The mechanical index (MI) attempts to quantify the likelihood that exposure to diagnostic ultrasound will produce an adverse biological effect by a nonthermal mechanism. The current formulation of the MI implicitly assumes that the acoustic field is generated using the short pulse durations appropriate to B-mode imaging. However, acoustic radiation force impulse (ARFI) imaging employs high-intensity pulses up to several hundred acoustic periods long. The effect of increased pulse durations on the thresholds for inertial cavitation was studied computationally in water, urine, blood, cardiac and skeletal muscle, brain, kidney, liver and skin. The results show that while the effect of pulse duration on cavitation thresholds in the three liquids can be considerable, reducing them by, e.g., 6% – 24% at 1 MHz, the effect in tissue is minor. More importantly, the frequency dependence of the MI appears to be unnecessarily conservative, i.e., that the magnitude of the exponent on frequency could be increased to 0.75. Comparison of these theoretical results with experimental measurements suggests that some tissues do not contain the pre-existing, optimally sized bubbles assumed for the MI. This means that in these tissues the MI is not necessarily a strong predictor of the probability for an adverse biological effect.

Aim: Development of MRI sequences and processing methods for the production of images appropriate for direct use in stereotactic radiosurgery (SRS) treatment planning.Background: MRI is useful in SRS treatment planning, especially for patients with brain lesions or anatomical targets that are poorly distinguished by CT, but its use requires further refinement. This methodology seeks to optimize MRI sequences to generate distortion-free and clinically relevant MR images for MRI-only SRS treatment planning. Materials and methods:We used commercially available SRS MRI-guided radiotherapy phantoms and eight patients to optimize sequences for patient imaging. Workflow involved the choice of correct MRI sequence(s), optimization of the sequence parameters, evaluation of image quality (artifact free and clinically relevant), measurement of geometrical distortion, and evaluation of the accuracy of our offline correction algorithm.Results: CT images showed a maximum deviation of 1.3 mm and minimum deviation of 0.4 mm from true fiducial position for SRS coordinate definition. Interestingly, uncorrected

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The mechanical index (MI) quantifies the likelihood that exposure to diagnostic ultrasound will produce an adverse biological effect by a nonthermal mechanism. The current formulation of the MI is based on inertial cavitation thresholds in two liquids, water and blood, as calculated by a formalism assuming very short pulse durations. Although tissue contains a high proportion of water, it is not a liquid but a viscoelastic solid. Further, acoustic radiation force impulse imaging employs high-intensity pulses up to several hundred acoustic periods long. The effect of these differences was studied in water, blood and five representative tissues.

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