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A Comparative Feasibility Study for Transcranial Extracorporeal Shock Wave Therapy.
Cyrill Slezak1,2,3, Jonas Flatscher2, Paul Slezak2,3
1Department of Physics, Utah Valley University, Orem, UT 84058, USA.
Biomedicines
|June 24, 2022
Summary
Extracorporeal shock wave therapy (ESWT) shows promise for central nervous system applications. Simulations reveal current ESWT applicators can effectively deliver therapeutic energy through the skull for transcranial treatments.
Area of Science:
- Biomedical Engineering
- Neuroscience
- Acoustics
Background:
- Extracorporeal shock wave therapy (ESWT) is being explored for regenerative and stimulatory effects on the central nervous system.
- Acoustic shielding by the skull bone presents a significant challenge for transcranial ESWT applications.
- Understanding sound field propagation through bone is crucial for effective treatment delivery.
Purpose of the Study:
- To compare the performance of different ESWT applicator technologies for transcranial applications using high-resolution simulations.
- To evaluate the impact of skull bone models on the accuracy of simulated sound fields.
- To assess the feasibility of current ESWT applicators for delivering therapeutic energy to the brain.
Main Methods:
- Utilized high-resolution, tissue-realistic simulations with the k-Wave toolbox in Matlab.
- Incorporated CT imaging data for realistic head density information.
- Compared electrohydraulic, electromagnetic, and piezoelectric transducers with various reflector geometries.
- Investigated three different bone attenuation models to assess skull modeling reliability.
Main Results:
- All tested ESWT applicator technologies demonstrated significant energy and peak pressure retention beyond the bone barrier.
- Electromagnetic transducers exhibited superior energy flux density compared to electrohydraulic and piezoelectric types.
- Low focusing strength piezoelectric applicators showed the weakest energy transmission.
- Attenuation estimates provided critical insights into sound field degradation and energy loss.
Conclusions:
- Current clinical ESWT applicator technologies are capable of achieving effective transcranial therapies.
- Electromagnetic transducers offer promising performance for transcranial applications due to higher energy flux.
- Accurate modeling of bone attenuation is essential for reliable simulation of transcranial ESWT.
- The simulation approach enables future in silico development for optimizing ESWT applicators and treatment plans.
