A few thoughts...
20MPa is not exceptional. E.g. 20MPa is the tension in a 1mm diameter vertical string with 1.6kg hanging from it. Think of that as a ‘pressure’ of -20MPa.
The article refers to ‘extremely powerful ultrasound’ which sounds dramatic but may be misleading. The author probably means ‘high intensity ultrasound’ - intensity of not the same as power.
When ultrasound passes through a liquid, pressure oscillates between positive and negative values. If the pressure is sufficiently negative for long enough, then cavitation (bubble formation) occurs – followed by collapse of the bubble as the pressure increases. In tissue, this can cause localised cell-damage.
I think the article should be saying this:
- we can use a pattern of widely-spaced, high intensity, short bursts of ultrasound;
- the lowest pressure (-20MPa) and duration (##\sim \mu s##) of each burst is sufficient to cause controlled cavitation resulting in local cell-damage;
- with a suitable choice of burst-spacing there is relatively little unwanted heating of non-target cells.
So target cells are destroyed without collateral damage caused by excess heat.
This means cavitation is no longer a nuisance. It can be used as the main mechanism to destroy targetted (unhealthy) cells.
Minor edits.