Sector-switching sonication strategy for accelerated HIFU treatment of prostate cancer: in vitro experimental validation

Model-guided respiratory organ motion prediction of the liver from 2D ultrasound

With the availability of new and more accurate tumour treatment modalities such as high-intensity focused ultrasound or proton therapy, accurate target location prediction has become a key issue. Various approaches for diverse application scenarios have been proposed over the last decade. Whereas external surrogate markers such as a breathing belt work to some extent, knowledge about the internal motion of the organs inherently provides more accurate results. In this paper, we combine a population-based statistical motion model and information from 2d ultrasound sequences in order to predict the respiratory motion of the right liver lobe. For this, the motion model is fitted to a 3d exhalation breath-hold scan of the liver acquired before prediction. Anatomical landmarks tracked in the ultrasound images together with the model are then used to reconstruct the complete organ position over time. The prediction is both spatial and temporal, can be computed in real-time and is evaluated on ground truth over long time scales (5.5 min). The method is quantitatively validated on eight volunteers where the ultrasound images are synchronously acquired with 4D-MRI, which provides ground-truth motion. With an average spatial prediction accuracy of 2.4 mm, we can predict tumour locations within clinically acceptable margins.

Simulation techniques in hyperthermia treatment planning

Abstract Clinical trials have shown that hyperthermia (HT), i.e. an increase of tissue temperature to 39-44 °C, significantly enhance radiotherapy and chemotherapy effectiveness [1]. Driven by the developments in computational techniques and computing power, personalised hyperthermia treatment planning (HTP) has matured and has become a powerful tool for optimising treatment quality. Electromagnetic, ultrasound, and thermal simulations using realistic clinical set-ups are now being performed to achieve patient-specific treatment optimisation. In addition, extensive studies aimed to properly implement novel HT tools and techniques, and to assess the quality of HT, are becoming more common. In this paper, we review the simulation tools and techniques developed for clinical hyperthermia, and evaluate their current status on the path from 'model' to 'clinic'. In addition, we illustrate the major techniques employed for validation and optimisation. HTP has become an essential tool for improvement, control, and assessment of HT treatment quality. As such, it plays a pivotal role in the quest to establish HT as an efficacious addition to multi-modality treatment of cancer.

An MR-compliant phased-array HIFU transducer with augmented steering range, dedicated to abdominal thermotherapy

A novel architecture for a phased-array high intensity focused ultrasound (HIFU) device was investigated, aiming to increase the capabilities of electronic steering without reducing the size of the elementary emitters. The principal medical application expected to benefit from these developments is the time-effective sonication of large tumours in moving organs. The underlying principle consists of dividing the full array of transducers into multiple sub-arrays of different resonance frequencies, with the reorientation of these individual emitters, such that each sub-array can focus within a given spatial zone. To enable magnetic resonance (MR) compatibility of the device and the number of output channels from the RF generator to be halved, a passive spectral multiplexing technique was used, consisting of parallel wiring of frequency-shifted paired piezoceramic emitters with intrinsic narrow-band response. Two families of 64 emitters (circular, 5 mm diameter) were mounted, with optimum efficiency at 0.96 and 1.03 MHz, respectively. Two different prototypes of the HIFU device were built and tested, each incorporating the same two families of emitters, but differing in the shape of the rapid prototyping plastic support that accommodated the transducers (spherical cap with radius of curvature/aperture of 130 mm/150 mm and, respectively, 80 mm/110 mm). Acoustic measurements, MR-acoustic radiation force imaging (ex vivo) and MR-thermometry (ex vivo and in vivo) were used for the characterization of the prototypes. Experimental results demonstrated an augmentation of the steering range by 80% along one preferentially chosen axis, compared to a classic spherical array of the same total number of elements. The electric power density provided to the piezoceramic transducers exceeded 50 W cm(-2) CW, without circulation of coolant water. Another important advantage of the current approach is the versatility of reshaping the array at low cost.

HIFU Lesion Volume as a Function of Sonication Time, as Determined by MRI, Histology, and Computations

Characterization of high-intensity focused ultrasound (HIFU) systems using ex vivo tissues is an important part of the preclinical testing for new HIFU devices. In ex vivo characterization, the lesion volume produced by the absorption of HIFU energy is quantified as operational parameters are varied. This paper examines the three methods used for lesion-volume quantification: histology, magnetic resonance (MR) imaging, and numerical calculations. The methods were studied in the context of a clinically relevant problem for HIFU procedures—that of quantifying the change in the lesion volume with changing sonication time. The lesion volumes of sonicated samples of porcine liver were determined using the three methods, at focal intensities ranging from 800 W/cm2 to 1700 W/cm2 and sonication times between 20 s and 40 s. It was found that histology consistently yielded lower lesion volumes than the other two methods, and the calculated values were below magnetic resonance imaging (MRI) at high applied energies. Still, the three methods agreed with each other to within a ±10% difference for all of the experiments. Increasing the sonication time produced much larger changes in the lesion volume than increasing the acoustic intensity, for the same total energy expenditure, at lower energy (less than 1000 J) levels. At higher energy levels, (around 1500 J), increasing the sonication time and increasing the intensity produced roughly the same change in the lesion volume for the same total energy expenditure.