Intensification of the impact of high-intensity focused ultrasound (HIFU) with special spatiotemporal modulation

The principle of forming a special form of powerful acoustic signals is proposed, which makes it possible to ensure precise spatiotemporal beam focusing. The introduction of a transverse-coordinate-dependent local wave frequency is suggested, due to which the equality of the formation lengths of a discontinuity for all rays is achieved. This thereby ensures an increase in nonlinear absorption; as a result, the temperature and radiation action of focused ultrasound on the medium increase.     

High-intensity focused ultrasound (HIFU) for adenomyosis: Two-year follow-up results

ObjectiveTo evaluate the long-term improvement of clinical symptoms of adenomyosis after treatment with ultrasound-guided high intensity focused ultrasound (USgHIFU).MethodsFrom January 2010 to December 2011, 350 patients with adenomyosis were treated with USgHIFU. Among the 350 patients, 224 of them completed the two years follow-up. The patients were followed up at 3 months, 1 year, and 2 years after HIFU treatment. Adverse effects and complications were recorded.ResultsAll patients completed HIFU ablation without severe postoperative complications. 203 of the 224 patients who showed varying degrees of dysmenorrhea before treatment had the symptom scores decreased significantly after treatment (P < 0.001). The relief rate was 84.7%, 84.7%, and 82.3%, respectively at 3 months, 1 year, and 2 years after treatment. The menstrual volume in 109 patients with menorrhagia was significantly improved after treatment (P < 0.001) with a relief rate of 79.8%, 80.7%, and 78.9%, respectively at 3 months, 1 year, and 2 years after HIFU treatment.ConclusionWith its ability to sustain long-term clinical improvements, HIFU is a safe and effective treatment for adenomyosis.     

Effect of acoustic nonlinearity on heating of biological tissue by high-intensity focused ultrasound

Effect of strong acoustic nonlinearity on the efficiency of heating of a biological tissue by high-intensity focused ultrasound in the modes of operation used in real clinical setups is studied. The spatial distributions of thermal sources and the corresponding temperature increments caused by ultrasonic absorption are analyzed. Numerical algorithms are developed for simulating the nonlinear focusing of ultrasound in the calculations of both the heat sources on the basis of the Khokhlov-Zabolotskaya-Kuznetsov-type equations and the temperature field in a tissue on the basis of an inhomogeneous thermal conduction equation with a relaxation term. It is demonstrated that in the mode of operation typical of acoustic surgery, the nonlinearity improves the locality of heating and leads to an increase in the power of thermal sources in the focus by approximately an order of magnitude. The diffusion phenomena in the tissue lead to a smoothing of the spatial temperature distributions, as compared to the distributions of thermal sources. In the case of one-second exposure in the nonlinear mode of focusing, the maximal temperature in the focus exceeds the values obtained in the approximation of linear wave propagation by a factor of three.     

高强聚焦超声(HIFU)加热活体组织中的温度分布

在高强聚焦超声(HIFU)加热的情况下,利用多针射频(RF)测温装置测量活体组织内的温度分布,结果表明,温度梯度依赖于局部温度,温度越高,梯度越大。此外,本文还研究了血流对温度梯度的影响,结果似乎证实了理论预测,即血流(或血液灌注)减缓了温度(梯度)的变化。     

Perspectives in clinical uses of high-intensity focused ultrasound

Focused ultrasound holds promise in a large number of therapeutic applications. It has long been known that high intensity focused ultrasound can kill tissue through coagulative necrosis. However, it is only in recent years that practical clinical applications are becoming possible, with the development of high power ultrasound phased arrays and noninvasive monitoring methods. These technologies, combined with more sophisticated treatment planning methods allow noninvasive focusing in areas such as the brain, that were once thought to be unreachable. Meanwhile, exciting investigations are underway in microbubble-enhanced heating which could significantly reduce treatment times. These developments have promoted an increase in the number of potential applications by providing valuable new tools for medical research. This paper provides an overview of the scientific and engineering advances that are allowing the growth in clinical focused ultrasound applications. It also discusses some of these prospective applications, including the treatment of brain disorders and targeted drug delivery.     

Simulation of thermal lesions in biological tissues irradiated by high-intensity focused ultrasound through the rib cage

Thermal effect of high-intensity focused ultrasound on biological tissue behind the rib cage phantom has been numerically simulated. A phased array was used as a source of ultrasound. Temperature and thermal dose distributions in the biological tissue were calculated and used to find the form of thermal lesions. The results of the calculations are in good agreement with experiment and show that the model is applicable for predicting the effect produced by ultrasound in tissue.     

Enhancement and quenching of high-intensity focused ultrasound cavitation activity via short frequency sweep gaps

This letter reports on the use of frequency sweeps to probe acoustic cavitation activity generated by high-intensity focused ultrasound (HIFU). Unprecedented enhancement and quenching of HIFU cavitation activity were observed when short frequency sweep gaps were applied in negative and positive directions, respectively. It was revealed that irrespective of the frequency gap, it is the direction and frequency sweep rate that govern the cavitation activity. These effects are related to the response of bubbles generated by the starting frequency to the direction of the frequency sweep, and the influence of the sweep rate on growth and coalescence of bubbles, which in turn affects the active bubble population. These findings are relevant for the use of HIFU in chemical and therapeutic applications, where greater control of cavitation bubble population is critical.     

High-speed observation of cavitation bubble clouds near a tissue boundary in high-intensity focused ultrasound fields

Cavitation bubble clouds generated near a tissue boundary by high-intensity focused ultrasound (HIFU) were studied using high-speed photography. In all, 171 image series were captured during the initial 100 ms of continuous HIFU exposure, which showed that cavitation bubble clouds at the tissue boundary organized into two structures - “cone-shape bubble cloud structure” recorded in 146 image series and “crown-shape bubble cloud structure” recorded in 18 image series. The remaining 7 image series showed the interchanging of these two structures. It was found that when cavitation bubbles first appeared at the tissue boundary, they developed to cone-shape bubble cloud. The cone-shape bubble cloud structure was characterized by a nearly fixed tip in front of the tissue boundary. When the cavitation bubbles initially appeared away from the tissue boundary they evolved into a crown-shape bubble cloud. Deformation of tissue boundary was shown in all the recorded image series.     

The inception of cavitation bubble clouds induced by high-intensity focused ultrasound

In many therapeutic applications of high-intensity focused ultrasound (HIFU) the appearance of cavitation bubbles is unavoidable, whereas the dynamics of the bubbles induced by HIFU have not been clarified. The objective of the present work is to observe the inception process of cavitation bubble clouds generated by HIFU transducer in water using high-speed photography. Sequential images captured within 600 micros after the onset of ultrasound transmission show the dynamics of cavitation bubbles' generation, growth, deformation, expansion and collapse in the focal region. However, when the observation time is narrowed to the initial 145 micros, both the still and streak images reveal that the cavitation bubbles astonishingly stay stable in the focal region for at least 60 micros. The results imply that through adjusting the HIFU exposure time while other physical parameters are appropriately chosen, it might be possible to control the generation of stable cavitation bubbles locally in the focal region.     

Targeted damage effects of high intensity focused ultrasound (HIFU) on liver tissues of Guizhou Province miniswine

HIFU can pass through tissues and accurately damage target tissues inside organisms. This article reports on the oriented damage effects of HIFU upon miniswine internal and external liver tissues, and suggests a new conception of the 'biological focal field'. The results revealed that: (1) HIFU can be used to damage accurately liver tissues under the guide of a B-modal ultrasound device; (2) the scope of the injury is connected with sound intensity and irradiation time; and (3) the different layers of tissue through which the ultrasound has passed remain undamaged.     

Radiation force on absorbing targets and power measurements of a high intensity focused ultrasound (HIFU) source

Based on the analytic expressions for the radiated field of a circular concave piston given by Hasegawa et al.,an integral for calculation of the radiation force on a plane absorbing target in a spherically focused field is derived.A general relation between acoustic power P and normal radiation force Fn is obtained under the condition of kr 1.Numerical computation is carried out by using the symbolic computation program for practically focused sources and absorbing circular targets.The results show that,for a given source,there is a range of target positions where the radiation force is independent of the target's position under the assumption that the contribution of the acoustic field behind the target to the radiation force can be neglected.The experiments are carried out and confirm that there is a range of target positions where the measured radiation force is basically independent of the target's position even at high acoustic power (up to 700 W).It is believed that when the radiation force method is used to measure the acoustic power radiated from a focused source,the size of the target must be selected in such a way that no observable sound can be found in the region behind the target.     

Feasibility study of high intensity focused ultrasound (HIFU) for the treatment of hydatid cysts of the liver

This study evaluates the feasibility of using high intensity focused ultrasound (HIFU) for the treatment of hydatid cysts of the liver. HIFU ablation was carried out in 62 patients with echinococcosis of the liver. The mean age of patients was 40.76 ± 14.84 (range: 17–72 years). The effectiveness of the treatment was monitored in real-time by changes in the gray-scale, and by morphological studies, computed tomography, magnetic resonance imaging, and ultrasound.Criteria for evaluating the effectiveness of treatment in real time were outlines. Cytomorphological picture of destructive changes of parasitic elements was presented as well. Loss of embryonic elements of the parasite was observed at the subcellular level after HIFU-ablation and underlines the effectiveness of HIFU.     

Applications of high-intensity focused ultrasound in medicine: Spotlight on neurological applications

High-intensity focused ultrasound (HIFU) has the potential to become a modality of treatment for a wide range of clinical conditions. HIFU enables non-invasive, selective ablation of tissues including tumors and punctured vessels. Another promising area of research within the field of therapeutic ultrasound is the application of HIFU to treat neurological disorders by selectively targeting the brain, spinal cord, or nerves. This paper provides an overview of the current applications of focused ultrasound in medicine with an emphasis on its use in the fields of neurology and neurosurgery.     

Modeling of high-intensity focused ultrasound-induced lesions in the presence of cavitation bubbles

The classical "Bio Heat Transfer Equation (BHTE)" model is adapted to take into account the effects of oscillating microbubbles that occur naturally in the tissue during high-intensity focused ultrasound (HIFU) treatment. First, the Gilmore-Akulichev model is used to quantify the acoustic pressure scattered by microbubbles submitted to HIFU. Because this scattered pressure is not monochromatic, the concept of harmonic attenuation is introduced and a global attenuation coefficient is estimated for bubble-filled tissues. The first results show that this global attenuation coefficient varies significantly with respect to several parameters such as the frequency and the density of microbubbles in the medium, but also with respect to the incident acoustic pressure which thus becomes a transcendental function. Under these conditions, a layer-by-layer modeling, in the direction of propagation, is proposed to calculate the ultrasonic beam. Finally, the BHTE is solved and the HIFU-induced lesions are estimated by the calculation of the thermal dose. Using this model, it can be observed first that, when the firing power increases, the lesion develops clearly in the direction of the transducer, with a shape agreeing with in vivo experimentation. Next, it is observed that the lesion can be significantly modified in size and position, if an interface (skin or inner wall) is simulated as a zone with multiple cavitation nuclei. With a firing power increase, it is also shown how a secondary lesion can appear at the interface and how, beyond a certain threshold, this lesion develops at the main lesion expense. Finally, a better in-depth homogeneity of lesions is observed when the acoustic frequency of HIFU is increased.     

Nonlinear propagation acoustics of dual-frequency wide-band excitation pulses in a focused ultrasound system

In this article, acoustic propagation effects of dual-frequency wide-band excitation pulses in a focused ultrasound system are demonstrated in vitro. A designed and manufactured dual-frequency band annular array capable of transmitting 0.9/7.5 MHz center frequency wide-band pulses was used for this purpose. The dual-frequency band annular array, has been designed using a bi-layer piezo-electric stack. Water tank measurements demonstrate the function of the array by activating the low- and high-frequency layers individually and simultaneously. The results show that the array works as intended. Activating the low- and high-frequency layers individually, results in less than -50 dB signal level from the high- and low-frequency layers respectively. Activating both layers simultaneously, produce a well defined dual-frequency pulse. The presence of the low-frequency pulse leads to compression, expansion, and a time delay of the high-frequency pulse. There is a phase shift between the low- and high-frequency pulse as it propagates from the array to the focus. This makes the latter described effects also dependent on the array configuration. By varying the low-frequency pressure, a shift of up to 0.5 MHz in center frequency of a 8.0 MHz transmitted high-frequency pulse is observed at the array focus. The results demonstrate the high propagation complexity of dual-frequency pulses.     

从临床角度浅谈体外高强度聚焦超声肿瘤治疗设备的研制

本文从临床角度探讨在体外高强度聚焦超声（HIFU）治疗机的研发中应该关注的问题，指出重视HIFU的生物学效应研究、充分理解HIFU治疗肿瘤的临床意义对HIFU治疗机的研发具有的指导价值，提出了HIFU治疗机主要部件性能的临床要点，以及开发专用治疗机等构想，强调医工结合在HIFU治疗机开发中的重要性。     

On-demand regulation and enhancement of the nucleation in acoustic droplet vaporization using dual-frequency focused ultrasound

Acoustic droplet vaporization (ADV) plays an important role in focused ultrasound theranostics. Better understanding of the relationship between the ultrasound parameters and the ADV nucleation could provide an on-demand regulation and enhancement of ADV for improved treatment outcome. In this work, ADV nucleation was performed in a dual-frequency focused ultrasound configuration that consisted of a continuous low-frequency ultrasound and a short high-frequency pulse. The combination was modelled to investigate the effects of the driving frequency and acoustic power on the nucleation rate, efficiency, onset time, and dimensions of the nucleation region. The results showed that the inclusion of short pulsed high-frequency ultrasound significantly increased the nucleation rate with less energy, reduced the nucleation onset time, and changed the length–width ratio of the nucleation region, indicating the dual-frequency ultrasound mode yields an efficient enhancement of the ADV nucleation, compared to a single-frequency ultrasound mode. Furthermore, the acoustic and temperature fields varied independently with the dual-frequency ultrasound parameters. This facilitated the spatial and temporal control over the ADV nucleation, and opens the door to the possibility to realize on-demand regulation of the ADV occurrence in ultrasound theranostics. In addition, the improved energy efficacy that is obtained with the dual-frequency configuration lowered the requirements on hardware system, increasing its flexibility and could facilitate its implementation in practical applications.     

The correlation between frequency difference and mode polarization in an intracavity birefringent dual-frequency laser

We discuss the correlations between the measured lasing-mode frequency difference and the mode polarization angle in an intracavity birefringent dual-frequency laser. The frequency difference and polarization are adjusted by rotating an intracavity quartz crystal through a large angular range. We propose two kinds of frequency difference: the equal-order frequency difference and the adjacent frequency difference. By measuring the equal-order frequency difference versus the quartz crystal rotation angle, the real physical process behind frequency splitting is revealed. Based on this, the adjacent frequency difference curve is also obtained. The emitted laser beam polarization angle is also measured for large rotations of the intracavity quartz crystal. These measurements reveal the complete process of optical activity in frequency splitting and allow us to predict the trends of frequency difference and polarization angle for large quartz crystal rotation angles. We analyze the correlations between the equal-order frequency difference and the polarization angle based on the experimental results, which show that the certain points on the two curves are inter-related. The principal results agree well with the optical theory of crystals.     

Optimization of acoustic scattering from dual-frequency driven microbubbles at the difference frequency

The second harmonic radiation of acoustically driven bubbles is a useful discriminant for their presence in clinical ultrasound applications. It is useful because the scatter from a bubble at a frequency different from the driving can have a contrast-to-tissue ratio better than at the drive frequency. In this work a technique is developed to optimize the scattering from a microbubble at a frequency different from the driving. This is accomplished by adjusting the relative phase and amplitudes of the components of a dual-frequency incident ultrasound wave form. The investigation is focused primarily on the example of dual-mode driving at frequencies of 1 MHz and 3 MHz, with the scattering optimized at 2 MHz. Bubble radii of primary interest are 0.5 to 2 microm and driving amplitudes to 0.5 atm. Bubbles in this size range are sensitive to modulation of driving. It is shown that an optimal forcing scheme can increase the target response eightfold or more. This suggests new applications in imaging and in bubble detection.