Tissue elasticity is related to pathology and therefore has important medical applications. Radiation force from a focused ultrasound beam has been used to produce shear waves in tissues for shear wave speed and tissue elasticity measurements. The feasibility of shear wave speed measurement using radiation force for an unfocused ultrasound beam is demonstrated in this study with a linear and a curved array transducer. Consistent measurement of shear wave speed was achieved over a relatively long axial extent (z = 10-40 mm for the linear array, and z = 15-60 mm for the curved array) in 3 calibrated phantoms with different shear moduli. In vivo measurements on the biceps of a healthy volunteer show consistent increase of shear wave speed for the biceps under 0, 1, 2, and 3 kg loading. Advantages and limitations of unfocused push are discussed.
Elasticity; Shear wave; Ultrasound radiation force; Unfocused
Fast and accurate tissue elasticity imaging is essential in studying dynamic tissue mechanical properties. Various ultrasound shear elasticity imaging techniques have been developed in the last two decades. However, to reconstruct a full field-of-view 2D shear elasticity map, multiple data acquisitions are typically required. In this paper, a novel shear elasticity imaging technique, comb-push ultrasound shear elastography (CUSE), is introduced in which only one rapid data acquisition (less than 35 ms) is needed to reconstruct a full field-of-view 2D shear wave speed map (40 mm × 38 mm). Multiple unfocused ultrasound beams arranged in a comb pattern (comb-push) are used to generate shear waves. A directional filter is then applied upon the shear wave field to extract the left-to-right (LR) and right-to-left (RL) propagating shear waves. Local shear wave speed is recovered using a time-of-flight method based on both LR and RL waves. Finally a 2D shear wave speed map is reconstructed by combining the LR and RL speed maps. Smooth and accurate shear wave speed maps are reconstructed using the proposed CUSE method in two calibrated homogeneous phantoms with different moduli. Inclusion phantom experiments demonstrate that CUSE is capable of providing good contrast (contrast-to-noise-ratio ≥ 25 dB) between the inclusion and background without artifacts and is insensitive to inclusion positions. Safety measurements demonstrate that all regulated parameters of the ultrasound output level used in CUSE sequence are well below the FDA limits for diagnostic ultrasound.
comb-push; unfocused ultrasound beam; ultrasound elastography; acoustic radiation force; inclusion
Elasticity imaging methods have been used to study tissue mechanical properties and have demonstrated that tissue elasticity changes with disease state. In current shear wave elasticity imaging methods typically only shear wave speed is measured and rheological models, e.g., Kelvin-Voigt, Maxwell and Standard Linear Solid, are used to solve for tissue mechanical properties such as the shear viscoelastic complex modulus. This paper presents a method to quantify viscoelastic material properties in a model-independent way by estimating the complex shear elastic modulus over a wide frequency range using time-dependent creep response induced by acoustic radiation force. This radiation force induced creep (RFIC) method uses a conversion formula that is the analytic solution of a constitutive equation. The proposed method in combination with Shearwave Dispersion Ultrasound Vibrometry (SDUV) is used to measure the complex modulus so that knowledge of the applied radiation force magnitude is not necessary. The conversion formula is shown to be sensitive to sampling frequency and the first reliable measure in time according to numerical simulations using the Kelvin-Voigt model creep strain and compliance. Representative model-free shear complex moduli from homogeneous tissue mimicking phantoms and one excised swine kidney were obtained. This work proposes a novel model-free ultrasound-based elasticity method that does not require a rheological model with associated fitting requirements.
Shearwave Dispersion Ultrasound Vibrometry (SDUV) is used to quantify both tissue shear elasticity and shear viscosity by evaluating dispersion of shear wave propagation speed over a certain bandwidth (50–500 Hz). The motivation for developing elasticity imaging techniques is based on the possibility of diagnosing disease process. However, it is important to study the mechanical properties of healthy tissues; such data can enhance clinical knowledge and improve understanding of the mechanical properties of tissue. The purpose of this study is to evaluate the feasibility of SDUV for in vitro measurements of renal cortex shear elasticity and shear viscosity on healthy swine kidney. A total of eight excised kidneys from female pigs were used in these in vitro experiments, and a battery of different tests were performed to gain insight on the material properties of the renal cortex. From these eight kidneys, the overall renal cortex elasticity and viscosity was 1.81 ± 0.17 kPa and 1.48 ± 0.49 Pa·s, respectively. In an analysis of the material properties over time after excision, there was not a statistically significant difference in shear elasticity over a 24 hour period, but a statistically significant difference in shear viscosity was found. Homogeneity of the renal cortex was examined and it was found that shear elasticity and shear viscosity were statistically different within a kidney, suggesting global tissue inhomogeneity. More than 30% increases in shear elasticity and shear viscosity were observed after immersion in 10% formaldehyde. Lastly, it was found that the renal cortex is rather anisotropic. Two values for shear elasticity and shear viscosity were measured depending on shear wave propagation direction. These various tests elucidated different aspects of the material properties and the structure of the ex vivo renal cortex.
Measurement of tissue elasticity has emerged as an important advance in medical imaging and tissue characterization. However, soft tissue is inherently a viscoelastic material. One way to characterize the viscoelastic material properties of a material is to measure shear wave propagation velocities within the material at different frequencies and use the dispersion of the velocities, or variation with frequency, to solve for the material properties. Shearwave Dispersion Ultrasound Vibrometry (SDUV) is an ultrasound-based technique that uses this feature to characterize the viscoelastic nature of soft tissue. This method has been used to measure the shear elasticity and viscosity in various types of soft tissues including skeletal muscle, cardiac muscle, liver, kidney, prostate, and arterial vessels. This versatile technique provides measurements of viscoelastic material properties with high spatial and temporal resolution, which can be used for assessing these properties in normal and pathologic tissues. The goals of this paper are to 1) give an overview of viscoelasticity and shear wave velocity dispersion, 2) provide a history of the development of the SDUV method, and 3) survey applications for SDUV that have been previously reported.
dispersion; radiation force; shear waves; ultrasound; viscoelasticity; viscosity
Measurement of shear wave propagation speed has important clinical applications because it is related to tissue stiffness and health state. Shear waves can be generated in tissues by the radiation force of a focused ultrasound beam (push beam). Shear wave speed can be measured by tracking its propagation laterally from the push beam focus using the time-of-flight principle. This study shows that shear wave speed measurements with such methods can be transducer, depth, and lateral tracking range dependent. Three homogeneous phantoms with different stiffness were studied using curvilinear and linear array transducer. Shear wave speed measurements were made at different depths, using different aperture sizes for push, and at different lateral distance ranges from the push beam. The curvilinear transducer shows a relatively large measurement bias that is depth dependent. The possible causes of the bias and options for correction are discussed. These bias errors must be taken into account to provide accurate and precise time-of-flight shear wave speed measurements for clinical use.
Shear wave speed; Liver fibrosis; Bias; ARFI
Tissue mechanical properties such as elasticity are linked to tissue pathology state. Several groups have proposed shear wave propagation speed to quantify tissue mechanical properties. It is well known that biological tissues are viscoelastic materials; therefore velocity dispersion resulting from material viscoelasticity is expected. A method called Shearwave Dispersion Ultrasound Vibrometry (SDUV) can be used to quantify tissue viscoelasticity by measuring dispersion of shear wave propagation speed. However, there is not a gold standard method for validation. In this study we present an independent validation method of shear elastic modulus estimation by SDUV in 3 gelatin phantoms of differing stiffness. In addition, the indentation measurements are compared to estimates of elasticity derived from shear wave group velocities. The shear elastic moduli from indentation were 1.16, 3.40 and 5.6 kPa for a 7, 10 and 15% gelatin phantom respectively. SDUV measurements were 1.61, 3.57 and 5.37 kPa for the gelatin phantoms respectively. Shear elastic moduli derived from shear wave group velocities were 1.78, 5.2 and 7.18 kPa for the gelatin phantoms respectively. The shear elastic modulus estimated from the SDUV, matched the elastic modulus measured by indentation. On the other hand, shear elastic modulus estimated by group velocity did not agree with indentation test estimations. These results suggest that shear elastic modulus estimation by group velocity will be bias when the medium being investigated is dispersive. Therefore a rheological model should be used in order to estimate mechanical properties of viscoelastic materials.
Indentation; SDUV; elasticity
Vibro-acoustography (VA) is an imaging method that forms a two-dimensional (2-D) image by moving two cofocused ultrasound beams with slightly different frequencies over the object in a C-scan format and recording acoustic emission from the focal region at the difference frequency. This article studies tissue heating due to a VA scan using a concentric confocal transducer. The three-dimensional (3-D) ultrasound intensity field calculated by Field II is used with the bio-heat equation to estimate tissue heating due to ultrasound absorption. Results calculated with thermal conduction and with blood perfusion, with conduction and without perfusion and without conduction and without perfusion are compared. Maximum heating due to ultrasound absorption occurs in the transducer’s near-field and maximum temperature rise in soft tissue during a single VA scan is below 0.05°C for all three attenuation coefficients evaluated: 0.3, 0.5 and 0.7 dB/cm/MHz. Transducer self-heating during a single VA scan measured by a thermocouple is less than 0.27°C.
Vibro-acoustography; Tissue heating; Bio-heat equation
Characterization of tissue elasticity (stiffness) and viscosity has important medical applications because these properties are closely related to pathological changes. Quantitative measurement is more suitable than qualitative measurement (i.e., mapping with a relative scale) of tissue viscoelasticity for diagnosis of diffuse diseases where abnormality is not confined to a local region and there is no normal background tissue to provide contrast. Shearwave dispersion ultrasound vibrometry (SDUV) uses shear wave propagation speed measured in tissue at multiple frequencies (typically in the range of hundreds of Hertz) to solve quantitatively for both tissue elasticity and viscosity. A shear wave is stimulated within the tissue by an ultrasound push beam and monitored by a separate ultrasound detect beam. The phase difference of the shear wave between 2 locations along its propagation path is used to calculate shear wave speed within the tissue. In vitro SDUV measurements along and across bovine striated muscle fibers show results of tissue elasticity and viscosity close to literature values. An intermittent pulse sequence is developed to allow one array transducer for both push and detect function. Feasibility of this pulse sequence is demonstrated by in vivo SDUV measurements in swine liver using a dual transducer prototype simulating the operation of a single array transducer.
Shear wave velocity measurements are used in elasticity imaging to find the shear elasticity and viscosity of tissue. A technique called shear wave dispersion ultrasound vibrometry (SDUV) has been introduced to use the dispersive nature of shear wave velocity to locally estimate the material properties of tissue. Shear waves are created using a multifrequency ultrasound radiation force, and the propagating shear waves are measured a few millimeters away from the excitation point. The shear wave velocity is measured using a repetitive pulse-echo method and Kalman filtering to find the phase of the harmonic shear wave at 2 different locations. A viscoelastic Voigt model and the shear wave velocity measurements at different frequencies are used to find the shear elasticity (μ1) and viscosity (μ2) of the tissue. The purpose of this paper is to report the accuracy of the SDUV method over a range of different values of μ1 and μ2.
A motion detection model of a vibrating scattering medium was used to analyze measurement errors of vibration phase in a scattering medium. To assess the accuracy of the SDUV method, we modeled the effects of phase errors on estimates of shear wave velocity and material properties while varying parameters such as shear stiffness and viscosity, shear wave amplitude, the distance between shear wave measurements (Δr), signal-to-noise ratio (SNR) of the ultrasound pulse-echo method, and the frequency range of the measurements. We performed an experiment in a section of porcine muscle to evaluate variation of the aforementioned parameters on the estimated shear wave velocity and material property measurements and to validate the error prediction model.
The model showed that errors in the shear wave velocity and material property estimates were minimized by maximizing shear wave amplitude, pulse-echo SNR, Δr, and the bandwidth used for shear wave measurements. The experimental model showed optimum performance could be obtained for Δr = 3-6 mm, SNR ≥35 dB, with a frequency range of 100 to 600 Hz, and with a shear wave amplitude on the order of a few microns down to 0.5 μm. The model provides a basis to explore different parameters related to implementation of the SDUV method. The experiment confirmed conclusions made by the model, and the results can be used for optimization of SDUV.
Elasticity imaging is an emerging medical imaging modality that seeks to map the spatial distribution of tissue stiffness. Ultrasound radiation force excitation and motion tracking using pulse-echo ultrasound have been used in numerous methods. Dynamic radiation force is used in vibrometry to cause an object or tissue to vibrate, and the vibration amplitude and phase can be measured with exceptional accuracy. This paper presents a model that simulates harmonic motion detection in a vibrating scattering medium incorporating 3-D beam shapes for radiation force excitation and motion tracking. A parameterized analysis using this model provides a platform to optimize motion detection for vibrometry applications in tissue. An experimental method that produces a multifrequency radiation force is also presented. Experimental harmonic motion detection of simultaneous multifrequency vibration is demonstrated using a single transducer. This method can accurately detect motion with displacement amplitude as low as 100 to 200 nm in bovine muscle. Vibration phase can be measured within 10° or less. The experimental results validate the conclusions observed from the model and show multifrequency vibration induction and measurements can be performed simultaneously.
We introduced a harmonic-to-fundamental ratio (HFR) of the radiofrequency (RF) signals that reduces confounding effects of attenuation. We studied whether HFR analysis of RF signals received from contrast microbubbles allows accurate measurement of the left ventricular (LV) cavity area under varying levels of attenuation.
Attenuation is a fundamental problem in ultrasound imaging and limits the use of clinical echocardiography.
RF data from short axis systolic and diastolic scans were obtained from 14 open-chest dogs following left-atrial bolus of Optison. Attenuation was induced by interposed silicone pads calibrated to induce 7 dB or 14 dB reductions of the backscattered RF signal. RF images were reconstructed from the RF signals, HFR values calculated for each image pixel for 0 dB, 7 dB and 14 dB attenuation conditions, and LV area obtained by summation of “LV cavity pixels”. A reference LV cavity area was obtained from endocardial border tracings in enhanced scans by experts.
Correlation of the HFR-defined and reference areas at systole was R = 0.95, R= 0.94, and R= 0.91 for 0 dB, 7 dB and 14 dB levels of attenuation, respectively, and at diastole was R = 0.95 for 0dB, 7 dB and 14 dB levels of attenuation. The mean difference from both systolic and diastolic values was < 1.45 cm2 (i.e. negligible) in all attenuation settings.
Our novel HFR method supports precise measurement of the LV cavity area in contrast images with simulated high attenuation of ultrasound signals.
Contrast echocardiography; ultrasound attenuation; left ventricle cavity area; radiofrequency signal; harmonic signal; fundamental signal