Evaluation of Reconstruction Parameters for 2-D Comb-Push Ultrasound Shear Wave Elastography

Shear wave elastography primer for the abdominal radiologist

PURPOSE

Shear wave elastography (SWE) provides a means for adding information about the mechanical properties of tissues to a diagnostic ultrasound examination. It is important to understand the physics and methods by which the measurements are made to aid interpretation of the results as they relate to disease processes.

METHODS

The components of how ultrasound is used to generate shear waves and make measurements of the induced motion are reviewed. The physics of shear wave propagation are briefly described for elastic and viscoelastic tissues. Additionally, shear wave propagation in homogeneous and inhomogeneous cases is addressed.

RESULTS

SWE technology has been implemented by many clinical vendors with different capabilities. Various quality metrics are used to define valid measurements based on aspects of the shear wave signals or wave velocity estimates.

CONCLUSION

There are many uses for SWE in abdominal imaging, but it is important to understand how the measurements are performed to gauge their utility for diagnosis of different conditions. Continued efforts to make the technology robust in complex clinical situations are ongoing, but many applications actively benefit from added information about tissue mechanical properties for a more holistic view of the patient for diagnosis or assessment of prognosis and treatment management.

On the Role of Coherent Plane Wave Compounding in Shear Wave Elasticity Imaging: The Convolution Effect and Its Implications

OBJECTIVE

The clinical applicability of shear wave elasticity imaging (SWEI) has been confounded by its appreciable inter-system variability and unsatisfactory sensitivity. While SWEI relies on plane wave imaging (PWI) to achieve real-time rendering, it has been rarely noticed that PWI can affect SWEI's performance. This work is aimed at demonstrating that the use of coherent plane wave compounding (CPWC) can be a factor causing SWEI's underperformance.

METHODS

We presented a model to formally describe the slow-time behavior of CPWC in motion tracking. This model reveals that CPWC introduces temporal convolution on the observed motion, making the motion sampling process a low-pass filter (LPF). For validation, shear waves were produced in a phantom in the same way but sampled via PWI using different compounding numbers (CN) and pulse repetition frequencies (PRF), with the obtained signals compared with the inferences drawn from our model. Similar experiments were performed to reconstruct two small targets in the phantom in order to appraise the impact of CPWC on SWEI's sensitivity.

DISCUSSION

The validation experiment shows that the measurements match well with the model inferences, which verifies the LPF nature of CPWC. The phantom study also shows that either increasing CN or decreasing PRF can cause the loss of high-frequency motion information, leading to blurred target delineation by SWEI.

CONCLUSION

The convolution effect can help understand the variability of SWEI. Researchers should beware this effect when working on SWEI standardization. Clinicians using SWEI should also be cautious because this effect makes it harder to identify small lesions.

A New Estimation Scheme for Improving the Performance of Shear Wave Elasticity Imaging

Shear wave velocity (SWV) reconstruction based on time-of-flight (TOF) is widely adopted to realize shear wave elasticity imaging (SWEI). It typically breaks down the reconstruction of a SWV image into many kernels and treats them independently. We hypothesized that information exchange among kernels improves the performance of SWEI. Therefore, we propose the approach of iterative re-weighted least squares based on inter-kernel communication (IKC-IRLS). We also hypothesized that time-to-peak (TTP) is superior to cross-correlation (CC) in visualizing small targets because TTP uses higher shear wave frequencies than CC. To examine the hypotheses, IKC-IRLS was combined with TTP data and compared with four established methods. The five methods were tested by imaging several small-size stiff targets (2.5, 4.0 and 6.4 mm in diameter) using different kernel sizes in the simulation and real experiments. The results indicate that the IKC-IRLS approach can mitigate speckle noise and is robust to TTP outliers. Consequently, the proposed method achieves the highest contrast-to-noise ratio and the lowest mean absolute percentage error of target in almost all tested cases.

Shear Wave Elastography Implementation on a Portable Research Ultrasound System: Initial Results

Ultrasound shear wave elastography (SWE) has emerged as a promising technique that enables the quantitative estimation of soft tissue stiffness. However, its practical implementation is complicated and presents a number of engineering challenges, including high-energy burst transmission, high-frame rate data acquisition and high computational requirements to process huge datasets. Therefore, to date, SWE has only been available for high-end commercial systems or bulk and expensive research platforms. In this work, we present a low-cost, portable and fully configurable 256-channel research system that is able to implement various SWE techniques. We evaluated its transmit capabilities using various push beam patterns and developed algorithms for the reconstruction of tissue stiffness maps. Three different push beam generation methods were evaluated in both homogeneous and heterogeneous experiments using an industry-standard elastography phantom. The results showed that it is possible to implement the SWE modality using a portable and cost-optimized system without significant image quality losses.

A Non-invasive Method to Estimate the Stress-Strain Curve of Soft Tissue Using Ultrasound Elastography

Ultrasound elastography performed under small strain conditions has been intensively studied. However, small deformations may be not sufficiently large to differentiate some abnormal tissues. By combining quasi-static and shear wave elastography, we developed a non-invasive method to estimate the localized stress- strain curve of materials. This method exerts progressive multistep uniaxial compression on the materials, and shear wave measurements were performed at every compression step. This method estimates the 2-D displacements between steps via a 2-D region growing motion tracking method and accumulates these displacements to obtain the large material displacements with respect to the initial configuration. At each step, the shear modulus and stress were calculated according to linear elastic theory. The proposed method was tested on custom-made tissue-mimicking phantoms. Mechanical compression testing was conducted on the samples made of the same material as the phantoms and taken as the reference. The stress-strain curves for the same material from the proposed method and from mechanical testing are in good agreement. The root mean square error (RMSE) and area percentage error (APE) of the stress-strain curve between ultrasound measurement and mechanical testing for soft materials ranged from 0.18 to 0.26 kPa and from 5.6% to 7.8%, respectively. The RMSE and APE for stiff materials ranged from 0.56 to 1.17 kPa and 8.0% to 17.9%. Therefore, our method was able to provide good estimates of the stress-strain curve for tissue-mimicking materials.

Shear Wave Velocity Estimation Using the Real-Time Curve Tracing Method in Ultrasound Elastography

The estimation of shear wave velocity is very important in ultrasonic shear wave elasticity imaging (SWEI). Since the stability and accuracy of ultrasonic testing equipment have been greatly improved, in order to further improve the accuracy of shear wave velocity estimation and increase the quality of shear wave elasticity maps, we propose a novel real-time curve tracing (RTCT) technique to accurately reconstruct the motion trace of shear wave fronts. Based on the curve fitting of each frame shear wave, the propagation velocity of two-dimensional shear waves can be estimated. In this paper, shear wave velocity estimation and shear wave image reconstruction are implemented for homogeneous regions and stiff spherical inclusion regions with different elasticity, respectively. The experimental result shows that the proposed shear wave velocity estimation method based on the real-time curve tracing method has advantages in accuracy and anti-noise performance. Moreover, by eliminating artifacts of shear wave videos, the velocity map acquired can restore the shape of inclusions better. The real-time curve tracing method can provide a new idea for the estimation of shear wave velocity and elastic parameters.

Three-dimensional shear wave elastography on conventional ultrasound scanners with external vibration

Two-dimensional (2D) ultrasound shear wave elastography (SWE) has been widely used for soft tissue properties assessment. Given that shear waves propagate in three dimensions (3D), extending SWE from 2D to 3D is important for comprehensive and accurate stiffness measurement. However, implementation of 3D SWE on a conventional ultrasound scanner is challenging due to the low volume rate (tens of Hertz) associated with limited parallel receive capability of the scanner's hardware beamformer. Therefore, we developed an external mechanical vibration-based 3D SWE technique allowing robust 3D shear wave tracking and speed reconstruction for conventional scanners. The aliased shear wave signal detected with a sub-Nyquist sampling frequency was corrected by leveraging the cyclic nature of the sinusoidal shear wave generated by the external vibrator. Shear wave signals from different sub-volumes were aligned in temporal direction to correct time delays from sequential pulse-echo events, followed by 3D speed reconstruction using a 3D local frequency estimation algorithm. The technique was validated on liver fibrosis phantoms with different stiffness, showing good correlation (r = 0.99, p < 0.001) with values measured from a state-of-the-art SWE system (GE LOGIQ E9). The phantoms with different stiffnesses can be well-differentiated regardless of the external vibrator position, indicating the feasibility of the 3D SWE with regard to different shear wave propagation scenarios. Finally, shear wave speed calculated by the 3D method correlated well with magnetic resonance elastography performed on human liver (r = 0.93, p = 0.02), demonstrating the in vivo feasibility. The proposed technique relies on low volume rate imaging and can be implemented on the widely available clinical ultrasound scanners, facilitating its clinical translation to improve liver fibrosis evaluation.