Dual Curved Ultrasound Phased-Arrays with Energy Density Method

for Respiratory-Gated Tumor Thermal Therapy

Ming-Chuan Hsu1, Chihng-Tsung Liauh2, Yung-Yaw Chen3, Hsu Chang4, Win-Li Lin1,4*
1 Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
2 Department of Mechanical Engineering, Kung-Shan University of Science and Technology, Tainan, Taiwan
3 Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
4 Division of Medical Engineering Research, National Health Research Institutes, Miaoli, Taiwan
0.5 8
Abstract • B. Heating Strategy 0.0
T raj ectory #B (a)
7
Traject ory #B
Duty Cycle = 50%
(b)

6
-0.5
This study investigated the feasibility of using dual curved ultrasound For a fixed acoustic output power, the exposure time of the focal spot 5
-1.0
at each location along the Y-D can be calculated for a known motion 4
phased-arrays with respiratory-gated strategy based on energy density -1.5
3 TD = 240, 100, 10 (min)
trajectory and this exposure time distribution can be considered as the -2.0 Skin
2
method to perform thermal therapy on the target region with respiratory relative energy deposition density at the focal depth along the Y- -2.5 1

motion. The set of dual phased-arrays was tilted with a tilt angle of 30° to direction. Hence, the location of maximum exposure time is the -3.0
0 5 10 15 20 25 30
0
-5 -4 -3 -2 -1 0 1 2 3 4 5

generate a confocus to increase the heating efficiency and reduce maximum deposited energy location. Figure 2(a) shows a simulated Time (seconds) Y-D (cm)

0.5 8
regular motion trajectory (trajectory #A) with a motion range of 3.0 cm Traject ory #C (d)
energy density in skin. The energy density method was employed to 0.0 7 Duty Cycle = 50%

and a period of 5 sec/cycle, which is conformed to the finite state model -0.5 6
determine the location of maximum energy density and a suitable gating -1.0
[1] for respiratory motion. Figure 2(b) shows the energy density along -1.5
5
4
window for a desired duty cycle. The set of dual phased-arrays was the motion direction, the location of maximum energy density and the -2.0
3 TD = 240, 100, 10 (min)
-2.5
arranged to have their confocus coincident with the location of maximum gating window, which was determined as the ratio of accumulated -3.0 2
Skin

1
energy density and the acoustic power was turned on as the tracker energy to total energy equals to the desired duty cycle. The acoustic -3.5
Trajectory #C (c)
-4.0 0
power was turned on as the tracker moved in the gating window and 0 10 20 30 40 50 60 70 80 -5 -4 -3 -2 -1 0 1 2 3 4 5
moved in the gating window and turned off as it moved out. The heating Time (seconds) Y-D (cm)
turned off as it moved out. 2.5 8
process was terminated as the maximum temperature of the target 2.0
(e)
7
Trajectory #D
Duty Cycle = 50%
(f)

1.5
region achieved the target temperature (Ttgt). Computer simulation 6
1.0 5
results demonstrated that the proposed heating system with energy 0.5
4
0.0
3 TD = 240, 100, 10 (min)
density method was capable of generating a clinically useful thermal -0.5
Skin
2
-1.0
lesion within a short period of treatment time for a target region with a -1.5 1
Trajectory #D
-2.0 0
respiratory motion. In addition, the temperature of skin at the end of 0 10 20 30 40 50 60 70 80 90 -5 -4 -3 -2 -1 0 1
Y-D (cm)
2 3 4 5
Time (seconds)

heating could be effectively alleviated due to the low acoustic intensity in

skin and the cooling water. For in-situ experiments, a set of curved
phased-arrays was submerged in water and emitted the acoustic power
into a piece of fresh pork which moving with a respiratory motion. The
experimental results showed that the proposed heating system with
energy density method was able to efficiently generate a thermal lesion
in the moving target. This study reveals that it is very promising to have
an appropriate arrangement of curved ultrasound phased-arrays with
respiratory-gated strategy based on energy density method for moving
FIG. 4
• B. Experiment Results
Figure 5(a) indicates that the thermal lesion expanded from the
location of maximum energy density and the lesion extended to the
motion direction for a 100% duty cycle (without gating strategy). As the
Results energy density method was applied to determine the location of
maximum energy density and to select a suitable gating window, Figure
• A. Simulation Results 5(b) displayed that the thermal lesion expanded from the location of
Figures 3(a-c) show the resulting thermal dose on the X = 0 cm maximum energy density and formed a symmetric lesion without

tumor thermal therapy.
Materials and Methods
• A. System Arrangement
Figure 1 shows a schematic diagram of the proposed ultrasound
thermal therapy system. Each phased-array consists of 80 elements
and its driving frequency, radius of curvature, length and width of the
phased-array are 1.0 MHz, 15.0 cm, 16.0 cm, and 1.5 cm, respectively.
The treatment tissue moved in the lateral direction (Y-D) with a given
respiratory motion trajectory and it was modeled as a rigid body above
Z = 1cm in the transverse direction covered with a motionless skin of 1
plane for the duty cycle equal to 10%, 50% or 100% for the motion deformation. Figures 5(c)-(d) further display the experimental results on
trajectory #A, and target temperature 65℃. The results show that the X=0cm plane for the irregular motion trajectories #C and #D,
respectively, with a duty cycle of 50% and a sonication time of 120s,
lesion enclosed by 240 min for different duty cycles are similar, while a
The thermal lesion was centered at about Y=0.3cm and 1.5cm,
100% duty cycle can enlarge the thermal effect on the adjacent tissue
with a tail-like high thermal dose region due to the motion, especially respectively, and the symmetric thermal lesion also expanded from the
for the region with TD equal to 10 min. Furthermore, a 100% duty cycle location of maximum energy density.
also results in a much higher thermal dose region in skin. Figure 3(d)
indicates that the treatment time reduces as the duty cycle increases,
and the maximum temperature of skin rises significantly as the duty
cycle is greater than 50%.
8 8
7
Duty Cycle = 10% (a)
7
Duty Cycle = 50% (b)

mm thickness. O-X-Y-Z coordinates were fixed on the skin. Degassed 6 6

water was filled between the phased-arrays and the skin as a coupling 5 5
Z-D(cm)
Z-D(cm)

4 4
and cooling medium. The set of phased-arrays was mechanically
3 TD = 240, 100, 10 (min) 3 TD = 240, 100, 10 (min)
moved to have its confocus located at the location of maximum energy Skin Skin
2 2
density, which was obtained by the energy density method. 1 1

0 0
-5 -4 -3 -2 -1 0 1 2 3 4 5 -5 -4 -3 -2 -1 0 1 2 3 4 5
Z Y-D (cm) Y-D (cm)
8 80 68
Gating Window Duty Cycle = 100% (c) (d)
Treatment Time
7 70 66
Maximum Temp. of Skin (°C)

Tracker Respiratory-Induced Motion Maximum Temp. of Skin

Confocus
6 60 64
Conclusions
Treatment Time (S)

5 50 36.8 Sec. 62
Z-D(cm)

4 40 60
Treatment Tissue
3 TD = 240, 100, 10 (min) 30 58
The propsoed dual curved ultrasound phased-arays have the
r Target Region
Skin ( Z = 1 )
2
Skin
20 56 capability to perform thermal therapy for respiratory-gated tumors
1 10
55.3 °C
54 without producing a motion-induced deformed thermal lesion and with
Y 0 0 52 minimizing skin overheating within a reasonable treatment time. The
O -5 -4 -3 -2 -1 0 1 2 3 4 5 0.0 20 40 60 80 100

Degassed Water r'

Y-D (cm) Duty Cycle (%) results of this study demonstrated that the proposed curved ultrasound
FIG. 3 phased-arrays with respiratory-gated heating strategy is very promising
d to make remarkable improvement on conducting focused ultrasound
Figures 4(b), 4(d) and 4(f) show the thermal dose profiles on the X = thermal therapy for respiratory motion treatment.
e (θT)

Tilt
Angl 0 cm plane for irregular motion trajectories #B, #C and #D [1], as
Curved Ultrasound Curved Ultrasound shown in Figures 4(a), 4(c) and 4(e),respectively, with 65℃ target
Phased-Array Phased-Array References
temperature and a duty cycle of 50%. The simulation results indicate
that the proposed ultrasound system can produce a thermal lesion for [1] H. Wu, G. C. Sharp, B. Salzberg et al., "A finite state model for
FIG. 1
different motion trajectories through the respiratory-gated strategy with respiratory motion analysis in image guided radiation therapy," Physics
energy density method. Medicine and Biology 49 (23), 5357-5372 (2004)

2009 Society for Thermal Medicine Annual Meeting, Tuscon, April 3-7, 2009.