Interstitial thermal ablation with a fast rotating dual-mode transducer.

Interstitial ultrasound applicators can be a minimally invasive alternative for treating targets that are unresectable or are inaccessible by extracorporeal methods. Dual-mode transducers for ultrasound imaging and therapy were developed to address the constraints of a miniaturized applicator and real-time treatment monitoring. We propose an original treatment strategy that combines ultrasound imaging and therapy using a dual-mode transducer rotating at 8 revolutions per second. Real-time B-mode imaging was interrupted to emit high-intensity ultrasound over a selected therapy aperture. A full 360 degrees image was taken every 8th rotation to image the therapy aperture. Numerical simulations were performed to study the effect of rotation on tissue heating, and to study the effect of the treatment sequence on transducer temperature. With the time-averaged transducer surface intensity held at 12 W/cm(2) to maintain transducer temperature below 66 degrees C, higher field intensities and deeper lesions were produced by narrower therapy apertures. A prototype system was built and tested using in vitro samples of porcine liver. Lesions up to 8 mm were produced using a time-averaged transducer surface intensity of 12 W/cm(2) applied for a period of 240 s over a therapy aperture of 40 degrees. Apparent strain imaging of the therapy aperture improved the contrast between treated and spared tissues, which could not be differentiated on B-mode images. With appropriate limits on the transducer output, real-time imaging and deep thermal ablation are feasible and sustainable using a rotating dual-mode transducer.

In vivo evaluation of a mechanically oscillating dual-mode applicator for ultrasound imaging and thermal ablation.

Unresectable liver tumors are often treated with interstitial probes that modify tissue temperature, and efficacious treatment relies on image guidance for tissue targeting and assessment. Here, we report the in vivo evaluation of an interstitial applicator with a mechanically oscillating five-element dual-mode transducer. After thoroughly characterizing the transducer, tissue response to high-intensity ultrasound was numerically calculated to select parameters for experimentation in vivo. Using perfused porcine liver, B-mode sector images were formed before and after a 120-s therapy period, and M-mode imaging monitored the therapy axis during therapy. The time-averaged transducer surface intensity was 21 or 27 W/cm (2). Electroacoustic conversion efficiency was maximally 72 +/- 3% and impulse response length was 295 +/- 1.0 ns at -6 dB. The depth of thermal damage measured by gross histology ranged from 10 to 25 mm for 13 insertion sites. For six sites, M-mode data exhibited a reduction in gray-scale intensity that was interpreted as the temporal variation of coagulation necrosis. Contrast ratio analysis indicated that the gray-scale intensity dropped by 7.8 +/- 3.3 dB, and estimated the final lesion depth to an accuracy of 2.3 +/- 2.4 mm. This paper verified that the applicator could induce coagulation necrosis in perfused liver and demonstrated the feasibility of real-time monitoring.

Dual-mode ultrasound transducer for image-guided interstitial thermal therapy.

Deep-seated tumors can be treated by minimally invasive interstitial ultrasound thermal therapy. A miniature transducer emitting high-intensity acoustic waves is placed in contact with the targeted area to induce local thermal necrosis. Accurate positioning of the probe and treatment monitoring must be achieved for the technique to be effective. A piezocomposite technology was used for obtaining both high-quality imaging and effective treatment with the same transducer. Prototypes were designed and built to be compatible with an endoscopic approach for treating cholangiocarcinomas in the biliary ducts. The transducer had dimensions of 2.5 x 7.5 mm(2), it was cylindrically focused at 10 mm and it was operated at a center frequency of 11 MHz. Transducer efficiency was measured at 71%, and the impulse response corresponded to an axial resolution of 0.2 mm. In-vitro tests were conducted on samples of pig liver in which lesions up to 10 mm in depth were induced. B-mode images were obtained by mechanically rotating the transducer. Treatments were monitored in three ways: (i) classical M-mode images, (ii) images of local deformation of ultrasound lines during heating and (iii) comparison of the displacements induced in the tissue by radiation force, before and after treatments. The successful use of piezocomposite materials to manufacture dual-mode transducers opens new perspectives for interstitial ultrasound thermal therapy.

Fabrication and characterization of annular thickness mode piezoelectric micro ultrasonic transducers.

Micromachining techniques, in combination with low temperature ceramic composite sol-gel processing, have been used to fabricate annular array thickness-mode piezoelectric micro ultrasonic transducers (Tm-pMUTs). The processing techniques of low temperature (710 degrees C) composite sol-gel ceramic (sol + ceramic powder) deposition and wet etching were used to deposit and structure 27-microm thick lead zirconate titanate (PZT) films on silicon substrates to produce annular array Tm-pMUTs. Using these techniques, high quality PZT materials with near bulk permittivity have been obtained. The Tm-pMUT devices were shown to resonate at approximately 60 MHz in air and 50 MHz in water. From resonance measurements k(t) values ranging between 0.2 and 0.47 have been calculated and shown to depend on the level of porosity within the film. Lower values of kt were observed for films with higher levels of porosity, which was attributed to the relative decrease in the effective piezoelectric coefficient epsilon(33) with respect to stiffness and permittivity as a function of increasing porosity. This paper presents the successful micro-fabrication of a Tm-pMUT device and discusses the optimization of the poling conditions and effect of PZT microstructure on the coupling coefficient k(t). Pulse echo measurements in water, showing a -6 dB center frequency of 53 MHz and 47% -6 dB bandwidth, using a target 15 mm away from the transducer, have been included to demonstrate successful operation of the device. Full analysis of these results will be conducted in later publications.