{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T18:29:11Z","timestamp":1789410551340,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T00:00:00Z","timestamp":1538352000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100009420","name":"Varsinais-Suomen Sairaanhoitopiiri","doi-asserted-by":"publisher","award":["K3007"],"award-info":[{"award-number":["K3007"]}],"id":[{"id":"10.13039\/501100009420","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","award":["EP\/L020262\/1"],"award-info":[{"award-number":["EP\/L020262\/1"]}],"id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","award":["EP\/M011119\/1"],"award-info":[{"award-number":["EP\/M011119\/1"]}],"id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Transurethral ultrasound therapy is an investigational treatment modality which could potentially be used for the localized treatment of prostate cancer. One of the limiting factors of this therapy is prostatic calcifications. These attenuate and reflect ultrasound and thus reduce the efficacy of the heating. The aim of this study is to investigate how prostatic calcifications affect therapeutic efficacy, and to identify the best sonication strategy when calcifications are present.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Realistic computational models were used on clinical patient data in order to simulate different therapeutic situations with naturally occurring calcifications as well as artificial calcifications of different sizes (1\u201310\u00a0mm) and distances (5\u201315\u00a0mm). Furthermore, different sonication strategies were tested in order to deliver therapy to the untreated tissue regions behind the calcifications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The presence of calcifications in front of the ultrasound field was found to increase the peak pressure by 100% on average while the maximum temperature only rose by 9% during a 20\u2010s sonication. Losses in ultrasound energy were due to the relatively large acoustic impedance mismatch between the prostate tissue and the calcifications (1.63 vs 3.20 <jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content>ayl) and high attenuation coefficient (0.78 vs 2.64\u00a0<jats:styled-content style=\"fixed-case\">dB<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>z<jats:sup>1.1<\/jats:sup>\/cm), which together left untreated tissue regions behind the calcifications. In addition, elevated temperatures were seen in the region between the transducer and the calcifications. Lower sonication frequencies (1\u20134\u00a0<jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>z) were not able to penetrate through the calcifications effectively, but longer sonication durations (20\u201360\u00a0s) with selective transducer elements were effective in treating the tissue regions behind the calcifications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Prostatic calcifications limit the reach of therapeutic ultrasound treatment due to reflections and attenuation. The tissue regions behind the calcifications can possibly be treated using longer sonication durations combined with proper transducer element selection. However, caution should be taken with calcifications located close to sensitive organs such as the urethra, bladder neck, or rectal wall.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.13183","type":"journal-article","created":{"date-parts":[[2018,9,16]],"date-time":"2018-09-16T06:24:25Z","timestamp":1537079065000},"page":"4793-4805","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Transurethral ultrasound therapy of the prostate in the presence of calcifications: A simulation study"],"prefix":"10.1002","volume":"45","author":[{"given":"Visa","family":"Suomi","sequence":"first","affiliation":[{"name":"Department of Radiology Turku University Hospital Kiinamyllynkatu 4\u20108 20521 Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"Treeby","sequence":"additional","affiliation":[{"name":"Department of Medical Physics and Biomedical Engineering University College London Gower Street London WC1E 6BT UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiri","family":"Jaros","sequence":"additional","affiliation":[{"name":"Centre of Excellence IT4Innovation Faculty of Information Technology Brno University of Technology Bozetechova 1\/2 612 66 Brno Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietari","family":"Makela","sequence":"additional","affiliation":[{"name":"Department of Radiology Turku University Hospital Kiinamyllynkatu 4\u20108 20521 Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Anttinen","sequence":"additional","affiliation":[{"name":"Department of Urology Turku University Hospital Kiinamyllynkatu 4\u20108 20521 Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jani","family":"Saunavaara","sequence":"additional","affiliation":[{"name":"Department of Medical Physics Turku University Hospital Kiinamyllynkatu 4\u20108 20521 Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teija","family":"Sainio","sequence":"additional","affiliation":[{"name":"Department of Medical Physics Turku University Hospital Kiinamyllynkatu 4\u20108 20521 Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"Kiviniemi","sequence":"additional","affiliation":[{"name":"Department of Radiology Turku University Hospital Kiinamyllynkatu 4\u20108 20521 Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Blanco","sequence":"additional","affiliation":[{"name":"Department of Radiology Turku University Hospital Kiinamyllynkatu 4\u20108 20521 Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","unstructured":"StewartB WildC.World Cancer Report 2014. 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