Tissue heterogeneity and weak nonlinearity using a phased array transducer for clinical transrectal treatment

Phase aberration correction is critical for optimizing the therapeutic efficacy of HIFU in various clinical applications. While much research has focused on transcranial focal therapy, transrectal treatment of prostate cancer presents unique challenges. In this context, the acoustic beam must traverse coupling liquid, rectum, and fatty tissue before reaching the prostate, which can introduce phase distortions that affect treatment precision. Using the Focal One® system (EDAP TMS, France) as a research platform, we evaluated and refined methods to predict and compensate for these effects in controlled in vitro settings. To address the complexities beyond the assumptions of Rayleigh integrals, we developed a comprehensive numerical framework that includes: (i) acoustic holography to accurately reconstruct the transducer’s vibration patterns; (ii) a scaling factor for peak pressure estimation from electrical power; and (iii) simulations incorporating heterogeneous media and weak nonlinearity to improve focal shift predictions. This work complements existing phase aberration correction strategies and offers a computational–experimental toolkit for enhancing HIFU protocol customization. These findings contribute to advancing precision in prostate cancer treatments, underscoring the importance of integrating physics-informed corrections in clinical practice.