Hayato Jimbo

Effect of controlled offset of focal position in cavitation-enhanced high-intensity focused ultrasound treatment

High-intensity focused ultrasound (HIFU) is a noninvasive treatment for tumors such as cancer. In this method, ultrasound is generated outside the body and focused to the target tissue. Therefore, physical and mental stresses on the patient are minimal. A drawback of the HIFU treatment is a long treatment time for a large tumor due to the small therapeutic volume by a single exposure. Enhancing the heating effect of ultrasound by cavitation bubbles may solve this problem. However, this is rather difficult because cavitation clouds tend to be formed backward from the focal point while ultrasonic intensity for heating is centered at the focal point. In this study, the focal points of the trigger pulses to generate cavitation were offset forward from those of the heating ultrasound to match the cavitation clouds with the heating patterns. Results suggest that the controlled offset of focal points makes the thermal coagulation more predictable.

Feasibility of real-time treatment feedback using novel filter for eliminating therapeutic ultrasound noise with high-speed ultrasonic imaging in ultrasound-guided high-intensity focused ultrasound treatment

In the conventional ultrasonic monitoring of high-intensity focused ultrasound (HIFU) treatment, a significant interval between HIFU shots is required when monitoring target tissue to avoid interference between HIFU noise and RF echo signals. In our previous study, a new filtering method to eliminate only HIFU noise while maintaining tissue signals intact was proposed, and it was shown that the thermal coagulation could be detected during simultaneous HIFU irradiation through off-line processing. In this study, the filtering method and a real-time coagulation detection algorithm were implemented in an ultrasound imaging system, whose use for sequential exposure with multiple foci was demonstrated similarly to a commercial HIFU ablation system. The coagulation was automatically detected by the proposed method during real-time simultaneous HIFU irradiation, and the HIFU exposure time was controlled according to the changes in the tissue. The results imply that ultrasonic monitoring with the filtering and detection methods is useful for true real-time detection of changes in the tissue due to thermal coagulation during HIFU exposure.

Advantage of annular focus generation by sector-vortex array in cavitation-enhanced high-intensity focused ultrasound treatment

High-intensity focused ultrasound (HIFU) is a noninvasive method for cancer treatment. One of the disadvantages of this method is that it has a long total treatment time because of the smallness of the treatment volume by a single exposure. To solve this problem, we have proposed a method of cavitation-enhanced heating, which utilized the heat generated by oscillating the cavitation bubbles, in combination with the method of lateral enlargement of a HIFU focal zone to minimize the surface volume ratio. In a previous study, focal spot scanning at multiple points was employed for the enlargement. This method involves nonlinear propagation and absorption due to the high spatial-peak temporal-peak (SPTP) intensity in addition to the cavitation-enhanced heating. However, it is difficult to predict the size and position of the coagulation volume because they are significantly affected by the nonlinear parameters of the tissue. In this study, a sector vortex method was employed to directly synthesize an annular focal pattern. Since this method can keep the SPTP intensity at a manageably low level, nonlinear propagation and absorption can be minimized. Experimental results demonstrate that the coagulation was generated only in the region where both the cavitation cloud and the heating ultrasound were matched. The proposed method will make the cavitation-enhanced HIFU treatment more accurate and predictable.

Study of ultrasound transducer which produces second harmonic superimposed signal

Cavitation is the formation of gas cavities in a liquid, in the consequence of rarefactional pressure acting upon the liquid. Producing such negative pressure exceeding the cavitation threshold in a travelling wave mode is hard to achieve due to nonlinear propagation followed by focal phase shift. Superimposing the second harmonic to fundamental is an alternative way to solve the problem while able to efficiently form and control the cavitation bubbles which expedite the treatment with high intensity focused ultrasound (HIFU). However, an air-backed transducer in conventional design is not suitable to generate both the second harmonic and fundamental at the same time. In order to overcome this problem, we propose a high impedance matching layer approach. We further explore the possibility of a double matching layer design with an additional lighter layer, to increase the performance of the transducer. Numerical simulation and experimental measurement have shown that by using high impedance matching layer, efficiently generating both the second harmonic (2 MHz) and fundamental (1 MHz) at the same time is possible. Numerical simulation also showed that further study is needed for the double matching layer approach to significant improve the performance.

A Study of the driving circuit for array transducer considering its impedance properties

A multi-channel array transducer can enlarge the treatment volume of HIFU (High-Intensity Focused Ultrasound), which is a noninvasive method for cancer therapy, by generating and scanning multiple foci. In our previous study, we developed a compact and highly efficient driving circuit using staircase wave voltage for typical single HIFU transducer that the impedance is almost real at the resonance frequency. However, an array transducer element can have too capacitive impedance that affects the output voltage waveform designed for reducing the harmonics components. To solve this problem, we propose a new circuit to drive an array transducer considering its imaginary impedance. The proposed circuit was able to reduce not only the odd harmonics but also electrical power consumption. Simulation of the relationship between the number of staircase wave steps and the power consumption proved that the total power consumption due to intentional turn-on decreased in proportion to the number of steps.

Elimination of therapeutic ultrasound noise from pre-beamformed RF data in ultrasound imaging for ultrasound-guided high-intensity focused ultrasound treatment

In conventional ultrasonic monitoring of high-intensity focused ultrasound (HIFU) treatment, a significant interval between consecutive HIFU shots is set for monitoring target tissue to avoid the interference of HIFU noise with RF echo signals. Thus, it is difficult to detect changes in tissue on the order of milliseconds, which are required to dynamically control the HIFU exposure. In this study, a new filtering method to eliminate the HIFU noise in the RF signals before beamforming is proposed. The CW response was estimated from RF signals with no pulse response to the imaging exposure, and the estimated CW response was subtracted from the entire RF signal to selectively eliminate the HIFU noise for each channel of the array probe before dynamic focusing was applied. The HIFU noise was selectively eliminated by this method when it existed. The results imply that the proposed filtering method is useful for true real-time detection of changes in tissue due to thermal coagulation during HIFU exposure.

Acceleration of lithotripsy using cavitation bubbles induced by second-harmonic superimposition

Shock wave lithotripsy potentially produces residual stone fragments too large to pass through ureters and significant injury to the normal tissue surrounding the stone. Previous works have shown that the collapse of cavitation bubbles induced by high-intensity focused ultrasound can produce small stone fragments via cavitation erosion. However, the erosion rate is hypothesized to be reduced by ultrasound attenuation by excessively generated bubble clouds. If so, it is important to generate the bubbles only on the stone surface. The effects of peak-negative-enhanced (PNE) and peak-positive-enhanced (PPE) waves obtained by second-harmonic superimposition were investigated to control cavitation bubbles. With the PNE waves, the bubbles were generated only on the stone surface and the maximum erosion rate was 232 ± 32 mg/min. All the fragments were smaller than 2 mm, which makes them pass through ureters naturally. The proposed method shows the potential to significantly improve the speed of lithotripsy.

Study on heavy matching layer transducer towards producing second harmonics

Cavitation bubbles are microbubbles which can be incepted by highly negative pressure. Producing such highly negative pressure exceeding the cavitation threshold is difficult to accomplish due to nonlinear propagation followed by focal phase shift. By superimposing the second harmonic to fundamental is a way to significantly reduce the problem. However, the conventional design for an air-backed transducer is not suitable to generate both the second harmonic and fundamental at the same time. In order to overcome this problem, we propose a high impedance matching layer approach. Furthermore, we also construct a study to foresee the impact by adjusting the thickness ratio towards fundamental and second harmonic. Numerical simulation and experimental measurement have shown that by using a high impedance matching layer, efficiently generation of both the second harmonic (2 MHz) and fundamental (1 MHz) at the same time is possible. Besides, by adjusting the thickness ratio between piezocomposite and heavy matching layer will influence the amplitude of acoustic power over squared of voltage of the fundamental and second harmonic.

Monitoring of lesions induced by cavitation-enhanced high-intensity focused ultrasound using shear wave elastography

Shear wave elastography is expected as a noninvasive monitoring method in high-intensity focused ultrasound treatment. Since elastography is usually applied to detect a lesion near a superficial layer, it is challenging to induce and propagate shear waves in deep tissue. Acoustic cavitation bubbles have the potential to promote the efficiency of the treatment; however the presence of remaining microbubbles may interfere with the shear wave propagation and make the detection of the accompanying displacements difficult. In this paper, it is examined whether the detection of the region where increased shear wave propagation velocity in ex vivo tissue is possible even in the presence of microbubbles and “HIFU push” shear wave elastography has the advantage in terms of shear wave induction in deep tissue compared with a conventional technique by irradiating push beams from the same therapeutic transducer as HIFU exposure.