis process was also examined. While the presence of either hydrophobic IP effectively increased the encapsulation of LY294002 during FNP, HDPA resulted in well-defined colloidally stable particles, while the PA resulted in ill-defined aggregates. The incorporation of hydrophobic IPs with FNP opens the door for the intravenous administration of APIs that were previously deemed unusable due to their hydrophobic nature.

Iron-based coupling media for MRI-guided ultrasound surgery.

PURPOSE: In this study, we examine the effects of a recently developed, iron-based coupling medium (IBCM) on guidance magnetic resonance (MR) scans during transcranial, magnetic-resonance-guided, focused ultrasound surgery (tMRgFUS) procedures. More specifically, this study tests the hypotheses that the use of the IBCM will (a) not adversely affect image quality, (b) remove aliasing from small field-of-view scans, and (c) decouple image quality from the motion state of the coupling fluid. METHODS: An IBCM, whose chemical synthesis and characterization are reported elsewhere, was used as a coupling medium during tMRgFUS procedures on gel phantoms. Guidance magnetization-prepared rapid-gradient-echo (MP-RAGE), TSE, and GRE scans were acquired with fields of view of 28 and 18 cm. Experiments were repeated with the IBCM in several distinct flow states. GRE scans were used to estimate temperature time courses as a gel target was insonated. IBCM performance was measured by computing (i) the root mean square difference (RMSD) of TSE and GRE pixel values acquired using water and the IBCM, relative to the use of water; (ii) through-time temperature uncertainty for GRE scans; and (iii) Bland-Altman analysis of the temperature time courses. Finally, guidance TSE and GRE scans of a human volunteer were acquired during a separate sham tMRgFUS procedure. As a control, all experiments were repeated using a water coupling medium. RESULTS: Use of the IBCM reduced RMSD in TSE scans by a factor of 4 or more for all fields of view and nonstationary motion states, but did not reduce RMSD estimates in MP-RAGE scans. With the coupling media in a stationary state, the IBCM altered estimates of temperature uncertainty relative to the use of water by less than 0.2°C. However, with a high flow state, the IBCM reduced temperature uncertainties by the statistically significant amounts (at the 0.01 level) of 0.5°C (28 cm field of view) and 5°C (18 cm field of view). Bland-Altman analyses found a 0.1°C ± 0.5°C difference between temperature estimates acquired using water and the IBCM as coupling media. Finally, scans of a human volunteer using the IBCM indicate more conspicuous grey/white matter contrast, a reduction in aliasing, and a less than 0.2°C change in temperature uncertainty. CONCLUSIONS: The use of an IBCM during tMRgFUS procedures does not adversely affect image quality for TSE and GRE scans, can decouple image quality from the motion state of the coupling fluid, and can remove aliasing from scans where the field of view is set to be much smaller than the spatial extent of the coupling fluid.

Novel acoustic coupling bath using magnetite nanoparticles for MR-guided transcranial focused ultrasound surgery.

PURPOSE: Acoustic coupling baths, nominally composed of degassed water, play important roles during transcranial focused ultrasound surgery. However, this large water bolus also degrades the quality of intraoperative magnetic resonance (MR) guidance imaging. In this study, we test the feasibility of using dilute, aqueous magnetite nanoparticle suspensions to suppress these image degradations while preserving acoustic compatibility. We examine the effects of these suspensions on metrics of image quality and acoustic compatibility for two types of transcranial focused ultrasound insonation regimes: low-duty cycle histotripsy procedures and high-duty cycle thermal ablation procedures. METHODS: Magnetic resonance guidance imaging was used to monitor thermal ablations of in vitro gel targets using a coupling bath composed of various concentrations of aqueous, suspended, magnetite nanoparticles in a clinical transcranial transducer under stationary and flowing conditions. Thermal deposition was monitored using MR thermometry simultaneous to insonation. Then, using normal degassed water as a coupling bath, various concentrations of aqueous, suspended, magnetite nanoparticles were placed at the center of this same transducer and insonated using high-duty cycle pulsing parameters. Passive cavitation detectors recorded cavitation emissions, which were then used to estimate the relative number of cavitation events per insonation (cavitation duty cycle) and the cavitation dose estimates of each nanoparticle concentration. Finally, the nanoparticle mixtures were exposed to low-duty cycle, histotripsy pulses. Passive cavitation detectors monitored cavitation emissions, which were used to estimate cavitation threshold pressures. RESULTS: The nanoparticles reduced the MR signal of the coupling bath by 90% in T2- and T2*-weighted images and also removed almost all imaging artifacts caused by coupling bath motion. The coupling baths caused <5% changes in peak temperature change achieved during sonication, as observed via MR thermometry. At low duty cycle insonations, the nanoparticles decreased the cavitation threshold pressure by about 15 ± 7% in a manner uncorrelated with nanoparticle concentration. At high duty cycle insonations, the 0.5 cavitation duty cycle acoustic power threshold varied linearly with nanoparticle concentration. CONCLUSIONS: Dilute aqueous magnetite nanoparticle suspensions effectively reduced MR imaging artifacts caused by the acoustic coupling bath. They also attenuated acoustic power deposition by <5%. For low duty cycle insonation regimes, the nanoparticles decreased the cavitation threshold by 15 ± 7%. However, for high-duty cycle regimes, the nanoparticles decreased the threshold for cavitation in proportion to nanoparticle concentration.