Precision control of lesions by high-intensity focused ultrasound cavitation-based histotripsy through varying pulse...

The goal of this experimental study was to explore the feasibility of acquiring controllable precision through varying pulse duration for lesions generated by cavitation-based histotripsy. Histotripsy uses high-intensity focused ultrasound (HIFU) at low duty factor to create energetic bubble clouds inside tissue to liquefy a region. It uses cavitation-mediated mechanical effects while minimizing heating, and has the advantages of real-time monitoring and lesion fidelity to treatment planning. In our study, histotripsy was applied to three groups of tissue-mimicking agar samples of different stiffnesses (29.4 ± 5.3, 44.8 ± 5.9, and 66.4 ± 7.1 kPa). B-mode imaging was used first to quantify bubble cluster dimensions in both water and agar. Then, a 4.5-mm-wide square (lateral to the focal plane) was scanned in a raster pattern with a step size of 0.75 mm in agar histotripsy experiments to estimate equivalent bubble cluster dimensions based on the histotripsyinduced damage. The 15-s exposure at each treatment location comprised 5000 sine-wave tone bursts at a spatial-peak pulseaverage intensity of 41.1 kW/cm2, with peak compressional and rarefactional pressures of 102 and 17 MPa, respectively. The results showed that bubble cluster width and length increased with pulse duration and decreased with agar stiffness. Therefore, a significant improvement in histotripsy precision could be achieved by reducing the pulse duration.