A focused ultrasound method for simultaneous diagnostic and therapeutic applications—a simulation study

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Abstract
Similar to other therapeutic methods, ultrasound surgery requires an imaging modality to monitor the extent of tissue damage during treatment. In this paper, we have considered the method of ultrasound-stimulated acoustic emission (USAE) that uses two ultrasonic beams at high frequency (1.7 MHz) (same as that used for ablation) to locally excite the tissue by generating a low-frequency (1–50 kHz) radiation force. Recording of the tissue response at several locations yields an image. The amplitude of the tissue response depends on the mechanical and acoustic tissue properties, namely its stiffness and absorption. These two properties were initially hypothesized to have counteractive effects on the response amplitude, i.e., the amplitude should increase with absorption and decrease with stiffness. To check this hypothesis as well as the degree to which these properties influence the response, finite-element simulations of a uniform lesion formed inside a homogeneous medium were used. The results show that, as expected, the displacement amplitude decreased with increasing lesion stiffness at lower frequencies (except at resonance) while, contrary to our initial hypothesis, it increased with stiffness at relatively higher frequencies (>22 kHz). At resonance, a frequency upshift occurred with increasing stiffness but was found to be highly spatially variant and system dependent, i.e., not yielding a uniform lesion response when imaged. On the other hand, the absorption increase led to a uniform linear increase of the mechanical response amplitude of the lesion. Therefore, at higher frequencies, increase of the two parameters had a synergistic effect on the tissue response to the applied radiation force. This study showed that relatively higher frequencies constitute the optimal range in the use of USAE for coagulation monitoring. A preliminary experimental verification in vitro is also provided.