# US 12,214,223 B2 · Noninvasive tissue displacement control and monitoring for neuromodulation

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- Number: US 12,214,223 B2
- Document ID: US12214223B2
- Status: Granted
- Kind: B2
- Application number: 18/189,011
- Filed: 2023-03-23
- Published: 2023-07-20
- Granted: 2025-02-04
- Earliest claimed: 2020-01-23
- Assignees: GE Precision Healthcare LLC
- Applicants: GE Precision Healthcare LLC
- Inventors: Jeffrey Michael Ashe; Christopher Michael Puleo; Victoria Eugenia Cotero; Ying Fan; Kirk Dennis Wallace; John Frederick Graf
- Web page: https://patentgrep.com/patent/US12214223B2

## CPC

- A61N 7/00: Ultrasound therapy (lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 {; using ultrasound for introducing media into the body A61M37/0092})
- A61B 8/085: {for locating body or organic structures, e.g. tumours, calculi, blood vessels, nodules}
- A61B 8/4245: {involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient}
- A61B 8/469: {for selection of a region of interest}
- A61B 8/485: {involving measuring strain or elastic properties}
- A61B 8/5223: {for extracting a diagnostic or physiological parameter from medical diagnostic data (for algorithms to analyse biomedical images G06T7/0012)}
- A61B 2034/2065: {Tracking using image or pattern recognition}
- A61B 2090/378: {using ultrasound}
- A61N 2007/0026: {Stimulation of nerve tissue}
- A61N 2007/0082: {Scanning transducers}
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

The subject matter of the present disclosure generally relates to techniques for neuromodulation that include applying energy (e.g., ultrasound energy) into an internal tissue to cause tissue displacement and identifying that the tissue displacement has occurred. In one embodiment, the presence of tissue displacement is associated with a desired therapeutic or physiological outcome, such as a change in a molecule of interest.

## Claims

### Claim 1

A neuromodulation delivery system, comprising:
an energy application device configured to deliver energy to an internal tissue in a subject; and
a controller configured to:
control application of the energy via the energy application device to a plurality of locations of the internal tissue to deliver the energy thereto, wherein the energy application device is controlled under first control parameters;
receive image data of the plurality of locations during the application of the energy;
track real-time tissue displacement of the plurality of locations of the internal tissue using the image data;
rank individual locations of the plurality of locations based on the real-time tissue displacement, wherein the individual locations control glucose concentration in the blood;
identify one or more top-ranked individual locations based on the ranking; and
control the energy application device to apply a neuromodulating energy dose using second control parameters to the identified one or more top-ranked individual locations to effect therapeutic changes in blood glucose concentrations.

### Claim 2 (depends on 1)

The system of claim 1, wherein the energy application device comprises an ultrasound therapy transducer.

### Claim 3 (depends on 2)

The system of claim 2, wherein the energy application device comprises an imaging transducer configured to acquire the image data.

### Claim 4 (depends on 1)

The system of claim 1, wherein the controller is configured to acquire a baseline image of the internal tissue and determine the tissue displacement based on the baseline image and the image data.

### Claim 5 (depends on 1)

The system of claim 1, wherein the controller is configured to generate a responsiveness map of the internal tissue based on the real-time tissue displacement.

### Claim 6 (depends on 1)

The system of claim 1, wherein the control parameters comprise one or more of driving voltage, pulse length, pulse duration, and pulse repetition interval.

### Claim 7 (depends on 6)

The system of claim 6, wherein the first control parameters are the same as the second control parameters.

### Claim 8 (depends on 6)

The system of claim 6, wherein the first control parameters are the same between the plurality of locations.

### Claim 9 (depends on 1)

The system of claim 1, wherein the internal tissue is an organ.

### Claim 10 (depends on 1)

The system of claim 1, wherein the controller is configured to control the application of the energy via the energy application device to the plurality of locations of the internal tissue at an initiation of therapy.

### Claim 11

A neuromodulation delivery system, comprising:
an ultrasound probe configured to deliver neuromodulating energy to an internal tissue in a subject via a therapy transducer and acquire image data of the internal tissue via an imaging transducer; and
a controller configured to:
set a characteristic tissue displacement between a first threshold displacement and a second threshold displacement;
control application of the neuromodulating energy via the therapy transducer of the ultrasound probe to a location of the internal tissue to deliver the neuromodulating energy thereto, wherein the therapy transducer is controlled under control parameters;
receive the image data of the location acquired by the imaging transducer of the ultrasound probe during the application of the neuromodulating energy;
track real-time tissue displacement of the location during the application of the neuromodulating energy based on the image data; and
tracking a change in glucose concentration based on the tracked real-time tissue displacement.

### Claim 12 (depends on 11)

The system of claim 11, wherein the controller is configured to:
receive additional image data of the location acquired by the imaging transducer of the ultrasound probe during the application of additional neuromodulating energy using modified control parameters;
track second real-time tissue displacement of the location during the application of the additional neuromodulating energy based on the image data;
determine that the second real-time tissue displacement is the characteristic tissue displacement; and
set the location as a region of interest for the modified control parameters.

### Claim 13 (depends on 12)

The system of claim 12, wherein the controller is configured to:
modify subsequent control parameters for doses of a therapy protocol applied to the location such that subsequent tracked tissue displacement at the location is a set tissue displacement.

### Claim 14 (depends on 11)

The system of claim 11, wherein the controller is configured to:
receive additional image data of a second location acquired by the imaging transducer of the ultrasound probe during the application of additional neuromodulating energy using the control parameters;
track second real-time tissue displacement of the second location during the application of the additional neuromodulating energy based on the image data;
determine that the second real-time tissue displacement is the characteristic tissue displacement; and
set the second location as a region of interest for the control parameters.

### Claim 15 (depends on 11)

The system of claim 11, wherein the control parameters comprise one or more of driving voltage, pulse length, pulse duration, and pulse repetition interval.

### Claim 16 (depends on 11)

The system of claim 11, wherein the internal tissue is an organ.

### Claim 17

A method of delivery of neuromodulating energy, the method comprising:
setting a characteristic tissue displacement for a region of interest in an internal tissue of a subject between a first threshold displacement and a second threshold displacement;
delivering a reference pulse to the region of interest via an energy application device;
delivering a therapy pulse to the region of interest via the energy application device subsequent to delivering the reference pulse, wherein the therapy pulse is delivered using control parameters of the energy application device;
delivering a tracking pulse to the region of interest via the energy application device subsequent to delivering the therapy pulse;
identifying a phase change between the reference pulse and the tracking pulse;
determining a tissue displacement in or near the region of interest based on the phase change;
determining that the tissue displacement deviates from the set characteristic tissue displacement, wherein the reference and tracking pulse do not cause displacement and the tissue displacement is in response to the therapy pulse; and
adjusting the control parameters of the therapy pulse based on the determined tissue displacement.

### Claim 18 (depends on 17)

The method of claim 17, wherein the reference pulse and the tracking pulse are delivered by an imaging transducer and the therapy pulse is delivered by a therapy transducer.

### Claim 19 (depends on 17)

The method of claim 17, wherein the tissue displacement is determined based on an area under a curve of the identified phase change.

### Claim 20 (depends on 17)

The method of claim 17, comprising applying a neuromodulating energy dose via the energy application device to the region of interest using the adjusted control parameters.
