Multielement Ultrasound Applicators Research Articles

Development of a new control strategy for 3D MRI‐controlled interstitial ultrasound cancer therapy

MRI-controlled interstitial ultrasound therapy is being developed as a minimally invasive, image-guided treatment for localized cancers. The method uses an interstitial multielement ultrasound applicator to deliver high-intensity ultrasound energy to tissue in order to achieve thermal coagulation in a target volume. A new temperature feedback control algorithm incorporating a proportional-integral controller is introduced to tackle a multiple-input single-output control problem arising in MRI-controlled interstitial ultrasound cancer therapy. The inputs to the controller block are the frequency, rotation rate, and applied power of an interstitial applicator and the output is the boundary temperature during treatment. Multiplanar magnetic resonance (MR) thermometry is acquired continuously during heating and used in the feedback control algorithm to achieve spatial control over treatment. The method has been evaluated for prostate cancer treatment as an initial clinical application. Spatial treatment accuracy of a few millimeters is demonstrated in both simulations and experiments with the new controller. The spatial treatment accuracy of the new algorithm is shown to be equivalent or slightly improved over the existing approach implemented for this technology; however, the implementation of the new algorithm is much simpler, and does not involve time-intensive tuning of gain constants. The study demonstrates the potential advantages of a new automatic temperature control system adapted to image guided interstitial ultrasound therapy.

Multiplanar MR temperature‐sensitive imaging of cerebral thermal treatment using interstitial ultrasound applicators in a canine model

To study the feasibility of an interleaved gradient-echo, echo-planar imaging (iGE-EPI) sequence for multiplanar magnetic resonance temperature imaging (MRTI) to monitor intracerebral thermal treatment three-dimensionally using multielement ultrasound applicators. Transmissible venereal tumor (TVT) fragments were injected into the right cerebral hemisphere of five dogs. Guided by MRI, an interstitial ultrasound applicator was inserted into the tumor or normal brain tissue. The iGE-EPI sequence was used to estimate temperature changes by computing the complex phase-difference induced by temperature-dependent shifts in the proton resonance frequency of water. The thermal dose maps were updated every 6-8 seconds for five to seven image planes during treatment. The results of MRTI were compared with those of post-treatment MRI and histologic analysis. The multiplanar MRTI monitored temperature and thermal dose distributions in tumor and normal brain tissue over the entire user-defined treatment volume. The ultrasound applicators produced contiguous areas of coagulative necrosis, resulting in 1.5-4.0 cm(3) volumes of tissue necrosis. MRTI-based assessments of thermal-dose distributions were consistent with the results of post-treatment MRI and histologic analysis. Multiplanar MRTI is feasible for measuring necrosing thermal doses during intracerebral thermal delivery by interstitial ultrasound applicators.

Arrays of multielement ultrasound applicators for interstitial hyperthermia.

Arrays of multielement ultrasound applicators for interstitial hyperthermia have been developed and tested both in vitro and in vivo. The system includes multielement applicators, a 64 channel RF driving unit, a power measuring unit, a 112 channel multisensor temperature measuring unit, and a water cooling unit. Ninety-five arrays of single-element and nine arrays of three-element ultrasound applicators were designed, built, and characterized by measuring transducer efficiency and ultrasound field distribution. Improved uniformity in the azimuthal direction was achieved by using multiple driving frequencies. In addition, production of ultrasound in a desired sector of the transducer was possible by selecting a suitable frequency. Both in vitro and in vivo experiments showed that 92% of monitored temperature points within the target volume of 30 mm x 30 mm x 35 mm achieved a therapeutic temperature rise (above 5 degrees C) when an array of five three-element applicators were used. These results indicated that the arrays of multielement ultrasound applicators have distinct advantages over present interstitial hyperthermia modalities in terms of the capability to control the temperature distribution with a large catheter spacing. As a conclusion, the feasibility of a practical arrays of multielement ultrasound applicators for interstitial hyperthermia was demonstrated.

Transrectal ultrasound applicator for prostate heating monitored using MRI thermometry

Purpose: For potential localized hyperthermia treatment of tumors within the prostate, an ultrasound applicator consisting entirely of nonmagnetic materials for use with magnetic resonance imaging (MRI) has been developed and tested on muscle tissue ex vivo and in vivo. Methods and Materials: A partial-cylindrical intracavitary transducer consisting of 16 elements in a 4 × 4 pattern was constructed. It produced a radially propagating acoustic pressure field. Each element of this array (1.5 × 0.75 cm), operating at 1.5 MHz, could be separately powered to produce a desired energy deposition pattern within a target volume. Spatial and temporal temperature elevations were determined using the temperature-dependent proton resonant frequency (PRF) shift and phase subtraction of MR images acquired during ultrasonic heating. Four rabbits were exposed to the ultrasound to raise the local tissue temperature to 45°C for 25 minutes. Six experiments compared thermocouple temperature results to PRF shift temperature results. Results: The tests showed that the multi-element ultrasound applicator was MRI-compatible and allowed imaging during sonication. The induced temperature distribution could be controlled by monitoring the RF power to each transducer element. Therapeutic temperature elevations were easily achieved in vivo at power levels that were about 16% of the maximum system power. From the six thermocouple experiments, comparison between the thermocouple temperature and the PRF temperature yielded an average error of 0.34 ± 0.36°C. Conclusions: The MRI-compatible intracavitary applicator and driving system was able to control the ultrasound field and temperature pattern in vivo. MRI thermometry using the PRF shift can provide adequate temperature accuracy and stability for controlling the temperature distribution.

Direct-coupled interstitial ultrasound applicators for simultaneous thermobrachytherapy: a feasibility study.

This study presents the design and performance evaluation of interstitial ultrasound applicators designed specifically for thermal therapy with simultaneous brachytherapy. The applicator consists of a multielement array of piezoceramic tubular radiators, each with separate power control, surrounded by thin layers of electrically-insulating and biocompatible coatings (< 2.6 mm OD). A catheter which is compatible with remote afterloaders and standard brachytherapy technology forms the inner lumen. These 'direct-coupled interstitial ultrasound applicators' (DCIUA's) are placed within the tumour or target region, with the coated transducer surface forming the outer wall of the implant catheter. Thermocouple sensors embedded in the coating over each transducer can be used for continuous monitoring of the tissue/applicator interface temperatures for feedback control of power to each transducer segment. Theoretical acoustic power deposition and corresponding temperature distributions from thermal simulations have demonstrated that the radius of effective heating is highly dependent upon the acoustic efficiency of the piezoceramic transducers, with effective heating extending > 1 - 1.5 cm radially for typical DCIUA applicators that are 60-65% efficient. This exceeds the effective heating radius of both thermal conduction and RF heating technologies. Measurements with prototype multielement ultrasound applicators have demonstrated acoustic efficiencies between 60 and 65% and beam distributions which are fairly uniform and collimated to the transducer axial length. Thermal dosimetry measurements within in vivo tissues have demonstrated controllable therapeutic temperature rises at 1 - 1.5 cm radial depth from the applicators, which were in agreement with the simulations. This study demonstrates that direct-coupled ultrasound applicators, designed without an active cooling mechanism in order to accommodate the insertion of radiation sources, are practicable for simultaneous thermobrachytherapy and promises to give more adjustable heating patterns than current alternative techniques.

Ultrasound applicators with integrated catheter-cooling for interstitial hyperthermia: theory and preliminary experiments.

Theoretical and experimental methods were used to evaluate a design of ultrasound applicators for interstitial hyperthermia. The basic schema consists of a multielement array of tubular piezoceramic radiators (1.5-1.6 mm diameter), each 5-10 mm long with separate power control, designed to be inserted within a 13-14 gauge closed-end brachytherapy implant catheter. Channels for circulating temperature-regulated water are integrated within the applicator to provide control of the catheter/tissue interface temperature. A quantitative theoretical analysis was undertaken to determine heating performance as a function of applicator spacing, blood perfusion, catheter material, frequency and required acoustic power output. Prototype multielement applicators were constructed and characterized in terms of acoustic pressure-squared distributions and acoustic power output capabilities. This study demonstrated distinct advantages of these catheter-cooled multielement ultrasound applicators within an implant, including higher T90's achievable within highly perfused tissues, dynamic control of the longitudinal power deposition, and no interaction between adjacent applicators or elements or sensitivity to applicator alignment. Preliminary measurements of prototype devices have indicated that implementation of these interstitial ultrasound applicators with integrated catheter-cooling is practicable, yet further development and in vivo verification of performance is warranted.

A perfused tissue phantom for ultrasound hyperthermia

A perfused tissue phantom, developed as a tool for analyzing the performance of ultrasound hyperthermia applicators, was investigated. The phantom, consisting of a fixed porcine kidney with thermocouples placed throughout the tissue, was perfused with degassed water by a variable flow rate pump. The phantom was insonated by an unfocused multielement ultrasound applicator and the temperatures in the phantom were recorded. The results indicate that for testing protocols where tissue phantoms are needed, the fixed kidney preparation offers an opportunity to use a more realistic phantom than has previously been available to assess the heating performance of ultrasound hyperthermia applicators.

Analysis of a multielement ultrasound hyperthermia applicator

An unfocused multielement ultrasound applicator was developed for hyperthermia treatment of superficial tumors. The applicator contains sixteen 3.8-cm(2) individually controllable elements on a 15.2-cm(2) piezoelectric ceramic plate. The acoustical power output of each element can be independently applied to facilitate uniform heating throughout the treatment area while minimizing undesired heating in normal tissues. The performance of the applicator was examined by measuring acoustical power output and beam profiles. The results of this analysis indicated that the applicator is capable of producing required therapeutic output levels with excellent localization and control of the power deposition.

Improved coupling of ultrasound hyperthermia applicators to patients

Coupling ultrasound (US) hyperthermia (HT) applicators to patients requires an acoustical medium conforming to both applicator and patient that allows for rapid, reproducible set-up for each treatment and prevents drift or misalignment of the applicator during treatments. We describe a technique that uses a commercially available immobilization foam to create a rigid, conforming foam block that kinematically positions the US applicator over the tumor area. The central volume of the foam block is removed and filled with a plastic bag of degassed water or with US gel during treatments. We also describe a technique for positioning surface and interstitial thermometry sensors in alignment with individual elements of a multi-element US applicator. Using these techniques, relative movement between patient and applicator is minimized, correct thermometry sensor location relative to each US element is confirmed, and efficient transmission of the acoustical power into the target volume is assured. These techniques are particularly important when using multi-element applicators with complex temperature-power control algorithms.