The Effect of High Intensity Focused Ultrasound Combined with Ethanol on the Lesion of Porcine Liver in Vitro

Document Type : Original Paper

Authors

1 School of Information Science and Engineering, Changsha Normal University, Changsha 410100, China

2 School of Physics and Electronics, Central South University, Changsha 410083, China

Abstract

Introduction: As a non-invasive method of tumor hyperthermia, high intensity focused ultrasound (HIFU) has been widely used in the treatment of various solid tumors in recent years. The purpose of this study was to investigate the effect of HIFU combined with ethanol on biological tissue lesions.
Material and Methods: Firstly, 0.5ml 95% ethanol was injected into the porcine liver tissue in vitro, then HIFU was used to irradiate the porcine liver. The B-mode ultrasound and needle hydrophone were used to monitor the cavitation. A thermocouple was also used to measure the real-time focal temperature. The ultrasonic signal scattered at the focal point of HIFU irradiation was collected by the fiber hydrophone, and the attenuation coefficient was calculated. Finally, the attenuation coefficient was input into the Khokhlov-Zabolotskaya-Kuznetov (KZK) equation and combined with the Pennes equation. The thermal lesion of the porcine liver was simulated by MATLAB software.
Results: The length of the long axis of the lesion area simulated by the attenuation coefficient of cavitation was closer to the length of the long axis of the actual measured lesion area with ethanol injection, but the length of the short axis of the simulated lesion area was smaller than that of the measured lesion area. However, the length of the long axis of the lesion area simulated by the attenuation coefficient of cavitation was larger than the length of the long axis of the lesion area simulated by the attenuation coefficient of liver at room temperature. The same results were obtained for the length of short axis.
Conclusion: HIFU combined with ethanol can produce larger lesions to biological tissues and improve the therapeutic effect.

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Main Subjects


  1. Xu D, Zou W J, Luo Y, Gao Y, Jiang B L, Wang Y T, et al. Feasibility between Bifidobacteria Targeting and Changes in the Acoustic Environment of tumor tissue for Synergistic HIFU. Scientific Reports. 2020; 10(1):1-9. DOI: 10.1038/s41598-020-64661-6.
  2. Zhou Y F. High intensity focused ultrasound in clinical tumor ablation. World Journal of Clinical Oncology. 2011; 2(1):8-27. DOI:10.5306/wjco.v2.i1.8.
  3. Chang N, Lu S, Qin D, Xu T, Han M, Wang S, et al. Efficient and controllable thermal ablation induced by short-pulsed HIFU sequence assisted with perfluorohexane nanodroplets. Ultrasonics Sonochemistry. 2018; 45:57-64. DOI: 10.1016/j.ultsonch.2018.02.033.
  4. Lang H, Woo Y, Chiu W. Combining high-intensity focused ultrasound (HIFU) ablation with percutaneous ethanol injection (PEI) in the treatment of benign thyroid nodules. European Radiology. 2020;1-8. DOI:10.1007/s00330-020-07317-3.
  5. Yang Z, Zhang Y, Zhang R, et al. A case-control study of high-intensity focused ultrasound combined with sonographically guided intratumoral ethanol injection in the treatment of uterine fibroids. Journal of Ultrasound in Medicine Official Journal of the American Institute of Ultrasound in Medicine. 2014; 33(4):657-65. DOI:10.7863/ultra.33.4.657.
  6. Hoang N H, Murad H Y, Ratnayaka S H, Chen C, Khismatullin D B. Synergistic ablation of liver tissue and liver cancer cells with high-intensity focused ultrasound and ethanol. Ultrasound in Medicine & Biology. 2014; 40(8): 1869-81. DOI: 10.1016/j.ultrasmedbio.2014.02.026.
  7. Flannigan D, Suslick K. Plasma formation and temperature measurement during single-bubble cavitation. Nature. 2005; 434(7029):52-55. DOI: 10.1038/nature03361.
  8. Gaudron R, Warnez, et al. Bubble dynamics in a viscoelastic medium with nonlinear elasticity. Journal of Fluid Mechanics. 2015; 766:54-75. DOI: 10.1017/jfm.2015.7.
  9. Sazgarnia A, Shanei A, Taheri A R, et al. Therapeutic Effects of Acoustic Cavitation in the Presence of Gold Nanoparticles on a Colon Tumor Model. J Ultrasound Med. 2013; 32(3):475- 83. DOI: 10.7863/jum.2013.32.3.475.
  10. Sazgarnia A, Shanei A, Shanei MM. Monitoring of transient cavitation induced by ultrasound and intense pulsed light in presence of gold nanoparticles. Ultrasonics Sonochemistry. 2014; 21(1):268-74. DOI: 10.1016/j.ultsonch.2013.07.008.
  11. Yu J, Chen C, Chen G, et al. Real-Time Monitoring and Quantitative Evaluation of Cavitation Bubbles Induced by High Intensity Focused Ultrasound Using B-Mode Imaging. Chinese Physics Letters. 2014; 31(3): 034302. DOI: 10.1088/0256-307X/31/3/034302.
  12. Charles C C. The mechanical index and bubbles in tissue, an evidentiary review. Journal of the Acoustical Society of America. 2013; 134(5): 3975. DOI: 10.1121/1.4830482.
  13. Hynynen K. The threshold for thermally significant cavitation in dog's thigh muscle in vivo. Ultrasound in Medicine & Biology. 1991; 17(2):157-69. DOI: 10.1016/0301-5629(91)90123-E.
  14. Maxwell A D, Cain C A, Hall T L, et al. Probability of Cavitation for Single Ultrasound Pulses Applied to Tissues and Tissue-Mimicking Materials. Ultrasound in Medicine & Biology. 2013; 39(3):449-65. DOI: 10.1016/j.ultrasmedbio.2012.09.004.
  15. Vlaisavljevich E, Aydin O, Lin K W, et al. The role of positive and negative pressure on cavitation nucleation in nanodroplet-mediated histotripsy. Physics in Medicine & Biology. 2016; 61(2):663-82. DOI:10.1088/0031-9155/61/2/663.
  16. Bull V, Civale J, Rivens I, Haar G T. A Comparison of Acoustic Cavitation Detection Thresholds Measured with Piezo-electric and Fiber-optic Hydrophone Sensors. Ultrasound in Medicine & Biology. 2013; 39(12):2406-21. DOI: 10.1016/j.ultrasmedbio.2013.06.010.
  17. Shou W, Huang X, Duan S, et al. Acoustic power measurement of high intensity focused ultrasound in medicine based on radiation force. Ultrasonics. 2006;44(8):e17-e20. DOI:10.1016/ j.ultras.2006.06.034.
  18. Dasgupta S, Banerjee R K, Hariharan P, et al. Beam localization in HIFU temperature measurements using thermocouples, with application to cooling by large blood vessels. Ultrasonics. 2011; 51(2):171-80. DOI:10.1016/j.ultras.2010.07.007.
  19. Guntur S R, Choi M J. Influence of temperature-dependent thermal parameters on temperature elevation of tissue exposed to high-intensity focused ultrasound: numerical simulation. Ultrasound in Medicine & Biology. 2015; 41(3): 806-13. DOI: 10.1016/j.ultrasmedbio.2014.10.008.
  20. Mohammadpour M, Firoozabadi B. High intensity focused ultrasound (HIFU) ablation of porous liver: Numerical analysis of heat transfer and hemodynamics. Applied Thermal Engineering. 2020; 170:115014. DOI: 10.1016/j.applthermaleng.2020.115014.
  21. Filonenko E A, Khokhlova V A. Effect of acoustic nonlinearity on heating of biological tissue by high-intensity focused ultrasound. Acoustical Physics; 2001, 47(4):468-75. DOI:10.1134/ 1.1385422.
  22. Khokhlova V A, Bailey M R, Reed J A, et al. Effects of nonlinear propagation, cavitation, and boiling in lesion formation by high intensity focused ultrasound in a gel phantom. Journal of the Acoustical Society of America. 2006; 119(3):1834-48. DOI:10.1121/1.2161440.
  23. Saeid N H, Pop I. Viscous dissipation effects on free convection in a porous cavity. International Communications in Heat and Mass Transfer. 2004; 31(5):723-32. DOI:10.1016/ S0735-1933(04)00059-4.
  24. Kamangar S, Baig M A A, Azeem, et al. Finite element solution strategy for viscous dissipation in porous medium. AIP Conference Proceedings. 2019; 2014(1):030057-1. DOI:10.1063/ 1.5100484.
  25. Zhang Z, Chen T, Zhang D. Lesions in Porcine Liver tissues Created by Continuous High Intensity Ultrasound Exposures in Vitro. Chin.phys.lett. 2013; 30(2): 024302. DOI: 10.1088/0256- 307X/30/2/024302.
  26. Solovchuk M, Sheu W H, Thiriet M. Multiphysics Modeling of Liver Tumor Ablation by High Intensity Focused Ultrasound. Communications in Computational Physics.2015; 18(4):1050- 71. DOI:10.4208/cicp.171214.200715s.
  27. Gharloghi S, Gholami M, Haghparast A, et al. Numerical study for optimizing parameters of high intensity focused ultrasound-induced thermal field during liver tumor ablation: HIFU simulator. Iranian journal of medical physics. 2017; 14(1):15-22. DOI:10.22038/ijmp.2017. 19268.1176.
  28. Qi M, Liu J H, Mao Y W, Liu X Z. Temperature rise induced by an annular focused transducer with a wide aperture angle in multi-layer tissue. Chinese Physics B. 2018; 27(1):14301. DOI: 10.1088/1674-1056/27/1/014301.
  29. Guo G P, Su H D, Ding H P, Ma Q Y. Noninvasive temperature monitoring for high intensity focused ultrasound therapy based on electrical impedance tomography. Acta Physica Sinica. 2017; 66(16): 164301. DOI: 10.7498/aps.66.164301.
  30. Wang M, Zhou Y. Simulation of non-linear acoustic field and thermal pattern of phased-array high-intensity focused ultrasound (HIFU). Int J Hyperthermia. 2014;1-14. DOI:10.1109/IECBES. 2014.7047558.
  31. Sapareto S, Dewey W. Thermal dose determination in cancer therapy. Int J Radiat Oncol Biol Phys. 1984; 10:787– DOI: 10.1016/0360-3016(84)90379-1.
  32. Vaezy S, Shi X, Martin R W, et al. Real-time visualization of high-intensity focused ultrasound treatment using ultrasound imaging. Ultrasound in Medicine & Biology. 2001; 27(1): 33-42. DOI: 10.1016/S0301-5629(00)00279-9.
  33. Khokhlova T, Rosnitskiy P, Hunter C, Maxwell A, Kreider W, Haar G T, et al. Dependence of inertial cavitation induced by high intensity focused ultrasound on transducer F-number and nonlinear waveform distortion. Journal of the Acoustical Society of America. 2018; 144 (3): 1160-9. DOI: 10.1121/1.5052260.
  34. Keshavarzi A, Vaezy S, Kaczkowski P J, Keilman G, Martin R, Chi P E, et al. Attenuation coefficient and sound speed in human myometrium and uterine fibroid tumors. J Ultrasound Med. 2001; 20(5):473-80. DOI: 10.7863/jum.2001.20.5.473.
  35. Righetti R, Kallel F, Stafford R J, et al. Elastographic characterization of HIFU-induced lesions in canine livers. Ultrasound in Medicine & Biology. 1999; 25(7):1099-113. DOI: 10. 1016/j.tecto.2006.09.017.
  36. Sorensen S M, Mortensen F V, Nielsen D T. Radiofrequency ablation of colorectal liver metastases:long-term survival. Acta Radiologica. 2007;48(3):253-8. DOI:10.1080/ 028418506011 61539.
  37. Lide DR. CRC handbook of chemistry and physics. Vol. 85. CRC press, 2004.
  38. Chang P P, Chen W S, Mourad P D, et al. Thresholds for inertial cavitation in Albunex suspensions under pulsed ultrasound conditions. IEEE Transactions on Ultrasonics Ferroelectrics and Frequency Control. 2001; 48(1):161-70. DOI:10.1109/58.895927.
  39. Chen C, Liu Y, Maruvada S, et al. Effect of ethanol injection on cavitation and heating of tissues exposed to high-intensity focused ultrasound. Physics in Medicine & Biology. 2012; 57 (4): 937-61.DOI:10.1088/0031-9155/57/4/937.
  40. Vazquez G, Alvarez E, Navaza J M. Surface Tension of Alcohol Water + Water from 20 to 50℃. Journal of Chemical & Engineering Data. 1995; 40(3). DOI: 10.1021/je00019a016.
  41. Lauterborn W, Kurz T, Mettin R, et al. Acoustic cavitation and bubble dynamics. Archives of Acoustics. 2008; 33(4):609-17. DOI:10.1007/978-3-642-51070-0_10.
  42. Roy R A. A precise technique for the measurement of acoustic cavitation thresholds and some preliminary results. The Journal of the Acoustical Society of America.1985; 78(5):1799-805. DOI:10.1121/1.392767.