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Lesion generation through ribs using histotripsy therapy without aberration correction.

Yohan Kim1, Tzu-Yin Wang, Zhen Xu

  • 1University of Michigan, Department of Biomedical Engineering, Ann Arbor, MI, USA. yohankim@umich.edu

IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
|November 16, 2011
PubMed
Summary

High-intensity pulsed therapeutic ultrasound, or histotripsy, can create precise lesions through ribs without aberration correction. This non-invasive method shows high tolerance for rib-induced field aberrations, minimizing collateral damage.

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Area of Science:

  • Medical physics
  • Biomedical engineering
  • Acoustic therapies

Background:

  • Histotripsy uses focused ultrasound to mechanically ablate tissue via cavitation.
  • Non-invasive therapeutic ultrasound faces challenges with tissue heterogeneity, like bone.
  • Ribs can distort ultrasound fields, potentially hindering precise lesion formation.

Purpose of the Study:

  • To assess the feasibility of histotripsy for non-invasive lesion generation through rib structures.
  • To determine if histotripsy can create precise lesions without aberration correction.
  • To evaluate the impact of rib-induced field aberrations on histotripsy efficacy and safety.

Main Methods:

  • Utilized a 750-kHz focused transducer to apply histotripsy to tissue phantoms.

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  • Simulated rib structures (aberrators) were placed in the ultrasound path.
  • Lesions were generated without aberration correction, applying 8000 pulses at 16-18 MPa.
  • High-speed imaging monitored cavitation bubble cloud formation and lesion characteristics.

    • Main Results:

    • Histotripsy successfully generated well-confined lesions in phantoms with and without rib aberrators.
    • Cavitation bubble clouds formed exclusively at the focus, despite significant secondary lobes from ribs.
    • Lesion dimensions were comparable between conditions, with negligible collateral damage.
    • Collateral damage was minimal, attributed to single bubbles rather than cloud formation.

    Conclusions:

    • Histotripsy demonstrates high tolerance to aberrated ultrasound fields caused by ribs.
    • Precise, confined focal lesions can be generated through rib obstacles without aberration correction.
    • This finding supports the potential of histotripsy as a non-invasive therapeutic option in anatomically challenging regions.