Weighted ultrasound entropy imaging for HIFU ablation monitoring with improved sensitivity and contrast

Abstract Background Although B‐mode imaging has been widely used in ultrasound‐guided high‐intensity focused ultrasound (HIFU) treatment, challenges remain in improving its quality and sensitivity for monitoring the thermal dose. Recently, quantitative ultrasound (QUS) imaging has been recognized with the potential to better sense the changes in the microstructure of ablated tissues. Purpose This study proposed to use a QUS method called weighted ultrasound entropy (WUE) imaging to monitor the HIFU ablation. Methods Based on ex‐vivo and in‐vivo experiments, WUE images reflecting tissue changes during HIFU treatment under different acoustic power levels (174–308 W) were reconstructed with a newly established imaging framework. The performance of the proposed WUE imaging in the monitoring of HIFU treatment was compared with the corresponding B‐mode images in terms of their contrast‐to‐noise ratios (CNRs) between the focal region and the background. Results It was found that HIFU irradiation with higher power generated larger WUE values in the focal region, and the bright spots grew in size as the acoustic sonication proceeded. Compared with the in‐situ B‐mode images, the WUE images had higher image quality in indicating lesion formation, with a 39.2%–53.4% improvement in the CNR at different stages. Meanwhile, a correlation ( R = 0.84) between the damage area estimated in WUE images and that measured from the dissected ex‐vivo tissue samples was found. Conclusions WUE imaging is more sensitive and accurate than B‐mode imaging in monitoring HIFU therapy. These findings suggest that WUE imaging could be a promising technique for assisting ultrasound‐guided HIFU ablation.