Localized motion imaging for monitoring HIFU therapy: Comparison of modulating frequencies and utilization of square modulating wave

Monitoring focused ultrasound ablation surgery (FUAS) using echo amplitudes of the therapeutic focused transducer

OBJECTIVE

B-mode sonography is commonly used to monitor focused ultrasound ablation surgery (FUAS), but has limitations in sensitivity. More accurate and reliable prediction of coagulation is required.

METHODS

The focused ultrasound (FUS) transducer was adapted for echo reception. Numerical simulations compared the normalized echo amplitudes from the FUS transducer and imaging probe at varying tissue depths and frequencies with a 3 mm necrosis at focus. An ex vivo experiment then evaluated echo changes from the FUS transducer and ultrasound imaging probe under different settings. Finally, coagulation prediction using FUS echo data was compared to sonography in a clinical ex vivo context.

RESULTS

The echo amplitudes from the FUS transducer exhibit a less pronounced decline with increasing tissue penetration depth compared to the ultrasound imaging probe. In ex vivo bovine liver experiments at depths of 2 cm and 4 cm, the FUS transducer detected normalized echo amplitudes that were significantly larger (i.e., 2∼3 folds) than those received by the ultrasound imaging probe. Moreover, multi-layered ex vivo tissue experiments that replicate clinical conditions revealed that coagulation prediction utilizing the FUS transducer's echo amplitudes achieved superior accuracy (91.2% vs. 60.3 %), sensitivity (92.1% vs. 54.5 %), and negative prediction (78.9% vs. 30.6 %), but similar specificity (88.2% vs. 84.6 %) and positive prediction (95.9% vs. 93.8 %) in comparison to sonography.

CONCLUSION

The echo amplitude of the FUS transducer serves as a sensitive and dependable metric for monitoring the FUAS outcomes. Its utilization may augment the procedure's safety and efficacy.

Optimization of the Tracking Beam Sequence in Harmonic Motion Imaging

Harmonic motion imaging (HMI) is an ultrasound elastography technique that estimates the viscoelastic properties of tissues by inducing localized oscillatory motion using focused ultrasound (FUS). The resulting displacement, assumed to be inversely proportional to the tissue local stiffness, is estimated using an imaging array based on RF speckle tracking. In conventional HMI, this is accomplished with plane-wave (PW) imaging, which inherently suffers from low lateral resolution. Coherent PW compounding (PWC) leverages spatial and temporal resolution using synthetic focusing in transmit. In this study, we introduced focused imaging with parallel tracking in HMI and compared parallel tracking of various transmit F-numbers (F/2.6, 3, 4, and 5) qualitatively and quantitatively with PW and PWC imaging at various compounded angle ranges (6°, 12°, and 18°). An in silico model of a 56-kPa spherical inclusion (diameter: 3.6 mm) embedded in a 5.3-kPa background and a 5.3-kPa elastic phantom with cylindrical inclusions (Young's moduli: 22-56 kPa, diameters: 2.0-8.6 mm) were imaged to assess different tracking beam sequences. Speckle biasing in displacement estimation associated with parallel tracking was also investigated and concluded to be negligible in HMI. Parallel tracking in receive (Rx) resulted in 2%-7% and 8%-12% increase compared to PW imaging ( ) in HMI contrast and contrast-to-noise ratio in silico and phantoms. Focused imaging with parallel tracking in Rx was concluded to be most robust among PW and PWC imaging for displacement estimation, and its preclinical feasibility was demonstrated in postsurgical human cancerous breast tissue specimens and in vivo murine models of breast cancer.