State Key Laboratory of Ultrasound Engineering in Medicine, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.
Med Phys. 2023 Sep;50(9):5449-5459. doi: 10.1002/mp.16565. Epub 2023 Jun 22.
High-intensity focused ultrasound (HIFU) is currently used for the treatment of various diseases, but it still lacks a reliable technique in the preoperative stage to accurately place its "energy blade" onto diseased targets. Acoustic radiation force imaging (ARFI) was recently introduced to tackle this issue, but its applicability and limitations were not clear.
The aim of this study was to evaluate the performance of ARFI method in prediction of HIFU focal location at the preoperative stage.
A point spread function (PSF) localization method, which was borrowed from the ultrasound super resolution field, was used to validate the core autocorrelation-based motion estimation algorithm in the ARFI procedure. Accuracy of the ARFI method for estimating the HIFU focus were tested with in vitro and ex vivo experiments with a clinically equivalent HIFU system. Comparisons were made between the estimated focal locations and those of the damaged area after the testing objects were cut open.
Results showed that the PSF localization was able to serve as a validating method for motion detection only when the tissue displacement was large. With the ARFI method, location of the HIFU focus could be accurately predicted by a 2D motion map preoperatively, and the axial spatial errors were less than 0.5 mm. However, the derived 2D motion maps can only be valuable when the acoustic stimulation in ARFI were strong enough, which was probably due to the fact that the HIFU focal locations were at large depths and the ultrasound imaging signal had low signal to noise ratio.
The ARFI method was indeed an accurate technique for preoperatively predicting HIFU focus in vitro and ex vivo. If clinical applications were to be considered, particularly in deep tissues, efforts might need to be made to improve ability of the ultrasound motion estimation technique.
高强度聚焦超声(HIFU)目前用于治疗各种疾病,但在术前阶段仍然缺乏一种可靠的技术来将其“能量刀”准确地放置在病变目标上。声辐射力成像(ARFI)最近被引入来解决这个问题,但它的适用性和局限性尚不清楚。
本研究旨在评估 ARFI 方法在预测术前 HIFU 焦点位置中的性能。
借用超声超分辨率领域的点扩散函数(PSF)定位方法,对 ARFI 过程中的基于核心自相关的运动估计算法进行了验证。使用临床等效的 HIFU 系统进行了体外和离体实验,测试了 ARFI 方法对估计 HIFU 焦点的准确性。将测试对象切开后,对估计的焦点位置和损伤区域的位置进行了比较。
结果表明,只有当组织位移较大时,PSF 定位才能作为运动检测的有效方法。使用 ARFI 方法,术前可以通过 2D 运动图准确预测 HIFU 焦点的位置,轴向空间误差小于 0.5mm。然而,所得到的 2D 运动图只有在 ARFI 中的声刺激足够强时才有价值,这可能是由于 HIFU 焦点位置较深,超声成像信号的信噪比较低。
ARFI 方法确实是一种准确的体外和离体预测 HIFU 焦点的技术。如果要考虑临床应用,特别是在深部组织中,可能需要努力提高超声运动估计技术的能力。