Extension of boiling histotripsy lesions by axial focus steering during pulse delivery

Boiling histotripsy (BH) is a pulsed high intensity focused ultrasound (HIFU) method relying on the generation of high amplitude shocks and bubble activity to induce tissues liquefaction. A sequence of pulses, 1–20 ms long, generates boiling bubbles at the focus of the HIFU transducer within each pulse, and the remainder of the pulse then interacts with those bubbles. One effect is the creation of a prefocal bubble cloud due to shock scattering: the shock is inverted when reflected from the bubble wall resulting in sufficient negative pressure to reach intrinsic cavitation threshold immediately proximally to these bubbles. Here, a methodology is proposed to extend the length of this prefocal bubble cloud by steering the focus toward the transducer during the BH pulse and thus accelerate treatment. A BH system comprising a 1.5 MHz 256-element phased array connected to a Verasonics V1 system was used. High-speed imaging in transparent gels was performed to observe the extension of the bubble cloud resulting from shock scattering. Volumetric BH lesions were generated in ex vivo tissue. Results showed a threefold increase of the volumetric ablation rate with focus steering compared to standard BH. [Work supported by NIH R01EB007643, R01GM122859, and R01EB25187.]