The Clinical Ultrasound Laboratory (CUL) was established in April 2013 to improve and expand the use of ultrasound in medicine. The Principal Investigator is Greg Clement, PhD, who joined the Lerner Research Institute from Harvard University and the Brigham and Women’s Hospital in Boston, where he was an Associate Professor, Head of Imaging for the National Center for Image Guided Therapy, and the Technical Director of the Focused Ultrasound Laboratory.
Dr. Clement’s research has concentrated on methods to improve ultrasound resolution and ways to access areas in the body traditionally considered “off limits” to ultrasound due to the presence of bone. With specific concentration on the brain, he has developed several novel techniques for focusing ultrasound through the skull for improved ultrasound imaging and therapy.
Laboratory efforts at the Cleveland Clinic will center on developing disorder-specific noninvasive ultrasound tools and techniques. By using contrast agents, and with a better understanding of how these agents travel through the circulatory system, the laboratory will investigate methods for quantifying and mapping blood flow in the kidneys, the testicles, and in certain tumors. Imaging efforts in the brain will include the development of ultrasound brain tomography to detect hemorrhage and lesions, methods to detect brain shift during surgery, and monitors for hydrocephalus.
The laboratory is supported by grants from the National Institutes of Health and the US Army Medical Research and Materiel Command (Department of Defense).
In other words ...
Standard ultrasound machines can’t “see” through bone, making many organs – including the brain – unreachable. Dr. Clement is exploring ways to get ultrasound through bone to make images of the brain, heart, and other parts of the body. He has already developed several methods for focusing ultrasound energy through the skull and is now using these techniques to get better pictures that may show blood leakage or vessel blockage that, if untreated, could lead to stroke. His new ultrasound methods can detect how much the brain shifts during brain surgery and can help doctors monitor patients with "water on the brain."
Using ultrasound, the Clement team is also finding how to measure blood flow in the capillaries, the body’s tiniest vessels. The ability to detect unusual flows in these small vessels could help determine if organs, such as the kidney, are working properly. These same methods may also help doctors detect certain tumors that are currently invisible to other imaging methods. Dr. Clement’s new, nonsurgical techniques will help doctors in many specialties give patients better care.
Q. Wang, M. Howell, S. Shimizu, S. James, A Smiley, and G.T. Clement, "Investigation of the correlation between diffuse infrared and ultrasound for transcranial ultrasound" Biomedical Physics & Engineering Express, 2016 2(2) : 035016.
G.T. Clement, H. Nomura, T. Kamakura " Ultrasound Field Measurement Using a Binary Lens ," IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control, 2015 62(2): 350-359.
C. Arvanitis, G.T. Clement, N McDannold " Transcranial Assessment and Visualization of Acoustic Cavitation: Modeling and Experimental Validation In-Vivo ," IEEE Transactions on Medical Imaging, 2015 34(6): 1270-1281.
T. Kamakura, H. Nomura, and G.T. Clement " Linear and nonlinear ultrasound fields formed by planar sources with random pressure distributions ," Acoustical Science and Technology, 2015 36(3): 208:215.
G.T. Clement " A projection-based approach to diffraction tomography on curved boundaries ," Inverse problems, 2014 30(12):125010.
H.J. Paltiel, C.R. Estrada Jr., A.I. Alomari, C. Stamoulis, C.C. Passerotti, F.C. Meral, R.S. Lee, G.T. Clement " Multiplanar Dynamic Contrast-enhanced US Assessment of Blood Flow in a Rabbit Model of Testicular Torsion ," Ultrasound in Medicine and Biology, 2014 40:361-370.
H. Noumura, H. Adachi, T. Kamakura, G.T. Clement " Feasibility of low-frequency directive sound source with high range resolution using pulse compression technique ," Japanese Journal of Applied Physics, 2014; 53(7S):07KC03.
G.T. Clement, H. Nomura, H. Adachi, and T. Kamakura " Measurement of thin films using very long acoustic wavelengths," Journal of Applied Physics; 2013 114:234904
G.T. Clement, H. Nomura, H. Adachi, and T. Kamakura " The feasibility of non-contact ultrasound for medical imaging ," Physics in Medicine and Biology; 2013 58: 6263-6278. IOP FEATURED ARTICLE
T. Kamakura, H. Nomura and G.T. Clement " Application of the split-step Pade' approach to nonlinear field predictions ," Ultrasonics; 2013 Feb;53(2):432-8.
F.C. Meral; M.A. Jafferji; P.J. White; G.T. Clement, " Two-dimensional image reconstruction with spectrally-randomized ultrasound signals," IEEE Transactions In Ultrasonics, Ferroelectrics, and Frequency Control, 2013 60: 2501-2510.
Y. Jing, T. Wang, and G.T. Clement " A k-space method for moderately nonlinear wave propagation ," IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control , 2012 Aug;59(8):1664-73.
Y. Jing, F.C. Meral, and G.T. Clement " Time-reversal transcranial ultrasound beam focusing using a k-space method ," Physics in Medicine and Biology 2012 57; 901-917
G.T. Clement, H. Nomura, and T. Kamakura" The feasibility of pulse compression by nonlinear effective bandwidth extension," Journal of the Acoustical Society of America 2011 130(4); 1810-1819
Y. Jing and G.T. Clement "On the use of Gegenbauer reconstructions for shock wave propagation modeling," Journal of the Acoustical Society of America 2011 130(3); 1115-1124
S.C. Tang, F. Jolesz, and G.T. Clement "A Wireless Batteryless Deep-Seated Implantable Ultrasonic Pulser-Receiver Powered by Magnetic Coupling ," IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control , 2011; 58(6) 1211-1221.
Y. Jing, D. Shen, and G.T. Clement "Verification of the Westervelt equation for focused transducers ," IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control , 2011; 58(5) 1097-1101.
Y. Jing, M. Tao, and G.T. Clement "Evaluation of a wave vector frequency domain method for nonlinear wave propagation ," Journal of the Acoustical Society of America. 2011; 129(1): 32-46.
H.J. Paltiel, H.M. Padua1, P.C. Gargollo, G.M. Cannon, Jr, A.I. Alomari, R. Yu and G.T. Clement, "Contrast-enhanced, real-time volumetric ultrasound imaging of tissue perfusion: preliminary results in a rabbit model of testicular torsion," Physics in Medicine and Biology, 2011; 56: 2183-2197.
McDannold N, Clement GT, Black PM, Jolesz FA, Hynynen K,"Transcranial MRI-guided focused ultrasound surgery of brain tumors: Initial findings in three patients," Neurosurgery. 2010; 66(2): 323-332.
S.C. Tang and G.T. Clement "Standing wave suppression for transcranial ultrasound by random-modulation ," IEEE Transactions on Biomedical Engineering. 2010; 57(1): 201-205.
G.T. Clement "Planar projection in absorbing media possessing an arbitrary dispersion relation ," Acoustical Science and Technology. 2010; 31(6): 379-386.
S.C. Tang and G.T. Clement "Acoustic standing wave suppression using randomized phase-shift-keying (PSK) excitations ," Journal of the Acoustical Society of America. 2009; 126(4): 1667-1670.
B. Madore, P.J. White, K. Thomenius, G.T. Clement "Accelerated Focused Ultrasound Imaging ," IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control. 2009; 56(12): 2612-2623.
C. Farny, G.T. Clement "Ultrasound phase contrast thermal imaging with reflex transmission imaging methods in tissue phantoms," Ultrasound in Medicine and Biology. 2009; 35(12): 1995-2009.
P.J. White, S. Whalen, S.C. Tang, G.T. Clement, F.A. Jolesz, and A.J. Golby, "An Intraoperative Brain-shift Monitor Using Shear-mode Transcranial Ultrasound: Preliminary Results," Journal of Ultrasound in Medicine 2009; 28 191-203.
М. А. Миронов, П. А. Пятаков, И. И. Конопацкая, Г. Т. Клемент, Н. И. Выходцева;, " Параметрическое возбуждение сдвиговых волн в мягких упругих средах ," Akusticheskii zhurnal 2009; 55(4-5) 557-564.
M. Mironov, I. Konopatskaya, G.T. Clement, and N.Vykhodtseva "The Parametric Excitation of Shear Waves in Soft Elastic Media ," Acoustical Physics 2009 55(4-5); 567-574.
C. Farny and G.T. Clement, "A feasibility study of ultrasound phase angle contrast for heating localization," Journal of the Acoustical Society of America 2008; 123(3) 1773-83
S.C. Tang and G.T. Clement, " A harmonic cancellation technique for an ultrasound transducer excited by a switched-mode power converter," IEEE Trans Ultrason Ferroelectr Freq Control. 2008 Feb;55(2):359-67. Erratum in: IEEE Trans Ultrason Ferroelectr Freq Control. 2008 Mar;55(3):738.
White PJ and Clement GT, "Two-Dimensional Localization with a Single Diffuse Ultrasound Field Excitation," IEEE TUFFC. 2007 Nov;54(11):2309-17.
White PJ, Palchaudhuri S, Hynynen K, Clement GT. "The effects of desiccation on skull bone sound speed " IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control 2007 54 (8), 1708-1710
S-C. Tang, G.T. Clement, K. Hynynen, "A computer-controlled ultrasound pulser-receiver system from transskull fluid detection using a shear wave detection technique" IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control, 2007; 54(9) 1772-1783.
K. Hynynen and G.T.Clement, "Clinical applications of High Intensity Focused Ultrasound: The Brain, International Journal of Hyperthermia, 2007 23 (2) 193-202.
G.T.Clement, "Two-dimensional ultrasound detection with unfocused frequency-randomized signals" J Acoust Soc Am. 121(1):636-647 (2007).
JS Thierman, GT Clement, LA Kalish, PL O'Kane, F Frauscher and HJ Paltiel, Automated sonographic evaluation of testicular perfusionPhysics in Medicine and Biology. 2006; 51: 3419-3432.
K.Hynynen, N.McDannold, G.Clement, F.A.Jolesz, E.Zadicario, R.Killiany, T.Moore, and D.Rosen, Pre-clinical testing of a phased array ultrasound system for MRI-guided noninvasive surgery of the brain- A primate study Eur. J. Radiol. 59(2):149-56 (2006).
P.J.White, G.T.Clement, and K.Hynynen,Longitudinal and shear mode ultrasound propagation in human skull bone Ultrasound Med Biol. 32(7):1085-96 (2006).
P.J.White, G.T.Clement, and K.Hynynen,Local frequency dependence in transcranial ultrasound transmission Phys. Med. Biol. 51(9), 2293-305 (2006).
J. Aarnio, G.T. Clement, and K. Hynynen, “A new ultrasound method for determining the acoustic phase shifts caused by the skull bone” Ultrasound Med. Biol. 31(6), 771-80 (2005).
G.T.Clement, J.Huttunen, and K.Hynynen, “Superresolution ultrasound imaging using back-projected reconstruction” J. Acoust. Soc. Am. 118(6), 3953-60 (2005).
GT Clement and K Hynynen, “Ultrasound phase-contrast transmission imaging of localized thermal variation and the identification of fat/tissue boundaries” Phys. Med. Biol. 50(7), 1585-600 (2005).
G.T. Clement, PhD, FInstP, P.J. White, MS, R.L. King, MS, N. McDannold, PhD and K. Hynynen, PhD, “A Magnetic Resonance Imaging-Compatible, Large-Scale Array for Trans-Skull Ultrasound Surgery and Therapy” J. Ultrasound Med. 24(8), 1117-25 (2005).
G.T. Clement, “Spectral image reconstruction for transcranial ultrasound measurement” Phys. Med. Biol. 50(23), 5557-72 (2005).
J. White, G.T. Clement, and K. Hynynen, “Transcranial ultrasound focus reconstruction with phase and amplitude correction” IEEE Trans. Ultrason. Ferroelectr. Freq. Control 52(9), 1518-22 (2005).
G.T. Clement, P.J. White, and K. Hynynen, “Enhanced ultrasound transmission through the human skull using shear mode conversion” J. Acoust. Soc. Am. 115(3), 1356-64 (2004).
G.T.Clement, “Perspectives in clinical uses of high-intensity focused ultrasound” Ultrasonics 42(10), 1087-93 (2004).
K. Hynynen, G.T. Clement, N. McDannold, N. Vykhodtseva, R. King, P.J. White, S. Vitek, and F. A. Jolesz, “500-element ultrasound phased array system for noninvasive focal surgery of the brain: A preliminary rabbit study with ex vivo human skulls” Magn Reson. Med. 52(1), 100-7 (2004).
G.T. Clement and K. Hynynen, “Forward planar projection through layered media” IEEE Trans. Ultrason. Ferroelectr. Freq. Control 50(12), 1689-98 (2003).
R. L. King, G.T. Clement, S. Maruvada, and K. Hynynen, “Preliminary results using ultrasound transmission for image-guided thermal therapy”Ultrasound Med. Biol. 29(2), 301-7 (2003).
G.T. Clement and K. Hynynen, “Correlation of ultrasound phase with physical skull properties” Ultrasound Med. Biol. 28(5), 617-24 (2002).
G.T. Clement and K. Hynynen, “A non-invasive method for focusing ultrasound through the human skull” Phys Med. Biol. 47(8), 1219-36 (2002).
G.T. Clement and K. Hynynen, “Micro-receiver guided transcranial beam steering” IEEE Trans. Ultrason. Ferroelectr. Freq. Control 49(4), 447-53 (2002).
C.W. Connor, G.T. Clement, and K. Hynynen, “A unified model for the speed of sound in cranial bone based on genetic algorithm optimization” Phys. Med. Biol. 47(22), 3925-44 (2002).
K. Mahoney, T. Fjield, N. McDannold, G. Clement, and K. Hynynen,“Comparison of modeled and observed in vivo temperature elevations induced by focused ultrasound: implications for treatment planning” Phys Med. Biol. 46(7), 1785-98 (2001).
G.T. Clement, Sun J, Hynynen K. , “The role of internal reflection in transskull phase distortion. ” Ultrasonics. 2001; 39(2): 109-13.
G.T. Clement, J. Sun, T. Giesecke, and K. Hynynen. “A hemisphere array for non-invasive ultrasound brain therapy and surgery” Phys Med Biol 45(12), 3707-19 (2000).
G.T. Clement, J. White, and K. Hynynen. “Investigation of a large-area phased array for focused ultrasound surgery through the skull” Phys Med Biol 45(4), 1071-83 (2000).
G.T. Clement and K. Hynynen. “Field characterization of therapeutic ultrasound phased arrays through forward and backward planar projection”J Acoust Soc Am 108(1), 441-6 (2000).
Y. Sharf, G.T. Clement, and K. Hynynen. “Absolute measurements of ultrasonic pressure by using high magnetic fields” IEEE Trans Ultrason Ferroelectr Freq Contr 46(6), 1504 (1999).
G.T. Clement, R. Liu, S. Letcher, and P. Stepanishen. “Forward projection of transient signals obtained from a fiber-optic pressure sensor ” J. Acoust. Soc. Am. 104, 166-1273 (1998).
G.T. Clement, R. Liu, S. Letcher, and P. Stepanishen. “Temporal backward planar projection of acoustic transients ” J. Acoust. Soc. Am. 103, 1723-1726 (1998).