Validated ultrasonic power measurements up to 20 W

Acoustic Radiation Forces at the Crossroads of Ultrasound Exposimetry, HIFU, and Elastography

The applications of the acoustic radiation force (ARF) continue to multiply and extend from elastography into high-intensity focused ultrasound (HIFU), diagnostic imaging, lithotripsy, sonochemistry, levitation, and microsonics yet fundamental principles remain shrouded in mystery. A well-known and popular equation often used for calculating ARF in elastography is in conflict with the equation commonly employed for calculating ARF for determining acoustic power in radiation force balances (RFBs). Controversies have sparked debate for over a century concerning the physical mechanisms underlying ARFs. For over four decades, the science of ultrasound exposimetry has steadily improved and has provided clues in terms of accumulated data about the characteristics of transmitted ultrasound fields. Concurrently, the availability and capability of predicting these fields have improved significantly. The author draws on these sources to re-examine the physical principles behind ARFs. Conflicts are shown to stem from idealized configurations and simplistic assumptions. By more fully accounting for the pulse shape and spectrum, the effect of frequency power law attenuation, diffraction, and nonlinearity, more accurate equations are developed for ARFs for practical applications which are more consistent with exposimetry observations. Simulations compare well to corrected 1.5 MHz RFB data. While some questions await resolution, the approach presented here settles several longstanding conflicts and provides a new broadband framework for future ARF work.

Sonochemical activity in ultrasonic reactors under heterogeneous conditions

Due to its physical and chemical effects, ultrasound is widely used for industrial purposes, especially in heterogeneous medium. Nevertheless, this heterogeneity can influence the ultrasonic activity. In this study, the effect of the addition of inert glass beads on the sonochemical activity inside an ultrasonic reactor is investigated by monitoring the formation rate of triiodide, and the ultrasonic power is measured by calorimetry and by acoustic radiation. It was found that the sonochemical activity strongly depends on the surface area of the glass beads in the medium: it decreases above a critical area value (around 10^-2 m²), partly due to wave scattering and attenuation. This result is confirmed for a large range of frequencies (from 20 to 1135 kHz) and glass beads diameters (from 8-12 µm to 6 mm). It was also demonstrated that above a given threshold of the surface area, only part of the supplied ultrasonic power is devoted to chemical effects of ultrasound. Finally, the acoustic radiation power appears to describe the influence of solids on sonochemical activity, contrary to the calorimetric power.

Field Characterization and Compensation of Vibrational Nonuniformity for a 256-Element Focused Ultrasound Phased Array

Multielement focused ultrasound phased arrays have been used in therapeutic applications to treat large tissue volumes by electronic steering of the focus, to target multiple simultaneous foci, and to correct aberration caused by inhomogeneous tissue pathways. There is an increasing interest in using arrays to generate more complex beam shapes and corresponding acoustic radiation force patterns for manipulation of particles such as kidney stones. Toward this end, experimental and computational tools are needed to enable accurate delivery of desired transducer vibrations and corresponding ultrasound fields. The purpose of this paper was to characterize the vibrations of a 256-element array at 1.5 MHz, implement strategies to compensate for variability, and test the ability to generate specified vortex beams that are relevant to particle manipulation. The characterization of the array output was performed in water using both element-by-element measurements at the focus of the array and holography measurements for which all the elements were excited simultaneously. Both methods were used to quantify each element's output so that the power of each element could be equalized. Vortex beams generated using both compensation strategies were measured and compared to the Rayleigh integral simulations of fields generated by an idealized array based on the manufacturer's specifications. Although both approaches improved beam axisymmetry, compensation based on holography measurements had half the error relative to the simulation results in comparison to the element-by-element method.

Quality assurance for clinical high intensity focused ultrasound fields

As the use of HIFU in the clinic becomes more widespread there is an ever increasing need to standardise quality assurance protocols, an important step in facilitating the wider acceptance of HIFU as a therapeutic modality. This article reviews pertinent aspects of HIFU treatment delivery, encompassing the closely related aspects of quality assurance and calibration. Particular attention is given to the description and characterisation of relevant acoustic field parameters and the measurement of acoustic power. Where appropriate, recommendations are made.

The development of a shock-tube based characterization technique for air-coupled ultrasonic probes

The present paper proposes a new characterization technique for air-coupled ultrasound probes. The technique is based on a shock tube to generate a controlled pressure wave to calibrate transducers within their operating frequency range. The aim is to generate a high frequency pressure wave (at least up to 200 kHz) with the low energy levels typical of commonly used air-coupled ultrasound probes. A dedicated shock-tube has been designed and tested to assess calibration performances. The sensor transfer function has been measured by using a pressure transducer as reference.

Progress in developing a thermal method for measuring the output power of medical ultrasound transducers that exploits the pyroelectric effect

Progress in developing a new measurement method for ultrasound output power is described. It is a thermal-based technique with the acoustic power generated by a transducer being absorbed within a specially developed polyurethane rubber material, whose high absorption coefficient ensures energy deposition within a few mm of the ultrasonic wave entering the material. The rate of change of temperature at the absorber surface is monitored using the pyroelectric voltage generated from electrodes disposed either side of a 60 mm diameter, 0.061 mm thick membrane of the piezoelectric polymer polyvinylidene fluoride (pvdf) bonded to the absorber. The change in the pyroelectric output voltage generated by the sensor when the transducer is switched ON and OFF is proportional to the delivered ultrasound power. The sensitivity of the device is defined as the magnitude of these switch voltages to a unit input stimulus of power (watt). Three important aspects of the performance of the pyroelectric sensor have been studied. Firstly, measurements have revealed that the temperature dependent sensitivity increases over the range from approximately 20°C to 30°C at a rate of +1.6% °C(-1). Studies point to the key role that the properties of both the absorbing backing layer and pvdf membrane play in controlling the sensor response. Secondly, the high sensitivity of the technique has been demonstrated using an NPL Pulsed Checksource, a 3.5 MHz focused transducer delivering a nominal acoustic power level of 4 mW. Finally, proof-of-concept of a new type of acoustic sensor responding to time-averaged intensity has been demonstrated, through fabrication of an absorber-backed hydrophone of nominal active element diameter 0.4 mm. A preliminary study using such a device to resolve the spatial distribution of acoustic intensity within plane-piston and focused 3.5 MHz acoustic fields has been completed. Derived beam profiles are compared to conventional techniques that depend on deriving intensity from acoustic pressure measurements made using the sensor as a calibrated hydrophone.

Measurements, phantoms, and standardization

The last 25 years has seen a number of significant developments in the establishment of a measurement infrastructure supporting medical applications of ultrasound. This has allowed manufacturers and users of medical ultrasonic equipment to undertake and compare measurements of key parameters describing the magnitude or strength of the applied ultrasonic field in a meaningful and traceable way: for equipment development, standards compliance, and quality assurance purposes. This paper describes the current state of the art for measurement techniques used to determine the key properties of an ultrasonic field, principally acoustic pressure and acoustic power. Measurement tools and methodologies are described in detail, alongside considerations of how these are likely to develop, shaped by user need. The way that these measurement methods underpin a range of international and national specification standards enabling equipment manufacturers to demonstrate that their equipment is safe and fit for purpose is covered.

Power dissipated measurement of an ultrasonic generator in a viscous medium by flowmetric method

A new flowmetric method of the power dissipated by an ultrasound generator in an aqueous medium has been developed in previous works and described in a preceding paper [V. Mancier, D. Leclercq, Ultrasonics Sonochemistry 14 (2007) 99-106]. The works presented here are an enlargement of this method to a high viscosity liquid (glycerol) for which the classical calorimetric measurements are rather difficult. As expected, it is shown that the dissipated power increases with the medium viscosity. It was also found that this flowmetric method gives good results for various quantities of liquid and positioning of the sonotrode in the tank. Moreover, the important variation of viscosity due to the heating of the liquid during experiments does not disturb flow measurements.

Evaluation of a novel solid-state method for determining the acoustic power generated by physiotherapy ultrasound transducers

A new secondary method of determining ultrasound power is presented based on the pyroelectricity of a thin membrane of the piezoelectric polymer, polyvinylidene fluoride (PVDF). In operation, the membrane is backed by a polyurethane-based rubber material that is extremely attenuating to ultrasound, resulting in the majority of the acoustic power applied to the PVDF being absorbed within a short distance of the membrane-backing interface. The resulting rapid heating leads to a pyroelectric voltage being generated across the electrodes of the sensor that, under appropriate conditions, is related to the rate of change of temperature with respect to time. For times immediately after changes in transducer excitation (switching either ON or OFF), the change in the pyroelectric voltage is proportional to the delivered ultrasound power level. This paper describes a systematic evaluation of the measurement concept applied at physiotherapy frequencies and power levels, investigating key aspects such as repeatability, linearity and sensitivity. The research demonstrates the way that heating of the backing material affects the sensor performance, but outlines the potential of the method as a reproducible, rapid, solid-state method of determining power, requiring calibration using a known ultrasound power source.

Calibration and measurement issues for therapeutic ultrasound

This review paper examines some of the issues relating to calibration and measurement of therapeutic medical ultrasonic equipment (MUE). This is not intended to be an all-encompassing review of all aspects of characterising therapeutic ultrasound. Instead it concentrates on issues related to the acoustic output of two applications: physiotherapy and high intensity focused ultrasound surgery (HIFUS or HIFU; also referred to as high intensity therapeutic ultrasound, HITU). Physiotherapy has a well-established standards infrastructure for calibration: the requirements are small in number and well-defined. The issue for physiotherapy is not so much 'How to calibrate?' but rather, 'How to ensure that equipment IS calibrated?' The situation in the much newer area of HIFU is very different: the first steps towards writing standards are just starting and even the very basic questions of what to measure and with what type of sensor are open for debate. Readers whose main interest is in other ultrasound therapies will find ideas of relevance to their own specialty.

A buoyancy method for the measurement of total ultrasound power generated by HIFU transducers

Total acoustic output power is a key parameter for most ultrasonic medical equipment and especially for high intensity focused ultrasound (HIFU) systems, which treat certain cancers and other conditions by the noninvasive thermal ablation of the affected tissue. In planar unfocused fields, the use of a radiation force balance has been considered the most accurate method of measuring ultrasound power. However, radiation force is not strictly dependent on the ultrasound power but, rather, on the wave momentum resolved in one direction. Consequently, measurements based on radiation force become progressively less accurate as the ultrasound wave deviates further from a true plane-wave. HIFU transducers can be very strongly focused with F-numbers less than one: under these conditions, the uncertainty associated with use of the radiation force method becomes very significant. In this article, a new method for determining power is described in detail. Instead of radiation force, the new method relies on measuring the change in buoyancy caused by thermal expansion of castor oil inside a target suspended in a water bath. The change in volume is proportional to the incident energy and is independent of focusing or the angle of incidence of the ultrasound. The principles and theory behind the new method are laid out and the characteristics and construction of an appropriate target are examined and the results of validation tests are presented. The uncertainties of the method are calculated to be approximately +/-3.4% in the current implementation, with the potential to reduce these further. The new technique has several important advantages over the radiation force method and offers the potential to be an alternative primary standard method.

A novel pyroelectric method of determining ultrasonic transducer output power: device concept, modeling, and preliminary studies

This paper describes a new thermally based method of monitoring acoustic output power generated by ultrasonic transducers. Its novelty lies in the exploitation of the pyroelectric properties of a thin membrane of polyvinylidene fluoride (PVDF). The membrane is backed by a thick layer of polyurethane rubber that is extremely attenuating to ultrasound, with the result that the majority of the applied acoustic power is absorbed within a few millimeters of the membrane-backing interface. Through the resultant rapid increase in temperature of the membrane, a voltage is generated across its electrodes whose magnitude is proportional to the rate of change of temperature with respect to time. Changes in the pyroelectric voltage generated by switching the transducer ON and OFF are related to the acoustic power delivered by the transducer. Features of the technique are explored through the development of a simple one-dimensional model. An experimental evaluation of the potential secondary measurement technique is also presented, covering the frequency range 1 to 5 MHz, for delivered powers up to a watt. Predictions of the sensor output signals, as well as the frequency dependent sensitivity, are in good agreement with observation. The potential of the new method as a simple, rapid means of providing traceable ultrasonic power measurements is outlined.

Acoustic power calibration of high-intensity focused ultrasound transducers using a radiation force technique

To address the challenges associated with measuring the ultrasonic power from high-intensity focused ultrasound transducers via radiation force, a technique based on pulsed measurements was developed and analyzed. Two focused ultrasound transducers were characterized in terms of an effective duty factor, which was then used to calculate the power during the pulse at high applied power levels. Two absorbing target designs were used, and both gave comparable results and displayed no damage and minimal temperature rise if placed near the transducer and away from the focus. The method yielded reproducible results up to the maximum pulse power generated of approximately 230 W, thus allowing the radiated power to be calibrated in terms of the peak-to-peak voltage applied to the transducer.

New flowmetric measurement methods of power dissipated by an ultrasonic generator in an aqueous medium

Two new determination methods of the power dissipated in an aqueous medium by an ultrasound generator were developed. They are based on the use of a heat flow sensor inserted between a tank and a heat sink that allows to measure the power directly coming through the sensor. To be exploitable, the first method requires waiting for stationary flow. On the other hand, the second, extrapolated from the first one, makes it possible to determine the dissipated power in only five minutes. Finally, the results obtained with the flowmetric method are compared to the classical calorimetric ones.

Metrology for ultrasonic applications

This paper provides a review of current metrological capability applied to the characterisation of the acoustic output of equipment used within medical ultrasonic applications. Key measurement devices, developed to underpin metrology in this area, are the radiation force balance, used to determine total output power, and the piezo-electric hydrophone, used to resolve the spatial and temporal distribution of acoustic pressure. The measurement infrastructure in place within the United Kingdom ensuring users are able to carry out traceable measurements of these quantities in a meaningful way, is described. This includes the relevant primary standards, the way international equivalence of national standards is demonstrated and the routes by which the standards are disseminated to the user community. Emerging measurement techniques that may in future lead to improved measurement capability, are also briefly discussed.

Transfer standard device to improve the traceable calibration of physiotherapy ultrasound machines

Ultrasound (US) physiotherapy as a clinical treatment is extremely common in the Western world. Internationally, regulation to ensure safe application of US physiotherapy by regular calibration ranges from nil to mandatory. The need for a portable power standard (PPS) has been addressed within a European Community (EC)-funded project. This PPS consists of an electrical driver, a set of US transducers and a cavitation detector (CD). Each component has been extensively tested for stability and travel robustness. Transducer output power has been determined with an uncertainty of <3.3% and with a long-term (2-y) output stability of better than 3%. The CD can detect bubble activity for powers above 3 W for a 1-MHz transducer. Travel trials demonstrated the utility of the PPS in practical measurement environments. Deviations in power measurements observed during these trials were mostly acceptable (<10%), although there were also examples of gross differences (>100%). The PPS is now ready to be used to underpin traceable calibration of physiotherapy devices.

Ultrasound Produced by a Conventional Therapeutic Ultrasound Unit Accelerates Fracture Repair

Background and Purpose. A recent novel application of ultrasound therapy is the treatment of bone fractures. The aim of this study was to investigate the effect on fracture repair of ultrasound produced by a conventional therapeutic ultrasound unit as used by physical therapists. Subjects and Methods. Bilateral midshaft femur fractures were created in 30 adult male Long-Evans rats. Ultrasound therapy was commenced on the first day after fracture and introduced 5 days a week for 20 minutes a day. Each animal was treated unilaterally with active ultrasound and contralaterally with inactive ultrasound. Active ultrasound involved a 2-millisecond burst of 1.0-MHz sine waves repeating at 100 Hz. The spatially averaged, temporally averaged intensity was set at 0.1 W/cm2. Animals were killed at 25 and 40 days after fracture induction, and the fractures were assessed for bone mass and strength. Results. There were no differences between fractures treated with active ultrasound and fractures treated with inactive ultrasound at 25 days. However, at 40 days, active ultrasound-treated fractures had 16.9% greater bone mineral content at the fracture site than inactive ultrasound-treated fractures. This change resulted in a 25.8% increase in bone size, as opposed to an increase in bone density, and contributed to active ultrasound-treated fractures having 81.3% greater mechanical strength than inactive ultrasound-treated fractures. Discussion and Conclusion. These data indicate that ultrasound produced by a conventional therapeutic ultrasound unit as traditionally used by physical therapists may be used to facilitate fracture repair. However, careful interpretation of this controlled laboratory study is warranted until its findings are confirmed by clinical trials. [Warden SJ, Fuchs RK, Kessler CK, et al. Ultrasound produced by a conventional therapeutic ultrasound unit accelerates fracture repair. Phys Ther. 2006;86:1118–1127.]

An ultrasound mini-balance for measurement of therapy level ultrasound

This paper describes a cost-effective method for measuring acoustic power using a radiation force balance. The device is based around a long established balance design with a gantry arrangement fitted with an absorbing target. The notion of this balance design is that it can easily be constructed from materials that would be readily available within a clinical or industrial environment. The mini-balance was calibrated using a transfer standard against an NPL Reference balance, so a comparison of the performance between the two systems could be assessed. The measurements were completed at 1 MHz and 3 MHz and over the acoustic power range of 1 W to 15 W. The results show the acoustic power measured on the mini-balance to be within 5% of the reference measurements made on the NPL Balance. A separate systematic uncertainty budget is also presented based on studies made on the balance and on similar systems. The overall expanded uncertainty was calculated to be within 14% at 1 W level, decreasing with increasing power level to 7.4% above 5 W.

Comparison of laser interferometry and radiation force method of measuring ultrasonic power

The aim of this paper is to compare two different methods for the calculation of the ultrasonic output power of underwater transducers: the radiation force balance, which is the standard method, and the laser heterodyne interferometry, which is rather used to depict displacement or velocity distributions of the acoustic field. Here it is shown that the latter can also be used to calculate the acoustic time-average power with an uncertainty of about 22%, the radiation force balance giving an uncertainty of 12% (with 95% confidence). The interferometry experiments performed with two transducers working at 2.25 MHz and 8.25 MHz showed that they produce different acoustic fields (respectively Gaussian and Lorentz-sigmoidal distributions). Taking into account the acoustic field profiles, the acoustic time-average power from interferometry was calculated. It was found very similar to the time-average power measured with the radiation force balance in the plane-wave assumption.

Progress in medical ultrasound exposimetry

Biomedical applications of ultrasound have experienced tremendous growth over the past 50 years. Early work in thermal therapy and surgery soon was followed by diagnostic imaging and Doppler. Because patient safety was an important issue from the beginning, the study of methods for measuring exposure levels, and their relationship to possible biological effects, paralleled the growth of the various therapeutic and diagnostic techniques. The diverse conditions of use have presented a range of exposure measurement challenges, and the sensors and techniques used to evaluate ultrasound fields have had to evolve as new or expanded clinical applications have emerged. In this paper some of the more notable of these developments are presented and discussed. Topics covered include devices and techniques, methods of calibration, progress in standardization, and current problem areas, including the effects of nonlinear propagation. Some early methods are described, but emphasis is given to more recent work applicable to present and future uses of ultrasound in medicine and biology.

Measurement of ultrasonic power using an acoustically absorbing well

This paper describes a quick and cost-effective method for constructing a radiation force balance for measuring ultrasonic output power. It utilises a target manufactured from a high-quality acoustical absorber material. The target geometry is in the form of a cup or well that is water-filled and placed directly on the pan of a top-loading chemical balance, thus overcoming the need for the traditional gantry arrangement found in the majority of commercially available balances. The face of the transducer is placed directly in the water contained within the well. This simplification reduces time spent in setting up a balance for measurement, and targets can be manufactured to any required geometry and used on any suitable top-loading balance to measure output power. Within this study, the performance of the absorbing well method was evaluated over the frequency range of 1 MHz to 5 MHz, for acoustic power levels up to 1 W. Power measurements on three transducers were compared with measurements made on the National Physical Laboratory (NPL) primary standard radiation force balance and good agreement is demonstrated between the two systems. At a power of 50 mW, using a chemical balance of resolution 0.1 mg, typical type A (random) uncertainties were +/- 2.0% when expressed at the 95% confidence level.

A new direction for ultrasound therapy in sports medicine

Ultrasound therapy is a widely available and frequently used electrophysical agent in sports medicine. However, systematic reviews and meta-analyses have repeatedly concluded that there is insufficient evidence to support a beneficial effect of ultrasound at dosages currently being introduced clinically. Consequently, the role of ultrasound in sports medicine is in question. This does not mean that ultrasound should be discarded as a therapeutic modality. However, it does mean that we may need to look in a new direction to explore potential benefits. A new direction for ultrasound therapy has been revealed by recent research demonstrating a beneficial effect of ultrasound on injured bone. During fresh fracture repair, ultrasound reduced healing times by between 30 and 38%. When applied to non-united fractures, it stimulated union in 86% of cases. These benefits were generated using low-intensity (<0.1 W/cm(2)) pulsed ultrasound (LIPUS), a dose alternative to that traditionally used in sports medicine. Although currently developed for the intervention of bone injuries, LIPUS has the potential to be used on tissues and conditions more commonly encountered in sports medicine. These include injuries to ligament, tendon, muscle and cartilage. This review discusses the effect of LIPUS on bone fractures, the dosages introduced and the postulated mechanisms of action. It concludes by discussing the relevance of these latest findings to sports medicine and how this evidence of a beneficial clinical effect may be implemented to intervene in sporting injuries to bone and other tissues. The aim of the paper is to highlight this latest direction in ultrasound therapy and stimulate new lines of research into the efficacy of ultrasound in sports medicine. In time this may lead to accelerated recovery from injury and subsequent earlier return to activity.