[HN Gopher] Focused Ultrasound
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       Focused Ultrasound
        
       Author : birriel
       Score  : 121 points
       Date   : 2023-10-01 14:02 UTC (8 hours ago)
        
 (HTM) web link (twitter.com)
 (TXT) w3m dump (twitter.com)
        
       | aaron695 wrote:
       | The Tricorder moonshot was a stupid waste of time with their
       | impossible stupid rules.
       | 
       | A cheap conventual ultrasound in a stick would be a tricorder
       | moment. Hook in a mobile phone and 3D analyzing humans or pets or
       | livestock or many inanimate things becomes software.
       | 
       | This is cool and all, but unless you get the tech out of their
       | hands it'll go nowhere for decades. Just like we've stagnated
       | with conventual ultra sound.
       | 
       | The cost needs to be smashed down. It shouldn't take a moonshot.
       | This is old tech that's not hugely complicated.
       | 
       | Get these down to $50 - https://www.aliexpress.com/w/wholesale-
       | ultrasound-transducer...
        
         | mschuster91 wrote:
         | > The cost needs to be smashed down. It shouldn't take a
         | moonshot. This is old tech that's not hugely complicated.
         | 
         | The tech is not the problem, the _certifications_ are. It 's
         | incredibly expensive and onerous to bring new medical device
         | designs to market, and for good reasons - if it were easier,
         | you'd get _even more_ quackery than you already have now (e.g.
         | homeopathy, penis enhancement pills,  "nutritional"
         | supplements).
         | 
         | The same is true for airplanes. Your run-off-the-mill Cessna?
         | Its design dates back to the 50s. Almost all of GA _still_ runs
         | with fucking lead in the fuel because it took the FAA over 12
         | years to get it certified, and even in the US it is estimated
         | to take until 2026 (!) until G100UL is widely available. Europe
         | doesn 't even have a timeframe.
         | 
         | [1] https://en.wikipedia.org/wiki/Avgas#G100UL
        
         | MauranKilom wrote:
         | Not completely objecting to this idea, but even in ideal
         | scenarios with high-tech hardware and specialized setup,
         | getting useful US image quality can be non-trivial and requires
         | training and expertise. I can conceivably see that these are to
         | some extent technical limitations that can be overcome for some
         | level of mass-adoption. However, I don't see what use cases you
         | have in mind that don't require a doctor for interpretation
         | anyway (in which case having a professional device and the
         | required expertise present in the facility is much simpler and
         | cheaper than putting it in the hands of every patient).
         | 
         | But also, particularly for pets I believe anything with a non-
         | negligible amount of fur or similar (i.e. anything that is not
         | just bare skin) will be fundamentally impossible to achieve
         | good enough acoustic coupling for. Unless you also sell shaving
         | equipment with it. Anything with bone in the way (e.g. a
         | ribcage with gaps smaller than a human one) is also more or
         | less out.
         | 
         | For inanimate objects I really wonder what use cases you have
         | in mind. Acoustic properties (and coupling) are even more of a
         | variable there...
        
       | glfharris wrote:
       | Describing it as a best kept secret seems unnecessarily
       | adversarial. The medical community aren't jealously guarding
       | treatments from the populace.
       | 
       | Arguably shock wave lithotripsy, a common method for breaking up
       | kidney stones, could be described as focused ultrasound.
        
         | mmastrac wrote:
         | I think it's a figure of speech meaning that it's just not
         | widely known.
        
       | jharohit wrote:
       | Interesting - have a friend going through Prostate Cancer and all
       | docs here in Singapore have suggested surgery + chemo. I noticed
       | in Steve's shared PDF that Prostate Cancer has already crossed
       | the FDA Approval and Reimbursement stage. Anyone had any personal
       | experiences in using HIFU (high intensity focussed ultrasound)?
       | Specifically the stage up to which it is effective over
       | surgery+chemo
       | 
       | My data sources: -
       | https://cdn.fusfoundation.org/2023/02/06115144/Focused-Ultra... -
       | https://www.mayoclinic.org/medical-professionals/urology/new...
        
         | gadders wrote:
         | You might find this podcast of interest. The guy talks about
         | his experience of the TULSA procedure. They're kind of cynical
         | about the state of prostate treatment in general but seem keen
         | on this procedure.
         | 
         | https://www.podchaser.com/podcasts/starting-strength-radio-9...
        
       | _Microft wrote:
       | Via Nitter:
       | 
       | https://nitter.net/FutureJurvetson/status/170830632272960759...
        
       | caycep wrote:
       | From the brain side, those of us who remember the pallidotomy and
       | thalamotomy days, the "noninvasive" part is a marketing misnomer.
       | It's invasive (it's a lesioning/ablation therapy); it just
       | doesn't require a pallidotomy. But it's a shockingly effective
       | tactic; there's a steady stream of patients rolling in the office
       | with mild symptoms who are willingly requesting to have a hole
       | burned in their head.
       | 
       | (Also it's turning out not to be nearly as effective in treating
       | symptoms as deep brain stimulation)
        
       | izoow wrote:
       | I remember randomly visiting a lecture of one of my professors
       | that specializes in high performance computing, he was showing
       | off the research they do and it was regarding computing the
       | necessary "parameters" for this. Apparently calculating the
       | parameters for a single patient to focus just the right spot and
       | not damage anything is a task that takes several hours on a
       | supercomputer. This might've been like 5 years ago.
        
       | gadders wrote:
       | I recently learnt about this procedure for prostate cancer -
       | TULSA (Transurethral Ultrasound Ablation)
       | 
       | https://buschcenter.com/tulsa-procedure/
        
         | elcritch wrote:
         | NIH study:
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9579879/
        
       | latchkey wrote:
       | When I was a kid, I fell on my wrist. It healed up badly and
       | formed a lot of calcium deposits around the bones. I couldn't
       | bend my wrist backwards more than a couple degrees and it was
       | painful. Went to a PT who used ultrasound treatments and
       | stretching to break down the deposits, which freed my wrist up.
       | 
       | This was in the 1980's.
        
         | whatshisface wrote:
         | Dealing acoustically with something different from the
         | surrounding material (calcium deposits) is a lot easier than
         | focusing on tissues with roughly the acoustic properties of
         | water among other tissues with the acoustic properties of water
         | - in the former case the stuff can distinguish itself w.r.t.
         | application of the waves, the latter requires focusing to come
         | "from the outside."
        
       | minihat wrote:
       | Not a secret to the research community... Let me balance the hype
       | with some of the remaining challenges.
       | 
       | Depth is a problem; the deeper you go, the less effective it is.
       | Heat is another issue; you can inadvertently damage nearby
       | tissue. Targeting accuracy is vital, especially near critical
       | structures (think nerves), and we're not at sub-millimeter
       | precision yet. Also, real-time monitoring like MRI-guided FUS is
       | expensive and complicated, and without it you have to guess that
       | you're affecting the right tissue. Great promise, but multiple
       | engineering hurdles to clear before FUS lives up to the hype.
        
         | denton-scratch wrote:
         | > and we're not at sub-millimeter precision yet
         | 
         | How do you get sub-millimeter precision with ultrasound? At
         | 300KHz, the sound has a wavelength of 1mm. My understanding is
         | that sound with a frequency greater than about 150Khz
         | dissipates after passing through 5cms of _air_ ; it must
         | dissipate faster in flesh.
         | 
         | Also, a wavelength of 1mm should give you a resolution of about
         | 4mm, right?
         | 
         | I wish I knew more about the propagation of ultrasound; I'm
         | getting interested in the bats that live around here.
        
           | polishdude20 wrote:
           | Isn't this like saying how can we move something one
           | millimeter if our fingers are bigger than one millimeter?
        
             | aesh2Xa1 wrote:
             | Yes, I think it _is_ like saying that, but I also think
             | that OP was considering targets less than 4mm in size. The
             | focus of the FUS wave being no smaller than 4mm, very small
             | targets would be larger than the smallest focus.
             | 
             | It's like saying "how can a syringe extract the cytoplasm
             | of a cell?" if you take OP's angle.
        
               | polishdude20 wrote:
               | Ah I guess in the case of ultrasound, the thing you're
               | trying to do is not nudge or move something, you're
               | literally trying to "ablate" or hit it and only it.
               | That's more like pressing a tiny button with your finger
               | and trying not to touch the outside of the button.
        
           | IshKebab wrote:
           | > My understanding is that sound with a frequency greater
           | than about 150Khz dissipates after passing through 5cms of
           | air; it must dissipate faster in flesh.
           | 
           | Flesh is basically water. Water transmits sound extremely
           | well.
           | 
           | Ultrasonic imaging typically uses frequencies in the low MHz.
           | Like 1-10 MHz.
        
             | denton-scratch wrote:
             | > Ultrasonic imaging typically uses frequencies in the low
             | MHz. Like 1-10 MHz.
             | 
             | Oh, thank you! So the dissipation is low (because it's
             | water), and the theoretical resolution is 500x greater than
             | my ignorant estimate. I now consider myself better-
             | informed.
             | 
             | [Edit] Now I guess I'm off to see if I can find out what a
             | MHz-grade ultrasound transducer looks like...
        
           | jameshart wrote:
           | > At 300KHz, the sound has a wavelength of 1mm
           | 
           | And that's in air. In water (which is more like what most
           | bodily tissues are made of) the speed of sound is almost five
           | times higher so the wavelength is five times longer.
        
         | doh wrote:
         | I know this is maybe completely out there, but could focused
         | ultrasound be used to heat up food? The current issue with
         | microwaves is that they heat up food very unevenly. I am sure
         | the current cost is quite prohibitive and all. I'm more
         | interested in the science part itself.
        
           | Kirby64 wrote:
           | Seems like the challenge would be heating the right places.
           | How would you know what food to heat more or less?
           | 
           | Also, ultrasonic transducers today, as far as I know, require
           | essentially direct contact to impart energy. You probably
           | don't want to dip something into your leftovers just to heat
           | it.
        
       | thrwyfrths wrote:
       | I've always wondered what happened to Steve Jurvetson. He laid
       | low for a while after resigning from the Tesla Board of
       | Directors. I see he is active on Twitter/X now.
        
         | cinntaile wrote:
         | Isn't every VC investor basically a "thought leader" on
         | Twitter? I assume it helps with deal flow?
        
       | tommiegannert wrote:
       | The gamma knife is a similar idea, but using gamma radiation
       | focusing: https://www.mayoclinic.org/tests-procedures/brain-
       | stereotact...
       | 
       | Edit: similar _idea_
        
       | bobim wrote:
       | Meh? It's been on the French health market for at least two
       | decades (Ablatherm).
       | 
       | It's effective for people that wouldn't bear anesthesia but it
       | comes with some limitations.
       | 
       | It can't be used when there are bones, lungs or non-uniform
       | propagation medium in front of the target. And while the tissues
       | are burnt their mechanical properties are evolving and deflecting
       | the beam. The cavitation due to negative alternance of pressure
       | waves puts a limit on the power. Perfusion can take the heat
       | away, etc...
       | 
       | It's probably not widely used because conventional surgery is
       | often more practical.
        
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       (page generated 2023-10-01 23:01 UTC)