Application Of Ultrasound Research Articles

Using Four-Component Instructional Design to Create an Interactive Point-of-Care Ultrasound Curriculum for Physician Associate Students.

Many physician assistant/associate (PA) programs lack point-of-care ultrasound (POCUS) education in the PA curricula and a standardized approach to ultrasound training. The four-component instructional design (4C/ID) model merges 4 concepts for developing effective instructional design content for complex content delivery, such as ultrasound. This research study created an interactive, 2-part ultrasound curriculum with an instructional designer for PA students using the 4C/ID model. Two interactive ultrasound curriculum models were created from the 4C/ID model using a knowledge-based precurriculum quiz, learning tasks with online modules and recordings, part-task practice with ultrasound experts, skills checkoffs, and a postcurriculum quiz including questions on students' perspectives of ultrasound. Two-tailed paired t-test analysis assessed the effectiveness of training. Evaluation of prelearning and postlearning quizzes demonstrated multiple statistically significant assessments supporting the use of instructional design technology for a PA program's ultrasound curriculum. This small study demonstrated that the 4C/ID model may be beneficial for PA POCUS training. The 2-part interactive curriculum improved PA student competency of ultrasound principles and applications and increased confidence for future clinical use of ultrasound.

Non-Invasive Ultrasound Diagnostic Techniques for Steatotic Liver Disease and Focal Liver Lesions: 2D, Colour Doppler, 3D, Two-Dimensional Shear Wave Elastography (2D-SWE), and Ultrasound-Guided Attenuation Parameter (UGAP).

We conducted a comprehensive literature review to evaluate the efficacy of combining two-dimensional shear wave elastography (2D-SWE) and ultrasound-guided attenuation parameter (UGAP) in assessing the risk of progressive metabolic dysfunction-associated steatohepatitis (MASH). This narrative review explores the applications of liver ultrasound in diagnosing metabolic liver diseases, focusing on recent advancements in diagnostic techniques for steatotic liver disease (SLD). Liver ultrasound can detect a spectrum of SLD manifestations, from metabolic dysfunction-associated liver disease (MASLD) to fibrosis and cirrhosis. It is also possible to identify inflammation, hepatitis, hepatocellular carcinoma (HCC), and various other liver lesions. Innovative ultrasound applications, including elastography and UGAP, can significantly enhance the diagnostic capabilities of ultrasound in accurately interpreting liver diseases. Understanding the pathogenesis of liver diseases requires a thorough analysis of their etiology and progression in order to develop sound diagnostic and therapeutic approaches. Chronic liver diseases (CLD) vary in origin, with MASLD affecting approximately 20-25% of the general population. The insidious progression of CLD from inflammation to fibrosis and cirrhosis underscores the need for effective early detection methods. This review aims to highlight the evolving role of non-invasive ultrasound-based diagnostic tests in the early detection and staging of liver diseases. By synthesizing current evidence, we aim to provide an updated perspective on the utility of advanced ultrasound techniques in redefining the diagnostic landscape for metabolic liver diseases.

The Application of Ultrasound Pre-Treatment in Low-Temperature Synthesis of Zinc Oxide Nanorods

Zinc oxide, due to its unique physicochemical properties, including dual piezoelectric and semiconductive ones, demonstrates a high application potential in various fields, with a particular focus on nanotechnology. Among ZnO nanoforms, nanorods are gaining particular interest. Due to their ability to efficiently transport charge carriers and photoelectric properties, they demonstrate significant potential in energy storage and conversion, as well as photovoltaics. They can be prepared via various methods; however, most of them require large energy inputs, long reaction times, or high-cost equipment. Hence, new methods of ZnO nanorod fabrication are currently being sought out. In this paper, an ultrasound-supported synthesis of ZnO nanorods with zinc acetate as a zinc precursor has been described. The fabrication of nanorods included the treatment of the precursor solution with ultrasounds, wherein various sonication times were employed to verify the impact of the sonication process on the effectiveness of ZnO nanorod synthesis and the sizes of the obtained nanostructures. The morphology of the obtained ZnO nanorods was imaged via a scanning electron microscope (SEM) analysis, while the particle size distribution within the precursor suspensions was determined by means of dynamic light scattering (DLS). Additionally, the dynamic viscosity of precursor suspensions was also verified. It was demonstrated that ultrasounds positively affect ZnO nanorod synthesis, yielding longer nanostructures through even reactant distribution. Longer nanorods were obtained as a result of short sonication (1–3 min), wherein prolonged treatment with ultrasounds (4–5 min) resulted in obtaining shorter nanorods. Importantly, the application of ultrasounds increased particle homogeneity within the precursor suspension by disintegrating particle agglomerates. Moreover, it was demonstrated that ultrasonic treatment reduces the dynamic viscosity of precursor suspension, facilitating faster particle diffusion and promoting a more uniform growth of longer ZnO nanorods. Hence, it can be concluded that ultrasounds constitute a promising solution in obtaining homogeneous ZnO nanorods, which is in line with the principles of green chemistry.

Recent Advancements in High-Frequency Ultrasound Applications from Imaging to Microbeam Stimulation.

Ultrasound is a versatile and well-established technique using sound waves with frequencies higher than the upper limit of human hearing. Typically, therapeutic and diagnosis ultrasound operate in the frequency range of 500 kHz to 15 MHz with greater depth of penetration into the body. However, to achieve improved spatial resolution, high-frequency ultrasound (>15 MHz) was recently introduced and has shown promise in various fields such as high-resolution imaging for the morphological features of the eye and skin as well as small animal imaging for drug and gene therapy. In addition, high-frequency ultrasound microbeam stimulation has been demonstrated to manipulate single cells or microparticles for the elucidation of physical and functional characteristics of cells with minimal effect on normal cell physiology and activity. Furthermore, integrating machine learning with high-frequency ultrasound enhances diagnostics, including cell classification, cell deformability estimation, and the diagnosis of diabetes and dysnatremia using convolutional neural networks (CNNs). In this paper, current efforts in the use of high-frequency ultrasound from imaging to stimulation as well as the integration of deep learning are reviewed, and potential biomedical and cellular applications are discussed.

Elucidating siRNA Cellular Delivery Mechanism Mediated by Quaternized Starch Nanoparticles.

Starch-based nanoparticles are highly utilized in the realm of drug delivery taking advantage of their biocompatibility and biodegradability. Studies have utilized Quaternized starch (Q-starch) for small interfering RNA (siRNA) delivery, in which quaternary amines enable interaction with negatively charged siRNA, resulting in self-assembly complexation. Although reports present numerous applications, the demonstrated efficacy is nonetheless limited due to undiscovered cellular mechanistic delivery. In this study, a deep dive into Q-starch/siRNA complexes' cellular mechanism and kinetics at the cellular level is revealed using single-particle tracking and cell population level using imaging flow cytometry. Uptake studies depict the efficient cellular internalization via endocytosis while a significant fraction of complexes' intracellular fate is lysosome. Utilizing single-particle tracking, it is found that an average of 15% of cellular detected complexes escape the endosome which holds the potential for the integration in the cytoplasmatic gene silencing mechanism. Additional experimental manipulations (overcoming endosomal escape) demonstrate that the complex's disassembly is the rate-limiting step, correlating Q-starch's structure-function properties as siRNA carrier. Structure-function properties accentuating the high affinity of the interaction between Q-starch's quaternary groups and siRNA's phosphate groups that results in low release efficiency. However, low-frequency ultrasound (20kHz) application may have induced siRNA release resulting in faster gene silencing kinetics.

Wireless Ultrasound Devices in Anatomy Education: Insights from Medical Undergraduates

AbstractPoint-of-care ultrasound has become an important part of patient care, and the increased use thereof has led to a greater demand for the integration of ultrasound training in the early medical undergraduate curriculum. The use of handheld wireless ultrasound devices is not currently integrated within the undergraduate anatomy medical curriculum of Stellenbosch University and the additional value of wireless ultrasonography, in relation to the clinical practice of anatomical knowledge, therefore, warranted further investigation. This study aimed to explore undergraduate medical students’ perceptions of the use of handheld wireless ultrasound scanning to enhance knowledge and understanding of anatomy for clinical application. During the dissection sessions, students visualized anatomical structures of the musculoskeletal system, by scanning themselves, using handheld, wireless ultrasound devices. After the session, an electronic survey was distributed to the students and three ultrasonography questions were included in the routine practical test. Eighty-one survey responses were collected, with 41 of those responses being completed. The highest student agreement in the Likert scale survey was observed when assessing the convenience of practice of wireless ultrasound devices, while the lowest agreement was reported for confidence in the participant’s capability of generating ultrasound images. Two main themes were developed from the open-ended questions at the end of the survey: the instructional integration of ultrasound and ultrasound within the clinical setting. This research demonstrated that readily available access to handheld wireless ultrasound scanning has the potential to enhance students’ longitudinal learning experience and improve anatomical comprehension. As future clinicians, improved understanding could aid ultrasound application in the clinical realm.

Effect of Physical Separation with Ultrasound Application on Brewers' Spent Grain to Obtain Powders for Potential Application in Foodstuffs.

Brewers' spent grain (BSG) is the primary by-product of beer production, and its potential use in food products is largely dependent on its processing, given its moisture content of up to 80%. This study aimed to evaluate the effects of physical separation with ultrasound application on the color, total phenolic content (TPC), antioxidant activity, proximate composition, total dietary fibers, and particle size distribution of BSG powders. Wet BSG (W) was subjected to two processes: one without ultrasound (A) and one with ultrasound (B). Both processes included pressing, convective air-drying, sieving, fraction separation (A1 and B1 as coarse with particles ≥ 2.36 mm; A2 and B2 as fine with particles < 2.36 mm), and milling. The total color difference compared to W increased through both processes, ranging from 1.1 (B1 vs. A1) to 5.7 (B1 vs. A2). There was no significant difference in TPC, but process B powders, particularly B2, showed lower antioxidant activity against ABTS•+, likely due to the release of antioxidant compounds into the liquid fraction during pressing after ultrasound treatment. Nonetheless, process B powders exhibited a higher content of soluble dietary fibers. In conclusion, ultrasound application shows potential for further extraction of soluble fibers. However, process A might be more practical for industrial and craft brewers. Further studies on the use of the resulting BSG powders as food ingredients are recommended.

Investigation of a cascaded piezoelectric transducer with cone horn for multi-mode power ultrasound application

To meet the ultrasonic application requirement of high power intensity and large mechanical displacement, a new theoretical method is used to study the multi-mode characteristic of the cascaded piezoelectric transducer with cone horn in this paper. Based on equivalent circuit and Kirchhoff’s law to obtain the frequency equation and vibration velocity expression of the transducer, then the resonance frequency and effective electromechanical coupling coefficient can be calculated, the velocity amplification ratio can be obtained in the meantime. This method is distinguish from traditional theoretical analysis, which avoids complex transformation of the multi-excitation sources in cascaded structure, and can calculate more performance parameters. The relationships between these performance parameters and the excitation position of the piezoelectric stack, the length and output end radius of the cone horn are analyzed and compared with the numerical simulation, and the optimized parameters of the transducer size are given. A transducer is manufactured for experimental test, the results show that the experimental value is in good agreement with theoretical calculation and finite element simulation. This work is expected to be used in the optimal analysis of the multi-mode transducer in high power ultrasonic field.

The LUSBI Protocol (Lung Ultrasound/BREST Score/Inferior Vena Cava)-Its Role in a Differential Diagnostic Approach to Dyspnea of Cardiogenic and Non-Cardiogenic Origin.

Background and Objectives: PoCUS ultrasound applications are widely used in everyday work, especially in the field of emergency medicine. The main goal of this research was to create a diagnostic and therapeutic protocol that will integrate ultrasound examination of the lungs, ultrasound measurements of the inferior vena cava (assessment of central venous pressure) and BREST scores (risk stratification for heart failure), with the aim of establishing a more effective differential diagnostic approach for dyspneic patients. Materials and Methods: A cross-sectional study was conducted in the emergency medicine department with the educational center of the community health center of Banja Luka. Eighty patients of both sexes were included and divided into experimental and control groups based on the presence or absence of dyspnea as a dominant subjective complaint. Based on the abovementioned variables, the LUSBI protocol (lung ultrasound/BREST score/inferior vena cava) was created, including profiles to determine the nature of the origin of complaints. The biochemical marker of heart failure NT pro-BNP served as a laboratory confirmation of the cardiac origin of the complaints. Results: The distribution of NT pro BNP values in the experimental group showed statistically significant differences between individual profiles of the LUSBI protocol (p < 0.001). Patients assigned to group B PLAPS 2 had significantly higher average values of NT pro-BNP (20159.00 ± 3114.02 pg/mL) compared to other LUSBI profiles. Patients from the experimental group who had a high risk of heart failure according to their BREST scores also had a significantly higher average maximum expiratory diameter compared to those without heart failure (p = 0.004). A statistically significant difference (p = 0.001) in LUSBI profiles was observed between the groups of patients divided according to CVP categories. Conclusion: The integration of the LUSBI protocol into the differential diagnosis of dyspnea has been shown to be very effective in confirming or excluding a cardiac cause of the disease in patients.

Agreement between manual and automatic ultrasound measurement of the velocity-time integral in the left ventricular outflow tract in intensive care patients: evaluation of the AUTO-VTI® tool.

Transthoracic echocardiography is widely used in intensive care unit (ICU) to manage patients with acute circulatory failure. Recently, automated ultrasound (US) measurement applications have been developed but their clinical performance has not been evaluated yet. The aim of this study was to assess the agreement between automated and manual measurements of the velocity-time integral in the left ventricular outflow tract (VTI-LVOT) using the auto-VTI® tool. This prospective, single-center, interventional study included ICU patients with acute circulatory failure. The examination involved two successive manual measurements of VTI-LVOT (mean of 3 consecutive heartbeats in regular sinus rhythm, and 5 heartbeats in irregular rhythm), followed by a measurement using auto-VTI® software. In patients receiving a fluid challenge, trending ability in detecting fluid responsiveness was also evaluated. Seventy patients were included between January 19, 2020, and September 24, 2020, at the Nîmes University Hospital. The feasibility of the auto-VTI® was 94%. The mean difference between the two methods was 11% with limits of agreement from - 19% to 42%. The proportion of agreement at the 15% difference threshold was 68% [58%; 80%]. The precision and least significant change measured for the manual measurement of VTI were 7.4 and 10.5%, respectively, and by inference for the automated method 28% and 40%. The new auto-VTI® tool, despite interesting feasibility, demonstrated an insufficient agreement with a systematic bias and an insufficient precision limiting its implementation in critically ill patients.Clinical trial registration: ClinicalTrials.gov identifier: NCT04360304.

Enhanced Recovery of Lithium and Cobalt from Spent Lithium-Ion Batteries Using Ultrasound-Assisted Deep Eutectic Solvent Leaching

This study investigates the ultrasound-assisted leaching of Li and Co from spent batteries using a deep eutectic solvent (DES) composed of polyethylene glycol and thiourea. The synergistic effect of ultrasound and DESs was explored to enhance the efficiency of Li and Co recovery. The experimental results demonstrated that ultrasound significantly accelerates the leaching process, achieving up to four times higher recovery rates compared to traditional methods. Optimal leaching conditions were identified at a solid-to-liquid ratio of 0.02 g/g, a temperature of 160 °C, and periodic ultrasound exposure. Under these conditions, the leaching efficiency reached 74% for Li and 71% for Co within 24 h. A kinetic analysis revealed that the ultrasound application shifts the rate-limiting step from a mixed control of mass transfer and chemical reactions to predominantly chemical reaction control, reducing the activation energy by approximately 27%.

Augmented reality for point-of-care ultrasound-guided vascular access in pediatric patients using Microsoft HoloLens 2: a preliminary evaluation.

Conventional ultrasound-guided vascular access procedures are challenging due to the need for anatomical understanding, precise needle manipulation, and hand-eye coordination. Recently, augmented reality (AR)-based guidance has emerged as an aid to improve procedural efficiency and potential outcomes. However, its application in pediatric vascular access has not been comprehensively evaluated. We developed an AR ultrasound application, HoloUS, using the Microsoft HoloLens 2 to display live ultrasound images directly in the proceduralist's field of view. We presented our evaluation of the effect of using the Microsoft HoloLens 2 for point-of-care ultrasound (POCUS)-guided vascular access in 30 pediatric patients. A custom software module was developed on a tablet capable of capturing the moving ultrasound image from any ultrasound machine's screen. The captured image was compressed and sent to the HoloLens 2 via a hotspot without needing Internet access. On the HoloLens 2, we developed a custom software module to receive, decompress, and display the live ultrasound image. Hand gesture and voice command features were implemented for the user to reposition, resize, and change the gain and the contrast of the image. We evaluated 30 (15 successful control and 12 successful interventional) cases completed in a single-center, prospective, randomized study. The mean overall rendering latency and the rendering frame rate of the HoloUS application were 139.30ms and 30 frames per second, respectively. The average procedure completion time was 17.3% shorter using AR guidance. The numbers of puncture attempts and needle redirections were similar between the two groups, and the number of head adjustments was minimal in the interventional group. We presented our evaluation of the results from the first study using the Microsoft HoloLens 2 that investigates AR-based POCUS-guided vascular access in pediatric patients. Our evaluation confirmed clinical feasibility and potential improvement in procedural efficiency.

Ultrasound-Induced Release Profile of Nimodipine from Drug-Loaded Block Copolymers after Singular vs. Repeated Sonication: In Vitro Analysis in Artificial Cerebrospinal Fluid.

Nimodipine still represents a unique selling point in the prevention of delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH). Its intrathecal effect is limited by a low oral bioavailability, leading to the development of nanocarrier systems to overcome this limitation. This study investigated the ultrasound-induced release profile of nimodipine from drug-loaded copolymers in artificial cerebrospinal fluid (CSF) within 72 h after a singular versus repeated sonication. Pluronic® F127 copolymers (Sigma-Aldrich, Taufkirchen, Germany)were loaded with nimodipine by direct dissolution. Spontaneous and on-demand drug release by ultrasound (1 MHz at 1.7 W/cm2) was determined in artificial cerebrospinal fluid using the dialysis bag method. Nimodipine concentrations were measured at predefined time points within 72 h of sonication. Spontaneous release of nimodipine was enhanced by ultrasound application with significantly increased nimodipine concentrations two hours after a repeated sonication compared to a singular sonication (median 1.62 vs. 17.48 µg/µL, p = 0.04). A further trend was observed after four hours (median 1.82 vs. 22.09 µg/µL, p = 0.06). There was no difference in the overall nimodipine concentrations between the groups with a singular versus repeated sonication (357.2 vs. 540.3 µg/µL, p = 0.60) after 72 h. Repeated sonication resulted in an acceleration of nimodipine release from the drug-loaded copolymer in a CSF medium. These findings confirm the proof of principle of an on-demand guidance of nimodipine release from nimodipine-loaded nanodrugs by means of ultrasound, which suggests that evaluating the concept in an animal model may be appropriate.

Robotic Recto-Sigmoid Resection with Total Intracorporeal Colorectal Anastomosis (TICA) in Recurrent Ovarian Cancer.

About 70% of women affected by ovarian cancer experience relapse within 2 years of diagnosis. Traditionally, the standard treatment for recurrent ovarian cancer (ROC) has been represented by systemic chemotherapy.1 Recently, several retrospective studies have suggested that secondary cytoreductive surgery could provide better clinical outcomes than chemotherapy alone, in the case of complete tumor cytoreduction.2,3 About 50% of patients with ROC have a pelvic component of the disease and 22% of patients present isolated pelvic recurrence, often involving the rectum.4,5 Minimally invasive secondary cytoreductive surgery is a feasible option and is associated with favorable perioperative outcomes.6-8 It is crucial to fully explore the peritoneal cavity before starting cytoreductive procedures in order to confirm the absence of carcinomatosis.9 The robotic system facilitates the identification of anatomical structures and makes it easier to perform complex surgical steps in narrow spaces. It also allows the integrated use of surgical tools such as intraoperative ultrasound and indocyanine green application. In this video, we present the case of a 64-year-old woman who experienced a rectal recurrence of ovarian cancer after a platinum-free interval of 12 months. We describe, in a step-by-step manner, the surgical procedure of a robotic rectosigmoid resection with totally intracorporeal colorectal anastomosis (TICA).10-12 RESULTS: Robotic secondary cytoreduction with complete gross resection was achieved. The patient did not report any intraoperative or postoperative complications. Final histology confirmed ROC. Totally robotic rectosigmoid resection is a feasible option in isolated bowel recurrences. Thanks to continuous technical evolution, robot-assisted surgery has the potential to have a central role in the fight against solid tumors. Integration of multiple pre- and intraoperative technologies allows personalized surgery to be performed for each different patient.13,14.

A novel theoretical analysis method for the longitudinal cascaded piezoelectric transducer based on equivalent circuit

Abstract High power ultrasonic transducers are widely used in the fields of ultrasonic cleaning, ultrasonic welding and therapeutic ultrasound. To further improve the ultrasonic intensity and power of piezoelectric transducers for power ultrasound applications, the cascaded piezoelectric transducer have received tons of attention. The electromechanical equivalent circuit, as a classical transducer analysis method, translates the structural and mechanical parameters into the corresponding circuit parameters and helps us to better understand and analyze the performance characteristics of the transducer, which is of great significance for the design and optimization of the transducer. In this paper, a new theoretical analysis method based on the equivalent circuit is proposed for cascaded piezoelectric transducer. In this method, the equivalent circuit of each component of the longitudinal piezoelectric transducer is cascaded, and equivalent circuit is analyzed using the Kirchhoff’s law to obtain the frequency resonance equation of the piezoelectric transducer. This analysis method avoids the complex equivalent transformation of the equivalent circuit including multiple excitation sources and also obtains the vibration velocity of the piezoelectric transducer radiation surfaces, more information on the vibration characteristics of the transducer was gained from the theoretical aspect. Finally, the theoretical analysis results are compared with the finite element simulation analysis and the traditional analysis results for verification.

The Ultrasound Perspective for Sternoclavicular Joint in Spondyloarthritis.

Spondyloarthritis (SpA) is a prevalent genetic disorder that significantly impairs mobility, particularly in the spine, sacroiliac, and peripheral joints. Recent evidence highlights early involvement of the sternoclavicular joint in SpA, which may serve as an initial indicator. Diagnosis often relies on CT and MRI, neglecting ultrasound's potential in identifying SpA-related sternoclavicular arthritis. This review focuses on the joint's anatomy, exploring ultrasound's diagnostic and therapeutic role in SpA-related sternoclavicular arthritis, aiming to provide insights for future ultrasound applications in SpA management.

Modification of pea protein isolates by high-intensity ultrasonication: Functional, structural and nutritional properties

The current study aims to modify the functional, physical, structural and nutritional characteristics of pea protein isolate. High-intensity ultrasound treatment was used at 20 kHz frequency and 25 % amplitude for 10 (US10), 20 (US20), or 30 (US30) min. Results indicated that ultrasound application enhanced the protein solubility and zeta potential. When compared to control samples, the foaming capacity (FC) and stability (FS) as well as emulsion activity (EA) and stability (ES) were also increased from 157.5, 42.03, 46.25 and 53.75 % up to 182.5, 81.57, 72.50 and 67.50 %, respectively. Besides, particle size was found to be lower for ultrasound treated samples (92.9–131.1 nm) in comparison to that of untreated commercial pea protein isolate (161.9 nm). Moreover, while the bioaccessibility of pea protein in untreated sample was calculated as 28.90 %, ultrasonication increased the retention of pea protein up to 49.36 %. It can be concluded from the results that the ultrasonication process can be used as an advantageous, green and non-thermal tool for obtaining protein isolates with improved techno-functional properties and nutritional quality. Therefore, this treatment might improve the characteristics, and thus increase the utilization of plant-based proteins, especially pea protein, in various food systems.

Air-coupled ultrasound using broadband shock waves from piezoelectric spark igniters

We used an optomechanical sensor to study the ultrasound generated by manually operated piezoelectric spark igniters. These low-energy sparks produce short-duration acoustic shock-wave pulses, with sub-microsecond rise times and frequency content extending well beyond 2 MHz in air. The same source–receiver combination was then used to demonstrate broadband characterization of solid (polymer and glass) plates in a simple setup, where single spark events yielded high signal-to-noise ratio data without the need for critical alignment. This setup also enabled us to estimate pressure excursions approaching 105 Pa at millimeter-scale distances from the spark. The results are in large part made possible by the small size, wide bandwidth, and high sensitivity of the optomechanical sensor and might be of interest for air-coupled ultrasound applications in nondestructive testing.

Improved synthesis of cobalt‐doped TiO2 catalyst using ultrasound and subsequent application for Acid Violet 7 degradation

Improved synthesis of cobalt‐doped TiO₂ catalyst using ultrasound and subsequent application for Acid Violet 7 degradation

Ultrasound-Mediated Antibiotic Delivery to In Vivo Biofilm Infections: A Review.

Bacterial biofilms are a significant concern in various medical contexts due to their resilience to our immune system as well as antibiotic therapy. Biofilms often require surgical removal and frequently lead to recurrent or chronic infections. Therefore, there is an urgent need for improved strategies to treat biofilm infections. Ultrasound-mediated drug delivery is a technique that combines ultrasound application, often with the administration of acoustically-active agents, to enhance drug delivery to specific target tissues or cells within the body. This method involves using ultrasound waves to assist in the transportation or activation of medications, improving their penetration, distribution, and efficacy at the desired site. The advantages of ultrasound-mediated drug delivery include targeted and localized delivery, reduced systemic side effects, and improved efficacy of the drug at lower doses. This review scrutinizes recent advances in the application of ultrasound-mediated drug delivery for treating biofilm infections, focusing on in vivo studies. We examine the strengths and limitations of this technology in the context of wound infections, device-associated infections, lung infections and abscesses, and discuss current gaps in knowledge and clinical translation considerations.