A feasibility study of wireless inductively coupled surface coil for MR-guided high-intensity focused ultrasound ablation of rodents on clinical MRI systems.

Recently, to conduct preclinical imaging research on clinical MRI systems has become an attractive alternative to researchers due to its wide availability, cost, and translational application to clinical human studies when compared to dedicated small animal, high-field preclinical MRI. However, insufficient signal-to-noise ratio (SNR) significantly degrades the applicability of those applications which require high SNR, e.g. magnetic resonance guided high-intensity focused ultrasound (MRgHIFU) treatment. This study introduces a wireless inductively coupled surface (WICS) coil design used on a clinical 3 T MRI system for MRgHIFU ablation. To evaluate the SNR improvement and temperature accuracy of WICS coil, the ex vivo experiments were performed on the pork tenderloins (n = 7) and the hind legs of deceased Sprague-Dawley rats (n = 5). To demonstrate the feasibility, the in vivo experiments were performed on the hind leg of Sprague-Dawley rat (n = 1). For all experiments, temperature measurements were performed before and during HIFU ablation. Temperature curves with and without WICS coil were compared to evaluate the temperature precision in ex vivo experiments. The use of WICS coil improves the temperature accuracy from 0.85 to 0.14 °C, demonstrating the feasibility of performing small animal MRgHIFU experiments using clinical 3 T MRI system with WICS coil.

An integrated biometric voice and facial features for early detection of Parkinson's disease.

Hypomimia and voice changes are soft signs preceding classical motor disability in patients with Parkinson's disease (PD). We aim to investigate whether an analysis of acoustic and facial expressions with machine-learning algorithms assist early identification of patients with PD. We recruited 371 participants, including a training cohort (112 PD patients during "on" phase, 111 controls) and a validation cohort (74 PD patients during "off" phase, 74 controls). All participants underwent a smartphone-based, simultaneous recording of voice and facial expressions, while reading an article. Nine different machine learning classifiers were applied. We observed that integrated facial and voice features could discriminate early-stage PD patients from controls with an area under the receiver operating characteristic (AUROC) diagnostic value of 0.85. In the validation cohort, the optimal diagnostic value (0.90) maintained. We concluded that integrated biometric features of voice and facial expressions could assist the identification of early-stage PD patients from aged controls.

A novel sound-blocking structure based on the muffler principle for rib-sparing transcostal high-intensity focused ultrasound treatment.

The main challenge in transcostal high-intensity focused ultrasound therapy is minimising heat deposition in the ribs while ensuring that a sufficient dose is delivered to the target region. Current approaches rely on expensive multichannel phased-array systems to turn the individual transducer on and off according to either geometrical arrangements or complicated wave calculations. To protect the ribs from heating, the ultrasound energy must not only not reach the ribs, but must also not accumulate in front of the ribs. The research in this paper proposes a different approach, of attaching a sound-blocking structure in front of the rib cage with similar effects to those of an engine exhaust muffler. The sound-blocking structure is based on the muffler principle to prevent ultrasound energy from reaching the ribs and reduce the amount of energy reflected back to the applicator. Finite element simulations with a 0.5-MHz transducer of the overall sound fields and temperature distribution showed that the ultrasound pressure and energy level would decrease behind the novel sound-blocking structures, thereby resulting in a lower temperature at the ribs than at the tumour. Without the protecting structure, the rib temperature reached 104.19 °C whereas with the structure it reached only 37.86 °C. An experimental set-up using porcine ribs with a phantom was also developed to validate the concept, which showed that the rib temperature reached 73 °C without protection within 1 min of ablation time whereas it reached 36.5 °C with the device. The tumour region in the tests reached 51 °C and 49 °C with and without protection, respectively.

MRI-compatible ultrasound heating system with ring-shaped phased arrays for breast tumor thermal therapy.

Therapeutic ultrasound transducers can carry out precise and efficient power deposition for tumor thermal therapy under the guidance of magnetic resonance imaging. For a better heating, organ-specific ultrasound transducers with precision location control system should be developed for tumors located at various organs. It is feasible to perform a better heating for breast tumor thermal therapy with a ring-shaped ultrasound phased-array transducer. In this study, we developed ring-shaped phased-array ultrasound transducers with 1.0 and 2.5 MHz and a precision location control system to drive the transducers to the desired location to sonicate the designated region. Both thermo-sensitive hydrogel phantom and ex vivo fresh pork were used to evaluate the heating performance of the transducers. The results showed that the ring-shaped phased array ultrasound transducers were very promising for breast tumor heating with the variation of heating patterns and without overheating the ribs.

Effectiveness of external respiratory surrogates for in vivo liver motion estimation.

PURPOSE: Due to low frame rate of MRI and high radiation damage from fluoroscopy and CT, liver motion estimation using external respiratory surrogate signals seems to be a better approach to track liver motion in real-time for liver tumor treatments in radiotherapy and thermotherapy. This work proposes a liver motion estimation method based on external respiratory surrogate signals. Animal experiments are also conducted to investigate related issues, such as the sensor arrangement, multisensor fusion, and the effective time period. METHODS: Liver motion and abdominal motion are both induced by respiration and are proved to be highly correlated. Contrary to the difficult direct measurement of the liver motion, the abdominal motion can be easily accessed. Based on this idea, our study is split into the model-fitting stage and the motion estimation stage. In the first stage, the correlation between the surrogates and the liver motion is studied and established via linear regression method. In the second stage, the liver motion is estimated by the surrogate signals with the correlation model. Animal experiments on cases of single surrogate signal, multisurrogate signals, and long-term surrogate signals are conducted and discussed to verify the practical use of this approach. RESULTS: The results show that the best single sensor location is at the middle of the upper abdomen, while multisurrogate models are generally better than the single ones. The estimation error is reduced from 0.6 mm for the single surrogate models to 0.4 mm for the multisurrogate models. The long-term validity of the estimation models is quite satisfactory within the period of 10 min with the estimation error less than 1.4 mm. CONCLUSIONS: External respiratory surrogate signals from the abdomen motion produces good performance for liver motion estimation in real-time. Multisurrogate signals enhance estimation accuracy, and the estimation model can maintain its accuracy for at least 10 min. This approach can be used in practical applications such as the liver tumor treatment in radiotherapy and thermotherapy.

Split-focused ultrasound transducer with multidirectional heating for breast tumor thermal surgery.

This study investigated the feasibility of using a split-focused ultrasound transducer to perform thermal surgery on breast tumors, based on a multidirectional heating scheme. The transducer is a square section of a sphere with a radius of 10 cm. The transducer was tilted such that its acoustic beam was 45 degrees relative to the rib surface, and its focal zone was arranged by a shift of 6 mm away from the center of the planning target volume. The multifocus switching technique was employed to enhance the heating efficiency. When a single transducer was used, the transducer sonicated from a certain position for a given duration, and then rotated sequentially to continue the heating. Computer simulations and in vitro phantom experiments have been studied for this heating system. Both simulation and experimental results demonstrated that the system based on a multidirectional heating scheme is capable of generating a proper thermal lesion within 8 min. Meanwhile, from the simulation results, the rib heating was effectively alleviated by tilting the transducer to induce the total reflection at the muscle/bone interface. While using multiple ultrasound transducers, an appropriate arrangement was designed to have the same configuration of acoustic beams as is used for a single-transducer strategy. The simulation results from the four-transducer strategy indicated that the heating results could be further improved. This study revealed that it is very promising to have an appropriate arrangement of a single split-focused ultrasound transducer with mechanical rotation, or to have multiple split-focused transducers that use multidirectional heating for breast tumor thermal therapy.

Focused ultrasound thermal therapy system with ultrasound image guidance and temperature measurement feedback.

In this study, we developed a focused ultrasound (FUS) thermal therapy system with ultrasound image guidance and thermocouple temperature measurement feedback. Hydraulic position devices and computer-controlled servo motors were used to move the FUS transducer to the desired location with the measurement of actual movement by linear scale. The entire system integrated automatic position devices, FUS transducer, power amplifier, ultrasound image system, and thermocouple temperature measurement into a graphical user interface. For the treatment procedure, a thermocouple was implanted into a targeted treatment region in a tissue-mimicking phantom under ultrasound image guidance, and then the acoustic interference pattern formed by image ultrasound beam and low-power FUS beam was employed as image guidance to move the FUS transducer to have its focal zone coincident with the thermocouple tip. The thermocouple temperature rise was used to determine the sonication duration for a suitable thermal lesion as a high power was turned on and ultrasound image was used to capture the thermal lesion formation. For a multiple lesion formation, the FUS transducer was moved under the acoustic interference guidance to a new location and then it sonicated with the same power level and duration. This system was evaluated and the results showed that it could perform two-dimensional motion control to do a two-dimensional thermal therapy with a small localization error 0.5 mm. Through the user interface, the FUS transducer could be moved to heat the target region with the guidance of ultrasound image and acoustic interference pattern. The preliminary phantom experimental results demonstrated that the system could achieve the desired treatment plan satisfactorily.

Thermal therapy for breast tumors by using a cylindrical ultrasound phased array with multifocus pattern scanning: a preliminary numerical study.

The purpose of this study is to investigate the feasibility of using a 1 MHz cylindrical ultrasound phased array with multifocus pattern scanning to produce uniform heating for breast tumor thermal therapy. The breast was submerged in water and surrounded by the cylindrical ultrasound phased array. A multifocus pattern was generated and electrically scanned by the phased array to enlarge the treatment lesion in single heating. To prevent overheating normal tissues, a large planning target volume (PTV) would be divided into several planes with several subunits on each plane and sequentially treated with a cooling phase between two successive heatings of the subunit. Heating results for different target temperatures (T(tgt)), blood perfusion rates and sizes of the PTV have been studied. Furthermore, a superficial breast tumor with different water temperatures was also studied. Results indicated that a higher target temperature would produce a slightly larger thermal lesion, and a higher blood perfusion rate would not affect the heating lesion size but increase the heating time significantly. The acoustic power deposition and temperature elevations in ribs can be minimized by orienting the acoustic beam from the ultrasound phased array approximately parallel to the ribs. In addition, a large acoustic window on the convex-shaped breast surface for the proposed ultrasound phased array and the cooling effect of water would prevent the skin overheating for the production of a lesion at any desired location. This study demonstrated that the proposed cylindrical ultrasound phased array can provide effective heating for breast tumor thermal therapy without overheating the skin and ribs within a reasonable treatment time.

A fast and conformal heating scheme for producing large thermal lesions using a 2D ultrasound phased array.

The treatment conformability and the total treatment time of large tumors are both important issues in ultrasound thermal therapy. Previous heating strategies all show their restrictions in achieving these two issues to satisfactory levels simultaneously. This work theoretically presents a new heating strategy which is capable of both increasing the treatment conformability and shortening the treatment time, when using a 2D ultrasound phased array transducer. To perform this, a set of the multiple-foci patterns (considered the basic heating units) were temporally switched to steer the beam at different focal planes with the lesion length being well-controlled. Then, to conformally cover an irregular target volume, the 2D phased array was laterally shifted by a positioning system to deposit a suitable heating unit to cover a subvolume part. Results demonstrated that the totally treatment time can be largely reduced. The heating rate can be increased up to 0.96 cm3/min compared to the previously reported 0.26 cm3/min. Also, the proposed scheme showed that the tumor regions can be completely treated with the normal tissue damage at satisfactory level. The feasibility of the proposed strategy for irregular tumor treatment was also demonstrated. This study offers useful information in large tumor treatment in ultrasound thermal therapy.

Interactions between consecutive sonications for characterizing the thermal mechanism in focused ultrasound therapy.

The use of focused ultrasound for thermal ablation or therapy has become a promising modality due to its high selectivity and noninvasiveness. The temperature increase that induces thermal necrosis in the focal beam area has been reported to be attributed to the absorption of ultrasound energy and heating enhancement by acoustic cavitation. The purpose of this study is to propose a novel experimental arrangement to observe the thermal lesion formation and to demonstrate that the presence of the ultrasound-induced, macroscopically-visible bubbles may exert a key effect in thermal lesion formation. In our experiments, consecutive sonications with orthogonal intersections were applied to observe the thermal lesion interaction induced by 577- or 1155-kHz ultrasound. Results showed that the 1155-kHz heating was dominated by ultrasound energy absorption, with blocking of consecutive sonications being evident only rarely. However, in 577-kHz sonications, the thermal process was dominated by inertial cavitation and the corresponding ultrasound-induced, macroscopically-visible bubbles, which was verified from the later lesion being blocked by the former one and direct observation from light microscopy. This study demonstrates that the operating frequency for ultrasound thermal ablation should be selected based on the intended specific thermal mechanisms to be induced.

Cavitation-enhanced ultrasound thermal therapy by combined low- and high-frequency ultrasound exposure.

This paper demonstrates a novel approach for enhancing ultrasound-induced heating by the introduction of acoustic cavitation using simultaneous sonication with low- and high-frequency ultrasound. A spherical focused transducer (566 or 1155 kHz) was used to generate the thermal lesions, and a low-frequency planar transducer (40 or 28 kHz) was used to enhance the bubble activity. Ex vivo fresh porcine muscles were used as the target of ultrasound ablation. The emitted signals and the signals backscattered from the bubble activity were also recorded during the heating process by a PVDF-type needle hydrophone, and thermocouples were inserted to measure temperatures. Compared with the lesions formed by a single focused transducer, the size of the lesions generated by this approach were as much as 140% larger along the axial direction and 200% larger along the radial direction for combined 566- and 40-kHz sonication. They were 47% and 66% larger along the axial and radial directions, respectively, for combined 1155- and 28-kHz sonication. Cavitation activities enhanced by low-frequency ultrasound were confirmed by the presence of subharmonics in the spectrum and temperature increase as a result of increased tissue absorption. These observations imply that cavitation-enhanced lesions can be generated without reducing the penetration ability; they also show the advantage of producing larger and more uniform thermal lesions by multiple sonications. This technique provides an easy and effective way to achieve cavitation-enhanced heating, and may be useful for generating large and deep-seated thermal lesions.

Investigation of a scanned cylindrical ultrasound system for breast hyperthermia.

This paper investigates the feasibility of a scanned cylindrical ultrasound system for producing uniform heating from the central to the superficial portions of the breast or localized heating within the breast at a specific location. The proposed system consists of plane ultrasound transducer(s) mounted on a scanned cylindrical support. The breast was immersed in water and surrounded by this system during the treatment. The control parameters considered are the size of the transducer, the ultrasound frequency, the scan angle and the shifting distance between the axes of the breast and the system. Three-dimensional acoustical and thermal models were used to calculate the temperature distribution. Non-perfused phantom experiments were performed to verify the simulation results. Simulation results indicate that high frequency ultrasound could be used for the superficial heating, and the scan angle of the transducer could be varied to obtain an appropriate high temperature region to cover the desired treatment region. Low frequency ultrasound could be used for deep heating and the high temperature region could be moved by shifting the system. In addition, a combination of low and high frequency ultrasound could result in a portion treatment from the central to the superficial breast or an entire breast treatment. Good agreement was obtained between non-perfused experiments and simulation results. The findings of this study can be used to determine the effects of the control parameters of this system, as well as to select the optimal parameters for a specific treatment.

Investigation of a cylindrical ultrasound phased-array with multiple-focus scanning for breast tumor thermal therapy.

The purpose of this study is to investigate the feasibility of a cylindrical ultrasound phased-array with multiple-focus scanning strategy to produce a uniform heating for breast thermal therapy. In this study, a breast is surround by a 1-MHz cylindrical ultrasound phased-array consists of 200 elements with a radius of 10 cm and a height of 2 cm. To prevent overheating in the normal tissue, a scanning region of 1 cmt x 1 cm was selected as a single heating unit. Planning target volume (PTV) larger than this size would be divided into several sub-heating units, and then be treated sequentially with cooling phase to prevent overheating in the surrounding normal tissue. Parameters such as the target temperature, blood perfusion rate and the size of PTV are evaluated. Simulation results show that the target temperature affects the thermal lesion size and the blood perfusion rate increases the heating time significantly. This method provides efficient heating for breast tumor thermal therapy while preventing overheating the ribs.

Treatment time reduction for large thermal lesions by using a multiple 1D ultrasound phased array system.

To generate large thermal lesions in ultrasound thermal therapy, cooling intermissions are usually introduced during the treatment to prevent near-field heating, which leads to a long treatment time. A possible strategy to shorten the total treatment time is to eliminate the cooling intermissions. In this study, the two methods, power optimization and acoustic window enlargement, for reducing power accumulation in the near field are combined to investigate the feasibility of continuously heating a large target region (maximally 3.2 x 3.2 x 3.2 cm3). A multiple 1D ultrasound phased array system generates the foci to scan the target region. Simulations show that the target region can be successfully heated without cooling and no near-field heating occurs. Moreover, due to the fact that there is no cooling time during the heating sessions, the total treatment time is significantly reduced to only several minutes, compared to the existing several hours.

One-dimensional phased array with mechanical motion for conformal ultrasound hyperthermia.

This paper investigates the feasibility of conformal heating for external ultrasound hyperthermia by using a phased array transducer with mechanical motion. In this system, a one-dimensional phased array is arranged on a shaft and moves along the shaft, while dynamically focusing on the planning target volume (PTV) with numerous focal spots. To prevent overheating in the intervening tissue between the skin and the PTV, the shaft and the phased array are rotated together to enlarge the acoustical window. With the purpose of conformal heating, the power deposition of the PTV is constructed by combinations of the focal spots and an iterative gradient descent method is then used to determine an optimal set of power weightings for the focal spots. Different tumour shapes are evaluated and the simulation results demonstrate that the volume percentage of the PTV with temperatures higher than 43 degrees C is over 95%. The overheating volume outside the PTV is less than 25% of the PTV. This method provides good conformal heating for external ultrasound hyperthermia. The concept of combining electrical focusing and mechanical motion has the advantages of both enlarging the acoustic window and providing dynamic focusing ability, which is essential for successful conformal heating.