X-ray phase-attenuation duality and phase retrieval

Phase retrieval is the key to quantitative x-ray phase-contrast imaging. To retrieve the phase image of an x-ray wave field, in general one needs multiple phase-contrast images. We have made a new observation of phase-attenuation duality for soft tissues, and we show how only a single phase-contrast image is needed for successful phase retrieval based on this duality. The phase-retrieval formula based on a single phase-contrast image of inhomogeneous soft tissue is derived and presented. We show the striking enhancement of the tissue contrast in simulated phase images that this new approach produces.

[Development of the ultrasonic characterization of biological tissue elasticity]

The variation of tissue elasticity or stiffness is related with diseases of tissue, so the characterization of tissue elasticity is important to diagnosis. There are four methods for ultrasonic characterization of tissue elasticity: imaging inspection techniques, vibration velocity measurements, quasi-static strain measurements and parametric methods. The theories of the method of vibration velocity measurements and the method of quasi-static strain measurements and their new developments are discussed in this paper. The applications and the problems of this technique are discussed also.

Effect of dose on image quality in a detector-based dual-exposure, dual-energy system for chest radiography

PURPOSE

To assess the image quality of subtracted soft tissue and bone images of a CsI-detector-based dual-energy system for chest radiography at varying dose levels.

MATERIAL AND METHODS

We evaluated a CsI-detector-based, dual-exposure, dual-energy prototype system; 126 patients were categorized into groups of small, medium, and large. Fixed values were applied for mAs and mA. The patients were randomized into two groups with intended higher and lower speed pairs of approximately 400/1000 (high and low energy shot) and 200/500, respectively. True speed equivalents were calculated retrospectively using the detector dose. Image quality was evaluated by two highly experienced radiologists in consensus applying a rating scale of 1 to 5 for quality indicators such as image noise, residual bone structures, motion artifacts, and others.

RESULTS

Significantly decreased noise and a significant improvement for display of bone details in the bone image were noted with the higher dose, whereas a significant increase in motion artifacts reduced image quality at the higher dose.

CONCLUSION

Radiation dose did not significantly influence the perception of dual-energy image quality. Dual-energy subtraction, as described, has the potential to become a future routine application in chest radiography.

Estimation of displacement vectors and strain tensors in elastography using angular insonifications

In current practice, only one out of three components of the tissue displacement vector and one of nine components of the strain tensor are accurately estimated and imaged in ultrasound elastography. Since, only the axial component of both the displacement and strain are imaged, other important elastic parameters, such as shear strains and the Poisson's ratio, also are not imaged. Moreover, reconstruction of the Young's modulus would be significantly improved if all components of the strain tensor were available. In this paper, we describe a new method for estimating all the components of the tissue displacement vector following a quasi-static compression. The method uses displacements estimated from radiofrequency echo-signals along multiple ultrasound beam insonification directions. At each spatial location in the compressed medium, orthogonal tissue displacements in both the axial and lateral direction with respect to the direction of the applied compression are estimated by curve fitting angular displacement vector data calculated for all insonification directions. Following displacement estimation in orthogonal directions, components of the corresponding normal and shear strain tensors are estimated. Simulation and experimental results demonstrate the utility of this technique for the computation of the normal and shear strain tensors.

Correlation between mammographic density and volumetric fibroglandular tissue estimated on breast MR images

Previous studies have found that mammographic breast density is highly correlated with breast cancer risk. Therefore, mammographic breast density may be considered as an important risk factor in studies of breast cancer treatments. In this paper, we evaluated the accuracy of using mammograms for estimating breast density by analyzing the correlation between the percent mammographic dense area and the percent glandular tissue volume as estimated from MR images. A dataset of 67 cases having MR images (coronal 3-D SPGR T1-weighted pre-contrast) and corresponding 4-view mammograms was used in this study. Mammographic breast density was estimated by an experienced radiologist and an automated image analysis tool, Mammography Density ESTimator (MDEST) developed previously in our laboratory. For the estimation of the percent volume of fibroglandular tissue in breast MR images, a semiautomatic method was developed to segment the fibroglandular tissue from each slice. The tissue volume was calculated by integration over all slices containing the breast. Interobserver variation was measured for 3 different readers. It was found that the correlation between every two of the three readers for segmentation of MR volumetric fibroglandular tissue was 0.99. The correlations between the percent volumetric fibroglandular tissue on MR images and the percent dense area of the CC and MLO views segmented by an experienced radiologist were both 0.91. The correlation between the percent volumetric fibroglandular tissue on MR images and the percent dense area of the CC and MLO views segmented by MDEST was 0.91 and 0.89, respectively. The root-mean-square (rms) residual ranged from 5.4% to 6.3%. The mean bias ranged from 3% to 6%. The high correlation indicates that changes in mammographic density may be a useful indicator of changes in fibroglandular tissue volume in the breast.

The role of viscosity in the impulse diffraction field of elastic waves induced by the acoustic radiation force

Several ultrasound-based techniques for the estimation of soft tissue elasticity are currently being investigated. Most of them study the medium response to dynamic excitations. Such responses are usually modeled in a purely elastic medium using a Green's function solution of the motion equation. However, elasticity by itself is not necessarily a discriminant parameter for malignancy diagnosis. Modeling viscous properties of tissues could also be of great interest for tumor characterization. We report in this paper an explicit derivation of the Green's function in a viscous and elastic medium taking into account shear, bulk, and coupling waves. From this theoretical calculation, 3D simulations of mechanical waves in viscoelastic soft tissues are presented. The relevance of the viscoelastic Green's function is validated by comparing simulations with experimental data. The experiments were conducted using the supersonic shear imaging (SSI) technique which dynamically and remotely excites tissues using acoustic radiation force. We show that transient shear waves generated with SSI are modeled very precisely by the Green's function formalism. The combined influences of out-of-plane diffraction, beam shape, and shear viscosity on the shape of transient waves are carefully studied as they represent a major issue in ultrasound-based viscoelasticity imaging techniques.

Sonoelastographic imaging of interference patterns for estimation of the shear velocity of homogeneous biomaterials

The shear wave velocity is one of a few important parameters that characterize the mechanical properties of bio-materials. In this paper, two noninvasive methods are proposed to measure the shear velocity by inspecting the shear wave interference patterns. In one method, two shear wave sources are placed on the opposite two sides of a sample, driven by the identical sinusoidal signals. The shear waves from the two sources interact to create interference patterns, which are visualized by the vibration sonoelastography technique. The spacing between the pattern bands equals half of the shear wavelength. The shear velocity can be obtained by taking the product of the wavelength and the frequency. An alternative method is to drive the two vibration sources at slightly different frequencies. In this case, the interference patterns no longer remain stationary. It is proved that the apparent velocity of the moving patterns is proportional to the shear velocity in the medium. Since the apparent velocity of the patterns can be measured by analysing the video sequence, the shear velocity can be obtained thereafter. These approaches are validated by a conventional shear wave time-of-flight approach, and they are accurate within 4% on various homogeneous tissue-mimicking phantoms.

Overdetermined least-squares aberration estimates using common-midpoint signals

As medical ultrasound imaging moves to larger apertures and higher frequencies, tissue sound-speed variations continue to limit resolution. In geophysical imaging, a standard approach for estimating near-surface aberrating delays is to analyze the time shifts between common-midpoint signals. This requires complete data-echoes from every source/receiver pair in the array. Unfocused common-midpoint signals remain highly correlated in the presence of delay aberrations; there is also tremendous redundancy in the data. In medical ultrasound, this technique has been impaired by the wide-angle, random-scattering nature of tissue. This has made it difficult to estimate azimuth-dependent aberration profiles or to harness the full redundancy in the complete data. Prefiltering the data with two-dimensional fan filters mitigates these problems, permitting highly overdetermined, least-squares solutions for the aberration profiles at many steering angles. In experiments with a tissue-mimicking phantom target and silicone rubber aberrators at nonzero stand-off distances from a one-dimensional phased array, this overdetermined, fan-filtering algorithm significantly outperformed other phase-screen algorithms based on nearest-neighbor cross-correlation, speckle brightness maximization, and common-midpoint signal analysis. Our results imply that there is still progress to be made in imaging with single-valued focusing operators. It also appears that the signal-to-noise penalty for using complete data sets is partially compensated by the overdetermined nature of the problem.

Tissue displacements during acupuncture using ultrasound elastography techniques

Acupuncture needle manipulation has been previously shown to result in measurable changes in connective tissue architecture in animal experiments. In this study, we used a novel in vivo ultrasound (US)-based technique to quantify tissue displacement during acupuncture manipulation in humans. B-scan ultrasonic imaging was performed on the thighs of 12 human subjects at different stages of needle motion, including varying amounts of rotation, downward and upward movement performed with a computer-controlled acupuncture needling instrument. Tissue displacements, estimated using cross-correlation techniques, provided successful mapping and quantitative analysis of spatial and temporal tissue behavior during acupuncture needle manipulation. Increasing amounts of rotation had a significant linear effect on tissue displacement during downward and upward needle motion, as well as on rebound tissue displacement after downward needle movement. In addition to being a valuable tool for studies of acupuncture's mechanism of action, this technique may have applications to other types of needling including biopsies.

Radiography of soft tissue of the foot and ankle with diffraction enhanced imaging

Non-calcified tissues, including tendons, ligaments, adipose tissue and cartilage, are not visible, for any practical purposes, with conventional X-ray imaging. Therefore, any pathological changes in these tissues generally necessitate detection through magnetic resonance imaging or ultrasound technology. Until recently the development of an X-ray imaging technique that could detect both bone and soft tissues seemed unrealistic. However, the introduction of diffraction enhanced X-ray imaging (DEI) which is capable of rendering images with absorption, refraction and scatter rejection qualities has allowed detection of specific soft tissues based on small differences in tissue densities. Here we show for the first time that DEI allows high contrast imaging of soft tissues, including ligaments, tendons and adipose tissue, of the human foot and ankle.

Theoretical study in applications of doublet mechanics to detect tissue pathological changes in elastic properties using high frequency ultrasound

The mathematical framework of a new elastic theory-doublet mechanics (DM)-was reviewed. The fundamental difference between DM and classical continuum mechanics (CCM) is that the former has taken the discrete nature of tissue on the cellular level into account and the latter assumes tissue is uniform and continuous. Theoretical calculations based on DM were performed for reflection coefficients of a substrate-tissue layer-substrate assembly. Results of computer simulations have shown that ultrasound reflection coefficients in the range of 15-30 MHz are sensitive to changes in cell size and elastic moduli of tissue according to DM but not to CCM. Potential experimental applications of this technique to tissue characterization are discussed.

Dimensions of the dentogingival unit in maxillary anterior teeth: a new exploration technique (parallel profile radiograph)

This study sought to develop and evaluate a radiographic exploration technique (parallel profile radiograph [PPRx]) for measuring the dentogingival unit on the buccal surfaces of anterior teeth, and to provide additional information on the dimensions of the dentogingival unit in humans. In 88 periodontally healthy individuals, a PPRx was made of the maxillary left central incisor. Over these images, the components of the dentogingival unit were measured. PPRx was a highly reproducible exploratory technique. Mean dentogingival measurements on the buccal surfaces of the teeth were 2.05 +/- 0.87 mm for distance between the CEJ and bone crest; 2.00 +/- 0.72 mm for biologic width; 1.75 +/- 0.24 mm for thickness of connective tissue attachment; 1.12 +/- 0.24 mm for thickness of free gingiva at its base; 0.45 +/- 0.20 mm for thickness of bone plate at crest level; and 1.41 +/- 0.62 mm for gingival overlap on enamel surface. A statistically significant relationship was observed between free gingival width and thickness of connective attachment, and the depth of the gingival sulcus. These results corroborate the notion that the dimensions of the dentogingival unit are highly variable in humans. The thicknesses of both the connective tissue attachment and free gingiva, however, showed less variability than did the thickness of the bone crest, distance between CEJ and bone crest, and biologic width. The results suggest that gingival dimensions are correlated to dentogingival unit dimensions.

Influence of soft tissues on mandibular gray scale levels

The purpose of this study was to analyze the gray levels, expressed in pixels, of the mandibular retromolar region, with regard to the influence of muscular and fat soft tissues near this region. Fifteen dry mandibles were X-rayed with the presence of soft tissue simulators. The radiographs were digitized and evaluated by Digora software. A one cm thick layer of wax was used as a simulator of the muscular soft tissue. Animal fat samples of different thicknesses - 0.5, 1.0, 1.5 and 2.0 cm - were used as a simulator of the fat soft tissue. Results showed that the fat soft tissue simulator influenced the gray level values in pixels of the mandibular retromolar region when analyzed in different thicknesses using the Digora digitized image software.

Spectral estimation for characterization of acoustic aberration

Spectral estimation based on acoustic backscatter from a motionless stochastic medium is described for characterization of aberration in ultrasonic imaging. The underlying assumptions for the estimation are: The correlation length of the medium is short compared to the length of the transmitted acoustic pulse, an isoplanatic region of sufficient size exists around the focal point, and the backscatter can be modeled as an ergodic stochastic process. The motivation for this work is ultrasonic imaging with aberration correction. Measurements were performed using a two-dimensional array system with 80 x 80 transducer elements and an element pitch of 0.6 mm. The f number for the measurements was 1.2 and the center frequency was 3.0 MHz with a 53% bandwidth. Relative phase of aberration was extracted from estimated cross spectra using a robust least-mean-square-error method based on an orthogonal expansion of the phase differences of neighboring wave forms as a function of frequency. Estimates of cross-spectrum phase from measurements of random scattering through a tissue-mimicking aberrator have confidence bands approximately +/- 5 degrees wide. Both phase and magnitude are in good agreement with a reference characterization obtained from a point scatterer.

A quantitative comparison of modulus images obtained using nanoindentation with strain elastograms

Tissue stiffness is generally known to be associated with pathologic changes. Ultrasound (US) elastography, on the other hand, is capable of imaging tissue strain, which may or may not be well-correlated with tissue stiffness. Hence, a quantitative comparison between the elastographic tissue strain images and the corresponding tissue modulus images needed to be performed to evaluate the usefulness of elastography in imaging tissue stiffnesss properties. Simulations were performed to demonstrate and quantify the similarities between modulus images and strain elastograms. This was followed by comparing nanoindenter-based modulus images with strain elastograms of thin slices of tissue-mimicking phantoms. Finally, some beef slices, canine prostates, ovine kidneys and breast cancers grown in mice were used to demonstrate the qualitative correspondence between modulus images and strain elastograms. The simulations and the experiments indicated that it is feasible to perform quantitative comparisons between strain images (using elastography) and modulus images on certain tissue structures and geometries. A good quantitative correspondence (correlation values of greater than 0.8) between structures in the modulus and strain images could be obtained at scales equal to or larger than 20 Qlambda (where Q is the quality factor defined as the ratio of the center frequency over the band width and lambda is the wavelength of the US system) modulus contrasts larger than 5, applied strains between 0.5% and 3% and window lengths for computing strain elastograms between 3 Qlambda and 5 Qlambda. The gelatin-phantom experiments showed lower values of correlation (values around 0.5) than with theory and simulations. The decrease in correlation was attributed to the presence of measurement noise in both strain elastography and modulus imaging, an increase of dimensionality of the problem (from 2-D to 3-D), local anisotropy, heterogeneity and nonstationarity. Experiments on real tissue slices showed further decrease in the correlation to around 0.3, possibly due to additional confounding factors such as time-dependent mechanical properties and geometrical distortions in the tissue during imaging. The work presented in this paper demonstrates that there is an intrinsic relationship between strain elastograms and the actual distribution of soft tissue elastic moduli, and bodes well for continued work in the area of elastography.

Free of speckle ultrasonic imaging of soft tissue with account of second harmonic signal

The Born approximation deconvolved inverse scattering imaging technique is an alternative to the conventional pulse-echo method. This novel technique deconvolves the incident pulse from the reflected pulse, and uses the resulting impulse response to produce an image of the acoustic impedance distribution. It is applicable mainly to structures that resemble a layered medium. The images captured by this method prove to have improved resolution and are free of speckle. With this method one can use ultrasound of lower frequencies than would be required by the pulse-echo method to achieve the same resolution. To provide further improvement of images the second harmonic signals can be employed. Here we describe the deconvolved inverse scattering imaging technique with account of the second harmonic signal. For this purpose the hybrid transducer by Krautkramer Branson Co., which consists of a cylindrical 5 MHz transducer wrapped in an annulus-shaped 2.5 MHz transducer, has been used. The phantom and soft tissue were imaged and in both cases the account of the second harmonic reflection data provides an improvement of the image quality.

Linear approach to axial resolution in elasticity imaging

Thus far axial resolution in elasticity imaging has been addressed only empirically. No clear analytical approaches have emerged because the estimator is non-linear in the data, correlation functions are nonstationary, and system responses vary spatially. This paper describes a linear systems approach based on a small-strain impulse approximation that results in the derivation of a local impulse response (LIR) and local modulation transfer function (LMTF). Closed-form solutions for strain LIR are available to provide new insights on the role of instrumentation and processing on axial strain resolution. Novel phantom measurements are generated to validate results. We found that the correlation window determines axial resolution in most practical situations, but that the the same system properties that determine B-mode resolution ultimately limit elasticity imaging.

Ultrasonography for the interosseous membrane of the forearm

The ability to improve the technique for an accurate clinical diagnosis of the injury of interosseous membrane of the forearm (IOM) associated with forearm fractures and dislocations is important for its treatment and prognosis. Ultrasound examination of the IOM in 46 forearms from 18 normal volunteers, five patients with restricted forearm pronation and supination, and two preoperative cases was performed to determine the usefulness and reproductivity of this examination. The intact IOM was observed as a continuous, slightly convex anteriorly and hyperechoic structure between the radius and ulna with both transverse and longitudinal views. IOMs with histories of forearm injuries were distinguished by the findings, which demonstrated a loss of continuity and were seen as hypoechoic traces from the others. This study confirmed that it is possible to trace the entire IOM and to detect differences between intact and disrupted IOMs with transverse and longitudinal views.

Nonlinear elasticity imaging: theory and phantom study

In tissue the Young's modulus cannot be assumed constant over a wide deformation range. For example, direct mechanical measurements on human prostate show up to a threefold increase in Young's modulus over a 10% deformation. In conventional elasticity imaging, these effects produce strain-dependent elastic contrast. Ignoring these effects generally leads to suboptimal contrast (stiffer tissues at lower strain are contrasted against softer tissues at higher strain), but measuring the nonlinear behavior results in enhanced tissue differentiation. To demonstrate the methods extracting nonlinear elastic properties, both simulations and measurements were performed on an agar-gelatin phantom. Multiple frames of phase-sensitive ultrasound data are acquired as the phantom is deformed by 12%. All interframe displacement data are brought back to the geometry of the first frame to form a three-dimensional (3-D) data set (depth, lateral, and preload dimensions). Data are fit to a 3-D second order polynomial model for each pixel that adjusts for deformation irregularities. For the phantom geometry and elastic properties considered in this paper, reconstructed frame-to-frame strain images using this model result in improved contrast to noise ratios (CNR) at all preload levels, without any sacrifice in spatial resolution. From the same model, strain hardening at all preload levels can be extracted. This is an independent contrast mechanism. Its maximum CNR occurs at 5.13% preload, and it is a 54% improvement over the best case (preload 10.6%) CNR for frame-to-frame strain reconstruction. Actual phantom measurements confirm the essential features of the simulation. Results show that modeling of the nonlinear elastic behavior has the potential to both increase detectability in elasticity imaging and provide a new independent mechanism for tissue differentiation.

Temperature estimation using ultrasonic spatial compound imaging

The feasibility of temperature estimation during high-intensity focused ultrasound therapy using pulse-echo diagnostic ultrasound data has been demonstrated. This method is based upon the measurement of thermally-induced modifications in backscattered RF echoes due to thermal expansion and local changes in the speed of sound. It has been shown that strong ripple artifacts due to the thermo-acoustic lens effect severely corrupt the temperature estimates behind the heated region. We propose here a new imaging technique that improves the temperature estimation behind the heated region and reduces the variance of the temperature estimates in the entire image. We replaced the conventional beamforming on transmit with multiple steered plane wave insonifications using several subapertures. A two-dimensional temperature map is estimated from axial displacement maps between consecutive RF images of identically steered plane wave insonifications. Temperature estimation is then improved by averaging the two-dimensional maps from the multiple steered plane wave insonifications. Experiments were conducted in a tissue-mimicking gelatin-based phantom and in fresh bovine liver.

On the thermal effects associated with radiation force imaging of soft tissue

Several laboratories are investigating the use of acoustic radiation force to image the mechanical properties of tissue. Acoustic Radiation Force Impulse (ARFI) imaging is one approach that uses brief, high-intensity, focused ultrasound pulses to generate radiation force in tissue. This radiation force generates tissue displacements that are tracked using conventional correlation-based ultrasound methods. The tissue response provides a mechanism to discern mechanical properties of the tissue. The acoustic energy that is absorbed by tissue generates radiation force and tissue heating. A finite element methods model of acoustic heating has been developed that models the thermal response of different tissues during short duration radiation force application. The beam sequences and focal configurations used during ARFI imaging are modeled herein; the results of these thermal models can be extended to the heating due to absorption associated with other radiation force-based imaging modalities. ARFI-induced thermal diffusivity patterns are functions of the transducer f-number, the tissue absorption, and the temporal and spatial spacing of adjacent ARFI interrogations. Cooling time constants are on the order of several seconds. Tissue displacement due to thermal expansion is negligible for ARFI imaging. Changes in sound speed due to temperature changes can be appreciable. These thermal models demonstrate that ARFI imaging of soft tissue is safe, although thermal response must be monitored when ARFI beam sequences are being developed.