Paul BOULOS: Ultrasound imaging of the ultrasound thrombolysis

Abstract:

Ultrasound therapy techniques emerged very recently with the discovery of high intensity focused ultrasound (HIFU) technology. Extracorporeal ultrasound thrombolysis is one of these promising innovative low-invasive treatment based on the mechanical destruction of thrombus caused by acoustic cavitation mechanisms. Yet, it is a poorly controlled phenomenon and therefore raises problems of reproducibility that could damage vessel walls. Thus, better control of cavitation activity during the ultrasonic treatment and especially its localization during the therapy is an essential approach to consider the development of a therapeutic device. A prototype has already been designed and improved with a real-time feedback loop in order to control the cavitation power activity. However, to monitor the treatment in real-time, an ultrasound imaging system needs to be incorporated into the therapeutic device. It should be able to first spot the blood clot, to position the focal point of the therapy transducer, control the proper destruction of the thrombus, and evaluate in real-time the cavitation activity. Present work focusses mainly on the development of passive ultrasound techniques used to reconstruct cavitation activity maps. Different beamforming algorithms were investigated and validated through point source simulations, in vitro experiments on a wire, and cavitation experiments in a water tank. It was demonstrated that an accurate beamforming algorithm for focal cavitation point localization is the passive acoustic mapping weighted with the phase coherence factor (PAM-PCF). Additionally, in vivo testing on an animal model of acute limb ischemia was assessed. Finally, some optimizations of the previous developed imaging system were carried out as 3D imaging, real-time implementation, and hybrid imaging combining active anatomical imaging with passive cavitation mapping.