Motion compensation with skin contact control for high intensity focused ultrasound surgery in moving organs

Abstract

High intensity focused ultrasound (HIFU) is an emerging therapeutic solution that enables non-invasive treatment of several pathologies, mainly in oncology. On the other hand, accurate targeting of moving abdominal organs (e.g. liver, kidney, pancreas) is still an open challenge. This paper proposes a novel method to compensate the physiological respiratory motion of organs during HIFU procedures, by exploiting a robotic platform for ultrasound-guided HIFU surgery provided with a therapeutic annular phased array transducer. The proposed method enables us to keep the same contact point between the transducer and the patient's skin during the whole procedure, thus minimizing the modification of the acoustic window during the breathing phases. The motion of the target point is compensated through the rotation of the transducer around a virtual pivot point, while the focal depth is continuously adjusted thanks to the axial electronically steering capabilities of the HIFU transducer. The feasibility of the angular motion compensation strategy has been demonstrated in a simulated respiratory-induced organ motion environment. Based on the experimental results, the proposed method appears to be significantly accurate (i.e. the maximum compensation error is always under 1 mm), thus paving the way for the potential use of this technique for in vivo treatment of moving organs, and therefore enabling a wide use of HIFU in clinics.

Effects of Regional and General Anesthesia on the Therapeutic Outcome of Benign Thyroid Nodules Treated with High Intensity Focused Ultrasound (HIFU)

“…Research is already being conducted in relation to other organs to develop motion compensation techniques. [19–21]…”

Latest Advances in the Use of Therapeutic Focused Ultrasound in the Treatment of Pancreatic Cancer

“…To improve the safety and efficacy of HIFU treatments, methods of compensating for respiratory motion and improving thermometry have been developed, e.g., by fluidfilling the digestive tract surrounding the pancreas of patients [166][167][168][169][170]. For example, simulation data in seven patients showed that the air in the digestive tract and its proximity to the pancreas led to errors in temperature of more than 10 • C due to differences in the magnetic susceptibility between the two tissues and peristaltic motion.…”

A Review on Advances in Intra-operative Imaging for Surgery and Therapy: Imagining the Operating Room of the Future

“…Intraoperatively, [167] introduced focal spot localization using Harmonic Motion Imaging (HMI). The motion of the organs can be compensated using robotic end-effectors [168].…”