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A real-time dual-mode ultrasound array (DMUA) system for imaging and therapy is described. The system utilizes a concave (40-mm radius of curvature) 3.5 MHz, 32 element array and modular multi-channel transmitter/receiver. It is capable of operating in a variety of imaging and therapy modes (on transmit) and continuous receive on all array elements even during high-power operation. A signal chain consisting of field-programmable gate arrays (FPGA) and graphical processing units (GPU) is used to enable real-time, software-defined beamforming and image formation. Imaging data, from quality assurance phantoms as well as in vivo small and large animal models, are presented and discussed. Corresponding images obtained using a temporally-synchronized and spatially-aligned diagnostic probe confirm the DMUA’s ability to form anatomically-correct images with sufficient contrast in an extended field of view (FOV) around its geometric center. In addition, high frame rate DMUA data also demonstrate the feasibility of detection and localization of echo changes indicative of cavitation and/or tissue boiling during HIFU exposures with 45 – 50 dB dynamic range. The results also show that the axial and lateral resolution of the DMUA are consistent with its fnumber and bandwidth with well behaved speckle cell characteristics. These results point the way to a theranostic DMUA system capable of quantitative imaging of tissue property changes with high specificity to lesion formation using focused ultrasound.

We present experimental validation results of an adaptive, image-based refocusing algorithm of dualmode ultrasound arrays (DMUAs) in the presence of strongly scattering objects. This study is motivated by the need to develop noninvasive techniques for therapeutic targeting of tumors seated in organs where the therapeutic beam is partially obstructed by the ribcage, e.g., liver and kidney. We have developed an algorithm that takes advantage of the imaging capabilities of DMUAs to identify the ribs and the intercostals within the path of the therapeutic beam to produce a specified power deposition at the target while minimizing the exposure at the rib locations. This image-based refocusing algorithm takes advantage of the inherent registration between the imaging and therapeutic coordinate systems of DMUAs in the estimation of array directivity vectors at the target and rib locations. These directivity vectors are then used in solving a constrained optimization problem allowing for adaptive refocusing, directing the acoustical energy through the intercostals, and avoiding the rib locations. The experimental validation study utilized a 1-MHz, 64-element DMUA in focusing through a block of tissue-mimicking phantom [0.5 dB/(cm·MHz)] with embedded Plexiglas ribs. Single transmit focus (STF) images obtained with the DMUA were used for imageguided selection of the critical and target points to be used for adaptive refocusing. Experimental results show that the echogenicity of the ribs in STF images provide feedback on the reduction of power deposition at rib locations. This was confirmed by direct comparison of measured temperature rise and integrated backscatter at the rib locations. Direct temperature measurements also confirm the improved power deposition at the target and the reduction in power deposition at the rib locations. Finally, we have compared the quality of the image-based adaptive refocusing algorithm with a phase-conjugation solution obtained by direct measurement of the complex pressures at the target

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