High intensity focused ultrasound enhanced by cavitation

1. A medical apparatus comprising:

high intensity focused ultrasound system configured for generating focused ultrasonic energy for sonicating within a target volume of a subject, wherein the high intensity focused ultrasound system comprises an ultrasonic transducer with a controllable focus;

a memory containing machine executable instructions for controlling the medical apparatus;

a processor configured for controlling high intensity focused ultrasound system based on the instructions to:

cause ultrasonic cavitations at multiple cavitation locations on a rear surface of the target volume to form an acoustically reflective shield, wherein the multiple cavitation locations are targeted by adjusting the controllable focus; and

sonicate multiple sonication locations within the target volume in front of the acoustically reflective shield and below a threshold which induces cavitation, wherein the multiple sonication locations are targeted by adjusting the controllable focus.

2. The medical apparatus of claim 1 , further including:

a passive cavitation detector, and

wherein the processor is further configured to:

measure a cavitation spectrum using the passive cavitation detector during the causing of the ultrasonic cavitation; and

control at least partially the cavitation in accordance with the cavitation spectrum by controlling the high intensity focused ultrasound system.

3. The medical apparatus of claim 1 , further including:

multiple passive cavitation detectors, and

wherein the processor is further configured to:

detect a cavitation location using the multiple cavitation detectors during the causing of the ultrasonic cavitation; and

control at least partially the cavitation in accordance with the cavitation location by controlling the high intensity focused ultrasound system.

4. The medical apparatus of claim 1 , further including:

an ultrasound measurement transducer configured for performing pulse-echo measurements, and

wherein the processor is further configured to:

measure at least one pulse-echo measurement with the ultrasound measurement transducer during or after the causing of the ultrasonic cavitation; and

control at least partially the cavitation in accordance with the pulse-echo measurement by controlling the high intensity focused ultrasound system.

5. The medical apparatus of claim 1 , wherein the ultrasonic cavitations and the sonication of multiple sonication locations is repeated by the processor multiple times.

6. The medical apparatus of claim 1 , wherein the processor is configured to arrange the multiple cavitation locations in a circular pattern.

7. The medical apparatus of claim 1 wherein the processor is configured to arrange the multiple cavitation locations to be identical with the multiple sonication locations.

8. The medical apparatus of claim 1 , further including:

a magnetic resonance imaging system configured for acquiring magnetic resonance thermometry data from an imaging zone, wherein the target volume is within the imaging zone, and

wherein the processor is further configured to:

control the magnetic resonance imaging system to acquire the magnetic resonance thermometry data during the sonication of the multiple sonication locations; and

control the high intensity focused ultrasound system to adjust the sonication of the multiple sonication locations in accordance with the magnetic resonance thermometry data.

9. The medical apparatus of claim 8 , wherein the magnetic resonance imaging system is further configured for acquiring phase image magnetic resonance data, and

wherein the processor is further configured to:

control the magnetic resonance imaging system to acquire the phase image magnetic resonance data during ultrasonic cavitations at multiple cavitation locations;

control the high intensity focused ultrasound system to adjust the ultrasonic cavitations in accordance with the phase image magnetic resonance data.

10. The medical apparatus of claim 1 , wherein ultrasonic cavitations at the multiple cavitation locations form an acoustic barrier.

11. A method of operating a medical apparatus, wherein the medical apparatus comprises a high intensity focused ultrasound system configured for generating focused ultrasonic energy for sonicating within a target volume of a subject, wherein the high intensity focused ultrasound system comprises an ultrasonic transducer with a controllable focus, wherein the method comprises the steps of:

creating an acoustic shield by causing ultrasonic cavitations at multiple cavitation locations at a rear of the target volume using the high intensity focused ultrasound system, wherein the multiple cavitation locations are targeted by adjusting the controllable focus; and

sonicating multiple sonication locations within the target volume using the high intensity focused ultrasound system and below a threshold which induces cavitation, wherein the multiple sonication locations are targeted by adjusting the controllable focus, wherein the acoustic shield prevents acoustic propagation into tissue behind the acoustic shield during the sonicating.

12. The method of claim 11 , wherein the medical apparatus further comprises a passive cavitation detector, wherein the method further comprises the steps of:

detecting a cavitation spectrum using the passive cavitation detector during the causing of the ultrasonic cavitation; and

controlling at least partially the cavitation in accordance with the cavitation spectrum by controlling the high intensity focused ultrasound system.

13. The method of claim 11 , wherein the medical apparatus further comprises multiple passive cavitation detectors, wherein the method further comprises the steps of:

detecting a cavitation location using the multiple cavitation detectors during the causing of the ultrasonic cavitation; and

controlling at least partially the cavitation in accordance with the cavitation location by controlling the high intensity focused ultrasound system.

14. A non-transitory computer-readable medium carrying software which controls one or more processors to:

control a high intensity focused ultrasound system which includes at least one ultrasound transducer to form a bubble cloud by causing ultrasonic cavitations at multiple cavitation locations within the target volume; and

control the high intensity focused ultrasound system to sonicate multiple sonication locations within the target volume and below a threshold which induces cavitation;

wherein the bubble cloud is configured to prevent acoustic propagation to tissue beyond the bubble cloud during the sonication.

15. A medical apparatus comprising:

a high intensity focused ultrasound system including at least one ultrasound transducer with a controllable focus;

one or more processors configured to:

control the high intensity focused ultrasound system to cavitate tissue in a target volume to create an acoustically reflected barrier, and

sonicate a plurality of locations adjacent the acoustically reflective barrier by applying high intensity focused ultrasound at a plurality of locations in a target region adjacent the acoustically reflective barrier, the acoustically reflective barrier and the plurality of sonication locations being configured such that the acoustically reflective barrier prevents the high intensity focused ultrasound applied during the sonication from propagating through the barrier to tissue on another side of the acoustically reflective barrier.