`Twinkling` Ultrasound technology to enhance kidney treatment

Houston: A new ultrasound technology could soon help in overcoming medical challenges associated with kidney stone treatment for astronauts in the space and make it a thing of the past, researchers say.

In space, the threat from kidney stones is greater due to the difficulty of keeping astronauts fully hydrated.

Scientists with the National Space Biomedical Research Institute (NSBRI) are developing an ultrasound technology that detects stones with advanced ultrasound imaging based on a process called "Twinkling Artifact" and provides treatment by "pushing" the stone with focused ultrasound.

This technology could not only be beneficial for kidney stone treatment in space, but also alter health care facilities on Earth.

"Space has demanded medical care technology that is versatile, low-cost and has restricted size. All of these required specifications for use in a space environment are now almost demanded by the general public," NSBRI Smart Medical Systems and Technology Team Principal Investigator Dr Lawrence Crum said.

The project is led by researchers at the Applied Physics Laboratory at the University of Washington (APL-UW), Dr Crum and Co-Investigator Dr Michael Bailey. Bailey said their technology is based on equipment currently available.

"We have a diagnostic ultrasound machine that has enhanced capability to image kidney stones in the body," said Bailey, a principal engineer at APL-UW.

"We also have a capability that uses ultrasound waves coming right through the skin to push small stones or pieces of stones toward the exit of the kidney, so they will naturally pass, avoiding surgery."

Currently on Earth, the preferred removal method is for patients to drink water to encourage the stones to pass naturally, but this does not always work, and surgery is often the only option.

Another factor is that bones demineralize in the reduced-gravity environment of space, dumping salts into the blood and eventually into the urine.

The elevated concentration of salts in the urine is a risk factor for stones.

The ultrasound technology being developed for NSBRI by Crum and Bailey is not limited to kidney stone detection and removal, but also fro diagnosis and therapy.

"It is possible that if a human were in a space exploration environment and could not easily return to Earth, such as a mission to an asteroid or Mars, kidney stones could be a dangerous situation," Crum said.

"We want to prepare for this risk by having a readily available treatment, such as pushing the stone via ultrasound."

Crum, who is a principal physicist at APL-UW, said kidney stones could be a serious problem on a long-duration mission.

Standard ultrasound machines have a black and white imaging mode called B-mode that creates a picture of the anatomy.

They also have a Doppler mode that specifically displays blood flow and the motion of the blood within tissue in colour.

In Doppler mode a kidney stone can appear brightly coloured and twinkling.

The reason for this is unknown, but Crum and Bailey are working to understand what causes the Twinkling Artifact image.

"At the same time, we have gone beyond Twinkling Artifact and utilised what we know with some other knowledge about kidney stones to create specific modes for kidney stones," Bailey said.

The stone moves about one centimetre per second.

"We envision a platform technology that has open architecture, is software-based and can use ultrasound for a variety of applications," he said.

"Not just for diagnosis, but also for therapy." NSBRI’s research portfolio includes other projects seeking to develop smart medical systems and technologies, such as new uses for ultrasound, that provide health care to astronauts in space.

The ultrasound work by Crum and Bailey has also received support from the Defense Advance Research Projects Agency, the National Institutes of Health, and the University of Washington and foundations associated with it to promote commercialisation.

PTI

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