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A Theragnostic HIFU Transducer and System for Inherently Registered Imaging and Therapy
A Theragnostic HIFU Transducer and System for Inherently Registered Imaging and Therapy
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INTRODUCTION.
HIGH intensity focused ultrasound (HIFU) is awell-known non-invasive therapeutic modality that has been used clinically for treating many types of tumors or cancers [1].
Its popularity keeps growing since the 2000s, mainly due to its non-invasiveness when compared with other methods.
According to the Focused Ultrasound Foundation, currently there are over 150 clinical indications that are being or have been investigated at different stages around the world.
Despite its great advancements and popularity, the lack of a reliable imaging guiding system poses a significant challenge to researchers and clinicians working in this field.
In clinical practices, the most common imaging modalities for guiding HIFU therapy are MRI and ultrasound, which has been well reviewed by Hectors and Ebbini respectively [2], [3].
The current MRI guided clinical HIFU system is able to guide and monitor the therapeutic procedure with satisfactory results, but its wider applications are limited by the high cost and low accessibility of MRI device in clinical environment.
Ultrasound-guided HIFU system could compensate for those limitations, but currently it has difficulties in predicting focus of the HIFU sonication on the guiding images [4], [5], [6].
Those difficulties are caused by the fact that the therapeutic system and the imaging system are independent, and the link between them is based on a spatial registration.
While performing the spatial registration, it is assumed that all of the acoustic waves produced by the HIFU transducer travel along straight lines, as they would in a homogeneous medium.
Obviously, this assumption could easily break down, especially when the acoustic passage is complicated and in that case it is not practical to predict acoustic propagation with mathematical models without knowing acoustic properties of the tissue [7], [8].
Some studies turned to estimating the HIFU focal location using ultrasound imaging at the planning stage via stimulating the focal region with sub-therapeutic HIFU sonication [9], [10], [11].
In spite of those efforts, accurately predicting the HIFU focus prior to the ablation is still a challenge in clinical practice.
A better idea for addressing the problem could be seamlessly integrating the HIFU therapy system and the imaging system into one acoustic device to achieve an inherent registration between them.
This idea is possible, at least in the following two ways.
The first strategy is to use a phased array dual-mode HIFU transducer, which on one hand transmits high intensity energy for therapy and on the other hand conducts pulse-echo ultrasound imaging at the diagnostic level.
In this way, the imaging and therapy share the same coordinate system.
This method was first proposed by Ebbini and investigated in a series of studies [5], [6], [12], [13], [14], [15].
Due to the necessity of having a concave structure in HIFU therapy, the resultant sonication field is strongly-focused.
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1
INTRODUCTION.
2
HIGH intensity focused ultrasound (HIFU) is awell-known non-invasive therapeutic modality that has been used clinically for treating many types of tumors or cancers [1].
3
Its popularity keeps growing since the 2000s, mainly due to its non-invasiveness when compared with other methods.
4
According to the Focused Ultrasound Foundation, currently there are over 150 clinical indications that are being or have been investigated at different stages around the world.
5
Despite its great advancements and popularity, the lack of a reliable imaging guiding system poses a significant challenge to researchers and clinicians working in this field.
6
In clinical practices, the most common imaging modalities for guiding HIFU therapy are MRI and ultrasound, which has been well reviewed by Hectors and Ebbini respectively [2], [3].
7
The current MRI guided clinical HIFU system is able to guide and monitor the therapeutic procedure with satisfactory results, but its wider applications are limited by the high cost and low accessibility of MRI device in clinical environment.
8
Ultrasound-guided HIFU system could compensate for those limitations, but currently it has difficulties in predicting focus of the HIFU sonication on the guiding images [4], [5], [6].
9
Those difficulties are caused by the fact that the therapeutic system and the imaging system are independent, and the link between them is based on a spatial registration.
10
While performing the spatial registration, it is assumed that all of the acoustic waves produced by the HIFU transducer travel along straight lines, as they would in a homogeneous medium.
11
Obviously, this assumption could easily break down, especially when the acoustic passage is complicated and in that case it is not practical to predict acoustic propagation with mathematical models without knowing acoustic properties of the tissue [7], [8].
12
Some studies turned to estimating the HIFU focal location using ultrasound imaging at the planning stage via stimulating the focal region with sub-therapeutic HIFU sonication [9], [10], [11].
13
In spite of those efforts, accurately predicting the HIFU focus prior to the ablation is still a challenge in clinical practice.
14
A better idea for addressing the problem could be seamlessly integrating the HIFU therapy system and the imaging system into one acoustic device to achieve an inherent registration between them.
15
This idea is possible, at least in the following two ways.
16
The first strategy is to use a phased array dual-mode HIFU transducer, which on one hand transmits high intensity energy for therapy and on the other hand conducts pulse-echo ultrasound imaging at the diagnostic level.
17
In this way, the imaging and therapy share the same coordinate system.
18
This method was first proposed by Ebbini and investigated in a series of studies [5], [6], [12], [13], [14], [15].
19
Due to the necessity of having a concave structure in HIFU therapy, the resultant sonication field is strongly-focused.
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