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Transcranial ultrasound applications require accurate simulations to predictintracranial acoustic pressure fields. The current gold standard typicallyconsists of calculating a longitudinal ultrasound wave propagation using afluid skull model, which is based on full head CT images for retrieving theskull's geometry and elastic constants. Although this approach has extensivelybeen validated for deep brain targets and routinely used in transcranialultrasound ablation procedures, its accuracy in shallow cortical regionsremains unexplored. In this study, we explore the shear wave effects associatedwith transcranial focused ultrasound propagation, both numerically andexperimentally. The intracranial acoustic pressure was measured at differentincidence angles at the parietal and frontal regions in an ex vivo human skull.The fluid-like skull model was then compared to the solid model comprising bothlongitudinal and shear waves. The results consistently show a larger error andvariability for both models when considering an oblique incidence, reaching amaximum of 125% mean deviation of the focal area when employing the fluid skullmodel. Statistical assessments further revealed that ignoring shear wavesresults in an average ~40% overestimation of the intracranial acoustic pressureand inability to obtain an accurate intracranial acoustic pressuredistribution. Moreover, the solid model has a more stable performance, evenwhen small variations in the skull-transducer relative position are introduced.Our results could contribute to the refinement of the transcranial ultrasoundpropagation modeling methods thus help improving the safety and outcome oftranscranial ultrasound therapy in the cortical brain areas.

Influence of shear waves on transcranial ultrasound propagation in cortical brain regions