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As of 2022, breast cancer continues to be the most diagnosed cancer worldwide. This problem persists within the United States as well, as the American Cancer Society has reported that ∼12.5% of women will be diagnosed with invasive breast cancer over the course of their lifetime. Therefore, a clinical need continues to exist to address this disease from a treatment and therapeutic perspective. Current treatments for breast cancer and cancers more broadly include surgery, radiation, and chemotherapy. Adjuncts to these methods have been developed to improve the clinical outcomes for patients. One such adjunctive treatment is mild hyperthermia therapy (MHTh), which has been shown to be successful in the treatment of cancers by increasing effectiveness and reduced dosage requirements for radiation and chemotherapies. MHTh-assisted treatments can be performed with invasive thermal devices, noninvasive microwave induction, heating and recirculation of extracted patient blood, or whole-body hyperthermia with hot blankets.One common method for inducing MHTh is by using microwave for heat induction and magnetic resonance imaging for temperature monitoring. However, this leads to a complex, expensive, and inaccessible therapy platform. Therefore, in this work we aim to show the feasibility of a novel all-acoustic MHTh system that uses focused ultrasound (US) to induce heating while also using US tomography (UST) to provide temperature estimates. Changes in sound speed (SS) have been shown to be strongly correlated with temperature changes and can therefore be used to indirectly monitor heating throughout the therapy. Additionally, these SS estimates allow for heterogeneous SS-corrected phase delays when heating complex and heterogeneous tissue structures.Feasibility to induce localized heat in tissue was investigated in silico with a simulated breast model, including an embedded tumor using continuous wave US. Here, both heterogenous acoustic and thermal properties were modeled in addition to blood perfusion. We further demonstrate, with ex vivo tissue phantoms, the feasibility of using ring-based UST to monitor temperature by tracking changes in SS. Two phantoms (lamb tissue and human abdominal fat) with latex tubes containing varied temperature flowing water were imaged. The measured SS of the water at each temperature were compared against values that are reported in literature.Results from ex vivo tissue studies indicate successful tracking of temperature under various phantom configurations and ranges of water temperature. The results of in silico studies show that the proposed system can heat an acoustically and thermally heterogenous breast model to the clinically relevant temperature of 42°C while accounting for a reasonable time needed to image the current cross section (200 ms). Further, we have performed an initial in silico study demonstrating the feasibility of adjusting the transmit waveform frequency to modify the effective heating height at the focused region. Lastly, we have shown in a simpler 2D breast model that MHTh level temperatures can be maintained by adjusting the transmit pressure intensity of the US ring.This work has demonstrated the feasibility of using a 256-element ring array transducer for temperature monitoring; however, future work will investigate minimizing the difference between measured SS and the values shown in literature. A hypothesis attributes this bias to potential volumetric average artifacts from the ray-based SS inversion algorithm that was used, and that moving to a waveform-based SS inversion algorithm will greatly improve the SS estimates. Additionally, we have shown that an all-acoustic MHTh system is feasible via in silico studies. These studies have indicated that the proposed system can heat a tumor within a heterogenous breast model to 42°C within a narrow time frame. This holds great promise for increasing the accessibility and reducing the complexity of a future all-acoustic MHTh system.

Isolating the mainlobe and sidelobe contribution to the ultrasound image can improve imaging contrast by removing off-axis clutter. Previous work achieves this separation of mainlobe and sidelobe contributions based on the covariance of received signals. However, the formation of a covariance matrix at each imaging point can be computationally burdensome and memory intensive for real-time applications. Our work demonstrates that the mainlobe and sidelobe contributions to the ultrasound image can be isolated based on the receive aperture spectrum, greatly reducing computational and memory requirements.The separation of mainlobe and sidelobe contributions to the ultrasound image is shown in simulation,The aperture spectrum approach improves contrast by 1.9 to 6.4 dB beyond MIST and 8.9 to 13.5 dB beyond conventional DAS B-mode imaging. However, the aperture spectrum approach yields speckle texture similar to DAS. As a result, the aperture spectrum-based approach has less CNR than MIST but greater CNR than conventional DAS. The CPU implementation of the aperture spectrum-based approach is shown to reduce computation time by a factor of 9 and memory consumption by a factor of 128 for a 128-element transducer.The mainlobe contribution to the ultrasound image can be isolated based on the receive aperture spectrum, which greatly reduces the computational cost and memory requirement of this approach as compared with MIST.

Ultrasound computed tomography (USCT) is a promising imaging technique for breast cancer diagnosis. Full-waveform inversion (FWI)-based image reconstruction methods based on the acoustic wave equation can produce quantitatively accurate images of acoustic properties with higher spatial resolution compared to ray-based methods. One common USCT design employs a circular ring-array of elevation-focused ultrasonic transducers that can be translated orthogonally to the imaging plane to achieve volumetric scanning. Currently, slice-by-slice (SBS) reconstruction methods are often used in this setting. Such methods use a 2D wave physic model to reconstruct a cross-sectional image for each position of the ring-array and vertically stack them together to render the 3D volume. However, this approach neglects the 3D wave propagation physics and transducer’s focusing properties, leading to out-of-plane scattering artifacts and degraded spatial resolution. To address this, a 3D time-domain FWI method that utilizes measurement data acquired at multiple adjacent ring-array locations is proposed. The reconstruction method was investigated using virtual imaging studies of ring-array-based USCT that employed realistic 3D numerical breast phantoms. The results demonstrated improved spatial resolution (both in-plane and off-plane) and reduced image artifacts compared to the SBS approach. Additionally, the impact of the number of ring-array locations on image quality is assessed.