title: Evaluation of focused ultrasound algorithms: Issues for reducing pre-focal heating and treatment time.
abstract: BACKGROUND
  Due to the heating in the pre-focal field the delay between successive movements in high intensity focused ultrasound (HIFU) are sometimes as long as 60s, resulting to treatment time in the order of 2-3h. Because there is generally a requirement to reduce treatment time, we were motivated to explore alternative transducer motion algorithms in order to reduce pre-focal heating and treatment time.
  
  
  METHODS
  A 1 MHz single element transducer with 4 cm diameter and 10 cm focal length was used. A simulation model was developed that estimates the temperature, thermal dose and lesion development in the pre-focal field. The simulated temperature history that was combined with the motion algorithms produced thermal maps in the pre-focal region. Polyacrylimde gel phantom was used to evaluate the induced pre-focal heating for each motion algorithm used, and also was used to assess the accuracy of the simulation model.
  
  
  RESULTS
  Three out of the six algorithms having successive steps close to each other, exhibited severe heating in the pre-focal field. Minimal heating was produced with the algorithms having successive steps apart from each other (square, square spiral and random). The last three algorithms were improved further (with small cost in time), thus eliminating completely the pre-focal heating and reducing substantially the treatment time as compared to traditional algorithms.
  
  
  CONCLUSIONS
  Out of the six algorithms, 3 were successful in eliminating the pre-focal heating completely. Because these 3 algorithms required no delay between successive movements (except in the last part of the motion), the treatment time was reduced by 93%. Therefore, it will be possible in the future, to achieve treatment time of focused ultrasound therapies shorter than 30 min. The rate of ablated volume achieved with one of the proposed algorithms was 71 cm(3)/h. The intention of this pilot study was to demonstrate that the navigation algorithms play the most important role in reducing pre-focal heating. By evaluating in the future, all commercially available geometries, it will be possible to reduce the treatment time, for thermal ablation protocols intended for oncological targets.
authors.affiliation: Cyprus University of Technology, Limassol, Cyprus.
authors.forename: Marinos
authors.initials: M
authors.lastname: Yiannakou
authors.affiliation: Cyprus University of Technology, Limassol, Cyprus.
authors.forename: Michael
authors.initials: M
authors.lastname: Trimikliniotis
authors.affiliation: Cyprus University of Technology, Limassol, Cyprus; MEDSONIC, Limassol, Cyprus.
authors.forename: Christos
authors.initials: C
authors.lastname: Yiallouras
authors.affiliation: Cyprus University of Technology, Limassol, Cyprus.
authors.forename: Christakis
authors.initials: C
authors.lastname: Damianou
mesh_terms: D000465:Algorithms; D001831:Body Temperature / Q000502:physiology* / Q000528:radiation effects*; D003198:Computer Simulation; D019220:High-Energy Shock Waves; D057086:High-Intensity Focused Ultrasound Ablation / Q000379:methods*; D006801:Humans; D008954:Models, Biological; D013813:Therapy, Computer-Assisted / Q000379:methods*
keywords: Algorithm; Pre-focal field; Ultrasound