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Bryan Cunitz

Limited Term Appointment - Pro Staff

Email

bwc@apl.washington.edu

Phone

206-543-6804

Education

B.A. Physics, Colby College, 1999

B.S. Engineering, Dartmouth College, 2000

M.S. Electrical Engineering, University of Washington, 2005

Videos

Burst Wave Lithotripsy: An Experimental Method to Fragment Kidney Stones

CIMU researchers are investigating a noninvasive method to fragment kidney stones using ultrasound pulses rather than shock waves. Consecutive acoustic cycles accumulate and concentrate energy within the stone. The technique can be 'tuned' to create small fragments, potentially improving the success rate of lithotripsy procedures.

20 Nov 2014

SonoMotion: A Budding Start-up Company

A research team has developed new technologies to treat kidney stone disease with an ultrasound-based system. Embraced by clinicians, their advances are now being taken to the next step: transition the prototype to an approved device that will roll into hospitals and clinics around the world.

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11 Feb 2013

At the Center for Industrial and Medical Ultrasound a team of scientists, engineers, and students has developed an ultrasound-based system that may provide an office procedure to speed the natural passage of kidney stones. The system uses commercial ultrasound components to locate stones in kidneys. It creates clear pictures of them and then applies an acoustic radiative force, repositioning stones in the kidney so they are more likely to pass naturally.

As a research team, considerable technical advancements have been made and valuable feedback and cooperation has been garnered from the user community – the clinicians. The scientists, engineers, urologists, and commercialization experts are now collaborating to take the next steps.

SonoMotion has partnered with a hardware manufacturing company and licensed the ultrasonic propulsion of kidney stones technology with the University of Washington. The next big step will be to transition the prototype system into one that will pass the rigors of FDA review and be ready to roll into hospitals and clinics around the world.

Center for Industrial and Medical Ultrasound - CIMU

CIMU is a group of scientists, engineers, and technicians dedicated to research across the field of bio-medical ultrasonics with the goal of developing technologies that will be used in a clinic to treat patients.

1 Nov 2010

Publications

2000-present and while at APL-UW

Development of an automated ultrasound signal indicator of lung interstitial syndrome

Khokhlova, T.D., G.P. Thomas, J. Hall, K. Steinbock, J. Thiel, B.W. Cunitz, M.R. Bailey, L. Anderson, R. Kessler, M.K. Hall, and A.A. Adedipe, "Development of an automated ultrasound signal indicator of lung interstitial syndrome," J. Ultrasound Med., EOR, doi:10.1002/jum.16383, 2023.

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5 Dec 2023

The number and distribution of lung ultrasound (LUS) imaging artifacts termed B-lines correlate with the presence of acute lung disease such as infection, acute respiratory distress syndrome (ARDS), and pulmonary edema. Detection and interpretation of B-lines require dedicated training and is machine and operator-dependent. The goal of this study was to identify radio frequency (RF) signal features associated with B-lines in a cohort of patients with cardiogenic pulmonary edema. A quantitative signal indicator could then be used in a single-element, non-imaging, wearable, automated lung ultrasound sensor (LUSS) for continuous hands-free monitoring of lung fluid.

Dual-mode 1D linear ultrasound array for image-guided drug delivery enhancement without ultrasound contrast agents

Williams, R.P., M.M. Karzova, P.V. Yuldashev, A.Z. Kaloev, F.A. Nartov, V.A. Khokhlova, B.W. Cunitz, K.P. Morrison, and T.D. Khokhlova, "Dual-mode 1D linear ultrasound array for image-guided drug delivery enhancement without ultrasound contrast agents," IEEE Trans. Ultrason. Ferroelectr. Freq. Control, 70, 693-707, doi:10.1109/TUFFC.2023.3268603, 2023.

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19 Apr 2023

Pulsed high-intensity focused ultrasound (pHIFU) uses nonlinearly distorted millisecond-long ultrasound pulses of moderate intensity to induce inertial cavitation in tissue without administration of contrast agents. The resulting mechanical disruption permeabilizes the tissue and enhances the diffusion of systemically administered drugs. This is especially beneficial for tissues with poor perfusion such as pancreatic tumors. Here we characterize the performance of a dual-mode ultrasound array designed for image-guided pHIFU therapies in producing inertial cavitation and ultrasound imaging. The 64-element linear array (1.071 MHz, aperture of 14.8 mm x 51.2 mm, and pitch of 0.8 mm) with elevational focal length of 50 mm was driven by the Verasonics V-1 ultrasound system with extended burst option. The attainable focal pressures and electronic steering range in linear and nonlinear operating regimes (relevant to pHIFU treatments) were characterized through hydrophone measurements, acoustic holography, and numerical simulations. The steering range at ±10% from the nominal focal pressure was found to be ±±6 mm axially and ±11 mm azimuthally. Focal waveforms with shock fronts of up to 45 MPa, and peak negative pressures up to 9 MPa were achieved at focusing distances of 38–75 mm from the array. Cavitation behaviors induced by isolated 1 ms pHIFU pulses in optically transparent agarose gel phantoms were observed by high-speed photography across a range of excitation amplitudes and focal distances. For all focusing configurations the appearance of sparse, stationary cavitation bubbles occurred at the same P_ threshold of 2 MPa. As the output level increased, a qualitative change in cavitation behavior occurred, to pairs and sets of proliferating bubbles. The pressure P_ at which this transition was observed corresponded to substantial nonlinear distortion and shock formation in the focal region and was thus dependent on the focal distance of the beam ranging within 3–4 MPa for azimuthal F-numbers of 0.74 to 1.5. The array was capable of B-mode imaging at 1.5 MHz of centimeter-sized targets in phantoms and in vivo pig tissues at depths of 3 cm to 7 cm, relevant to pHIFU applications in abdominal targets.

Fragmentation of stones by burst wave lithotripsy in the first 19 humans

Harper, J.D., J.E. Lingeman, R.M. Sweet, I.S. Metzler, P. Sunaryo, J.C. Williams, A.D. Maxwell, J. Thiel, B.M. Cunitz, B. Dunmire, M.R. Bailey, and M.D. Sorensen, "Fragmentation of stones by burst wave lithotripsy in the first 19 humans," J. Urol., 207, doi:10.1097/JU.0000000000002446, 2022.

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1 May 2022

We report stone comminution in the first 19 human subjects by burst wave lithotripsy (BWL), which is the transcutaneous application of focused, cyclic ultrasound pulses. This was a prospective multi-institutional feasibility study recruiting subjects undergoing clinical ureteroscopy (URS) for at least 1 stone ≤12 mm as measured on computerized tomography. During the planned URS, either before or after ureteroscope insertion, BWL was administered with a handheld transducer, and any stone fragmentation and tissue injury were observed. Up to 3 stones per subject were targeted, each for a maximum of 10 minutes. The primary effectiveness outcome was the volume percent comminution of the stone into fragments ≤2 mm. The primary safety outcome was the independent, blinded visual scoring of tissue injury from the URS video. Overall, median stone comminution was 90% (IQR 20, 100) of stone volume with 21 of 23 (91%) stones fragmented. Complete fragmentation (all fragments ≤2 mm) within 10 minutes of BWL occurred in 9 of 23 stones (39%). Of the 6 least comminuted stones, likely causative factors for decreased effectiveness included stones that were larger than the BWL beamwidth, smaller than the BWL wavelength or the introduction of air bubbles from the ureteroscope. Mild reddening of the papilla and hematuria emanating from the papilla were observed ureteroscopically. The first study of BWL in human subjects resulted in a median of 90% comminution of the total stone volume into fragments ≤2 mm within 10 minutes of BWL exposure with only mild tissue injury.

More Publications

Inventions

Noninvasive Fragmentation of Urinary Tract Stones with Focused Ultrasound

Patent Number: 11,583,299

Adam Maxwell, Bryan Cunitz, Wayne Kreider, Oleg Sapozhnikov, Mike Bailey

Patent

21 Feb 2023

Broadly Focused Ultrasonic Propulsion Probes, Systems, and Methods

Disclosed herein are ultrasonic probes and systems incorporating the probes. The probes are configured to produce an ultrasonic therapy exposure that, when applied to a kidney stone, will exert an acoustic radiation force sufficient to produce ultrasonic propulsion. Unlike previous probes configured to produce ultrasonic propulsion, however, the disclosed probes are engineered to produce a relatively large (both wide and long) therapy region effective to produce ultrasonic propulsion. This large therapy region allows the probe to move a plurality of kidney stones (or fragments from lithotripsy) in parallel, thereby providing the user the ability to clear several stones from an area simultaneously. This "broadly focused" probe is, in certain embodiments, combined in a single handheld unit with a typical ultrasound imaging probe to produce real-time imaging. Methods of using the probes and systems to move kidney stones are also provided.

Patent Number: 10,667,831

Mike Bailey, Bryan Cunitz, Barbrina Dunmire, Adam Maxwell, Oren Levy

Patent

2 Jun 2020

Noninvasive Fragmentation of Urinary Tract Stones with Focused Ultrasound

Patent Number: 10,251,657

Adam Maxwell, Mike Bailey, Bryan Cunitz, Wayne Kreider, Oleg Sapozhnikov

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Patent

9 Apr 2019

Methods, computing devices, and a computer-readable medium are described herein related to fragmenting or comminuting an object in a subject using a burst wave lithotripsy (BWL) waveform. A computing device, such a computing device coupled to a transducer, may carry out functions for producing a BWL waveform. The computing device may determine a burst frequency for a number of bursts in the BWL waveform, where the number of bursts includes a number of cycles. Further, the computing device may determine a cycle frequency for the number of cycles. Yet further, the computing device may determine a pressure amplitude for the BWL waveform, where the pressure amplitude is less than or equal to 8 MPa. In addition, the computing device may determine a time period for producing the BWL waveform.

More Inventions

Acoustics Air-Sea Interaction & Remote Sensing Center for Environmental & Information Systems Center for Industrial & Medical Ultrasound Electronic & Photonic Systems Ocean Engineering Ocean Physics Polar Science Center
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