Optimization of real-time acoustical and mechanical monitoring of high intensity focused ultrasound (HIFU) treatment using harmonic motion imaging for high focused ultrasound (HMIFU).

Harmonic Motion Imaging (HMI) for Focused Ultrasound (HMIFU) is a recently developed high-intensity focused ultrasound (HIFU) treatment monitoring method with feasibilities demonstrated in silica, in vitro and in vivo. Its principle is based on emission of an Amplitude-modulated therapeutic ultrasound beam utilizing a therapeutic transducer to induce an oscillatory radiation force while tracking the focal tissue mechanical response during the HIFU treatment using a confocally-aligned diagnostic transducer. In order to translate towards the clinical implementation of HMIFU, a complete assessment study is required in order to investigate the optimal radiation force threshold for reliable monitoring the local tissue mechanical property changes, i.e., the estimation HMIFU displacement under thermal, acoustical, and mechanical effects within focal medium (i.e., boiling, cavitation, and nonlinearity) using biological specimen. In this study, HMIFU technique is applied on HIFU treatment monitoring on freshly excised ex vivo canine liver specimens. In order to perform the multi-characteristic assessment, the diagnostic transducer was operated as either a pulse-echo imager or Passive Cavitation Detector (PCD) to assess the acoustic and mechanical response, while a bare-wire thermocouple was used to monitor the focal temperature change. As the acoustic power of HIFU treatment was ranged from 2.3 to 11.4 W, robust HMI displacement was observed across the entire range. Moreover, an optimized range for high quality displacement monitoring was found to be between 3.6 to 5.2W, where displacement showed an increase followed by significant decrease, indicating a stiffening of focal medium due to thermal lesion formation, while the correlation coefficient was maintained above 0.95.