Roland Beard

The History of Ultrasound

Introduction

• My timeline describes the history of ultrasound which is also known as sonography. Ultrasound uses sound waves to produce ultrasound images. The tool can be used to image the inside of the human body. Details such as size, shape, and consistency of soft tissues and organs can be discerned. Following image formation, a radiologist or doctor will interpret the ultrasound images. Ultrasound is primarily used for pregnancy, diagnostics, and medical procedures. Birth defects, sex, and due dates can be determined in regards to pregnancies. Further ultrasound can be used to diagnose a plethora of conditions affecting organs and soft tissues in the body. Lastly, ultrasound imaging can be used to guide needle biopsies. As a result, ultrasound is necessary in all hospital settings. It’s history will be outlined in the following slides.

• 1880 - Ultrasound technology was first discovered in 1880 in Paris, France. Pierre and Jacques Curie discovered the piezoelectric effect in certain crystals. The discovery of the piezoelectric effect led to the evolution of high frequency echo-sounding techniques. This effect proved to be useful in transducers to generate and detect ultrasonic waves in air and water.

• 1915 – Ultrasonic waves were used for the first time in a practical setting. Paul Langevin , a French professor, and Swiss physicist Constantin Chilowski were commissioned to invent a device that detected objects at the bottom of the sea. They developed a high frequency ultrasonic device called a hydrophone. The World Congress Ultrasound in Medical Education refers to the hydrophone as the “first transducer”. The hydrophone was employed in the surveillance of German U-boats and submarines.

• 1930s – In 1932, Ultrasound was first considered for therapeutic use. Freundlich, Collner, Rogowski suggested the use of ultrasound to therapeutically heat tissue. In 1935, ultrasound was first focused. Gruetzmacher was able to focus ultrasound waves by placing a concave surface next to a piezoelectric generator

• In 1942, Neurologist Karl Dussik was the first person to employ sonography for medical diagnoses. He transmitted an ultrasound beam through the human skull in attempts of detecting brain tumors. During this year, John G. Lynn suggested that ultrasound could be intensely focused to produce extreme heat. The resulting heat source could then be used to noninvasively destroy targeted diseased tissue within the body. The effect was realized when Lynn used ultrasound to produce lesions deep in bovine liver without damaging surrounding tissue. Following this discovery, William Fry, a physicist veteran of naval sonar research, and his brother along with a research team at the Bioacoustic Research Lab at the University of Illinois developed the first focused ultrasound device. The device mechanically aligned four focused ultrasound generators to produce a lesion in a specific location without damaging surrounding tissue. In 1944, the first pre-clinical animal study was realized. John G. Lynn and Tracy J. Putcham treated 37 animals which were described as having a range of reversible and irreversible clinical deficits. The focused ultrasound was used to destroy cerebral tissue in the animals. They found the subsequent lesions to well defined in the target areas. In 1948, George D. Ludwig, M.D., an Internist at the Naval Medical Research Institute, developed A-mode ultrasound equipment to detect gallstones. A-mode (amplitude mode) is the most basic type of ultrasound. This mode allows for pinpoint accurate focus of the destructive wave energy of an ultrasound wave.

•1950s – From 1949-1951, B-mode ultrasound was discovered and implemented. B-mode, brightness mode, ultrasound is essentially 2-D ultrasound. Douglas Howry and Joseph Holmes, from the University of Colorado, were two of the leading pioneers of B-mode ultrasound equipment. They were primarily known for the 2D B-mode linear compound scanner. Furthermore, John Reid and John Wild invented a handheld B-mode device to be used to detect breast tumors. In, 1950 ultrasound was first utilized for therapeutic uses. Lars Leksell designed a custom frame and ultrasound transducer which were used to focus ultrasound waves to produce lesions. He successfully used it to treat patients who had psychiatric disorders. Two years later, in 1952, the first ultrasound meeting was held at the University of Illinois in the form of a symposium focused on Ultrasound in Biology and Medicine. In 1957 the first research group dedicated to focused ultrasound was founded by William Fry, Francis Fry, and Reginald C. Eggleton in Champaign Illinois. The group was called the Interscience Research Institute. The goal of the Institute was to develop and apply high-intensity ultrasound instrumentation to treat neurological disorders, and to develop computer-based, low-intensity ultrasound instrumentation for visualization of the soft tissue. To end, in 1958, ultrasound was first incorporated in the OB/GYN field of medicine by Dr. Ian MacDonald.

• 1960s – In 1962, Russell Meyers and William, employed focused ultrasound to treat human patient suffering from brain ailments, specifically Parkinson’s disease. Two years later, in 1964, ultrasound was first used for cancer applications. M. Oka, reported the successful treatment of thyroid and breast cancers using focused ultrasound. A few years later, in 1966, Don Baker, Dennis Watkins, and John Reid invented pulsed Doppler ultrasound technology. This innovation would lead to the technology capable of imaging blood flow in various layers of the heart. In 1968, Dr. Robert Heimburger of the Dept. of Neurosurgery from IU Medical School in Indianapolis, IN was the first neurosurgeon to use an ultrasound guided HIFU, high intensity focused ultrasound, device to treat brain cancer.

• 1970s – The 1970s were characterized by several developments including the continuous wave Doppler, spectral wave Doppler and color Doppler ultrasound instruments. These advancements led to new functionalities of ultrasound.

•1980s –In the 1980’s 3D ultrasound technology was invented. Kazunori Baba of the University of Tokyo developed 3D ultrasound technology. He then captured the first three-dimensional images of a fetus in 1986. A few years later, in 1989, Professor Daniel Lichtenstein began incorporating lung and general sonography in intensive care units.

• 1990s – Similar to the 1980s, ultrasound technology became more sophisticated in the 1990’s. 4D (real time) capabilities were discovered. Also, ultrasound guided biopsies (endoscopic ultrasounds) began in the 1990s. Ultrasound was used to treat more ailments. In 1990, N. Sanghvi developed the first ultrasound prostate treatment. The clinical protocol was geared toward the treatment of benign prostatic hyperplasia. In 1991, A. Guthkelch and K. Hynynen treated malignant brain tumors with focused ultrasound hyperthermia and radiation. In 1992, ultrasound was first combined with MRI. K. Hynynen proposed the use of non-invasive focused ultrasound surgery in a magnet using magnetic resonance imaging to guide and monitor tissue damage. As a result, the term Magnetic Resonance Guided Focused Ultrasound (MRgFUS) was first coined. At the tail end of the 90s, in 1999, InSightec was founded by GE Healthcare and Elbit Medical Imaging in order to transform MRgFUS into a clinically viable technology.

• 2000 - 2010– The ultrasound technology continues to evolve. During the 2000s, ultrasound has become handheld and portable. With the gain in popularity of the ultrasound, the International Society for Therapeutic Ultrasound was founded to spread the knowledge of therapeutic ultrasound to the scientific and medical community in 2001. This was the first focused ultrasound society. In 2003, the first clinical trial of non-invasive MRgFUS was performed by C. Tempany. There were several clinical trils carried out in 2003. Following, in 2004, the FDA approved the use of focused ultrasound. The system was called the ExAblate 2000 which was used to treat uterine fibroids. Then, 2005, Black performed the first brain tumer treatments using focused ultrasound. The next year in 2006, the first brain clinical study was realized by Z. Ram. From 2006-2009, MRgFUS was used in several different capacities which include antibody delivery, chemotherapy delivery, the treatment of neuropathic pain, and the treatment of uterine fibroids.

•2010 – 2014– In recent times, ultrasound technology has continued to progress at a high rate. In 2010, Elias successfully treated patients with essential tremor. Also, during that year Jordao utilized MRIgFUS to deliver antibodies in mice to reduce amyloid load in AD model mice. Two years later, in 2012, the FDA approved the second used of focused ultrasound. The approved treatment was for the mediation of pain from bone metastases. In 2013, HF. Gao, carried out the first clinical trial using HIFU to treat local advanced pancreatic cancer. The results were promising. The next year, Hurwitz employed MRgFUS to noninvasively treat pain resulting from bone metastases. Also, during 2014, ultrasound was used to treat the first pediatric patient. The child’s bone tumor was treated with the Philips Sonalleve system in a clinical trial conducted by the Hospital for Sick Children (SickKids) and Sunnybrook Health Sciences Center. Inexpensive portable ultrasound devices were also invented during this time.

References

• "History of Ultrasound." History of Ultrasound.UltrasoundSchoolsInfo, n.d. Web. 13 July 2015.• "Focused Ultrasound Timeline." Focused Ultrasound Foundation. N.p.,

n.d. Web. 13 July 2015.