An acoustic backscatter-based method for localization of lesions induced by high-intensity focused ultrasound

High-Intensity Focused Ultrasound Lesion Detection Using Adaptive Compressive Sensing Based on Empirical Mode Decomposition

Background:

The main goal of ultrasound therapy is to have clinical effects in the tissue without damage to the intervening and surrounding tissues. Treatments have been developed for both in vitro and in clinical applications. HIFU therapy is one of these. Non-invasive surgeries, such as HIFU, have been developed to treat tumors or to stop bleeding. In this approach, an adequate imaging method for monitoring and controlling the treatment is required.

Methods:

In this paper, an adaptive compressive sensing representation of ultrasound RF echo signals is presented based on empirical mode decomposition (EMD). According to the different numbers of intrinsic mode functions (IMFs) produced by the EMD, the ultrasound signals is adaptively compressive sampled in the source and then adaptively reconstructed in the receiver domains. In this paper, a new application of compressive sensing based on EMD (CS-EMD) in the monitoring of high-intensity focused ultrasound (HIFU) treatment is presented. Non-invasive surgeries such as HIFU have been developed for various therapeutic applications. In this technique, a suitable imaging method is necessary for monitoring of the treatment to achieve adequate treatment safety and efficacy. So far, several methods have been proposed, such as ultrasound radiofrequency (RF) signal processing techniques, and imaging methods such as X-ray, MRI, and ultrasound to monitor HIFU lesions.

Results:

In this paper, a CS-EMD method is used to detect the HIFU thermal lesion dimensions using different types of wavelet transform. The results of the processing on the real data demonstrate the potential for this technique in image-guided HIFU therapy.

Conclusions:

In this study, a new application of compressive sensing in the field of monitoring of the HIFU treatment is presented. To the best of our knowledge, so far no studies on compressive sensing have been carried out in the monitoring of the HIFU. Based on the results obtained, it was showed that the number of measurements and Intrinsic Mode Functions have the function of noise reduction. In addition, results were shown that the successful reconstruction of the compressive sensing signals can be gained using a threshold based algorithm. To this end, in this paper it was shown that by selecting an suitable number of measurements, the sparse transform, and a thresholding algorithm, we can achieve a more accurate detection of the HIFU thermal lesion size.

Toward high-intensity focused ultrasound lesion quantification using compressive sensing theory

Compressive sensing theory has in recent years been increasingly used in various pattern recognition applications. Compressive sensing theory makes it possible, under certain assumptions, to recover a signal or an image sampled below the Nyquist sampling limit. In this work, a new application of compressive sensing based on the threshold algorithm, in the area of controlling and monitoring of high-intensity focused ultrasound therapy, was investigated. In this work, a new method of high-intensity focused ultrasound lesion detection is presented based on a modified compressive sensing method in combination with the threshold algorithm and the wavelet transforms. In this study, analysis of the suggested method is performed using two sets of data: simulated and experimental ultrasound radio frequency data. The results of processing the data show that the proposed algorithm results in enhancement of the high-intensity focused ultrasound lesion contrast in comparison with the ultrasound B-mode and standard compressive sensing imaging methods. The results of the study show that the modified compressive sensing method could effectively detect thermal lesions in vitro. Comparing the estimated size of the thermal lesion (8.3 mm × 8.4 mm) using the proposed algorithm with the actual size of that from physical examination (10.1 mm × 9 mm) shows that we could detect high-intensity focused ultrasound thermal lesions with the difference of 0.8 mm × 0.5 mm.

High-intensity focused ultrasound monitoring using harmonic motion imaging for focused ultrasound (HMIFU) under boiling or slow denaturation conditions

Harmonic motion imaging for focused ultrasound (HMIFU) is a recently developed high-intensity focused ultrasound (HIFU) treatment monitoring method that utilizes an amplitude-modulated therapeutic ultrasound beam to induce an oscillatory radiation force at the HIFU focus and estimates the focal tissue displacement to monitor the HIFU thermal treatment. In this study, the performance of HMIFU under acoustic, thermal, and mechanical effects was investigated. The performance of HMIFU was assessed in ex vivo canine liver specimens (n = 13) under slow denaturation or boiling regimes. A passive cavitation detector (PCD) was used to assess the acoustic cavitation activity, and a bare-wire thermocouple was used to monitor the focal temperature change. During lesioning with slow denaturation, high quality displacements (correlation coefficient above 0.97) were observed under minimum cavitation noise, indicating the tissue initial-softening-then- stiffening property change. During HIFU with boiling, HMIFU monitored a consistent change in lesion-to-background displacement contrast (0.46 ± 0.37) despite the presence of strong cavitation noise due to boiling during lesion formation. Therefore, HMIFU effectively monitored softening-then-stiffening during lesioning under slow denaturation, and detected lesioning under boiling with a distinct change in displacement contrast under boiling in the presence of cavitation. In conclusion, HMIFU was shown under both boiling and slow denaturation regimes to be effective in HIFU monitoring and lesioning identification without being significantly affected by cavitation noise.

Multi-parametric monitoring and assessment of high-intensity focused ultrasound (HIFU) boiling by harmonic motion imaging for focused ultrasound (HMIFU): an ex vivo feasibility study

Harmonic motion imaging for focused ultrasound (HMIFU) is a recently developed high-intensity focused ultrasound (HIFU) treatment monitoring method with feasibilities demonstrated in vitro and in vivo. Here, a multi-parametric study is performed to investigate both elastic and acoustics-independent viscoelastic tissue changes using the Harmonic Motion Imaging (HMI) displacement, axial compressive strain and change in relative phase shift during high energy HIFU treatment with tissue boiling. Forty three (n = 43) thermal lesions were formed in ex vivo canine liver specimens (n = 28). Two-dimensional (2D) transverse HMI displacement maps were also obtained before and after lesion formation. The same method was repeated in 10 s, 20 s and 30 s HIFU durations at three different acoustic powers of 8, 10, and 11 W, which were selected and verified as treatment parameters capable of inducing boiling using both thermocouple and passive cavitation detection (PCD) measurements. Although a steady decrease in the displacement, compressive strain, and relative change in the focal phase shift (Δϕ) were obtained in numerous cases, indicating an overall increase in relative stiffness, the study outcomes also showed that during boiling, a reverse lesion-to-background displacement contrast was detected, indicating potential change in tissue absorption, geometrical change and/or, mechanical gelatification or pulverization. Following treatment, corresponding 2D HMI displacement images of the thermal lesions also mapped consistent discrepancy in the lesion-to-background displacement contrast. Despite the expectedly chaotic changes in acoustic properties with boiling, the relative change in phase shift showed a consistent decrease, indicating its robustness to monitor biomechanical properties independent of the acoustic property changes throughout the HIFU treatment. In addition, the 2D HMI displacement images confirmed and indicated the increase in the thermal lesion size with treatment duration, which was validated against pathology. In conclusion, multi-parametric HMIFU was shown capable of monitoring and mapping tissue viscoelastic response changes during and after HIFU boiling, some of which were independent of the acoustic parameter changes.

Estimating dynamic changes of tissue attenuation coefficient during high-intensity focused ultrasound treatment

BACKGROUND

This study investigated the dynamic changes of tissue attenuation coefficients before, during, and after high-intensity focused ultrasound (HIFU) treatment at different total acoustic powers (TAP) in ex vivo porcine muscle tissue. It further assessed the reliability of employing changes in tissue attenuation coefficient parameters as potential indicators of tissue thermal damage.

METHODS

Two-dimensional pulse-echo radio frequency (RF) data were acquired before, during, and after HIFU exposure to estimate changes in least squares attenuation coefficient slope (Δβ) and attenuation coefficient intercept (Δα 0). Using the acquired RF data, Δβ and Δα 0 images, along with conventional B-mode ultrasound images, were constructed. The dynamic changes of Δβ and Δα 0, averaged in the region of interest, were correlated with B-mode images obtained during the HIFU treatment process.

RESULTS

At a HIFU exposure duration of 40 s and various HIFU intensities (737-1,068 W/cm(2)), Δβ and Δα 0 increased rapidly to values in the ranges 1.5-2.5 dB/(MHz.cm) and 4-5 dB/cm, respectively. This rapid increase was accompanied with the appearance of bubble clouds in the B-mode images. Bubble activities appeared as strong hyperechoic regions in the B-mode images and caused fluctuations in the estimated Δβ and Δα 0 values. After the treatment, Δβ and Δα 0 values gradually decreased, accompanied by fade-out of hyperechoic spots in the B-mode images. At 10 min after the treatment, they reached values in ranges 0.75-1 dB/(MHz.cm) and 1-1.5 dB/cm, respectively, and remained stable within those ranges. At a long HIFU exposure duration of around 10 min and low HIFU intensity (117 W/cm(2)), Δβ and Δα 0 gradually increased to values of 2.2 dB/(MHz.cm) and 2.2 dB/cm, respectively. This increase was not accompanied with the appearance of bubble clouds in the B-mode images. After HIFU treatment, Δβ and Δα 0 gradually decreased to values of 1.8 dB/(MHz.cm) and 1.5 dB/cm, respectively, and remained stable at those values.

CONCLUSIONS

Δβ and Δα 0 estimations were both potentially reliable indicators of tissue thermal damage. In addition, Δβ and Δα 0 images both had significantly higher contrast-to-speckle ratios compared to the conventional B-mode images and outperformed the B-mode images in detecting HIFU thermal lesions at all investigated TAPs and exposure durations.

Ultrasound-guided characterization of interstitial ablated tissue using RF time series: feasibility study

This paper presents the results of a feasibility study to demonstrate the application of ultrasound RF time series imaging to accurately differentiate ablated and nonablated tissue. For 12 ex vivo and two in situ tissue samples, RF ultrasound signals are acquired prior to, and following, high-intensity ultrasound ablation. Spatial and temporal features of these signals are used to characterize ablated and nonablated tissue in a supervised-learning framework. In cross-validation evaluation, a subset of four features extracted from RF time series produce a classification accuracy of 84.5%, an area under ROC curve of 0.91 for ex vivo data, and an accuracy of 85% for in situ data. Ultrasound RF time series is a promising approach for characterizing ablated tissue.

Estimating dynamic changes of tissue attenuation coefficient during high-intensity focused ultrasound treatment

BACKGROUND

This study investigated the dynamic changes of tissue attenuation coefficients before, during, and after high-intensity focused ultrasound (HIFU) treatment at different total acoustic powers (TAP) in ex vivo porcine muscle tissue. It further assessed the reliability of employing changes in tissue attenuation coefficient parameters as potential indicators of tissue thermal damage.

METHODS

Two-dimensional pulse-echo radio frequency (RF) data were acquired before, during, and after HIFU exposure to estimate changes in least squares attenuation coefficient slope (Δβ) and attenuation coefficient intercept (Δα 0). Using the acquired RF data, Δβ and Δα 0 images, along with conventional B-mode ultrasound images, were constructed. The dynamic changes of Δβ and Δα 0, averaged in the region of interest, were correlated with B-mode images obtained during the HIFU treatment process.

RESULTS

At a HIFU exposure duration of 40 s and various HIFU intensities (737-1,068 W/cm(2)), Δβ and Δα 0 increased rapidly to values in the ranges 1.5-2.5 dB/(MHz.cm) and 4-5 dB/cm, respectively. This rapid increase was accompanied with the appearance of bubble clouds in the B-mode images. Bubble activities appeared as strong hyperechoic regions in the B-mode images and caused fluctuations in the estimated Δβ and Δα 0 values. After the treatment, Δβ and Δα 0 values gradually decreased, accompanied by fade-out of hyperechoic spots in the B-mode images. At 10 min after the treatment, they reached values in ranges 0.75-1 dB/(MHz.cm) and 1-1.5 dB/cm, respectively, and remained stable within those ranges. At a long HIFU exposure duration of around 10 min and low HIFU intensity (117 W/cm(2)), Δβ and Δα 0 gradually increased to values of 2.2 dB/(MHz.cm) and 2.2 dB/cm, respectively. This increase was not accompanied with the appearance of bubble clouds in the B-mode images. After HIFU treatment, Δβ and Δα 0 gradually decreased to values of 1.8 dB/(MHz.cm) and 1.5 dB/cm, respectively, and remained stable at those values.

CONCLUSIONS

Δβ and Δα 0 estimations were both potentially reliable indicators of tissue thermal damage. In addition, Δβ and Δα 0 images both had significantly higher contrast-to-speckle ratios compared to the conventional B-mode images and outperformed the B-mode images in detecting HIFU thermal lesions at all investigated TAPs and exposure durations.

High-frequency rapid B-mode ultrasound imaging for real-time monitoring of lesion formation and gas body activity during high-intensity focused ultrasound ablation

The goal of this study was to examine the ability of high-frame-rate, high-resolution imaging to monitor tissue necrosis and gas-body activities formed during high-intensity focused ultrasound (HIFU) application. Ex vivo porcine cardiac tissue specimens (n = 24) were treated with HIFU exposure (4.33 MHz, 77 to 130 Hz pulse repetition frequency (PRF), 25 to 50% duty cycle, 0.2 to 1 s, 2600 W/cm(2)). RF data from B-mode ultrasound imaging were obtained before, during, and after HIFU exposure at a frame rate ranging from 77 to 130 Hz using an ultrasound imaging system with a center frequency of 55 MHz. The time history of changes in the integrated backscatter (IBS), calibrated spectral parameters, and echo-decorrelation parameters of the RF data were assessed for lesion identification by comparison against gross sections. Temporal maximum IBS with +12 dB threshold achieved the best identification with a receiver-operating characteristic (ROC) curve area of 0.96. Frame-to-frame echo decorrelation identified and tracked transient gas-body activities. Macroscopic (millimeter-sized) cavities formed when the estimated initial expansion rate of gas bodies (rate of expansion in lateral-to-beam direction) crossed 0.8 mm/s. Together, these assessments provide a method for monitoring spatiotemporal evolution of lesion and gas-body activity and for predicting macroscopic cavity formation.

High-frequency ultrasound m-mode imaging for identifying lesion and bubble activity during high-intensity focused ultrasound ablation

Effective real-time monitoring of high-intensity focused ultrasound (HIFU) ablation is important for application of HIFU technology in interventional electrophysiology. This study investigated rapid, high-frequency M-mode ultrasound imaging for monitoring spatiotemporal changes during HIFU application. HIFU (4.33 MHz, 1 kHz PRF, 50% duty cycle, 1 s, 2600‒6100 W/cm²) was applied to ex vivo porcine cardiac tissue specimens with a confocally and perpendicularly aligned high-frequency imaging system (Visualsonics Vevo 770, 55 MHz center frequency). Radio-frequency (RF) data from M-mode imaging (1 kHz PRF, 2 s × 7 mm) was acquired before, during and after HIFU treatment (n = 12). Among several strategies, the temporal maximum integrated backscatter with a threshold of +12 dB change showed the best results for identifying final lesion width (receiver-operating characteristic curve area 0.91 ± 0.04, accuracy 85 ± 8%, compared with macroscopic images of lesions). A criterion based on a line-to-line decorrelation coefficient is proposed for identification of transient gas bodies.

Monitoring of tissue ablation using time series of ultrasound RF data

PURPOSE

This paper is the first report on the monitoring of tissue ablation using ultrasound RF echo time series.

METHODS

We calcuate frequency and time domain features of time series of RF echoes from stationary tissue and transducer, and correlate them with ablated and non-ablated tissue properties.

RESULTS

We combine these features in a nonlinear classification framework and demonstrate up to 99% classification accuracy in distinguishing ablated and non-ablated regions of tissue, in areas as small as 12mm2 in size. We also demonstrate significant improvement of ablated tissue classification using RF time series compared to the conventional approach of using single RF scan lines.

CONCLUSIONS

The results of this study suggest RF echo time series as a promising approach for monitoring ablation, and capturing the changes in the tissue microstructure as a result of heat-induced necrosis.

Real-time passive acoustic monitoring of HIFU-induced tissue damage

Thermal ablation by high-intensity focused ultrasound (HIFU) shows great promise as a noninvasive cancer therapy. This work proposes a novel method of real-time HIFU treatment monitoring that uses the passively monitored acoustic signal emanating from the focus during HIFU exposure. We performed 212 exposures in seven freshly excised ox livers using 1.067-MHz HIFU at a 95% duty cycle for a range of insonation durations and acoustic intensities. Acoustic emissions were recorded using a 15-MHz passive detector aligned confocally and coaxially with the HIFU transducer. Lesion presence and size were ascertained by slicing the tissue in the transverse and axial focal planes post exposure. Our results demonstrate that successful formation of HIFU lesions in ex vivo ox liver is highly correlated with the presence of pronounced dips in the magnitude of the received signal at integer harmonics of the insonation frequency. A detector based on this observation predicted lesioning with >80% accuracy in regimes that were very likely to create lesions (≥60 J of energy) and had an error rate of <6% for exposures that were too short to cause lesioning (≤1 s long). The overall sensitivity and specificity of the detector were 75.6% and 74.2%, respectively. The proposed detector could therefore provide a low-cost means of effectively monitoring clinical HIFU treatments passively and in real time.

Visualization of HIFU-induced lesion boundaries by axial-shear strain elastography: a feasibility study

In this paper, we report on a study that investigated the feasibility of reliably visualizing high-intensity focused ultrasound (HIFU) lesion boundaries using axial-shear strain elastograms (ASSE). The HIFU-induced lesion cases used in the present work were selected from data acquired in a previous study. The samples consisted of excised canine livers with thermal lesions produced by a magnetic resonance-compatible HIFU system (GE Medical System, Milwaukee, WI, USA) and were cast in a gelatin block for the elastographic experiment. Both single and multiple HIFU-lesion samples were investigated. For each of the single-lesion samples, the lesion boundaries were determined independently from the axial strain elastogram (ASE) and ASSE at various iso-intensity contour thresholds (from -2 dB to -6 dB), and the area of the enclosed lesion was computed. For samples with multiple lesions, the corresponding ASSE was analyzed for identifying any unique axial-shear strain zones of interest. We further performed finite element modeling (FEM) of simple two-inclusion cases to verify whether the in vitro ASSE obtained were reasonable. The results show that the estimation of the lesion area using ASSE is less sensitive to iso-intensity threshold selection, making this method more robust compared with the ASE-based method. For multiple lesion cases, it was shown that ASSE enables high-contrast visualization of a "thin" untreated region in between multiple fully-treated HIFU-lesions. This contrast visualization was also noticed in the FEM predictions. In summary, the results demonstrate that it is feasible to reliably visualize HIFU lesion boundaries using ASSE.