Progress in medical ultrasound exposimetry

Coded Excitation for Ultrasonic Testing: A Review

Originating in the early 20th century, ultrasonic testing has found increasingly extensive applications in medicine, industry, and materials science. Achieving both a high signal-to-noise ratio and high efficiency is crucial in ultrasonic testing. The former means an increase in imaging clarity as well as the detection depth, while the latter facilitates a faster refresh of the image. It is difficult to balance these two indicators with a conventional short pulse to excite the probe, so in general handling methods, these two factors have a trade-off. To solve the above problems, coded excitation (CE) can increase the pulse duration and offers great potential to improve the signal-to-noise ratio with equivalent or even higher efficiency. In this paper, we first review the fundamentals of CE, including signal modulation, signal transmission, signal reception, pulse compression, and optimization methods. Then, we introduce the application of CE in different areas of ultrasonic testing, with a focus on industrial bulk wave single-probe detection, industrial guided wave detection, industrial bulk wave phased array detection, and medical phased array imaging. Finally, we point out the advantages as well as a few future directions of CE.

Nominal Versus Actual Spatial Resolution: Comparison of Directivity and Frequency-Dependent Effective Sensitive Element Size for Membrane, Needle, Capsule, and Fiber-Optic Hydrophones

Frequency-dependent effective sensitive element radius [Formula: see text] is a key parameter for elucidating physical mechanisms of hydrophone operation. In addition, it is essential to know [Formula: see text] to correct for hydrophone output voltage reduction due to spatial averaging across the hydrophone sensitive element surface. At low frequencies, [Formula: see text] is greater than geometrical sensitive element radius a_g . Consequently, at low frequencies, investigators can overrate their hydrophone spatial resolution. Empirical models for [Formula: see text] for membrane, needle, and fiber-optic hydrophones have been obtained previously. In this article, an empirical model for [Formula: see text] for capsule hydrophones is presented, so that models are now available for the four most common hydrophone types used in biomedical ultrasound. The [Formula: see text] value was estimated from directivity measurements (over the range from 1 to 20 MHz) for five capsule hydrophones (three with [Formula: see text] and two with [Formula: see text]). The results suggest that capsule hydrophones behave according to a "rigid piston" model for k a _g ≥ 0.7 ( k = 2π /wavelength). Comparing the four hydrophone types, the low-frequency discrepancy between [Formula: see text] and a_g was found to be greatest for membrane hydrophones, followed by capsule hydrophones, and smallest for needle and fiber-optic hydrophones. Empirical models for [Formula: see text] are helpful for choosing an appropriate hydrophone for an experiment and for correcting for spatial averaging (over the sensitive element surface) in pressure and beamwidth measurements. When reporting hydrophone-based pressure measurements, investigators should specify [Formula: see text] at the center frequency (which may be estimated from the models presented here) in addition to a_g .

Dissemination of the Acoustic Pascal: The Role and Experiences of a National Metrology Institute

Hydrophones are pivotal measurement devices ensuring medical ultrasound acoustic exposures comply with the relevant national and international safety criteria. These devices have enabled the spatial and temporal distribution of key safety parameters to be determined in an objective and standardized way. Generally based on piezoelectric principles of operation, to convert generated voltage waveforms to acoustic pressure, they require calibration in terms of receive sensitivity, expressed in units of [Formula: see text]Pa-1. Reliable hydrophone calibration with associated uncertainties plays a key role in underpinning a measurement framework that ensures exposure measurements are comparable and traceable to internationally agreed units, irrespective of where they are carried out globally. For well over three decades, the U.K. National Physical Laboratory (NPL) has provided calibrations to the user community covering the frequency range 0.1-60 MHz, traceable to a primary realization of the acoustic pascal through optical interferometry. Typical uncertainties for sensitivity are 6%-22% (for a coverage factor k = 2), degrading with frequency. The article specifically focuses on the dissemination of the acoustic pascal through NPL's calibration services that are based on a comparison with secondary standard hydrophones previously calibrated using the NPL primary standard. The work demonstrates the stability of the employed dissemination protocols by presenting representative calibration histories on a selection of commercially available hydrophones. Results reaffirm the guidance provided within international standards for regular calibration of a hydrophone in order to underpin measurement confidence. The process by which internationally agreed realizations of the acoustic pascal are compared and validated through key comparisons (KCs) is also described.

Passive Cavitation Detection With a Needle Hydrophone Array

Therapeutic ultrasound and microbubble technologies seek to drive systemically administered microbubbles into oscillations that safely manipulate tissue or release drugs. Such procedures often detect the unique acoustic emissions from microbubbles with the intention of using this feedback to control the microbubble activity. However, most sensor systems reported introduce distortions to the acoustic signal. Acoustic shockwaves, a key emission from microbubbles, are largely absent in reported recording, possibly due to the sensors being too large or too narrowband, or having strong phase distortions. Here, we built a sensor array that countered such limitations with small, broadband sensors and a low-phase distorting material. We built eight needle hydrophones with polyvinylidene fluoride (PVDF, diameter: 2 mm) then fit them into a 3-D-printed scaffold in a two-layered, staggered arrangement. Using this array, we monitored microbubbles exposed to therapeutically relevant ultrasound pulses (center frequency: 0.5 MHz, peak-rarefactional pressure: 130-597 kPa, pulselength: four cycles). Our tests revealed that the hydrophones were broadband with the best having a sensitivity of -224.8 dB ± 3.2 dB re 1 V/ μ Pa from 1 to 15 MHz. The array was able to capture shockwaves generated by microbubbles. The signal-to-noise ratio (SNR) of the array was approximately two times higher than individual hydrophones. Also, the array could localize microbubbles (-3 dB lateral resolution: 2.37 mm) and determine the cavitation threshold (between 161 and 254 kPa). Thus, the array accurately monitored and localized microbubble activities, and may be an important technological step toward better feedback control methods and safer and more effective treatments.

AAPM Task Group 241: A medical physicist's guide to MRI-guided focused ultrasound body systems

Magnetic resonance-guided focused ultrasound (MRgFUS) is a completely non-invasive technology that has been approved by FDA to treat several diseases. This report, prepared by the American Association of Physicist in Medicine (AAPM) Task Group 241, provides background on MRgFUS technology with a focus on clinical body MRgFUS systems. The report addresses the issues of interest to the medical physics community, specific to the body MRgFUS system configuration, and provides recommendations on how to successfully implement and maintain a clinical MRgFUS program. The following sections describe the key features of typical MRgFUS systems and clinical workflow and provide key points and best practices for the medical physicist. Commonly used terms, metrics and physics are defined and sources of uncertainty that affect MRgFUS procedures are described. Finally, safety and quality assurance procedures are explained, the recommended role of the medical physicist in MRgFUS procedures is described, and regulatory requirements for planning clinical trials are detailed. Although this report is limited in scope to clinical body MRgFUS systems that are approved or currently undergoing clinical trials in the United States, much of the material presented is also applicable to systems designed for other applications.

Hydrophone Spatial Averaging Correction for Acoustic Exposure Measurements From Arrays-Part I: Theory and Impact on Diagnostic Safety Indexes

This article reports underestimation of mechanical index (MI) and nonscanned thermal index for bone near focus (TIB) due to hydrophone spatial averaging effects that occur during acoustic output measurements for clinical linear and phased arrays. TIB is the appropriate version of thermal index (TI) for fetal imaging after ten weeks from the last menstrual period according to the American Institute of Ultrasound in Medicine (AIUM). Spatial averaging is particularly troublesome for highly focused beams and nonlinear, nonscanned modes such as acoustic radiation force impulse (ARFI) and pulsed Doppler. MI and variants of TI (e.g., TIB), which are displayed in real-time during imaging, are often not corrected for hydrophone spatial averaging because a standardized method for doing so does not exist for linear and phased arrays. A novel analytic inverse-filter method to correct for spatial averaging for pressure waves from linear and phased arrays is derived in this article (Part I) and experimentally validated in a companion article (Part II). A simulation was developed to estimate potential spatial-averaging errors for typical clinical ultrasound imaging systems based on the theoretical inverse filter and specifications for 124 scanner/transducer combinations from the U.S. Food and Drug Administration (FDA) 510(k) database from 2015 to 2019. Specifications included center frequency, aperture size, acoustic output parameters, hydrophone geometrical sensitive element diameter, etc. Correction for hydrophone spatial averaging using the inverse filter suggests that maximally achievable values for MI, TIB, thermal dose ( t ₄₃ ), and spatial-peak-temporal-average intensity ( [Formula: see text]) for typical clinical systems are potentially higher than uncorrected values by (means ± standard deviations) 9% ± 4% (ARFI MI), 19% ± 15% (ARFI TIB), 50% ± 41% (ARFI t ₄₃ ), 43% ± 39% (ARFI [Formula: see text]), 7% ± 5% (pulsed Doppler MI), 15% ± 11% (pulsed Doppler TIB), 42% ± 31% (pulsed Doppler t ₄₃ ), and 33% ± 27% (pulsed Doppler [Formula: see text]). These values correspond to frequencies of 3.2 ± 1.3 (ARFI) and 4.1 ± 1.4 MHz (pulsed Doppler), and the model predicts that they would increase with frequency. Inverse filtering for hydrophone spatial averaging significantly improves the accuracy of estimates of MI, TIB, t ₄₃ , and [Formula: see text] for ARFI and pulsed Doppler signals.

Hydrophone Spatial Averaging Correction for Acoustic Exposure Measurements From Arrays-Part II: Validation for ARFI and Pulsed Doppler Waveforms

This article reports the experimental validation of a method for correcting underestimates of peak compressional pressure ( pc) , peak rarefactional pressure ( pr) , and pulse intensity integral (pii) due to hydrophone spatial averaging effects that occur during output measurement of clinical linear and phased arrays. Pressure parameters ( pc , pr , and pii), which are used to compute acoustic exposure safety indexes, such as mechanical index (MI) and thermal index (TI), are often not corrected for spatial averaging because a standardized method for doing so does not exist for linear and phased arrays. In a companion article (Part I), a novel, analytic, inverse-filter method was derived to correct for spatial averaging for linear or nonlinear pressure waves from linear and phased arrays. In the present article (Part II), the inverse filter is validated on measurements of acoustic radiation force impulse (ARFI) and pulsed Doppler waveforms. Empirical formulas are provided to enable researchers to predict and correct hydrophone spatial averaging errors for membrane-hydrophone-based acoustic output measurements. For example, for a 400- [Formula: see text] membrane hydrophone, inverse filtering reduced errors (means ± standard errors for 15 linear array/hydrophone pairs) from about 34% ( pc) , 22% ( pr) , and 45% (pii) down to within 5% for all three parameters. Inverse filtering for spatial averaging effects significantly improves the accuracy of estimates of acoustic pressure parameters for ARFI and pulsed Doppler signals.

Correction for Hydrophone Spatial Averaging Artifacts for Circular Sources

This article reports an investigation of an inverse-filter method to correct for experimental underestimation of pressure due to spatial averaging across a hydrophone sensitive element. The spatial averaging filter (SAF) depends on hydrophone type (membrane, needle, or fiber-optic), hydrophone geometrical sensitive element diameter, transducer driving frequency, and transducer F number (ratio of focal length to diameter). The absolute difference between theoretical and experimental SAFs for 25 transducer/hydrophone pairs was 7% ± 3% (mean ± standard deviation). Empirical formulas based on SAFs are provided to enable researchers to easily correct for hydrophone spatial averaging errors in peak compressional pressure ( p_c ), peak rarefactional pressure ( p_r ), and pulse intensity integral. The empirical formulas show, for example, that if a 3-MHz, F /2 transducer is driven to moderate nonlinear distortion and measured at the focal point with a 500- [Formula: see text] membrane hydrophone, then spatial averaging errors are approximately 16% ( p_c ), 12% ( p_r ), and 24% (pulse intensity integral). The formulas are based on circular transducers but also provide plausible upper bounds for spatial averaging errors for transducers with rectangular-transmit apertures, such as linear and phased arrays.

Directivity and Frequency-Dependent Effective Sensitive Element Size of Membrane Hydrophones: Theory Versus Experiment

It is important to know hydrophone frequency-dependent effective sensitive element size in order to account for spatial averaging artifacts in acoustic output measurements. Frequency-dependent effective sensitive element size may be obtained from hydrophone directivity measurements. Directivity was measured at 1, 2, 3, 4, 6, 8, and 10 MHz from ±60° in two orthogonal planes for eight membrane hydrophones with nominal geometrical sensitive element radii ( a_g ) ranging from 100 to [Formula: see text]. The mean precision of directivity measurements (obtained from four repeated measurements at each frequency and angle) averaged over all frequencies, angles, and hydrophones was 5.8%. Frequency-dependent effective hydrophone sensitive element radii a_eff(f) were estimated by fitting the theoretical directional response for a disk receiver to directivity measurements using the sensitive element radius ( a ) as an adjustable parameter. For the eight hydrophones in aggregate, the relative difference between effective and geometrical sensitive element radii, ( a_eff - a_g)/a_g , was fit to C /( ka_g)ⁿ , where k = 2π/λ and λ = wavelength. The functional fit yielded C = 1.89 and n = 1.36 . The root mean square difference between the data and the model was 34%. It was shown that for a given value for a_g , [Formula: see text] for membrane hydrophones far exceeds that for needle hydrophones at low frequencies (e.g., < 4 MHz when [Formula: see text]). This empirical model for [Formula: see text] provides information required for the compensation of spatial averaging artifacts in acoustic output measurements and is useful for choosing an appropriate sensitive element size for a given experiment.

Correction for Spatial Averaging Artifacts in Hydrophone Measurements of High-Intensity Therapeutic Ultrasound: An Inverse Filter Approach

High-intensity therapeutic ultrasound (HITU) pressure is often measured using a hydrophone. HITU pressure waves typically contain multiple harmonics due to nonlinear propagation. As harmonic frequency increases, harmonic beamwidth decreases. For sufficiently high harmonic frequency, beamwidth may become comparable to the hydrophone effective sensitive element diameter, resulting in signal reduction due to spatial averaging. An analytic formula for a hydrophone spatial averaging filter for beams with Gaussian harmonic radial profiles was tested on HITU pressure signals generated by three transducers (1.45 MHz, F/1; 1.53 MHz, F/1.5; 3.91 MHz, F/1) with focal pressures up to 48 MPa. The HITU signals were measured using fiber-optic and needle hydrophones (nominal geometrical sensitive element diameters: 100 and [Formula: see text]). Harmonic radial profiles were measured with transverse scans in the focal plane using the fiber-optic hydrophone. Harmonic radial profiles were accurately approximated by Gaussian functions with root-mean-square (rms) differences between transverse scans and Gaussian fits less than 9% for frequencies up to approximately 50 MHz. The Gaussian harmonic beamwidth parameter σ_n varied with harmonic number n according to a power law, σ_n = σ₁/n^q where . RMS differences between experimental and theoretical spatial averaging filters were 11% ± 1% (1.45 MHz), 8% ± 1% (1.53 MHz), and 4% ± 1% (3.91 MHz). For the two more highly focused (F/1) transducers, the effect of spatial averaging was to underestimate peak compressional pressure (pcp), peak rarefactional pressure (prp), and pulse intensity integral (pii) by (mean ± standard deviation) (pcp: 4.9% ± 0.5%, prp: 0.4% ± 0.2%, pii: 2.9% ± 1%) and (pcp: 28.3% ± 9.6%, prp: 6% ± 2.4%, pii: 24.3% ± 6.7%) for the 100- and 400- [Formula: see text]-diameter hydrophones, respectively. These errors can be suppressed by the application of the inverse spatial averaging filter.

Advances in acoustic monitoring and control of focused ultrasound-mediated increases in blood-brain barrier permeability

Transcranial focused ultrasound (FUS) combined with intravenously circulating microbubbles can transiently and selectively increase blood-brain barrier permeability to enable targeted drug delivery to the central nervous system, and is a technique that has the potential to revolutionize the way neurological diseases are managed in medical practice. Clinical testing of this approach is currently underway in patients with brain tumors, early Alzheimer's disease, and amyotrophic lateral sclerosis. A major challenge that needs to be addressed in order for widespread clinical adoption of FUS-mediated blood-brain barrier permeabilization to occur is the development of systems and methods for real-time treatment monitoring and control, to ensure that safe and effective acoustic exposure levels are maintained throughout the procedures. This review gives a basic overview of the oscillation dynamics, acoustic emissions, and biological effects associated with ultrasound-stimulated microbubbles in vivo, and provides a summary of recent advances in acoustic-based strategies for detecting, controlling, and mapping microbubble activity in the brain. Further development of next-generation clinical FUS brain devices tailored towards microbubble-mediated applications is warranted and required for translation of this potentially disruptive technology into routine clinical practice.

Considerations for Choosing Sensitive Element Size for Needle and Fiber-Optic Hydrophones-Part I: Spatiotemporal Transfer Function and Graphical Guide

The spatiotemporal transfer function for a needle or reflectance-based fiber-optic hydrophone is modeled as separable into the product of two filters corresponding to frequency-dependent sensitivity and spatial averaging. The separable hydrophone transfer function model is verified numerically by comparison to a more general rigid piston spatiotemporal response model that does not assume separability. Spatial averaging effects are characterized by frequency-dependent "effective" sensitive element diameter, which can be more than double the geometrical sensitive element diameter. The transfer function is tested in simulation using a nonlinear focused pressure wave model based on Gaussian harmonic radial pressure distributions. The pressure wave model is validated by comparing to experimental hydrophone scans of nonlinear beams produced by three source transducers. An analytic form for the spatial averaging filter, applicable to Gaussian harmonic beams, is derived. A second analytic form for the spatial averaging filter, applicable to quadratic harmonic beams, is derived by extending the spatial averaging correction recommended by IEC 62127-1 Annex E to nonlinear signals with multiple harmonics. Both forms are applicable to all hydrophones (not just needle and fiber-optic hydrophones). Simulation analysis performed for a wide variety of transducer geometries indicates that the Gaussian spatial averaging filter formula is more accurate than the quadratic formula over a wider range of harmonics. Additional experimental validation is provided in Part II. Readers who are uninterested in hydrophone theory may skip the theoretical and experimental sections of this paper and proceed to the graphical guide for practical information to inform and support selection of hydrophone sensitive element size (but might be well advised to read the Introduction).

Considerations for Choosing Sensitive Element Size for Needle and Fiber-Optic Hydrophones-Part II: Experimental Validation of Spatial Averaging Model

Acoustic pressure can be measured with a hydrophone. Hydrophone measurements can underestimate incident acoustic pressure due to spatial averaging effects across the hydrophone sensitive element. The spatial averaging filter for a nonlinear focused beam is a low-pass filter that decreases monotonically from 1 to 0 as frequency increases from 0 to infinity. Experiments were performed to test an analytic model for the spatial averaging filter. Nonlinear pressure tone bursts were generated by three source transducers with driving frequencies ranging from 2.5 to 6 MHz, diameters ranging from 19 to 64 mm, and focal lengths ranging from 38 to 89 mm. The nonlinear pressure fields were measured using four needle hydrophones with nominal geometrical sensitive element diameters of 200, 400, 600, and [Formula: see text]. The average root-mean-square difference between theoretical and experimental spatial averaging filters was 5.8% ± 2.6%.

Pressure Pulse Distortion by Needle and Fiber-Optic Hydrophones due to Nonuniform Sensitivity

Needle and fiber-optic hydrophones have frequency-dependent sensitivity, which can result in substantial distortion of nonlinear or broadband pressure pulses. A rigid cylinder model for needle and fiber-optic hydrophones was used to predict this distortion. The model was compared with measurements of complex sensitivity for a fiber-optic hydrophone and three needle hydrophones with sensitive element sizes ( ) of 100, 200, 400, and . Theoretical and experimental sensitivities agreed to within 12 ± 3% [root-mean-square (RMS) normalized magnitude ratio] and 8° ± 3° (RMS phase difference) for the four hydrophones over the range from 1 to 10 MHz. The model predicts that distortions in peak positive pressure can exceed 20% when and spectral index (SI) >7% and can exceed 40% when and SI >14%, where is the wavelength of the fundamental component and SI is the fraction of power spectral density contained in harmonics. The model predicts that distortions in peak negative pressure can exceed 15% when . Measurements of pulse distortion using a 2.25 MHz source and needle hydrophones with , 400, and agreed with the model to within a few percent on the average for SI values up to 14%. This paper 1) identifies conditions for which needle and fiber-optic hydrophones produce substantial distortions in acoustic pressure pulse measurements and 2) offers a practical deconvolution method to suppress these distortions.

Acoustic field characterization of a clinical magnetic resonance-guided high-intensity focused ultrasound system inside the magnet bore

PURPOSE

With the expanding clinical application of magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU), acoustic field characterization of MR-HIFU systems is needed for facilitating regulatory approval and ensuring consistent and safe power output of HIFU transducers. However, the established acoustic field measurement techniques typically use equipment that cannot be used in a magnetic resonance imaging (MRI) suite, thus posing a challenge to the development and execution of HIFU acoustic field characterization techniques. In this study, we developed and characterized a technique for HIFU acoustic field calibration within the MRI magnet bore, and validated the technique with standard hydrophone measurements outside of the MRI suite.

METHODS

A clinical Philips MR-HIFU system (Sonalleve V2, Philips, Vantaa, Finland) was used to assess the proposed technique. A fiber-optic hydrophone with a long fiber was inserted through a 24-gauge angiocatheter and fixed inside a water tank that was placed on the HIFU patient table above the acoustic window. The long fiber allowed the hydrophone control unit to be placed outside of the magnet room. The location of the fiber tip was traced on MR images, and the HIFU focal point was positioned at the fiber tip using the MR-HIFU therapy planning software. To perform acoustic field mapping inside the magnet, the HIFU focus was positioned relative to the fiber tip using an MRI-compatible 5-axis robotic transducer positioning system embedded in the HIFU patient table. To perform validation measurements of the acoustic fields, the HIFU table was moved out of the MRI suite, and a standard laboratory hydrophone measurement setup was used to perform acoustic field measurements outside the magnetic field.

RESULTS

The pressure field scans along and across the acoustic beam path obtained inside the MRI bore were in good agreement with those obtained outside of the MRI suite. At the HIFU focus with varying nominal acoustic powers of 10-500 W, the peak positive pressure and peak negative pressure measured inside the magnet bore were 3.87-68.67 MPa and 3.56-12.06 MPa, respectively, while outside the MRI suite the corresponding pressures were 3.27-67.32 MPa and 3.06-12.39 MPa, respectively. There was no statistically significant difference (P > 0.05) between measurements inside the magnet bore and outside the MRI suite for the p⁺ and p^- at any acoustic power level. The spatial-peak pulse-average intensities (I_SPPA ) for these powers were 312-17816 W/cm² and 220-15698 W/cm² for measurements inside and outside the magnet room, respectively. In addition, when the scanning step size of the HIFU focus was increased from 100 μm to 500 μm, the execution time for scanning a 4 × 4 mm² area decreased from 210 min to 10 min, the peak positive pressure decreased by 14%, the peak negative pressure decreased by 5%, and the lateral full width at half maximum dimension of pressure profiles increased from 1.15 mm to 1.55 mm.

CONCLUSIONS

The proposed hydrophone measurement technique offers a convenient and reliable method for characterizing the acoustic fields of clinical MR-HIFU systems inside the magnet bore. The technique was validated for use by measurements outside the MRI suite using a standard hydrophone calibration technique. This technique can be a useful tool in MR-HIFU quality assurance and acoustic field assessment.

Predicting the growth of nanoscale nuclei by histotripsy pulses

Histotripsy is a focused ultrasound therapy that ablates tissue through the mechanical action of cavitation. Histotripsy-initiated cavitation activity is generated from shocked ultrasound pulses that scatter from incidental nuclei (shock scattering histotripsy), or purely tensile ultrasound pulses (microtripsy). The Yang/Church model was numerically integrated to predict the behavior of the cavitation nuclei exposed to measured shock scattering histotripsy pulses. The bubble motion exhibited expansion only behavior, suggesting that the ablative action of a histotripsy pulse is related to the maximum size of the bubble. The analytic model of Holland and Apfel was extended to predict the maximum size of cavitation nuclei for both shock scattering histotripsy and microtripsy excitations. The predictions of the analytic model and the numerical model agree within 2% for fully developed shock scattering histotripsy pulses (>72 MPa peak positive pressure). For shock scattering histotripsy pulses that are not fully developed (<72 MPa), the analytic model underestimated the maximum size by less than 5%. The analytic model was also used to predict bubble growth nucleated from microtripsy insonations, and was found to be consistent with experimental observations. Based on the extended analytic model, metrics were developed to predict the extent of the treatment zone from histotripsy pulses.

Acoustic holography as a metrological tool for characterizing medical ultrasound sources and fields

Acoustic holography is a powerful technique for characterizing ultrasound sources and the fields they radiate, with the ability to quantify source vibrations and reduce the number of required measurements. These capabilities are increasingly appealing for meeting measurement standards in medical ultrasound; however, associated uncertainties have not been investigated systematically. Here errors associated with holographic representations of a linear, continuous-wave ultrasound field are studied. To facilitate the analysis, error metrics are defined explicitly, and a detailed description of a holography formulation based on the Rayleigh integral is provided. Errors are evaluated both for simulations of a typical therapeutic ultrasound source and for physical experiments with three different ultrasound sources. Simulated experiments explore sampling errors introduced by the use of a finite number of measurements, geometric uncertainties in the actual positions of acquired measurements, and uncertainties in the properties of the propagation medium. Results demonstrate the theoretical feasibility of keeping errors less than about 1%. Typical errors in physical experiments were somewhat larger, on the order of a few percent; comparison with simulations provides specific guidelines for improving the experimental implementation to reduce these errors. Overall, results suggest that holography can be implemented successfully as a metrological tool with small, quantifiable errors.

Conditionally Increased Acoustic Pressures in Nonfetal Diagnostic Ultrasound Examinations Without Contrast Agents: A Preliminary Assessment

The mechanical index (MI) has been used by the US Food and Drug Administration (FDA) since 1992 for regulatory decisions regarding the acoustic output of diagnostic ultrasound equipment. Its formula is based on predictions of acoustic cavitation under specific conditions. Since its implementation over 2 decades ago, new imaging modes have been developed that employ unique beam sequences exploiting higher-order acoustic phenomena, and, concurrently, studies of the bioeffects of ultrasound under a range of imaging scenarios have been conducted. In 2012, the American Institute of Ultrasound in Medicine Technical Standards Committee convened a working group of its Output Standards Subcommittee to examine and report on the potential risks and benefits of the use of conditionally increased acoustic pressures (CIP) under specific diagnostic imaging scenarios. The term "conditionally" is included to indicate that CIP would be considered on a per-patient basis for the duration required to obtain the necessary diagnostic information. This document is a result of that effort. In summary, a fundamental assumption in the MI calculation is the presence of a preexisting gas body. For tissues not known to contain preexisting gas bodies, based on theoretical predications and experimentally reported cavitation thresholds, we find this assumption to be invalid. We thus conclude that exceeding the recommended maximum MI level given in the FDA guidance could be warranted without concern for increased risk of cavitation in these tissues. However, there is limited literature assessing the potential clinical benefit of exceeding the MI guidelines in these tissues. The report proposes a 3-tiered approach for CIP that follows the model for employing elevated output in magnetic resonance imaging and concludes with summary recommendations to facilitate Institutional Review Board (IRB)-monitored clinical studies investigating CIP in specific tissues.

Ultrasound field measurement using a binary lens

Field characterization methods using a scattering target in the absence of a point-like receiver have been well described, in which scattering is recorded by a relatively large receiver located outside the field of measurement. Unfortunately, such methods are prone to artifacts caused by averaging across the receiver surface. To avoid this problem while simultaneously increasing the gain of a received signal, the present study introduces a binary plate lens designed to focus sphericallyspreading waves onto a planar region having a nearly-uniform phase proportional to that of the target location. The lens is similar to a zone plate, but modified to produce a bi-convexlike behavior, such that it focuses both planar and spherically spreading waves. A measurement device suitable for characterizing narrowband ultrasound signals in air is designed around this lens by coupling it to a target and planar receiver. A prototype device is constructed and used to characterize the field of a highly-focused 400-kHz in-air transducer along 2 radial lines. Comparison of the measurements with numeric predictions formed from nonlinear acoustic simulation showed good relative pressure correlation, with mean differences of 10% and 12% over the center 3-dB full-width at half-maximum drop and 12% and 17% over the 6-dB drop.

Correction for frequency-dependent hydrophone response to nonlinear pressure waves using complex deconvolution and rarefactional filtering: application with fiber optic hydrophones

Nonlinear acoustic signals contain significant energy at many harmonic frequencies. For many applications, the sensitivity (frequency response) of a hydrophone will not be uniform over such a broad spectrum. In a continuation of a previous investigation involving deconvolution methodology, deconvolution (implemented in the frequency domain as an inverse filter computed from frequency-dependent hydrophone sensitivity) was investigated for improvement of accuracy and precision of nonlinear acoustic output measurements. Timedelay spectrometry was used to measure complex sensitivities for 6 fiber-optic hydrophones. The hydrophones were then used to measure a pressure wave with rich harmonic content. Spectral asymmetry between compressional and rarefactional segments was exploited to design filters used in conjunction with deconvolution. Complex deconvolution reduced mean bias (for 6 fiber-optic hydrophones) from 163% to 24% for peak compressional pressure (p+), from 113% to 15% for peak rarefactional pressure (p-), and from 126% to 29% for pulse intensity integral (PII). Complex deconvolution reduced mean coefficient of variation (COV) (for 6 fiber optic hydrophones) from 18% to 11% (p+), 53% to 11% (p-), and 20% to 16% (PII). Deconvolution based on sensitivity magnitude or the minimum phase model also resulted in significant reductions in mean bias and COV of acoustic output parameters but was less effective than direct complex deconvolution for p+ and p-. Therefore, deconvolution with appropriate filtering facilitates reliable nonlinear acoustic output measurements using hydrophones with frequency-dependent sensitivity.

Improved measurement of acoustic output using complex deconvolution of hydrophone sensitivity

The traditional method for calculating acoustic pressure amplitude is to divide a hydrophone output voltage measurement by the hydrophone sensitivity at the acoustic working frequency, but this approach neglects frequency dependence of hydrophone sensitivity. Another method is to perform a complex deconvolution between the hydrophone output waveform and the hydrophone impulse response (the inverse Fourier transform of the sensitivity). In this paper, the effects of deconvolution on measurements of peak compressional pressure (p+), peak rarefactional pressure (p_), and pulse intensity integral (PII) are studied. Time-delay spectrometry (TDS) was used to measure complex sensitivities from 1 to 40 MHz for 8 hydrophones used in medical ultrasound exposimetry. These included polyvinylidene fluoride (PVDF) spot-poled membrane, needle, capsule, and fiber-optic designs. Subsequently, the 8 hydrophones were used to measure a 4-cycle, 3 MHz pressure waveform mimicking a pulsed Doppler waveform. Acoustic parameters were measured for the 8 hydrophones using the traditional approach and deconvolution. Average measurements (across all 8 hydrophones) of acoustic parameters from deconvolved waveforms were 4.8 MPa (p+), 2.4 MPa (p_), and 0.21 mJ/cm(2) (PII). Compared with the traditional method, deconvolution reduced the coefficient of variation (ratio of standard deviation to mean across all 8 hydrophones) from 29% to 8% (p+), 39% to 13% (p_), and 58% to 10% (PII).

Challenges and regulatory considerations in the acoustic measurement of high-frequency (>20 MHz) ultrasound

This article examines the challenges associated with making acoustic output measurements at high ultrasound frequencies (>20 MHz) in the context of regulatory considerations contained in the US Food and Drug Administration industry guidance document for diagnostic ultrasound devices. Error sources in the acoustic measurement, including hydrophone calibration and spatial averaging, nonlinear distortion, and mechanical alignment, are evaluated, and the limitations of currently available acoustic measurement instruments are discussed. An uncertainty analysis of acoustic intensity and power measurements is presented, and an example uncertainty calculation is done on a hypothetical 30-MHz high-frequency ultrasound system. This analysis concludes that the estimated measurement uncertainty of the acoustic intensity is +73%/-86%, and the uncertainty in the mechanical index is +37%/-43%. These values exceed the respective levels in the Food and Drug Administration guidance document of 30% and 15%, respectively, which are more representative of the measurement uncertainty associated with characterizing lower-frequency ultrasound systems. Recommendations made for minimizing the measurement uncertainty include implementing a mechanical positioning system that has sufficient repeatability and precision, reconstructing the time-pressure waveform via deconvolution using the hydrophone frequency response, and correcting for hydrophone spatial averaging.

Characterization of a multi-element clinical HIFU system using acoustic holography and nonlinear modeling

High-intensity focused ultrasound (HIFU) is a treatment modality that relies on the delivery of acoustic energy to remote tissue sites to induce thermal and/or mechanical tissue ablation. To ensure the safety and efficacy of this medical technology, standard approaches are needed for accurately characterizing the acoustic pressures generated by clinical ultrasound sources under operating conditions. Characterization of HIFU fields is complicated by nonlinear wave propagation and the complexity of phased-array transducers. Previous work has described aspects of an approach that combines measurements and modeling, and here we demonstrate this approach for a clinical phased-array transducer. First, low amplitude hydrophone measurements were performed in water over a scan plane between the array and the focus. Second, these measurements were used to holographically reconstruct the surface vibrations of the transducer and to set a boundary condition for a 3-D acoustic propagation model. Finally, nonlinear simulations of the acoustic field were carried out over a range of source power levels. Simulation results were compared with pressure waveforms measured directly by hydrophone at both low and high power levels, demonstrating that details of the acoustic field, including shock formation, are quantitatively predicted.

Laser-induced fluorescence thermometry of heating in water from short bursts of high intensity focused ultrasound

Free field experimental measurements of the temperature rise of water in the focal region of a 2 MHz high intensity focused ultrasound (HIFU) transducer were performed. The transducer was operated in pulse-mode with millisecond bursts, at acoustic intensities of 5 to 18.5 kW/cm(2) at the focus, resulting in non-linear wave propagation and shock wave formation. Pulsed, planar, laser-induced fluorescence (LIF) was used as a fast rise-time, non-intrusive, temperature measurement method of the water present in the focal region. LIF thermometry is based on calibrating the temperature-dependent fluorescence intensity signal emitted by a passive dye dissolved in water when excited by a pulse of laser light. The laser beam was formed into a thin light sheet to illuminate a planar area in the HIFU focal region. The laser light sheet was oriented transverse to the acoustic axis. Cross-sectional, instantaneous temperature field measurements within the HIFU focal volume showed that the water temperature increased steadily with increasing HIFU drive voltage. Heating rates of 4000-7000°C/s were measured within the first millisecond of the HIFU burst. Increasing the length of the burst initially resulted in an increase in the water temperature within the HIFU focal spot (up to ∼3 ms), after which it steadied or slightly dropped. Acoustic streaming was measured and shown to be consistent with the reduction in heating with increased burst length due to convective cooling. LIF thermometry may thus be a viable non-invasive method for the characterization of HIFU transducers at high power intensities.

Membrane hydrophone measurement and numerical simulation of HIFU fields up to developed shock regimes

For the characterization of high-intensity focused ultrasound (HIFU) fields, hydrophone measurements should be performed in water in the whole range of the radiated power; however, cavitation occurs at high output, leading to the destruction of the hydrophone. To avoid this problem, a new hydrophone with additional protective layers covering the electrodes was developed and tested in the experiments. A single-element 1-MHz focusing ultrasound source was used for detailed measurements of the acoustic field in the axial and lateral planes. Measurements were performed with a new membrane hydrophone up to the focal peak compressional and rarefactional pressures of 55.6 and of 12.8 MPa, respectively, when the shock front had already formed in the waveform. Numerical modeling for the beams of periodic waves with an initially uniform amplitude distribution was performed, based on the Khokhlov-Zabolotskaya-Kuznetsov equation. Numerical solutions were compared with the experimental data and found to be in good agreement (within 10%). The influences of the limited bandwidth and the spatial averaging effect of the hydrophone on the accurate measurements of the acoustic field parameters were also investigated.

Characterization of nonlinear ultrasound fields of 2D therapeutic arrays

A current trend in high intensity focused ultrasound (HIFU) technologies is to use 2D focused phased arrays that enable electronic steering of the focus, beamforming to avoid overheating of obstacles (such as ribs), and better focusing through inhomogeneities of soft tissue using time reversal methods. In many HIFU applications, the acoustic intensity in situ can reach thousands of W/cm2 leading to nonlinear propagation effects. At high power outputs, shock fronts develop in the focal region and significantly alter the bioeffects induced. Clinical applications of HIFU are relatively new and challenges remain for ensuring their safety and efficacy. A key component of these challenges is the lack of standard procedures for characterizing nonlinear HIFU fields under operating conditions. Methods that combine low-amplitude pressure measurements and nonlinear modeling of the pressure field have been proposed for axially symmetric single element transducers but have not yet been validated for the much more complex 3D fields generated by therapeutic arrays. Here, the method was tested for a clinical HIFU source comprising a 256-element transducer array. A numerical algorithm based on the Westervelt equation was used to enable 3D full-diffraction nonlinear modeling. With the acoustic holography method, the magnitude and phase of the acoustic field were measured at a low power output and used to determine the pattern of vibrations at the surface of the array. This pattern was then scaled to simulate a range of intensity levels near the elements up to 10 W/cm2. The accuracy of modeling was validated by comparison with direct measurements of the focal waveforms using a fiber-optic hydrophone. Simulation results and measurements show that shock fronts with amplitudes up to 100 MPa were present in focal waveforms at clinically relevant outputs, indicating the importance of strong nonlinear effects in ultrasound fields generated by HIFU arrays.

Overview of therapeutic ultrasound applications and safety considerations

Applications of ultrasound in medicine for therapeutic purposes have been accepted and beneficial uses of ultrasonic biological effects for many years. Low-power ultrasound of about 1 MHz has been widely applied since the 1950s for physical therapy in conditions such as tendinitis and bursitis. In the 1980s, high-pressure-amplitude shock waves came into use for mechanically resolving kidney stones, and "lithotripsy" rapidly replaced surgery as the most frequent treatment choice. The use of ultrasonic energy for therapy continues to expand, and approved applications now include uterine fibroid ablation, cataract removal (phacoemulsification), surgical tissue cutting and hemostasis, transdermal drug delivery, and bone fracture healing, among others. Undesirable bioeffects can occur, including burns from thermal-based therapies and severe hemorrhage from mechanical-based therapies (eg, lithotripsy). In all of these therapeutic applications of ultrasound bioeffects, standardization, ultrasound dosimetry, benefits assurance, and side-effect risk minimization must be carefully considered to ensure an optimal benefit to risk ratio for the patient. Therapeutic ultrasound typically has well-defined benefits and risks and therefore presents a manageable safety problem to the clinician. However, safety information can be scattered, confusing, or subject to commercial conflicts of interest. Of paramount importance for managing this problem is the communication of practical safety information by authoritative groups, such as the American Institute of Ultrasound in Medicine, to the medical ultrasound community. In this overview, the Bioeffects Committee of the American Institute of Ultrasound in Medicine outlines the wide range of therapeutic ultrasound methods, which are in clinical use or under study, and provides general guidance for ensuring therapeutic ultrasound safety.

Time-delay spectrometry measurement of magnitude and phase of hydrophone response

A method based on time-delay spectrometry (TDS) was developed for measuring both magnitude and phase response of a hydrophone. The method was tested on several types of hydrophones used in medical ultrasound exposimetry over the range from 5 to 18 MHz. These included polyvinylidene fluoride (PVDF) spot-poled membrane, needle, and capsule designs. One needle hydrophone was designed for high-intensity focused ultrasound (HIFU) applications. The average reproducibility (after repositioning the hydrophone) of the phase measurement was 2.4°. The minimum-phase model, which implies that the phase response is equal to the inverse Hilbert transform of the natural logarithm of the magnitude response, was tested with TDS hydrophone data. Direct TDS-based measurements of hydrophone phase responses agreed well with calculations based on the minimum-phase model, with rms differences of 1.76° (PVDF spot-poled membrane hydrophone), 3.10° (PVDF capsule hydrophone), 3.43° (PVDF needle hydrophone), and 3.36° (ceramic needle hydrophone) over the range from 5 to 18 MHz. Therefore, phase responses for several types of hydrophones may be inferred from measurements of their magnitude responses. Calculation of phase response based on magnitude response using the minimumphase model is a relatively simple and practical alternative to direct measurement of phase.

FDA regulation of clinical high intensity focused ultrasound (HIFU) devices

In the U. S., medical devices are regulated under the authority of the 1976 Medical Device Amendments to the Food, Drug, and Cosmetic Act, with the Food and Drug Administration's Center for Devices and Radiological Health having primary responsibility. The Act defines several regulatory paths to market depending on the complexity of the device and indications for use. For most high intensity focused ultrasound (HIFU) devices the premarket submissions include both pre-clinical and clinical data. Pre-clinical testing generally comprises ultrasound power measurements and field characterization, in vitro and in vivo temperature measurements, thermal computational modeling, and demonstrating the accuracy for targeting the region of interest and monitoring treatment progress. Protocols for clinical trials are developed by the device sponsor in conjunction with FDA medical and scientific staff. Currently there are no recognized guidance or standards documents for HIFU testing that could be used in the regulatory review process, but such work is underway within the International Electrotechnical Commission.

Potential mechanism in sonodynamic therapy and focused ultrasound induced apoptosis in sarcoma 180 cells in vitro

Sonodynamic therapy employs a combination of ultrasound and a sonosensitizer to enhance the cytotoxic effect of ultrasound and promote apoptosis. However, the mechanism underlying the synergistic effect of ultrasound and hematoporphyrin is still unclear. In this study, we investigated mechanism of the induction of apoptosis by sonodynamic therapy in Sarcoma 180 cells. The cell suspension was treated by 1.75-MHz focused continuous ultrasound at an acoustic power (I(SATA)) of 1.4+/-0.07 W/cm(2) for 3 min in the absence or presence of 20 microg/ml hematoporphyrin. The proportion of apoptotic cells was determined by flow cytometry. We then analyzed the reactive oxygen species generation and localization by confocal microscopy. Western blotting and reverse transcriptase-polymerase chain reaction were used to analyze the expression of caspase-8, caspase-9, poly(ADP)-ribose polymerase, and nuclear factor-kappaB. The findings of our study indicate that ultrasound treatment induced the activation of nuclear factor-kappaB as an early stress response. When cells were pretreated with hematoporphyrin, the initial response to the therapy was the formation of (1)O(2) in the mitochondria. Our results primarily demonstrate that the mechanisms of induction of apoptosis by ultrasound and hematoporphyrin-sonodynamic therapies are very different. Our findings can provide a basis for explaining the synergistic effect of ultrasound and hematoporphyrin.

A Fabry-Perot fiber-optic ultrasonic hydrophone for the simultaneous measurement of temperature and acoustic pressure

A dual sensing fiber-optic hydrophone that can make simultaneous measurements of acoustic pressure and temperature at the same location has been developed for characterizing ultrasound fields and ultrasound-induced heating. The transduction mechanism is based on the detection of acoustically- and thermally-induced thickness changes in a polymer film Fabry-Perot interferometer deposited at the tip of a single mode optical fiber. The sensor provides a peak noise-equivalent pressure of 15 kPa (at 5 MHz, over a 20 MHz measurement bandwidth), an acoustic bandwidth of 50 MHz, and an optically defined element size of 10 microm. As well as measuring acoustic pressure, temperature changes up to 70 degrees C can be measured, with a resolution of 0.34 degrees C. To evaluate the thermal measurement capability of the sensor, measurements were made at the focus of a high-intensity focused ultrasound (HIFU) field in a tissue mimicking phantom. These showed that the sensor is not susceptible to viscous heating, is able to withstand high intensity fields, and can simultaneously acquire acoustic waveforms while monitoring induced temperature rises. These attributes, along with flexibility, small physical size (OD approximately 150 microm), immunity to Electro-Magnetic Interference (EMI), and low sensor cost, suggest that this type of hydrophone may provide a practical alternative to piezoelectric based hydrophones.

Development of a miniaturized piezoelectric ultrasonic transducer

A 421 kHz miniaturized piezoelectric ultrasonic transducer for portable and internal body therapeutic applications was developed. The weight, outer diameter, and length of the transducer are 0.15 g, 2 mm, and 10.35 mm, respectively. The transducer is a one-wavelength design based on the longitudinal vibration mode with a stepped horn to focus the energy. Finite element analysis and equivalent circuit models were applied for theoretical analysis. Q(m)and k(eff)of the transducer measured using the impedance analyzer were 393 and 0.21, respectively. The acoustic output properties of the transducer were measured based on the hydrophone measurements under the condition of 1/4lambda immersion depth. The maximum input electrical power, output acoustic power, sound intensity, radiation pressure, and vibration velocity at the radiation surface were derived to be 0.45 W, 0.11 W, 38 W/cm(2), 1.8 MPa, and 2.7 m/s, respectively. The directivity pattern shows that the pressure distribution is omnidirectional within the range from 30 to 150 degrees. The nonlinear effects of ultrasonic streaming in water and cavitation in silicone oil due to the intense ultrasound were also observed. The potential applications of the transducer are sonodynamic therapy, drug delivery, and microfluidic pumping.

Acoustic characterization of high intensity focused ultrasound fields: a combined measurement and modeling approach

Acoustic characterization of high intensity focused ultrasound (HIFU) fields is important both for the accurate prediction of ultrasound induced bioeffects in tissues and for the development of regulatory standards for clinical HIFU devices. In this paper, a method to determine HIFU field parameters at and around the focus is proposed. Nonlinear pressure waveforms were measured and modeled in water and in a tissue-mimicking gel phantom for a 2 MHz transducer with an aperture and focal length of 4.4 cm. Measurements were performed with a fiber optic probe hydrophone at intensity levels up to 24,000 W/cm(2). The inputs to a Khokhlov-Zabolotskaya-Kuznetsov-type numerical model were determined based on experimental low amplitude beam plots. Strongly asymmetric waveforms with peak positive pressures up to 80 MPa and peak negative pressures up to 15 MPa were obtained both numerically and experimentally. Numerical simulations and experimental measurements agreed well; however, when steep shocks were present in the waveform at focal intensity levels higher than 6000 W/cm(2), lower values of the peak positive pressure were observed in the measured waveforms. This underrepresentation was attributed mainly to the limited hydrophone bandwidth of 100 MHz. It is shown that a combination of measurements and modeling is necessary to enable accurate characterization of HIFU fields.

Involvement of caspase 8 in apoptosis induced by ultrasound-activated hematoporphyrin in sarcoma 180 cells in vitro

OBJECTIVE

Sonodynamic therapy (SDT), a novel and promising cancer therapy that uses a combination of ultrasound and hematoporphyrin, can induce apoptosis in some cancer cells. However, the mechanism(s) of SDT-induced cell apoptosis is not well understood. This study investigated SDT-induced apoptosis in sarcoma 180 cells.

METHODS

Cell suspension were treated by 1.75-MHz continuous focused ultrasound in the presence of hematoporphyrin for 3 minutes, and apoptosis was assessed by flow cytometry, scanning electron microscopy, terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling, confocal microscopy, and apoptosis-related protein analysis.

RESULTS

DNA breaks, apoptotic bodies, and cleaved poly (adenosine triphosphate-ribose) polymerase were observed 1 hour after SDT. By using laser-scanning confocal microscopy, we found that the Fas-associated death domain and caspase 8 translocated from the cytoplasm to the plasma membrane. Activities of caspase 8 and caspase 3 were detected by an immunohistochemical assay. The results suggested that SDT led to activation of caspase 8, which in turn activated downstream caspase 3. In addition, Z-Ile-Glu-Thr-Asp-fluoromethylketone, a specific inhibitor for caspase 8, was used to confirm the effect of caspase 8 in apoptosis.

CONCLUSIONS

Our data primarily show that SDT can induce apoptosis in sarcoma 180 cells in vitro, and caspase 8 may play an important role in SDT-induced apoptosis.

Membrane fluidity altering and enzyme inactivating in sarcoma 180 cells post the exposure to sonoactivated hematoporphyrin in vitro

Sonodynamic therapy (SDT) is a novel tumor therapy method. We investigated membrane fluidity, activity of the enzymes and membrane morphology in vitro post hematoporphyrin-SDT treatment. Furthermore, the potential mechanisms behind the changes in membrane fluidity and enzymic activity were discussed. Tumor cells were exposed to ultrasound at 1.75 MHz for up to 3 min in the presence and absence of hematoporphyrin. Fluorescence polarization, contents of Malonaldehyde, and levels of free fatty acid were assessed. Activity of enzymes was checked by the plumbic nitrate detection method. For the morphologic study, a scanning electron microscope was used to observe the cellular surface. Ultrasonically induced cell damage increased in the presence of HPD (from 15% to 24%). Compared with ultrasound treatment alone, the fluidity decreased from 5.037 to 3.908, malonaldehyde content and free fatty acid level increased from 0.743 nmol/mL to 0.97 9 nmol/mL and from 237.180 micromol/L to 730.769 micromol/L, respectively, post ultrasound combined with HPD treatment. Inactivity of adenylate cyclase and guanylate cyclase and significant deformation of the cellular surface were also observed post SDT treatment. Our results suggested that alterations in membrane modality and lipid composition played important roles in SDT-mediated inhibition of tumor growth, even inducing tumor cell death, which might be attributed to a sono-chemical activation mechanism.

Acoustic power calibration of high-intensity focused ultrasound transducers using a radiation force technique

To address the challenges associated with measuring the ultrasonic power from high-intensity focused ultrasound transducers via radiation force, a technique based on pulsed measurements was developed and analyzed. Two focused ultrasound transducers were characterized in terms of an effective duty factor, which was then used to calculate the power during the pulse at high applied power levels. Two absorbing target designs were used, and both gave comparable results and displayed no damage and minimal temperature rise if placed near the transducer and away from the focus. The method yielded reproducible results up to the maximum pulse power generated of approximately 230 W, thus allowing the radiated power to be calibrated in terms of the peak-to-peak voltage applied to the transducer.