IEEE International Ultrasonics Symposium : [proceedings]. IEEE International Ultrasonics Symposium最新文献

Thermal ablation is a minimally invasive cancer treatment which has been rapidly gaining clinical acceptance. It is well known that thermal ablation increases the acoustic attenuation and shear modulus of tissue. In this work, we examine changes to the spatial distribution of scatterers in liver tissue following thermal ablation. Acoustic scatterers within liver tissue have frequently been modeled as pseudo-periodic. The positions of pseudo-periodic scatterers have been Gamma distributed along the beam dimension, and these scatterers are characterized by their mean scatterer spacing (MSS). Prior work have demonstrated significant changes in MSS due to diffuse liver disease, such as steatosis progressing to cirrhosis. However, relatively few results have been reported regarding changes in MSS following thermal ablation. In this study, we estimated MSS in ex vivo bovine liver by detecting local maxima in spectral coherence functions calculated using Thomson's multi-taper method. We examined a large number of uncorrelated regions of interest recorded from five normal bovine livers (~300 images from each animal). We also examined a large number of ROI's from five bovine livers following thermal coagulation. All bovine livers were obtained from a commercial meat production facility immediately following animal sacrifice and imaged within 12 hours. Thermal coagulation was induced by heating liver in saline water baths at 80° C for 45 minutes. For normal, unheated liver an MSS of approximately 1.5 mm was estimated. Following thermal ablation, an MSS of approximately 0.5 mm in thermally coagulated tissue was obtained. Frequently, studies estimating MSS in liver tissue provide an MSS estimate regardless of the state of tissue. Authors rarely present what their MSS estimation algorithm would produce if it were applied to tissue which is better modeled as a collection of uniformly, randomly distributed scatterers lacking periodicity. In this study, we found that thermal coagulation results in a loss of periodicity. The MSS of 0.5 mm corresponds to the value that a spectral coherence-based MSS algorithm would produce if presented with a signal that was generated from uniform, randomly distributed scatterers.

Kidney stones have been shown to exhibit a "twinkling artifact" (TA) under Color-Doppler ultrasound. Although this technique has better specificity than conventional Bmode imaging, it has lower sensitivity. To improve the overall performance of using TA as a diagnostic tool, Doppler output parameters were optimized in-vitro. The collected data supports a previous hypothesis that TA is caused by random oscillations of micron sized bubbles trapped in the cracks and crevices of kidney stones. A set of optimized parameters were implemented such that that the MI & TI remained within the FDA approved limits. Several clinical kidney scans were performed with the optimized settings and were able to detect stones with improved SNR relative to the default settings.

One in 11 Americans has experienced kidney stones, with a 50% average recurrence rate within 5-10 years. Ultrasonic propulsion (UP) offers a potential method to expel small stones or residual fragments before they become a recurrent problem. Reported here are preliminary findings from the first investigational use of UP in humans. The device uses a Verasonics ultrasound engine and Philips HDI C5-2 probe to generate real-time B-mode imaging and targeted "push" pulses on demand. There are three arms of the study: de novo stones, post-lithotripsy fragments, and the preoperative setting. A pain questionnaire is completed prior to and following the study. Movement is classified based on extent. Patients are followed for 90 days. Ten subjects have been treated to date: three de novo, five post-lithotripsy, and two preoperative. None of the subjects reported pain associated with the treatment or a treatment related adverse event, beyond the normal discomfort of passing a stone. At least one stone was moved in all subjects. Three of five post-lithotripsy subjects passed a single or multiple stones within 1-2 weeks following treatment; one subject passed two (1-2 mm) fragments before leaving clinic. In the pre-operative studies we successfully moved 7 - 8 mm stones. In four subjects, UP revealed multiple stone fragments where the clinical image and initial ultrasound examination indicated a single large stone.

Animal studies have shown that shock wave lithotripsy (SWL) delivered with an initial course of low-energy shocks followed by a pause reduces renal injury. The pause correlates with increased arterial resistive index (RI) during SWL as measured by ultrasound. This suggests that renal vasoconstriction is associated with protecting the kidney from injury. This study explored whether a similar increase in RI is observed in humans. Patients were prospectively recruited from two hospitals. All received an initial dose of 250 lowest energy shocks followed by a two-minute pause. Shock power was then ramped up at the discretion of the physician; shock rate was maintained at 1 Hz. Spectral Doppler velocity measurements were taken from an interlobar artery at baseline after induction, during the pause at 250 shocks, after 750 shocks, after 1500 shocks, and at the end of the procedure. RI was calculated from the peak systolic and end diastolic velocities and a linear mixed-effects model was used to compare RIs. The statistical model accounted for age, gender, laterality, and body mass index (BMI). Measurements were taken from 15 patients. Average RI ± standard deviation pretreatment, after 250 shocks, after 750 shocks, after 1500 shocks, and post treatment was 0.68 ± 0.06, 0.71 ± 0.07, 0.73 ± 0.06, 0.75 ± 0.07 and 0.75 ± 0.06, respectively. RI was found to be significantly higher after 250 shocks compared to pretreatment (p = 0.04). RI did not correlate with age, gender, BMI, or treatment side. This is suggestive that allowing a pause for renal vascular vasoconstriction to develop may be beneficial, and can be monitored for during SWL, providing real-time feedback as to when the kidney is protected.

Platelet-rich plasma (PRP) has been applied in a series of clinical treatments. PRP contains high-concentrated platelets, which, when activated, could secret a variety of growth factors and cytokines, to promote and/or enhance healing of injured tissues. Non-activated platelets suspension could be prepared by an isolation method of centrifugation and washing currently. However, it is not clear whether platelets, if any, are already activated during this process and there is no simple method to monitor their activation accordingly. Shear-Horizontal Surface Acoustic Wave sensors (SH-SAW, Love Mode) are promising in fundamental biology as well as biomedical engineering, detecting cell behaviors in liquid in a non-invasive, simple and quantitative manner. In this study, Love mode sensors are adopted for the label-free detection of protein secreted by platelets. Carbon nanotube (CNT) is reported as an advisable platform of both non-specific protein adsorption and specific protein binding. For further improvement of Love mode sensor performance, novel CNT -coated parylene-C film is prepared on its surface as both the acoustic-wave-guiding layer and bio-interface layer. The S21 loss curves of Love mode sensors were recorded and the corresponding resonance frequencies were extracted. The results showed that the CNT-enhanced sensor possessed an increased resonance frequency shift when compared to normal sensor with single parylene-C film under identical collagen concentrations. Then, the modified sensor is used for label-free detection of protein released by various concentrations of platelets. The results revealed high sensitivity and consistency, indicating the potential of CNT-enhanced Love mode sensors in cell-based applications.

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.

The mechanical index (MI) quantifies the likelihood that exposure to diagnostic ultrasound will produce an adverse biological effect by a nonthermal mechanism. The current formulation of the MI is based on inertial cavitation thresholds in two liquids, water and blood, as calculated by a formalism assuming very short pulse durations. Although tissue contains a high proportion of water, it is not a liquid but a viscoelastic solid. Further, acoustic radiation force impulse imaging employs high-intensity pulses up to several hundred acoustic periods long. The effect of these differences was studied in water, blood and five representative tissues.

Liquid atomization and fountain formation by focused ultrasound was first published by Wood and Loomis [1]. Since then, the cavitation-wave hypothesis emerged to explain atomization in a fountain, which states atomization arises from a combination of surface capillary waves and the collapse of cavitation bubbles. More recently, high intensity focused ultrasound (HIFU) has been shown to fractionate tissue through either pulsed-cavitation or millisecond boiling histotripsy therapies; however it is unclear how millimeter-size boiling bubbles or cavitation bubble clouds fractionate tissue into submicron-size fragments. The objective of this work is to test the hypothesis experimentally that atomization and fountain formation occurs similarly in liquids and tissues and results in tissue erosion. A 2-MHz HIFU transducer operating at peak in situ pressures of 50 MPa and -11 MPa (linear intensity = 14,000 W/cm²) was focused at the interface between a liquid or tissue and air. A high-speed camera was used to monitor atomization and fountain formation in water, ethanol, glycerol, bovine liver, and porcine blood clots. The in situ linear intensity threshold for consistent atomization in one 10-ms pulse increased in the order: ethanol (180 W/cm²) < blood clot (250 W/cm²) < water (350 W/cm²) < liver (6200 W/cm²); glycerol did not atomize. Average jet velocities for the initial spray at the maximum acoustic intensity were similar for all materials and on the order of 20 m/s. The tissue erosion rate of liver approached saturation at around 300 10-ms pulses repeated at 1 Hz, which had an average erosion volume of 25.7±10.9 mm³. While tissue atomization and fountain formation does not completely mimic what is observed in liquids, atomization provides a plausible explanation of how tissue is fractionated in millisecond boiling and possibly even cavitation cloud histotrispy therapies.