An integrated mechanism–monitoring–control–application framework for power ultrasound cavitation in intelligent theranostics and engineering

Power ultrasound, harnessing controlled cavitation dynamics, represents a versatile platform for energy focusing and matter interaction with broad implications across biomedicine and industry. While prior reviews have cataloged cavitation phenomena, a cohesive framework integrating multiscale mechanisms, advanced monitoring, and intelligent control across disciplines is lacking. This review provides a critical synthesis of the past decade's advances, organized within a closed-loop “mechanism–monitoring–control–application” (MMCA) framework that integrates multiscale physics with real-time monitoring and intelligent control. We first elucidate the multiscale physics of cavitation, from nucleation to collapse, emphasizing insights gained from high-speed imaging and molecular-to-continuum simulations. We then systematically evaluate translational applications in drug delivery, tumor therapy, and materials processing, highlighting how cavitation mechanics dictate efficacy and safety. A comparative analysis reveals common challenges and domain-specific adaptations. Finally, we propose a forward-looking roadmap centered on intelligent closed-loop systems, multimodal integration, and standardized dosimetry. By consolidating foundational knowledge within the MMCA framework, this review provides a strategic roadmap to accelerate the translation of power ultrasound from laboratory innovation to precision medicine and sustainable engineering.