20 Participants Needed

Ultrasound Technique for Spinal Tap Assessment

FF
AK
Overseen ByAmina Keita
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: Thomas Jefferson University
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

Trial Summary

What is the purpose of this trial?

The Subharmonic Aided Pressure Estimation (SHAPE) technique is a noninvasive ultrasound-based imaging technique that can estimate ambient pressure using subharmonic emissions from ultrasound contrast agents. Ultrasound contrast agents are encapsulated microbubbles (mean diameter \< 8 µm) with a lipid, protein, or polymer shell that traverse the entire vasculature. When the contrast microbubbles are insonated with relatively high acoustic pressures (\>100-150 kPa), these microbubbles act as nonlinear oscillators yielding energy components in the received echo signals at frequencies ranging from the subharmonic (half of transmit frequency) to higher harmonics and even ultraharmonics. Based on empirical evidence, the subharmonic signal exhibits a sigmoidal relationship with incident acoustic pressure i.e., subharmonic signal can be divided into occurrence, growth and saturation stages. In the growth stage, the subharmonic signal has shown sensitivity to ambient pressure characterized by an inverse linear relationship between subharmonic signal and ambient pressure changes. This inverse linear relationship forms the basis for the SHAPE technique. Several pre-clinical and clinical studies have been conducted to utilize the SHAPE technique for in vivo pressure estimation e.g., to diagnose portal hypertension, to estimate intra-cardiac pressures and to determine interstitial fluid pressures. The core imaging mode underpinning the SHAPE technology (subharmonic imaging) is now available on some commercial scanners. In the proposed pilot study, the SHAPE technique will be leveraged for monitoring intracranial pressure (ICP). The use of SHAPE technique for the ophthalmic artery could potentially provide an accurate noninvasive method of measuring ICP in patients with idiopathic intracranial hypertension (IIH) and other conditions of raised ICP, which would revolutionize the field.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is the ultrasound technique for spinal tap assessment safe for humans?

Research on ultrasound techniques combined with microbubbles shows that they can safely open barriers in the spinal cord without causing nerve damage, even with repeated use, in animal models. This suggests a potential for safe use in humans, but more studies are needed to confirm this.12345

How does the treatment Perflutren lipid microsphere differ from other treatments for spinal tap assessment?

Perflutren lipid microsphere is unique because it uses ultrasound to activate tiny bubbles that can enhance imaging and potentially improve the precision of spinal tap procedures. This approach is different from traditional methods as it combines ultrasound with microbubbles to provide better visualization and assessment.26789

Eligibility Criteria

This trial is for adults over the age of 18 who are scheduled to undergo a lumbar puncture, commonly known as a spinal tap, to measure intracranial pressure (ICP).

Inclusion Criteria

I am scheduled for a spinal tap to check pressure in my brain.
I am over 18 years old.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo noninvasive ultrasound-based imaging using the SHAPE technique to estimate intracranial pressure

1 year

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

  • Perflutren lipid microsphere
Trial Overview The SHAPE technique using Perflutren lipid microsphere contrast agents in ultrasound imaging is being tested as a noninvasive method to estimate ICP. This could be an alternative to direct measurement methods like lumbar punctures.
Participant Groups
1Treatment groups
Experimental Treatment
Group I: SHAPE for ICP diagnosisExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Thomas Jefferson University

Lead Sponsor

Trials
475
Recruited
189,000+

Mayo Clinic

Collaborator

Trials
3,427
Recruited
3,221,000+

Findings from Research

Low intensity pulsed ultrasound (LIPUS) can be effectively delivered to specific regions of lumbar intervertebral discs (IVDs) using advanced simulation techniques, showing a significant focal intensity gain of 5-168, which may enhance healing of injured or degenerated disc tissues.
The simulations indicate that LIPUS treatment can be safely applied with minimal temperature increase (<1 °C) in the target area, suggesting its potential as a non-invasive option for managing discogenic lower back pain.
In silico feasibility assessment of extracorporeal delivery of low-intensity pulsed ultrasound to intervertebral discs within the lumbar spine.Adams, MS., Lotz, JC., Diederich, CJ.[2022]
In a study of 27 patients with failed back surgery syndrome, ultrasound-guided facet joint injections significantly reduced pain levels over six months, with a notable decrease in pain rating scores from 7.0 to 6.0 (p=0.006).
The injections also led to a significant improvement in lumbar flexion, increasing from 50.0° at baseline to 70.0° by the sixth month (p<0.001), indicating enhanced mobility without any reported complications.
Does ultrasound-guided facet joint injection reduce pain and improve mobility in patients with failed back surgery syndrome?Çırak, M., Çağlar Okur, S.[2021]

References

Ultrasound-Induced Blood-Spinal Cord Barrier Opening in Rabbits. [2020]
In silico feasibility assessment of extracorporeal delivery of low-intensity pulsed ultrasound to intervertebral discs within the lumbar spine. [2022]
Indirect MR arthrography of the knee: effects of low-intensity ultrasound on the diffusion rate of intravenously administered Gd-DTPA in healthy volunteers. [2019]
Magnetic resonance imaging-guided focused ultrasound to increase localized blood-spinal cord barrier permeability. [2020]
Does ultrasound-guided facet joint injection reduce pain and improve mobility in patients with failed back surgery syndrome? [2021]
A pilot randomized clinical safety study of sonothrombolysis augmentation with ultrasound-activated perflutren-lipid microspheres for acute ischemic stroke. [2021]
A numerical investigation of passive acoustic mapping for monitoring bubble-mediated focused ultrasound treatment of the spinal cord. [2023]
"Sonology" of programmable intrathecal pumps. [2022]
Intracellular acoustic droplet vaporization in a single peritoneal macrophage for drug delivery applications. [2011]
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