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Barbrina Dunmire

Senior Engineer

Email

mrbean@apl.washington.edu

Phone

206-685-6953

Education

B.S. Aeronautics & Astronautics, University of Washington, 1989

M.S. Aeronautics & Astronautics, University of Washington, 1991

M.S. Bioengineering, University of Washington, 1998

Videos

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

Impact of stone type on caviation in burst wave lithotripsy

Hunter, C., A.D. Maxwell, B. Cunitz, B. Dunmire, M.D. Sorensen, J.C. Williams Jr., A. Randad, M. Bailey, and W. Kreider, "Impact of stone type on caviation in burst wave lithotripsy," Proc. Mtgs. Acoust., 35, 020005, doi:10.1121/2.0000950, 2018.

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26 Dec 2018

Proceedings, 176th Meeting of the Acoustical Society of America, 5-9 November 2018, Victoria, BC, Canada.

Non-invasive kidney stone treatments such as shock wave lithotripsy (SWL) and burst wave lithotripsy (BWL) rely on the delivery of pressure waves through tissue to the stone. In both SWL and BWL, the potential to hinder comminution by exciting cavitation proximal to the stone has been reported. To elucidate how different stones alter prefocal cavitation in BWL, different natural and synthetic stones were treated in vitro using a therapy transducer operating at 350 kHz (peak negative pressure 7 MPa, pulse length 20 cycles, pulse repetition frequency 10 Hz). Stones were held in a confined volume of water designed to mimic the geometry of a kidney calyx, with the water filtered and degassed to maintain conditions for which the cavitation threshold (in the absence of a stone) matches that from in vivo observations. Stone targeting and cavitation monitoring were performed via ultrasound imaging using a diagnostic probe aligned coaxially with the therapy transducer. Quantitative differences in the extent and location of cavitation activity were observed for different stone types — e.g., stones (natural and synthetic) that are known to be porous produced larger prefocal cavitation clouds. Ongoing work will focus on correlation of such cavitation metrics with stone fragmentation.

Update on clinical trials of kidney stone repositioning and preclinical results of stone breaking with one system

Bailey, M.R., Y.-N. Wang, W. Kreider, J.C. Dai, B.W. Cunitz, J.D. Harper, H. Chang, M.D. Sorensen, Z. Liu, O. Levy, B. Dunmire, and A.D. Maxwell, "Update on clinical trials of kidney stone repositioning and preclinical results of stone breaking with one system," Proc. Mtgs. Acoust, 35, 020004, doi:10.1121/2.0000949, 2018.

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21 Dec 2018

176th Meeting of the Acoustical Society of America 5-9 November 2018, Victoria, BC, Canada.

Our goal is an office-based, handheld ultrasound system to target, detach, break, and/or expel stones and stone fragments from the urinary collecting system to facilitate natural clearance. Repositioning of stones in humans (maximum 2.5 MPa, and 3-second bursts) and breaking of stones in a porcine model (maximum 50 cycles, 20 Hz repetition, 30 minutes, and 7 MPa peak negative pressure) have been demonstrated using the same 350-kHz probe. Repositioning in humans was conducted during surgery with a ureteroscope in the kidney to film stone movement. Independent video review confirmed stone movements (≥ 3 mm) in 15 of 16 kidneys (94%). No serious or unanticipated adverse events were reported. Experiments of burst wave lithotripsy (BWL) effectiveness on breaking human stones implanted in the porcine bladder and kidney demonstrated fragmentation of 7 of 7 stones on post mortem dissection. A 1-week survival study with the BWL exposures and 10 specific pathogen-free pigs, showed all findings were within normal limits on clinical pathology, hematology, and urinalysis. These results demonstrate that repositioning of stones with ultrasonic propulsion and breaking of stones with BWL are safe and effective.

Measurement of posterior acoustic stone shadow on ultrasound is a learnable skill for inexperienced users to improve accuracy of stone sizing

Dai, J.C., B. Dunmire, Z. Liu, K.M. Sternberg, M.R. Bailey, J.D. Harper, and M.D. Sorensen, "Measurement of posterior acoustic stone shadow on ultrasound is a learnable skill for inexperienced users to improve accuracy of stone sizing," J. Endourol., 32, doi:10.1089/end.2018.0577, 2018.

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8 Nov 2018

Introduction: Studies suggest that the width of the acoustic shadow on ultrasound (US) more accurately reflects true stone size than the stone width in US images. We evaluated the need for training in the adoption of the acoustic shadow sizing technique by clinical providers.

Methods: Providers without shadow sizing experience were recruited and assigned in a stratified, alternating manner to receive a training tutorial ("trained") or no intervention ("control"). Each conducted a baseline assessment of 24 clinical US images; where present, shadow width was measured using custom calipers. The trained group subsequently completed a standardized training module on shadow sizing. All subjects repeated measurements after ~1 week. Group demographics were compared using Fisher's exact test. Measurements were compared to clinically reported stone sizes on corresponding CT and US using mixed-effects models. One millimeter concordance between shadow and CT size was compared using a generalized linear mixed-effects model.

Results: Twenty-six subjects were included. There was no significant difference between groups in demographics, clinical role, or US experience. Mean reported CT and US stone sizes were 6.8 ± 4.0 mm and 10.3 ± 4.1 mm, respectively. At baseline, there was no difference in shadow size measurements between groups (p = 0.18), and shadow size was no more accurate than US stone size (p = 0.28 trained; p = 0.81 control), compared to CT. After training, overestimation bias of shadow size in the trained group decreased to 1.6 ± 0.5 mm (p < 0.01), relative to CT. This was not significantly associated with clinical rank, US experience, or stone-measuring experience. One millimeter concordance with CT size significantly increased from 23% to 35% of stones after training (p = 0.01). No significant improvement occurred in the control group.

Conclusion: Acoustic shadow sizing was readily adopted by inexperienced providers, but was not more accurate than reported US stone sizes without training. Education on shadow sizing may be warranted before clinical adoption.

More Publications

Inventions

Ultrasound Based Method and Apparatus for Stone Detection and to Facilitate Clearance Thereof

Patent Number: 10,039,562

Mike Bailey, Bryan Cunitz, Barbrina Dunmire

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Patent

7 Aug 2018

Described herein are methods and apparatus for detecting stones by ultrasound, in which the ultrasound reflections from a stone are preferentially selected and accentuated relative to the ultrasound reflections from blood or tissue. Also described herein are methods and apparatus for applying pushing ultrasound to in vivo stones or other objects, to facilitate the removal of such in vivo objects.

Renal Needle Access Guide for Ultrasound Guided Percutaneous Nephrolithotomy

Record of Invention Number: 48366

Mike Bailey, Helen Chang, Barbrina Dunmire, Jonathan Harper, Katy Kuznetsova

Disclosure

26 Jun 2018

Targeting Methods and Devices for Non-invasive Therapy Delivery

Record of Invention Number: 48305

Bryan Cunitz, Mike Bailey, Barbrina Dunmire, Michael Kennedy Hall, Adam Maxwell, Matthew Sorenson

Disclosure

11 Apr 2018

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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