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Prediction of high-intensity focused ultrasound (HIFU)-induced lesion size using the echo amplitude from the focus in tissue

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Abstract

In the realm of high-intensity focused ultrasound (HIFU) therapy, the precise prediction of lesion size during treatment planning remains a challenge, primarily due to the difficulty in quantitatively assessing energy deposition at the target site and the acoustic properties of the tissue through which the ultrasound wave propagates. This study investigates the hypothesis that the echo amplitude originating from the focus is indicative of acoustic attenuation and is directly related to the resultant lesion size. Echoes from multi-layered tissues, specifically porcine tenderloin and bovine livers, with varying fat thickness from 0 mm to 35 mm were collected using a focused ultrasound (FUS) transducer operated at a low power output and short duration. Subsequent to HIFU treatment under clinical conditions, the resulting lesion areas in the ex vivo tissues were meticulously quantified. A novel treatment strategy that prioritizes treatment spots based on descending echo amplitudes was proposed and compared with the conventional raster scan approach. Our findings reveal a consistent trend of decreasing echo amplitudes and HIFU-induced lesion areas with the increasing fat thickness. For porcine tenderloin, the values decreased from 2541.7 ± 641.9 mV and 94.4 ± 17.9 mm2 to 385(342.5) mV and 24.9 ± 18.7 mm2, and for bovine liver, from 1406(1202.5) mV and 94.4 ± 17.9 mm2 to 502.1 ± 225.7 mV and 9.4 ± 6.3 mm2, respectively, as the fat thickness increases from 0 mm to 35 mm. Significant correlations were identified between preoperative echo amplitudes and the HIFU-induced lesion areas (R = 0.833 and 0.784 for the porcine tenderloin and bovine liver, respectively). These correlations underscore the potential for an accurate and dependable prediction of treatment outcomes. Employing the proposed treatment strategy, the ex vivo experiment yielded larger lesion areas in bovine liver at a penetration depth of 8 cm compared to the conventional approach (58.84 ± 17.16 mm2 vs. 44.28 ± 15.37 mm2, p < 0.05). The preoperative echo amplitude from the FUS transducer is shown to be a reflective measure of acoustic attenuation within the wave propagation window and is closely correlated with the induced lesion areas. The proposed treatment strategy demonstrated enhanced efficiency in ex vivo settings, affirming the feasibility and accuracy of predicting HIFU-induced lesion size based on echo amplitude.

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References

  1. Zhou Y (2011) High intensity focused ultrasound in clinical tumor ablation. World J Clin Oncol 2(1):8–27. https://doi.org/10.5306/wjco.v2.i1.8

    Article  PubMed  PubMed Central  Google Scholar 

  2. Izadifar Z, Izadifar Z, Chapman D, Babyn P (2020) An introduction to high intensity focused ultrasound: systematic review on principles, devices, and clinical applications. J Clin Med 9(2):460. https://doi.org/10.3390/jcm9020460

    Article  PubMed  PubMed Central  Google Scholar 

  3. Eranki A, Srinivasan P, Ries M, Kim A, Lazarski CA, Rossi C et al (2020) High-intensity focused ultrasound (HIFU) triggers immune sensitization of refractory murine neuroblastoma to checkpoint inhibitor therapy. Clin Cancer Res 26(5):1152–1161. https://doi.org/10.1158/1078-0432.CCR-19-1604

    Article  CAS  PubMed  Google Scholar 

  4. Fite BZ, Wang J, Kare AJ, Ilovitsh A, Chavez M, Ilovitsh T et al (2021) Immune modulation resulting from MR-guided high intensity focused ultrasound in a model of murine breast cancer. Sci Rep 11:927. https://doi.org/10.1038/s41598-020-80135-1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Focused Ultrasound Foundation https://www.fusfoundation.org/the-technology/state-of-the-technology/

  6. Qin S-z, Jiang Y, Wang Y-l, Liu N, Lin Z-y, Jia Q et al (2023) Predicting the efficacy of high-intensity focused ultrasound (HIFU) ablation for uterine leiomyomas based on DTI indicators and imaging features. Abdom Radiol. https://doi.org/10.1007/s00261-023-03865-6

    Article  Google Scholar 

  7. Zheng Y, Chen L, Liu M, Wu J, Yu R, Lv F (2021) Prediction of clinical outcome for high-intensity focused ultrasound ablation of uterine leiomyomas using multiparametric MRI radiomics-based machine learning model. Front Oncol 11:618604. https://doi.org/10.3389/fonc.2021.618604

    Article  PubMed  PubMed Central  Google Scholar 

  8. Wang Y, Gong C, He M, Lin Z, Xu F, Peng S et al (2023) Therapeutic dose and long-term efficiacy of high-intnensity focused ultrasound ablation for different types of uterine fibroids based on signal intensity on T2-weighted MR images. Int J Hyperth 40(1):2194594. https://doi.org/10.1080/02656736.2023.2194594

    Article  CAS  Google Scholar 

  9. Chang C-T, Jeng C-J, Long C-Y, Chuang LT, Shen J (2022) High-intensity focused ultrasound treatment for large and small solitary uterine fibroids. Int J Hyperth 39(1):485–489. https://doi.org/10.1080/02656736.2022.2039788

    Article  Google Scholar 

  10. Lesser TG, Boltze C, Schubert H, Wolframe F (2016) Flooded lung generates a suitable acoustic pathway for transthoracic application of high intensity focused ultrasound in liver. Int J Med Sci 13(10):741–748. https://doi.org/10.7150/ijms.16411

    Article  PubMed  PubMed Central  Google Scholar 

  11. Song P, Zhang L, Hu L, Chen J, Ju J, Wang X et al (2015) Factors influencing the dosimetry for high-intensity focused ultrasound ablation of uterine fibroids: a retrospective study. Medicine 94(13):e650. https://doi.org/10.1097/MD.0000000000000650

    Article  Google Scholar 

  12. Zhang T, Zhou Y, Wang Z (2023) In situ measurement of acoustic attenuation for fouced ultrasound ablation surgery using a boiling bubble at the focus. Ultrasound Med Biol 49:1672–1678. https://doi.org/10.1016/j.ultrasmedbio.2023.02.014

    Article  PubMed  Google Scholar 

  13. Wang Z, Bai J, Li F, Du Y, Wen S, Hu K et al (2003) Study of a biological focal region of high-intensity focused ultrasound. Ultrasound Med Biol 29(5):749–754. https://doi.org/10.1016/S0301-5629(02)00785-8

    Article  PubMed  Google Scholar 

  14. Hachiya H (2012) Measurement of acoustic properties of tissues using ultrasonic tissue imaging system. J Acoust Soc Am 131(4):3495. https://doi.org/10.1121/1.4709205

    Article  Google Scholar 

  15. Zhou Y, Gong X, You Y (2024) In vivo evaluation of focused ultrasound ablation surgery (FUAS)-induced coagulation using echo amplitudes of the therapeutic focused ultrasound transducer. Int J Hyperth 41(1):2325477. https://doi.org/10.1080/02656736.2024.2325477

    Article  CAS  Google Scholar 

  16. Okawai H, Kobayashi K, Nitta S (2001) An approach to acoustic properties of biological tissues using acoustic micrographs of attenuation constant and sound speed. J Ultrasound Med 20(8):891–907. https://doi.org/10.7863/jum.2001.20.8.891

    Article  CAS  PubMed  Google Scholar 

  17. Jolesz FA (2009) MRI-guided focused ultrasound surgery. Annu Rev Med 60:417–430. https://doi.org/10.1146/annurev.med.60.041707.170303

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Hazle JD, Diederich CJ, Kangasniemi M, Price RE, Olsson LE, Stafford RJ (2002) MRI-guided thermal therapy of transplanted tumors in the canine prostate using a directional transurethral ultrasound applicator. J Magn Reson Imaging 15(4):409–417. https://doi.org/10.1002/jmri.10076

    Article  PubMed  Google Scholar 

  19. McDannold N, Tempany CM, Fennessy FM, So MJ, Rybicki FJ, Stewart EA et al (2006) Uterine leiomyomas: MR imaging-based thermometry and thermal dosimetry during focused ultrasound thermal ablation. Radiology 240(1):263–270. https://doi.org/10.1148/radiol.2401050717

    Article  PubMed  Google Scholar 

  20. Mouratidis P, Rivens XE, Civale I, Symonds-Tayler J, ter Haar R G (2019) Relationship between thermal dose and cell death for rapid ablative and slow hyperthermic heating. Int J Hyperth 36(1):229–243. https://doi.org/10.1080/02656736.2018.1558289

    Article  Google Scholar 

  21. Walsh LP, Anderson JK, Baker M, Han B, Hsieh J-T, Lotan Y et al (2007) In vitro assessment of the efficacy of thermal therapy in human renal cell carcinoma. Urology 70(2):380–384. https://doi.org/10.1016/j.urology.2007.03.007

    Article  PubMed  Google Scholar 

  22. Khokhlova TD, Canney MS, Lee D, Marro KI, Crum LA, Khokhlova VA et al (2009) Magnetic resonance imaging of boiling induced by high intensity focused ultrasound. J Acoust Soc Am 125(4):2420–2431. https://doi.org/10.1121/1.3081393

    Article  PubMed  PubMed Central  Google Scholar 

  23. Munn Z, Moola S, Lisy K, Riitano D, Murphy F (2015) Claustrophobia in magnetic resonance imaging: a systematic review and meta-analysis. Radiography 21(2):e59–e63. https://doi.org/10.1016/j.radi.2014.12.004

    Article  Google Scholar 

  24. Zhang C, Liang M, **a T, Yin H, Yang H, Wang Z et al (2022) Dosimetric analysis of ultrasound-guided high intensity focused ultrasound ablation for breast fibroadenomas: a retrospective study. Int J Hyperth 39(1):743–750. https://doi.org/10.1080/02656736.2022.2074151

    Article  CAS  Google Scholar 

  25. Yu J-W, Yang M-J, Jiang L, Su X-Y, Chen J-Y (2023) Factors influencing USgHIFU ablation for adenomyosis with NPVR ≥ 50%. Int J Hyperth 40(1). https://doi.org/10.1080/02656736.2023.2211753

  26. ter Haar G (2016) HIFU tissue ablation: concept and devices. Adv Exp Med Biol 880(1). https://doi.org/10.1007/978-3-319-22536-4_1

  27. Kennedy JE (2005) High-intensity focused ultrasound in the treatment of solid tumours. Nat Rev Cancer 5:321–327. https://doi.org/10.1038/nrc1591

    Article  CAS  PubMed  Google Scholar 

  28. Yang M-J, Yu R-Q, Chen J-Y, Wang Z-B (2021) Comparison of dose and effectiveness of a single-session ultrasound-guided high-intensity focused ultrasound ablation of uterine fibroids with different sizes. Front Oncol 11:725193. https://doi.org/10.3389/fonc.2021.725193

    Article  PubMed  PubMed Central  Google Scholar 

  29. Park H, Kim E, Kim J, Ro Y, Ko J (2015) High-intensity focused ultrasound for the treatment of wrinkles and skin laxity in seven different facial areas. Ann Dermatol 27(6):688–693. https://doi.org/10.5021/ad.2015.27.6.688

    Article  PubMed  PubMed Central  Google Scholar 

  30. Bader KB, Vlaisavljevich E, Maxwell AD (2019) For whom the bubble grows: physical principes of bubble nucleation and dynamics in histotripsy ultrasound therapy. Ultrasound Med Biol 45(5):1056–1080. https://doi.org/10.1016/j.ultrasmedbio.2018.10.035

    Article  PubMed  PubMed Central  Google Scholar 

  31. Wang M, Lei Y, Zhou Y (2019) High-intensity focused ultrasound (HIFU) ablation by the frequency chirps: enhanced thermal field and cavitation at the focus. Ultrasonics 91(1):134–149. https://doi.org/10.1016/j.ultras.2018.08.017

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors thank Dr. Tianfeng Zhang for experimental work.

Funding

This work was supported by the CQMU Program for Youth Innovation in Future Medicine (2022-W0061).

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Authors and Affiliations

  1. State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, 1 Medical College Road, Chongqing, 400016, China

    Yufeng Zhou

  2. Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China

    Yufeng Zhou

  3. Key Laboratory for Quality Evaluation of Ultrasonic Surgical Equipment, National Medical Products Administration (NMPA), Donghu New Technology Development Zone, 507 Gaoxin Ave, Wuhan, 430075, Hubei, China

    Yufeng Zhou

  4. National Engineering Research Center of Ultrasound Medicine, Chongqing, 401120, China

    **aobo Gong & Yaqin You

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  1. Yufeng Zhou
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  3. Yaqin You
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Contributions

Study conception and design: YZ. Data collection and analysis: XG, YY. Statistical analysis and interpretation of data: XG, YY. Drafting the article: XG. Paper view and editing: YZ.

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Correspondence to Yufeng Zhou.

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Zhou, Y., Gong, X. & You, Y. Prediction of high-intensity focused ultrasound (HIFU)-induced lesion size using the echo amplitude from the focus in tissue. Phys Eng Sci Med (2024). https://doi.org/10.1007/s13246-024-01449-2

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