Dual mode ultrasound transducer (DMUT) system and method for controlling delivery of ultrasound therapy

• US 10,231,712 B2
• Filed: 06/09/2011
• Issued: 03/19/2019
• Est. Priority Date: 06/09/2010
• Status: Active Grant

• Current Assignee: Regents of The University of Minnesota (University of Minnesota)
• Original Assignee: Regents of The University of Minnesota (University of Minnesota)
• Inventors: Ebbini, Emad S., Casper, Andrew J., Liu, Dalong, Ballard, John R.
• Primary Examiner(s): Cattungal, Sanjay
• Application Number:
  US13/702,813
• Publication Number:
  US 20130144165A1
• Time in Patent Office: 2,840 Days
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 8/00 Diagnosis using ultrasonic, sonic or infrasonic waves imaging of objects using sonar G01S15/00
• CPC Class Codes: A61B 8/08 Detecting organic movements or changes, e.g. tumours, cysts, swellings A61B8/02 - A61B8/06 take precedence
• CPC Class Codes: A61B 8/0816 using echo-encephalography
• CPC Class Codes: A61B 8/0891 for diagnosis of blood vessels
• CPC Class Codes: A61B 8/14 Echo-tomography
• CPC Class Codes: A61B 8/4438 Means for identifying the diagnostic device, e.g. barcodes
• CPC Class Codes: A61B 8/4488 the transducer being a phased array
• CPC Class Codes: A61B 8/485 involving measuring strain or elastic properties
• CPC Class Codes: A61B 8/5207 involving processing of raw data to produce diagnostic data, e.g. for generating an image reconstruction G06T11/00
• CPC Class Codes: A61B 8/5223 for extracting a diagnostic or physiological parameter from medical diagnostic data for algorithms to analyse biomedical images G06T7/0012
• CPC Class Codes: A61B 8/54 Control of the diagnostic device
• CPC Class Codes: A61N 2007/0052 using the same transducer for therapy and imaging
• CPC Class Codes: A61N 2007/0095 by modifying an excitation signal
• CPC Class Codes: A61N 2007/027 with multiple foci created simultaneously
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00
• CPC Class Codes: G01S 15/8915 using a transducer array
• CPC Class Codes: G01S 15/892 the array being curvilinear
• CPC Class Codes: G01S 15/8927 using simultaneously or sequentially two or more subarrays or subapertures
• CPC Class Codes: G01S 15/8952 using discrete, multiple frequencies
• CPC Class Codes: G01S 15/8959 : using coded signals for correlation purposes
• CPC Class Codes: G01S 15/8997 : using synthetic aperture techniques
• CPC Class Codes: G01S 7/5202 : for pulse systems
• CPC Class Codes: G01S 7/52046 : Techniques for image enhancement involving transmitter or receiver image enhancement by image data processing G06T5/00
• CPC Class Codes: G01S 7/52085 : Details related to the ultrasound signal acquisition, e.g. scan sequences control of medical diagnostic ultrasound devices A61B8/54
• CPC Class Codes: G16H 50/30 : for calculating health indices; for individual health risk assessment

Abstract

A dual-mode ultrasound system provides real-time imaging and therapy delivery using the same transducer elements of a transducer array. The system may use a multichannel driver to drive the elements of the array. The system uses a real-time monitoring and feedback image control of the therapy based on imaging data acquired using the dual-mode ultrasound array (DMUA) of transducer elements. Further, for example, multimodal coded excitation may be used in both imaging and therapy modes. Still further, for example, adaptive, real-time refocusing for improved imaging and therapy can be achieved using, for example, array directivity vectors obtained from DMUA pulse-echo data.

Claims

1. A dual mode ultrasound transducer system for integrated image-guided therapy comprising:

a refocusable array of ultrasound transducer elements configured to provide synthesized ultrasound wavefronts, the ultrasound transducer elements configured to deliver one or more therapy shots to at least a portion of a target region and to transmit/receive imaging ultrasound wavefronts to/from the target region, wherein each of the one or more therapy shots comprises a plurality of sequential therapy bursts of ultrasound wavefronts; and

control apparatus comprising at least one processor configured to;

control conveyance of imaging signals to/from one or more of the plurality of ultrasound transducer elements;

generate treatment region image data usable to identify at least one or more target points within a target region based on imaging signals conveyed to/from one or more of the plurality of ultrasound transducer elements;

generate one or more signals to drive one or more of the plurality of ultrasound transducer elements to provide a synthesized ultrasound wavefront using image-based refocusing;

generate therapy signals to drive one or more of the plurality of ultrasound transducer elements to deliver one or more therapy shots to at least a portion of a target region, wherein each therapy shot is configured to achieve a therapeutic endpoint comprising at least one of a desired thermal and mechanical change in the target region, wherein delivery of each of the one or more therapy shots comprises delivery of a plurality of sequential therapy bursts of ultrasound wavefronts to at least one of the one or more target points in the target region configured to achieve the therapeutic endpoint within the therapy shot using accumulated exposure over the plurality of sequential therapy bursts, wherein each of the plurality of sequential therapy bursts is a continuous therapy burst having an amplitude, a duration, and a spectral content separated in time from a subsequent therapy burst, wherein each of the continuous therapy bursts has a duration less than 10 milliseconds, and further wherein the time between the continuous therapy bursts is less than 10 milliseconds; and

generate control image data based on at least one of imaging signals from one or more of the plurality of ultrasound transducer elements during delivery of each therapy burst of a plurality of sequential therapy bursts and imaging signals from one or more of the plurality of ultrasound transducer elements following delivery of each therapy burst of a plurality of sequential therapy bursts to monitor tissue response in the target region to the delivery of the sequential therapy bursts in real-time, wherein the control image data is used as feedback to generate therapy signals to drive one or more of the plurality of ultrasound transducer elements to deliver at least one subsequent continuous therapy burst within the therapy shot, wherein the control image data is used as feedback to adjust at least one of the amplitude, the duration, and the spectral content of at least one subsequent continuous therapy burst to be delivered to achieve the therapeutic endpoint within the therapy shot being delivered to the target region.

2. The system of claim 1, wherein the control apparatus is configured to generate at least one imaging signal using transmit focus at one or more points in the target region to drive one or more of the plurality of ultrasound transducers to transmit at least one ultrasound wavefront to produce single transmit focus (STF) imaging data for control image data.

3. The system of claim 1, wherein the control apparatus is further configured to generate treatment region image data usable to identify one or more critical points representative of intervening tissue in the path between the plurality of ultrasound transducer elements and the one or more target points within the target region based on imaging signals conveyed to/from one or more of the plurality of ultrasound transducer elements.

4. The system of claim 3, wherein, to generate control image data the control apparatus is configured to generate at least one imaging signal to drive one or more of the plurality of ultrasound transducers elements to transmit at least one single transmit energy pulse focused to one or more of the critical points resulting in pulse-echo data to be captured.

5. The system of claim 2, wherein the control apparatus is configured to generate imaging signals using transmit focus at one or more points in the target region to drive one or more of the plurality of ultrasound transducers to transmit sequential single transmit focus (STF) ultrasound wavefronts focused to at least one of one or more target points within the target region and one or more critical points resulting in pulse-echo data to be captured.

6. The system of claim 1, wherein the control apparatus is further configured to use coded excitation to generate at least two signals to drive one or more of the plurality of ultrasound transducers to produce at least two overlapping continuous bursts of ultrasound wavefronts, wherein each overlapping continuous burst is configured to provide a different waveform to one or more target points.

7. The system of claim 1, prior to delivery of a subsequent therapy burst of the plurality of sequential therapy bursts at therapeutic levels based on therapy signals generated using the control image data generated the control apparatus is configured to control a test of the subsequent therapy burst at sub-therapeutic levels.

8. The system of claim 1, wherein the control apparatus is further configured to generate one or more signals to drive one or more of the plurality of ultrasound transducer elements to provide at least one of the sequential therapy bursts based on imaging at least one of a reversible thermal change and a reversible mechanical change at one or more points in the target region caused by a sub-therapeutic burst of ultrasound.

9. The system of claim 1, wherein the control apparatus is configured to generate at least one imaging signal to drive one or more of the plurality of ultrasound transducers to transmit at least one ultrasound energy pulse to the target region resulting in pulse-echo data to be captured by one or more of the plurality of ultrasound transducer elements between the generation of therapy signals that result in each sequential therapy burst of ultrasonic energy to be delivered to the target region via the plurality of ultrasound transducer elements.

10. The system of claim 1, wherein to generate control image data the control apparatus is configured to generate control image data comprising ultrasound transducer element directivity data, wherein at least the ultrasound transducer element directivity data is used to generate therapy signals to drive one or more of the plurality of ultrasound transducer elements to deliver a subsequent therapy burst of the plurality of sequential therapy bursts.

11. The system of claim 1, wherein to generate control image data the control apparatus is configured to generate control image data comprising thermal response data, wherein at least the thermal response data is used to generate therapy signals to drive one or more of the plurality of ultrasound transducer elements to deliver a subsequent therapy burst of the plurality of sequential therapy bursts.

12. The system of claim 1, wherein to generate control image data the control apparatus is configured to generate control image data comprising at least one of displacement and strain data associated with at least the target region, wherein the at least one of the displacement and strain data is used to generate therapy signals to drive one or more of the plurality of ultrasound transducer elements to deliver a subsequent therapy burst of the plurality of sequential therapy bursts.

13. The system of claim 1, wherein to generate control image data the control apparatus is configured to generate control image data comprising data indicative of cavitation, wherein at least the data indicative of cavitation is used to generate therapy signals to drive one or more of the plurality of ultrasound transducer elements to deliver a subsequent therapy burst of the plurality of sequential therapy bursts.

14. The system of claim 1, wherein the system comprises a control channel associated with each of a plurality of ultrasound transducer elements of the array, wherein each control channel associated with each of the plurality of ultrasound transducer elements comprises a configurable diplexer between analog to digital converter apparatus and a corresponding ultrasound element to isolate the analog to digital converter apparatus from high voltage therapy signals applied to the ultrasound transducer element but still allow low level imaging signals from pulse echo data to pass through, and further wherein each of the configurable diplexers comprises an amplifier controllable to have its output set to an impedance state when a therapy signal is not being transmitted that is higher than an impedance state of the output when a therapy signal is being transmitted, and further wherein the control apparatus is configured to:

generate multiple channel therapy signals for driving the plurality of ultrasound transducer elements via the respective control channels to deliver energy to at least one target point in the target region, wherein each of the plurality of ultrasound transducer elements is driven at one or more drive parameters to focus the ultrasound energy for delivery of each sequential therapy burst;

generate control image data based on at least one of imaging signals received via the respective control channels from one or more of the plurality of ultrasound transducer elements during delivery of each therapy burst of a plurality of sequential therapy bursts and imaging signals received via the respective control channels from one or more of the plurality of ultrasound transducer elements following delivery of each therapy burst of a plurality of sequential therapy bursts to monitor tissue response in the target region;

adjust one or more of the drive parameters of one or more of the plurality of ultrasound transducer elements based on the control image data; and

set the output of the amplifier associated with each of the plurality of ultrasound transducer elements, when a therapy signal is not being transmitted, to an impedance state that is higher than an impedance state of the output when a therapy signal is being transmitted.

15. The system of claim 1, wherein the system further comprises a display apparatus to display image data and a user interface to allow a user to input one or more commands for real-time control of the delivery of the plurality of sequential therapy bursts, and further wherein the user interface is configured to allow a user to select at least one of one or more target points and one or more critical points for use in controlling delivery of the plurality of sequential therapy bursts.

16. The system of claim 14, wherein the configurable diplexer further comprises a selectable voltage divider to attenuate a pulse echo signal received by the transducer element, and further wherein the control apparatus is configured to control the selectable voltage divider to at least one of attenuate the pulse echo signal or leave the pulse echo signal at its current level.

17. The system of claim 1, wherein the control apparatus comprises at least one processor coupled to a multimodal imaging apparatus, wherein the multimodal imaging apparatus comprises at least one processor configured to fuse image data resulting from a plurality of different imaging modes, wherein the control apparatus is configured to provide the fused image data for at least one of display and use to generate control image data.

18. The system of claim 1, wherein the system further comprises at least one other ultrasound diagnostic apparatus comprising an imaging probe configured to capture ultrasound pulse-echo data of at least a portion of the target region in response to the delivery of one or more of the plurality of sequential therapy bursts.

19. The system of claim 1, wherein the control apparatus is configured to generate therapy signals usable for thermal treatments.

20. The system of claim 1, wherein the control apparatus is configured to generate therapy signals usable for non-thermal treatments.

21. The system of claim 1, wherein the control apparatus is configured to generate therapy signals to drive one or more of the plurality of ultrasound transducer elements to deliver a plurality of sequential therapy bursts of ultrasonic energy to at least one of the one or more target points in the target region using coded excitation.

22. The system of claim 1, wherein the system further comprises a control channel associated with each of a plurality of ultrasound transducer elements of the array,

wherein the control apparatus comprises a multichannel driver configured to drive the plurality of ultrasound transducer elements with therapy signals and imaging signals, wherein the multichannel driver is configurable to store and control the therapy signals and imaging signals used to drive the plurality of ultrasound transducer elements,

wherein the multichannel driver comprises a plurality of buffers, wherein the plurality of buffers comprises:

at least a first buffer to provide storage of a therapy protocol of therapy signals to be delivered by the plurality of ultrasound transducer elements during a current time period for use in driving the plurality of ultrasound transducer elements via the respective control channels to deliver energy to at least one target point in the target region, wherein each of the plurality of ultrasound transducer elements is driven at one or more drive parameters to focus the ultrasound energy for delivery of each sequential therapy burst, the one or more drive parameters corresponding to at least one of the amplitude, the duration, and the spectral content defining each continuous therapy burst of the plurality of sequential therapy bursts; and

a second buffer to store a therapy protocol of therapy signals to be delivered in a next time period following the current time period; and

further wherein the control apparatus comprising the at least one processor is configured to;

generate control image data based on at least one of imaging signals received via the respective control channels from one or more of the plurality of ultrasound transducer elements during delivery of each therapy burst of a plurality of sequential therapy bursts and imaging signals received via the respective control channels from one or more of the plurality of ultrasound transducer elements following delivery of each therapy burst of a plurality of sequential therapy bursts to monitor tissue response in the target region; and

adjust one or more of the drive parameters of one or more of the plurality of ultrasound transducer elements based on the control image data for storage by the second buffer of the therapy protocol comprising the adjusted drive parameters to be delivered in the next time period following the current time period for use in driving the plurality of ultrasound transducer elements via the respective control channels to deliver energy to at least one target point in the target region, wherein each of the plurality of ultrasound transducer elements is driven at the adjusted drive parameters to focus the ultrasound energy for delivery of the subsequent therapy burst, the adjusted drive parameters corresponding to at least one of the amplitude, the duration, and the spectral content defining the continuous therapy burst corresponding to the subsequent therapy burst of the plurality of sequential therapy bursts.

23. The system of claim 22, wherein the control apparatus is configured to manage the first and second buffers to provide a reconfigurable silencing period with a granularity of less than 1 microsecond, the reconfigurable silencing period being below the mechanical and thermal response time of the tissue.

24. The system of claim 1, wherein, to generate control image data to monitor tissue response in the target region to the delivery of the sequential therapy bursts in real-time, the control image data is generated based on at least one of imaging signals from one or more of the plurality of ultrasound transducer elements during delivery of each therapy burst of a plurality of sequential therapy bursts and imaging signals from one or more of the plurality of ultrasound transducer elements following delivery of each therapy burst of a plurality of sequential therapy bursts and before each next therapy burst.

41. The system of claim 1, wherein control image data is generated based at least in part on imaging performed at least in part during delivery of one or more therapy bursts using coded excitation.

25. A dual mode ultrasound transducer therapy method for integrated image-guided therapy comprising:

providing a refocusable array of ultrasound transducer elements configured to provide synthesized ultrasound wavefronts, the ultrasound transducer elements configured to deliver one or more therapy shots to at least a portion of a target region and to transmit/receive imaging ultrasound wavefronts to/from the target region, wherein each of the one or more therapy shots comprises a plurality of sequential therapy bursts of ultrasound wavefronts;

generating treatment region image data and identifying at least one or more target points within a target region thereof based on pulse echo data received by one or more of the plurality of ultrasound transducer elements;

generating one or more signals to drive one or more of the plurality of ultrasound transducer elements to provide a synthesized ultrasound wavefront using image-based refocusing;

generating therapy signals to drive one or more of the plurality of ultrasound transducer elements to deliver one or more therapy shots to at least a portion of a target region, wherein each therapy shot is configured to achieve a therapeutic endpoint comprising at least one of a desired thermal and mechanical change in the target region, wherein delivery of each of the one or more therapy shots comprises delivery of a plurality of sequential therapy bursts of ultrasound wavefronts to at least one of the one or more target points in the target region to produce a response at the one or more target points within the target region configured to achieve the therapeutic endpoint within the therapy shot using accumulated exposure over the plurality of sequential therapy bursts, wherein each of the plurality of sequential therapy bursts is a continuous therapy burst having an amplitude, a duration, and a spectral content separated in time from a subsequent therapy burst, wherein each of the continuous therapy bursts has a duration less than 10 milliseconds, and further wherein the time between the continuous therapy bursts is less than 10 milliseconds; and

generating control image data based on at least one of pulse echo data received by one or more of the plurality of ultrasound transducer elements during delivery of each therapy burst of a plurality of sequential therapy bursts and pulse echo data received by one or more of the plurality of ultrasound transducer elements following delivery of each therapy burst of a plurality of sequential therapy bursts to monitor tissue response in the target region to the delivery of the sequential therapy bursts in real-time, wherein the control image data is used as feedback to generate therapy signals to drive one or more of the plurality of ultrasound transducer elements to deliver at least one subsequent continuous therapy burst within the therapy shot, wherein the control image data is used as feedback to adjust at least one of the amplitude, the duration, and the spectral content of at least one subsequent continuous therapy burst to be delivered to achieve the therapeutic endpoint within the therapy shot being delivered to the target region.

26. The method of claim 25, wherein generating at least one imaging signal using transmit focus at one or more points in the target region to drive one or more of the plurality of ultrasound transducers to transmit at least one ultrasound wavefront to produce single transmit focus (STF) imaging data for control image data.

27. The method of claim 25, wherein the method further comprises identifying one or more critical points within the treatment region representative of intervening tissue in the path between the plurality of ultrasound transducer elements and the one or more target points within the target region.

28. The method of claim 27, wherein generating control image data comprises generating at least one imaging signal to drive one or more of the plurality of ultrasound transducers to transmit at least one single transmit energy pulse focused to one or more of the critical points resulting in pulse-echo data to be captured.

29. The method of claim 26, wherein generating at least one imaging signal comprises generating imaging signals using transmit focus at one or more points in the target region to drive one or more of the plurality of ultrasound transducers to transmit sequential single transmit focus (STF) ultrasound wavefronts focused to each of a plurality of one or more target points within the target region or one or more critical points resulting in pulse-echo data to be captured.

30. The method of claim 25, further comprising using coded excitation to generate at least two signals to drive one or more of the plurality of ultrasound transducers to produce at least two overlapping continuous bursts of ultrasound wavefronts, wherein each overlapping continuous burst is configured to provide a different waveform to one or more target points.

31. The method of claim 25, prior to delivery of a subsequent therapy burst of the plurality of sequential therapy bursts based on therapy signals generated using control image data generated, the method comprises testing the subsequent therapy burst at sub-therapeutic levels lower than therapeutic levels associated with the subsequent therapy burst.

32. The method of claim 25, generating one or more signals to drive one or more of the plurality of ultrasound transducer elements to provide at least one of the sequential therapy bursts based on imaging at least one of a reversible thermal change and a reversible mechanical change at one or more points in the target region caused by a sub-therapeutic burst of ultrasound.

33. The method of claim 25, wherein control image data is generated between the generation of therapy signals that result in each sequential therapy burst of ultrasonic energy to be delivered to the target region via the plurality of ultrasound transducer elements.

34. The method of claim 25, wherein generating control image data comprises generating control image data comprising at least one of ultrasound transducer element directivity data, displacement data, strain data, thermal response data, and data indicative of cavitation, wherein the control image data is used to generate therapy signals to drive one or more of the plurality of ultrasound transducer elements to deliver a subsequent therapy burst of the plurality of sequential therapy bursts.

35. The method of claim 25, wherein a control channel is associated with each of a plurality of ultrasound transducer elements of the array, wherein each control channel associated with each of the plurality of ultrasound transducer elements comprises a configurable diplexer between analog to digital converter apparatus and a corresponding ultrasound element to isolate the analog to digital converter apparatus from high voltage therapy signals applied to the ultrasound transducer element but still allow low level imaging signals from pulse echo data to pass through, and further wherein each of the configurable diplexers comprises an amplifier controllable to have its output set to an impedance state when a therapy signal is not being transmitted that is higher than an impedance state of the output when a therapy signal is being transmitted, and further wherein the method comprises:

generating multiple channel therapy signals for driving the plurality of ultrasound transducer elements via the respective control channels to deliver energy to at least one target point in the target region, wherein each of the plurality of ultrasound transducer elements is driven at one or more drive parameters to focus the ultrasound energy for delivery of each sequential therapy burst;

generating control image data based on at least one of pulse echo data received via the respective control channels from one or more of the plurality of ultrasound transducer elements during delivery of each therapy burst of a plurality of sequential therapy bursts and pulse echo data received via the respective control channels from one or more of the plurality of ultrasound transducer elements following delivery of each therapy burst of a plurality of sequential therapy bursts to monitor tissue response in the target region;

adjusting the one or more drive parameters to drive each of the plurality of ultrasound transducer elements based on the control image data; and

setting the output of the amplifier associated with each of the plurality of ultrasound transducer elements, when a therapy signal is not being transmitted, to an impedance state that is higher than an impedance state of the output when a therapy signal is being transmitted.

36. The method of claim 25, wherein the method further comprises:

displaying image data;

providing a user interface to allow a user to input one or more commands for real-time control of the delivery of the plurality of sequential therapy bursts; and

selecting, by a user using the user interface, at least one of one or more target points and one or more critical points for use in controlling delivery of the plurality of sequential therapy bursts.

37. The method of claim 25, wherein the method further comprises:

fusing image data resulting from a plurality of different imaging modes; and

providing the fused image data for at least one of display and use to generate control image data.

38. The method of claim 25, wherein generating the control image data comprises generating the control image data in real-time relative to the therapy signals.

39. The method of claim 25, wherein the method further comprises using at least one other ultrasound diagnostic apparatus to capture ultrasound pulse-echo data of at least a portion of the target region in response to the delivery one or more of the plurality of sequential therapy bursts.

40. The method of claim 25, wherein generating therapy signals comprises generating therapy signals to drive one or more of the plurality of ultrasound transducer elements to deliver a plurality of sequential therapy bursts of ultrasonic energy to at least one of the one or more target points in the target region using coded excitation.

42. The method of claim 25, wherein therapy signals are generated for use in one or more non-thermal treatments, wherein the one or more non-thermal treatments comprise at least one of delivery of therapy to a target region in which a vessel of the patient is located, delivery of therapy to a target region in which a nerve is located, activation of a drug in a target region, and delivery of therapy to a target region in which a tumor is located.

43. The method of claim 25, wherein therapy signals are generated for use in one or more thermal treatments, wherein the one or more thermal treatments comprise at least one of delivery of therapy to a target region in which a blood vessel is located, delivery of therapy to a target region in which a tumor is located, delivery of therapy to a target region in which a nerve is located, activation of a drug in a target region, and delivery of therapy to a target region in which a vessel of the patient is located.

44. The method of claim 35, wherein the configurable diplexer further comprises a selectable voltage divider to attenuate a pulse echo signal received by the transducer element, and further wherein the method comprises controlling the selectable voltage divider to at least one of attenuate the pulse echo signal or leave the pulse echo signal at its current level.

45. The method of claim 25, wherein a control channel is associated with each of a plurality of ultrasound transducer elements of the array,

wherein a multichannel driver is configured to drive the plurality of ultrasound transducer elements with therapy signals and imaging signals, wherein the multichannel driver is configurable to store and control the therapy signals and imaging signals used to drive the plurality of ultrasound transducer elements,

wherein the multichannel driver comprises a plurality of buffers, wherein the plurality of buffers comprises:

at least a first buffer to provide storage of a therapy protocol of therapy signals to be delivered by the plurality of ultrasound transducer elements during a current time period for use in driving the plurality of ultrasound transducer elements via the respective control channels to deliver energy to at least one target point in the target region, wherein each of the plurality of ultrasound transducer elements is driven at one or more drive parameters to focus the ultrasound energy for delivery of each sequential therapy burst, the one or more drive parameters corresponding to at least one of the amplitude, the duration, and the spectral content defining each continuous therapy burst of the plurality of sequential therapy bursts; and

a second buffer to store a therapy protocol of therapy signals to be delivered in a next time period following the current time period; and

further wherein the method comprises;

generating control image data based on at least one of pulse echo data received via the respective control channels from one or more of the plurality of ultrasound transducer elements during delivery of each therapy burst of a plurality of sequential therapy bursts and pulse echo data received via the respective control channels from one or more of the plurality of ultrasound transducer elements following delivery of each therapy burst of a plurality of sequential therapy bursts to monitor tissue response in the target region; and

adjusting one or more of the drive parameters of one or more of the plurality of ultrasound transducer elements based on the control image data for storage by the second buffer of the therapy protocol comprising the adjusted drive parameters to be delivered in the next time period following the current time period for use in driving the plurality of ultrasound transducer elements via the respective control channels to deliver energy to at least one target point in the target region, wherein each of the plurality of ultrasound transducer elements is driven at the adjusted drive parameters to focus the ultrasound energy for delivery of the subsequent therapy burst, the adjusted drive parameters corresponding to at least one of the amplitude, the duration, and the spectral content defining the continuous therapy burst corresponding to the subsequent therapy burst of the plurality of sequential therapy bursts.

46. The method of claim 45, wherein the method includes managing the first and second buffers to provide a reconfigurable silencing period with a granularity of less than 1 microsecond, the reconfigurable silencing period being below the mechanical and thermal response time of the tissue.

47. The method of claim 25, wherein, in generating control image data to monitor tissue response in the target region to the delivery of the sequential therapy bursts in real-time, the control image data is generated based on at least one of pulse echo data received by one or more of the plurality of ultrasound transducer elements during delivery of each therapy burst of a plurality of sequential therapy bursts and pulse echo data received by one or more of the plurality of ultrasound transducer elements following delivery of each therapy burst of a plurality of sequential therapy bursts and before each next therapy burst.