Toward patient-specific HIFU planning: In vivo attenuation mapping using plane wave ultrasound

High Intensity Focused Ultrasound (HIFU) therapy is increasingly used in clinical practice for noninvasive tissue ablation. However, its effectiveness is still limited by a lack of precise knowledge of tissue properties—especially ultrasound attenuation—which is essential for optimizing energy delivery. In vivo attenuation measurement remains challenging due to technical complexity. We introduce a new method using a linear ultrasound imaging probe emitting a single plane wave. Under specific conditions, the backscattered wave also behaves as a plane wave, allowing simple and accurate estimation of both local and global attenuation. The method was validated on reference phantoms and surgical human tissue samples, and its feasibility was demonstrated in vivo on 15 human volunteers. Measurements were performed on the pancreas, liver, kidney, and breast. Numerical simulations clarified the physical conditions necessary for reliable application. The measured attenuation values—0.098 ± 0.016 (pancreas), 0.075 ± 0.008 (liver), 0.066 ± 0.007 (kidney), and 0.140 ± 0.014 Np/(cm·MHz) (breast)—were consistent with previously published data from more complex methods. This robust and accessible technique enables quantitative assessment of tissue attenuation and paves the way for personalized HIFU therapy in both research and clinical environments.