Changes in ultrasonic properties of liver tissue in vitro during heating-cooling cycle concomitant with thermal coagulation

The present work considers the ultrasonic properties of porcine liver tissue in vitro measured during heating concomitant with thermal coagulation followed by natural cooling, so as to provide information about changes in the ultrasonic properties of the tissue after thermal coagulation. The excised liver samples were heated in a degassed water bath up to 75°C and naturally cooled down to 30°C. The tissue was observed to begin thermally coagulating at temperatures lower than 75°C. The ultrasonic parameters considered include the speed of sound, the attenuation coefficient, the backscatter coefficient and the nonlinear parameter of B/A. They were more sensitive to temperature when heating than during natural cooling. All of the parameters were shown to rise significantly on completion of the heating-cooling cycle. At 35°C after thermal coagulation, the B/A value was increased by 96%, the attenuation and backscatter coefficients were increased by 50%∼68% and 33%∼37%, respectively, in the typical frequency ranges of 3 MHz∼5 MHz used for ultrasonic imaging and the speed of sound was increased by 1.4%. The results of this study added to the evidence that tissue characterization, in particular, based on the B/A could be valuable for ultrasonically imaging the thermal lesions following high-intensity focused ultrasound (HIFU) surgery.     

Metrological Validation of a Measurement Procedure for the Characterization of a Biological Ultrasound Tissue-Mimicking Material

The speed of sound and attenuation are important properties for characterizing reference materials such as biological phantoms used in ultrasound applications. There are many publications on the manufacture of ultrasonic phantoms and the characterization of their properties. However, few studies have applied the principles of metrology, such as the expression of the uncertainty of measurement. The objective of this study is to validate a method for characterizing the speed of sound and the attenuation coefficient of tissue-mimicking material (TMM) based on the expression of the measurement of uncertainty. Six 60-mm-diameter TMMs were fabricated, three 10 mm thick and three 20 mm thick. The experimental setup comprised two ultrasonic transducers, acting as transmitter or receiver depending on the stage of the measurement protocol, both with a nominal center frequency of 5 MHz and an element diameter of 12.7 mm. A sine burst of 20 cycles and 20-V peak-to-peak amplitude at 5 MHz excited the transmitter transducer, producing a maximum pressure of 0.06 MPa. The measurement method was based on the through-transmission substitution immersion technique. The speed of sound measurement system was validated using a calibrated stainless-steel cylinder as reference material, and normalized errors were <0.8. The attenuation coefficient measurement method was validated using replicated measurements under repeatability conditions. The normalized error between the two measurement sets was <1. The proposed uncertainty models for the measurements of the speed of sound and the attenuation coefficient can help other laboratories develop their own uncertainty models. These validated measurement methods can be used to certify a TMM as a reference material for biotechnological applications.     

Site Dependence of Thickness and Speed of Sound in Articular Cartilage of Bovine Patella

Researchers have made efforts to quantify thickness of articular cartilage as well as its acoustic and mechanical properties using various ultrasound (US) techniques during the last decades, because they are important indicators of articular cartilage degeneration. However, the variation of the thickness and speed of sound of articular cartilage at different anatomical sites would result in the uncertainty of US assessment of degeneration. In this paper, the site dependences of speed of sound and thickness of bovine patellar articular cartilage (n = 10) were investigated using a custom-made US measurement system. The thickness and speed of sound of articular cartilage at different locations of the bovine patella were measured on excised specimens ex situ using a noncontact US approach. A total of 10 patellae were tested. The results showed the overall mean value of the speed of sound in the articular cartilage at the 25 measured sites was 1626 ± 86 m/s (range, 1507 to 1834 m/s). No statistically significant difference in the speed of sound was observed among the 25 locations or among the four quadrants of the patella. The highest speed of sound (1834 ± 74 m/s) was obtained at the medial-upper quadrant and the lowest value (1507 ± 74 m/s) at the medial-lower quadrant. Further grouping of the data revealed that the speed of sound in the central region (1633 ± 21 m/s) was significantly (p < 0.01) larger than that for the surrounding region (1621 ± 22 m/s). The overall mean thickness of the patellar articular cartilage was 1.34 ± 0.34 mm. No significant difference was obtained in the thickness among the 25 locations and also among the four quadrants. However, when the thickness values were divided diagonally, a significant difference (p < 0.01) was observed between the upper region (1.27 ± 0.11 mm) and the lower region (1.31 ± 0.41 mm) of the patellae. Although no significant differences in the thickness and speed of sound among the tested sites were observed, it was demonstrated in this study that they did show some degree of site dependence. (E-mail: sushil78@gmail.com)     

Paraffin-Gel Tissue-Mimicking Material for Ultrasound-Guided Needle Biopsy Phantom

Paraffin-gel waxes have been investigated as new soft tissue–mimicking materials for ultrasound-guided breast biopsy training. Breast phantoms were produced with a broad range of acoustical properties. The speed of sound for the phantoms ranged from 1425.4 ± 0.6 to 1480.3 ± 1.7 m/s at room temperature. The attenuation coefficients were easily controlled between 0.32 ± 0.27 dB/cm and 2.04 ± 0.65 dB/cm at 7.5 MHz, depending on the amount of carnauba wax added to the base material. The materials do not suffer dehydration and provide adequate needle penetration, with a Young's storage modulus varying between 14.7 ± 0.2 kPa and 34.9 ± 0.3 kPa. The phantom background material possesses long-term stability and can be employed in a supine position without changes in geometry. These results indicate that paraffin-gel waxes may be promising materials for training radiologists in ultrasound biopsy procedures.     

Ultrasonic Assessment of Thermal Therapy in Rat Liver

One way to assess the efficacy of thermal therapy is to quantify changes in tissue properties through ultrasonic interrogation, which requires knowledge of the acoustic properties of thermally treated tissues. In this study, estimates of ultrasonic attenuation, speed of sound, backscatter coefficient (BSC), and scattering property estimates were generated from rat liver samples submersed for 10 minutes in a saline bath that was heated to one of seven temperature values over a range of 37–70°C. The attenuation coefficient increased monotonically with exposure temperature, with a maximum increase of 90%. Speed of sound changed by <1% for the different treatment conditions. The BSC had close agreement for all thermal doses over the frequency range of 8–15 MHz. Above this frequency range, samples heated ≥55°C demonstrated an increased BSC slope, and the effective scatterer diameter and effective acoustic concentration were able to distinguish treated from nontreated cases. The findings suggest that attenuation and either BSCs or scatterer property estimates above 15 MHz were sensitive to tissue changes in excised liver caused by thermal therapy.     

Development of a Tissue-Mimicking Phantom of the Brain for Ultrasonic Studies

Constructing tissue-mimicking phantoms of the brain for ultrasonic studies is complicated by the low backscatter coefficient of brain tissue, causing difficulties in simultaneously matching the backscatter and attenuation properties. In this work, we report on the development of a polyvinyl alcohol-based tissue-mimicking phantom with properties approaching those of human brain tissue. Polyvinyl alcohol was selected as the base material for the phantom as its properties can be varied by freeze–thaw cycling, variations in concentration and the addition of scattering inclusions, allowing some independent control of backscatter and attenuation. The ultrasonic properties (including speed of sound, attenuation and backscatter) were optimized using these methods with talc powder as an additive. It was determined that the ultrasonic properties of the phantom produced in this study are best matched to brain tissue in the frequency range 1–3 MHz, indicating its utility for laboratory ultrasonic studies in this frequency range.     

Properties of phantom tissuelike polymethylpentene in the frequency range 20-70 MHZ

Quantitative ultrasound (QUS) has been used to characterize soft tissues at ordinary abdominal ultrasound frequencies (2 to 15 MHz) and is beginning application at high frequencies (20 to 70 MHz). For example, backscatter and attenuation coefficients can be estimated in vivo using a reference phantom. At high frequencies, it is crucial that reverberations do not compromise the measurements. Such reverberations can occur between the phantom’s scanning window and transducer components as well as within the scanning window between its surfaces. Transducers are designed to minimize reverberations between the transducer and soft tissue. Thus, the acoustic impedance of a phantom scanning window should be tissuelike; polymethylpentene (TPX) is commonly used because of its tissuelike acoustic impedance. For QUS, it is also crucial to correct for the transmission coefficient of the scanning window. Computation of the latter requires knowledge of the ultrasonic properties, viz, density, speed and attenuation coefficients. This work reports values for the ultrasonic properties of two versions of TPX over the high-frequency range. One form (TPX film) is used as a scanning window on high-frequency phantoms, and at 40 MHz and 22°C was found to have an attenuation coefficient of 120 dB/cm and a propagation speed of 2093 m/s.     

Oil Gel-Based Phantom for Evaluating Quantitative Accuracy of Speed of Sound Measured in Ultrasound Computed Tomography

To evaluate the quantitative accuracy of the measured speed of sound in ultrasound computed tomography for breast imaging, it is necessary to use a phantom with inclusions whose speed of sound is known. Accordingly, a phantom with known-speed-of-sound inclusions (e.g., containing water and saltwater solution) under the control of temperature was developed. In addition, an oil gel was used as the phantom material for mimicking wave refraction from fatty breast tissue to dense breast tissue. The oil gel was generated by adding SEBS (styrene-ethylene/butylene-styrene, 10% w/w) to paraffin oil. The oil gel-based phantom has a cylindrical shape and contains rod-shaped inclusions that can be filled with water or saltwater solution (3.5% w/w sodium chloride in water). When temperature increases, the speed of sound in the water increases, while that in the oil gel decreases; in particular, the speed of sound in the oil gel was higher than that in the water at temperatures <20.6°C, while the speed of sound in the oil gel was lower than that in the water at temperatures >20.6°C. It has been reported that the speed of sound in dense breast tissue is higher than that in water, while that in fatty breast tissue is lower than that in water. Ultrasound is refracted owing to the difference between the speed of sound in the breast tissue and that in the background water. By controlling the temperatures of the oil gel and water, the oil gel-based phantom simulates the refraction of an ultrasound wave from fatty breast tissue to dense breast tissue. For 43 d, the variation ranges of the speed of sound and attenuation in the oil gel in the reconstructed images were 0.7 m/s and 0.03 dB/MHz/cm, respectively. The concentration of the saltwater solution in the polyacrylamide gel-based phantom decreased from 1% (w/w) to 0.48% (w/w) after 24 h, while that in the oil-gel-based phantom was constant. In addition, magnetic resonance imaging of the oil gel-based phantom revealed that NiSO₄ solution was stably contained in the phantom for 42 d. It is therefore concluded that the liquid cannot penetrate the oil gel. This oil gel-based phantom with such high temporal stability is suitable for multicenter distribution and may be used for standardization of data acquisition and image reconstruction across centers.     

Variance of speed of sound and correlation with acoustic impedance in canine corneas

The clinical standard for measuring corneal thickness is ultrasound pachymetry that assumes a constant speed of sound. The purpose of this study was to examine the variance of speed of sound and its relationship with acoustic impedance in healthy eyes of canines with a large age span. Corneal speed of sound and acoustic impedance were measured in 34 canine eyes at room temperature (21 ± 1°C). The mean speed of sound was 1577 ± 10 m/s ranging from 1553 to 1594 m/s. There was a strong correlation between speed of sound and acoustic impedance (R = 0.84, p < 0.001). Corneal speed of sound had a small variance in healthy canines over 1-year-old, but was significantly lower in younger canines suggesting an age effect. The strong correlation between corneal speed of sound and acoustic impedance may offer a potential means to noninvasively detect abnormal speed of sound for more accurate corneal thickness estimation.     

Acoustic Properties of Small Animal Soft Tissue in the Frequency Range 12–32 MHz

Quality assurance phantoms are made of tissue-mimicking materials (TMMs) the acoustic properties of which mimic those of soft tissue. However, the acoustic properties of many soft tissue types have not been measured at ultrasonic frequencies >9?MHz. With the increasing use of high-frequency ultrasound for both clinical and pre-clinical applications, it is of increasing interest to ensure that TMMs accurately reflect the acoustic properties of soft tissue at these higher frequencies. In this study, the acoustic properties of ex vivo brain, liver and kidney samples from 50 mice were assessed in the frequency range 12–32?MHz. Measurements were performed within 6?min of euthanasia in a phosphate-buffered saline solution maintained at 37.2?±?0.2?°C. The measured mean values for the speed of sound for all organs were found to be higher than the International Electrotechnical Commission guideline recommended value for TMMs. The attenuation coefficients measured for brain, liver and kidney samples were compared with the results of previous studies at lower frequencies. Only the measured kidney attenuation coefficient was found to be in good agreement with the International Electrotechnical Commission guideline. The information provided in this study can be used as a baseline on which to manufacture a TMM suitable for high-frequency applications.     

Acoustic characterization of tissue-mimicking materials for ultrasound perfusion imaging research

Materials with well-characterized acoustic properties are of great interest for the development of tissue-mimicking phantoms with designed (micro)vasculature networks. These represent a useful means for controlled in-vitro experiments to validate perfusion imaging methods such as Doppler and contrast-enhanced ultrasound (CEUS) imaging. In this work, acoustic properties of seven tissue-mimicking phantom materials at different concentrations of their compounds and five phantom case materials are characterized and compared at room temperature. The goal of this research is to determine the most suitable phantom and case material for ultrasound perfusion imaging experiments. The measurements show a wide range in speed of sound varying from 1057 to 1616 m/s, acoustic impedance varying from 1.09 to 1.71 × 10⁶ kg/m²s, and attenuation coefficients varying from 0.1 to 22.18 dB/cm at frequencies varying from 1 MHz to 6 MHz for different phantom materials. The nonlinearity parameter B/A varies from 6.1 to 12.3 for most phantom materials. This work also reports the speed of sound, acoustic impedance and attenuation coefficient for case materials. According to our results, polyacrylamide (PAA) and polymethylpentene (TPX) are the optimal materials for phantoms and their cases, respectively. To demonstrate the performance of the optimal materials, we performed power Doppler ultrasound imaging of a perfusable phantom, and CEUS imaging of that phantom and a perfusion system. The obtained results can assist researchers in the selection of the most suited materials for in-vitro studies with ultrasound imaging.     

Ultrasonic Through-Transmission Measurements of Human Musculoskeletal and Fat Properties

The study described here was aimed at investigating the feasibility of using the ultrasonic through-transmission technique to estimate human musculoskeletal and fat properties. Five hundred eighty-two volunteers were assessed by dual-energy X-ray absorptiometry (DXA) and ultrasonic transmission techniques. Bone mineral density (BMD), muscle and fat mass were measured for both legs and the whole body. Hip BMD and spine BMD were also measured. Ultrasonic transmission measurements were performed on the heel, and the measured parameters were broadband ultrasound attenuation (BUA), speed of sound (SOS), ultrasonic stiffness index (SI), T-score and Z-score, which were significantly correlated with all measured BMDs. The optimal correlation was observed between SI and left-leg BMD (p < 0.001) before and after adjustment for age, sex and body mass index (BMI). The linear and partial correlation analyses revealed that BUA and SOS were closely associated with muscle and fat mass, respectively. Multiple regressions revealed that muscle and fat mass significantly contributed to the prediction of transmission parameters, explaining up to 17.83% (p < 0.001) variance independently of BMD. The results suggest that the ultrasonic through-transmission technique could help in the clinical diagnosis of skeletal and muscular system diseases.     

Acoustic Radiation Force Impulse Imaging with Virtual Touch Tissue Quantification: Measurements of Normal Breast Tissue and Dependence on the Degree of Pre-compression

Acoustic radiation force impulse imaging (ARFI) with Virtual Touch tissue quantification (VTTQ) enables the determination of shear wave velocity in meters per second (m/s). We investigated shear wave velocity in normal breast tissue and analyzed the influence of the degree of pre-compression on the measurements. In repeated measurements and with normal pre-compression, the mean shear wave velocity in breast parenchyma was significantly higher than that in breast adipose tissue (3.33 ± 1.18 m/s vs. 2.90 ± 1.10 m/s; p < 0.001; 712 measurements in 89 patients). Furthermore, we found a significant positive correlation between degree of pre-compression and velocity measurements. Shear wave velocities with low, moderate and high pre-compression were 1.89, 3.18 and 4.39 m/s in parenchyma, compared with 1.46, 2.55 and 3.64 m/s in adipose tissue, respectively (p < 0.001; 360 measurements in 60 patients). VTTQ of breast tissue is a feasible method with high accuracy; however, the degree of pre-compression applied may significantly influence the measurements.     

Frequency Specific Ultrasound Attenuation is Sensitive to Trabecular Bone Structure

This study investigated the efficacy of frequency modulated ultrasound attenuation in the assessment of the trabecular structural properties. Four frequency modulated signals were created to represent four frequency bands centered at 500 kHz, 900 kHz, 1.3 MHz and 1.7 MHz with the bandwidth of 400 kHz. Five 1-cm trabecular cubes were harvested from fresh bovine distal femur. The cubes underwent four steps of demineralization process to expand the sample size to 25 with the greater variations of the structural properties for the better correlation study. Pearson correlation study was performed between the ultrasound attenuation in four frequency bands and the trabecular structural properties. The results showed that correlations of frequency modulated ultrasound attenuation to the trabecular structural properties are dependent on frequency bands. The attenuation in proximal-distal orientation had the highest correlation to BV/TV (R² = 0.73, p < 0.001) and trabecular thickness (R² = 0.50, p < 0.001) at the frequency band centered at 1.7 MHz. It was equivalent in the four frequency bands in correlation to the trabecular number (average R² = 0.80, p < 0.001) and to the trabecular separation (average R² = 0.83, p < 0.001). The attenuation in anterio-posterial orientation had the highest correlation to BV/TV (R² = 0.80, p < 0.001) and trabecular thickness (R² = 0.71, p < 0.001) at the frequency band centered at 1.3 MHz. The attenuation in the first frequency band was the most sensitive to the trabecular number (R² = 0.71, p < 0.001) and trabecular separation (R² = 0.80, p < 0.001). No significant correlation was observed for the attenuation in medial-lateral orientation across the four frequency bands.     

Attenuation coefficient and sound speed in human myometrium and uterine fibroid tumors.

OBJECTIVE: To develop a noninvasive method for treatment of uterine fibroid tumors using high-intensity focused ultrasound. Optimal high-intensity focused ultrasound treatment would be dependent on quantitative information about ultrasonic tissue characteristics. METHODS: Ultrasonic attenuation and the sound speed of fresh human fibroid tumors and myometrium were measured as a function of frequency (1-3 MHz) by using a pulse transmission technique before and after in vitro high-intensity focused ultrasound treatment (3.5 MHz at an intensity of 2,000 W/cm2). RESULTS: The ranges of the attenuation coefficients, before and after high-intensity focused ultrasound treatment, were 0.9 to 2.2 and 1.8 to 3.9 dB/cm2, respectively, for fibroid tumors and 0.5 to 1.6 and 1.7 to 3.3 dB/cm2, respectively, for myometrium. Although the sound speed appeared to be independent of frequency (1,611 to 1,616 m/s at 1 to 3 MHz) in both types of tissues, a slight increase of approximately 4 to 14 m/s was observed after high-intensity focused ultrasound treatment. CONCLUSIONS: The results of this study represent our first reported values of the attenuation coefficient and sound speed in fibroid tumors and myometrium before and after high-intensity focused ultrasound treatment.     

Beyond Cervical Length: A Pilot Study of Ultrasonic Attenuation for Early Detection of Preterm Birth Risk

The purpose of this study was to determine whether cervical ultrasonic attenuation could identify women at risk of spontaneous preterm birth. During pregnancy, women (n = 67) underwent from one to five transvaginal ultrasonic examinations to estimate cervical ultrasonic attenuation and cervical length. Ultrasonic data were obtained with a Zonare ultrasound system with a 5- to 9-MHz endovaginal transducer and processed offline. Cervical ultrasonic attenuation was lower at 17–21 wk of gestation in the SPTB group (1.02 dB/cm-MHz) than in the full-term birth groups (1.34 dB/cm-MHz) (p = 0.04). Cervical length was shorter (3.16 cm) at 22–26 wk in the SPTB group than in the women delivering full term (3.68 cm) (p = 0.004); cervical attenuation was not significantly different at this time point. These findings suggest that low attenuation may be an additional early cervical marker to identify women at risk for SPTB.     

Investigation of Acoustic Changes Resulting from Contrast Enhancement in Through-Transmission Ultrasonic Imaging

Through-transmitted ultrasonic waves can be used for computed projection imaging of the breast. The goal of this research was to analyze the acoustic properties changes associated with the propagation of ultrasonic waves through media before and after ultrasound contrast agent (UCA) injection and to study the feasibility of a new imaging method combining projection imaging and UCA. Two transmission techniques were examined: Gaussian pulses and pulse inversion. In the latter, three different double inverted pulses were studied: double Gaussian, double square and double sine. A computerized automatic ultrasonic scanning system was used for imaging. To simulate blood vessels, a phantom, consisting of a latex tube through which saline was circulated, was assembled. The phantom was placed within the scanner and sets of acoustic projection images were acquired. Then, a suspension of the UCA Definity™ was added to the saline and a new set of images was obtained. The pre and postcontrast images were quantitatively compared in terms of amplitude and time-of-flight (TOF). In addition, nonlinearity was evaluated by comparing the relative alteration of the positive and negative parts of the signal. Statistically significant (p < 0.001) changes in the projection images resulting from the UCA injection were observed in wave amplitude (22% ± 13%), TOF (7.9 ns ± 6.3 ns) and nonlinear properties (35% ± 32% and 56% ± 17% for Gausian pulses and pulse inversion, respectively). One in vivo study of a female breast is also presented and its preliminary outcomes discussed. Together, these results indicate the technical feasibility of the suggested method and its potential to detect breast tumors. (E-mail:haim@bm.technion.ac.il)     

Interlaboratory comparison of ultrasonic backscatter coefficient measurements from 2 to 9 MHz.

OBJECTIVE: As are the attenuation coefficient and sound speed, the backscatter coefficient is a fundamental ultrasonic property that has been used to characterize many tissues. Unfortunately, there is currently far less standardization for the ultrasonic backscatter measurement than for the other two, as evidenced by a previous American Institute of Ultrasound in Medicine (AIUM)-sponsored interlaboratory comparison of ultrasonic backscatter, attenuation, and speed measurements (J Ultrasound Med 1999; 18:615-631). To explore reasons for these disparities, the AIUM Endowment for Education and Research recently supported this second interlaboratory comparison, which extends the upper limit of the frequency range from 7 to 9 MHz. METHODS: Eleven laboratories were provided with standard test objects designed and manufactured at the University of Wisconsin (Madison, WI). Each laboratory was asked to perform ultrasonic measurements of sound speed, attenuation coefficients, and backscatter coefficients. Each laboratory was blinded to the values of the ultrasonic properties of the test objects at the time the measurements were performed. RESULTS: Eight of the 11 laboratories submitted results. The range of variation of absolute magnitude of backscatter coefficient measurements was about 2 orders of magnitude. If the results of 1 outlier laboratory are excluded, then the range is reduced to about 1 order of magnitude. Agreement regarding frequency dependence of backscatter was better than reported in the previous interlaboratory comparison. For example, when scatterers were small compared with the ultrasonic wavelength, experimental frequency-dependent backscatter coefficient data obtained by the participating laboratories were usually consistent with the expected Rayleigh scattering behavior (proportional to frequency to the fourth power). CONCLUSIONS: Greater standardization of backscatter measurement methods is needed. Measurements of frequency dependence of backscatter are more consistent than measurements of absolute magnitude.     

Tissue-mimicking materials for teaching sonographers and evaluation of their specifications after three years

In this paper, an algorithm is introduced for making breast phantoms and abnormal masses (cyst, fibroadenoma and cancer). The evaluation of ultrasonic properties (sound velocity and amplitude attenuation coefficient) of these normal breast phantoms and abnormal masses and their ultrasonic images shows that they are stable over 3 years. The measurement and evaluation results of ultrasonic images of our phantoms show that they behave like human breast tissues. Practicing with these phantoms for developing fine-needle aspiration (FNA) skills in sonographers shows that these phantoms reduce the time required for successful FNA. The ultrasonic phantoms have different ultrasonic applications, including ultrasonic medical imaging, the quality control of ultrasound (US) instruments, processing technique evaluation and US training; moreover, they are stable in room temperature and can keep their specifications for more than 3 years. (E-mail: Mokhtarm@modares.ac.ir)     

An Improved Tissue-Mimicking Polyacrylamide Hydrogel Phantom for Visualizing Thermal Lesions with High-Intensity Focused Ultrasound

A recipe was created to improve the tissue-mimicking (TM) bovine serum albumin (BSA) polyacrylamide hydrogel (PAG) reported in our previous study (Choi MJ, Guntur SR, Lee KI, Paeng DG, Coleman AJ. Ultrasound Med Biol 2013; 29:439–448). In that work, the concentration of acrylamide in TM BSA PAG was increased to make its attenuation coefficient the same as that of a tissue. However, this increase made the PAG stiffer and less homogeneous. In addition, the increase in acrylamide caused a significant increase in temperature over the denaturation threshold of BSA during polymerization, which required forced cooling so that the PAG did not become opaque at room temperature after polymerization. To eliminate those shortcomings, we substituted the increased acrylamide with a viscous polysaccharide liquid (corn syrup). The concentration of corn syrup was optimized to 20% (w/v, tested in the volume of 50 mL), so that the acoustic properties of the PAG would be close to those of human liver. The improved TM (iTM) BSA PAG constructed in this study had a speed of sound of 1588 ± 9 m/s, an attenuation coefficient of 0.51 ± 0.06 dB cm^?1 at 1 MHz and a backscattering coefficient of 0.22 ± 0.09 × 10^?3 sr^?1 cm^?1 MHz^?1. The density and acoustic impedance were 1057 kg/m³ and 1.68 MRayl, respectively, and the non-linear parameter (B/A) was 5.9 ± 0.3. The thermal, optical and mechanical properties were almost the same as those of the BSA PAG (Lafon et al.2005). Experimental verification indicated that the thermal lesions visualized in the proposed iTM BSA PAG by high-intensity focused ultrasound were highly reproducible. In conclusion, iTM BSA PAG was proven to eliminate TM BSA PAG shortcomings effectively and is expected to be a promising test phantom for clinical high-intensity focused ultrasound device.