Dual-mode transducers for ultrasound imaging and thermal therapy

Medical imaging is a vital component of high intensity focused ultrasound (HIFU) therapy, which is gaining clinical acceptance for tissue ablation and cancer therapy. Imaging is necessary to plan and guide the application of therapeutic ultrasound, and to monitor the effects it induces in tissue. Because they can transmit high intensity continuous wave ultrasound for treatment and pulsed ultrasound for imaging, dual-mode transducers aim to improve the guidance and monitoring stages. Their primary advantage is implicit registration between the imaging and treatment axes, and so they can help ensure before treatment that the therapeutic beam is correctly aligned with the planned treatment volume. During treatment, imaging signals can be processed in real-time to assess acoustic properties of the tissue that are related to thermal ablation. Piezocomposite materials are favorable for dual-mode transducers because of their improved bandwidth, which in turn improves imaging performance while maintaining high efficiency for treatment. Here we present our experiences with three dual-mode transducers for interstitial applications. The first was an 11-MHz monoelement designed for use in the bile duct. It had a aperture that was cylindrically focused to 10 mm. The applicator motion was step-wise rotational for imaging and therapy over a 360°, or smaller, sector. The second transducer had 5-elements, each measuring for a total aperture of . It operated at 5.6 MHz, was cylindrically focused to 14 mm, and was integrated with a servo-controlled oscillating probe designed for sector imaging and directive therapy in the liver. The last transducer was a 5-MHz, 64-element linear array designed for beam-formed imaging and therapy. The aperture was with a pitch of 0.280 mm. Characterization results included conversion efficiencies above 50%, pulse-echo bandwidths above 50%, surface intensities up to , and axial imaging resolutions to 0.2 mm. The second transducer was evaluated in vivo using porcine liver, where coagulation necrosis was induced up to a depth of 20 mm in 120 s. B-mode and M-mode images displayed a hypoechoic region that agreed well with lesion depth observed by gross histology. These feasibility studies demonstrate that the dual-mode transducers had imaging performance that was sufficient to aid the guidance and monitoring of treatment, and could sustain high intensities to induce coagulation necrosis in vivo.     

Feasibility of using ultrasound contrast agents to increase the size of thermal lesions induced by non-focused transducers: in vitro demonstration in tissue mimicking phantom

Miniature flat ultrasound transducers have shown to be effective for a large variety of thermal therapies, but the associated superficial heating implicates developing original strategies in order to extend therapeutic depth. The goal of the present paper is to use ultrasound contrast agents (UCA) to increase remote attenuation and heating. Theoretical simulations demonstrated that increasing attenuation from 0.27 to 0.8 Np/cm at 10 MHz beyond a distance of 18 mm from the transducer should result in longer thermal damages due to protein coagulation in a tissue mimicking phantom. Contrast agents (BR14, Bracco, Plan-les-Ouates, Switzerland) were embedded in thermo-sensitive gel and attenuations ranging from 0.27 to 1.33 Np/cm were measured at 10 MHz for concentrations of BR14 between 0 and 4.8%. Thermal damages were then induced in several gels, which had different layering configurations. Thermal damages, 12.8 mm in length, were obtained in homogeneous gels. When mixing contrast agents at a concentration of 3.2% beyond a first 18 mm-thick layer of homogeneous gel, the thermal damages reached 21.5 mm in length. This work demonstrated that contrast agents can be used for increasing attenuation remotely and extending therapeutic depth induced by a non-focused transducer. Additional work must be done in vivo in order to verify the remote-only distribution of bubbles and associated increase in attenuation.     

Fluid pressure measurement using bubbles insonified by two frequencies

The double frequency method, where bubbles rising through a fluid are illuminated simultaneously with a ‘pump’ frequency swept through the resonance frequency range and a megahertz imaging frequency, is used to measure pressure changes in fluids non-invasively. The bubble echo spectrum is centred at the imaging frequency with side bands at separations equal to the pump frequency. If the ambient pressure is changed, the bubbles undergo changes in their sizes. This would alter the resonant frequency of the bubble and hence the peak of the echo at the sum (or difference) frequency. By observing shifts in the frequency of the peak amplitude of the side bands it is shown that fluid pressure changes can be measured accurately.     

Ultrasonic wave propagation in human cancellous bone: application of Biot theory

Ultrasonic wave propagation in human cancellous bone is considered. Reflection and transmission coefficients are derived for a slab of cancellous bone having an elastic frame using Biot's theory modified by the model of Johnson et al. [J. Fluid Mech. 176, 379-402 (1987)] for viscous exchange between fluid and structure. Numerical simulations of transmitted waves in the time domain are worked out by varying the modified Biot parameters. The variation is applied to the governing parameters and is about 20%. From this study, we can gain an insight into the sensitivity of each physical parameter used in this theory. Some parameters play an important role in slow-wave wave form, such as the viscous characteristic length lambda and pore fluid bulk modulus Kf. However, other parameters play an important role in the fast-wave wave form, such as solid density rhos and shear modulus N. We also note from these simulations that some parameters such as porosity phi, tortuosity alpha(infinty), thickness, solid bulk modulus Ks, and skeletal compressibility frame Kb, play an important role simultaneously in both fast and slow wave forms compared to other parameters which act on the wave form of just one of the two waves. The sensitivity of the modified Biot parameters with respect to the transmitted wave depends strongly on the coupling between the solid and fluid phases of the cancellous bone. Experimental results for slow and fast waves transmitted through human cancellous bone samples are given and compared with theoretical predictions.     

A short and convenient access to a trans-hydrindane unit from the anti-meso-acetylmethyldivinylcyclopentane via a radical pathway

An efficient route for multigram synthesis of a trans-hydrindane unit, involving a selective 6-endo-trig α-carbonyl radical cyclization of the α-xanthyl ketone 10 derivating from the anti-meso-acetylmethyldivinylcyclopentane 9 through a xanthate group transfer, is achieved in good yield. Preparation of an advanced intermediate for the Julia-Kocienski coupling, used in the elaboration of the trienic system of vitamin D (or calciferol) analogs, was materialized by conversion of the xanthate moiety to a 2-benzothiazole sulfonyl group.     

Detection of object resonances by vibro-acoustography and numerical vibrational mode identification

Chalk sphere and cylinder resonance frequencies related to compressional and bending modes were detected in water, using vibro-acoustography, a relatively new imaging technique. The variable (radiation) force of low-frequency excitation, produced by intersecting two primary focused ultrasound waves with slightly different frequencies, forces the object to vibrate. The low-frequency acoustic emission field, resulting from object vibration, was detected by a hydrophone. By fixing the object at the focus of the ultrasound beam and sweeping the frequency of one of the primary beams within a chosen bandwidth, it was possible to detect some of the resonance frequencies (those related to compressional and bending modes) via variations in acoustic emission amplitude. Experimental results showed excellent agreement with finite element calculations. This method can be used to characterize the presence of heterogeneities in various media, in the field of materials science or biology.     

Heart ablation using a planar rectangular high intensity ultrasound transducer and MRI guidance

The aim of this study was to evaluate a flat rectangular (3 × 10 mm²) MRI compatible transducer operating at 5 MHz. The main task was to explore the feasibility of creating deep lesions in heart at a depth of at least 15 mm. The size of thermal necrosis in heart tissue was estimated as a function of power and time using a simulation model. The system was then tested in an excised lamb heart. In this study, we were able to create lesions of 15 mm deep with acoustic power of 6 W for an exposure of approximately 1 min. The contrast to noise ratio (CNR) between lesion and heart tissue was evaluated using fast spin echo (FSE). The CNR value was approximately 22 using T1 W FSE. Maximum CNR was achieved with repetition time (TR) between 300 and 800 ms. Using T2W FSE, the corresponding CNR was approximately 13 for the 14 in vivo experiments. The average lesion depth was 11.93 mm with a standard deviation of 0.62 mm. In vivo irradiation conditions were 6 W for 60 s. The size of the lesion in the other two dimensions was close to 3 × 10 mm² (size of the transducer element).     

Ultrasonic elastography using sector scan imaging and a radial compression

Elastography is an imaging technique based on strain estimation in soft tissues under quasi-static compression. The stress is usually created by a compression plate, and the target is imaged by an ultrasonic linear array. This configuration is used for breast elastography, and has been investigated both theoretically and experimentally. Phenomena such as strain decay with tissue depth and strain concentrations have been reported. However in some in vivo situations, like prostate or blood vessels imaging, this set-up cannot be used. We propose a device to acquire in vivo elastograms of the prostate. The compression is applied by inflating a balloon that covers a transrectal sector probe. The 1D algorithm used to calculate the radial strain fails if the center of the imaging probe does not correspond to the center of the compressor. Therefore, experimental elastograms are calculated with a 2D algorithm that accounts for tangential displacements of the tissue. In this article, in order to gain a better understanding of the image formation process, the use of ultrasonic sector scans to image the radial compression of a target is investigated. Elastograms of homogeneous phantoms are presented, and compared with simulated images. Both show a strain decay with tissue depth. Then experimental and simulated elastograms of a phantom that contains a hard inclusion are presented, showing that strain concentrations occur as well. A method to compensate for strain decay and therefore to increase the contrast of the strain elastograms is proposed. It is expected that such information will help to interpret and possibly improve the elastograms obtained via radial compression.     

The feasibility of constructing a cylindrical array with a plane rotating beam for interstitial thermal surgery

Thermal surgery has been shown to be a useful therapeutic option when external ultrasound applicators cannot be used as their beam will not reach the target site. If plane transducers are used, the ultrasound beam has to be rotated in order to generate a sufficiently large volume of necrosis. However, rotating deep-seated interstitial applicators and controlling their shooting direction presents major technical problems. The purpose of this study is to evaluate the feasibility of constructing a cylindrical array with a plane rotating beam for ablating esophageal tumors by interstitial hyperthermia. The feasibility of such an array has been initially evaluated using a plane array (which is easier to make from a technical point of view). This array was made with a new piezoelectric material because its mechanical properties make it ideal for the construction of a cylindrical array in the future. We showed that the beam of each array element is sufficiently divergent and that cross-coupling is small enough to generate a plane wave from a cylindrical array. In addition, power tests and electro-acoustic efficiency measurements demonstrated that the output was sufficient to induce tissue necrosis in the relevant conditions.