ThUNDDAR

THERAPY ULTRASOUND VIDEO RESOURCES

We present a series of films about therapy ultrasound and how it works.
We plan to add new stories here in the coming months.

Gail ter Haar introduces ThUNDDAR ThUNDDAR

A beginners guide
A beginners guide

Professor Gail ter Haar and animator AnneMarie Walsh team up to provide an engaging basic explanation of how focused ultrasound can be used both for treatment and to target drug therapy.

5 minutes

A week in the mountains
A week in the mountains

Experts and students meet in Les Houches to share their experience and explore an exciting future. The ThUNDDAR project sponsored 14 British students to attend the meeting.

Shorter version 6 minutes 45 secs. Main film 25 minutes 30 secs.

The case of the disappearing essential tremor
The case of the disappearing essential tremor

Professor Wady Gedroyc and his colleagues at St Mary’s Hospital cure Dinesh Kotecha’s debilitating tremor.

16 minutes

Reducing the pain of bone cancer
More films about the wide range of applications for therapy ultrasound will follow.

Key interviews from Les Houches

Larry Crum
Larry Crum

A long personal history with FUS.

10 minutes

  • Accoustic cavitation and HIFU
  • Killing tissue with temperature, exsanguination in Iraq War
  • Acoustic hemostasis, Centre for Industrial & Medical ultrasound
  • Concept of Doppler and imaging with ultrasound, leading to bloodless surgery
  • Your first magnifying glass as a kid, focus ultrasound like the sun’s rays and treat anywhere in the body
  • My surgeon daughter and the history of minimally invasive surgery
  • With MR guided HIFU, you can cure any disease
  • The treatment of uterine fibroids so reduce hysterectomies, FDA approval but still ‘experimental’
  • Urologists hope prostate cancer therapy using ultrasound would not work!
  • American versus Chinese regulation
  • The future of ultrasound therapy… the future of medicine
Betsy Repasky
Betsy Repasky

The immune system and therapy ultrasound

7 minutes

  • The potential of HIFU to enhance the immune response
  • A non-invasive and versatile technology, getting immune agents into tumours
  • Getting lymphocytes in with HIFU, similar to the problem of getting drugs into tumours
  • Great potential in fibroid and other non-oncologic applications, potential in cancer too
  • Need pre-clinical and animal research
  • Hyperthermia, thermal therapies to kill tumour cells
  • Nanoparticles can be heated up too, much potential
  • Ultrasound cavitation is fascinating, could stimulate immune system
Robin Cleveland
Robin Cleveland

Engineering HIFU, from kidney stones to cancer.

7 minutes

  • Background in fundamental acoustics and sonic booms
  • Shockwaves to break up kidney stones, same principles
  • Kidney stones treatment successful, now for cancer
  • Ultrasound non-invasive and non-ionising
  • Will make serious inroads in ablation of cancer and in drug delivery
  • Chemotherapy drugs are poisonous, so encapsulate them and pop the package at the right place
  • Barriers to ultrasound from conservative surgeons: ‘cancer belongs in a bucket’
  • Regulatory barriers as well as problems of costs of clinical trials
  • Blue skies technologies don’t guarantee a return
  • The virtues of the rigors of engineering… everybody is different, need robust systems and an understanding of physics
Gail ter Haar
Gail ter Haar

A journey towards exciting futures.

8 minutes

  • Therapy ultrasound first developed in the 40s by the Fry brothers
  • Now we have MRI and ultrasound imaging and we can target and monitor what we’re doing
  • Advantages of therapy ultrasound, must be non-invasive to damage only the target, reduce infection
  • Now people have realised chemotherapy has nasty side effects
  • If you can image a part of the body, you can treat it
  • Brain cannot be imaged with ultrasound, but using time-reversal techniques you cab now go through the skull
  • We now need to convince the clinical community that what we say we can do, we actually can do
  • Clinicians busy, stuck in their ways… and devices are not cheap and not small
  • But the treatments and cheap, fast and get quick results.  We have to convince NICE and FDA
  • Ultrasound guidance does not give temperature information.. trials so far are Phase 1 & Phase 2
  • But no other options for patients
  • The future will be very different, for example using low power to assist drug delivery
  • Ultrasound also enhances radiotherapy, attacking hypoxic regions of tumours
  • Exciting work on blood-brain barrier and Alzheimer’s and also for depression etc.
  • The EPSRC has funded ThUNDDAR, to spread the word
Joo Ha Hwang and Afshin Gangi
Joo Ha Hwang and Afshin Gangi

Innovation in the clinical future.

9 minutes

  • Ultrasound has been around a long time, but real progress now and truly non-invasive
  • Huge potential for clinicians, like a Swiss Army knife
  • Dramatic responses in essential tremor, cancer-related pain etc.
  • May replace surgery eventually in many cases
  • Therapeutic ultrasound faces challenges, needs multiple collaboration
  • Clinicians think it is complex & difficult, we must make it accessible and easy to use
  • Challenges have to do with education. It is not actually complex, but must invest time
  • If industry & science play their part, it is not expensive and will become accessible in many settings
  • Not multi-million dollar devices
  • Clinicians don’t believe in it yet, they have been trained to use their hands
  • This is the way to go for young people, you need to learn about HIFU
  • Radiologists in charge of MRI… but with better ultrasound guidance it can move into procedural areas
  • It will be like radiotherapy today… all kinds of uses, it will become and everyday tool for us
  • The area is intellectually stimulating, and we might be implementing care for millions
  • We do this research because oit will have an impact in the future
  • We’re very lucky to do this
Jean-Francois Aubry
Jean-Francois Aubry

From the Curies to the present excitement

7 minutes

  • Organising the winter school in Les Houches, a unique environment
  • Private discussions, get to know each other and the lecturers
  • The students are the future
  • Back in 19th century Pierre & Jacques Curie discovered piezoelectricity
  • Paul Langevin Squeezed crystals to create ultrasound
  • Ultrasound can be focused at an exact location in a non-invasive way, controlling effects in real time
  • You can abate tissue, dissolve blood clots, target drugs etc.
  • You can develop sophisticated devices, but also simple ones
  • You can revolutionise your specialty, for example in glaucoma treatment, cheaply and efficiently
  • Lots of barriers, though patients are easy to convince unlike physicians, which takes time
  • Must prove safety first, then efficacy.  These therapies are getting cheaper and cheaper
  • New low frequency MR in development and need to study smaller, lighter systems