Experimental model standardizing polyvinyl alcohol hydrogel to simulate endoscopic ultrasound and endoscopic ultrasound-elastography

A Polyvinyl Alcohol (PVA)-Based Phantom for Prostate Cancer Detection Using Multiparametric Ultrasound: A Validation Study

Multiparametric ultrasound (mpUS) enhances prostate cancer (PCa) diagnosis by using multiple imaging modalities. Tissue-mimicking materials (TMM) phantoms, favoured over animal models for ethical and consistency reasons, were created using polyvinyl alcohol (PVA) with varying molecular weights (Mw).

METHODS

Four PVA samples, varying in Mw with constant concertation, were mixed with glycerol, silicon carbide (SiC), and aluminium oxide (Al2O3). Phantoms with varying depth and inclusion sizes were created and tested using shear-wave elastography (SWE). An mpUS phantom was developed to mimic prostate tissue, including isoechoic and hypoechoic inclusions and vessels. The phantom was scanned using supersonic ultrasound, strain elastography, and Doppler ultrasound. Validation was performed using radical prostatectomy data and shear-wave elastography.

RESULTS

The acoustic properties varied with enhancers like glycerol and Al2O3. Low Mw PVA samples had a speed of sound ranging from 1547.50 ± 2 to 1553.70 ± 2.2 m/s and attenuation of 0.61 ± 0.062 to 0.63 ± 0.05 dB/cm/MHz. High Mw PVA samples ranged from 1555 ± 2.82 to 1566 ± 4.5 m/s and 0.71 ± 0.02 to 0.73 ± 0.046 dB/cm/MHz. Young's modulus ranged from 11 ± 2 to 82.3 ± 0.5 kPa across 1 to 10 freeze-thaw cycles. Inclusion size, depth, and interaction statistically affect the SWE measurements with p-value = 0.056327, p-value = 8.0039 × 10-8, and p-value = 0.057089, respectively. SWE showed isoechoic inclusions, prostate tissue, and surrounding tissue only. The Doppler velocity was measured in three different inner diameters.

CONCLUSION

PVA mixed with enhancer materials creates an mpUS phantom with properties that mimic normal and abnormal prostate tissue, blood vessels, and soft tissue, facilitating advanced diagnostic training and validation.

Development of Polyvinyl Alcohol Hydrogels for Controlled Glucose Release in Biomedical Applications

Polyvinyl alcohol (PVA) hydrogels have a wide range of applications in the pharmaceutical and biomedicine fields due to their exceptional biophysical properties. The study focuses on preparing and characterizing capsule-shaped PVA hydrogels to enhance their biocompatibility and porosity for controlled glucose release and cell proliferation. The hydrogels were prepared using different concentrations (Cs) and molecular weights (MWs) of PVA, with two different lengths, A (10 mm) and B (20 mm), to control glucose release over 60 min. The preparation process involved PVA gel preparation and PVA hydrogel formation. A total of 500 µL of glucose was injected into all dehydrated hydrogels in groups A and B. Glucose release was studied by immersing the hydrogels in saline at 37 °C with stirring at 500 rpm. The SUP-B15 cell line was grown in six A1 hydrogels for biocompatibility testing. The results indicate that all hydrogels remained stable at 37 °C without degrading. Those with a higher C and MW exhibited a denser and less porous structure, lower glucose storage capacity, and higher elongation at break. Significant differences in glucose release, diffusion speed, and flux were observed, which were more evident in A1 > A4, B1 > B4, and B1 > A1 over 60 min. A1 and B1 had higher values because their higher porosity distribution allowed glucose to diffuse more easily. B1, being larger, has more glucose due to its increased length. The cell growth response and viability at 48 h in contact with the hydrogels was similar to that of the control (4.5 × 105 cells/mL, 98.5% vs. 4.8 × 105 cells/mL, 99.7% viability), thus demonstrating biocompatibility. The hydrogels effectively released glucose over 60 min, with variations based on porosity, C, MW, and length, and demonstrated good biocompatibility with the cell line.

Tissue-Mimicking Material Fabrication and Properties for Multiparametric Ultrasound Phantoms: A Systematic Review

Medical imaging has allowed for significant advancements in the field of ultrasound procedures over the years. However, each imaging modality exhibits distinct limitations that differently affect their accuracy. It is imperative to ensure the quality of each modality to identify and eliminate these limitations. To achieve this, a tissue-mimicking material (TMM) phantom is utilised for validation. This study aims to perform a systematic analysis of tissue-mimicking materials used for creating ultrasound phantoms. We reviewed 234 studies on the use of TMM phantoms in ultrasound that were published from 2013 to 2023 from two research databases. Our focus was on studies that discussed TMMs' properties and fabrication for ultrasound, elastography, and flow phantoms. The screening process led to the selection of 16 out of 234 studies to include in the analysis. The TMM ultrasound phantoms were categorised into three groups based on the solvent used; each group offers a broad range of physical properties. The water-based material most closely aligns with the properties of ultrasound. This study provides important information about the materials used for ultrasound phantoms. We also compared these materials to real human tissues and found that PVA matches most of the human tissues the best.

Systematic quantification of differences in shear wave elastography estimates between linear-elastic and viscoelastic material assumptionsa)

Quantitative, accurate, and standardized metrics are important for reliable shear wave elastography (SWE)-based biomarkers. For over two decades, the linear-elastic material assumption has been employed in SWE modes. In recent years, viscoelasticity estimation methods have been adopted in a few clinical systems. The current study aims to systematically quantify differences in SWE estimates obtained using linear-elastic and viscoelastic material assumptions. An acousto-mechanical simulation framework of acoustic radiation force impulse-based SWE was created to elucidate the effect of material viscosity and shear modulus on SWE estimates. Shear modulus estimates exhibited errors up to 72% when a numerical viscoelastic phantom was assessed as linearly elastic. Shear modulus estimates of polyvinyl alcohol phantoms between rheometry and SWE following the Kelvin-Voigt viscoelastic model assumptions were not significantly different. However, the percentage difference in shear modulus estimates between rheometry and SWE using the linear-elastic assumption was 50.1%-62.1%. In ex vivo liver, the percentage difference in shear modulus estimates between linear-elastic and viscoelastic methods was 76.1%. These findings provide a direct and systematic quantification of the potential error introduced when viscoelastic tissues are imaged with SWE following the linear-elastic assumption. This work emphasizes the need to utilize viscoelasticity estimation methods for developing robust quantitative imaging biomarkers.

Study of Polyvinyl Alcohol Hydrogels Applying Physical-Mechanical Methods and Dynamic Models of Photoacoustic Signals

This study aims to analyze the physical-mechanical properties and dynamic models of tissue-simulating hydrogels, specifically the photoacoustic (PA) response signals, by varying the concentrations of polyvinyl alcohol (PVA) and molecular weight (MW). A state-space model (SSM) is proposed to study the PVA hydrogels to retrieve the PA-related signal's damping ratio and natural frequency. Nine box-shaped PVA hydrogels containing saline solution were used, with five concentrations of PVA (7, 9, 12, 15, 20%) for MW1 and four for MW2. The results indicated that the concentration of PVA and MW played an important role in the PA wave's amplitude, arrival time, and speed of sound over the hydrogels. The SSM parameters showed that increasing PVA and MW concentrations improved the hydrogels' ability to absorb and transfer energy under the PA effect. These parameters were also found to be correlated with density and modulus of elasticity. Additionally, the concentrations of PVA and MW affected the absorption and optical scattering coefficients. The physical-mechanical properties, including porosity, density, and modulus of elasticity, improved as the concentration of PVA and MW increased. The ultimate goal of this study is to develop hydrogels as phantoms that can be used for tissue simulation and imaging.

Characterizing Viscoelastic Polyvinyl Alcohol Phantoms for Ultrasound Elastography

Ultrasound phantoms mimic the acoustic and mechanical properties of native tissues. Polyvinyl alcohol (PVA) phantoms are used extensively as models for validating ultrasound elastography approaches. However, the viscous properties of PVA phantoms have not been investigated adequately. Glycerol is a viscous liquid that has been reported to increase the speed of sound of phantoms. This study aims to assess the acoustic and viscoelastic properties of PVA phantoms and PVA mixed with glycerol at varying concentrations. The phantoms were fabricated with 10% w/v PVA in water with varying concentrations of glycerol (10%, 15% and 20% v/v) and 2% w/v silicon carbide particles as acoustic scatterers. The phantoms were subjected to either one, two, or three 24-h freeze-thaw cycles. The longitudinal sound speeds of all PVA phantoms were measured, and ranged from 1529 to 1660 m/s. Attenuation spectroscopy was performed in the range of 5 to 20 MHz. The measured attenuation followed a power-law relationship with frequency, wherein the power-law fit constants and exponents ranged from 0.02 to 0.1 dB/cm/MHzⁿ and from 1.6 to 1.9, respectively. These results were in agreement with previous reports for soft tissues. Viscoelasticity of PVA phantoms was assessed using rheometry. The estimated values of shear modulus and viscosity using the Kelvin-Voigt and Kelvin-Voigt fractional derivative models were within the range of previously-reported tissue-mimicking phantoms and soft tissues. The number of freeze-thaw cycles were shown to alter the viscosity of PVA phantoms, even in the absence of glycerol. Scanning electron microscopy images of PVA phantoms without glycerol showed a porous hydrogel network, in contrast to those of PVA-glycerol phantoms with non-porous structure. Phantoms fabricated in this study possess tunable acoustic and viscoelastic properties within the range reported for healthy and diseased soft tissues. This study demonstrates that PVA phantoms can be manufactured with glycerol for applications in ultrasound elastography.