Development of a portable therapeutic and high intensity ultrasound system for military, medical, and research use

[Development of a high intensity focused ultrasound device for bio-samples preparation]

A miniaturized, low-cost high-intensity focused ultrasound device is developed for the problems of cross-contamination and uneven sample fragmentation in conventional ultrasound devices. This device generates ultrasonic waves through a concave spherical self-focusing piezoelectric ceramic piece, and creates a cavitation effect in the focusing area to achieve sample fragmentation. The feasibility of the device is demonstrated by physical simulation, then a driving circuit with adjustable power is designed and manufactured to generate 0 ~ 22.4 W acoustic power, and finally paraffin-embedded sample dewaxing experiments are performed to verify the validation of the device. The experimental results show that the dewaxing efficiency and safety of the high-intensity focused ultrasound device is significantly better than those of traditional chemical methods, and this device is comparable with commercial ultrasonic instruments. In summary, the high-intensity focused ultrasound device is expected to be applied in automated nucleic acid extraction and purification equipment and has a broad application prospect in the field of sample pre-processing.

An Ultrasound-Driven Bioadhesive Triboelectric Nanogenerator for Instant Wound Sealing and Electrically Accelerated Healing in Emergencies

A bioadhesive triboelectric nanogenerator (BA-TENG), as a first-aid rescue for instant and robust wound sealing and ultrasound-driven accelerated wound healing, is designed. This BA-TENG is fabricated with biocompatible materials, and integrates a flexible TENG as the top layer and bioadhesive as the bottom layer, resulting in effective electricity supply and strong sutureless sealing capability on wet tissues. When driven by ultrasound, the BA-TENG can produce a stable voltage of 1.50 V and current of 24.20 µA underwater. The ex vivo porcine colon organ models show that the BA-TENG seals defects instantly (≈5 s) with high interfacial toughness (≈150 J m^-2 ), while the rat bleeding liver incision model confirms that the BA-TENG performs rapid wound closure and hemostasis, reducing the blood loss by about 82%. When applied in living rats, the BA-TENG not only seals skin injuries immediately but also produces a strong electric field (E-field) of about 0.86 kV m^-1 stimulated by ultrasound to accelerate skin wound healing significantly. The in vitro studies confirm that these effects are attributed to the E-field-accelerated cell migration and proliferation. In addition, these TENG adhesives can be applied to not only wound treatment, nerve stimulation and regeneration, and charging batteries in implanted devices.

An automated system for nucleic acid extraction from formalin-fixed paraffin-embedded samples using high intensity focused ultrasound technology

Formalin-fixed paraffin-embedded (FFPE) tissue samples are routinely used in prospective and retrospective studies. It is crucial to obtain high-quality nucleic acid (NA) from FFPE samples for downstream molecular analysis, such as quantitative polymerase chain reaction (PCR), Sanger sequencing, next-generation sequencing, and microarray, in both clinical diagnosis and basic research. The current NA extraction methods from FFPE samples using chemical solvent are tedious, environmentally unfriendly, and unamenable to automation or field deployment. We present a tool for NA extraction from FFPE samples using a high-intensity focused ultrasound (HIFU) technology. A cartridge strip containing reagents for FFPE sample deparaffinization and NA extraction and purification is operated by an automation tool consisting of a HIFU module, a liquid handling robot unit, and accessories including a thermal block and magnets. The HIFU module is a single concaved piezoelectric ceramic plate driven by a current-mode class-D power amplifier. Based on the ultrasonic cavitation effects, the HIFU module provides highly concentrated energy introducing paraffin emulsification and disintegration. The high quantity and quality of NA extracted using the reported system are evaluated by PCR and compared with the quantity and quality of NA extracted using the current standard methods.

Self-Balancing Power Amplifier with a Minimal DC Offset for Launcher Automation Control Circuits of a Surface-to-Air Missile System

This paper discusses the design of a new self-balancing amplifier of an AC component power characterized by a minimal output DC offset. The design of the amplifier is based on semiconductor technology and intended for application in low-frequency analog signal processing paths, particularly in surface-to-air missile system launcher automation circuits. The proposed solution has several design and technical-implementation advantages, whereas the primary novelty compared to the commonly used ones is the ability for self-generating a near-zero DC component value of output signal. The design features and technical parameters of the developed amplifier make it suitable for use in a wide range of devices that must ensure the stable, prolonged operation of a low-frequency power amplifier under variable weather conditions and a minimal DC offset of output signal.

Alleviation Effects and Mechanisms of Low-intensity Focused Ultrasound on Pain Triggered by Soft Tissue Injury

OBJECTIVES

Pain caused by soft tissue injury (STI) is always intractable and will eventually result in physical and psychological problems. This experiment aimed to assess the efficacy and mechanisms of low-intensity focused ultrasound (LIFU) for pain-related STI.

METHODS

Rabbits (n = 30) with STI were given fixed treatment for 20 seconds and then mobile treatment for 60 seconds daily for 10 consecutive days by an LIFU device with a power output of 5 to 6 W and a frequency of 0.8 MHz. To evaluate the degree of pain, the levels of β-endorphin in serum were measured by an enzyme-linked immunosorbent assay before and 5 to 10 minutes after the 1st, 3rd, 7th, and 10th treatments. The pain threshold was measured by an electronic analgesy meter on the 1st, 3rd, 7th, 10th, 17th, and 24th days after the start of the treatment. To investigate inflammation, prostaglandin E₂ , interleukin-1β, and 5-hydroxytryptamine levels were detected by an enzyme-linked immunosorbent assay, and nuclear factor κB messenger RNA levels were determined by a real-time quantitative polymerase chain reaction at the same time as the pain threshold was tested.

RESULTS

Compared with non-LIFU groups, β-endorphin levels and pain thresholds were significantly increased (P < .05), whereas nuclear factor- κB messenger RNA, prostaglandin E₂ , interleukin- 1β, and 5-hydroxytryptamine levels were significantly reduced (P < .05) after LIFU treatment in rabbits with STI.

CONCLUSIONS

Low-intensity focused ultrasound can alleviate pain induced by STI and could have further clinical applications.

Transcutaneous ultrasound energy harvesting using capacitive triboelectric technology

A major challenge for implantable medical systems is the inclusion or reliable delivery of electrical power. We use ultrasound to deliver mechanical energy through skin and liquids and demonstrate a thin implantable vibrating triboelectric generator able to effectively harvest it. The ultrasound can induce micrometer-scale displacement of a polymer thin membrane to generate electrical energy through contact electrification. We recharge a lithium-ion battery at a rate of 166 microcoulombs per second in water. The voltage and current generated ex vivo by ultrasound energy transfer reached 2.4 volts and 156 microamps under porcine tissue. These findings show that a capacitive triboelectric electret is the first technology able to compete with piezoelectricity to harvest ultrasound in vivo and to power medical implants.

Broadband Linear High-Power Amplifier Based on the Parallel Amplification Architecture for Electromagnetic Ultrasonic Guided Wave

The linear power amplifier with high-output power in the broadband frequency is the critical component required by exciting the electromagnetic acoustic transducer (EMAT) to generate ultrasonic guided wave (UGW). The methods to realize the output of a high-power signal in the linear amplification mode and to expand the bandwidth at high-output power are seldom reported. To solve these problems, a power amplifier with differential structure is developed by using the parallel amplification architecture and the broadband feedback circuits. The proposed power amplifier uses a differential structure to suppress the even harmonic waves and remove the disruptions. Each branch of the differential structure consists of five linear power amplifier modules with output terminals connected in parallel to increase the output power. Also, the negative voltage feedback is used to extend the bandwidth of the power amplifier. The experimental results show that the −3 dB bandwidth of the amplifier is from 40 kHz to 2.5 MHz, and the transient output power is greater than 1 kW. The power amplifier can drive the EMATs to generate ultrasonic guided waves. Because of the high-output power and good linearity, the proposed power amplifier has excellent potential for EMAT UGW applications.

Development of temperature controller-integrated portable HIFU driver for thermal coagulation

BACKGROUND

Temperature monitoring during high-intensity focused ultrasound (HIFU) therapy on tissue is essential to regulate the degree of thermal coagulation and to achieve the desired treatment outcomes eventually. The aim of the current study was to design and investigate the feasibility of a proportional-integral-derivative (PID) temperature controller-integrated portable HIFU driver for thermal coagulation.

METHODS

A portable HIFU driver was designed and operated at a maximum output voltage of 50 V with pulse-width modulation signals at 2 MHz. The temperature of ex vivo bovine liver tissue was monitored using a K-type thermocouple during the 2-MHz HIFU exposure.

RESULTS

The tissue temperature was maintained at 60 °C using a PID controller-integrated HIFU driver that modulated the output voltage during the 300-s HIFU exposure. The ex vivo testing demonstrated that the tissue temperature at the focal point approached the chosen temperature, i.e., 60 °C, within 70 s. The temperature was maintained with a deviation of less than 4 °C until the HIFU driver voltage was turned off at 300 s.

CONCLUSIONS

The designed PID controller-integrated HIFU driver can be used as a small portable tool to regulate the tissue temperature in real time and achieve thermal coagulation via HIFU sonication.

A new ultrasonic transducer sample cell for in situ small-angle scattering experiments

Ultrasound irradiation is a commonly used technique for nondestructive diagnostics or targeted destruction. We report on a new versatile sonication device that fits in a variety of standard sample environments for neutron and X-ray scattering instruments. A piezoelectric transducer permits measuring of the time-dependent response of the sample in situ during or after sonication. We use small-angle neutron scattering (SANS) to demonstrate the effect of a time-dependent perturbation on the structure factor of micelles formed from sodium dodecyl sulfate surfactant molecules. We observe a substantial change in the micellar structure during and after exposure to ultrasonic irradiation. We also observe a time-dependent relaxation to the equilibrium values of the unperturbed system. The strength of the perturbation of the structure factor depends systematically on the duration of sonication. The relaxation behavior can be well reproduced after multiple times of sonication. Accumulation of the recorded intensities of the different sonication cycles improves the signal-to-noise ratio and permits reaching very short relaxation times. In addition, we present SANS data for the micellar form factor on alkyl-poly (ethylene oxide) surfactant molecules irradiated by ultrasound. Due to the flexibility of our new in situ sonication device, different experiments can be performed, e.g., to explore molecular potentials in more detail by introducing a systematic time-dependent perturbation.

Comparison of Electrical and Ultrasound Neurostimulation in Rat Motor Cortex

Ultrasound (US) is known to non-invasively stimulate and modulate brain function; however, the mechanism of action is poorly understood. This study tested US stimulation of rat motor cortex (100 W/cm², 200 kHz) in combination with epidural cortical stimulation. US directly evoked hindlimb movement. This response occurred even with short US bursts (3 ms) and had short latency (10 ms) and long refractory (3 s) periods. Unexpectedly, the epidural cortical stimulation hindlimb response was not altered during the 3-s refractory period of the US hindlimb response. This finding suggests that the US refractory period is not a general suppression of motor cortex, but rather the recovery time of a US-specific mechanism.

Sustained acoustic medicine: wearable, long duration ultrasonic therapy for the treatment of tendinopathy

OBJECTIVES

The effectiveness of sustained acoustic medicine to alleviate pain and improve function in subjects with elbow or Achilles tendinopathy was evaluated through a level IV case series study. Subjects were trained to self-apply the wearable, long-duration, low-intensity ultrasonic device on their affected body part at home for 4 hours a day, at least 5 times per week over 6 weeks. Twenty-five subjects with clinician-diagnosed tendinopathy of the elbow (medial or lateral epicondyle) or Achilles tendon were enrolled.

METHODS

Pain measurements were recorded before, during, and after daily intervention using an 11-point numeric rating scale (NRS). Function of the injured limb was assessed biweekly using dynamometry. Repeated measures ANOVAs and paired-samples t-tests were used to examine the effect of treatment over time.

RESULTS

Among subjects with elbow tendinopathy (n = 20), a 3.94 ± 2.15 point reduction in pain (p = 0.002) was observed over the 6-week study and a 2.83 ± 5.52 kg improvement in grip strength (p = 0.04) was observed over the first two weeks. In addition, a significant reduction in pain was observed within the 4-h treatment sessions (p < 0.001). Among 5 subjects with Achilles tendinopathy, a reduction in pain and improvement in strength was also observed.

CONCLUSIONS

Daily multi-hour ultrasonic therapy was associated with improved pain and increased function in subjects with chronic tendon injuries. This trial showed the safety and feasibility of self-administration of sustained acoustic medicine, and suggests that this therapy may be clinically beneficial in the treatment of tendinopathies of the elbow and Achilles tendon. A randomized controlled trial appears warranted to more definitively investigate the therapeutic potential of this treatment modality. Registered at www.ClinicalTrials.gov, NCT02466308.

Sustained Acoustic Medicine: A Novel Long Duration Approach to Biomodulation Utilizing Low Intensity Therapeutic Ultrasound

Therapeutic ultrasound is an established technique for biomodulation used by physical therapists. Typically it is used to deliver energy locally for the purpose of altering tissue plasticity and increasing local circulation. Access to ultrasound therapy has been limited by equipment and logistic requirements, which has reduced the overall efficacy of the therapy. Ultrasound miniaturization allows for development of portable, wearable, self-applied ultrasound devices that sidestep these limitations. Additionally, research has shown that the timescale of acoustic stimulation matters, and directly affects the quality of result. This paper describes a novel, long duration approach to therapeutic ultrasound and reviews the current data available for a variety of musculoskeletal conditions.

Measurement of total ultrasonic power using thermal expansion and change in buoyancy of an absorbing target

The Radiation Force Balance (RFB) technique is well established and most widely used for the measurement of total ultrasonic power radiated by ultrasonic transducer. The technique is used as a primary standard for calibration of ultrasonic transducers with relatively fair uncertainty in the low power (below 1 W) regime. In this technique, uncertainty comparatively increases in the range of few watts wherein the effects such as thermal heating of the target, cavitations, and acoustic streaming dominate. In addition, error in the measurement of ultrasonic power is also caused due to movement of absorber at relatively high radiated force which occurs at high power level. In this article a new technique is proposed which does not measure the balance output during transducer energized state as done in RFB. It utilizes the change in buoyancy of the absorbing target due to local thermal heating. The linear thermal expansion of the target changes the apparent mass in water due to buoyancy change. This forms the basis for the measurement of ultrasonic power particularly in watts range. The proposed method comparatively reduces uncertainty caused by various ultrasonic effects that occur at high power such as overshoot due to momentum of target at higher radiated force. The functionality of the technique has been tested and compared with the existing internationally recommended RFB technique.

Human Factors Engineering and testing for a wearable, long duration ultrasound system self-applied by an end user

One of the major challenges in the design of a new class of medical device is ensuring that the device will have a safe and effective user interface for the intended users. Human Factors Engineering addresses these concerns through direct study of how a user interacts with newly designed devices with unique features. In this study, a novel long duration, low intensity therapeutic ultrasound device is tested by 20 end users representative of the intended user population. Over 90% of users were able to operate the device successfully. The therapeutic ultrasound device was found to be reasonably safe and effective for the intended users, uses, and use environments.

Design and evaluation of a wearable self-applied therapeutic ultrasound device for chronic myofascial pain

Ultrasound therapy for pain and healing is a versatile treatment modality for musculoskeletal conditions that is used daily in rehabilitation clinics around the world. Our group designed and constructed a wearable, battery-operated, low-intensity therapeutic ultrasound (LITUS) device that patients could self-apply and operate during daily activity for up to 6 h. Thirty patients with chronic trapezius myofascial pain evaluated the LITUS system in a double-blind, placebo-controlled, 10-d study under institutional review board approval. While continuing their prescribed medication regimen, patients with the active device reported on average 1.94× reduction in pain and 1.58× improvement in health relative to placebo devices after 1 h of treatment. Both of these results were statistically significant (p < 0.05) for the first 2 d of the study. Male patients reported the majority of benefit, and there is a sex-treatment confound in the sample. The study indicates that wearable, long-duration LITUS technology improves mobile access to drug-free pain relief.

Ultrasound-assisted convection-enhanced delivery to the brain in vivo with a novel transducer cannula assembly: laboratory investigation

OBJECT

In convection-enhanced delivery (CED), drugs are infused locally into tissue through a cannula inserted into the brain parenchyma to enhance drug penetration over diffusion strategies. The purpose of this study was to demonstrate the feasibility of ultrasound-assisted CED (UCED) in the rodent brain in vivo using a novel, low-profile transducer cannula assembly (TCA) and portable, pocket-sized ultrasound system.

METHODS

Forty Sprague-Dawley rats (350-450 g) were divided into 2 equal groups (Groups 1 and 2). Each group was divided again into 4 subgroups (n = 5 in each). The caudate of each rodent brain was infused with 0.25 wt% Evans blue dye (EBD) in phosphate-buffered saline at 2 different infusion rates of 0.25 μl/minute (Group 1), and 0.5 μl/minute (Group 2). The infusion rates were increased slowly over 10 minutes from 0.05 to 0.25 μl/minute (Group 1) and from 0.1 to 0.5 μl/minute (Group 2). The final flow rate was maintained for 20 minutes. Rodents in the 4 control subgroups were infused using the TCA without ultrasound and without and with microbubbles added to the infusate (CED and CED + MB, respectively). Rodents in the 4 UCED subgroups were infused without and with microbubbles added to the infusate (UCED and UCED + MB) using the TCA with continuous-wave 1.34-MHz low-intensity ultrasound at a total acoustic power of 0.11 ± 0.005 W and peak spatial intensity at the cannula tip of 49.7 mW/cm(2). An additional 4 Sprague-Dawley rats (350-450 g) received UCED at 4 different and higher ultrasound intensities at the cannula tip ranging from 62.0 to 155.0 mW/cm(2) for 30 minutes. The 3D infusion distribution was reconstructed using MATLAB analysis. Tissue damage and morphological changes to the brain were assessed using H & E.

RESULTS

The application of ultrasound during infusion (UCED and UCED + MB) improved the volumetric distribution of EBD in the brain by a factor of 2.24 to 3.25 when there were no microbubbles in the infusate and by a factor of 1.16 to 1.70 when microbubbles were added to the infusate (p < 0.001). On gross and histological examination, no damage to the brain tissue was found for any acoustic exposure applied to the brain.

CONCLUSIONS

The TCA and ultrasound device show promise to improve the distribution of infused compounds during CED. The results suggest further studies are required to optimize infusion and acoustic parameters for small compounds and for larger molecular weight compounds that are representative of promising antitumor agents. In addition, safe levels of ultrasound exposure in chronic experiments must be determined for practical clinical evaluation of UCED. Extension of these experiments to larger animal models is warranted to demonstrate efficacy of this technique.

Design of low-loss 1-3 piezoelectric composites for high-power transducer applications

Lead zirconate titanate (PZT)/polymer 1-3 composites have improved electromechanical properties compared with monolithic counterparts, but possess a low mechanical quality factor, limiting their use in high-power transducer applications. The goal of this work was to improve the mechanical quality factor of 1-3 PZT/polymer composites by optimizing the polymer materials. Theoretical analysis and modeling were performed for optimum composite design and various polymers were prepared and characterized. 1-3 piezocomposites were constructed and their electromechanical properties were experimentally determined. The results demonstrated that the composites with high-thermal-conductivity polymers generally have degraded electromechanical properties with significantly decreased mechanical quality factors, whereas the composites filled with low-loss and low-moduli polymers were found to have higher mechanical quality factors with higher electromechanical coupling factors: Q(m) ~ 200 and k(t) ~ 0.68 for PZT4 composites; Q(m) ~ 400 and k(t) ~ 0.6 for PZT8 composites. The improved mechanical quality factor of 1-3 piezocomposites may offer improved performance and thermal stability of transducers under high-drive operation.

Driving circuitry for focused ultrasound noninvasive surgery and drug delivery applications

Recent works on focused ultrasound (FUS) have shown great promise for cancer therapy. Researchers are continuously trying to improve system performance, which is resulting in an increased complexity that is more apparent when using multi-element phased array systems. This has led to significant efforts to reduce system size and cost by relying on system integration. Although ideas from other fields such as microwave antenna phased arrays can be adopted in FUS, the application requirements differ significantly since the frequency range used in FUS is much lower. In this paper, we review recent efforts to design efficient power monitoring, phase shifting and output driving techniques used specifically for high intensity focused ultrasound (HIFU).

Time-reversal Techniques in Ultrasound-assisted Convection-enhanced Drug Delivery to the Brain: Technology Development and In Vivo Evaluation

We describe a drug delivery method that combines Time-Reversal Acoustics (TRA) with Convection-Enhanced Delivery (CED) to improve the delivery of therapeutics to the interstitium of the brain. The Ultrasound-assisted CED approach (UCED) circumvents the blood-brain barrier by infusing compounds through a cannula that is inserted into the brain while simultaneously delivering ultrasound to improve the penetration of pharmaceuticals. CED without ultrasound-assistance has been used to treat a variety of neural disorders, including glioblastoma multiforme, a malignancy that presents a very poor prognosis for patients. We describe a novel system that is used to infuse fluids into the brain parenchyma while simultaneously exposing the tissue to safe levels of 1-MHz, low intensity, ultrasound energy. The system includes a combined infusion needle-hydrophone, a 10-channel ultralow-output impedance amplifier, a broad-band ultrasound resonator, and MatLab®-based TRA control and user-interface. TRA allows easy coupling of ultrasound therapy through the skull without complex phase-correction and array design. The smart targeting UCED system has been tested in vivo and results show it provides 1.5-mm spatial resolution for UCED and improves tracer distribution in the brain over CED alone.

Primary measurement of total ultrasonic power with improved accuracy in rf voltage measurement

Out of the various existing ultrasonic power measurement techniques, the radiation force balance method using microbalance is most widely used in low power (below 1 W) regime. The major source of uncertainty associated with this technique is the error in ac voltage measurement applied to the transducer for the generation of ultrasonic waves. The sources that deteriorate the ac voltage measurement accuracy include cable length and impedance mismatch. We introduce a new differential peak to peak measurement approach to reduce the ac voltage measurement error. The method holds the average peak amplitude of each polarity. Ultralow offset difference amplifier is used to measure peak to peak voltage. The method is insensitive to the variations in the dc offset of the source. The functionality of this method has been tested and compared with the conventional rf voltage measurement method. The output of this proposed technique is dc, which can be measured with an error of less than 0.1%.

Design of low-cost portable ultrasound systems: review

Ultrasound continues to be one of the major imaging modalities used for the diagnosis and treatment of a number of medical conditions. Therefore emphasis on innovation is continually increasing the quality of the ultrasound systems. However focus is just beginning to shift into the low-cost and portable applications of ultrasound. These systems present interesting constraints which must be considered to transform a standalone system into a portable version. This review takes a look at some of the attempts which have been published, as well as some of the issues which have still yet to be resolved. In conclusion, low-cost portable ultrasound has the capability to be developed and commercialized, but until a suitable replacement to piezoelectric crystals has been developed (possibly CMUTs?) low-cost portable ultrasound system will be held back by the high cost burden associated with the cost of piezoceramics.

A portable high-intensity focused ultrasound device for noninvasive venous ablation

BACKGROUND

Varicose veins and other vascular abnormalities are common clinical entities. Treatment options include vein stripping, sclerotherapy, and endovenous laser treatment, but all involve some degree of invasive intervention. The purpose of this study was to determine ex vivo the effectiveness of a novel hand-held, battery-operated, high-intensity focused ultrasound (HIFU) device for transcutaneous venous ablation.

METHODS

The ultrasound device is 14 x 9 x 4 cm, weighs 650 g, and is powered by 4 lithium ion battery packs. An ex vivo testing platform consisting of two different models comprised of sequentially layered skin-muscle-vein or skin-fat-vein was developed, and specimens were treated with HIFU. The tissues were then disassembled, imaged, and processed for histology. The luminal cross-sectional area of vein that had been treated with HIFU and nontreated controls were measured, and the values presented as median and interquartile range (IQR). The values were compared using a Wilcoxon rank-sum test, and statistical significance was set at P < .05.

RESULTS

On gross and histologic examination, veins that had been treated with HIFU showed evidence of coagulation necrosis. The surface of the muscle in direct contact with the vein had a pinpoint area of coagulation, whereas the adjacent fat appeared undisturbed; the skin, fat, and the surface of the muscle in contact with the transducer remained completely unaffected. The cross-sectional area was 3.79 mm(2) (IQR, 3.38-4.22) of the control vein lumen and 0.16 mm(2) (IQR, 0.04-0.39) in those that had been treated with HIFU (P = .0304).

CONCLUSION

This inexpensive, portable HIFU device has the potential to allow clinicians to easily perform venous ablation in a manner that is entirely noninvasive and without the expense or inconvenience of large, complicated devices. This device represents a significant step forward in the development of new applications for HIFU technology.

Design and characterization of a high-power ultrasound driver with ultralow-output impedance

We describe a pocket-sized ultrasound driver with an ultralow-output impedance amplifier circuit (less than 0.05 ohms) that can transfer more than 99% of the voltage from a power supply to the ultrasound transducer with minimal reflections. The device produces high-power acoustical energy waves while operating at lower voltages than conventional ultrasound driving systems because energy losses owing to mismatched impedance are minimized. The peak performance of the driver is measured experimentally with a PZT-4, 1.54 MHz, piezoelectric ceramic, and modeled using an adjusted Mason model over a range of transducer resonant frequencies. The ultrasound driver can deliver a 100 V(pp) (peak to peak) square-wave signal across 0-8 MHz ultrasound transducers in 5 ms bursts through continuous wave operation, producing acoustic powers exceeding 130 W. Effects of frequency, output impedance of the driver, and input impedance of the transducer on the maximum acoustic output power of piezoelectric transducers are examined. The small size, high power, and efficiency of the ultrasound driver make this technology useful for research, medical, and industrial ultrasonic applications.