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The introduction of microbubbles in focused ultrasound therapies has enabled a diverse range of non-invasive technologies: sonoporation to deliver drugs into cells, sonothrombolysis to dissolve blood clots, and blood-brain barrier opening to deliver drugs into the brain. Current methods for passively monitoring the microbubble dynamics responsible for these therapeutic effects can identify the cavitation position by passive acoustic mapping and cavitation mode by spectral analysis. Here, we introduce a new feature that can be monitored: microbubble effective velocity. Previous studies have shown that echoes from short imaging pulses had a Doppler shift that was produced by the movement of microbubbles. Therapeutic pulses are longer (>1 000 cycles) and thus produce a larger alteration of microbubble distribution due to primary and secondary acoustic radiation force effects which cannot be monitored using pulse-echo techniques. In our experiments, we captured and analyzed the Doppler shift during long therapeutic pulses using a passive cavitation detector. A population of microbubbles (5  ×  104–5  ×  107 microbubbles ml−1) was embedded in a vessel (inner diameter: 4 mm) and sonicated using a 0.5 MHz focused ultrasound transducer (peak-rarefactional pressure: 75–366 kPa, pulse length: 50 000 cycles or 100 ms) within a water tank. Microbubble acoustic emissions were captured with a coaxially aligned 7.5 MHz passive cavitation detector and spectrally analyzed to measure the Doppler shift for multiple harmonics above the 10th harmonic (i.e. superharmonics). A Doppler shift was observed on the order of tens of kHz with respect to the primary superharmonic peak and is due to the axial movement of the microbubbles. The position, amplitude and width of the Doppler peaks depended on the acoustic pressure and the microbubble concentration. Higher pressures increased the effective velocity of the microbubbles up to 3 m s−1, prior to the onset of broadband emissions, which is an indicator for high magnitude inertial cavitation. Although the microbubble redistribution was shown to persist for the entire sonication period in dense populations, it was constrained to the first few milliseconds in lower concentrations. In conclusion, superharmonic microbubble Doppler effects can provide a quantitative measure of effective velocities of a sonicated microbubble population and could be used for monitoring ultrasound therapy in real-time. [ABSTRACT FROM AUTHOR]

Focused ultrasound and microbubbles have been extensively used to generate therapeutic bioeffects. Despite encouraging in vivo results, there remains poor control of the magnitude and spatial distribution of these bioeffects due to the limited ability of conventional pulse shapes and sequences to control cavitation dynamics. Thus current techniques are restricted by an efficacy-safety trade-off. The primary aim of the present study was to incorporate the presence of flow in the design of new short pulse sequences, which can more uniformly distribute the cavitation activity. Microbubbles flowing (fluid velocity: 10 mm s−1) through a 300 μm tube were sonicated with a focused 0.5 MHz transducer while acoustic emissions were captured with an inserted focused 7.5 MHz passive cavitation detector. The two foci were co-axially aligned and their focal points were overlapped. Whereas conventional sequences are composed of a long burst (>10 000 cycles) emitted at a low burst repetition frequency (<10 Hz), we decomposed this burst into short pulses by adding intervals to facilitate inter-pulse microbubble movement. To evaluate how this sequence influenced cavitation distribution, we emitted short pulses (peak-rarefactional pressure (PRP): 40–366 kPa, pulse length (PL): 5–25 cycles) at high pulse repetition frequencies (PRF: 0.625–10 kHz) for a burst length of 100 ms. Increased cavitation persistence, implied by the duration of the microbubble acoustic emissions, was a measure of improved distribution due to the presence of flow. Sonication at lower acoustic pressures, longer pulse intervals and lower PLs improved the spatial distribution of cavitation. Furthermore, spectral analysis of the microbubble emissions revealed that the improvement at low pressures is due to persisting stable cavitation. In conclusion, new short-pulse sequences were shown to improve spatiotemporal control of acoustic cavitation dynamics during physiologically relevant flow. This could lead to adjustable distribution of the generated in vivo bioeffect and therefore efficient and safe treatment of a wide range of pathologies. [ABSTRACT FROM AUTHOR]