Thermal ablation of soft tissue by a single shock wave sonication of discrete foci within the given volume

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Abstract

New protocols have been developed for shockwave irradiation of soft tissue volumes using trajectories uniformly filled within the given shape by discrete foci, while pulsed millisecond sonication immediately formed a single ablation. The influence of the initial peak power with the same time-average power, the interfocus distance and the geometry of the external contour of the trajectory on the shape, volume and ablation rate was analyzed. The most advantageous is the saturation mode using a trajectory with an interfocus step 1.5 times greater than the transverse size of a single lesion. To obtain volumes of thermal ablation on the order of cubic centimeters, layer-by-layer sonication protocols are proposed, which allow to 2.5 times greater thermal ablation rate compared with protocols used in clinical practice. The advantage of the proposed shockwave protocols is the possibility of obtaining localized and predictable thermal damage without accompanying MRI monitoring.

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About the authors

P. A. Pestova

Lomonosov Moscow State University

Author for correspondence.
Email: ppolina-98@yandex.ru

Faculty of Physics

Russian Federation, Leninskie Gory, GSP-1, Moscow, 119991

P. V. Yuldashev

Lomonosov Moscow State University

Email: ppolina-98@yandex.ru

Faculty of Physics

Russian Federation, Leninskie Gory, GSP-1, Moscow, 119991

V. A. Khokhlova

Lomonosov Moscow State University

Email: ppolina-98@yandex.ru

Faculty of Physics

Russian Federation, Leninskie Gory, GSP-1, Moscow, 119991

M. M. Karzova

Lomonosov Moscow State University

Email: ppolina-98@yandex.ru

Faculty of Physics

Russian Federation, Leninskie Gory, GSP-1, Moscow, 119991

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Supplementary files

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2. Fig. 1. (a) — Schematic diagram of the numerical experiment. The ultrasound beam is created by a randomized HIFU array (256 round elements with a diameter of 6.6 mm) with an aperture of 128 mm, an operating frequency of 1.2 MHz, and a focal length of F = 120 mm. Focusing occurs into a beef liver tissue sample to a depth of h = 2.5 cm, the emitter and the tissue sample are placed in water. (b) — Pressure profiles at the array focus in the tissue for the saturation mode (I₀ = 15 W/cm², red line) and the mode with the formation of a developed gap (I₀ = 8 W/cm², blue dash-dotted line). (c, d) — Discrete trajectories of a single impact on each focus, limited by an external contour in the form of equal in area (c) — a circle with a radius of 4 mm and (d) — a square with a side of 7 mm; The foci are located on a uniform grid with a step of s. The spiral sequence of the electronic movement of the grid focus is shown in the highlighted circle by an arrow (from the center outward).

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3. Fig. 2. Spatial distributions of temperature at the moment of completion of heating t under shock wave irradiation in the saturation mode (I₀ = 15 W/cm², left column) and in the mode of formation of a developed discontinuity (I₀ = 8 W/cm², right column) along a discrete trajectory limited by an external contour in the form of a circle, with different interfocal distances s: (a) — 0.40, (b) — 0.55, (c) — 0.60, (d) — 0.65, (e) — 0.75 mm for 15 W/cm² and (f) — 0.25, (g) — 0.45, (h) — 0.50, (i) — 0.52, (j) — 0.55 mm for 8 W/cm², respectively. The black contour indicates the region within which the thermal dose exceeded its threshold value after the sample cooled down. Each spatial temperature distribution shows the end time of heating, the achieved thermal ablation rate, and the value of the destroyed volume.

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4. Fig. 3. Spatial temperature distributions at the moment of heating completion t (a) − during shock-wave irradiation in the saturation mode (I₀ = 15 W/cm²) and (b) — in the mode of formation of a developed rupture (I₀ = 8 W/cm²) along a discrete trajectory limited by an external contour in the form of a square with a side of 7 mm, with an optimal interfocal step s (0.6 mm for 15 W/cm² and 0.5 mm for 8 W/cm²). The black contour indicates the region within which the thermal dose exceeded its threshold value after cooling of the sample. The time of heating completion, the achieved thermal ablation rate and the value of the destroyed volume are shown on each spatial temperature distribution.

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5. Fig. 4. Spatial temperature distributions at the end of heating t (a) — during shock wave irradiation of the liver sample in the saturation mode (I₀ = 15 W/cm²) and (b) — in the developed rupture formation mode (I₀ = 8 W/cm²) along a three-layer trajectory. The distance between adjacent layers was 5 mm, irradiation began with the layer farthest from the emitter. The black contour indicates the region within which the thermal dose exceeded its threshold value after the sample cooled. The top row shows the distributions in the focal plane for each of the layers, and the bottom row — the distribution in the axial plane. The distributions indicate the interfocal steps s in each layer, the irradiation duration t, the achieved thermal ablation rates and the volumes of the resulting destruction.

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