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Purpose: The aim of this study is to evaluate the acoustic and thermal properties of a plaque phantom. This is very important for the effective implementation of ultrasound not only in diagnosis but especially in treatment for the future., Material and Methods: An evaluation of acoustic and thermal properties of plaque phantoms to test their suitability mainly for ultrasound imaging and therapy was presented. The evaluation included measurements of the acoustic propagation speed using pulse-echo technique, ultrasonic attenuation coefficient using through transmission immersion technique, and absorption coefficient. Moreover, thermal properties (thermal conductivity, volumetric specific heat capacity and thermal diffusivity) were measured with the transient method using a needle probe., Results: It was shown that acoustic and thermal properties of atherosclerotic plaque phantoms fall well within the range of reported values for atherosclerotic plaque and slightly different for thermal diffusivity and volumetric specific heat capacity for soft tissues. The mean value of acoustic and thermal properties and their standard deviation of plaque phantoms were 1523 ± 23 m/s for acoustic speed, 0.50 ± 0.02 W/mK for thermal conductivity, 0.30 ± 0.21 db/cm-MHz for ultrasonic absorption coefficient and 1.63 ± 0.46 db/cm-MHz for ultrasonic attenuation coefficient., Conclusions: This study demonstrated that acoustic and thermal properties of atherosclerotic plaque phantoms were within the range of reported values. Future studies should be focused on the optimum recipe of the atherosclerotic plaque phantoms that mimics the human atherosclerotic plaque (agar 4% w/v, gypsum 10% w/v and butter 10% w/v) and can be used for HIFU therapy., (© 2023. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Aim: Phantoms are often utilized for the preclinical evaluation of novel high-intensity focused ultrasound (HIFU) systems, serving as valuable tools for validating efficacy. In the present study, the feasibility of a homogeneous agar-based breast-shaped phantom as a tool for the preclinical evaluation of HIFU systems dedicated to breast cancer was assessed. Specifically, the effect of the increased phantom curvature on temperature increase was examined through sonications executed on two sides having varied curvatures., Materials and Methods: Assessment was performed utilizing a 1.1 MHz focused transducer. Sonications on the two phantom sides were executed at varied acoustical power in both a laboratory setting and inside a 1.5 T magnetic resonance imaging scanner. Sonications were independently performed on two identical phantoms for repeatability purposes., Results: Temperature changes between 7.1°C-34.3°C and 5.1°C-21.5°C were recorded within the decreased and increased curvature sides, respectively, for acoustical power of 3.75-10 W. High-power sonications created lesions which were approximately symmetrically formed around the focal point at the decreased curvature side, while they were shifted away from the focal point at the increased curvature side., Conclusions: The present findings indicate that increased curvature of the breast phantom results in deformed focal shapes and decreased temperatures induced at the focal area, thus suggesting treatment correction requirements in the form of focus control or accurate robotic movement. The developed breast-shaped phantom can be utilized as an evaluation tool of HIFU systems dedicated to breast cancer since it can visually verify the efficacy of any system., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Medical Physics.)

Purpose: The study aims to provide insights on the practicality of using single-element transducers for transcranial Focused Ultrasound (tFUS) thermal applications., Methods: FUS sonications were performed through skull phantoms embedding agar-based tissue mimicking gels using a 1 MHz single-element spherically focused transducer. The skull phantoms were 3D printed with Acrylonitrile Butadiene Styrene (ABS) and Resin thermoplastics having the exact skull bone geometry of a healthy volunteer. The temperature field distribution during and after heating was monitored in a 3 T Magnetic Resonance Imaging (MRI) scanner using MR thermometry. The effect of the skull's thickness on intracranial heating was investigated., Results: A single FUS sonication at focal acoustic intensities close to 1580 W/cm 2 for 60 s in free field heated up the agar phantom to ablative temperatures reaching about 90 °C (baseline of 37 °C). The ABS skull strongly blocked the ultrasonic waves, resulting in zero temperature increase within the phantom. Considerable heating was achieved through the Resin skull, but it remained at hyperthermia levels. Conversely, tFUS through a 1 mm Resin skull showed enhanced ultrasonic penetration and heating, with the focal temperature reaching 70 °C., Conclusions: The ABS skull demonstrated poorer performance in terms of tFUS compared to the Resin skull owing to its higher ultrasonic attenuation and porosity. The thin Resin phantom of 1 mm thickness provided an efficient acoustic window for delivering tFUS and heating up deep phantom areas. The results of such studies could be particularly useful for accelerating the establishment of a wider range of tFUS applications., (© 2023. The Author(s).)

Purpose: Amyloid-β (Aβ) peptides, the main component of amyloid plaques found in the Alzheimer's disease (AD) brain, are implicated in its pathogenesis, and are considered a key target in AD therapeutics. We herein propose a reliable strategy for non-invasively delivering a specific anti-Aβ antibody in a mouse model of AD by microbubbles-enhanced Focused Ultrasound (FUS)-mediated Blood-brain barrier disruption (BBBD), using a simple single stage MR-compatible positioning device., Methods: The initial experimental work involved wild-type mice and was devoted to selecting the sonication protocol for efficient and safe BBBD. Pulsed FUS was applied using a single-element FUS transducer of 1 MHz (80 mm radius of curvature and 50 mm diameter). The success and extent of BBBD were assessed by Evans Blue extravasation and brain damage by hematoxylin and eosin staining. 5XFAD mice were divided into different subgroups; control (n = 1), FUS + MBs alone (n = 5), antibody alone (n = 5), and FUS + antibody combined (n = 10). The changes in antibody deposition among groups were determined by immunohistochemistry., Results: It was confirmed that the antibody could not normally enter the brain parenchyma. A single treatment with MBs-enhanced pulsed FUS using the optimized protocol (1 MHz, 0.5 MPa in-situ pressure, 10 ms bursts, 1% duty factor, 100 s duration) transiently disrupted the BBB allowing for non-invasive antibody delivery to amyloid plaques within the sonicated brain regions. This was consistently reproduced in ten mice., Conclusion: These preliminary findings should be confirmed by longer-term studies examining the antibody effects on plaque clearance and cognitive benefit to hold promise for developing disease-modifying anti-Aβ therapeutics for clinical use., (© 2023. The Author(s).)

Purpose: The current study provides insights into the challenges of safely operating a magnetic resonance imaging (MRI)-guided focused ultrasound (MRgFUS) robotic system in a high-field MRI scanner in terms of robotic motion accuracy., Materials and Methods: Grid sonications were carried out in phantoms and excised porcine tissue in a 3T MRI scanner using an existing MRgFUS robotic system. Fast low-angle shot-based magnetic resonance thermometry was employed for the intraprocedural monitoring of thermal distribution., Results: Strong shifting of the heated spots from the intended points was observed owing to electromagnetic interference (EMI)-induced malfunctions in system's operation. Increasing the slice thickness of the thermometry sequence to at least 8 mm was proven an efficient method for preserving the robotic motion accuracy., Conclusions: These findings raise awareness about EMI effects on the motion accuracy of MRgFUS robotic devices and how they can be mitigated by employing suitable thermometry parameters., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Medical Physics.)

Aim: Agar-based phantoms are popular in high intensity focused ultrasound (HIFU) studies, with magnetic resonance imaging (MRI) preferred for guidance since it provides temperature monitoring by proton resonance frequency (PRF) shift magnetic resonance (MR) thermometry. MR thermometry monitoring depends on several factors, thus, herein, the PRF coefficient of agar phantoms was estimated., Materials and Methods: Seven phantoms were developed with varied agar (2, 4, or 6% w/v) or constant agar (6% w/v) and varied silica concentrations (2, 4, 6, or 8% w/v) to assess the effect of the concentration on the PRF coefficient. Each phantom was sonicated using varied acoustical power for a 30 s duration in both a laboratory setting and inside a 3T MRI scanner. PRF coefficients were estimated through linear trends between phase shift acquired using gradient sequences and thermocouple-based temperatures changes., Results: Linear regression ( R = 0.9707-0.9991) demonstrated a proportional dependency of phase shift with temperature change, resulting in PRF coefficients between -0.00336 ± 0.00029 and -0.00934 ± 0.00050 ppm/°C for the various phantom recipes. Weak negative linear correlations of the PRF coefficient were observed with increased agar. With silica concentrations, the negative linear correlation was strong. For all phantoms, calibrated PRF coefficients resulted in 1.01-3.01-fold higher temperature changes compared to the values calculated using a literature PRF coefficient.2 = 0.9707-0.9991) demonstrated a proportional dependency of phase shift with temperature change, resulting in PRF coefficients between -0.00336 ± 0.00029 and -0.00934 ± 0.00050 ppm/°C for the various phantom recipes. Weak negative linear correlations of the PRF coefficient were observed with increased agar. With silica concentrations, the negative linear correlation was strong. For all phantoms, calibrated PRF coefficients resulted in 1.01-3.01-fold higher temperature changes compared to the values calculated using a literature PRF coefficient., Conclusions: Phantoms developed with a 6% w/v agar concentration and doped with 0%-8% w/v silica best resemble tissue PRF coefficients and should be preferred in HIFU studies. The estimated PRF coefficients can result in enhanced MR thermometry monitoring and evaluation of HIFU protocols., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Medical Physics.)

Background: The main goal of the study was to find the magnetic resonance imaging (MRI) parameters that optimize contrast between tissue and thermal lesions produced by focused ultrasound (FUS) using T1-weighted (T1-W) and T2-weighted (T2-W) fast spin echo (FSE) sequences., Methods: FUS sonications were performed in ex vivo porcine tissue using a single-element FUS transducer of 2.6 MHz in 1.5 and 3 T MRI scanners. The difference in relaxation times as well as the impact of critical MRI parameters on the resultant contrast-to-noise ratio (CNR) between coagulated and normal tissues were assessed. Discrete and overlapping lesions were inflicted in tissue with simultaneous acquisition of T2-W FSE images., Results: FUS lesions are characterized by lower relaxation times than intact porcine tissue. CNR values above 80 were sufficient for proper lesion visualization. For T1-W imaging, repetition time values close to 1500 ms were considered optimum for obtaining sufficiently high CNR at the minimum time cost. Echo time values close to 50 ms offered the maximum lesion contrast in T2-W FSE imaging. Monitoring of acute FUS lesions during grid sonications was performed successfully. Lesions appeared as hypointense spots with excellent contrast from surrounding tissue., Conclusion: MRI monitoring of signal intensity changes during FUS sonication in grid patterns using optimized sequence parameters can provide useful information about lesion progression and the success of ablation. This preliminary study demonstrated the feasibility of the proposed monitoring method in ex vivo porcine tissue and should be supported by in vivo studies to assess its clinical potential., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Medical Ultrasound.)

Purpose: The study aimed to compare the performance of eight commercially available single-element High Intensity Focused Ultrasound (HIFU) transducers in terms of Magnetic Resonance Imaging (MRI) compatibility., Methods: Imaging of an agar-based MRI phantom was performed in a 3 T MRI scanner utilizing T2-Weighted Fast Spin Echo (FSE) and Fast low angle shot (FLASH) sequences, which are typically employed for high resolution anatomical imaging and thermometry, respectively. Reference magnitude and phase images of the phantom were compared with images acquired in the presence of each transducer in terms of the signal to noise ratio (SNR), introduced artifacts, and overall image quality., Results: The degree of observed artifacts highly differed among the various transducers. The transducer whose backing material included magnetic impurities showed poor performance in the MRI, introducing significant susceptibility artifacts such as geometric distortions and signal void bands. Additionally, it caused the most significant SNR drop. Other transducers were shown to exhibit high level of MRI compatibility as the resulting images closely resembled the reference images with minimal to no apparent artifacts and comparable SNR values., Conclusions: The study findings may facilitate researchers to select the most suitable transducer for their research, simultaneously avoiding unnecessary testing. The study further provides useful design considerations for MRI compatible transducers., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Associazione Italiana di Fisica Medica e Sanitaria. Published by Elsevier Ltd. All rights reserved.)

Background: Tissue-mimicking phantoms (TMPs) have been used extensively in clinical and nonclinical settings to simulate the thermal effects of focus ultrasound (FUS) technology in real tissue or organs. With recent technological developments in the FUS technology and its monitoring/guided techniques such as ultrasound-guided FUS and magnetic resonance-guided FUS (MRgFUS) the need for TMPs are more important than ever to ensure the safety of the patients before being treated with FUS for a variety of diseases (e.g., cancer or neurological). The purpose of this study was to prepare a tumor-mimicking phantom (TUMP) model that can simulate competently a tumor that is surrounded by healthy tissue., Methods: The TUMP models were prepared using polyacrylamide (PAA) and agar solutions enriched with MR contrast agents (silicon dioxide and glycerol), and the thermosensitive component bovine serum albumin (BSA) that can alter its physical properties once thermal change is detected, therefore offering real-time visualization of the applied FUS ablation in the TUMPs models. To establish if these TUMPs are good candidates to be used in thermoablation, their thermal properties were characterized with a custom-made FUS system in the laboratory and a magnetic resonance imaging (MRI) setup with MR-thermometry. The BSA protein's coagulation temperature was adjusted at 55°C by setting the pH of the PAA solution to 4.5, therefore simulating the necrosis temperature of the tissue., Results: The experiments carried out showed that the TUMP models prepared by PAA can change color from transparent to cream-white due to the BSA protein coagulation caused by the thermal stress applied. The TUMP models offered a good MRI contrast between the TMPs and the TUMPs including real-time visualization of the ablation area due to the BSA protein coagulation. Furthermore, the T2 -weighted MR images obtained showed a significant change in T2 when the BSA protein is thermally coagulated. MR thermometry maps demonstrated that the suggested TUMP models may successfully imitate a tumor that is present in soft tissue., Conclusion: The TUMP models developed in this study have numerous uses in the testing and calibration of FUS equipment including the simulation and validation of thermal therapy treatment plans with FUS or MRgFUS in oncology applications., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright: © 2023 Journal of Medical Ultrasound.)

Background: The current study proposes simple methods for assessing the performance of robotic devices intended for Magnetic Resonance Imaging (MRI)-guided needle biopsy., Methods: In-house made agar-based breast phantoms containing biopsy targets served as the main tool in the evaluation process of an MRI compatible positioning device comprising a needle navigator. The motion accuracy of mechanical stages was assessed by calliper measurements. Laboratory evaluation of needle targeting included a repeatability phantom test and a laser-based method. The accuracy and repeatability of needle targeting was also assessed by MRI., Results: The maximum error of linear motion for steps up to 10 mm was 0.1 mm. Needle navigation relative to the phantom and alignment with the various biopsy targets were performed successfully in both the laboratory and MRI settings. The proposed biopsy phantoms offered tissue-like signal in MRI and good haptic feedback during needle insertion., Conclusions: The proposed methods could be valuable in the process of validating the accuracy of MRI-guided biopsy robotic devices in both laboratory and real environments., (© 2023 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons Ltd.)

Background: Herein, a robotic system offering Magnetic Resonance-guided Focused Ultrasound (MRgFUS) therapy of thyroid nodules was developed., Methods: The robotic system offers linear motion in 2 PC-controlled axes that navigate a 3 MHz single-element focused transducer. The system, through a C-arm structure attaches to the table of Magnetic Resonance Imaging (MRI) scanners and couples to the neck of patients lying in the supine position. The MRI compatibility of the developed system was assessed inside a 3 T scanner. Benchtop and MRI feasibility studies evaluating the heating performance of the system were executed on excised pork tissue and on homogeneous and thyroid model agar-based phantoms., Results: The MRI compatibility of the system was successfully established. Grid sonications executed using robotic motion inflicted discrete and overlapping lesions on the excised tissue, while magnetic resonance (MR) thermometry successfully monitored thermal heating in agar-based phantoms., Conclusions: The developed system was found to be efficient with ex-vivo evaluation. The system can perform clinical MRgFUS therapy of thyroid nodules and other shallow targets after further in-vivo evaluation., (© 2023 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons Ltd.)

Background: The persistent development of focused ultrasound (FUS) thermal therapy in the context of oncology creates the need for tissue-mimicking tumor phantom models for early-stage experimentation and evaluation of relevant systems and protocols., Purpose: This study presents the development and evaluation of a tumor-bearing tissue phantom model for testing magnetic resonance imaging (MRI)-guided FUS (MRgFUS) ablation protocols and equipment based on MR thermometry., Methods: Normal tissue was mimicked by a pure agar gel, while the tumor simulator was differentiated from the surrounding material by including silicon dioxide. The phantom was characterized in terms of acoustic, thermal, and MRI properties. US, MRI, and computed tomography (CT) images of the phantom were acquired to assess the contrast between the two compartments. The phantom's response to thermal heating was investigated by performing high power sonications with a 2.4 MHz single element spherically focused ultrasonic transducer in a 3T MRI scanner., Results: The estimated phantom properties fall within the range of literature-reported values of soft tissues. The inclusion of silicon dioxide in the tumor material offered excellent tumor visualization in US, MRI, and CT. MR thermometry revealed temperature elevations in the phantom to ablation levels and clear evidence of larger heat accumulation within the tumor owing to the inclusion of silicon dioxide., Conclusion: Overall, the study findings suggest that the proposed tumor phantom model constitutes a simple and inexpensive tool for preclinical MRgFUS ablation studies, and potentially other image-guided thermal ablation applications upon minimal modifications., (© 2023 The Authors. Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.)

Background and Objectives: Herein, a user-friendly software platform for 3-dimensional Focused Ultrasound treatment planning based on Magnetic Resonance Imaging (MRI) images is presented., Methods: The software directly retrieves and loads MRI images. Various design tools can be used on the MRI images to define the treatment area and the sonication parameters. Based on the treatment plan, the software controls the robotic motion and motion pattern of Magnetic Resonance guided Focused Ultrasound (MRgFUS) robotic systems to execute the treatment procedure. Real-time treatment monitoring is achieved through MRI images and thermometry. The software's functionality and performance were evaluated in both laboratory and MRI environments. Different treatment plans were designed on MRI images and sonications were executed on agar-based phantoms and polymer films., Results: Magnetic Resonance (MR) thermometry maps were acquired in the agar-based phantoms. An exceptional agreement was observed between the software-planned treatment area and the lesions produced on the polymer films., Conclusions: The developed software was successfully integrated with the MRI and robotic system controls for performing accurate treatment planning and real-time monitoring during sonications. The software provides an extremely user-friendly interface, while in the future it could be enhanced by providing dynamic modulation of the ultrasonic parameters during the treatment process., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Noninvasive neurosurgery has become possible through the use of transcranial focused ultrasound (FUS). This study assessed the heating ability of single element spherically focused transducers operating at 0.4 and 1.1 MHz through three-dimensional (3D) printed thermoplastic skull phantoms., Methods: Phantoms with precise skull bone geometry of a male patient were 3D printed using common thermoplastic materials following segmentation on a computed tomography head scan image. The brain tissue was mimicked by an agar-based gel phantom developed in-house. The selection of phantom materials was mainly based on transmission-through attenuation measurements. Phantom sonications were performed through water, and then, with the skull phantoms intervening the beam path. In each case, thermometry was performed at the focal spot using thermocouples., Results: The focal temperature change in the presence of the skull phantoms was reduced to less than 20 % of that recorded in free field when using the 0.4 MHz transducer, whereas the 1.1 MHz trans-skull sonication produced minimal or no change in focal temperature. The 0.4 MHz transducer showed better performance in trans-skull transmission but still not efficient., Conclusion: The inability of both tested single element transducers to steer the beam through the high attenuating skull phantoms and raise the temperature at the focus was confirmed, underlying the necessity to use a correction technique to compensate for energy losses, such those provided by phased arrays. The proposed phantom could be used as a cost-effective and ergonomic tool for trans-skull FUS preclinical studies., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Medical Ultrasound.)

In recent years, veterinary medicine has expanded its practices beyond conventional methods, gradually integrating the Focused Ultrasound (FUS) technology in the care of companion animals like dogs and cats. The current study aimed to examine the feasibility and provide insights into the application of thermal FUS in canine and feline mammary cancer therapy. FUS was delivered by a 2-MHz single-element spherically focused ultrasonic transducer as integrated with an existing robotic positioning device. The functionality of the FUS system and sonication protocol in efficiently and safely ablating live tissue was initially validated in a rabbit thigh model in a laboratory environment. Nine (9) dogs and cats with superficial mammary cancer were recruited through a dedicated campaign according to specific safety criteria. The veterinary patients underwent FUS ablation followed by immediate surgical resection of the entire malignancy. Histopathology examination demonstrated well-defined regions of coagulative necrosis in all treated tumors with no off-target damage. Further study with a larger patient population is needed to confirm the current findings and demonstrate the safety and feasibility of complete FUS ablation of deep-seated tumors., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Purpose: Tissue-mimicking materials (TMMs) have a prominent role in validating new high intensity focused ultrasound (HIFU) therapies. Agar-based TMMs are often developed mimicking the thermal properties of muscle tissue, while TMMs simulating fat tissue properties are rarely developed. Herein, twelve agar-based TMMs were iteratively developed with varied concentrations of agar, water, glycerol and propan-2-ol, and characterized for their suitability in emulating the thermal conductivity of human fat tissue., Methods: Varied agar concentrations (2%, 4%, 6%, 8%, 12%, 16% and 20% w/v) were utilized for developing seven water-based TMMs, while a 20% w/v agar concentration was utilized for developing two water/alcohol-based TMMs (50% v/v water and 50% v/v either glycerol or propan-2-ol) and three alcohol-based TMMs (varied glycerol and propan-2-ol concentrations). Thermal conductivity was measured for all TMMs, and the tissue mimicking material (TMM) exhibiting thermal conductivity closest to human fat was considered the optimum fat TMM and was further characterized using ultrasound (US) and Magnetic Resonance Imaging (MRI)., Results: For the seven water-based TMMs an inverse linear trend was observed between thermal conductivity and increased agar concentration, being between 0.524 and 0.445 W/m K. Alcohol addition decreased thermal conductivity of the two water/alcohol-based TMMs to about 0.33 W/m K, while in the alcohol-based TMMs, increased concentrations of propan-2-ol emerged as a modifier of thermal conductivity. The optimum fat TMM (33.3% v/v glycerol and 66.7% v/v propan-2-ol) exhibited a 0.231 W/m K thermal conductivity, and appeared hypoechoic on US images and with increased brightness on T1-Weighted MRI images., Conclusion: The optimum fat TMM emulates the thermal conductivity of human fat tissue and exhibits a fat-like appearance on US and MRI images. The TMM is cost-effective and has a long lifespan and possesses great potential for use in HIFU applications as a fat TMM., (© 2022. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Purpose: The popularity of Magnetic Resonance guided Focused Ultrasound (MRgFUS) as a beneficial therapeutic solution for many diseases is increasing rapidly, thus raising the need for reliable quality assurance (QA) phantoms for routine testing of MRgFUS systems. In this study, we propose a thin acrylic film as the cheapest and most easily accessible phantom for assessing the functionality of MRgFUS hardware and software., Methods: Through the paper, specific QA tests are detailed in the framework of evaluating an MRgFUS preclinical robotic device comprising a single element spherically focused transducer with a nominal frequency of 2.75 MHz. These tests take advantage of the reflection of ultrasonic waves at a plastic-air interface, which results in almost immediate lesion formation on the film at a threshold of applied acoustic energy., Results: The phantom offered qualitative information on the power field distribution of the FUS transducer and the ability to visualize different FUS protocols. It also enabled quick and reliable assessment of various navigation algorithms as they are used in real treatments, and also allowed for the assessment of the accuracy of robotic motion., Conclusion: Therefore, it could serve as a useful tool for detecting defects in system's performance over its lifetime after establishing a baseline while concurrently contributing to establish QA and calibration guidelines for clinical routine controls., (© 2022. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Tissue mimicking phantoms (TMPs) play an essential role in modern biomedical research as cost-effective quality assurance and training tools, simultaneously contributing to the reduction of animal use. Herein, we present the development and evaluation of an anatomically accurate mouse phantom intended for image-guided thermal ablation and Focused Ultrasound (FUS) applications. The proposed mouse model consists of skeletal and soft tissue mimics, whose design was based on the Computed tomography (CT) scans data of a live mouse. Advantageously, it is compatible with US, CT, and Magnetic Resonance Imaging (MRI). The compatibility assessment was focused on the radiological behavior of the phantom due to the lack of relevant literature. The X-ray linear attenuation coefficient of candidate materials was estimated to assess the one that matches best the radiological behavior of living tissues. The bone part was manufactured by Fused Deposition Modeling (FDM) printing using Acrylonitrile styrene acrylate (ASA) material. For the soft-tissue mimic, a special mold was 3D printed having a cavity with the unique shape of the mouse body and filled with an agar-based silica-doped gel. The mouse phantom accurately matched the size and reproduced the body surface of the imaged mouse. Tissue-equivalency in terms of X-ray attenuation was demonstrated for the agar-based soft-tissue mimic. The phantom demonstrated excellent MRI visibility of the skeletal and soft-tissue mimics. Good radiological contrast between the skeletal and soft-tissue models was also observed in the CT scans. The model was also able to reproduce realistic behavior during trans-skull sonication as proved by thermocouple measurements. Overall, the proposed phantom is inexpensive, ergonomic, and realistic. It could constitute a powerful tool for image-guided thermal ablation and FUS studies in terms of testing and optimizing the performance of relevant equipment and protocols. It also possess great potential for use in transcranial FUS applications, including the emerging topic of FUS-mediated blood brain barrier (BBB) disruption., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: A robotic device featuring three motion axes was manufactured for preclinical research on focussed ultrasound (FUS). The device comprises a 2.75 MHz single element ultrasonic transducer and is guided by Magnetic Resonance Imaging (MRI)., Methods: The compatibility of the device with the MRI was evaluated by estimating the influence on the signal-to-noise ratio (SNR). The efficacy of the transducer in generating ablative temperatures was evaluated in phantoms and excised porcine tissue., Results: System's activation in the MRI scanner reduced the SNR to an acceptable level without compromising the image quality. The transducer demonstrated efficient heating ability as proved by MR thermometry. Discrete and overlapping thermal lesions were inflicted in excised tissue., Conclusions: The FUS system was proven effective for FUS thermal applications in the MRI setting. It can thus be used for multiple preclinical applications of the emerging MRI-guided FUS technology. The device can be scaled-up for human use with minor modifications., (© 2022 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons Ltd.)

Purpose: The present study was stimulated by the continuous growth of commercially available high intensity focused ultrasound (HIFU) systems for fat reduction. Herein, HIFU was utilised for fat ablation using a single-element ultrasonic transducer operating in thermal mode., Methods: The custom-made concave transducer that operates at 1.1 MHz was assessed on excised porcine adipose tissue for its ability to reduce fat. Ultrasonic sonications were executed on the adipose tissue utilising acoustical power between 14 and 75 W and sonication time in the range of 1-10 min. The mass of the adipose tissue sample was weighed afore and after ultrasonic sonications and the effect of the sonication on the mass change was recorded., Results: Mass change was linearly dependent with either increasing acoustical power or sonication time and was in the range of 0.46-1.9 g. High acoustical power of 62.5 W for a sonication time of 1 min and a power of 75 W for a sonication time of 5 min, respectively resulted in the formation of a lesion or possible cavitation on the piece of excised adipose tissue., Conclusion: The study demonstrated the efficacy of the proposed transducer in achieving a reduction of excised fat tissue. The present findings indicate the potential use of the transducer in a HIFU system indicated for the reduction of subcutaneous adipose tissue where increased values of acoustical power can result in increased amounts of fat reduction., (© 2022. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Purpose: In recent years, veterinary medicine has enhanced its applications beyond traditional approaches, progressively incorporating the Focused Ultrasound (FUS) technology. This study investigated the ability of FUS to precisely ablate naturally occurring canine and feline soft tissue sarcomas (STS)., Methods: Six dogs and four cats with superficial tumours were enrolled in the study. The tumours were treated with a Magnetic Resonance guided FUS (MRgFUS) robotic system featuring a single element spherically focused transducer of 2.6 MHz. The tumours were then removed by surgery and sent for hematoxylin and eosin (H&E) staining., Results: The MRgFUS system was capable of inflicting well-defined overlapping lesions in the tumours. The anatomical sites of the treated tumours were the neck, leg, face, back and belly. Coagulative necrosis was evidenced by histopathology assessment in 80% of cases., Conclusion: Therefore, this technology can be a therapeutic solution for veterinary cancer and a model for advancing the knowledge on human STS., (© 2022. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Background: Focussed Ultrasound (FUS) combined with microbubbles (MBs) was proven a promising modality for non-invasive blood brain barrier disruption (BBBD). Herein, two devices for FUS-mediated BBBD in rodents are presented., Methods: A two-axes robotic device was manufactured for navigating a single element FUS transducer of 1 MHz relative to the brain of rodents. A second more compact device featuring a single motorized vertical axis was also developed. Their performance was assessed in terms of motion accuracy, MRI compatibility and trans-skull BBBD in wild type mice using MBs in synergy with pulsed FUS., Results: Successful BBBD was evidenced by the Evans Blue dye method, as well as by Fibronectin and Fibrinogen immunostaining. BBB permeability was enhanced when the applied acoustic intensity was increased., Conclusions: The proposed devices constitute a cost-effective and ergonomic solution for FUS-mediated BBBD in small animal models. Further experimentation is needed to examine the repeatability of results and optimise the therapeutic protocol., (© 2022 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons Ltd.)

Numerous challenges are faced when employing Magnetic Resonance guided Focused Ultrasound (MRgFUS) hardware in the Magnetic Resonance Imaging (MRI) setting. The current study aimed to provide insights on this topic through a series of experiments performed in the framework of evaluating the MRI compatibility of an MRgFUS robotic device. All experiments were performed in a 1.5 T MRI scanner. The main metric for MRI compatibility assessment was the signal to noise ratio (SNR). Measurements were carried out in a tissue mimicking phantom and freshly excised pork tissue under various activation states of the system. In the effort to minimize magnetic interference and image distortion, various set-up parameters were examined. Significant SNR degradation and image distortion occurred when the FUS transducer was activated mainly owing to FUS-induced target and coil vibrations and was getting worse as the output power was increased. Proper design and stable positioning of the imaged phantom play a critical role in reducing these vibrations. Moreover, isolation of the phantom from the imaging coil was proven essential for avoiding FUS-induced vibrations from being transferred to the coil during sonication and resulted in a more than 3-fold increase in SNR. The use of a multi-channel coil increased the SNR by up to 50 % compared to a single-channel coil. Placement of the electronics outside the coil detection area increased the SNR by about 65 %. A similar SNR improvement was observed when the encoders' counting pulses were deactivated. Overall, this study raises awareness about major challenges regarding operation of an MRgFUS system in the MRI environment and proposes simple measures that could mitigate the impact of noise sources so that the monitoring value of MR imaging in FUS applications is not compromised., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: The mechanical properties of therapeutic ultrasound (US) have attracted scientific interest for thrombolysis enhancement in combination with thrombolytic agents and microbubbles (MBs). The aim of the study was to develop an in vitro model to observe how the effects of sonothrombolysis change in the case where a tissue-mimicking material (TMM) is placed in the path of the US beam before the clot., Methods: Fully retracted blood clots were prepared and pulse sonicated for 1 h under various conditions. The system was in a state of real circulating flow with a branch of an open bypass and an occluded tube containing a blood clot, thus mimicking the case of ischemic stroke. The effectiveness of thrombolysis was quantified in milligrams of clots removed. An agar-based TMM was developed around the occluded tube., Results: The clot breakdown in a TMM was found to be more pronounced than in water, presumably due to the retention of the acoustic field. A higher level of acoustic power was required to initiate clot lysis (>76 W acoustic power) using only focused US (FUS). The greatest thrombolysis enhancement was observed with the largest chosen pulse duration (PD) and the use of MBs (150 mg clot mass lysis). The synergistic effect of FUS in combination with MBs on the enzymatic fibrinolysis enhanced thrombolysis efficacy by 260% compared to thrombolysis induced using only FUS. A reduction in the degree of clot lysis was detected due to the attenuation factor of the intervening material (30 mg at 1 and 4 ms PD)., Conclusion: In vitro thrombolytic models including a TMM can provide a more realistic evaluation of new thrombolytic protocols. However, higher acoustic power should be considered to compensate for the attenuation factor. The rate of clot lysis is slow and the clinical use of this method will be challenging., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Medical Ultrasound.)

Purpose: The aim of the proposed study was to conduct a feasibility study using a flat rectangular (2 × 10 mm 2 ) transducer operating at 4.0 MHz for creating thermal lesions in an arterial atherosclerotic plaque phantom. The proposed method can be used in the future for treating atherosclerotic plaques in human arteries., Materials and Methods: The flat rectangular transducer was firstly assessed in agar/silica evaporated milk phantom, polyacrylamide phantom and freshly excised turkeytissue phantom. Then, the same transducer was assessed in an arterial atherosclerotic plaque phantom which was created in the laboratory with a very low cost. The recipe of the atherosclerotic plaque phantom was 4% w/v agar, 1% w/v gypsum, 2% w/v butter and 93% water. The amount of plaque removal was evaluated visually and using an X-Ray system., Results: It was shown that the flat rectangular transducer can create thermal lesions on the agar/silica evaporated milk phantom, polyacrylamide phantom and in excised tissue. The size of the lesions matches the geometry of the transducer. Moreover, this transducer destroyed 27.1% of the atherosclerotic plaque phantom with 8 W acoustical power and 30 s duration., Conclusions: This feasibility study demonstrated that atherosclerotic plaque can be destroyed using a very small flat rectangular (2 × 10 mm 2 ) transducer in a very small time interval of 30 s. In future clinical trials the transducer will be incorporated in a catheter which will be inserted intravascular (1-3 mm) wide and can be used to treat atherosclerotic plaques in the coronary arteries., (© 2022. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Background: Canine mammary tumours (CMTs) are the most common neoplasm appearing in female dogs and are considered the equivalent animal model of human breast cancer. However, in the literature, there is a gap for ultrasonic characterisation of these tumours. In this study, experimental measurements for acoustic attenuation and propagation speed of three surgically excised malignant CMTs were implemented., Methods: The three tumours were fixed in formaldehyde for up to 72 h and a total of five sample pieces were sectioned from the three tumours to account for the varied morphology observed along the tumours. The through-transmission and pulse-echo techniques were employed for experimental measurements of the acoustic attenuation and propagation speed., Results: Acoustic propagation speed of the five samples as measured at 2.7 MHz was in the range of 1568-1636 m/s. Correspondingly, acoustic attenuation was in the range of 1.95-3.45 dB/cm.MHz. Variations in both speed and attenuation were observed between samples acquired from the same tumour., Conclusions: Present findings suggest that both acoustic attenuation and propagation speed of CMTs are higher than normal canine tissues due to increased heterogeneity and varied morphology visually observed between the tumour specimens and evidenced by histological examination. Nevertheless, experimental results could aid in enhancing the use of ultrasound in the diagnosis and treatment of CMTs as well as provide essential data for comparative oncology., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Purpose: Acoustic characterization of tissue mimicking materials in terms of attenuation, absorption, scattering and propagation velocity is essential for their utilisation in experiments, thus sparing the need for living tissues or cadavers. Although there is a vast literature regarding the acoustic characterization of such materials in terms of attenuation or propagation velocity, there is limited data regarding the quantification of the scattering coefficient. Herein stimulated the utilisation of four agar-based phantoms featuring different sizes of scattering agar-structures on one of their surfaces so as to provide experimental evaluation of the magnitude of scattering., Methods: The agar-based phantoms were developed with 6% w/v agar and 4% w/v silica and featured scatterers of sizes of 0-1 mm. The acoustic properties of propagation speed, impedance, insertion loss and attenuation were evaluated utilising the pulse-echo and through-transmission techniques. Scattering was deduced from the data., Results: The propagation speed measured at 2.7 MHz was in the range of 1531.23-1542.97 m/s. Respectively the attenuation as measured at 1.1 MHz was in the range of 1.216-1.546 dB/cm increasing with increased scatterer size. Respectively the scattering coefficient was in the range of 0.078-0.324 dB/cm. Moreover, the scattering coefficient was linearly dependent on frequency in the range of 0.8-2.1 MHz indicating a 6-23% effect of the total attenuation., Conclusions: The experimental results demonstrate the utilisation of the procedure for quantification of the scattering coefficient of tissue mimicking materials thus improving the diagnostic and therapeutic uses of ultrasound., (© 2021. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Background: High-quality methods for Magnetic Resonance guided Focussed Ultrasound (MRgFUS) therapy planning are needed for safe and efficient clinical practices. Herein, an algorithm for full coverage path planning based on preoperative MR images is presented., Methods: The software functionalities of an MRgFUS robotic system were enhanced by implementing the developed algorithm. The algorithm's performance in accurate path planning following a Zig-Zag pathway was assessed on MR images. The planned sonication paths were performed on acrylic films using the robotic system carrying a 2.75 MHz single element transducer., Results: Ablation patterns were successfully planned on MR images and produced on acrylic films by overlapping lesions with excellent match between the planned and experimental lesion shapes., Conclusions: The advanced software was proven efficient in planning and executing full ablation of any segmented target. The reliability of the algorithm could be enhanced through the development of a fully automated segmentation procedure., (© 2022 Cyprus University of Technology. The International Journal of Medical Robotics and Computer Assisted Surgery on behalf of John Wiley & Sons Ltd.)

Agar gels were previously proven capable of accurately replicating the acoustical and thermal properties of real tissue and widely used for the construction of tissue-mimicking phantoms (TMPs) for focused ultrasound (FUS) applications. Given the current popularity of magnetic resonance-guided FUS (MRgFUS), we have investigated the MR relaxation times T1 and T2 of different mixtures of agar-based phantoms. Nine TMPs were constructed containing agar as the gelling agent and various concentrations of silicon dioxide and evaporated milk. An agar-based phantom doped with wood powder was also evaluated. A series of MR images were acquired in a 1.5 T scanner for T1 and T2 mapping. T2 was predominantly affected by varying agar concentrations. A trend toward decreasing T1 with an increasing concentration of evaporated milk was observed. The addition of silicon dioxide decreased both relaxation times of pure agar gels. The proposed phantoms have great potential for use with the continuously emerging MRgFUS technology. The MR relaxation times of several body tissues can be mimicked by adjusting the concentration of ingredients, thus enabling more accurate and realistic MRgFUS studies., (© 2022 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine.)

Background: A robotic system for Magnetic Resonance guided Focussed Ultrasound (MRgFUS) therapy of tumours in the breast, bone, thyroid, and abdomen was developed., Methods: A special C-shaped structure was designed to be attached to the table of conventional magnetic resonance imaging (MRI) systems carrying 4 computer-controlled motion stages dedicated to positioning a 2.75 MHz spherically focussed transducer relative to a patient placed in the supine position. The developed system was evaluated for its MRI compatibility and heating abilities in agar-based phantoms and freshly excised tissue., Results: Compatibility of the system with a clinical high-field MRI scanner was demonstrated. FUS heating in the phantom was successfully monitored by magnetic resonance thermometry without any evidence of magnetically induced phenomena. Cigar-shaped discrete lesions and well-defined areas of overlapping lesions were inflicted in excised tissue by robotic movement along grid patterns., Conclusions: The developed MRgFUS robotic system was proven safe and efficient by ex-vivo feasibility studies., (© 2022 John Wiley & Sons Ltd.)

High quality tissue-mimicking phantoms (TMPs) have a critical role in the preclinical testing of emerging modalities for diagnosis and therapy. TMPs capable of accurately mimicking real tissue in Magnetic Resonance guided Focused Ultrasound (MRgFUS) applications should be fabricated with precise T1 and T2 relaxation times. Given the current popularity of the MRgFUS technology, we herein performed a systematic review on the MR relaxation properties of different phantoms types. Polyacrylamide (PAA) and agar based phantoms were proven capable of accurately replicating critical thermal, acoustical, and MR relaxation properties of various body tissues. Although gelatin phantoms were also proven factional in this regard, they lack the capacity to withstand ablation temperatures, and thus, are only recommended for hyperthermia applications. Other gelling agents identified in the literature are Poly-vinyl alcohol (PVA), Polyvinyl Chloride (PVC), silicone, and TX-150/ TX-151; however, their efficacy in thermal studies is yet to be established. PAA gels are favorable in that they offer optical transparency enabling direct visualization of coagulative lesions. On the other hand, agar phantoms have lower preparation costs and were proven very promising for use with the MRgFUS technology, without the toxicity issues related to the preparation and storage of PAA materials. Remarkably, agar turned out to be the prominent modifier of the T2 relaxation time even for phantoms containing other types of gelling agents instead of agar. This review could be useful in manufacturing realistic MRgFUS phantoms while simultaneously indicating an opportunity for further research in the field with a particular focus on the MR behavior of agar-based TMPs., (Copyright © 2021 Elsevier B.V. All rights reserved.)

An orange peel waste biorefinery was developed employing a design of experiments approach to optimize the ultrasound-assisted dilute acid hydrolysis process applied for production of useful commodities. Central composite design-based response surface methodology was used to approximate the combined effects of process parameters in simultaneous production of essential oils, pectin and a sugar-rich hydrolyzate. Application of a desirability function determined the optimal conditions required for maximal production efficiency of essential oils, pectin and sugars as 5.75% solid loading, 1.21% acid concentration and 34.2 min duration. Maximum production yields of 0.12% w/w essential oils, 45% w/w pectin and 40% w/w sugars were achieved under optimized conditions in lab- and pilot-scale facilities. The hydrolyzate formed was applied in bacterial cellulose fermentations producing 5.82 g biopolymer per 100 g waste. Design of experiments was efficient for process analysis and optimization providing a systems platform for the study of biomass-based biorefineries., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: A prototype robotic system that uses magnetic resonance guided focused ultrasound (MRgFUS) technology is presented. It features three degrees of freedom (DOF) and is intended for thermal ablation of abdominal cancer., Methods: The device is equipped with three identical transducers being offset between them, thus focussing at different depths in tissue. The efficacy and safety of the system in ablating rabbit liver and kidney was assessed, both in laboratory and magnetic resonance imaging (MRI) conditions., Results: Despite these organs' challenging location, in situ coagulative necrosis of a tissue area was achieved. Heating of abdominal organs in rabbit was successfully monitored with MR thermometry., Conclusions: The MRgFUS system was proven successful in creating lesions in the abdominal area of rabbits. The outcomes of the study are promising for future translation of the technology to the clinic., (© 2021 John Wiley & Sons Ltd.)

Background: Conventional motion algorithms utilized during High Intensity Focused Ultrasound (HIFU) procedures usually sonicate successive tissue cells, thereby inducing excess deposition of thermal dose in the pre-focal region. Long delays (~60 s) are used to reduce the heating around the focal region. In the present study the experimental evaluation of six motion algorithms so as to examine the required delay and algorithm for which the pre-focal (near-field) and post-focal (far-field) heating can be reduced using thermal dose estimations is presented., Materials and Methods: A single element spherically focused transducer operating at 1.1 MHz and focusing beam at 9 cm, was utilized for sonication on a 400 mm 2 area of an agar-based phantom. Movement of the transducer was performed with each algorithm, using 0-60 s (10 s step) delays between sonications. Temperatures were recorded at both near and far-field regions and thermal dose calculations were implemented., Results: With the algorithms used in the present study, a delay of 50-60 s was required to reduce heating in the near-field region. A 30 s delay induced a safe thermal dose in the far-field region using all algorithms except sequential which still required 60 s delay., Conclusions: The study verified the conservative need for 60 s delay for the sequential plan treatment. Nevertheless, present findings suggest that prolonged treatment times can be significantly reduced in homogeneous tissues by selection of the optimized nonlinear algorithm and delay., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Robotic-assisted diagnostic and therapeutic modalities require a highly accurate performance to be certified for clinical application. In this paper, three simple methods for assessing the accuracy of motion of magnetic resonance-guided focused ultrasound (MRgFUS) robotic systems are presented., Methods: The accuracy of motion of a 4 degrees of freedom robotic system intended for preclinical use of MRgFUS was evaluated by calliper-based and magnetic resonance imaging (MRI) methods, as well as visually by performing multiple ablations on a plastic film., Results: The benchtop results confirmed a highly accurate motion in all axes of operation. The spatial positioning errors estimated by MRI evaluation were defined by the size of the imaging pixels. Lesions arrangement in discrete and overlapping patterns confirmed satisfactory alignment of motion trajectories., Conclusions: We believe the methods presented here should serve as a standard for evaluating the accuracy of motion of MRgFUS robotic systems., (© 2021 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons Ltd.)

Objectives: A positioning device compatible with magnetic resonance imaging (MRI) used for preclinical studies in small animals was developed that fits in MRI scanners up to 7 T. The positioning device was designed with two computer-controlled linear stages., Methods: The positioning device was evaluated in an agar-based phantom, which mimics soft tissues, and in a rabbit. Experiments with this positioning device were performed in an MRI system using the agar-based phantom. The transducer used had a diameter of 50 mm, operated at 0.5 MHz, and focused energy at 60 mm., Results: Magnetic resonance thermometry was used to assess the functionality of the device, which showed adequate deposition of thermal energy and sufficient positional accuracy in all axes., Conclusions: The proposed system fits in MRI scanners up to 7 T. Because of the size of the positioning device, at the moment, it can be used to perform preclinical studies on small animals such as mice, rats, and rabbits., (© 2020 The Authors. Journal of Ultrasound in Medicine published by Wiley Periodicals LLC on behalf of American Institute of Ultrasound in Medicine.)

Background: A magnetic resonance image (MRI) guided robotic device for focussed ultrasound therapy of prostate cancer (PC) was developed. The device offers movement in 5 degrees of freedom (DOF) and uses a single-element transducer that operates at 3.2 MHz, has a diameter of 25 mm and focuses at 45 mm., Methods: The MRI compatibility of the system was evaluated in a 1.5 T scanner. The ability of the transducer to create lesions was evaluated in laboratory and MRI settings, on ex vivo pork tissue and in vivo rabbit thigh tissue., Results: Cavitational and thermal lesions were created on the excised pork tissue. In vivo experiments proved the efficacy of the system in ablating muscle tissue without damaging intervening areas., Conclusions: The MRI compatible robotic system can be placed on the table of any commercial MRI scanner up to 7 T. The device has the ability of future use for transrectal focal therapy of PC with the patient in supine position., (© 2021 Cyprus University of Technology. The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons Ltd.)

Background: It has been demonstrated that agar-based gel phantoms can emulate the acoustic parameters of real tissues and are the most commonly used tissue-mimicking materials for high-intensity focused ultrasound applications. The following study presents ultrasonic attenuation measurements of agar-based phantoms with different concentrations of additives (percent of agar, silicon dioxide and evaporated milk) in an effort of matching the material's acoustic property as close as possible to human tissues., Methods: Nine different agar-based phantoms with various amounts of agar, silicon dioxide, and evaporated milk were prepared. Attenuation measurements of the samples were conducted using the through-transmission immersion techniques., Results: The ultrasonic attenuation coefficient of the agar-based phantoms varied in the range of 0.30-1.49 dB/cm-MHz. The attenuation was found to increase in proportion to the concentration of agar and evaporated milk. Silicon dioxide was found to significantly contribute to the attenuation coefficient up to 4% weight to volume (w/v) concentration., Conclusion: The acoustic attenuation coefficient of agar-based phantoms can be adjusted according to the tissue of interest in the range of animal and human tissues by the proper selection of agar, silicon dioxide, and evaporated milk., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Medical Ultrasound.)

Background: Magnetic resonance-guided focused ultrasound surgery is an incisionless energy-based thermal method that is used for ablating tumors in the veterinary clinic., Aims and Objectives: In this article we describe a prototype of a veterinary system compatible with magnetic resonance imaging intended for small-to-medium-sized companion animals that was developed and tested in vivo in adult rabbits., Methods: Real-time monitoring of the ablation during the experiment was possible with MR thermometry. Experiments involved thermal monitoring of sonications applied in the thigh of the rabbits. A 38-mm diameter transducer operating at 2.6 MHz was used with a 60-mm-focal length. The robotic system employed 3 linear axes and one angular axis. For this study, only X and Y axis were enabled. Due to the target size limitations, motion in Z and Θ was not needed. The functionality of the positioning device was evaluated by means of MR thermometry, demonstrating sufficient heating and accurate motion in both axes of operation., Results: The postmortem findings confirm the ability of the system to induce thermal ablations in vivo in the absence of adverse effects., Conclusions: The device is a reliable and affordable solution for companion animal hospitals, offering and additional tool for the veterinary oncology society., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Medical Ultrasound.)

This study describes the development and characterization of an agar-based soft tissue-mimicking material (TMM) doped with wood powder destined for fabricating MRgFUS applications. The main objective of the following work was to investigate the suitability of wood powder as an inexpensive alternative in replacing other added materials that have been suggested in previous studies for controlling the ultrasonic properties of TMMs. The characterization procedure involved a series of experiments designed to estimate the acoustic (attenuation coefficient, absorption coefficient, propagation speed, and impedance), thermal (conductivity, diffusivity, specific heat capacity), and MR properties (T 1 and T 2 relaxation times) of the wood-powder doped material. The developed TMM (2% w/v agar and 4% w/v wood powder) as expected demonstrated compatibility with MRI scanner following images artifacts evaluation. The acoustic attenuation coefficient of the proposed material was measured over the frequency range of 1.1-3 MHz and found to be nearly proportional to frequency. The measured attenuation coefficient was 0.48 dB/cm at 1 MHz which was well within the range of soft tissue. Temperatures over 37 °C proved to increase marginally the attenuation coefficient. Following the transient thermoelectric method, the acoustic absorption coefficient was estimated at 0.34 dB/cm-MHz. The estimated propagation speed (1487 m/s) was within the range of soft tissue at room temperature, while it significantly increased with higher temperature. The material possessed an acoustic impedance of 1.58 MRayl which was found to be comparable to the corresponding value of muscle tissue. The thermal conductivity of the material was estimated at 0.51 W/m K. The measured relaxation times T 1 (844 ms) and T 2 (66 ms) were within the range of values found in the literature for soft tissue. The phantom was tested for its suitability for evaluating MRgFUS thermal protocols. High acoustic energy was applied, and temperature change was recorded using thermocouples and MR thermometry. MR thermal maps were acquired using single-shot Echo Planar Imaging (EPI) gradient echo sequence. The TMM matched adequately the acoustic and thermal properties of human tissues and through a series of experiments, it was proven that wood concentration enhances acoustic absorption. Experiments using MR thermometry demonstrated the usefulness of this phantom to evaluate ultrasonic thermal protocols by monitoring peak temperatures in real-time. Thermal lesions formed above a thermal dose were observed in high-resolution MR images and visually in dissections of the proposed TMM., (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)

With focused ultrasound (FUS) gaining popularity as a therapeutic modality for brain diseases, the need for skull phantoms that are suitable for evaluating FUS protocols is increasing. In the current study, the acoustical properties of several three-dimensional (3D) printed thermoplastic samples were evaluated to assess their suitability to mimic human skull and bone accurately. Samples were 3D printed using eight commercially available thermoplastic materials. The acoustic properties of the printed samples, including attenuation coefficient, speed of sound, and acoustic impedance, were investigated using transmission-through and pulse-echo techniques. The ultrasonic attenuation, estimated at a frequency of 1.1 MHz, varied from approximately 7 to 32 dB/cm. The frequency dependence of attenuation was described by a power law in the frequency range of 0.2-3.5 MHz, and the exponential index of frequency was found to vary from 1.30 to 2.24. The longitudinal velocity of 2.7 MHz sound waves was in the range of 1700-3050 m/s. The results demonstrate that thermoplastics could potentially be used for the 3D construction of high-quality skull phantoms.