# Ultra-high precision image-guided incisionless transcranial ultrasound surgery

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2024 · $764,056

## Abstract

PROJECT SUMMARY
Each year, nearly 2 million Americans receive a cancer diagnosis, with surgical removal being the primary
treatment approach for solid tumors. Nowhere are the challenges and benefits of high precision surgery more
apparent than in the brain where maximal resection is the primary therapeutic approach and where healthy tissue
must be preserved. For glioblastoma multiforme (GBM), one of the deadliest and treatment-resistant
malignancies, the extent of surgical resection provides the best indication of overall survival which is why
establishing maximum safe boundaries is a fundamental neuro-surgical objective. Despite two decades of
relentless improvements in surgical techniques, the median survival for GBM remains at 16 months using best-
practice radiosurgery with temozolomide. Advancements in diagnostic and imaging capabilities must be matched
by surgical practices to be effective. Consequently, as imaging modalities such as MRI, CT, or ultrasound have
improved in resolution, sensitivity, and specificity, so has the precision of surgical tools, such robotic surgery
systems or navigation systems, and minimally or non-invasive methods such as laparoscopies, radio-frequency
ablation, radiosurgery, and high intensity focused ultrasound. However, these methods struggle to achieve a
resolution beyond 2 mm, which is a significant hurdle when precision is crucial for the resection of complex
tumors near critical structures.
In this application, UNC-Chapel Hill and Caltech will collaborate to develop non-invasive transcranial volumetric
super-resolution imaging, targeted contrast agents, and image-guided focused ultrasound surgery. Our proposal
focuses on combining these techniques to resolve the persistent challenges of a) identifying tumor boundaries
b) targeting them with ultrasound, and c) establishing interaction between imaging and therapy systems to avoid
and/or target critical microvasculature. Advancements in imaging resolution (10 µm) will be matched by the co-
registered focused ultrasound beams (750 µm diameter, 50 µm positional accuracy). New ultrasound array
designs combined with super-harmonic sequences will enable the targeting of GV contrast agents as well as
freely circulating microbubble contrast agents that quantitatively image the intra- and extra-tumoral microvascular
environment. A programmable ultrasound scanner platform will control both the proposed therapy array and a
3D imaging array which will allow high-precision volumetric targeting and monitoring as well as enabling
sophisticated feedback between thermoablation and its effect on tumor microvasculature. If successful, this
project will thus enable effective surgical interventions in the highest mortality tumors.

## Key facts

- **NIH application ID:** 10954581
- **Project number:** 1R01EB036295-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Paul A Dayton
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $764,056
- **Award type:** 1
- **Project period:** 2024-08-20 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10954581

## Citation

> US National Institutes of Health, RePORTER application 10954581, Ultra-high precision image-guided incisionless transcranial ultrasound surgery (1R01EB036295-01). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10954581. Licensed CC0.

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