Nonlinear imaging-based bubble cloud size estimates compared with histotripsy treatment zone: An in vitro study

Abstract

Volterra filtering combined with subharmonic imaging was previously reported to enhance the visualization of the histotripsy bubble cloud. In this study, we compared the bubble cloud size obtained by imaging to the histotripsy ablation region using receiver operating characteristic (ROC) analysis. Histotripsy was performed in a red blood cell (RBC)-doped agarose phantom using a 1 MHz transducer. Ultrasound imaging data was acquired using a C5-2V probe and chirp-coded excitation (bandwidth: 2–5 MHz). These ultrasound acquisitions were then processed by subharmonic (SH) matched filtering alone, SH with quadratic Volterra filtering, and SH with cubic Volterra filtering. The therapy pulse and imaging sequence were interleaved (N = 100 frames), and a video camera was used to visualize the damaged region. A mean bubble cloud image was generated across all treatment sequences and co-registered with the camera image. A ROC curve was formed using binary classification of the mean bubble cloud versus the ablation zone, and the area under the ROC curve was determined. Filtering by quadratic and cubic Volterra filters reduced artifacts significantly [over 20 and 30 dB contrast-to-tissue enhancement (p < 0.01), respectively], along with achieving a high area under the ROC curve (0.97). These findings highlight the potential of Volterra filtering for histotripsy guidance.