Ex Vivo HIFU Experiments Using a $32 \times 32$ -Element CMUT Array

CMUT as a Transmitter for Microbubble-Assisted Blood-Brain Barrier Opening

Focused ultrasound (FUS) combined with microbubbles (MBs) has emerged as a promising strategy for transiently opening the blood-brain barrier (BBB) to enhance drug permeability in the brain. Current FUS systems for BBB opening use piezoelectric transducers as transmitters and receivers. While capacitive micromachined ultrasonic transducers (CMUTs) have been suggested as an FUS receiver alternative due to their broad bandwidth, their capabilities as transmitters have not been investigated. This is mainly due to the intrinsic nonlinear behavior of CMUTs, which complicates the detection of MB generated harmonic signals and their low-pressure output at FUS frequencies. Various methods have been proposed to mitigate CMUT nonlinearity; however, these approaches have primarily targeted contrast enhanced ultrasound imaging. In this study, we propose the use of polyphase modulation (PM) technique to isolate MB emissions when CMUTs are employed as transmitters for BBB opening. Our calculations for a human scale FUS system with multiple CMUT transmitters show that 10-kPa peak negative pressure (PNP) at 150-mm focal distance will be sufficient for MB excitation for BBB opening. Experimental findings indicate that this pressure level can be easily generated at 400-800 kHz using a readily available CMUT. Furthermore, more than 50-dB suppression of the fundamental harmonic signal is obtained in free field and transcranial hydrophone measurements by processing receive signals in response to phase-modulated transmit waveforms. In vitro validation of PM is also conducted using Definity MB flowing through a tube phantom. MB-filled tube phantoms show adequate nonlinear signal isolation and SNR for MB harmonic detection. Together our findings indicate that PM can effectively mitigate CMUT harmonic generation, thereby creating new opportunities for wideband transmission and receive operation for BBB opening in clinical and preclinical applications.

A Gas Flow Measurement System Based on Lead Zirconate Titanate Piezoelectric Micromachined Ultrasonic Transducer

Ultrasonic flowmeter is one of the most widely used devices in flow measurement. Traditional bulk piezoelectric ceramic transducers restrict their application to small pipe diameters. In this paper, we propose an ultrasonic gas flowmeter based on a PZT piezoelectric micromachined ultrasonic transducer (PMUT) array. Two PMUT arrays with a resonant frequency of 125 kHz are used as the sensitive elements of the ultrasonic gas flowmeter to realize alternate transmission and reception of ultrasonic signals. The sensor contains 5 × 5 circular elements with a size of 3.7 × 3.7 mm2. An FPGA with a resolution of ns is used to process the received signal, and a flow system with overlapping acoustic paths and flow paths is designed. Compared with traditional measurement methods, the sensitivity is greatly improved. The flow system achieves high-precision measurement of gas flow in a 20 mm pipe diameter. The flow measurement range is 0.5-7 m/s and the relative error of correction is within 4%.

Dynamic Ultrasound Focusing and Centimeter-Scale Ex Vivo Tissue Ablations With a CMUT Probe Developed for Endocavitary HIFU Therapies

Thermal ablation of localized prostate tumors via endocavitary ultrasound-guided high-intensity focused ultrasound (USgHIFU) faces challenges that could be alleviated by better integration of dual modalities (imaging/therapy). Capacitive micromachined ultrasound transducers (CMUTs) may provide an alternative to existing piezoelectric technologies by exhibiting advanced integration capability through miniaturization, broad frequency bandwidth, and potential for high electroacoustic efficiency. An endocavitary dual-mode USgHIFU probe was built to investigate the potential of using CMUT technologies for transrectal prostate cancer ablative therapy. The USgHIFU probe included a planar 64-element annular high-intensity focused ultrasound (HIFU) CMUT array ( [Formula: see text] = 3 MHz) surrounding a 256-element linear imaging CMUT array. Acoustic characterization of the HIFU array included 3-D pressure field mapping and radiation force balance measurements. Ex vivo proof-of-concept experiments consisted in generating HIFU thermal ablations with the CMUT probe on porcine liver tissues. The planar CMUT probe enabled HIFU dynamic focusing (distance range: 32-72 mm) while providing acoustic surface intensities of 1 W/cm2 that allowed producing elementary ex vivo ablations in depth of liver tissue ( L ×W ≈ 10×5 mm). Combinations of dynamic focusing, along with probe rotation and translation produced larger thermal ablations ( L ×W ≈ 20×20 mm) by juxtaposing multiple elementary ablations, consistent with expected results obtained through numerical modeling. The technical feasibility of using a USgHIFU probe, fully developed using CMUTs for tissue ablation purposes, was demonstrated. The HIFU-CMUT array showed tissue ablation capabilities with volumes compatible with localized cancer targeting, thus providing assets for further development of focal therapies.

Deep-Learning-Based High-Intensity Focused Ultrasound Lesion Segmentation in Multi-Wavelength Photoacoustic Imaging

Photoacoustic (PA) imaging can be used to monitor high-intensity focused ultrasound (HIFU) therapies because ablation changes the optical absorption spectrum of the tissue, and this change can be detected with PA imaging. Multi-wavelength photoacoustic (MWPA) imaging makes this change easier to detect by repeating PA imaging at multiple optical wavelengths and sampling the optical absorption spectrum more thoroughly. Real-time pixel-wise classification in MWPA imaging can assist clinicians in monitoring HIFU lesion formation and will be a crucial milestone towards full HIFU therapy automation based on artificial intelligence. In this paper, we present a deep-learning-based approach to segment HIFU lesions in MWPA images. Ex vivo bovine tissue is ablated with HIFU and imaged via MWPA imaging. The acquired MWPA images are then used to train and test a convolutional neural network (CNN) for lesion segmentation. Traditional machine learning algorithms are also trained and tested to compare with the CNN, and the results show that the performance of the CNN significantly exceeds traditional machine learning algorithms. Feature selection is conducted to reduce the number of wavelengths to facilitate real-time implementation while retaining good segmentation performance. This study demonstrates the feasibility and high performance of the deep-learning-based lesion segmentation method in MWPA imaging to monitor HIFU lesion formation and the potential to implement this method in real time.

A 2D Ultrasound Phased-Array Transmitter ASIC for High-Frequency US Stimulation and Powering

Ultrasound (US) neuromodulation and ultrasonic power transfer to implanted devices demand novel ultrasound transmitters capable of steering focused ultrasound waves in 3D with high spatial resolution and US pressure, while having a miniaturized form factor. Meeting these requirements needs a 2D array of ultrasound transducers directly integrated with a high-frequency 2D phased-array ASIC. However, this imposes severe challenges on the design of the ASIC. In order to avoid the generation of grating lobes, the elements in the 2D phased-array should have a pitch of half of the ultrasound wavelength, which, as frequency increases, highly reduces the area available for the design of high-voltage beamforming channels. This article addresses these challenges by presenting the system-level optimization and implementation of a high-frequency 2D phased-array ASIC. The system-level study focuses on the optimization of the US transmitter toward high-frequency operation while minimizing power consumption. This study resulted in the implementation of two ASICs in TSMC 180 nm BCD technology: firstly, an individual beamforming channel was designed to demonstrate the tradeoffs between frequency, driving voltage, and beamforming capabilities. Finally, a 12-MHz pitch matched 12 × 12 phased-array ASIC working at 20-V amplitude and 3-bit phasing was designed and experimentally validated, to demonstrate high-frequency phased-array operation. The measurement results verify the phasing functionality of the ASIC with a maximum DNL of 0.35 LSB. The CMOS chip consumes 130 mW and 26.6 mW average power during the continuous pulsing and delivering 200-pulse bursts with a PRF of 1 kHz, respectively.

Circuits on miniaturized ultrasound imaging system-on-a-chip: a review

Trends of medical system move from a traditional in-person visit to virtual healthcare increases demands on point-of-care devices. Because ultrasound (US) is non-invasive, the demands highlight US imaging among other imaging modalities. Thanks to the development of US transducer technology, miniaturized US with application-specific integrated circuits (ASIC) have been researched. For example, applications that require small aperture sizes such as intravascular US (IVUS) and intra-cardiac echocardiography (ICE) require integration of system-on-a-chip (SoC) on the transducer. This paper reviews circuit techniques on the transmitter (TX) and receiver (RX) of the US imaging system. As TX circuits, pulser, T/RX switch, TX beamformer, and power management circuits are discussed. State-of-the-art transducer modeling, pre-amplifier, time-gain compensation, RX beamformer, quadrature sampler, and output driver are introduced as RX circuits.

Applications of Capacitive Micromachined Ultrasonic Transducers: A Comprehensive Review

Capacitive micromachined ultrasonic transducer (CMUT) was introduced as an alternative to the piezoelectric thick-film-based transducers in medical imaging applications. Gradually, CMUTs have been investigated in almost all the applications in acoustics due to their superior transduction properties. CMOS compatible process flow and limitless possibilities of miniaturization made CMUT a preferred choice for the ultrasound industry. This article comprehensively reviews all the applications in which CMUT was used until now. Such a complete review of the practical applications of CMUT has not been reported elsewhere. A topicwise presentation approach is adopted, and wherever possible, the necessary details of the device properties and experimental niceties were briefly covered.

A novel matrix-array-based MR-conditional ultrasound system for local hyperthermia of small animals

OBJECTIVE

The goal of this work was to develop a novel modular focused ultrasound hyperthermia (FUS-HT) system for preclinical applications with the following characteristics: MR-compatible, compact probe for integration into a PET/MR small animal scanner, 3D-beam steering capabilities, high resolution focusing for generation of spatially confined FUS-HT effects.

METHODS

For 3D-beam steering capabilities, a matrix array approach with 11 11 elements was chosen. For reaching the required level of integration, the array was mounted with a conductive backing directly on the interconnection PCB. The array is driven by a modified version of our 128 channel ultrasound research platform DiPhAS. The system was characterized using sound field measurements and validated using tissue-mimicking phantoms. Preliminary MR-compatibility tests were performed using a 7T Bruker MRI scanner.

RESULTS

Four 11 11 arrays between 0.5 and 2 MHz were developed and characterized with respect to sound field properties and HT generation. Focus sizes between 1 and 4 mm were reached depending on depth and frequency. We showed heating by 4C within 60 s in phantoms. The integration concept allows a probe thickness of less than 12 mm.

CONCLUSION

We demonstrated FUS-HT capabilities of our modular system based on matrix arrays and a 128 channel electronics system within a 3D-steering range of up to 30. The suitability for integration into a small animal MR could be demonstrated in basic MR-compatibility tests.

SIGNIFICANCE

The developed system presents a new generation of FUS-HT for preclinical and translational work providing safe, reversible, localized, and controlled HT.

A Wearable Ultrasonic Neurostimulator-Part II: A 2D CMUT Phased Array System With a Flip-Chip Bonded ASIC

A 2D ultrasonic array is the ultimate form of a focused ultrasonic system, which enables electronically focusing beams in a 3D space. A 2D array is also a versatile tool for various applications such as 3D imaging, high-intensity focused ultrasound, particle manipulation, and pattern generation. However, building a 2D system involves complicated technologies: fabricating a 2D transducer array, developing a pitch-matched ASIC, and interconnecting the transducer and the ASIC. Previously, we successfully demonstrated 2D capacitive micromachined ultrasonic transducer (CMUT) arrays using various fabrication technologies. In this paper, we present a 2D ultrasonic transmit phased array based on a 32 × 32 CMUT array flip-chip bonded to a pitch-matched pulser ASIC for ultrasonic neuromodulation. The ASIC consists of 32 × 32 unipolar high-voltage (HV) pulsers, each of which occupies an area of 250 μm × 250 μm. The phase of each pulser output is individually programmable with a resolution of 1/f_C/16, where f_C is less than 10 MHz. This enables the fine granular control of a focus. The ASIC was fabricated in the TSMC 0.18- μm HV BCD process within an area of 9.8 mm × 9.8 mm, followed by a wafer-level solder bumping process. After flip-chip bonding an ASIC and a CMUT array, we identified shorted elements in the CMUT array using the built-in test function in the ASIC, which took approximately 9 minutes to scan the entire 32 × 32 array. A compact-form-factor wireless neural stimulator system-only requiring a connected 15-V DC power supply-was also developed, integrating a power management unit, a clock generator, and a Bluetooth Low-Energy enabled microcontroller. The focusing and steering capability of the system in a 3D space is demonstrated, while achieving a spatial-peak pulse-average intensity ( I_SPPA) of 12.4 and 33.1 W/ cm²; and a 3-dB focal volume of 0.2 and 0.05 mm³-at a depth of 5 mm-at 2 and 3.4 MHz, respectively. We also characterized transmission of ultrasound through a mouse skull and compensated the phase distortion due to the skull by using the programmable phase-delay function in the ASIC, achieving 10% improvement in pressure and a tighter focus. Finally, we demonstrated a ultrasonic arbitrary pattern generation on a 5 mm × 5 mm plane at a depth of 5 mm.

Robot-assisted ultrasound navigation platform for 3D HIFU treatment planning: Initial evaluation for conformal interstitial ablation

Interstitial Ultrasound-guided High Intensity Focused Ultrasound (USgHIFU) therapy has the potential to deliver ablative treatments which conform to the target tumor. In this study, a robot-assisted US-navigation platform has been developed for 3D US guidance and planning of conformal HIFU ablations. The platform was used to evaluate a conformal therapeutic strategy associated with an interstitial dual-mode USgHIFU catheter prototype (64 elements linear-array, measured central frequency f = 6.5 MHz), developed for the treatment of HepatoCellular Carcinoma (HCC). The platform included a 3D navigation environment communicating in real-time with an open research dual-mode US scanner/HIFU generator and a robotic arm, on which the USgHIFU catheter was mounted. 3D US-navigation was evaluated in vitro for guiding and planning conformal HIFU ablations using a tumor-mimic model in porcine liver. Tumor-mimic volumes were then used as targets for evaluating conformal HIFU treatment planning in simulation. Height tumor-mimics (ovoid- or disc-shaped, sizes: 3-29 cm³) were created and visualized in liver using interstitial 2D US imaging. Robot-assisted spatial manipulation of these images and real-time 3D navigation allowed reconstructions of 3D B-mode US images for accurate tumor-mimic volume estimation (relative error: 4 ± 5%). Sectorial and full-revolution HIFU scanning (angular sectors: 88-360°) could both result in conformal ablations of the tumor volumes, as soon as their radii remained ≤ 24 mm. The presented US navigation-guided HIFU procedure demonstrated advantages for developing conformal interstitial therapies in standard operative rooms. Moreover, the modularity of the developed platform makes it potentially useful for developing other HIFU approaches.

High-Efficiency Output Pressure Performance Using Capacitive Micromachined Ultrasonic Transducers with Substrate-Embedded Springs

Capacitive micromachined ultrasonic transducers (CMUTs) with substrate-embedded springs offer highly efficient output pressure performance over conventional CMUTs, owing to their nonflexural parallel plate movement. The embedded silicon springs support thick Si piston plates, creating a large nonflexural average volume displacement efficiency in the operating frequency range from 1⁻3 MHz. Static and dynamic volume displacements of the nonflexural parallel plates were examined using white light interferometry and laser Doppler vibrometry. In addition, an output pressure measurement in immersion was performed using a hydrophone. The device showed a maximum transmission efficiency of 21 kPa/V, and an average volume displacement efficiency of 1.1 nm/V at 1.85 MHz with a low DC bias voltage of 55 V. The device element outperformed the lead zirconate titanate (PZT) ceramic HD3203, in the maximum transmission efficiency or the average volume displacement efficiency by 1.35 times. Furthermore, its average volume displacement efficiency reached almost 80% of the ideal state-of-the-art single-crystal relaxor ferroelectric materials PMN-0.33PT. Additionally, we confirmed that high-efficiency output pressure could be generated from the CMUT device, by quantitatively comparing the hydrophone measurement of a commercial PZT transducer.

Integrated HIFU Drive System on a Chip for CMUT-Based Catheter Ablation System

Conventional High Intensity Focused Ultrasound (HIFU) is a therapeutic modality which is extracorporeally administered. In applications where a relatively small HIFU lesion is required, an intravascular HIFU probe can be deployed to the ablation site. In this paper, we demonstrate the design and implementation a fully integrated HIFU drive system on a chip to be placed on a 6 Fr catheter probe. An 8-element capacitive micromachined ultrasound transducer (CMUT) ring array of 2 mm diameter has been used as the ultrasound source. The driver chip is fabricated in 0.35 μm AMS high-voltage CMOS technology and comprises eight continuous-wave (CW) high-voltage CMUT drivers (10.9 ns and 9.4 ns rise and fall times at 20 V _pp output into a 15 pF), an eight-channel digital beamformer (8-12 MHz output frequency with 11.25 ^° phase accuracy) and a phase locked loop with an integrated VCO as a tunable clock source (128-192 MHz). The chip occupies 1.85 × 1.8 mm ² area including input and output (I/O) pads. When the transducer array is immersed in sunflower oil and driven by the IC with eight 20 V_pp CW pulses at 10 MHz, real-time thermal images of the HIFU beam indicate that the focal temperature rises by 16.8  ^°C in 11 seconds. Each HV driver consumes around 67 mW of power when driving the CMUT array at 10 MHz, which adds up to 560 mW for the whole chip. FEM based analysis reveals that the outer surface temperature of the catheter is expected to remain below the 42  ^°C tissue damage limit during therapy.