Comparing Phantom and Animal Metrics Applied in the Determination of Focused Ultrasound Stable and Inertial Cavitation Levels.

OBJECTIVE: The opening of the blood-brain barrier (BBB) to allow therapeutic drug passage can be achieved by inducing microbubble cavitation using focused ultrasound (FUS). This approach can be monitored through analysis of the received signal to distinguish between stable cavitation associated with safe BBB opening and inertial cavitation associated with blood vessel damage. In this study, FUS phantom and animal studies were used to evaluate the experimental conditions that generate several cross-consistent metrics having the potential to be combined for the reliable, automatic control of cavitation levels. METHODS: Typical metrics for cavitation monitoring involve observing changes in the spectrum generated by applying the discrete Fourier transform (DFT) to the time domain signal detected using a hydrophone during FUS. A confocal hydrophone was used to capture emissions during a 10 ms FUS burst, sampled at 32 ns intervals, to produce 321,500 points and a high-resolution spectrum when transformed. The FUS spectra were analyzed to show the impact that equipment-transients and well-known DFT-related distortions had on the metrics used for cavitation control. A new approach, physical sparsification (PH-SP), was introduced to sharpen FUS spectral peaks and minimize the effect of these distortions. DISCUSSION: It was demonstrated that the general spectral signal-to-noise ratio (SNR) could be improved by removing the initial noisy phantom hydrophone signal transient. Minor changes in the transient length digitally removed from the sampled values significantly changed the spectral bandwidths of all the harmonically related FUS signals. We evaluated signal processing techniques to minimize the impact these DFT-related distortions on area-under-the-curve (AUC) metric calculations, and we identified the advantages of using PH-SP and proposed new metrics when characterizing FUS spectral properties. The results show many second, third and sub-harmonic metrics provide cross-consistent evidence of changes between stable and inertial cavitation levels. Removing the first harmonic signal component with a hardware low-pass filter allowed the hydrophone gain to be boosted without introducing distortion, leading to an improved analysis of the sub-harmonic signal orders of magnitude smaller in intensity. Metrics that optimized the energy in the real component of the complex-valued PH-SP spectra provided a 32% increase in the sub-harmonic sensitivity compared to standard metrics. CONCLUSION: A preliminary investigation of existing and proposed metrics showed that system noise could be large enough to mask the transition between stable and inertial cavitation. Strong narrowing of sub-harmonic peak shapes on applying physical sparsification (PH-SP) were seen in both phantom and animal studies. However, validating equivalent trends of the metrics with pressure were limited by the increased system noise level in the animal study combined with the natural variability between subjects studied. The combined use of hardware low-pass filters and physical sparsification to selectively removing distortions in the spectrum allowed the optimization of metrics for cavitation monitoring by improving the sub-harmonic sensitivity.