The sound of progress

A while back we discussed the important role existing licensed medications could play when applied to the diseases of aging. A comparable discussion can be had about existing non-drug interventions and treatments, such as, in this case the venerable ultrasound. As a technology, ultrasound has much to commend it for medical purposes; in its areas of application it is less expensive, safer and can provide results faster than other methods of medical scanning. This blog discusses how those areas of application are expanding to increase ultrasound's impact upon human longevity.

It shows astonishing range that technology first used to help detect ocean-going submarines might now provide breakthroughs in the detection of human cancer. Towards the end of 2019, such a breakthrough was announced by researchers at Heriot-Watt university. Their creation of a super-resolution methodology for standard contrast-enhanced ultrasound allows precise mapping of the human circulatory system and can detect the vasculature differences that indicate tumour presence and severity, and thus guide treatment priorities. The vascular network is a key component in the development and spread of cancer. It follows that a technique deploying existing clinical equipment to image that network within an examination window measured in minutes could play a significant role in the diagnosis and treatment of multiple cancer types moving forward.

Since ultrasound generates heat it isn't only applied to imaging, but is also finding purchase as a treatment. The TACT (Tulsa-Pro Ablation Clinical Trial) relied upon MRI for imaging in order to guide an ultrasound probe in the very precise ablation of prostate tissue. Of course, prostate cancer can already be tackled with traditional surgery, but achieving a 90% reduction in prostate volume with a minimally-invasive procedure is notable; this is an area where invasive surgery often leaves men struggling with side effects such as impotence and incontinence. The results were also impressive: the cancer became clinically insignificant in 80% of participants, while no trace at all was detectable in 65%.

Finally we'll turn to preliminary results within neurological aging disease. After success with longevity's favourite animal in 2015, a trial investigating ultrasound to clear toxic proteins in the human brain began. At the end of 2019 that trial produced encouraging initial safety results showing that the blood-brain barrier could be safely manipulated as per the initial animal trials. There is obviously more to be discovered, but even if this research does not find the same positive impact on symptoms within humans, the safe opening of the blood-brain barrier provides an effective basis for other interventions. In other neurological progress, researchers at the University of L'Aquila used MRI to target ultrasound ablation within the brain region known as the thalamus. Previously, more invasive treatments such as thalamotomy or deep-brain stimulation were used to reduce tremor and thereby improve quality of life in patients with both Parkinson's disease and essential tremor. However, any kind of surgical entry to the skull carries risks of bleeding and infection, so the ongoing development of MRgFUS (magnetic resonance-guided focused ultrasound) delivers the necessary precision and a far safer means of treatment for a variety of conditions.

Whilst some of the trials discussed above have only partially reported it seems likely that, alongside its many existing uses, ultrasound technology will continue to make a big noise in the treatment of aging disease.

References:

Siemann D. W. (2011). The unique characteristics of tumor vasculature and preclinical evidence for its selective disruption by tumor-vascular disrupting agents. Cancer Treat. Rev. 37 63-74. 10.1016/j.ctrv.2010.05.001.

Nishida N., Yano H., Nishida T., Kamura T., Kojiro M. (2006) Angiogenesis in Cancer. Vasc Health Risk Manag. 2006 Sep; 2(3): 213-219.

Vassilis, S. et al. (2019). Super-Resolution Contrast-Enhanced Ultrasound Methodology for the Identification of In Vivo Vascular Dynamics in 2D. Investigative Radiology: August 2019 - Volume 54 - Issue 8 - p 500-516

Written by: Gavin Ritchie
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