Volumetric ultrasound localization microscopy with diverging cylindrical waves

Transcranial ultrasound plays a limited role in neuroradiology due to its lack of resolution, planar imaging, and user-dependency. By breaching the diffraction limit using injected microbubbles, volumetric ultrasound localization microscopy (ULM) could help alleviate those issues. However, performing 3D ultrasound imaging at a high frame rate with sufficient signal-to-noise ratio to track individual microbubbles through the skull remains a challenge, especially with a portable scanner. In this study, we describe a ULM sequence suitable for volumetric transcranial imaging exploiting cylindrical emissions on multiplexed matrix probes, through simulations, hydrophone measurements, and flow phantoms. This geometry leads to a doubling of the peak acoustic pressure, up to 400 kPa, with respect to spherical emission and improved volume rate, up to 180 Hz. Cylindrical emissions also improve ULM saturation rate by 60% through a skull phantom. The assessment of microbubble velocity was also improved from 33% error in the average flow measured with spherical waves to a 5% error with cylindrical waves. Conversely, we demonstrate the detrimental impacts of cylindrical waves toward the field of view and isotropic sensitivity. Nevertheless, due to its enhanced signal-to-noise ratio and 3D nature, such a cylindrical volumetric sequence could be beneficial for ULM as a diagnostic tool in humans, especially when portability is a necessity.