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DEPENDENCE OF BOILING HISTOTRIPSY TREATMENT EFFICIENCY ON HIFU FREQUENCY AND FOCAL PRESSURE LEVELS
DEPENDENCE OF BOILING HISTOTRIPSY TREATMENT EFFICIENCY ON HIFU FREQUENCY AND FOCAL PRESSURE LEVELS
DEPENDENCE OF BOILING HISTOTRIPSY TREATMENT EFFICIENCY ON HIFU FREQUENCY AND FOCAL PRESSURE LEVELS
INTRODUCTION
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INTRODUCTION
Boiling histotripsy (BH) is a high-intensity focused ultrasound (HIFU) regime that utilizes non-linear propagation effects and formation of shocks at the focus (Khokhlova et al. 2011). As a result of enhanced absorption of ultrasound energy at the shocks in tissue, a large vapor bubble is induced at the focus of a HIFU transducer within milliseconds (Canney et al. 2010) and its interaction with the incoming shocks mechanically lyses tissue into subcellular debris via atomization and acoustic micro-fountain mechanisms (Simon et al. 2012). Multiple clinical applications for BH have been suggested, primarily in oncology, to mechanically ablate unwanted soft tissues. The most relevant applications, in which traditional HIFU is faced with substantial problems are deep abdominal organ malignancies, including the liver, pancreas and kidney (Khokhlova et al. 2015). In order to access these organs, thermal HIFU treatments utilize the frequencies within 1–2 MHz range to balance the penetration depth with heating efficiency and precision (Wu et al. 2004). In BH, the dependence of treatment outcome on HIFU frequency has also been observed within 1–3 MHz range: The lesion size increased with decreasing frequency (Khokhlova et al. 2011), given the same number of BH pulses delivered. Therefore, the ablation of tissue volumes at 1 MHz would be much faster than at higher frequencies. Thus, using the frequency of 1 MHz or lower for deep abdominal applications would seem like a natural choice, since it combines the treatment efficiency and allows appropriate penetration depth.
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1 Boiling histotripsy (BH) is a high-intensity focused ultrasound (HIFU) regime that utilizes non-linear propagation effects and formation of shocks at the focus (Khokhlova et al. 2011). 2 As a result of enhanced absorption of ultrasound energy at the shocks in tissue, a large vapor bubble is induced at the focus of a HIFU transducer within milliseconds (Canney et al. 2010) and its interaction with the incoming shocks mechanically lyses tissue into subcellular debris via atomization and acoustic micro-fountain mechanisms (Simon et al. 2012). 3 Multiple clinical applications for BH have been suggested, primarily in oncology, to mechanically ablate unwanted soft tissues. 4 The most relevant applications, in which traditional HIFU is faced with substantial problems are deep abdominal organ malignancies, including the liver, pancreas and kidney (Khokhlova et al. 2015). 5 In order to access these organs, thermal HIFU treatments utilize the frequencies within 1–2 MHz range to balance the penetration depth with heating efficiency and precision (Wu et al. 2004). 6 In BH, the dependence of treatment outcome on HIFU frequency has also been observed within 1–3 MHz range: The lesion size increased with decreasing frequency (Khokhlova et al. 2011), given the same number of BH pulses delivered. 7 Therefore, the ablation of tissue volumes at 1 MHz would be much faster than at higher frequencies. 8 Thus, using the frequency of 1 MHz or lower for deep abdominal applications would seem like a natural choice, since it combines the treatment efficiency and allows appropriate penetration depth.