Abstract

The InSightec Exablate system is the standard of care used for transcranial focused ultrasound ablation treatments in the United States. The system calculates phase corrections that account for aberrations caused by the human skull. This work investigates whether skull aberration correction can be improved by comparing the standard of care InSightec ray tracing method with the hybrid angular spectrum (HAS) method and the gold standard hydrophone method. Three degassed ex vivo human skulls were sonicated with a 670 kHz hemispherical phased array transducer (InSightec Exablate 4000). Phase corrections were calculated using four different methods (straight ray tracing, InSightec ray tracing, HAS, and hydrophone) and were used to drive the transducer. 3D raster scans of the beam profiles were acquired using a hydrophone mounted on a 3-axis positioner system. Focal spots were evaluated using six metrics: pressure at the target, peak pressure, intensity at the target, peak intensity, positioning error, and focal spot volume. For three skulls, the InSightec ray tracing method achieved 52 ± 21% normalized target intensity (normalized to hydrophone), 76 ± 17% normalized peak intensity, and 0.72 ± 0.47 mm positioning error. The HAS method achieved 74 ± 9% normalized target intensity, 81 ± 9% normalized peak intensity, and 0.35 ± 0.09 mm positioning error. The InSightec-to-HAS improvement in focal spot targeting provides promise in improving treatment outcomes. These improvements to skull aberration correction are also highly relevant for the applications of focused ultrasound neuromodulation and blood brain barrier opening, which are currently being translated for human use.

Highlights

  • IntroductionThe InSightec ray tracing method achieved 52 ± 21% normalized target intensity (normalized to hydrophone), 76 ± 17% normalized peak intensity, and 0.72 ± 0.47 mm positioning error

  • The InSightec Exablate system is the standard of care used for transcranial focused ultrasound ablation treatments in the United States

  • 3D raster scans of phase corrected focal spots. 3D hydrophone raster scans were acquired for five sets of phase corrections: no correction, straight ray tracing, InSightec ray tracing, hybrid angular spectrum (HAS), and hydrophone

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Summary

Introduction

The InSightec ray tracing method achieved 52 ± 21% normalized target intensity (normalized to hydrophone), 76 ± 17% normalized peak intensity, and 0.72 ± 0.47 mm positioning error. The InSightec-toHAS improvement in focal spot targeting provides promise in improving treatment outcomes These improvements to skull aberration correction are highly relevant for the applications of focused ultrasound neuromodulation and blood brain barrier opening, which are currently being translated for human use. This iterative process can be achieved by generating small temperature rises and measuring them with magnetic resonance proton resonance frequency shift thermometry (MR thermometry)[15] In applications such as neuromodulation and blood brain barrier opening, the magnitude of temperature rise does not exceed the noise floor of MR thermometry. Either a different mode of measurement is needed for calibration, or better targeting is needed

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