Effects of Large Blood Vessel Locations during High Intensity Focused Ultrasound Therapy for Hepatic Tumors: a finite element study

Heating Induced by Therapeutic Ultrasound in the Presence of Magnetic Nanoparticles

The efficiency of ultrasound hyperthermia for anti-cancer treatments such as radiotherapy or chemotherapy can be improved by using sonosensitizers, which are materials that enhance the attenuation and dissipation of acoustic energy. We propose the use of magnetic nanoparticles as sonosensitizers because of their biocompatibility, nontoxicity, and common use in several medical applications. A magnetic material was synthetized and then incorporated in the form of a magnetic fluid in agar tissue-mimicking phantoms. Ultrasound hyperthermia studies were conducted at various ultrasound frequencies and concentrations of magnetic nanoparticles in the phantoms. The theoretical modeling based on a heat transfer equation and the experimental results show good agreement and confirm that the temperature rise during ultrasound heating in tissue-mimicking phantoms doped with sonosensitizers is greater than that in a pure agar phantom. Furthermore, on the basis of Pennes' bio-heat equation, which takes into consideration the blood perfusion and metabolic heat, the thermal dose and lesion shapes after sonication were determined for a hypothetical tissue.

Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablation of liver tumours

Recent decades have seen a paradigm shift in the treatment of liver tumours from invasive surgical procedures to minimally invasive image-guided ablation techniques. Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) is a novel, completely non-invasive ablation technique that has the potential to change the field of liver tumour ablation. The image guidance, using MR imaging and MR temperature mapping, provides excellent planning images and real-time temperature information during the ablation procedure. However, before clinical implementation of MR-HIFU for liver tumour ablation is feasible, several organ-specific challenges have to be addressed. In this review we discuss the MR-HIFU ablation technique, the liver-specific challenges for MR-HIFU tumour ablation, and the proposed solutions for clinical translation.

Beam localization in HIFU temperature measurements using thermocouples, with application to cooling by large blood vessels

Experimental studies of thermal effects in high-intensity focused ultrasound (HIFU) procedures are often performed with the aid of fine wire thermocouples positioned within tissue phantoms. Thermocouple measurements are subject to several types of error which must be accounted for before reliable inferences can be made on the basis of the measurements. Thermocouple artifact due to viscous heating is one source of error. A second is the uncertainty regarding the position of the beam relative to the target location or the thermocouple junction, due to the error in positioning the beam at the junction. This paper presents a method for determining the location of the beam relative to a fixed pair of thermocouples. The localization technique reduces the uncertainty introduced by positioning errors associated with very narrow HIFU beams. The technique is presented in the context of an investigation into the effect of blood flow through large vessels on the efficacy of HIFU procedures targeted near the vessel. Application of the beam localization method allowed conclusions regarding the effects of blood flow to be drawn from previously inconclusive (because of localization uncertainties) data. Comparison of the position-adjusted transient temperature profiles for flow rates of 0 and 400ml/min showed that blood flow can reduce temperature elevations by more than 10%, when the HIFU focus is within a 2mm distance from the vessel wall. At acoustic power levels of 17.3 and 24.8W there is a 20- to 70-fold decrease in thermal dose due to the convective cooling effect of blood flow, implying a shrinkage in lesion size. The beam-localization technique also revealed the level of thermocouple artifact as a function of sonication time, providing investigators with an indication of the quality of thermocouple data for a given exposure time. The maximum artifact was found to be double the measured temperature rise, during initial few seconds of sonication.