Real-Time Spatiotemporal Control of High-Intensity Focused Ultrasound Thermal Ablation Using Echo Decorrelation Imaging in ex Vivo Bovine Liver

Abbass, Mohamed A.; Killin, Jakob K.; Mahalingam, Neeraja; Hooi, Fong Ming; Barthé, Peter G.; Mast, T. Douglas

doi:10.1016/j.ultrasmedbio.2017.09.007

Cited by 24 publications

(30 citation statements)

References 68 publications

(119 reference statements)

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“…However, this approach can potentially lead to false alarms, due to any decorrelation artifacts outside the focal ablation region. In another previous study [36], HIFU thermal ablation was successfully controlled using the minimum cumulative echo decorrelation inside a small ROI (1 × 1 mm 2 ), placed at the focal zone in ex vivo bovine liver [36]. The present study extends the applicability of echo decorrelation imaging to control of bulk ultrasound ablation [37], which is of interest not only as a potential minimally invasive cancer treatment [4], [5], [8], but also as an analog to bulk ablation by RFA and MWA, with comparable lesion sizes and heating rates [4].…”

Section: Introductionmentioning

confidence: 99%

“…An optimization method was applied to determine control ROI dimensions and ablation control thresholds (treatment end points) for two different echo decorrelation feedback predictors, based on results of preliminary ablation and imaging experiments. Bulk US thermal ablation was performed by the same image-ablate array used in previous HIFU experiments [36], [38], allowing accurate image registration with treated tissue histology. The array was used to generate unfocused ultrasound, a configuration mimicking other bulk thermal ablation techniques (e.g., RFA and MWA) by ablating larger volumes with slower heating rates, compared to HIFU ablation.…”

Section: Introductionmentioning

confidence: 99%

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Optimized Echo Decorrelation Imaging Feedback for Bulk Ultrasound Ablation Control

Abbass

Garbo

Mahalingam

et al. 2018

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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Feasibility of controlling bulk ultrasound (US) thermal ablation using echo decorrelation imaging was investigated in ex vivo bovine liver. The first of two ablation and control procedures used a sequence of constant-intensity sonication cycles, ceased when the minimum echo decorrelation within a control region of interest (ROI) exceeded a predetermined threshold. The second procedure used a variable-intensity sonication sequence, with spatially averaged decorrelation as the stopping criterion. US exposures and echo decorrelation imaging were performed by a linear image-ablate array. Based on preliminary experiments, control ROIs and thresholds for the minimum-decorrelation and average-decorrelation criteria were specified. Controlled trials for the minimum-decorrelation and average-decorrelation criteria were compared with uncontrolled trials employing 9 or 18 cycles of matching sonication sequences. Lesion dimensions, treatment times, ablation rates, and areas under receiver operating characteristic curves were statistically compared. Successfully controlled trials using both criteria required significantly shorter treatment times than corresponding 18-cycle treatments, with better ablation prediction performance than uncontrolled 9-cycle and 18-cycle treatments. Either control approach resulted in greater ablation rate than corresponding 9-cycle or 18-cycle uncontrolled approaches. A post hoc analysis studied the effect of exchanging control criteria between the two series of controlled experiments. For either group, the average time needed to exceed the alternative decorrelation threshold approximately matched the average duration of successfully controlled experimental trials. These results indicate that either approach, using minimum-decorrelation or average-decorrelation criteria, is feasible for control of bulk US ablation. In addition, use of a variable-intensity sonication sequence for bulk US thermal ablation can result in larger ablated regions compared to constant-intensity sonication sequences.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Optimized Echo Decorrelation Imaging Feedback for Bulk Ultrasound Ablation Control

Abbass

Garbo

Mahalingam

et al. 2018

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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“…As a result, the experimental results imply that the proposed method enables us to confirm the focal area of HIFU and to monitor the echogenicity changes of the area due to its capability of real-time HIFU interference elimination. Additionally, this result implies that the proposed method can help the thermometry [6] and echo decorrelation [25,26] methods accurately visualize and measure the treatment area in real time because these methods require a high signal-to-noise ratio to achieve high accuracy. For this reason, the cessation of HIFU exposure is currently necessary at the time of measurement.…”

Section: Real-time Hifu Treatment Monitoringmentioning

confidence: 99%

Real-Time HIFU Treatment Monitoring Using Pulse Inversion Ultrasonic Imaging

2018

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Real-time monitoring of high-intensity focused ultrasound (HIFU) surgery is essential for safe and accurate treatment. However, ultrasound imaging is difficult to use for treatment monitoring during HIFU surgery because of the high intensity of the HIFU echoes that are received by an imaging transducer. Here, we propose a real-time HIFU treatment monitoring method based on pulse inversion of imaging ultrasound; an imaging transducer fires ultrasound twice in 0° and 180° phases for one scanline while HIFUs of the same phase are transmitted in synchronization with the ultrasound transmission for imaging. By doing so, HIFU interferences can be eliminated after subtracting the two sets of the signals received by the imaging transducer. This function was implemented in a commercial research ultrasound scanner, and its performance was evaluated using the excised bovine liver. The experimental results demonstrated that the proposed method allowed ultrasound images to clearly show the echogenicity change induced by HIFU in the excised bovine liver. Additionally, it was confirmed that the moving velocity of the organs in the abdomen due to respiration does not affect the performance of the proposed method. Based on the experimental results, we believe that the proposed method can be used for real-time HIFU surgery monitoring that is a pivotal function for maximized treatment efficacy.

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“…TSI can therefore be utilized in the intraoperative monitoring of regular clinical workflow, because ultrasound imaging is a noninvasive and easy‐to‐use modality with nonionizing radiation. There are several investigations which explore the potential applications of TSI in the clinic, including temperature measurement with diagnostic ultrasound in HIFU therapy, temperature monitoring during radiofrequency (RF) heating, 3D TSI with commercial system, evaluation of high‐risk atherosclerotic plaque and real‐time guidance of HIFU ablation . To the best of our knowledge, in‐vivo evaluation of drug release from thermal‐sensitive cerasomes using TSI is yet to be investigated.…”

Section: Introductionmentioning

confidence: 99%

“…Another way to perform image guidance of thermal therapy is thermal strain imaging (TSI), which is an advanced technique of ultrasound imaging based on the thermal strain theory and speckle tracking technique. 16,17,19,[27][28][29][30][31][32][33][34][35][36][37][38][39] Briefly, the ultrasound propagation speed within soft tissues changes with the tissue temperature, introducing echo shifts which can be estimated using the speckle tracking technique. 16,17 The spatial derivative of echo shifts is referred to as thermal strain.…”

Section: Introductionmentioning

confidence: 99%

Evaluating HIFU‐mediated local drug release using thermal strain imaging: Phantom and preliminary in‐vivo studies

Lee

Gao

et al. 2019

Medical Physics

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Purpose High‐intensity focused ultrasound (HIFU)‐mediated drug release becomes a promising therapeutic technique for treatment of cancer, which has merits of deep penetration, noninvasive approach and nonionizing radiation. However, conventional thermocouple‐based approach for treatment monitoring would encounter big challenges such as the viscous heating artifact and difficulty in monitoring in the deep region. In this study, we develop an effective method based on thermal strain imaging (TSI) for the evaluation of HIFU‐mediated drug release. Methods Both phantom experiments and preliminary animal experiments were performed to investigate the feasibility of the proposed approach. Doxorubicin (DOX)‐loaded cerasomes (HIFU and temperature‐sensitive cerasomes, HTSCs) were prepared. In the phantom experiments, the HTSC solution is contained inside a cylindrical chamber within a tissue‐mimicking phantom. In the animal experiments, the HTSCs are intravenously injected into tumor‐bearing mice. An HIFU transducer is used to trigger DOX release from the HTSCs within the phantom or mice, and TSI is performed during HIFU heating. In the phantom experiments, the accuracy of temperature estimation using TSI is validated by measuring with a thermocouple. In animal experiments, the spatial consistency between the distribution of DOX released within the tumor and the location of the heating region estimated by TSI is validated using a spectrofluorophotometer. Results In the phantom experiments, the HTSCs show a burst release of DOX when the temperature of the HTSC solution estimated by TSI reaches about 42°C, which is in agreement with the condition for drug release from the HTSCs. The temperature estimation using TSI has high accuracy with error below 2.5%. In animal experiments, fluorescence imaging of the tumor validates that the heating region of HIFU could be localized by the low‐strain region of TSI. Conclusion The present framework demonstrates a reliable and effective solution to the evaluation of HIFU‐mediated local drug delivery.

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Real-Time Spatiotemporal Control of High-Intensity Focused Ultrasound Thermal Ablation Using Echo Decorrelation Imaging in ex Vivo Bovine Liver

Cited by 24 publications

References 68 publications

Optimized Echo Decorrelation Imaging Feedback for Bulk Ultrasound Ablation Control

Optimized Echo Decorrelation Imaging Feedback for Bulk Ultrasound Ablation Control

Real-Time HIFU Treatment Monitoring Using Pulse Inversion Ultrasonic Imaging

Evaluating HIFU‐mediated local drug release using thermal strain imaging: Phantom and preliminary in‐vivo studies

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