Dual-mode ultrasound arrays for image-guided targeting of atheromatous plaques

John R. Ballard, Andrew J. Casper, Dalong Liu, Alyona Haritonova, Islam A. Shehata, Mitchell Troutman, Emad S. Ebbini

Research output: Chapter in Book/Report/Conference proceedingConference contribution

4 Scopus citations


A feasibility study was undertaken in order to investigate alternative noninvasive treatment options for atherosclerosis. In particular, the aim of this study was to investigate the potential use of Dual-Mode Ultrasound Arrays (DMUAs) for image guided treatment of atheromatous plaques. DMUAs offer a unique treatment paradigm for image-guided surgery allowing for robust image-based identification of tissue targets for localized application of HIFU. In this study we present imaging and therapeutic results form a 3.5 MHz, 64-element fenestrated prototype DMUA for targeting lesions in the femoral artery of familial hypercholesterolemic (FH) swine. Before treatment, diagnostic ultrasound was used to verify the presence of plaque in the femoral artery of the swine. Images obtained with the DMUA and a diagnostic (HST 15-8) transducer housed in the fenestration were analyzed and used for guidance in targeting of the plaque. Discrete therapeutic shots with an estimated focal intensity of 4000-5600 W/cm2 and 500-2000 msec duration were performed at several planes in the plaque. During therapy, pulsed HIFU was interleaved with single transmit focus imaging from the DMUA and M2D imaging from the diagnostic transducer for further analysis of lesion formation. After therapy, the swine's were recovered and later sacrificed after 4 and 7 days for histological analysis of lesion formation. At sacrifice, the lower half of the swine was perfused and the femoral artery with adjoining muscle was fixed and stained with H&E to characterize HIFU-induced lesions. Histology has confirmed that localized thermal lesion formation within the plaque was achieved according to the planned lesion maps. Furthermore, the damage was confined to the plaque tissue without damage to the intima. These results offer the promise of a new treatment potentially suited for vulnerable plaques. The results also provide the first real-time demonstration of DMUA technology in targeting fine tissue structures for precise lesion formation in the presence or arterial pulsation and tissue motion. In this paper, we show results from targeting both proximal and distal sides of the vessel wall with a series of 5 - 7 discrete shots in each plane (typically three planes per plaque). Experiments to demonstrate a full treatment forming contiguous lesion within the target plaque are currently underway.

Original languageEnglish (US)
Title of host publication12th International Symposium on Therapeutic Ultrasound
Number of pages5
StatePublished - 2012
Event12th International Symposium on Therapeutic Ultrasound, ISTU 2012 - Heidelberg, Germany
Duration: Jun 10 2012Jun 13 2012

Publication series

NameAIP Conference Proceedings
ISSN (Print)0094-243X
ISSN (Electronic)1551-7616


Other12th International Symposium on Therapeutic Ultrasound, ISTU 2012

Bibliographical note

Funding Information:
We would like to thank to Maria Angeles Busturia, Yeray Duque, Ascensión Valle and Eunate Arana for their clinical and technical help and thanks to Julia G Fenn (INC team) and Alejandro Urberuaga for their English translation. The study was financially supported by the Department of Health and Department of Education of the Government of the Basque Country (research grant: 200211011 , IT-472-07 ), Fundación Salud 2000 , Grant number 23301 and Fundación IKERTU . We extend our gratitude to the Sociedad Española de Endocrinología Pediátrica for the award “José Igea 2002” funded by Pfizer . Finally, we want to thank the children and their parents for their continued participation and involvement in this research.


  • Phased Arrays
  • Thermal Therapy


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