Optimization of pulsed focused ultrasound exposures for hyperthermia applications

Hyperthermic temperatures, with potential applications in drug/gene delivery and chemo/radio sensitization, may be generated in biological tissues by applying focused ultrasound (FUS) in pulsed mode. Here, a strategy for optimizing FUS exposures for hyperthermia applications is proposed based on theoretical simulations and in vitro experiments. Initial simulations were carried out for tissue-mimicking phantoms, and subsequent thermocouple measurements allowed for validation of the simulation results. Advanced simulations were then conducted for an ectopic, murine xenograft tumor model. The ultrasound exposure parameters investigated in this study included acoustic power (3-5 W), duty cycle (DC) (10%-50%), and pulse repetition frequency (PRF) (1-5 Hz), as well as effects of tissue perfusion. The thermocouple measurements agreed well with simulation outcomes, where differences between the two never exceeded 1.9%. Based on a desired temperature range of 39-44 °C, optimal tumor coverage (40.8% of the total tumor volume) by a single FUS exposure at 1 MHz was achieved with 4 W acoustic power, 50% DC, and 5 Hz PRF. Results of this study demonstrate the utility of a proposed strategy for optimizing pulsed-FUS induced hyperthermia. These strategies can help reduce the requirement for empirical animal experimentation, and facilitate the translation of pulsed-FUS applications to the clinic.     

Estimation of the content of fat and parenchyma in breast tissue using MRI T1 histograms and phantoms

Mammographic breast density has been correlated with breast cancer risk. Estimation of the volumetric composition of breast tissue using three-dimensional MRI has been proposed, but accuracy depends upon the estimation methods employed. The use of segmentation based on T1 relaxation rates allows quantitative estimates of fat and parenchyma volume, but is limited by partial volume effects. An investigation employing phantom breast tissue composed of various combinations of chicken breast (to represent parenchyma) and cooking fats was carried out to elucidate the factors that influence MRI T1 histograms. Using the phantoms, T1 histograms and their known fat and parenchyma composition, a logistic distribution function was derived to describe the apportioning of the T1 histogram to fat and parenchyma. This function and T1 histograms were then used to predict the fat and parenchyma content of breasts from 14 women. Using this method, the composition of the breast tissue in the study population was as follows: fat 69.9+/-22.9% and parenchyma 30.1+/-22.9%.     

Breast disease evaluation with fat-suppressed magnetic resonance imaging.

Thirty patients with a variety of pathologically confirmed malignant and benign pathologic lesions of the breast were evaluated with a spectrally selective fat suppression imaging technique to obtain fat-suppressed images of the breast. The technique, a selective partial inversion-recovery (SPIR) method, demonstrated the architectural relationship of malignant and benign tumors with respect to the normal water-containing elements of the breast. These relationships included signs of advanced malignant disease such as tissue retraction, invasive growth, and multicentricity, which appeared on the fat-suppressed images. Fat-suppressed imaging provided useful information for assessing the breasts of both pre- and postmenopausal women, especially in the latter group, where fatty involution of the breast is common. Microcysts, which are normally not visualized by conventional methods, were demonstrated and associated with patients having confirmed fibrocystic disease of the breast. As expected, the SPIR technique did not improve the ability to distinguish between tissues having similar T1 and T2 relaxation time values, such as malignant tumors and normal breast parenchymal tissues. The technique was able to demonstrate that the intense lipid signal, known to be responsible for obscuring the borders of water-fat interfaces and small tumors, could be eliminated in a variety of pathological settings.     

Hyperthermia induces T1 relaxation and blood flow changes in tumors. A MRI thermometry study in vivo

Regional hyperthermia in combination with chemotherapy and/or radiotherapy has proven to be an effective treatment concept for locally advanced deep-seated tumors. Simultaneous MR-imaging could be a promising approach for therapy optimization. Purpose of this study was the in vivo investigation of temperature induced longitudinal relaxation time (T(1)) and blood flow changes in a tumor model. Using a 1.5 Tesla MR system, the T(1) sensitivity on temperature and the onset of tissue changes at temperatures >44 degrees C were investigated in muscle samples. Also, fourteen Syrian Golden Hamsters with amelanotic melanoma A-MEL-3 were examined during heating of the tumors. Temperature induced blood flow and T(1) changes were determined continuously during hyperthermia. Changes of T(1) correlated linearly with temperature over a wide range (27-44 degrees C) in the tissue sample. Tissue changes became notable above 44 degrees C. In the tumor model, relative changes of T(1) (unlike blood flow) showed linear correlation with temperature over the entire range of hyperthermia relevant temperatures (32-44 degrees C). For a low thermal dose, T(1) allows the assessment of temperature changes in tumors in vivo. At higher thermal doses, in addition to temperature changes, T(1) also shows tissue changes. Both temperature and tissue changes supply important information for hyperthermia.     

Characterizing blood volume fraction (BVF) in a VX2 tumor

OBJECTIVES: Neovascular proliferation of a tumor's blood supply is an important precursor of malignant growth. Evaluation of blood volume may provide useful information for the characterization, prognosis and response of tumors to therapy. The purpose of this study was to determine and compare the blood volume of tumor tissue measured noninvasively by MRI and microbubble contrast ultrasound imaging. MATERIALS AND METHODS: Twenty-two rabbits injected with VX2 tumors were studied. The blood volume fraction in tumor and muscle tissue was obtained from MRI T(1)-weighted images using a blood-pool agent, Clariscan, and by ultrasound using Definity and pulse inversion imaging. RESULTS AND CONCLUSIONS: Similar results were obtained from MRI and ultrasound. Estimation of the blood volume in tissue in the rim of a VX2 tumor 1.5 to 5.0 cm in diameter relative to that in the surrounding muscle was (mean+/-S.D.) 3.31+/-1.43 by MRI and 2.99+/-1.83 by ultrasound. The blood volume in the tissue relative to the total tissue volume (relative blood volume fraction) measured by MRI was 13+/-4.1% in tumor versus 4+/-1.4% in muscle (P<.01). Our data also suggested that, compared to the distribution volume of an extracellular contrast agent, Gd-DTPA, Clariscan as an intravascular agent demonstrated high-quality depictions of vascular structure of the tumor.     

Quantitative evaluation of the use of microbubbles with transcranial focused ultrasound on blood-brain-barrier disruption

It has been shown that focused ultrasound (FUS) can disrupt the blood-brain barrier (BBB) noninvasively and reversibly at target locations when applied in the presence of ultrasound contrast agent (UCA). In this study, the dose-dependent effects of UCA on BBB disruption were investigated in the brains of 16 male Wistar rats sonicated by 1.0-MHz transcranial FUS, with the UCA present at four doses. The BBB disruption was evaluated quantitatively based on the extravasation of Evans blue (EB). The amount of EB extravasation in the brain increased with the quantity of UCA injected into the femoral vein prior to sonication. Moreover, the use of a suitable dose of UCA resulted in the BBB disruption being concentrated in the focal region instead of the entire brain. Our results indicate that injecting an appropriate quantity of UCA effectively increases and localizes the BBB disruption induced by transcranial FUS sonications.     

Quantitative multivoxel proton chemical shift imaging of the breast

The study of focal pathology by single-voxel magnetic resonance spectroscopy (MRS) is hampered by the impossibility to study tissue heterogeneity or compare the metabolite signals in breast lesion directly to those in unaffected tissue. Multivoxel MRS studies, while potentially allowing for truly quantitative tissue characterization, have up to now also been far from quantitative with, for example, the signal-to-noise ratio of the choline (Cho) signal serving as measure of tumor activity. Shown in this study is that in a standard clinical setting with a regular 1.5-T magnetic resonance scanner, it is possible to perform quantitative multivoxel MRS. With the use of literature values for the T1 and T2 relaxation times of Cho and water in fibroglandular breast tissue and tumors, one can determine the concentrations of Cho in different tumor compartments and surrounding tissues in two brief multivoxel MRS measurements. This opens excellent perspectives to quantitative diagnostic and follow-up studies of focal pathology such as lesions suspected of breast cancer.     

Fast fat-suppressed reduced field-of-view temperature mapping using 2DRF excitation pulses

The purpose of this study is to develop a fast and accurate temperature mapping method capable of both fat suppression and reduced field-of-view (rFOV) imaging, using a two-dimensional spatially-selective RF (2DRF) pulse. Temperature measurement errors caused by fat signals were assessed, through simulations. An 11×1140μs echo-planar 2DRF pulse was developed and incorporated into a gradient-echo sequence. Temperature measurements were obtained during focused ultrasound (FUS) heating of a fat-water phantom. Experiments both with and without the use of a 2DRF pulse were performed at 3T, and the accuracy of the resulting temperature measurements were compared over a range of TE values. Significant inconsistencies in terms of measured temperature values were observed when using a regular slice-selective RF excitation pulse. In contrast, the proposed 2DRF excitation pulse suppressed fat signals by more than 90%, allowing good temperature consistency regardless of TE settings. Temporal resolution was also improved, from 12 frames per minute (fpm) with the regular pulse to 28 frames per minute with the rFOV excitation. This technique appears promising toward the MR monitoring of temperature in moving adipose organs, during thermal therapies.     

MRI-guided focused ultrasound treatments

Focused ultrasound (FUS) allows noninvasive focal delivery of energy deep into soft tissues. The focused energy can be used to modify and eliminate tissue for therapeutic purposes while the energy delivery is targeted and monitored using magnetic resonance imaging (MRI). MRI compatible methods to deliver these exposures have undergone rapid development over the past 10 years such that clinical treatments are now routinely performed. This paper will review the current technical and clinical status of MRI-guided focused ultrasound therapy and discuss future research and development opportunities.     

Quantitative MR temperature monitoring of high-intensity focused ultrasound therapy

A new quantitative method has been developed for real-time mapping of temperature changes induced by high intensity focused ultrasound (HIFU). It is based on the temperature dependence of the T1 relaxation time and the equilibrium magnetization. To calibrate the temperature measurement, the functional relationship between T1 and temperature was examined in different samples of porcine muscle and fatty tissue. The method was validated by a comparison of calculated temperature maps with fiber-optic measurements in heated muscle tissue. The experiment showed that the accuracy of the MR method for temperature measurements is better than 1 degree C. Since the acquisition time of the employed MR sequence takes only 3 s per slice and the calculation of the temperature map can be performed within seconds, the imaging technique works nearly in real-time. The temperature measurement could be realized during HIFU showing no disturbances by ultrasound sonication. In comparison to other MR approaches, the advantages of the introduced method lie in a sufficient accuracy and time resolution combined with a reasonable robustness against motion as well as the feasibility for temperature monitoring in fatty tissues.     

S波段微波热致超声成像系统研究

微波热致超声成像技术通过向物体发射微波脉冲, 导致物体吸收电磁波温度迅速升高, 产生瞬时压力波, 从而激发产生超声波信号, 通过传感器对产生的超声波信号进行采集并成像, 最终还原了反映物体吸收电磁波能量特性的图像, 由于此方法兼具了微波成像的高对比性和超声成像的高分辨率特点, 理论上验证了热声成像技术对早期乳腺肿瘤检测的可行性. 本实验兼顾系统成像深度和分辨率, 采用S波段的微波脉冲信号源对物体进行辐射, 利用圆形扫描方式对待测物体进行检测, 同时为了更好的验证成像性能, 本实验同时使用了肿瘤仿体及实际生物组织进行成像实验. 通过实验分析, 验证了该系统对肿瘤仿体和生物组织检测的有效性, 以及系统的高分辨率和高对比度特性, 为早期乳房肿瘤检测提供了进一步的理论支撑.     

Temperature dependent ultrasonic characterization of biological media

Quantitative ultrasound (QUS) is an imaging technique that can be used to quantify tissue microstructure giving rise to scattered ultrasound. Other ultrasonic properties, e.g., sound speed and attenuation, of tissues have been estimated versus temperature elevation and found to have a dependence with temperature. Therefore, it is hypothesized that QUS parameters may be sensitive to changes in tissue microstructure due to temperature elevation. Ultrasonic backscatter experiments were performed on tissue-mimicking phantoms and freshly excised rabbit and beef liver samples. The phantoms were made of agar and contained either mouse mammary carcinoma cells (4T1) or chinese hamster ovary cells (CHO) as scatterers. All scatterers were uniformly distributed spatially at random throughout the phantoms. All the samples were scanned using a 20-MHz single-element f/3 transducer. Quantitative ultrasound parameters were estimated from the samples versus increases in temperature from 37 °C to 50 °C in 1 °C increments. Two QUS parameters were estimated from the backscatter coefficient [effective scatterer diameter (ESD) and effective acoustic concentration (EAC)] using a spherical Gaussian scattering model. Significant increases in ESD and decreases in EAC of 20%-40% were observed in the samples over the range of temperatures examined. The results of this study indicate that QUS parameters are sensitive to changes in temperature.     

Modeling of thermal effects in antivascular ultrasound therapy

Antivascular ultrasound consisting of low-intensity sonication in the presence of circulating microbubbles of an ultrasound contrast agent has been demonstrated to disrupt blood flow in solid cancers. In this study a mathematical framework is described for the microbubble-induced heating that occurs during antivascular ultrasound. Biological tissues are modeled as a continuum of microbubble-filled vasculature, cells, and interstitial fluids with compressibility equal to the sum of the compressibility of each component. The mathematical simulations show that the absorption of ultrasound waves by viscous damping of the microbubble oscillations induced significant local heating of the tissue vasculature. The extent and the rate of temperature increase not only depends on the properties of the microbubbles and the sonication parameters but is also influenced markedly by the blood flow. Slow flow conditions lead to higher tissue temperatures due to a stronger interaction between microbubbles and ultrasound and reduced heat dissipation. Because tumors have slower blood flow than healthy tissue, the microbubble-induced ultrasound antivascular therapy is likely to affect cancerous tissue more extensively than healthy tissue, providing a way to selectively target the vasculature of cancers.     

Two-point method for T1 estimation with optimized gradient-echo sequence

Relaxation times estimation methods play a central role in various problems, such as magnetic resonance (MR) hardware calibration, tissue characterization, or temperature measurement. Previous studies have proposed optimization criteria to estimate the relaxation time T1 faster than with a multipoint method leading to two-point methods. In this paper, the class of optimized two-point methods is extended to gradient-echo (GE) sequence offering new advantages over spin-echo (SE) or inversion recovery (IR) sequences. Two GE acquisitions, with optimal flip angles theta1 and theta2 minimizing both the total scan time and the variance in the computed T1 image were applied to estimate T1, and the results were compared with those of SE sequence with optimized paired repetition times T(R1) and T(R2). First, phantom studies were carried out with five tissue-like samples on a 0.5T scanner. Then in vivo, human brain T1 image were calculated using both optimized GE and SE two-point methods. More precise T1 GE estimates than those for SE were found thanks to high signal-to-noise ratio (SNR) per unit of time, but with a small bias. These results also concern the temperature variation measurement methods, based on T1 estimation. Preliminary experimental data for temperature measurement are given.     

Quo vadis elasticity imaging?

In the past decade, an important field that has emerged as complementary to ultrasonic imaging is that of elasticity imaging. The term encompasses a variety of techniques that can depict a mechanical response or property of tissues. In ultrasound, its premise is built on two important facts: (a) that significant differences between mechanical properties of several tissue components exist and (b) that the information contained in the coherent scattering, or speckle, is sufficient to depict these differences following an external or internal mechanical stimulus. Parameters, such as velocity of vibration, displacement, strain, strain rate, velocity of wave propagation and elastic modulus, have all been demonstrated feasible in their estimation and have resulted in the accurate depiction of stiffer tissue masses, such as tumors, high-intensity focused ultrasound (HIFU) lesions and atherosclerotic plaques. More recently, through the development of ultrafast algorithms tailored to suitable hardware as well as the familiarity of the physician with the sensitivity of the methods used, one elasticity imaging technique in particular, elastography, has been shown applicable in a typical clinical ultrasound setting. In other words, elastograms can currently be obtained at quasi real-time (approximately at a frame rate of 8 frames/s) and with the use of a hand-held transducer (as opposed to the previously used frame-suspended setup) during and simultaneously with an ultrasound exam of, e.g., the breast or the prostate. The higher frame rate available with certain clinical ultrasound scanners has also resulted in the successful application of elasticity imaging techniques on the myocardium and monitoring its deformation over several cardiac cycles for the detection of ischemic regions. As a result, elasticity imaging with its ever increasing number of applications and demonstrated applicability in a typical, clinical ultrasound setting promises to make an important contribution to the ultrasound practice as we know it.     

Critical issues in breast imaging by vibro-acoustography

Clinically, there are two important issues in breast imaging: detection of microcalcifications and identification of mass lesions. X-ray mammography is the main imaging method used for detection of microcalcification, and ultrasound imaging is normally used for detection of mass lesions in breast. Both these methods have limitations that reduce their clinical usefulness. For this reasons, alternative breast imaging modalities are being sought. vibro-acoustography is an imaging modality that has emerged in recent years. This method is based on low-frequency harmonic vibrations induced in the object by the radiation force of ultrasound. This paper describes potential applications of vibro-acoustography for breast imaging and addresses the critical imaging issues such as detection of microcalcifications and mass lesions in breast. Recently, we have developed a vibro-acoustography system for in vivo breast imaging and have tested it on a number of volunteers. Resulting images show soft tissue structures and calcifications within breast with high contrast, high resolution, and no speckles. The results have been verified using X-ray mammography. The encouraging results from in vitro and in vivo experiments suggest that further development of vibro-acoustography technology may lead to a new clinical tool that can be used to detect microcalcifications as well as mass lesions in breast.     

High intensity focused ultrasound-induced gene activation in solid tumors

In this work, the activation of heat-sensitive trans-gene by high-intensity focused ultrasound (HIFU) in a tumor model was investigated. 4T1 cancer cells (2 x 10(6)) were inoculated subcutaneously in the hind limbs of Balb/C mice. The tumors were subsequently transducted on day 10 by intratumoral injection of a heat-sensitive adenovirus vector (Adeno-hsp70B-Luc at 2 x 10(8) pfu/tumor). On day 11, the tumors were heated to a peak temperature of 55, 65, 75, or 85 degrees C within 10-30 s at multiple sites around the center of the tumor by a 1.1- or 3.3-MHz HIFU transducer. Inducible luciferase gene expression was increased from 15-fold to 120-fold of the control group following 1.1-MHz HIFU exposure. Maximum gene activation (120-fold) was produced at a peak temperature of 65-75 degrees C one day following HIFU exposure and decayed to baseline within 7 days. HIFU-induced gene activation (75 degrees C-10 s) could be further improved by using a 3.3-MHz transducer and a dense scan strategy to 170-fold. Thermal stress, rather than nonthermal mechanical stress, was identified as the primary physical mechanism for HIFU-induced gene activation in vivo. Overall, these observations open up the possibility for combining HIFU thermal ablation with heat-regulated gene therapy for cancer treatment.     

Identifying ultrasonic scattering sites from three-dimensional impedance maps

Ultrasonic backscattered signals contain frequency-dependent information that is usually discarded to produce conventional B-mode images. It is hypothesized that parametrization of the quantitative ultrasound frequency-dependent information (i.e., estimating scatterer size and acoustic concentration) may be related to discrete scattering anatomic structures in tissues. Thus, an estimation technique is proposed to extract scatterer size and acoustic concentration from the power spectrum derived from a three-dimensional impedance map (3DZM) of a tissue volume. The 3DZM can be viewed as a computational phantom and is produced from a 3D histologic data set. The 3D histologic data set is constructed from tissue sections that have been appropriately stained to highlight specific tissue features. These tissue features are assigned acoustic impedance values to yield a 3DZM. From the power spectrum, scatterer size and acoustic concentration estimates were obtained by optimization. The 3DZM technique was validated by simulations that showed relative errors of less than 3% for all estimated parameters. Estimates using the 3DZM technique were obtained and compared against published ultrasonically derived estimates for two mammary tumors, a rat fibroadenoma and a 4T1 mouse mammary carcinoma. For both tumors, the relative difference between ultrasonic and 3DZM estimates was less than 10% for the average scatterer size.     

Internal deformation of a uniform elastic solid by acoustic radiation force

Tissue elasticity estimation is a growing area of ultrasound research. One proposed approach would apply acoustic radiation force to displace tissue and use ultrasonic motion tracking techniques to measure the resultant displacement. Such a technique might allow noninvasive imaging of tissue elastic properties. The potential of this method will be limited by the magnitude of displacements which can be generated at reasonable acoustic intensity levels. This paper presents methods for estimating the internal displacements induced in an elastic solid by acoustic radiation force. These methods predict displacements on the order of 400 microns in the human vitreous body, 0.008 micron in human breast, and 0.020 micron in human liver at an acoustic intensity of 1.0 W/cm2 (in water) and an operating frequency of 10 MHz. While the displacement generated in the vitreous should be readily detectable using ultrasonic methods, the displacements generated in the breast and liver will be much more difficult to detect. Methods are also developed for predicting the time dependent temperature increases associated with attenuated acoustic fields in the absence of perfusion. These results indicate promise for radiation force imaging in the vitreous, but potential difficulties in applying these techniques in other parts of the body.