Shear wave spectroscopy for in vivo quantification of human soft tissues visco-elasticity

Magnetic resonance elastography of liver and spleen: Methods and applications

The viscoelastic properties of the liver and spleen can be assessed with magnetic resonance elastography (MRE). Several actuators, MRI acquisition sequences and reconstruction algorithms have been proposed for this purpose. Reproducible results are obtained, especially when the examination is performed in standard conditions with the patient fasting. Accurate staging of liver fibrosis can be obtained by measuring liver stiffness or elasticity with MRE. Moreover, emerging evidence shows that assessing the tissue viscous parameters with MRE is useful for characterizing liver inflammation, non-alcoholic steatohepatitis, hepatic congestion, portal hypertension, and hepatic tumors. Further advances such as multifrequency acquisitions and compression-sensitive MRE may provide novel quantitative markers of hepatic and splenic mechanical properties that may improve the diagnosis of hepatic and splenic diseases.

Viscoelasticity Measurement in Rat Livers Using Shear-Wave US Elastography

To investigate the usefulness of shear-wave speed and dispersion slope measurements obtained, using an ultrasound elastography system in rat livers with various degrees of necroinflammation and fibrosis. A total of 25 male Sprague Dawley rats were randomly divided into 5 groups of 5 rats each: G0 (control), G1 (CCl4 injected twice a week for 1 wk), G2 (CCl4 injected four times a wk for 1 wk), G3 (CCl4 injected twice a wk for 6 wk) and G4 (CCl4 injected twice a wk for 10 wk). The shear-wave speed (m/s) and the dispersion slope ([m/s]/kHz) were measured. Histologic features (inflammation, necrosis and fibrosis) were used as reference standards. In multivariable analysis with histologic features as independent variables, the fibrosis grade was significantly related to shear-wave speed (p < 0.05) and the necrosis grade was significantly related to dispersion slope (p < 0.05). Dispersion slope is more useful than shear-wave speed for predicting the degree of necroinflammation.

Acoustic Radiation Force Based Ultrasound Elasticity Imaging for Biomedical Applications

Pathological changes in biological tissue are related to the changes in mechanical properties of biological tissue. Conventional medical screening tools such as ultrasound, magnetic resonance imaging or computed tomography have failed to produce the elastic properties of biological tissues directly. Ultrasound elasticity imaging (UEI) has been proposed as a promising imaging tool to map the elastic parameters of soft tissues for the clinical diagnosis of various diseases include prostate, liver, breast, and thyroid gland. Existing UEI-based approaches can be classified into three groups: internal physiologic excitation, external excitation, and acoustic radiation force (ARF) excitation methods. Among these methods, ARF has become one of the most popular techniques for the clinical diagnosis and treatment of disease. This paper provides comprehensive information on the recently developed ARF-based UEI techniques and instruments for biomedical applications. The mechanical properties of soft tissue, ARF and displacement estimation methods, working principle and implementation instruments for each ARF-based UEI method are discussed.

Analysis of Transient Shear Wave in Lossy Media

The propagation of shear waves from impulsive forces is an important topic in elastography. Observations of shear wave propagation can be obtained with numerous clinical imaging systems. Parameter estimations of the shear wave speed in tissues, and more generally the viscoelastic parameters of tissues, are based on some underlying models of shear wave propagation. The models typically include specific choices of the spatial and temporal shape of the impulsive force and the elastic or viscoelastic properties of the medium. In this work, we extend the analytical treatment of 2-D shear wave propagation in a biomaterial. The approach applies integral theorems relevant to the solution of the generalized Helmholtz equation, and does not depend on a specific rheological model of the tissue's viscoelastic properties. Estimators of attenuation and shear wave speed are derived from the analytical solutions, and these are applied to an elastic phantom, a viscoelastic phantom and in vivo liver using a clinical ultrasound scanner. In these samples, estimated shear wave group velocities ranged from 1.7 m/s in the liver to 2.5 m/s in the viscoelastic phantom, and these are lower-bounded by independent measurements of phase velocity.

Muscle Shear Wave Elastography in Inclusion Body Myositis: Feasibility, Reliability and Relationships with Muscle Impairments

Degenerative muscle changes may be associated with changes in muscle mechanical properties. Shear wave elastography (SWE) allows direct quantification of muscle shear modulus (MSM). The aim of this study was to evaluate the feasibility and reliability of SWE in the severely disordered muscle as observed in inclusion body myositis. To explore the clinical relevance of SWE, potential relationships between MSM values and level muscle impairments (weakness and ultrasound-derived muscle thickness and echo intensity) were investigated. SWE was performed in the biceps brachii at 100°, 90°, 70° and 10° elbow flexion in 34 patients with inclusion body myositis. MSM was assessed before and after five passive stretch-shortening cycles at 4°/s from 70° to 10° elbow angle and after three maximal voluntary contractions to evaluate potential effects of muscle pre-conditioning. Intra-class correlation coefficients and standard errors of measurements were >0.83 and <1.74 kPa and >0.64 and <1.89 kPa for within- and between-day values, respectively. No significant effect of passive loading-unloading and maximal voluntary contractions was found (all p values  >0.18). MSM correlated to predicted muscle strength (all Spearman correlation coefficients (ρ) > 0.36; all p values < 0.05). A significant correlation was found between muscle echo intensity and muscle shear modulus at 70° only (ρ = 0.38, p <0.05). No correlation was found between muscle thickness and MSM (all ρ values > 0.23 and all p values > 0.25, respectively). Within- and between-day reliability of muscle SWE was satisfactory and moderate, respectively. SWE shows promise for assessing changes in mechanical properties of the severely disordered muscle. Further investigations are required to clarify these findings and to refine their clinical value.

Application of a forward model of axisymmetric shear wave propagation in viscoelastic media to shear wave elastography

A simple but general solution of Navier's equation for axisymmetric shear wave propagation in a homogeneous isotropic viscoelastic medium is presented. It is well-suited for use as a forward model for some acoustic radiation force impulse based shear wave elastography applications because it does not require precise knowledge of the strength of the source, nor its spatial or temporal distribution. Instead, it depends on two assumptions: (1) the source distribution is axisymmetric and confined to a small region near the axis of symmetry, and (2) the propagation medium is isotropic and homogeneous. The model accounts for the vector polarization of shear waves and exactly represents geometric spreading of the shear wavefield, whether spherical, cylindrical, or neither. It makes no assumption about the frequency dependence of material parameters, i.e., it is material-model independent. Validation using measured shear wavefields excited by acoustic radiation force in a homogeneous gelatin sample show that the model accounts for well over 90% of the measured wavefield "energy." An optimal fit of the model to simulated shear wavefields with noise in a homogeneous viscoelastic medium enables estimation of both the shear storage modulus and shear wave attenuation to within 1%.

Rapid scanning wide-field clutter elimination in epi-optoacoustic imaging using comb LOVIT

Epi-style optoacoustic (OA) imaging provides flexibility by integrating the irradiation optics and ultrasound receiver, yet clutter generated by optical absorption near the probe obscures deep OA sources. Localised vibration tagging (LOVIT) retrieves OA signal from images that are acquired with and without a preceding ultrasonic pushing beam: Radiation force leads to a phase shift of signals coming from the focal area resulting in their visibility in a difference image, whereas clutter from outside the pushing beam is eliminated. Disadvantages of a single-focus approach are residual clutter from inside the pushing beam above the focus, and time-intensive scanning of the focus to retrieve a large field-of-view. To speed up acquisition, we propose to create multiple foci in parallel, forming comb-shaped ARF patterns. By subtracting OA images obtained with interleaved combs, this technique moreover results in greatly improved clutter reduction in phantoms mimicking optical, acoustic and elastic properties of breast tissue.

In silico simulation of liver crack detection using ultrasonic shear wave imaging

Background

Liver trauma is an important source of morbidity and mortality worldwide. A timely detection and precise evaluation of traumatic liver injury and the bleeding site is necessary. There is a need to develop better imaging modalities of hepatic injuries to increase the sensitivity of ultrasonic imaging techniques for sites of hemorrhage caused by cracks. In this study, we conduct an in silico simulation of liver crack detection and delineation using an ultrasonic shear wave imaging (USWI) based method.

Methods

We simulate the generation and propagation of the shear wave in a liver tissue medium having a crack using COMSOL. Ultrasound radio frequency (RF) signal synthesis and the two-dimensional speckle tracking algorithm are applied to simulate USWI in a medium with randomly distributed scatterers. Crack detection is performed using the directional filter and the edge detection algorithm rather than the conventional inversion algorithm. Cracks with varied sizes and locations are studied with our method and the crack localization results are compared with the given crack.

Results

Our pilot simulation study shows that, by using USWI combined with a directional filter cum edge detection technique, the near-end edge of the crack can be detected in all the three cracks that we studied. The detection errors are within 5%. For a crack of 1.6 mm thickness, little shear wave can pass through it and the far-end edge of the crack cannot be detected. The detected crack lengths using USWI are all slightly shorter than the actual crack length. The robustness of our method in detecting a straight crack, a curved crack and a subtle crack of 0.5 mm thickness is demonstrated.

Conclusions

In this paper, we simulate the use of a USWI based method for the detection and delineation of the crack in liver. The in silico simulation helps to improve understanding and interpretation of USWI measurements in a physical scattered liver medium with a crack. This pilot study provides a basis for improved insights in future crack detection studies in a tissue phantom or liver.

Fourier-Domain Shift Matching: A Robust Time-of-Flight Approach for Shear Wave Speed Estimation

Our primary objective of this work was to design and test a new time-of-flight (TOF) method that allows measurements of shear wave speed (SWS) following impulsive excitation in soft tissues. Particularly, under the assumption of the local plane shear wave, this work named the Fourier-domain shift matching (FDSM) method, estimates SWS by aligning a series of shear waveforms either temporally or spatially using a solution space deduced by characteristic curves of the well-known 1-D wave equation. The proposed SWS estimation method was tested using computer-simulated data, and tissue-mimicking phantom and ex vivo tissue experiments. Its performance was then compared with three other known TOF methods: lateral time-to-peak (TTP) method with robust random sampling consensus (RANSAC) fitting method, Radon sum transformation method, and a modified cross correlation method. Hereafter, these three TOF methods are referred to as the TTP-RANSAC, Radon sum, and X-corr methods, respectively. In addition to an adapted form of the 2-D Fourier transform (2-D FT)-based method in which the (group) SWS was approximated by averaging phase SWS values was considered for comparison. Based on data evaluated, we found that the overall performance of the above-mentioned temporal implementation of the proposed FDSM method was most similar to the established Radon sum method (correlation = 0.99, scale factor = 1.03, and mean difference = 0.07 m/s), and the 2-D FT (correlation = 0.98, scale factor = 1.00, and mean difference = 0.10 m/s) at high signal quality. However, results obtained from the 2-D FT method diverged (correlation = 0.201) from these of the proposed temporal implementation in the presence of diminished signal quality, whereas the agreement between the Radon sum approach and the proposed temporal implementation largely remained the same (correlation = 0.98).

Characterization of Viscoelastic Materials Using Group Shear Wave Speeds

Recent investigations of viscoelastic properties of materials have been performed by observing shear wave propagation following localized, impulsive excitations, and Fourier decomposing the shear wave signal to parameterize the frequency-dependent phase velocity using a material model. This paper describes a new method to characterize viscoelastic materials using group shear wave speeds , , and determined from the shear wave displacement, velocity, and acceleration signals, respectively. Materials are modeled using a two-parameter linear attenuation model with phase velocity and dispersion slope at a reference frequency of 200 Hz. Analytically calculated lookup tables are used to determine the two material parameters from pairs of measured group shear wave speeds. Green's function calculations are used to validate the analytic model. Results are reported for measurements in viscoelastic and approximately elastic phantoms and demonstrate good agreement with phase velocities measured using Fourier analysis of the measured shear wave signals. The calculated lookup tables are relatively insensitive to the excitation configuration. While many commercial shear wave elasticity imaging systems report group shear wave speeds as the measures of material stiffness, this paper demonstrates that differences , , and of group speeds are first-order measures of the viscous properties of materials.

Nanobomb optical coherence elastography

Wave-based optical elastography is rapidly emerging as a powerful technique for quantifying tissue biomechanical properties due to its noninvasive nature and high displacement sensitivity. However, current approaches are limited in their ability to produce high-frequency waves and highly localized mechanical stress. In this Letter, we demonstrate that the rapid liquid-to-gas phase transition of dye-loaded perfluorocarbon nanodroplets ("nanobombs") initiated by a pulsed laser can produce highly localized, high-frequency, and broadband elastic waves. The waves were detected by an ultra-fast line-field low-coherence holography system. For comparison, we also excited waves using a focused micro-air-pulse. Results from tissue-mimicking phantoms showed that the nanobombs produced elastic waves with frequencies up to ∼9  kHz, which was much greater than the ∼2  kHz waves excited by the air-pulse. Consequently, the nanobombs enabled more accurate quantification of sample viscoelasticity. Combined with their potential for functionalization, the nanobombs show promise for accurate and highly specific noncontact all-optical elastography.

Ultrafast Ultrasound Imaging With Cascaded Dual-Polarity Waves

Ultrafast ultrasound imaging using plane or diverging waves, instead of focused beams, has advanced greatly the development of novel ultrasound imaging methods for evaluating tissue functions beyond anatomical information. However, the sonographic signal-to-noise ratio (SNR) of ultrafast imaging remains limited due to the lack of transmission focusing, and thus insufficient acoustic energy delivery. We hereby propose a new ultrafast ultrasound imaging methodology with cascaded dual-polarity waves (CDWs), which consists of a pulse train with positive and negative polarities. A new coding scheme and a corresponding linear decoding process were thereby designed to obtain the recovered signals with increased amplitude, thus increasing the SNR without sacrificing the frame rate. The newly designed CDW ultrafast ultrasound imaging technique achieved higher quality B-mode images than coherent plane-wave compounding (CPWC) and multiplane wave (MW) imaging in a calibration phantom, ex vivo pork belly, and in vivo human back muscle. CDW imaging shows a significant improvement in the SNR (10.71 dB versus CPWC and 7.62 dB versus MW), penetration depth (36.94% versus CPWC and 35.14% versus MW), and contrast ratio in deep regions (5.97 dB versus CPWC and 5.05 dB versus MW) without compromising other image quality metrics, such as spatial resolution and frame rate. The enhanced image qualities and ultrafast frame rates offered by CDW imaging beget great potential for various novel imaging applications.

Impact of Acoustic Radiation Force Excitation Geometry on Shear Wave Dispersion and Attenuation Estimates

Shear wave elasticity imaging (SWEI) characterizes the mechanical properties of human tissues to differentiate healthy from diseased tissue. Commercial scanners tend to reconstruct shear wave speeds for a region of interest using time-of-flight methods reporting a single shear wave speed (or elastic modulus) to the end user under the assumptions that tissue is elastic and shear wave speeds are not dependent on the frequency content of the shear waves. Human tissues, however, are known to be viscoelastic, resulting in dispersion and attenuation. Shear wave spectroscopy and spectral methods have been previously reported in the literature to quantify shear wave dispersion and attenuation, commonly making an assumption that the acoustic radiation force excitation acts as a cylindrical source with a known geometric shear wave amplitude decay. This work quantifies the bias in shear dispersion and attenuation estimates associated with making this cylindrical wave assumption when applied to shear wave sources with finite depth extents, as commonly occurs with realistic focal geometries, in elastic and viscoelastic media. Bias is quantified using analytically derived shear wave data and shear wave data generated using finite-element method models. Shear wave dispersion and attenuation bias (up to 15% for dispersion and 41% for attenuation) is greater for more tightly focused acoustic radiation force sources with smaller depths of field relative to their lateral extent (height-to-width ratios <16). Dispersion and attenuation errors associated with assuming a cylindrical geometric shear wave decay in SWEI can be appreciable and should be considered when analyzing the viscoelastic properties of tissues with acoustic radiation force source distributions with limited depths of field.

Robust Phase Velocity Dispersion Estimation of Viscoelastic Materials Used for Medical Applications Based on the Multiple Signal Classification Method

Ultrasound shear wave elastography (SWE) is emerging as a promising imaging modality for the noninvasive evaluation of tissue mechanical properties. One of the ways to explore the viscoelasticity is through analyzing the shear wave velocity dispersion curves. To explore the dispersion, it is necessary to estimate the shear wave velocity at each frequency. An increase of the available spectrum to be used for phase velocity estimation is significant for a tissue dispersion analysis in vivo. A number of available methods suffer because the available spectrum that one can work with is limited. We present an alternative method to the classical 2-D Fourier transform (2D-FT) that uses the multiple signal classification (MUSIC) technique to provide robust estimation of the -space and phase velocity dispersion curves. We compared results from the MUSIC method with the 2D-FT technique twofold: by searching for maximum peaks and gradient-based strategy. We tested this method on digital phantom data created using finite-element methods (FEMs) in viscoelastic media as well as on the experimental phantoms used in the Radiological Society of North America Quantitative Imaging Biomarker Alliance effort for the standardization of shear wave velocity in liver fibrosis applications. In addition, we evaluated the algorithm with different levels of added noise for FEMs. The MUSIC algorithm provided dispersion curves estimation with lower errors than the conventional 2D-FT method. The MUSIC method can be used for the robust evaluation of shear wave velocity dispersion curves in viscoelastic media.

Novel ultrasound-based methods to assess liver disease: The game has just begun

In the last 10 years the availability of ultrasound elastography allowed to diagnose and stage liver fibrosis in a non-invasive way and changed the clinical practice of hepatology. Newer ultrasound-based techniques to evaluate properties of the liver tissue other than fibrosis are emerging and will lead to a more complete characterization of the full spectrum of diffuse and focal liver disease. Since these methods are currently undergoing validation and go beyond elastography for liver tissue evaluation, they were not included in the recent guidelines regarding elastography issued by the European Federation of Societies in Ultrasound in Medicine and Biology. In this review paper, we outline the major advances in the field of ultrasound for liver applications, with special emphasis on techniques that could soon be part of the future armamentarium of ultrasound specialists devoted to the assessment of liver disease. Specifically, we discuss current and future ultrasound assessment of steatosis, spleen stiffness for portal hypertension, and elastography for the evaluation of focal liver lesions; we also provide a short glimpse into the next generation of ultrasound diagnostic methods.

Quantitative Evaluation of Denervated Muscle Atrophy with Shear Wave Ultrasound Elastography and a Comparison with the Histopathologic Parameters in an Animal Model

This study explored the efficacy of shear wave ultrasound elastography (SWUE) for quantitative evaluation of denervated muscle atrophy in a rabbit model. The elastic modulus of the triceps surae muscle was measured with SWUE and compared with histopathologic parameters at baseline and at various post-denervation times (2, 4 and 8 wk) with 10 animals in each group. Our results revealed that the elastic modulus of denervated muscle was significantly lower at 2 wk but higher at 8 wk compared with that at the baseline (p <0.05), and no significant difference was found between the elastic modulus at 4 wk and that at the baseline (p > 0.05). The wet-weight ratio and the muscle fiber cross-sectional area of the denervated muscle decreased gradually during the 8 wk post-denervation together with a gradual increase of the collagen fiber area (p <0.05). In conclusion, SWUE was useful for quantitative evaluation of muscle denervation. The decreased elastic modulus might be an early sign of denervated muscle atrophy.

Acoustic Radiation Force-Induced Creep-Recovery (ARFICR): A Noninvasive Method to Characterize Tissue Viscoelasticity

Ultrasound shear wave elastography is a promising noninvasive, low cost, and clinically viable tool for liver fibrosis staging. Current shear wave imaging technologies on clinical ultrasound scanners ignore shear wave dispersion and use a single group velocity measured over the shear wave bandwidth to estimate tissue elasticity. The center frequency and bandwidth of shear waves induced by acoustic radiation force depend on the ultrasound push beam (push duration, -number, etc.) and the viscoelasticity of the medium, and therefore are different across scanners from different vendors. As a result, scanners from different vendors may give different tissue elasticity measurements within the same patient. Various methods have been proposed to evaluate shear wave dispersion to better estimate tissue viscoelasticity. A rheological model such as the Kelvin-Voigt model is typically fitted to the shear wave dispersion to solve for the elasticity and viscosity of tissue. However, these rheological models impose strong assumptions about frequency dependence of elasticity and viscosity. Here, we propose a new method called Acoustic Radiation Force Induced Creep-Recovery (ARFICR) capable of quantifying rheological model-independent measurements of elasticity and viscosity for more robust tissue health assessment. In ARFICR, the creep-recovery time signal at the focus of the push beam is used to calculate the relative elasticity and viscosity (scaled by an unknown constant) over a wide frequency range. Shear waves generated during the ARFICR measurement are also detected and used to calculate the shear wave velocity at its center frequency, which is then used to calibrate the relative elasticity and viscosity to absolute elasticity and viscosity. In this paper, finite-element method simulations and experiments in tissue mimicking phantoms are used to validate and characterize the extent of viscoelastic quantification of ARFICR. The results suggest that ARFICR can measure tissue viscoelasticity reliably. Moreover, the results showed the strong frequency dependence of viscoelastic parameters in tissue mimicking phantoms and healthy liver.

Accounting for the Spatial Observation Window in the 2-D Fourier Transform Analysis of Shear Wave Attenuation

Recent measurements of shear wave propagation in viscoelastic materials have been analyzed by constructing the 2-D Fourier transform (2DFT) of the shear wave signal and measuring the phase velocity c(ω) and attenuation α(ω) from the peak location and full width at half-maximum (FWHM) of the 2DFT signal at discrete frequencies. However, when the shear wave is observed over a finite spatial range, the 2DFT signal is a convolution of the true signal and the observation window, and measurements using the FWHM can yield biased results. In this study, we describe a method to account for the size of the spatial observation window using a model of the 2DFT signal and a non-linear, least-squares fitting procedure to determine c(ω) and α(ω). Results from the analysis of finite-element simulation data agree with c(ω) and α(ω) calculated from the material parameters used in the simulation. Results obtained in a viscoelastic phantom indicate that the measured attenuation is independent of the observation window and agree with measurements of c(ω) and α(ω) obtained using the previously described progressive phase and exponential decay analysis.

Dual-Phase Transmit Focusing for Multiangle Compound Shear-Wave Elasticity Imaging

Shear-wave elasticity imaging (SWEI) enables the quantitative assessment of the mechanical properties of tissue. In SWEI, the effective generation of acoustic radiation force is of paramount importance. Consequently, several research groups have investigated various transmit beamforming and pulse-sequencing methods. To further improve the efficiency of the shear-wave generation, and therefore, to increase the quality of SWEI, we introduce a technique referred to as "multiangle compound SWEI" (MAC-SWEI), which uses simultaneous multiangular push beams created by dual-phase transmit focusing. By applying a constant phase offset on every other element of an array transducer, dual-phase transmit focusing creates both main and grating lobes (i.e., multiangular push beams for pushing) to simultaneously generate shear waves with several wavefront angles. The shear waves propagating at different angles are separated by multidirectional filtering in the frequency domain, leading to the reconstruction of multiple spatially co-registered shear-wave velocity maps. To form a single-elasticity image, these maps are combined, while regions associated with known artifacts created by the push beams are omitted. Overall, we developed and tested the MAC-SWEI method using Field II quantitative simulations and the experiments performed using a programmable ultrasound imaging system. Our results suggest that MAC-SWEI with dual-phase transmit focusing may improve the quality of elasticity maps.

Forward and inverse viscoelastic wave scattering by irregular inclusions for shear wave elastography

Inversion methods in shear wave elastography use simplifying assumptions to recover the mechanical properties of soft tissues. Consequently, these methods suffer from artifacts when applied to media containing strong stiffness contrasts, and do not provide a map of the viscosity. In this work, the shear wave field recorded inside and around an inclusion was used to estimate the viscoelastic properties of the inclusion and surrounding medium, based on an inverse problem approach assuming local homogeneity of both media. An efficient semi-analytical method was developed to model the scattering of an elastic wave by an irregular inclusion, based on a decomposition of the field by Bessel functions and on a decomposition of the boundaries as Fourier series. This model was validated against finite element modeling. Shear waves were experimentally induced by acoustic radiation force in soft tissue phantoms containing stiff and soft inclusions, and the displacement field was imaged at a high frame rate using plane wave imaging. A nonlinear least-squares algorithm compared the model to the experimental data and adjusted the geometrical and mechanical parameters. The estimated shear storage and loss moduli were in good agreement with reference measurements, as well as the estimated inclusion shape. This approach provides an accurate estimation of geometry and viscoelastic properties for a single inclusion in a homogeneous background in the context of radiation force elastography.

Altered viscoelastic properties of stroke-affected muscles estimated using ultrasound shear waves - Preliminary data

As a result of a brain injury such as stroke, the skeletal muscles may undergo numerous structural and functional alterations. These abnormal changes are linked to muscle weakness, joint contracture, and abnormal muscle tone and eventually, result in motor impairment. A subset of these alterations affects passive muscle stiffness, i.e., viscoelastic properties. However, in vivo estimation of changes in viscoelastic properties is a challenging task. Here, we used the shear wave velocity, estimated through ultrasound SuperSonic imaging (SSI), as a surrogate for viscoelastic properties. We estimated shear wave group and phase velocities (dispersion), and thus, quantified both elasticity and viscosity of the muscle tissue, respectively in muscles of hemiplegic stroke survivors. In these individuals, we found significantly higher group and phase velocities in the stroke-affected muscles (p<; 05) compared to those of the contralateral non-affected side. We hypothesize that in addition to changes in neural and contractile properties, there are also, changes in elastic and tissue dispersive properties through local mechanisms. An enhanced understanding of post-stroke changes in skeletal muscles will lead to better and targeted interventions for rehabilitation.

Automated Compression Device for Viscoelasticity Imaging

Noninvasive measurement of tissue viscoelastic properties is gaining more attention for screening and diagnostic purposes. Recently, measuring dynamic response of tissue under a constant force has been studied for estimation of tissue viscoelastic properties in terms of retardation times. The essential part of such a test is an instrument that is capable of creating a controlled axial force and is suitable for clinical applications. Such a device should be lightweight, portable, and easy to use for patient studies to capture tissue dynamics under external stress. In this paper, we present the design of an automated compression device for studying the creep response of materials with tissue-like behaviors. The device can be used to apply a ramp-and-hold force excitation for a predetermined duration of time and it houses an ultrasound probe for monitoring the creep response of the underlying tissue. To validate the performance of the device, several creep tests were performed on tissue-mimicking phantoms, and the results were compared against those from a commercial mechanical testing instrument. Using a second-order Kelvin-Voigt model and surface measurement of the forces and displacements, retardation times T1 and T2 were estimated from each test. These tests showed strong agreement between our automated compression device and the commercial mechanical testing system, with an average relative error of 2.9% and 12.4%, for T1 and T2, respectively. Also, we present the application of compression device to measure local retardation times for four different phantoms with different size and stiffness.

Acoustic Radiation Force Impulse (ARFI)-Induced Peak Displacements Reflect Degree of Anisotropy in Transversely Isotropic Elastic Materials

In transversely isotropic (TI) materials, mechanical properties (Young's modulus, shear modulus, and Poisson's ratio) are different along versus across the axis of symmetry (AoS). In this work, the feasibility of interrogating such directional mechanical property differences using acoustic radiation force impulse (ARFI) imaging is investigated. We herein test the hypotheses that 1) ARFI-induced peak displacements (PDs) vary with TI material orientations when an asymmetrical ARFI excitation point spread function (PSF) is used, but not when a symmetrical ARFI PSF is employed; and 2) the ratio of PDs induced with the long axis of an asymmetrical ARFI PSF oriented along versus across the material's AoS is related to the degree of anisotropy of the material. These hypotheses were tested in silico using finite element method (FEM) models and Field II. ARFI excitations had F/1.5, 3, 4, or 5 focal configurations, with the F/1.5 and F/5 cases having the most asymmetrical and symmetrical PSFs at the focal depth, respectively. These excitations were implemented for ARFI imaging in 52 different simulated TI materials with varying degrees of anisotropy, and the ratio of ARFI-induced PDs was calculated. The change in the ratio of PDs with respect to the anisotropy of the materials was highest for the F/1.5, indicating that PD was most strongly impacted by the material orientation when the ARFI excitation was the most asymmetrical. On the contrary, the ratio of PDs did not depend on the anisotropy of the material for the F/5 ARFI excitation, suggesting that PD did not depend on material orientation when the ARFI excitation was symmetrical. Finally, the ratio of PDs achieved using asymmetrical ARFI PSF reflected the degree of anisotropy in TI materials. These results support that symmetrical ARFI focal configurations are desirable when the orientation of the ARFI excitation to the AoS is not specifically known and measurement standardization is important, such as for longitudinal or cross-sectional studies of anisotropic organs. However, asymmetrical focal configurations are useful for exploiting anisotropy, which may be diagnostically relevant. Feasibility for future experimental implementation is demonstrated by simulating ultrasonic displacement tracking and by varying the ARF duration.

SWAVE Imaging of Placental Elasticity and Viscosity: Proof of Concept

The placenta is the interface between the fetus and the mother and is vital for fetal development. Ultrasound elastography provides a non-invasive way to examine in vivo the stiffness of the placenta; increased stiffness has previously been linked to fetal growth restriction. This study used a previously developed dynamic elastography method, called shear wave absolute vibro-elastography, to study 61 post-delivery clinically normal placentas. The shear wave speeds in the placenta were recorded under five different low-frequency mechanical excitations. The elasticity and viscosity were estimated through rheological modeling. The shear wave speeds at excitation frequencies of 60, 80, 90, 100 and 120 Hz were measured to be 1.23 ± 0.44, 1.67 ± 0.76, 1.74 ± 0.72, 1.80 ± 0.78 and 2.25 ± 0.80 m/s. The shear wave speed values we obtained are consistent with previous studies. In addition, our multi-frequency acquisition approach enables us to provide viscosity estimates that have not been previously reported.

40 MHz high-frequency ultrafast ultrasound imaging

PURPOSE

Ultrafast high-frame-rate ultrasound imaging based on coherent-plane-wave compounding has been developed for many biomedical applications. Most coherent-plane-wave compounding systems typically operate at 3-15 MHz, and the image resolution for this frequency range is not sufficient for visualizing microstructure tissues. Therefore, the purpose of this study was to implement a high-frequency ultrafast ultrasound imaging operating at 40 MHz.

METHODS

The plane-wave compounding imaging and conventional multifocus B-mode imaging were performed using the Field II toolbox of MATLAB in simulation study. In experiments, plane-wave compounding images were obtained from a 256 channel ultrasound research platform with a 40 MHz array transducer. All images were produced by point-spread functions and cyst phantoms. The in vivo experiment was performed from zebrafish. Since high-frequency ultrasound exhibits a lower penetration, chirp excitation was applied to increase the imaging depth in simulation.

RESULTS

The simulation results showed that a lateral resolution of up to 66.93 μm and a contrast of up to 56.41 dB were achieved when using 75-angles plane waves in compounding imaging. The experimental results showed that a lateral resolution of up to 74.83 μm and a contrast of up to 44.62 dB were achieved when using 75-angles plane waves in compounding imaging. The dead zone and compounding noise are about 1.2 mm and 2.0 mm in depth for experimental compounding imaging, respectively. The structure of zebrafish heart was observed clearly using plane-wave compounding imaging.

CONCLUSIONS

The use of fewer than 23 angles for compounding allowed a frame rate higher than 1000 frames per second. However, the compounding imaging exhibits a similar lateral resolution of about 72 μm as the angle of plane wave is higher than 10 angles. This study shows the highest operational frequency for ultrafast high-frame-rate ultrasound imaging.

Limitations and artifacts in shear-wave elastography of the liver

Recent studies have shown that real-time, two-dimensional shear-wave elastography (2D-SWE) can monitor liver fibrosis by measuring tissue elasticity (i.e., elastic modulus). Two clinical studies of 2D-SWE in the liver have shown that there are several practical issues that can compromise quantitation of liver tissue elasticity. Both general ultrasound (US) limitations and limitations in the 2D-SWE method itself resulted in significant variability in estimated liver elasticity. The most common US limitations were: poor acoustic window, limited penetration, and rib/lung shadows. The most common 2D-SWE limitations were: reverberations under the liver capsule, respiratory/cardiac motion, and vessel pulsation/loss of SWE signal. Based on these studies, scan protocols have been optimized to minimize the influence of these limitations on liver elasticity quantification. These refined protocols should move non-invasive SWE closer to becoming the preferred tool to diagnose and manage many chronic diseases of the liver.

Mechanics of ultrasound elastography

Ultrasound elastography enables in vivo measurement of the mechanical properties of living soft tissues in a non-destructive and non-invasive manner and has attracted considerable interest for clinical use in recent years. Continuum mechanics plays an essential role in understanding and improving ultrasound-based elastography methods and is the main focus of this review. In particular, the mechanics theories involved in both static and dynamic elastography methods are surveyed. They may help understand the challenges in and opportunities for the practical applications of various ultrasound elastography methods to characterize the linear elastic, viscoelastic, anisotropic elastic and hyperelastic properties of both bulk and thin-walled soft materials, especially the in vivo characterization of biological soft tissues.

A Frequency-Shift Method to Measure Shear-Wave Attenuation in Soft Tissues

In vivo quantification of shear-wave attenuation in soft tissues may help to better understand human tissue rheology and lead to new diagnostic strategies. Attenuation is difficult to measure in acoustic radiation force elastography because the shear-wave amplitude decreases due to a combination of diffraction and viscous attenuation. Diffraction correction requires assuming a cylindrical wavefront and an isotropic propagation medium, which may not be the case in some applications. In this paper, the frequency-shift method, used in ultrasound imaging and seismology, was adapted for shear-wave attenuation measurement in elastography. This method is not sensitive to diffraction effects. For a linear frequency dependence of the attenuation, a closed-form relation was obtained between the decrease in the peak frequency of the gamma-distributed wave amplitude spectrum and the attenuation coefficient of the propagation medium. The proposed method was tested against a plane-wave reference method in homogeneous agar-gelatin phantoms with 0%, 10%, and 20% oil concentrations, and hence different attenuations of 0.117, 0.202, and 0.292 [Formula: see text]/Hz, respectively. Applicability to biological tissues was demonstrated with two ex vivo porcine liver samples (0.79 and 1.35 [Formula: see text]/Hz) and an in vivo human muscle, measured along (0.43 [Formula: see text]/Hz) and across (1.77 [Formula: see text]/Hz) the tissue fibers. In all cases, the data supported the assumptions of a gamma-distributed spectrum for the source and linear frequency attenuation for the tissue. This method provides tissue attenuation, which is relevant diagnostic information to model viscosity, in addition to shear-wave velocity used to assess elasticity. Data processing is simple and could be performed automatically in real time for clinical applications.

Measuring shear-wave speed with point shear-wave elastography and MR elastography: a phantom study

OBJECTIVES

To compare shear-wave speed (SWS) measured by ultrasound-based point shear-wave elastography (pSWE) and MR elastography (MRE) on phantoms with a known shear modulus, and to assess method validity and variability.

METHODS

5 homogeneous phantoms of different stiffnesses were made. Shear modulus was measured by a rheometer, and this value was used as the standard. 10 SWS measurements were obtained at 4 different depths with 1.0-4.5 MHz convex (4C1) and 4.0-9.0 MHz linear (9L4) transducers using pSWE. MRE was carried out once per phantom, and SWSs at 5 different depths were obtained. These SWSs were then compared with those from a rheometer using linear regression analyses.

RESULTS

SWSs obtained with both pSWE as well as MRE had a strong correlation with those obtained by a rheometer (R²>0.97). The relative difference in SWS between the procedures was from -25.2% to 25.6% for all phantoms, and from -8.1% to 6.9% when the softest and hardest phantoms were excluded. Depth dependency was noted in the 9L4 transducer of pSWE and MRE.

CONCLUSIONS

SWSs from pSWE and MRE showed a good correlation with a rheometer-determined SWS. Although based on phantom studies, SWSs obtained with these methods are not always equivalent, the measurement can be thought of as reliable and these SWSs were reasonably close to each other for the middle range of stiffness within the measurable range.

Evaluation of the Effect of an Anisotropic Medium on Shear Wave Velocities of Intra-Muscular Gelatinous Inclusions

In highly anisotropic biological tissues such as muscle or tendons, calculating Young's modulus from the shear wave speed (c_sw) by using shear wave elastography (SWE) involves a complex transversally isotropic rheological model not yet used in common practice. To our knowledge, the effect of muscle anisotropy on c_sw of intra-muscular lesions has not yet been investigated. The objective of our study was to define the effect of an anisotropic medium on c_sw of intra-muscular gelatinous inclusions. We conducted a prospective monocentric, in vitro study in order to examine the quantitative and qualitative SWE behavior of a 9-mm gelatinous intra-muscular implant depending on the orientation of the probe relative to the muscle fibers. There were very significant differences in the prevalence of SWE signal void (p < 0.01) and in the c_sw (p < 0.01) in the gelatinous intra-muscular implants depending on the orientation of the probe relative to the fibers. Performing the c_sw measurements of centimetric intra-muscular lesions by orienting the probe perpendicular to the fibers decreases the probability of artifacts occurring at high intensity interfaces.

Guidelines for Finite-Element Modeling of Acoustic Radiation Force-Induced Shear Wave Propagation in Tissue-Mimicking Media

Ultrasound shear wave elastography is emerging as an important imaging modality for evaluating tissue material properties. In its practice, some systematic biases have been associated with ultrasound frequencies, focal depths and configuration, and transducer types (linear versus curvilinear), along with displacement estimation and shear wave speed estimation algorithms. Added to that, soft tissues are not purely elastic, so shear waves will travel at different speeds depending on their spectral content, which can be modulated by the acoustic radiation force (ARF) excitation focusing, duration, and the frequency-dependent stiffness of the tissue. To understand how these different acquisition and material property parameters may affect the measurements of shear wave velocity, the simulations of the propagation of shear waves generated by ARF excitations in viscoelastic media are a very important tool. This paper serves to provide an in-depth description of how these simulations are performed. The general scheme is broken into three components: 1) simulation of the 3-D ARF push beam; 2) applying that force distribution to a finite-element model; and 3) extraction of the motion data for post-processing. All three components will be described in detail and combined to create a simulation platform that is powerful for developing and testing algorithms for academic and industrial researchers involved in making quantitative shear-wave-based measurements of tissue material properties.

Attenuation measuring ultrasound shearwave elastography and in vivo application in post-transplant liver patients

Ultrasound and magnetic resonance elastography techniques are used to assess mechanical properties of soft tissues. Tissue stiffness is related to various pathologies such as fibrosis, loss of compliance, and cancer. One way to perform elastography is measuring shear wave velocity of propagating waves in tissue induced by intrinsic motion or an external source of vibration, and relating the shear wave velocity to tissue elasticity. All tissues are inherently viscoelastic and ignoring viscosity biases the velocity-based estimates of elasticity and ignores a potentially important parameter of tissue health. We present attenuation measuring ultrasound shearwave elastography (AMUSE), a technique that independently measures both shear wave velocity and attenuation in tissue and therefore allows characterization of viscoelasticity without using a rheological model. The theoretical basis for AMUSE is first derived and validated in finite element simulations. AMUSE is validated against the traditional methods for assessing shear wave velocity (phase gradient) and attenuation (amplitude decay) in tissue mimicking phantoms and excised tissue. The results agreed within one standard deviation. AMUSE was used to measure shear wave velocity and attenuation in 15 transplanted livers in patients with potential acute rejection, and the results were compared with the biopsy findings in a preliminary study. The comparison showed excellent agreement and suggests that AMUSE can be used to separate transplanted livers with acute rejection from livers with no rejection.

The impact of intraocular pressure on elastic wave velocity estimates in the crystalline lens

Intraocular pressure (IOP) is believed to influence the mechanical properties of ocular tissues including cornea and sclera. The elastic properties of the crystalline lens have been mainly investigated with regard to presbyopia, the age-related loss of accommodation power of the eye. However, the relationship between the elastic properties of the lens and IOP remains to be established. The objective of this study is to measure the elastic wave velocity, which represents the mechanical properties of tissue, in the crystalline lens ex vivo in response to changes in IOP. The elastic wave velocities in the cornea and lens from seven enucleated bovine globe samples were estimated using ultrasound shear wave elasticity imaging. To generate and then image the elastic wave propagation, an ultrasound imaging system was used to transmit a 600 µs pushing pulse at 4.5 MHz center frequency and to acquire ultrasound tracking frames at 6 kHz frame rate. The pushing beams were separately applied to the cornea and lens. IOP in the eyeballs was varied from 5 to 50 mmHg. The results indicate that while the elastic wave velocity in the cornea increased from 0.96  ±  0.30 m s^-1 to 6.27  ±  0.75 m s^-1 as IOP was elevated from 5 to 50 mmHg, there were insignificant changes in the elastic wave velocity in the crystalline lens with the minimum and the maximum speeds of 1.44  ±  0.27 m s^-1 and 2.03  ±  0.46 m s^-1, respectively. This study shows that ultrasound shear wave elasticity imaging can be used to assess the biomechanical properties of the crystalline lens noninvasively. Also, it was observed that the dependency of the crystalline lens stiffness on the IOP was significantly lower in comparison with that of cornea.

Ultrasound viscoelasticity assessment using an adaptive torsional shear wave propagation method

PURPOSE

Different approaches have been used in dynamic elastography to assess mechanical properties of biological tissues. Most techniques are based on a simple inversion based on the measurement of the shear wave speed to assess elasticity, whereas some recent strategies use more elaborated analytical or finite element method (FEM) models. In this study, a new method is proposed for the quantification of both shear storage and loss moduli of confined lesions, in the context of breast imaging, using adaptive torsional shear waves (ATSWs) generated remotely with radiation pressure.

METHODS

A FEM model was developed to solve the inverse wave propagation problem and obtain viscoelastic properties of interrogated media. The inverse problem was formulated and solved in the frequency domain and its robustness to noise and geometric constraints was evaluated. The proposed model was validated in vitro with two independent rheology methods on several homogeneous and heterogeneous breast tissue-mimicking phantoms over a broad range of frequencies (up to 400 Hz).

RESULTS

Viscoelastic properties matched benchmark rheology methods with discrepancies of 8%-38% for the shear modulus G' and 9%-67% for the loss modulus G″. The robustness study indicated good estimations of storage and loss moduli (maximum mean errors of 19% on G' and 32% on G″) for signal-to-noise ratios between 19.5 and 8.5 dB. Larger errors were noticed in the case of biases in lesion dimension and position.

CONCLUSIONS

The ATSW method revealed that it is possible to estimate the viscoelasticity of biological tissues with torsional shear waves when small biases in lesion geometry exist.

A diffraction correction for storage and loss moduli imaging using radiation force based elastography

Noninvasive evaluation of the rheological behavior of soft tissues may provide an important diagnosis tool. Nowadays, available commercial ultrasound systems only provide shear elasticity estimation by shear wave speed assessment under the hypothesis of a purely elastic model. However, to fully characterize the rheological behavior of tissues, given by its storage (G') and loss (G″) moduli, it is necessary to estimate both: shear wave speed and shear wave attenuation. Most elastography techniques use the acoustic radiation force to generate shear waves. For this type of source the shear waves are not plane and a diffraction correction is needed to properly estimate the shear wave attenuation. The use of a cylindrical wave approximation to evaluate diffraction has been proposed by other authors before. Here the validity of such approximation is numerically and experimentally revisited. Then, it is used to generate images of G' and G″ in heterogeneous viscoelastic mediums. A simulation algorithm based on the anisotropic and viscoelastic Green's function was used to establish the validity of the cylindrical approximation. Moreover, two experiments were carried out: a transient elastography experiment where plane shear waves were generated using a vibrating plate and a SSI experiment that uses the acoustic radiation force to generate shear waves. For both experiments the shear wave propagation was followed with an ultrafast ultrasound scanner. Then, the shear wave velocity and shear wave attenuation were recovered from the phase and amplitude decay versus distance respectively. In the SSI experiment the cylindrical approximation was applied to correct attenuation due to diffraction effects. The numerical and experimental results validate the use of a cylindrical correction to assess shear wave attenuation. Finally, by applying the cylindrical correction G' and G″ images were generated in heterogeneous phantoms and a preliminary in vivo feasibility study was carried out in the human liver.

Viscoelastic properties of normal rat liver measured by ultrasound elastography: Comparison with oscillatory rheometry

BACKGROUND

Ultrasound elastography has been widely used to measure liver stiffness. However, the accuracy of liver viscoelasticity obtained by ultrasound elastography has not been well established.

OBJECTIVE

To assess the accuracy of ultrasound elastography for measuring liver viscoelasticity and compare to conventional rheometry methods. In addition, to determine if combining these two methods could delineate the rheological behavior of liver over a wide range of frequencies.

METHODS

The phase velocities of shear waves were measured in livers over a frequency range from 100 to 400 Hz using the ultrasound elastography method of shearwave dispersion ultrasound vibrometry (SDUV), while the complex shear moduli were obtained by rheometry over a frequency range of 1 to 30 Hz. Three rheological models, Maxwell, Voigt, and Zener, were fit to the measured data obtained from the two separate methods and from the combination of the two methods.

RESULTS

The elasticity measured by SDUV was in good agreement with that of rheometry. However, the viscosity measured by SDUV was significantly different from that of rheometry.

CONCLUSIONS

The results indicate that the high frequency components of the dispersive data play a much more important role in determining the dispersive pattern or the viscous value than the low frequency components. It was found that the Maxwell model is not as appropriate as the Voigt and Zener models for describing the rheological behavior of liver.

In Vitro Comparison of Five Different Elastography Systems for Clinical Applications, Using Strain and Shear Wave Technology

Several different platforms providing ultrasound elastography have emerged in recent years. In this in vitro study on a single tissue-mimicking phantom (CIRS Model 49), we aimed to compare the performance of quantitative elastography measurements from platforms running strain elastography and others running shear wave elastography. We evaluated five different elastography platforms using both linear and curvilinear probes. All measurements were performed in parallel by two independent investigators who recorded the elasticity quantitatively. We investigated intra- and inter-observer agreement by intra-class correlation analysis and coefficient of variation, by correlation and limits of agreement. The reproducibility of elasticity measurements was good to excellent for shear wave and strain elastography. All five elastography platforms had high intra-observer (intra-class correlation coefficient: 0.932-1.0) and inter-observer correlation (intra-class correlation coefficient: 0.845-0.996). All inclusions could be differentiated by quantitative elastography by all systems (p < 0.001). The use of a linear probe yielded more reproducible measurements compared with use of a convex probe in 3/4 platforms.

Shear Wave Measurements for Evaluation of Tendon Diseases

This paper investigated the feasibility of using supersonic shear wave measurements to quantitatively differentiate normal and damaged tendons based on their mechanical properties. Five freshly harvested porcine tendons excised from pig legs were used. Tendon damage was induced by incubating the tendons with a 1% w/v collagenase solution. Values of shear modulus were derived both by a time-of-flight (TOF) approach and a transverse isotropic plate model (TI-model). The results show that as the preload applied to the tendon increased from 0 to 3 N, the mean shear modulus derived based on the TOF approach, the TI-model, and Young's modulus estimated from mechanical testing increased from 14.6 to 89.9 kPa, 53.9 to 348 kPa, and from 1.45 to 10.36 MPa, respectively, in untreated tendons, and from 8.4 to 67 kPa, 28 to 258 kPa, and from 0.93 to 7.2 MPa in collagenase-treated tendons. Both the TOF approach and the TI-model correlated well with the changes in Young's modulus. Although there is bias on the estimation of shear modulus using the TOF approach, it still provides statistical significance to differentiate normal and damaged tendons. Our data indicate that supersonic shear wave imaging is a valuable imaging technique to assess tendon stiffness dynamics and characterize normal and collagenase-damaged tendons.

Lorentz force optical coherence elastography

Quantifying tissue biomechanical properties can assist in detection of abnormalities and monitoring disease progression and/or response to a therapy. Optical coherence elastography (OCE) has emerged as a promising technique for noninvasively characterizing tissue biomechanical properties. Several mechanical loading techniques have been proposed to induce static or transient deformations in tissues, but each has its own areas of applications and limitations. This study demonstrates the combination of Lorentz force excitation and phase-sensitive OCE at ?1.5??million A-lines per second to quantify the elasticity of tissue by directly imaging Lorentz force-induced elastic waves. This method of tissue excitation opens the possibility of a wide range of investigations using tissue biocurrents and conductivity for biomechanical analysis.

Ultrasonic method to characterize shear wave propagation in micellar fluids

Viscoelastic micellar fluid characteristics have been measured with mechanically generated shear waves and showed good agreement to shear oscillatory methods. In this paper, shear waves in wormlike micellar fluids using ultrasound were successfully generated and detected. Micellar fluids of different concentrations (100, 200, 300, and 400 mM) were studied with ultrasound-based and conventional rheology methods. The measured micellar fluid complex modulus from oscillatory shear tests between 0.001 and 15.91 Hz was characterized with an extended Maxwell fluid model. The elastic and viscous parameters found using rheological testing were used to estimate shear wave phase velocity over a frequency range from 100 to 500 Hz, and compared to shear wave velocity measured with ultrasound-based methods with a mean absolute error 0.02 m/s. The shear wave frequency content was studied and an increase in shear wave center frequency was found as a function of micellar fluid concentration. Moreover, the bias found in the shear wave group velocity with respect to rheological measurement is attributed to the micellar fluid viscous component. Finally, the shear wave phase velocity evaluated at the center frequency agreed well with the rheological measurements.

Mechanical properties of the tumor stromal microenvironment probed in vitro and ex vivo by in situ-calibrated optical trap-based active microrheology

One of the hallmarks of the malignant transformation of epithelial tissue is the modulation of stromal components of the microenvironment. In particular, aberrant extracellular matrix (ECM) remodeling and stiffening enhances tumor growth and survival and promotes metastasis. Type I collagen is one of the major ECM components. It serves as a scaffold protein in the stroma contributing to the tissue's mechanical properties, imparting tensile strength and rigidity to tissues such as those of the skin, tendons, and lungs. Here we investigate the effects of intrinsic spatial heterogeneities due to fibrillar architecture, pore size and ligand density on the microscale and bulk mechanical properties of the ECM. Type I collagen hydrogels with topologies tuned by polymerization temperature and concentration to mimic physico-chemical properties of a normal tissue and tumor microenvironment were measured by in situ-calibrated Active Microrheology by Optical Trapping revealing significantly different microscale complex shear moduli at Hz-kHz frequencies and two orders of magnitude of strain amplitude that we compared to data from bulk rheology measurements. Access to higher frequencies enabled observation of transitions from elastic to viscous behavior that occur at ~200Hz to 2750Hz, which largely was dependent on tissue architecture well outside the dynamic range of instrument acquisition possible with SAOS bulk rheology. We determined that mouse melanoma tumors and human breast tumors displayed complex moduli ~5-1000 Pa, increasing with frequency and displaying a nonlinear stress-strain response. Thus, we show the feasibility of a mechanical biopsy in efforts to provide a diagnostic tool to aid in the design of therapeutics complementary to those based on standard histopathology.

On the Quantitative Potential of Viscoelastic Response (VisR) Ultrasound Using the One-Dimensional Mass-Spring-Damper Model

Viscoelastic response (VisR) ultrasound is an acoustic radiation force (ARF)-based imaging method that fits induced displacements to a one-dimensional (1-D) mass-spring-damper (MSD) model to estimate the ratio of viscous to elastic moduli, τ, in viscoelastic materials. Error in VisR τ estimation arises from inertia and acoustic displacement underestimation. These error sources are herein evaluated using finite-element method (FEM) simulations, error correction methods are developed, and corrected VisR τ estimates are compared with true simulated τ values to assess VisR's relevance to quantifying viscoelasticity. With regard to inertia, adding a mass term in series with the Voigt model, to achieve the MSD model, accounts for inertia due to tissue mass when ideal point force excitations are used. However, when volumetric ARF excitations are applied, the induced complex system inertia is not described by the single-degree-of-freedom MSD model, causing VisR to overestimate τ. Regarding acoustic displacement underestimation, associated deformation of ARF-induced displacement profiles further distorts VisR τ estimates. However, median error in VisR τ is reduced to approximately -10% using empirically derived error correction functions applied to simulated viscoelastic materials with viscous and elastic properties representative of tissue. The feasibility of corrected VisR imaging is then demonstrated in vivo in the rectus femoris muscle of an adult with no known neuromuscular disorders. These results suggest VisR's potential relevance to quantifying viscoelastic properties clinically.

Intrinsic elastography and its dependence on arterial flow volume

We propose a new estimation method of tissues stiffness from deformation induced by arterial pulsation. The new method was named Intrinsic Elastography (IE). Under two assumptions that the deformation induced by pulsation propagates throughout the body, and the propagation velocity (PV) is closely related to the mechanical properties of tissues, the IE can evaluate the tissue stiffness based on the PV. However, this method has an issue that the observed PVs change with the changes of amounts of the flow. In this paper, we propose the new estimation method in order to estimate true shear elasticity in spite of the changes. The results was compared to the results of SWI. The results was almost identical to the result of SWI, or showed the similar results.

Feasibility of coded vibration in a vibro-ultrasound system for tissue elasticity measurement

The ability of various methods for elasticity measurement and imaging is hampered by the vibration amplitude on biological tissues. Based on the inference that coded excitation will improve the performance of the cross-correlation function of the tissue displacement waves, the idea of exerting encoded external vibration on tested samples for measuring its elasticity is proposed. It was implemented by integrating a programmable vibration generation function into a customized vibro-ultrasound system to generate Barker coded vibration for elasticity measurement. Experiments were conducted on silicone phantoms and porcine muscles. The results showed that coded excitation of the vibration enhanced the accuracy and robustness of the elasticity measurement especially in low signal-to-noise ratio scenarios. In the phantom study, the measured shear modulus values with coded vibration had an R(2 )= 0.993 linear correlation to that of referenced indentation, while for single-cycle pulse the R(2) decreased to 0.987. In porcine muscle study, the coded vibration also obtained a shear modulus value which is more accurate than the single-cycle pulse by 0.16 kPa and 0.33 kPa at two different depths. These results demonstrated the feasibility and potentiality of the coded vibration for enhancing the quality of elasticity measurement and imaging.

Relationship between liver tissue stiffness and histopathological findings analyzed by shear wave elastography and compression testing in rats with non-alcoholic steatohepatitis

PURPOSE

The aim of the present study was to investigate two methods of determining liver stiffness in rats with various degrees of non-alcoholic steatohepatitis induced by a methionine- and choline-deficient (MCD) diet by comparing each finding with reference to histopathological liver findings.

METHODS

Twenty male Wister rats were fed an MCD diet for up to 32 weeks, and four were fed a normal diet. Ultrasound-based shear wave elastography (SWE) and mechanical compression testing using an Instron Universal Testing machine were performed on each rat at designated time points. After each examination, liver histopathology was analyzed to evaluate the degrees of steatosis, inflammation, and fibrosis based on non-alcoholic fatty liver disease (NAFLD) activity score, and each finding was compared with reference to liver histopathologic findings.

RESULTS

Median liver stiffness values measured using SWE showed a stepwise increase with increasing histological inflammation score (P = 0.002), hepatic fibrosis stage (P = 0.029), ballooning score (P = 0.012), and steatosis grade (P = 0.030). Median liver stiffness measured using an Instron machine showed a stepwise increase only with increasing histological fibrosis stage (P = 0.033).

CONCLUSIONS

Degree of liver stiffness measured by SWE and the Instron machine differed. SWE reflected mainly inflammation, whereas Instron machine-derived values primarily reflected fibrosis. This is the main source of discrepancies between measurements made with these two modalities.

A Two-Criterion Model for Microvascular Bio-Effects Induced In Vivo by Contrast Microbubbles Exposed to Medical Ultrasound

The mechanical index (MI) is a theoretical exposure parameter for cavitational bio-effects of diagnostic ultrasound. The theory for the MI assumed that bubbles of all relevant sizes exist in tissue, a condition that is approximated for tissues that include a microbubble contrast agent. Therefore, the MI should allow science-based safety guidance for contrast-enhanced diagnostic ultrasound. However, theoretical predictions of bio-effects thresholds based on the MI typically do not concur with the frequency dependence of experimentally measured thresholds for bio-effects. For example, experimental thresholds for glomerular capillary hemorrhage in rats infused with contrast microbubbles increased approximately linearly with frequency, whereas the MI predicted a square root dependence. Here, cavitation thresholds were computed for linear versions of the acoustic pulses used in that study assuming bubbles containing either air, C3F8, or a 1:1 mixture of the two and surrounded by either blood or kidney tissue. Although no single threshold criterion was successful, combining results for one criterion that maximized circumferential stress in the capillary wall with another that ensured an inertial collapse produced thresholds that were consistent with experimental data. This suggests that a contrast-specific safety metric may be achieved following validation of this two-criterion model.