MR monitoring of focused ultrasonic surgery of renal cortex: experimental and simulation studies

The aim of the study was to test the hypothesis that magnetic resonance (MR) imaging-guided and -monitored noninvasive ultrasonic surgery can be performed in highly perfused tissues from outside the body. A simulation study was performed to evaluate the optimal sonication parameters. An MR-compatible positioning device was then used to manipulate a focused ultrasound transducer in an MR imager, which was used to sonicate kidneys of five rabbits at various power levels and different durations. Temperature elevation during sonication was monitored with a T1-weighted spoiled gradient-echo sequence. The simulation study demonstrated that a sharply focused transducer and relatively short sonication times (30 seconds or less) are necessary to prevent damage to the overlying skin and muscle tissue, which have a much lower blood perfusion rate than kidney. The experiments showed that the imaging sequence was sensitive enough to show temperature elevation during sonication, thereby indicating the location of the beam focus. Histologic evaluations showed that kidney necrosis could be consistently induced without damage to overlying skin and muscle. The study demonstrated that highly perfused tissues such as the renal cortex can be coagulated from outside the body with focused ultrasound and that MR imaging can be used to guide and monitor this surgery.     

Transrectal ultrasound applicator for prostate heating monitored using MRI thermometry

PURPOSE: For potential localized hyperthermia treatment of tumors within the prostate, an ultrasound applicator consisting entirely of nonmagnetic materials for use with magnetic resonance imaging (MRI) has been developed and tested on muscle tissue ex vivo and in vivo. METHODS AND MATERIALS: A partial-cylindrical intracavitary transducer consisting of 16 elements in a 4 x 4 pattern was constructed. It produced a radially propagating acoustic pressure field. Each element of this array (1.5 x 0.75 cm), operating at 1.5 MHz, could be separately powered to produce a desired energy deposition pattern within a target volume. Spatial and temporal temperature elevations were determined using the temperature-dependent proton resonant frequency (PRF) shift and phase subtraction of MR images acquired during ultrasonic heating. Four rabbits were exposed to the ultrasound to raise the local tissue temperature to 45 degrees C for 25 minutes. Six experiments compared thermocouple temperature results to PRF shift temperature results. RESULTS: The tests showed that the multi-element ultrasound applicator was MRI-compatible and allowed imaging during sonication. The induced temperature distribution could be controlled by monitoring the RF power to each transducer element. Therapeutic temperature elevations were easily achieved in vivo at power levels that were about 16% of the maximum system power. From the six thermocouple experiments, comparison between the thermocouple temperature and the PRF temperature yielded an average error of 0.34+/-0.36 degrees C. CONCLUSIONS: The MRI-compatible intracavitary applicator and driving system was able to control the ultrasound field and temperature pattern in vivo. MRI thermometry using the PRF shift can provide adequate temperature accuracy and stability for controlling the temperature distribution.     

Computer-controlled dynamic phantom for ultrasound hyperthermiastudies

A dynamic phantom system for use in evaluating hyperthermia heating equipment has been designed, constructed, and tested. It consists of four in vitro preserved canine kidneys perfused with an 80% ethanol preparation by a single pump, plus four computer-controlled valves and four flow meters. The flow rate to each kidney is computer-controlled, giving flexibility in the types of spatial and temporal flow patterns possible. Examples are given for both step and ramp changes in flow, and for a temperature dependent flow which has been used to simulate physiological responses to elevated temperatures.     

Intracavitary ultrasound phased arrays for prostate thermal therapies: MRI compatibility and in vivo testing

A 62 element MRI-compatible linear phased array was designed and constructed to investigate the feasibility of using transrectal ultrasound for the thermal therapeutic treatment of prostate cancer and benign prostatic hyperplasia. An aperiodic design technique developed in a previous study was used in the design of this array, which resulted in reduced grating lobe levels by using an optimized random distribution of unequally sized elements. The element sizes used in this array were selected to be favorable for both grating lobe levels as determined by array aperiodicity and array efficiency as determined by width to thickness ratios. The heating capabilities and MRI compatibility of the array were tested with in vivo rabbit thigh muscle heating experiments using MRI temperature monitoring. The array produced therapeutic temperature elevations in vivo at depths of 3-6 cm and axial locations up to 3 cm off the central axis and increased the size of the heated volume with electronic scanning of a single focus. The ability of this array to be used for ultrasound surgery was demonstrated by creating necrosed tissue lesions in vivo using short high-power sonications. The ability of the array to be used for hyperthermia was demonstrated by inducing therapeutic temperature elevations for longer exposures. Based on the acoustic and heating performance of this array, it has the potential to be clinically useful for delivering thermal therapies to the prostate and other target volumes close to body cavities.     

A workbench for distributed production management systems

An end-user oriented workbench approach in the design of distributed production management systems (DPMS) is presented. We shall also deal with models and design of DPMS. Changes anticipated in design processes, roles and professionality required are discussed. In fact, complete structural rearrangements in the design of production management systems (PMS) are expected towards the end of this decade. The ideas presented are based on an on-going research project at Helsinki University of Technology (the so-called HUTDPMS project).     

A full-wave Helmholtz model for continuous-wave ultrasound transmission

A full-wave Helmholtz model of continuous-wave (CW) ultrasound fields may offer several attractive features over widely used partial-wave approximations. For example, many full-wave techniques can be easily adjusted for complex geometries, and multiple reflections of sound are automatically taken into account in the model. To date, however, the full-wave modeling of CW fields in general 3D geometries has been avoided due to the large computational cost associated with the numerical approximation of the Helmholtz equation. Recent developments in computing capacity together with improvements in finite element type modeling techniques are making possible wave simulations in 3D geometries which reach over tens of wavelengths. The aim of this study is to investigate the feasibility of a full-wave solution of the 3D Helmholtz equation for modeling of continuous-wave ultrasound fields in an inhomogeneous medium. The numerical approximation of the Helmholtz equation is computed using the ultraweak variational formulation (UWVF) method. In addition, an inverse problem technique is utilized to reconstruct the velocity distribution on the transducer which is used to model the sound source in the UWVF scheme. The modeling method is verified by comparing simulated and measured fields in the case of transmission of 531 kHz CW fields through layered plastic plates. The comparison shows a reasonable agreement between simulations and measurements at low angles of incidence but, due to mode conversion, the Helmholtz model becomes insufficient for simulating ultrasound fields in plates at large angles of incidence.     

Transcranial ultrasound focus reconstruction with phase and amplitude correction

Therapeutic and diagnostic ultrasound procedures performed noninvasively through the skull require a reliable method for maintaining acoustic focus integrity after transmission through layered bone structures. This study used a multiple-element, phased-array transducer to reconstruct ultrasound foci through the human skull by amplitude and phase correction. It was previously demonstrated that adaptive phase correction using a multiple-element, focused transducer array yields a significant correction to an acoustic field that has been distorted by the heterogeneities of the skull bone. The introduction of amplitude correction, in a regime in which acoustic pressures from individual transducer array elements are adjusted to be normalized at the focus, has demonstrated a 6% (-0.27 dB) average decrease in acoustic sidelobe acoustic intensity relative to the focal intensity and a 2% (-0.09 dB) average decrease in the full-width-at-half-maximum (FWHM) of the acoustic intensity profile at the focus. These improvements come at the expense of significant ultrasound intensity loss--as much as 30% lower (-1.55 dB)--at the focus because the amplitude correction method requires that, at constant power, a larger proportion of energy is absorbed or reflected by regions of the skull that transmit less energy. In contrast, a second correction method that distributes pressure amplitudes such that the sections of the skull which transmit more ultrasound energy are exposed with higher ultrasound intensities has demonstrated an average sidelobe intensity decrease of 3% (-0.13 dB) with no change in the FWHM at the focus. On average, there was a 2% (0.09 dB) increase in the acoustic intensity at the focus for this inverse amplitude correction method. These results indicate that amplitude correction according to the transmission properties of various segments of the skull have a clear effect on ultrasound energy throughput into a target site within the brain parenchyma.     

Histologic effects of high intensity pulsed ultrasound exposure with subharmonic emission in rabbit brain in vivo

In this study, the threshold for subharmonic emission during in vivo sonication of rabbit brain was investigated. In addition, the histologic effects of pulsed sonication above this threshold were studied. Two spherically curved focused ultrasound transducers with a diameter of 80 mm and a radius of curvature of 70 mm were used in the sonications. The operating frequencies of the transducers were 0.936 and 1.72 MHz. The sonication duration was varied between 0.001 and 1 s and the repetition frequency between 0.1 and 5 Hz. The threshold for subharmonic emission at the frequency of 0.936 MHz was found to be approximately 2000 W cm-2 and 3600 W cm-2 for pulse durations of 1 s and 0.001 s, respectively. The threshold was approximately 1.5-fold as high at a frequency of 1.72 MHz. However, there was considerable variation from experiment to experiment. The multiple pulse experiments at a frequency of 1.72 MHz and an intensity of 7000 W cm-2 showed that the histologic effects ranged from no observable damage of the tissue, to blood-brain barrier breakage, to local haemorrhagia, to local destruction of the tissue, to gross hemorrhage resulting in the death of the animal. The severity of the tissue damage increased as the pulse duration, number of pulses and their repetition frequency increased. The results indicate that the end point of the tissue damage may be controlled by selecting the sonication parameters. Such control over tissue effects can have several different applications when brain disorders are treated.     

Ultrafast 1D MR thermometry using phase or frequency mapping

Object  

To develop an ultrafast MRI-based temperature monitoring method for application during rapid ultrasound exposures in moving organs.