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dc.contributor.authorShaw, CJ
dc.contributor.authorRivens, I
dc.contributor.authorCivale, J
dc.contributor.authorBotting, KJ
dc.contributor.authorTer Haar, G
dc.contributor.authorGiussani, DA
dc.contributor.authorLees, CC
dc.date.accessioned2019-02-15T15:57:59Z
dc.date.issued2018-09-11
dc.identifier.citationScientific reports, 2018, 8 (1), pp. 13631 - ?
dc.identifier.issn2045-2322
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/3052
dc.identifier.eissn2045-2322
dc.identifier.doi10.1038/s41598-018-31914-4
dc.description.abstractPre-clinically, High Intensity Focused Ultrasound (HIFU) has been shown to safely and effectively occlude placental blood vessels in the acute setting, when applied through the uterus. However, further development of the technique to overcome the technical challenges of targeting and occluding blood vessels through intact skin remains essential to translation into human studies. So too does the assessment of fetal wellbeing following this procedure, and demonstration of the persistence of vascular occlusion. At 115 ± 10 d gestational age (term~147 days) 12 pregnant sheep were exposed to HIFU (n = 6), or to a sham (n = 6) therapy through intact abdominal skin (1.66 MHz, 5 s duration, in situ I SPTA 1.3-4.4 kW.cm -2 ). Treatment success was defined as undetectable colour Doppler signal in the target placental vessel following HIFU exposures. Pregnancies were monitored for 21 days using diagnostic ultrasound from one day before HIFU exposure until term, when post-mortem examination was performed. Placental vessels were examined histologically for evidence of persistent vascular occlusion. HIFU occluded 31/34 (91%) of placental vessels targeted, with persistent vascular occlusion evident on histological examination 20 days after treatment. The mean diameter of occluded vessels was 1.4 mm (range 0.3-3.3 mm). All pregnancies survived until post mortem without evidence of significant maternal or fetal iatrogenic harm, preterm labour, maternal or fetal haemorrhage or infection. Three of six ewes exposed to HIFU experienced abdominal skin burns, which healed without intervention within 21 days. Mean fetal weight, fetal growth velocity and other measures of fetal biometry were not affected by exposure to HIFU. Fetal Doppler studies indicated a transient increase in the umbilical artery pulsatility index (PI) and a decrease in middle cerebral artery PI as a result of general anaesthesia, which was not different between sham and treatment groups. We report the first successful application of fully non-invasive HIFU for occlusion of placental blood flow in a pregnant sheep model, with a low risk of significant complications. This proof of concept study demonstrates the potential of this technique for clinical translation.
dc.formatElectronic
dc.format.extent13631 - ?
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectUterus
dc.subjectBlood Vessels
dc.subjectMiddle Cerebral Artery
dc.subjectUmbilical Arteries
dc.subjectFetus
dc.subjectPlacenta
dc.subjectAnimals
dc.subjectSheep
dc.subjectHumans
dc.subjectDisease Models, Animal
dc.subjectHemorrhage
dc.subjectUltrasonography, Prenatal
dc.subjectBlood Flow Velocity
dc.subjectPregnancy
dc.subjectFemale
dc.subjectHigh-Intensity Focused Ultrasound Ablation
dc.titleTrans-abdominal in vivo placental vessel occlusion using High Intensity Focused Ultrasound.
dc.typeJournal Article
dcterms.dateAccepted2018-06-28
rioxxterms.versionofrecord10.1038/s41598-018-31914-4
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2018-09-11
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfScientific reports
pubs.issue1
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Imaging for Radiotherapy Adaptation
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Therapeutic Ultrasound
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Imaging for Radiotherapy Adaptation
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Therapeutic Ultrasound
pubs.publication-statusPublished
pubs.volume8
pubs.embargo.termsNot known
icr.researchteamImaging for Radiotherapy Adaptationen_US
icr.researchteamTherapeutic Ultrasounden_US
dc.contributor.icrauthorCivale, Johnen
dc.contributor.icrauthorRivens, Ianen
dc.contributor.icrauthorTer Haar, Gailen


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