LAUSR

BACKGROUND Transcranial ultrasound imaging and therapy depend on the efficient transmission of acoustic energy through the skull. Multiple previous studies have concluded that a large incidence angle should be avoided during transcranial focused ultrasound therapy to ensure transmission through the skull. Alternatively, some other studies have shown that longitudinal-to-shear wave mode conversion might improve transmission through the skull when the incidence angle is increased above the critical angle (i.e., 25° to 30°). PURPOSE The effect of skull porosity on the transmission of ultrasound through the skull at varying incidence angles was investigated for the first time to elucidate why transmission through the skull at large angles of incidence is decreased in some cases but improved in other cases. METHODS Transcranial ultrasound transmission at varying incidence angles (0° to 50°) was investigated in phantoms and ex vivo skull samples with varying bone porosity (0% to 28.54 ± 3.36%) using both numerical and experimental methods. First, the elastic acoustic wave transmission through the skull was simulated using micro-computed tomography data of ex vivo skull samples. The trans-skull pressure was compared between skull segments having three levels of porosity, i.e. low porosity (2.65 ± 0.03%), medium porosity (13.41 ± 0.12%) and high porosity (26.9%). Next, transmission through two 3D-printed resin skull phantoms (compact versus porous phantoms) was experimentally measured to test the effect of porous microstructure alone on ultrasound transmission through flat plates. Finally, the effect of skull porosity on ultrasound transmission was investigated experimentally by comparing transmission through two ex vivo human skull segments having similar thicknesses but different porosities (13.78 ± 2.05% versus 28.54 ± 3.36%). RESULTS Numerical simulations indicated that an increase in transmission pressure occurs at large incidence angles for skull segments having low porosities but not for those with high porosity. In experimental studies, a similar phenomenon was observed. Specifically, for the low porosity skull sample (13.78 ± 2.05%), the normalized pressure was 0.25 when the incidence angle increased to 35°. However, for the high porosity sample (28.54 ± 3.36%), the pressure was no more than 0.1 at large incidence angles. CONCLUSIONS These results indicate that the skull porosity has an evident effect on the transmission of ultrasound at large incidence angles. The wave mode conversion at large, oblique incidence angles could enhance the transmission of ultrasound through parts of the skull having lower porosity in the trabecular layer. However, for transcranial ultrasound therapy in the presence of highly porous trabecular bone, transmission at a normal incidence angle is preferable relative to oblique incidence angles due to the higher transmission efficiency. This article is protected by copyright. All rights reserved.