Telling it like it is

With the amazing successes that have been reported over the past 10 years, it is easy for researchers in therapeutic ultrasound to be seduced by the appeal of biological and clinical studies but understanding the biology alone is insufficient. All good science requires repeatability, and developing a successful therapy is no different. It is imperative from both a scientific and a commercial perspective that we can not only demonstrate the interaction of ultrasound with biological systems but also quantify the relationship between the delivered ultrasound and the biological effect. Moreover, we then need to be able to control the delivered ultrasound the ultrasound dose, if you like to achieve consistent and repeatable treatments. A distinguishing feature of our new journal whose stated goal is to ‘accelerate the adoption of therapeutic ultrasound as a clinical tool’ should be an insistence that best practice is followed first when planning the ultrasound exposure regime and again when reporting those conditions. We should set a clear example for other journals, and for funding bodies, to follow. This will make it apparent, even to those researchers who are not primarily interested in physics and engineering, that knowledge and control of the delivered ultrasound is not something that can be ignored until writing the final paper. It absolutely must be built into a study even before the proposal is submitted. Too often, even in high-quality and esteemed journals, the exposure description is inadequate, and assumptions (for instance, about the mechanism of interaction) are not properly explained. The researchers themselves may often not be fully aware of these weaknesses in their study. It is our belief that a handful of simple guidelines [1] published by the authors of this piece will serve to remind researchers of the importance of good ultrasound measurement and exposure estimation and will lead over time to a greater body of research which can be replicated and tested by others. Our starting principles in preparing these guidelines were simple enough: firstly, that for a quantitative exposure-response study, there must be some measurements