Estimation of the Proton Resonance Frequency Coefficient in Agar-based Phantoms.

Aim: Agar-based phantoms are popular in high intensity focused ultrasound (HIFU) studies, with magnetic resonance imaging (MRI) preferred for guidance since it provides temperature monitoring by proton resonance frequency (PRF) shift magnetic resonance (MR) thermometry. MR thermometry monitoring depends on several factors, thus, herein, the PRF coefficient of agar phantoms was estimated. Materials and Methods: Seven phantoms were developed with varied agar (2, 4, or 6% w/v) or constant agar (6% w/v) and varied silica concentrations (2, 4, 6, or 8% w/v) to assess the effect of the concentration on the PRF coefficient. Each phantom was sonicated using varied acoustical power for a 30 s duration in both a laboratory setting and inside a 3T MRI scanner. PRF coefficients were estimated through linear trends between phase shift acquired using gradient sequences and thermocouple-based temperatures changes. Results: Linear regression (R 2 = 0.9707-0.9991) demonstrated a proportional dependency of phase shift with temperature change, resulting in PRF coefficients between -0.00336 ± 0.00029 and -0.00934 ± 0.00050 ppm/°C for the various phantom recipes. Weak negative linear correlations of the PRF coefficient were observed with increased agar. With silica concentrations, the negative linear correlation was strong. For all phantoms, calibrated PRF coefficients resulted in 1.01-3.01-fold higher temperature changes compared to the values calculated using a literature PRF coefficient. Conclusions: Phantoms developed with a 6% w/v agar concentration and doped with 0%-8% w/v silica best resemble tissue PRF coefficients and should be preferred in HIFU studies. The estimated PRF coefficients can result in enhanced MR thermometry monitoring and evaluation of HIFU protocols.

Characterization of a fat tissue mimicking material for high intensity focused ultrasound applications.

PURPOSE: Tissue-mimicking materials (TMMs) have a prominent role in validating new high intensity focused ultrasound (HIFU) therapies. Agar-based TMMs are often developed mimicking the thermal properties of muscle tissue, while TMMs simulating fat tissue properties are rarely developed. Herein, twelve agar-based TMMs were iteratively developed with varied concentrations of agar, water, glycerol and propan-2-ol, and characterized for their suitability in emulating the thermal conductivity of human fat tissue. METHODS: Varied agar concentrations (2%, 4%, 6%, 8%, 12%, 16% and 20% w/v) were utilized for developing seven water-based TMMs, while a 20% w/v agar concentration was utilized for developing two water/alcohol-based TMMs (50% v/v water and 50% v/v either glycerol or propan-2-ol) and three alcohol-based TMMs (varied glycerol and propan-2-ol concentrations). Thermal conductivity was measured for all TMMs, and the tissue mimicking material (TMM) exhibiting thermal conductivity closest to human fat was considered the optimum fat TMM and was further characterized using ultrasound (US) and Magnetic Resonance Imaging (MRI). RESULTS: For the seven water-based TMMs an inverse linear trend was observed between thermal conductivity and increased agar concentration, being between 0.524 and 0.445 W/m K. Alcohol addition decreased thermal conductivity of the two water/alcohol-based TMMs to about 0.33 W/m K, while in the alcohol-based TMMs, increased concentrations of propan-2-ol emerged as a modifier of thermal conductivity. The optimum fat TMM (33.3% v/v glycerol and 66.7% v/v propan-2-ol) exhibited a 0.231 W/m K thermal conductivity, and appeared hypoechoic on US images and with increased brightness on T1-Weighted MRI images. CONCLUSION: The optimum fat TMM emulates the thermal conductivity of human fat tissue and exhibits a fat-like appearance on US and MRI images. The TMM is cost-effective and has a long lifespan and possesses great potential for use in HIFU applications as a fat TMM.

Robotic system for magnetic resonance imaging-guided focused ultrasound treatment of thyroid nodules.

BACKGROUND: Herein, a robotic system offering Magnetic Resonance-guided Focused Ultrasound (MRgFUS) therapy of thyroid nodules was developed. METHODS: The robotic system offers linear motion in 2 PC-controlled axes that navigate a 3 MHz single-element focused transducer. The system, through a C-arm structure attaches to the table of Magnetic Resonance Imaging (MRI) scanners and couples to the neck of patients lying in the supine position. The MRI compatibility of the developed system was assessed inside a 3 T scanner. Benchtop and MRI feasibility studies evaluating the heating performance of the system were executed on excised pork tissue and on homogeneous and thyroid model agar-based phantoms. RESULTS: The MRI compatibility of the system was successfully established. Grid sonications executed using robotic motion inflicted discrete and overlapping lesions on the excised tissue, while magnetic resonance (MR) thermometry successfully monitored thermal heating in agar-based phantoms. CONCLUSIONS: The developed system was found to be efficient with ex-vivo evaluation. The system can perform clinical MRgFUS therapy of thyroid nodules and other shallow targets after further in-vivo evaluation.

Advanced software for MRgFUS treatment planning.

BACKGROUND AND OBJECTIVES: Herein, a user-friendly software platform for 3-dimensional Focused Ultrasound treatment planning based on Magnetic Resonance Imaging (MRI) images is presented. METHODS: The software directly retrieves and loads MRI images. Various design tools can be used on the MRI images to define the treatment area and the sonication parameters. Based on the treatment plan, the software controls the robotic motion and motion pattern of Magnetic Resonance guided Focused Ultrasound (MRgFUS) robotic systems to execute the treatment procedure. Real-time treatment monitoring is achieved through MRI images and thermometry. The software's functionality and performance were evaluated in both laboratory and MRI environments. Different treatment plans were designed on MRI images and sonications were executed on agar-based phantoms and polymer films. RESULTS: Magnetic Resonance (MR) thermometry maps were acquired in the agar-based phantoms. An exceptional agreement was observed between the software-planned treatment area and the lesions produced on the polymer films. CONCLUSIONS: The developed software was successfully integrated with the MRI and robotic system controls for performing accurate treatment planning and real-time monitoring during sonications. The software provides an extremely user-friendly interface, while in the future it could be enhanced by providing dynamic modulation of the ultrasonic parameters during the treatment process.

Phantom-based assessment of motion and needle targeting accuracy of robotic devices for magnetic resonance imaging-guided needle biopsy.

BACKGROUND: The current study proposes simple methods for assessing the performance of robotic devices intended for Magnetic Resonance Imaging (MRI)-guided needle biopsy. METHODS: In-house made agar-based breast phantoms containing biopsy targets served as the main tool in the evaluation process of an MRI compatible positioning device comprising a needle navigator. The motion accuracy of mechanical stages was assessed by calliper measurements. Laboratory evaluation of needle targeting included a repeatability phantom test and a laser-based method. The accuracy and repeatability of needle targeting was also assessed by MRI. RESULTS: The maximum error of linear motion for steps up to 10 mm was 0.1 mm. Needle navigation relative to the phantom and alignment with the various biopsy targets were performed successfully in both the laboratory and MRI settings. The proposed biopsy phantoms offered tissue-like signal in MRI and good haptic feedback during needle insertion. CONCLUSIONS: The proposed methods could be valuable in the process of validating the accuracy of MRI-guided biopsy robotic devices in both laboratory and real environments.

Experimental evaluation of high intensity focused ultrasound for fat reduction of ex vivo porcine adipose tissue.

PURPOSE: The present study was stimulated by the continuous growth of commercially available high intensity focused ultrasound (HIFU) systems for fat reduction. Herein, HIFU was utilised for fat ablation using a single-element ultrasonic transducer operating in thermal mode. METHODS: The custom-made concave transducer that operates at 1.1 MHz was assessed on excised porcine adipose tissue for its ability to reduce fat. Ultrasonic sonications were executed on the adipose tissue utilising acoustical power between 14 and 75 W and sonication time in the range of 1-10 min. The mass of the adipose tissue sample was weighed afore and after ultrasonic sonications and the effect of the sonication on the mass change was recorded. RESULTS: Mass change was linearly dependent with either increasing acoustical power or sonication time and was in the range of 0.46-1.9 g. High acoustical power of 62.5 W for a sonication time of 1 min and a power of 75 W for a sonication time of 5 min, respectively resulted in the formation of a lesion or possible cavitation on the piece of excised adipose tissue. CONCLUSION: The study demonstrated the efficacy of the proposed transducer in achieving a reduction of excised fat tissue. The present findings indicate the potential use of the transducer in a HIFU system indicated for the reduction of subcutaneous adipose tissue where increased values of acoustical power can result in increased amounts of fat reduction.

Evaluation of ultrasonic scattering in agar-based phantoms using 3D printed scattering molds.

PURPOSE: Acoustic characterization of tissue mimicking materials in terms of attenuation, absorption, scattering and propagation velocity is essential for their utilisation in experiments, thus sparing the need for living tissues or cadavers. Although there is a vast literature regarding the acoustic characterization of such materials in terms of attenuation or propagation velocity, there is limited data regarding the quantification of the scattering coefficient. Herein stimulated the utilisation of four agar-based phantoms featuring different sizes of scattering agar-structures on one of their surfaces so as to provide experimental evaluation of the magnitude of scattering. METHODS: The agar-based phantoms were developed with 6% w/v agar and 4% w/v silica and featured scatterers of sizes of 0-1 mm. The acoustic properties of propagation speed, impedance, insertion loss and attenuation were evaluated utilising the pulse-echo and through-transmission techniques. Scattering was deduced from the data. RESULTS: The propagation speed measured at 2.7 MHz was in the range of 1531.23-1542.97 m/s. Respectively the attenuation as measured at 1.1 MHz was in the range of 1.216-1.546 dB/cm increasing with increased scatterer size. Respectively the scattering coefficient was in the range of 0.078-0.324 dB/cm. Moreover, the scattering coefficient was linearly dependent on frequency in the range of 0.8-2.1 MHz indicating a 6-23% effect of the total attenuation. CONCLUSIONS: The experimental results demonstrate the utilisation of the procedure for quantification of the scattering coefficient of tissue mimicking materials thus improving the diagnostic and therapeutic uses of ultrasound.

Ultrasonic attenuation of canine mammary tumours.

BACKGROUND: Canine mammary tumours (CMTs) are the most common neoplasm appearing in female dogs and are considered the equivalent animal model of human breast cancer. However, in the literature, there is a gap for ultrasonic characterisation of these tumours. In this study, experimental measurements for acoustic attenuation and propagation speed of three surgically excised malignant CMTs were implemented. METHODS: The three tumours were fixed in formaldehyde for up to 72 h and a total of five sample pieces were sectioned from the three tumours to account for the varied morphology observed along the tumours. The through-transmission and pulse-echo techniques were employed for experimental measurements of the acoustic attenuation and propagation speed. RESULTS: Acoustic propagation speed of the five samples as measured at 2.7 MHz was in the range of 1568-1636 m/s. Correspondingly, acoustic attenuation was in the range of 1.95-3.45 dB/cm.MHz. Variations in both speed and attenuation were observed between samples acquired from the same tumour. CONCLUSIONS: Present findings suggest that both acoustic attenuation and propagation speed of CMTs are higher than normal canine tissues due to increased heterogeneity and varied morphology visually observed between the tumour specimens and evidenced by histological examination. Nevertheless, experimental results could aid in enhancing the use of ultrasound in the diagnosis and treatment of CMTs as well as provide essential data for comparative oncology.

Experimental evaluation of the near-field and far-field heating of focused ultrasound using the thermal dose concept.

BACKGROUND: Conventional motion algorithms utilized during High Intensity Focused Ultrasound (HIFU) procedures usually sonicate successive tissue cells, thereby inducing excess deposition of thermal dose in the pre-focal region. Long delays (~60 s) are used to reduce the heating around the focal region. In the present study the experimental evaluation of six motion algorithms so as to examine the required delay and algorithm for which the pre-focal (near-field) and post-focal (far-field) heating can be reduced using thermal dose estimations is presented. MATERIALS AND METHODS: A single element spherically focused transducer operating at 1.1 MHz and focusing beam at 9 cm, was utilized for sonication on a 400 mm2 area of an agar-based phantom. Movement of the transducer was performed with each algorithm, using 0-60 s (10 s step) delays between sonications. Temperatures were recorded at both near and far-field regions and thermal dose calculations were implemented. RESULTS: With the algorithms used in the present study, a delay of 50-60 s was required to reduce heating in the near-field region. A 30 s delay induced a safe thermal dose in the far-field region using all algorithms except sequential which still required 60 s delay. CONCLUSIONS: The study verified the conservative need for 60 s delay for the sequential plan treatment. Nevertheless, present findings suggest that prolonged treatment times can be significantly reduced in homogeneous tissues by selection of the optimized nonlinear algorithm and delay.

Magnetic resonance image-guided focused ultrasound robotic system for transrectal prostate cancer therapy.

BACKGROUND: A magnetic resonance image (MRI) guided robotic device for focussed ultrasound therapy of prostate cancer (PC) was developed. The device offers movement in 5 degrees of freedom (DOF) and uses a single-element transducer that operates at 3.2 MHz, has a diameter of 25 mm and focuses at 45 mm. METHODS: The MRI compatibility of the system was evaluated in a 1.5 T scanner. The ability of the transducer to create lesions was evaluated in laboratory and MRI settings, on ex vivo pork tissue and in vivo rabbit thigh tissue. RESULTS: Cavitational and thermal lesions were created on the excised pork tissue. In vivo experiments proved the efficacy of the system in ablating muscle tissue without damaging intervening areas. CONCLUSIONS: The MRI compatible robotic system can be placed on the table of any commercial MRI scanner up to 7 T. The device has the ability of future use for transrectal focal therapy of PC with the patient in supine position.