Thanks to a generous philanthropic gift from Nancy and Tom Chewning, UNC Health is now among the select few health systems in the United States to have a full spectrum of focused ultrasound equipment for image-guided brain surgery.

The Chewning gift enabled the recent acquisition of a low-frequency (220 KHz) focused ultrasound system, a new research device which allows ultrasound at low frequencies and intensities to achieve several therapeutic outcomes currently being advanced in clinical trials. One of the first applications of this system will be a clinical trial exploring an experimental diagnostic procedure for patients diagnosed with glioblastoma.

“We’ve observed the growing importance and use of focused ultrasound in treating a number of different medical conditions,” said Tom Chewning. “We believe in the people at UNC and the technology, and we are delighted that UNC can utilize it to help patients.”

With a long-standing interest in focused ultrasound that has included active involvement with the advisory board of the Focused Ultrasound Foundation, the Chewnings were motivated by their excitement for the growth of UNC Health’s focused ultrasound program and the addition of Vibhor Krishna, MD, to lead the program.

As the Chewnings watched the success of the high-frequency (650 KHz) focused ultrasound technology, with which UNC Health treated its first patient in late 2023, they wanted to do more to support the growth of the program at UNC and make an impact on patient care.

“We knew that the low-frequency focused ultrasound machinery has enabled physicians to open the blood brain barrier,” said Tom. “We feel that that is a tremendous opportunity to improve drug delivery to the brain and to treat problems in the brain, and we felt that UNC had developed the excellence in terms of staff who are passionate about this technology.”

Most patients diagnosed with glioblastoma will require surgery to remove the tumor. Before surgery, a patient’s care team needs to know the tumor’s biomarkers to determine the tumor type, and then develop the right treatment plan personalized for that patient. However, it is difficult for surgeons to extract a sample of a tumor because of the blood brain barrier, a protective layer that regulates the movement of substances between the blood and the brain. Physicians typically perform a needle biopsy, an invasive surgical procedure, to obtain a tumor sample.

Using low-frequency focused ultrasound and an FDA-approved contrast agent called a “microbubble”, researchers can temporarily open the blood brain barrier, allowing brain tumor DNA to enter the blood stream. Researchers can then perform a liquid biopsy by taking a blood sample to collect the tumor’s biomarkers. In the future, this capability can accelerate diagnosis, perform monitoring of the tumor progression, and customize treatment plans based on patient-specific tumor markers.

UNC Health is now enrolling patients in a UNC Lineberger Comprehensive Cancer Center clinical trial using low-frequency focused ultrasound to evaluate the safety and effectiveness of liquid biopsy for patients with newly diagnosed or recurrent glioblastoma. During the study, researchers will temporarily open the blood-brain barrier using focused ultrasound, facilitating liquid biopsies. The study at UNC Health will be led by neuro-oncologist Yasmeen Rauf, MD, and neurosurgical oncologist Dominique Higgins, MD, PhD.

“The Department of Neurosurgery’s acquisition of the low-frequency ultrasound system is a testament to its commitment to offering cutting-edge treatments and clinical trials to patients with primary brain tumors and brain metastasis,” said Dr. Rauf.

Results from the BT015/LIBERATE clinical trial may have an impact on how physicians treat patients with other neurological conditions, and the technology will benefit patients across various disciplines.

“We are excited to bring this cutting-edge technology to UNC,” said Dr. Higgins. “Low-frequency ultrasound will allow us to advance our understanding and treatment of brain tumors and other neurologic disorders.”

Dr. Krishna is responsible for building the focused ultrasound program at UNC Health for the treatment of patients with movement disorders. Since the installation of the first high-frequency focused ultrasound system, Dr. Krishna has successfully treated many essential tremor and Parkinson’s disease patients using this minimally invasive treatment for patients that no longer respond to medication.

With focused ultrasound technology, sound waves are used to precisely target and ablate tissue with no incisions, no risk of infection, and patients can often go home the same day.

“By investing in state-of-the-art HIFU technology, we demonstrate our dedication to enhancing patient outcomes and ensuring that all people in North Carolina have access to the most advanced therapeutic options available,” said Matthew Ewend, MD, Chief Clinical Officer at UNC Health and President of UNC Physicians. “This unit will not only serve our immediate community but also reinforces UNC Health’s broader mission of elevating healthcare standards across the state and beyond, exemplifying our unwavering commitment to both excellence in care and innovation in medicine.”

Dr. Krishna explained that the low-frequency ultrasound system represents a significant advancement in brain therapeutics.

“While we’re exploring its use for liquid biopsies in brain tumor patients, its potential extends far beyond diagnostics,” said Dr. Krishna. “The technology enables targeted drug delivery directly to the brain and allows for incisionless neuromodulation—essentially giving us the ability to modify brain circuit activity without surgery. We’re excited to develop these additional therapeutic applications, which could transform how we treat various neurological conditions.”

Paul Dayton, PhD, Chair of the Joint Department of Biomedical Engineering at the University of North Carolina at Chapel Hill and North Carolina State University, is part of the Carolina Consortium for Ultrasound Brain Imaging and Therapeutics (CCUBIT) leadership team. Dr. Dayton is distinguished for his contributions to focused ultrasound, particularly in using microbubble and nanodroplet contrast agents to enhance the efficacy and precision of ultrasound imaging and therapy.

“The acquisition of the clinical low-frequency system is a key step forward in our ability to translate several groundbreaking new ultrasound therapies to patients,” said Dr. Dayton. “This equipment, together with the physician and scientist working groups which we are assembling, further strengthens UNC’s position as a world leader in biomedical ultrasound, neurosurgery, and neuroscience.”

The multi-center clinical trial is sponsored by INSIGHTEC, the manufacturer of the human focused ultrasound equipment.

UNC Health’s low-frequency system and advanced software provide a wide treatment envelope, allowing physicians to precisely target any region throughout the brain. “The generous donation made by the Chewnings allows the University of North Carolina to remain a leader in focused ultrasound treatment,” said Nelson Oyesiku, MD, PhD, FACS, Chair of the Department of Neurosurgery at UNC Health. “This technology has the potential to impact patient care for patients across multiple disciplines. Many of our colleagues in various departments across UNC Health are excited to collaborate on research studies using the low-frequency ultrasound technology.”

For more information about the focused ultrasound program at UNC Health, please visit the Carolina Consortium for Ultrasound Brain Imaging and Therapeutics website.

 

Written by Makenzie Hardy, Marketing Coordinator, UNC Health Department of Neurosurgery