Fundamental limitations of noninvasive temperature imaging by means of ultrasound echo strain estimation.

Ultrasonic estimation of temperature-induced echo strain has been suggested as a means of predicting the location of thermal lesions formed by focused ultrasound (US) surgery before treatment. Preliminary investigations of this technique have produced optimistic results because they were carried out with rubber phantoms and used room temperature, rather than body temperature, as the baseline. The objective of the present study was to determine, through modelling, the likely feasibility of using ultrasonic temperature imaging to detect and localise the focal region of the heating beam for a medium with a realistic temperature-dependence of sound speed subjected to a realistic temperature rise. We determined the minimum ultrasonic signal-to-noise ratio (SNR) required to visualise the heated region for liver of varying fat content. Due to the small (0.5%) change in sound speed at the focus, the threshold SNR for normal liver (low fat content) was found to be at least 20 dB. This implies that temperature imaging in this tissue type will only be feasible if the effects of electronic noise can be minimised and if other sources of noise, such as cardiac-induced motion, do not substantially reduce the visibility of the focal region. For liver of intermediate fat content, the heated region could not be visualised even when the echo data were noise-free. Tissues with a very high fat content are likely to represent the most favourable conditions for ultrasonic temperature imaging.