When Maya Langman, a senior at Virginia Tech Carillion School of Medicine (VTCSOM), was choosing a research project to pursue throughout her four years of school, she wanted to make a difference. Now, the aspiring neurosurgeon’s research is being hailed as the first of its kind with the potential to lead to revolutionary treatments for brain tumors.
Langman worked in the lab of her mentor, Eli Vlaisavljevich. Eli Vlaisavljevich is Associate Professor of Biomedical Engineering and Mechanics and Director of the Institute of Ultrasound and Non-Invasive Therapies at Virginia Tech. Vlaisavljevich is internationally renowned for developing new uses for histotrypsy therapy.
Histotripsy is a non-invasive focused ultrasound therapy that can remove cancerous tumors in various areas of the body. However, one area showing limitations is the brain. Due to the high density of bone, the skull acts like a barrier, reducing the power of ultrasound waves as they pass through. Langman’s research focused on how to make histotrypsy therapy more viable for the brain.
She is one of nine students to receive honors for her research and will be an oral presenter at VTCSOM’s Annual Medical Student Research Symposium on March 24 from noon to 5 p.m. I plan to.
Langman was paired with graduate student Lauren Ruger, and for four years the two were active research partners and friends.
“I came into the lab without a mechanical engineering background, so the learning curve was steep. Lauren has been a great teacher and partner over the last four years. We think,” said Langman.
To overcome the skull wall, Langman began his research by testing the acoustic properties of recently developed cranial implants. Implants are opaque, sound-transparent materials that act like windows that allow ultrasound transmission into the cranial cavity with minimal distortion. This implant has previously proven effective in bedside monitoring of brain tumor regrowth and in combination with other focused ultrasound modalities for opening the blood-brain barrier. However, its use in histotripsy for brain tumor resection has not been investigated.
In early tests, Langman used the transducer to test a range of ultrasound parameters to explore the feasibility of treating histotripsy with implants. Overcoming the barrier effect of implants with prototype transducers proved difficult. They hope that future iterations of the device will allow for histotryptic ablation via implants.
Research then took a new direction. Dr. Langman collaborated with research partners in the lab and his University of Maryland School of Veterinary Medicine at Virginia Tech team to facilitate the first-ever histotripsy resection of a brain tumor in a clinical patient. The patient was a dog with a benign tumor called meningioma. The procedure removed part of the animal’s skull, allowing the team to use histotrypsy to treat the dog’s tumor through an open window.
Dogs responded well to the procedure without adverse effects.
“This is the first time histotrypsy has been used to remove a brain tumor in a clinical patient,” she said. A second dog was successfully treated. The team plans to treat at least four more of her over the course of the pilot series.
“The two things we want to prove are that the procedure is safe and effective.
Langman describes his time in the Vlaisavljevich lab as one of the highlights of his medical school.
“Dr. Vlaisavljevich is a brilliant mind and always encourages us to think beyond current problems,” she said. “He’s what you envision as the best type of mentor to make you wonder, ‘What else?'”
Team members were allowed to present their research at the fall expert meeting and to present their research at this spring’s international conference. Langman hopes to continue to integrate her focused ultrasound research into her clinical career for as long as her residency placement allows.
“Maya’s work contributed significantly to the development of histotrypsy as a new non-invasive therapy for treating brain tumors,” said Vlaisavljevich. “She has set an amazing example of how to conduct groundbreaking interdisciplinary biomedical research within her team environment.”
“Focused ultrasound is an incredible modality,” says Langman. “There’s so much more than we can do. I think we’re just at the tip of the iceberg.”
Langman and the rest of the class of 2023 will be in the 10th graduating class of the medical school when the opening exercises take place on May 6.