A review of tissue substitutes for ultrasound imaging

Full-waveform inversion imaging of the human brain

Magnetic resonance imaging and X-ray computed tomography provide the two principal methods available for imaging the brain at high spatial resolution, but these methods are not easily portable and cannot be applied safely to all patients. Ultrasound imaging is portable and universally safe, but existing modalities cannot image usefully inside the adult human skull. We use in silico simulations to demonstrate that full-waveform inversion, a computational technique originally developed in geophysics, is able to generate accurate three-dimensional images of the brain with sub-millimetre resolution. This approach overcomes the familiar problems of conventional ultrasound neuroimaging by using the following: transcranial ultrasound that is not obscured by strong reflections from the skull, low frequencies that are readily transmitted with good signal-to-noise ratio, an accurate wave equation that properly accounts for the physics of wave propagation, and adaptive waveform inversion that is able to create an accurate model of the skull that then compensates properly for wavefront distortion. Laboratory ultrasound data, using ex vivo human skulls and in vivo transcranial signals, demonstrate that our computational experiments mimic the penetration and signal-to-noise ratios expected in clinical applications. This form of non-invasive neuroimaging has the potential for the rapid diagnosis of stroke and head trauma, and for the provision of routine monitoring of a wide range of neurological conditions.

Low-cost fabrication of optical tissue phantoms for use in biomedical imaging

The rapid development of new optical imaging techniques is dependent on the availability of low-cost and easily reproducible standards for technique validation. This work describes a low-cost fabrication process of an agar gel-based phantom that may accurately simulate the optical properties of different human tissues at 532 and 630nm wavelengths. It was designed to match the optical properties of the brain, bladder wall, and lung tissues. These low-cost phantoms use agar powders dissolved in water as the bulk matrix. The latter is loaded with varying amounts of India ink, and aluminium oxide Al2O3 particles for optical absorption and scattering targets. The optical properties (absorption and scattering coefficients), the primary design factor and critical parameters of these phantoms were deduced from measurements of the total attenuation coefficients( μ t ) . It is anticipated that the constructed tissue phantoms have the potential to be used as a reference standard since it's possible to preserve the optical properties in a period exceeding two years, under ideal storage conditions.

Enhanced Instantaneous Elastography in Tissues and Hard Materials Using Bulk Modulus and Density Determined Without Externally Applied Material Deformation

Ultrasound is a continually developing technology that is broadly used for fast, non-destructive mechanical property detection of hard and soft materials in applications ranging from manufacturing to biomedical. In this study, a novel monostatic longitudinal ultrasonic pulsing elastography imaging method is introduced. The existing elastography methods require an acoustic radiational or dynamic compressive externally applied force to determine the effective bulk modulus or density. This new, passive M-mode imaging technique does not require an external stress and can be effectively used for both soft and hard materials. Strain map imaging and shear wave elastography are two current categories of M-mode imaging that show both relative and absolute elasticity information. The new technique is applied to hard materials and soft material tissue phantoms for demonstrating effective bulk modulus and effective density mapping. When compared with standard techniques, the effective parameters fall within 10% of standard characterization methods for both hard and soft materials. As neither the standard A-mode imaging technique nor the presented technique require an external applied force, the techniques are applied to composite heterostructures and the findings presented for comparison. The presented passive M-mode technique is found to have enhanced resolution over standard A-mode modalities.

A New Inexpensive Simulation Model for Ultrasound Assessment of Optic Nerve Sheath Diameter

BACKGROUND

Sonographic measurement of optic nerve sheath diameter (ONSD) is becoming increasingly accepted as a diagnostic modality to detect elevations in intracranial pressure. As this technique becomes more widespread, methods to address the inherent operator-dependent nature of this modality will need to be developed. We propose a novel low-cost model to accurately simulate sonographic ONSD measurement for purposes of training and assessment.

METHODS

We designed models composed of medical tubing of various diameters readily available from typical hospital supplies and suspended them in gelatin. The models were evaluated by ultrasound by three expert point-of-care sonographers using a standard linear array probe and technique proposed in the literature.

RESULTS

This model generates faithful simulation of the ONS that closely approximates in vivo images and can be used to produce accurate, reproducible measurements. Materials are low cost and easy to acquire and assemble.

CONCLUSIONS

Our model provides realistic simulated images of the ONS. Through comparison of sonographic measurements to the known tube diameters, this model serves as a promising inexpensive tool to teach the method of ultrasound assessment of ONSD or as a way to determine accuracy of this novel ultrasound technology.

Optoacoustic brain stimulation at submillimeter spatial precision

Low-intensity ultrasound is an emerging modality for neuromodulation. Yet, transcranial neuromodulation using low-frequency piezo-based transducers offers poor spatial confinement of excitation volume, often bigger than a few millimeters in diameter. In addition, the bulky size limits their implementation in a wearable setting and prevents integration with other experimental modalities. Here, we report spatially confined optoacoustic neural stimulation through a miniaturized Fiber-Optoacoustic Converter (FOC). The FOC has a diameter of 600 μm and generates omnidirectional ultrasound wave locally at the fiber tip through the optoacoustic effect. We show that the acoustic wave generated by FOC can directly activate individual cultured neurons and generate intracellular Ca²⁺ transients. The FOC activates neurons within a radius of 500 μm around the fiber tip, delivering superior spatial resolution over conventional piezo-based low-frequency transducers. Finally, we demonstrate direct and spatially confined neural stimulation of mouse brain and modulation of motor activity in vivo.

Low-intensity ultrasound can be used for neuromodulation in vivo, but it has poor spatial confinement and can result in unwanted cochlear pathway activation. Here the authors use the optoacoustic effect to generate spatially confined ultrasound waves to activate neurons within a 500 μm radius in the mouse brain.

Experimental Characterization of Optoacoustic Phantoms in Gel Wax and Polyvinyl Alcohol for Blood Pressure Measurements

An experimental evaluation and characterization of two transparent phantoms of arms, to be used as non-invasive experimental models to measure the blood pressure continuously, was performed in an in vitro study. The first phantom was made of polyvinyl alcohol (PVA) gel and the second phantom is based on gel wax. For the first time, a PVA and gel wax phantom for the arm, respectively, were developed, including tissue, radial artery, and ulnar and radius bones. The optoacoustic parameters of various samples for both phantoms were characterized and systematically compared, obtaining a maximum acoustic transmission of T=(78.3±1.9)% at 921 nm in the PVA hydrogel, due to its high transparency and homogeneity. The gel wax phantom possesses similar optical properties as the PVA hydrogel and presents acoustic characteristics similar to those of the soft tissue. Thus, both phantoms are well-suited as in vitro models for the development of new methods in optical-acoustic medical diagnosis.

Skull Impact on the Ultrasound Beam Profile of Transcranial Focused Ultrasound Stimulation

Transcranial focused ultrasound stimulation (tFUS) is a promising noninvasive neuromodulation tool for targeting brain regions with millimeter-scale spatial resolutions. In conventional tFUS studies, a focused ultrasound beam generated by an external ultrasound transducer is delivered to the neural target. In tFUS, ultrasound should travel through the skull that features large attenuation and different acoustic impedance compared with the soft tissue, thereby resulting in acoustic impedance mismatch and reflections. In this paper, we study the impact of the rat skull on the ultrasound beam profile generated by both focused and unfocused (but with a natural focus) transducers at a wide sonication frequency (f_p) range of 0.5-9.5 MHz. At different axial and lateral distances from the transducers, we measured ultrasound intensity profiles of three transducers operating at f_ps of 0.5 MHz, 1.2 MHz and 9.5 MHz with and without the skull. Our results showed that ultrasound beam profiles were significantly distorted by the skull. The transmission factor due to skull attenuation was measured 0.79,0.34 and 0.03 at f_ps of 0.5 MHz, 1.2 MHz and 9.5 MHz, respectively, when the skull was close to transducers focal zones.

Experimental evaluation of a self-propelling bio-inspired needle in single- and multi-layered phantoms

In percutaneous interventions, reaching targets located deep inside the body with minimal tissue damage and patient pain requires the use of long and thin needles. However, when pushed through a solid substrate, a structure with a high aspect ratio is prone to buckle. We developed a series of multi-element needles with a diameter smaller than 1 mm and a length larger than 200 mm, and we experimentally evaluated the performance of a bio-inspired insertion mechanism that prevents needle buckling of such slender structures. The needles consisted of Nitinol wires and advance into a substrate by pushing the wires forward one after the other, followed by pulling all the wires simultaneously backward. The resulting net push force is low, allowing the needles to self-propel through the substrate. We investigated the effect of the needle design parameters (number of wires and their diameter) and substrate characteristics (stiffness and number of layers) on the needle motion. Three needle prototypes (consisting of six 0.25-mm wires, six 0.125-mm wires, and three 0.25-mm wires, respectively) were inserted into single- and multi-layered tissue-mimicking phantoms. The prototypes were able to move forward in all phantoms without buckling. The amount of needle slip with respect to the phantom was used to assess the performance of the prototypes. The six-wire 0.25-mm prototype exhibited the least slip among the three prototypes. Summarizing, we showed that a bio-inspired motion mechanism prevents buckling in very thin (diameter <1 mm), long (length >200 mm) needles, allowing deep insertion into tissue-mimicking phantoms.

Contact-free endoscopic photoacoustic sensing using speckle analysis

Photoacoustic endoscopy (PAE) is an emerging imaging modality, which offers a high imaging penetration and a high optical contrast in soft tissue. Most of the developed endoscopic photoacoustic sensing systems use miniaturized contact ultrasound transducers or complex optical approaches. In this work, a new fiber-based detection technique using speckle analysis for contact-free signal detection is presented. Phantom and ex vivo experiments are performed in transmission and reflection mode for proof of concept. In summary, the potential of the technique for endoscopic photoacoustic signal detection is demonstrated. The new technique might help in future to broaden the applications of PAE in imaging or guiding minimally invasive laser procedures.

Acoustic Histology with Specific Dyes and Antibodies

The present study aims to identify specific staining methods for acoustic histology. We compared attenuation-of-sound (AOS) images from scanning acoustic microscopy (SAM) with light microscopy (LM) images. Ethanol-fixed tissue or cytology samples and formalin-fixed surgical or autopsy specimens were examined. Nuclei, collagen, elastic fibers and polysaccharides and various antigens, including cell surface, cytoplasmic, nuclear and stromal substances, were observed. Samples with various fixation methods were used. Hematoxylin staining had significantly higher AOS values in accordance with staining duration. Specific staining for collagen, elastic fibers and polysaccharides increased the AOS values of the specific substance. Using diaminobenzidine tetrahydrochloride in NiCl₂ solution as a substrate for horseradish peroxidase increased the AOS values to those suitable for acoustic immunostaining. Collagenase digestion after collagen staining decreased AOS values, reflecting collagen density and distribution. Staining with specific dyes or acoustic immunostaining enabled the histologic localization of specific substances by SAM, similar to LM.

Focused Ultrasound-Mediated Hyperthermia in Vitro: An Experimental Arrangement for Treating Cells under Tissue-Mimicking Conditions

An experimental arrangement that allows in vitro exposure of cells to focused ultrasound-mediated hyperthermia (43°C-55°C) in a tissue-mimicking phantom with biological, acoustic and thermal properties comparable to those of human soft tissue is described. Cells were embedded in a compressed collagen gel, which was sandwiched between 6-mm-thick slices of biocompatible, acoustically absorbing and thermally tissue mimicking poly(vinyl alcohol) cryo-gel. To illustrate the system's potential, cells were exposed using a 1.66-MHz focused ultrasound beam (spatial-peak temporal-average intensities (ISPTA) = 900-1400 W/cm2) that traced out a circular trajectory (5-8 mm in diameter). Real-time temperature monitoring allowed cells to be exposed reproducibly to a pre-determined thermal dose. An experimental planning tool that estimates the thermal dose distribution throughout the sample and allows spatial correlation with cell position has been developed. Treatment response was evaluated qualitatively using microscopy and cell viability testing. This experimental arrangement has significant potential for future, biologically relevant, in vitro focused ultrasound-mediated hyperthermia studies.

A Responsive Mesoporous Silica Nanoparticle Platform for Magnetic Resonance Imaging-Guided High-Intensity Focused Ultrasound-Stimulated Cargo Delivery with Controllable Location, Time, and Dose

Magnetic resonance imaging (MRI) is an essential modality for clinical diagnosis, and MRI-guided high-intensity focused ultrasound (MRgHIFU) is a powerful technology for targeted therapy. Clinical applications of MRgHIFU primarily utilize hyperthermia and ablation to treat cancerous tissue, but for drug delivery applications thermal damage is undesirable. A biofriendly MRgHIFU-responsive mesoporous silica nanoparticle (MSN) platform that is stimulated within a physiological safe temperature range has been developed, reducing the possibility of thermal damage to the surrounding healthy tissues. Biocompatible polyethylene glycol (PEG) was employed to cap the pores of MSNs, and the release of cargo molecules by HIFU occurs without substantial temperature increase (∼4 °C). To visualize by MRI and measure the stimulated delivery in situ, a U.S. Food and Drug Administration (FDA)-approved gadolinium-based contrast agent, gadopentetate dimeglumine (Gd(DTPA)^2-), was used as the imageable cargo. Taking advantage of the three-dimensional (3-D) imaging and targeting capabilities of MRgHIFU, the release of Gd(DTPA)^2- stimulated by HIFU was pinpointed at the HIFU focal point in 3-D space in a tissue-mimicking gel phantom. The amount of Gd(DTPA)^2- released was controlled by HIFU stimulation times and power levels. A positive correlation between the amount of Gd(DTPA)^2- released and T₁ was found. The MRgHIFU-stimulated cargo release was further imaged in a sample of ex vivo animal tissue. With this technology, the biodistribution of the nanocarriers can be tracked and the MRgHIFU-stimulated cargo release can be pinpointed, opening up an opportunity for future image-guided theranostic applications.

Mild hyperthermia by MR-guided focused ultrasound in an ex vivo model of osteolytic bone tumour: optimization of the spatio-temporal control of the delivered temperature

BACKGROUND

Magnetic resonance guided focused ultrasound was suggested for the induction of deep localized hyperthermia adjuvant to radiation- or chemotherapy. In this study we are aiming to validate an experimental model for the induction of uniform temperature elevation in osteolytic bone tumours, using the natural acoustic window provided by the cortical breakthrough.

MATERIALS AND METHODS

Experiments were conducted on ex vivo lamb shank by mimicking osteolytic bone tumours. The cortical breakthrough was exploited to induce hyperthermia inside the medullar cavity by delivering acoustic energy from a phased array HIFU transducer. MR thermometry data was acquired intra-operatory using the proton resonance frequency shift (PRFS) method. Active temperature control was achieved via a closed-loop predictive controller set at 6 °C above the baseline. Several beam geometries with respect to the cortical breakthrough were investigated. Numerical simulations were used to further explain the observed phenomena. Thermal safety of bone heating was assessed by cross-correlating MR thermometry data with the measurements from a fluoroptic temperature sensor inserted in the cortical bone.

RESULTS

Numerical simulations and MR thermometry confirmed the feasibility of spatio-temporal uniform hyperthermia (± 0.5 °C) inside the medullar cavity using a fixed focal point sonication. This result was obtained by the combination of several factors: an optimal positioning of the focal spot in the plane of the cortical breakthrough, the direct absorption of the HIFU beam at the focal spot, the "acoustic oven effect" yielded by the beam interaction with the bone, and a predictive temperature controller. The fluoroptical sensor data revealed no heating risks for the bone and adjacent tissues and were in good agreement with the PRFS thermometry from measurable voxels adjacent to the periosteum.

CONCLUSION

To our knowledge, this is the first study demonstrating the feasibility of MR-guided focused ultrasound hyperthermia inside the medullar cavity of bones affected by osteolytic tumours. Our results are considered a promising step for combining adjuvant mild hyperthermia to external beam radiation therapy for sustained pain relief in patients with symptomatic bone metastases.

Multiplexed ultrasound beam summation for side lobe reduction

Two-way focusing, which relies on sweeping a focused beam across a field of view, is the conventional method for performing high-quality ultrasound imaging. Side lobes resulting from diffraction reduce the image contrast, thus degrade the image quality. In this paper, we present a new method for beam shaping the transmitted ultrasound waveform in order to reduce side lobes and improve image quality. The beam shaping is achieved by transmitting two different waveforms that are interlaced between the odd and even elements. One waveform generates a standard diffraction-limited single focus, and the second waveform generates two foci at the same focal depth as the single focus. The distance between the two foci is selected such that they will destructively interfere with the first order side lobes of the single focus, effectively eliminating these side lobes. A 7.5 dB side lobe reduction was measured experimentally at a depth of 60 mm, using a phased array transducer with a center frequency of 3 MHz. This real-time method utilizes standard receive beamforming, identical to traditional two-way focusing, and does not require post-processing. The method can be implemented with conventional ultrasound systems, without the need for additional components. The proposed method is described analytically, optimized via numerical simulation, and validated by experiments using wire targets, tissue-mimicking phantoms, and in vivo imaging of the rat bladder.

Real-Time Optoacoustic Tracking of Single Moving Micro-objects in Deep Phantom and Ex Vivo Tissues

Medical imaging plays an important role in diagnosis and treatment of multiple diseases. It is a field which seeks for improved sensitivity and spatiotemporal resolution to allow the dynamic monitoring of diverse biological processes that occur at the micro- and nanoscale. Emerging technologies for targeted diagnosis and therapy such as nanotherapeutics, microimplants, catheters, and small medical tools also need to be precisely located and monitored while performing their function inside the human body. In this work, we show for the first time the real-time tracking of moving single micro-objects below centimeter thick phantom tissue and ex vivo chicken breast, using multispectral optoacoustic tomography (MSOT). This technique combines the advantages of ultrasound imaging regarding depth and resolution with the molecular specificity of optical methods, thereby facilitating the discrimination between the spectral signatures of the micro-objects from those of intrinsic tissue molecules. The resulting MSOT signal is further improved in terms of contrast and specificity by coating the micro-objects' surface with gold nanorods, possessing a unique absorption spectrum, which facilitate their discrimination from surrounding biological tissues when translated to future in vivo settings.

Various 3D printed materials mimic bone ultrasonographically: 3D printed models of the equine cervical articular process joints as a simulator for ultrasound guided intra-articular injections

Introduction

In the equine racehorse industry, reduced athletic performance due to joint injury and lameness has been extensively reviewed. Intra-articular injections of glucocorticoids are routinely used to relieve pain and inflammation associated with osteoarthritis. Intra-articular injections of pharmaceutical agents require practice for precise needle placement and to minimize complications. Training on simulators or models is a viable alternative for developing these technical skills. The purpose of this study was to compare the qualitative ultrasonographic characteristics of three-dimensional (3D) printed models of equine cervical articular process joints to that of a dissected equine cervical spine (gold standard).

Methods

A randomized complete block design study was conducted in which a total of thirteen cervical articular process joint models were printed using several materials, printers, and printing technologies. Ultrasound video clips with the models immersed in water were recorded. Two board certified veterinary radiologists and three veterinary radiology residents reviewed the videos and responded to a survey assessing and comparing the ultrasonographic characteristics of the 3D printed models to those of the gold standard.

Results

Six 3D printed models had ultrasonographic characteristics similar to the gold standard. These six models were (material, printer, printing technology): nylon PA 12, EOS Formiga P100, selective laser sintering (P = 0.99); Onyx nylon with chopped carbon fiber, Markforged Onyx Two, fused deposition modeling (P = 0.48); polycarbonate, Ultimaker 3, fused deposition modeling (P = 0.28); gypsum, ProJet CJP 660 Pro, ColorJet Printing (P = 0.28); polylactic acid, Prusa I3, fused deposition modeling (P = 0.23); and high temperature V1 resin, Form 2, stereolithography (P = 0.22).

Conclusion

When assessed in water, it is possible to replicate the qualitative ultrasonographic characteristics of bone using three dimensional printed models made by combining different materials, printing technologies, and printers. However, not all models share similar qualitative ultrasonographic characteristics with bone. We suggest that the aforementioned six models be used as proxy for simulating bones or joints for use with ultrasound. In order to replicate the resistance and acoustic window provided by soft tissues, further work testing the ability of these models to withstand embedding in material such as ballistic gelatin is required.

Hybrid organosilicon/polyol phantom for photoacoustic imaging

The rapid development of hardware and software for photoacoustic technologies is urging the establishment of dedicated tools for standardization and performance assessment. In particular, the fabrication of anatomical phantoms for photoacoustic imaging remains an open question, as current solutions have not yet gained unanimous support. Here, we propose that a hybrid material made of a water-in-oil emulsion of glycerol and polydimethylsiloxane may represent a versatile platform to host a broad taxonomy of hydrophobic and hydrophilic dyes and recapitulate the optical and acoustic features of bio tissue. For a full optical parameterization, we refer to Wróbel, et al. [ Biomed. Opt. Express7, 2088 (2016)], where this material was first presented for optical imaging. Instead, here, we complete the picture and find that its speed of sound and acoustic attenuation resemble those of pure polydimethylsiloxane, i.e. respectively 1150 ± 30 m/s and 3.5 ± 0.4 dB/(MHz·cm). We demonstrate its use under a commercial B-mode scanner and a home-made A-mode stage for photoacoustic analysis to retrieve the ground-truth encoded in a multilayer architecture containing indocyanine green, plasmonic particles and red blood cells. Finally, we verify the stability of its acoustic, optical and geometric features over a time span of three months.

Development and Characterization of Medical Phantoms for Ultrasound Imaging Based on Customizable and Mouldable Polyvinyl Alcohol Cryogel-Based Materials and 3-D Printing: Application to High-Frequency Cranial Ultrasonography in Infants

This work presents an affordable and easily customizable methodology for phantom manufacturing, which can be used to mimic different anatomic organs and structures. This methodology is based on the use of polyvinyl alcohol-based cryogels as a physical substitute for biologic soft tissues and of 3-D printed polymers for hard tissues, moulding and supporting elements. Thin and durable soft-tissue mimicking layers and multilayer arrangements can be obtained using these materials. Special attention was paid to the acoustic properties (sound speed, attenuation coefficient and mechanical impedance) of the materials developed to simulate soft tissues. These properties were characterized as a function of the additives concentration (propylene-glycol and alumina particles). The polyvinyl alcohol formulation proposed in this work is stable over several freeze-thaw cycles, allowing the manufacturing of multilayer materials with controlled properties. The manufacturing methodology presented was applied to the development of a phantom for high-frequency cranial ultrasonography in infants. This phantom was able to reproduce the main characteristics of the ultrasound images obtained in neonates through the anterior fontanel, down to 8-mm depth.

Ultrasound assessment of the conversion of sound energy into heat in tissue phantoms enriched with magnetic micro- and nanoparticles

PURPOSE

Nowadays, the improvement of ultrasonic hyperthermia therapy is often achieved by adding hard particles to the sonicated medium in order to increase the heating efficiency. The explanation of the phenomenon of ultrasonic heating still requires testing on tissue mimicking materials (TMMs), enriched with particles of different sizes and physical properties. Our goal was to determine, by comparing their quantitative acoustic properties, which TMMs, with magnetic micro- or nanoparticles, convert more ultrasonic energy into heat or which of the particles embedded in the agar gel act as more effective thermal sonosensitizers.

METHODS

We manufactured a pure agar gel and an agar gel with the addition of magnetic micro- or nanoparticles in two proportions of 8 and 16 mg/ml. Ultrasound quantitative techniques, the broadband reflection substitution technique and backscattered spectrum analysis were used to characterize the samples by speed of sound (SOS), frequency-dependent attenuation, and backscattering coefficients. The integrated backscattering coefficients were also calculated. The quantitative parameters, scattering, and attenuation coefficients of ultrasound in phantoms with micro- and nanoparticles were estimated. Based on the attenuation and scattering of ultrasound in the samples, the ultrasonic energy absorption, which determines the heating efficiency, was evaluated. Additionally, the temperature increase during sonication of the phantoms by an ultrasonic beam was directly measured using thermocouples.

RESULTS

The density of the materials with nanoparticles was higher than for the materials with microparticles with the same fractions of particles. The SOS for all materials ranged from 1489 to 1499 m/s. The attenuation in the whole frequency range (3-8 MHz) was higher for the materials with nanoparticles than for the materials with microparticles. For the materials with the lower content (8 mg/ml) of particles, the attenuation coefficient was 0.2 dB/(MHz cm). For the 16 mg/ml concentration of nanoparticles and microparticles, the attenuation coefficients were 0.66 and 0.45 dB/(MHz cm), respectively. The value of backscattering coefficient in the whole frequency range was greater for the materials with microparticles than for the materials with nanoparticles. The values of the integrated backscattering coefficient were 0.05 and 0.08 1/m for the materials with nanoparticles and 0.46 and 0.82 1/m for the materials with microparticles and concentrations of 8 and 16 mg/ml, respectively. The rates of temperature increase in the first 3 s due to ultrasonic heating were higher for the materials with nanoparticles than for the materials with microparticles.

CONCLUSIONS

Based on acoustical measurements, we confirmed that all materials can be used as tissue phantoms in the study of ultrasonic hyperthermia, as their properties were in the range of soft tissue properties. We found that the nanoparticle-doped materials had greater attenuation and smaller scattering of ultrasound than the materials with microparticles, so absorption in these materials is greater. Thus, the TMMs with nanoparticles convert more acoustic energy into heat and we conclude that magnetic nanoparticles are more effective thermal sonosensitizers than microparticles. This conclusion is confirmed by direct measurement of the temperature increase in the samples subjected to sonification.

Designing and validating a PVA liver phantom with respiratory motion for needle-based interventions

Purpose

The purpose is to design and validate an anthropomorphic polyvinyl alcohol (PVA) liver phantom with respiratory motion to simulate needle-based interventions. Such a system can, for example, be used as a validation tool for novel needles.

Methods

Image segmentations of CT scans of four patients during inspiration and expiration were used to measure liver and rib displacement. An anthropomorphic liver mold based on a CT scan was 3D printed and filled with 5% w/w PVA-to-water, undergoing two freeze–thaw cycles, in addition to a 3D-printed compliant rib cage. They were both held in place by a PVA abdominal phantom. A sinusoidal motion vector, based on the measured liver displacement, was applied to the liver phantom by means of a motion stage. Liver, rib cage and needle deflection were tracked by placing electromagnetic sensors on the phantom. Liver and rib cage phantom motion was validated by comparison with the CT images of the patients, whereas needle deflection was compared with the literature.

Results

CT analysis showed that from the state of expiration to inspiration, the livers moved predominantly toward the right (mean: 2 mm, range: − 11 to 11 mm), anterior (mean: 15 mm, range: 9–21 mm) and caudal (mean: 16 mm, range: 6–24 mm) direction. The mechatronic design of the liver phantom gives the freedom to set direction and amplitude of the motion and was able to mimic the direction of liver motion of one patient. Needle deflection inside the phantom increased from 1.6 to 3.8 mm from the initial expiration state to inspiration.

Conclusions

The developed liver phantom allows for applying different motion patterns and shapes/sizes and thus allows for patient-specific simulation of needle-based interventions. Moreover, it is able to mimic appropriate respiratory motion and needle deflection as observed in patients.

Electronic supplementary material

The online version of this article (10.1007/s11548-019-02029-6) contains supplementary material, which is available to authorized users.

In vivo ultrasound-switchable fluorescence imaging

The conventional fluorescence imaging has limited spatial resolution in centimeter-deep tissue because of the tissue's high scattering property. Ultrasound-switchable fluorescence (USF) imaging, a new imaging technique, was recently proposed to realize high-resolution fluorescence imaging in centimeter-deep tissue. However, in vivo USF imaging has not been achieved so far because of the lack of stable near-infrared contrast agents in a biological environment and the lack of data about their biodistributions. In this study, for the first time, we achieved in vivo USF imaging successfully in mice with high resolution. USF imaging in porcine heart tissue and mouse breast tumor via local injections were studied and demonstrated. In vivo and ex vivo USF imaging of the mouse spleen via intravenous injections was also successfully achieved. The results showed that the USF contrast agent adopted in this study was very stable in a biological environment, and it was mainly accumulated into the spleen of the mice. By comparing the results of CT imaging and the results of USF imaging, the accuracy of USF imaging was proved.

Imaging the Vocal Folds: A Feasibility Study on Strain Imaging and Elastography of Porcine Vocal Folds

Vocal folds are an essential part of human voice production. The biomechanical properties are a good indicator for pathological changes. In particular, as an oscillation system, changes in the biomechanical properties have an impact on the vibration behavior. Subsequently, those changes could lead to voice-related disturbances. However, no existing examination combines biomechanical properties and spatial imaging. Therefore, we propose an image registration-based approach, using ultrasound in order to gain this information synchronously. We used a quasi-static load to compress the tissue and measured the displacement by image registration. The strain distribution was directly calculated from the displacement field, whereas the elastic properties were estimated by a finite element model. In order to show the feasibility and reliability of the algorithm, we tested it on gelatin phantoms. Further, by examining ex vivo porcine vocal folds, we were able to show the practicability of the approach. We displayed the strain distribution in the tissue and the elastic properties of the vocal folds. The results were superimposed on the corresponding ultrasound images. The findings are promising and show the feasibility of the suggested approach. Possible applications are in improved diagnosis of voice disorders, by measuring the biomechanical properties of the vocal folds with ultrasound. The transducer will be placed on the vocal folds of the anesthetized patient, and the elastic properties will be measured. Further, the understanding of the vocal folds’ biomechanics and the voice forming process could benefit from it.

Quantitative Ultrasound and B-Mode Image Texture Features Correlate with Collagen and Myelin Content in Human Ulnar Nerve Fascicles

We investigate the usefulness of quantitative ultrasound and B-mode texture features for characterization of ulnar nerve fascicles. Ultrasound data were acquired from cadaveric specimens using a nominal 30-MHz probe. Next, the nerves were extracted to prepare histology sections. Eighty-five fascicles were matched between the B-mode images and the histology sections. For each fascicle image, we selected an intra-fascicular region of interest. We used histology sections to determine features related to the concentration of collagen and myelin and ultrasound data to calculate the backscatter coefficient (-24.89 ± 8.31 dB), attenuation coefficient (0.92 ± 0.04 db/cm-MHz), Nakagami parameter (1.01 ± 0.18) and entropy (6.92 ± 0.83), as well as B-mode texture features obtained via the gray-level co-occurrence matrix algorithm. Significant Spearman rank correlations between the combined collagen and myelin concentrations were obtained for the backscatter coefficient (R = -0.68), entropy (R = -0.51) and several texture features. Our study indicates that quantitative ultrasound may potentially provide information on structural components of nerve fascicles.

Focused Ultrasound Effects on Osteosarcoma Cell Lines

MRI guided Focused Ultrasound (MRgFUS) has shown to be effective therapeutic modality for non-invasive clinical interventions in ablating of uterine fibroids, in bone metastasis palliative treatments, and in breast, liver, and prostate cancer ablation. MRgFUS combines high intensity focused ultrasound (HIFU) with MRI images for treatment planning and real time thermometry monitoring, thus enabling non-invasive ablation of tumor tissue. Although in the literature there are several studies on the Ultrasound (US) effects on cell in culture, there is no systematic evidence of the biological effect of Magnetic Resonance guided Focused Ultrasound Surgery (MRgFUS) treatment on osteosarcoma cells, especially in lower dose regions, where tissues receive sub-lethal acoustic power. The effect of MRgFUS treatment at different levels of acoustic intensity (15.5-49 W/cm²) was investigated on Mg-63 and Saos-2 cell lines to evaluate the impact of the dissipation of acoustic energy delivered outside the focal area, in terms of cell viability and osteogenic differentiation at 24 h, 7 days, and 14 days after treatment. Results suggested that the attenuation of FUS acoustic intensities from the focal area (higher intensities) to the “far field” (lower intensities) zones might determine different osteosarcoma cell responses, which range from decrease of cell proliferation rates (from 49 W/cm² to 38.9 W/cm²) to the selection of a subpopulation of heterogeneous and immature living cells (from 31.1 W/cm² to 15.5 W/cm²), which can clearly preserve bone tumor cells.

A Mechatronic Platform for Computer Aided Detection of Nodules in Anatomopathological Analyses via Stiffness and Ultrasound Measurements

This study presents a platform for ex-vivo detection of cancer nodules, addressing automation of medical diagnoses in surgery and associated histological analyses. The proposed approach takes advantage of the property of cancer to alter the mechanical and acoustical properties of tissues, because of changes in stiffness and density. A force sensor and an ultrasound probe were combined to detect such alterations during force-regulated indentations. To explore the specimens, regardless of their orientation and shape, a scanned area of the test sample was defined using shape recognition applying optical background subtraction to the images captured by a camera. The motorized platform was validated using seven phantom tissues, simulating the mechanical and acoustical properties of ex-vivo diseased tissues, including stiffer nodules that can be encountered in pathological conditions during histological analyses. Results demonstrated the platform’s ability to automatically explore and identify the inclusions in the phantom. Overall, the system was able to correctly identify up to 90.3% of the inclusions by means of stiffness in combination with ultrasound measurements, paving pathways towards robotic palpation during intraoperative examinations.

Bidirectional Ultrasound Elastographic Imaging Framework for Non-invasive Assessment of the Non-linear Behavior of a Physiologically Pressurized Artery

Studies of non-destructive bidirectional ultrasound assessment of non-linear mechanical behavior of the artery are scarce in the literature. We hereby propose derivation of a strain-shear modulus relationship as a new graphical diagnostic index using an ultrasound elastographic imaging framework, which encompasses our in-house bidirectional vascular guided wave imaging (VGWI) and ultrasound strain imaging (USI). This framework is used to assess arterial non-linearity in two orthogonal (i.e., longitudinal and circumferential) directions in the absence of non-invasive pressure measurement. Bidirectional VGWI estimates longitudinal (μ_L) and transverse (μ_T) shear moduli, whereas USI estimates radial strain (ɛ_r). Vessel-mimicking phantoms (with and without longitudinal pre-stretch) and in vitro porcine aortas under static and/or dynamic physiologic intraluminal pressure loads were examined. ɛ_r was found to be a suitable alternative to intraluminal pressure for representation of cyclic loading on the artery wall. Results revealed that μ_T values of all samples examined increased non-linearly with ε_r magnitude and more drastically than μ_L, whereas μ_L values of only the pre-stretched phantoms and aortas increased with ɛ_r magnitude. As a new graphical representation of arterial non-linearity and function, strain-shear modulus loops derived by the proposed framework over two consecutive dynamic loading cycles differentiated sample pre-conditions and corroborated direction-dependent non-linear mechanical behaviors of the aorta with high estimation repeatability.

Four-dimensional optoacoustic monitoring of tissue heating with medium intensity focused ultrasound

Medium-intensity focused ultrasound (MIFU) concerns therapeutic ultrasound interventions aimed at stimulating physiological mechanisms to reinforce healing responses without reaching temperatures that can cause permanent tissue damage. The therapeutic outcome is strongly affected by the temperature distribution in the treated region and its accurate monitoring represents an unmet clinical need. In this work, we investigate on the capacities of four-dimensional optoacoustic tomography to monitor tissue heating with MIFU. Calibration experiments in a tissue-mimicking phantom have confirmed that the optoacoustically-estimated temperature variations accurately match the simultaneously acquired thermocouple readings. The performance of the suggested approach in real tissues was further shown with bovine muscle samples. Volumetric temperature maps were rendered in real time, allowing for dynamic monitoring of the ultrasound focal region, estimation of the peak temperature and the size of the heat-affected volume.

An easy-to-handle speed of sound test object for skills labs using additive manufacturing (RAPTUS-SOS)

A new generation of speed of sound (SOS) test object is presented that is fully constructed using additive manufacturing processes with a 3D-printer. The object contains 2 compartments with thin filaments and tubes that can be filled with fluid substances. The filaments are located at equal distances to each other; the tubes have fixed diameters. Depending on the chosen fluids (e.g. water, glycerol-water, corn oil, salt water) and room temperature, the mismatch in distance or diameter depending on the SOS error has been measured using ultrasound imaging equipment. The velocity of the fluid could be calculated deductively with high accuracy (range of total error: 0.1-3.4%). The results show that 3D-printed objects or additive manufacturing techniques can be suitable to use as teaching test objects within skills labs.

A novel range-verification method using ionoacoustic wave generated from spherical gold markers for particle-beam therapy: a simulation study

This study proposes a novel alternative range-verification method for proton beam with acoustic waves generated from spherical metal markers. When proton beam is incident on metal markers, most of the resulting pressure waves are confined in the markers because of the large difference in acoustic impedance between the metal and tissue. However, acoustic waves with frequency equal to marker’s resonant frequency escape this confinement; the marker briefly acts as an acoustic transmitter. Herein, this phenomenon is exploited to measure the range of the proton beam. We test the proposed strategy in 3-D simulations, combining the dose calculations with modelling of acoustic-wave propagation. A spherical gold marker of 2.0 mm diameter was placed in water with a 60 MeV proton beam incident on it. We investigated the dependence of pressure waves on the width of beam pulse and marker position. At short beam pulse, specific high-frequency acoustic waves of 1.62 MHz originating from the marker were observed in wave simulations, whose amplitude correlated with the distance between the marker and Bragg peak. Results indicate that the Bragg peak position can be estimated by measuring the acoustic wave amplitudes from the marker, using a single detector properly designed for the resonance frequency.

Surface deformation tracking and modelling of soft materials

Many computer vision algorithms have been presented to track surface deformations, but few have provided a direct comparison of measurements with other stereoscopic approaches and physics-based models. We have previously developed a phase-based cross-correlation algorithm to track dense distributions of displacements over three-dimensional surfaces. In the present work, we compare this algorithm with one that uses an independent tracking system, derived from an array of fluorescent microspheres. A smooth bicubic Hermite mesh was fitted to deformations obtained from the phase-based cross-correlation data. This mesh was then used to estimate the microsphere locations, which were compared to stereo reconstructions of the microsphere positions. The method was applied to a 35 mm × 35 mm × 35 mm soft silicone gel cube under indentation, with three square bands of microspheres placed around the indenter tip. At an indentation depth of 4.5 mm, the root-mean-square (RMS) differences between the reconstructed positions of the microspheres and their identified positions for the inner, middle, and outer bands were 60 µm, 20 µm, and 19 µm, respectively. The usefulness of the strain-tracking data for physics-based finite element modelling of large deformation mechanics was then demonstrated by estimating a neo-Hookean stiffness parameter for the gel. At the optimal constitutive parameter estimate, the RMS difference between the measured microsphere positions and their finite element model-predicted locations was 143 µm.

Enabling Ultrasound In-Body Communication: FIR Channel Models and QAM Experiments

Ultrasound waves pose a promising alternative to the commonly used electromagnetic waves for intra-body communication. This due to the lower ultrasound wave attenuation, the reduced health risks, and the reduced external interference. Current state-of-the-art ultrasound designs, however, are limited in their practical in-body deployment and reliability. This stems from their use of bulky, focused transducers, the use of simple modulation schemes or the absence of a realistic test environment and corresponding realistic channel models. Therefore, this paper proposes a new, ultrasound, static emulation test bed consisting of small, omnidirectional transducers, and custom gelatin phantoms with additional scattering materials. Using this test bed, we investigate different in-body communication scenarios. Multiple communication channels were extracted and mapped onto finite impulse response (FIR) channel models, which are verified and open sourced for future research. Furthermore, a basic quadrature-amplitude modulation (QAM) modem was built to assess the communication performance under various modulation schemes. A link was established using 4-QAM and 200 kbit/s resulting in a BER <1e-4 at received Eb/No of 13dB. Identical results were obtained by computer simulations on the FIR channels, which makes the extracted FIR channels suitable for the design of future ultrasound in-body communication schemes.

Simultaneous Axial Multifocal Imaging Using a Single Acoustical Transmission: A Practical Implementation

Standard ultrasound imaging techniques rely on sweeping a focused beam across a field of view; however, outside the transmission focal depth, image resolution and contrast are degraded. High-quality deep tissue in vivo imaging requires focusing the emitted field at multiple depths, yielding high-resolution and high-contrast ultrasound images but at the expense of a loss in frame rate. Recent developments in ultrasound technologies have led to user-programmable systems, which enable real-time dynamic control over the phase and apodization of each individual element in the imaging array. In this paper, we present a practical implementation of a method to achieve simultaneous axial multifoci using a single acoustical transmission. Our practical approach relies on the superposition of axial multifoci waveforms in a single transmission. The delay in transmission between different elements is set such that pulses constructively interfere at multiple focal depths. The proposed method achieves lateral resolution similar to successive focusing, but with an enhanced frame rate. The proposed method uses standard dynamic receive beamforming, identical to two-way focusing, and does not require additional postprocessing. Thus, the method can be implemented in real time on programmable ultrasound systems that allow different excitation signals for each element. The proposed method is described analytically and validated by laboratory experiments in phantoms and ex vivo biological samples.

Remote photoacoustic sensing using speckle-analysis

Laser surgery is a rising surgical technique, which offers several advantages compared to the traditional scalpel. However, laser surgery lacks a contact-free feedback system which offers high imaging contrast to identify the tissue type ablated and also a high penetration depth. Photoacoustic imaging has the potential to fill this gap. Since photoacoustic detection is commonly contact based, a new non-interferometric detection technique based on speckle-analysis for remote detection is presented in this work. Phantom and ex-vivo experiments are carried out in transmission and reflection-mode for proof of concept. In summary, the potential of the remote speckle sensing technique for photoacoustic detection is demonstrated. In future, this technique might be applied for usage as a remote feedback system for laser surgery, which could help to broaden the applications of lasers as smart surgical tools.

Doppler sonography enhances rtPA-induced fibrinolysis in an in vitro clot model of spontaneous intracerebral hemorrhages

Background

Transcranial Doppler (TCD) was shown to enhance intravascular fibrinolysis by rtPA in ischemic stroke. Studies revealed that catheter-based administration of rtPA induces lysis of intracerebral hemorrhages (ICH). However, it is unknown whether TCD would be suitable to enhance rtPA-induced fibrinolysis in patients with ICH. The aim of this study was to assess the potential of TCD to enhance rtPA-induced fibrinolysis in an in vitro clot system.

Methods

Reproducible human blood clots of 25 ml were incubated in a water bath at 37°C during treatments. They were weighed before and after 6 different treatments: (I) control (incubation only), (II) rtPA only, (III) one Doppler probe, (IV) two Doppler probes placed vis-à-vis, (V) one probe and rtPA and (VI) two probes and rtPA. To quantify lysis of the blood clots and attenuation of the Doppler through a temporal squama acoustic peak rarefaction pressure (APRP) was measured in the field of the probes. Temperature was assessed to evaluate possible side effects.

Results

Clot weight was reduced in all groups. The control group had the highest relative end weight of 70.2%±7.2% compared to all other groups (p<0,0001). Most efficient lysis was achieved using (VI) 2 probes and rtPA 36.3%±4.4% compared to (II, III, IV) (p<0.0001; p = 0.0002; p = 0.048). APRP was above lysis threshold (535.5±7.2 kPa) using 2 probes even through the temporal squama (731.6±32.5 kPa) (p = 0.0043). There was a maximal temperature elevation of 0.17±0.07°C using both probes.

Conclusions

TCD significantly enhances rtPA-induced lysis of blood clots, and the effect is amplified by using multiple probes. Our results indicate that bitemporal TCD insonation of hematomas could be a new and safe approach to enhance fibrinolysis of ICH´s treated with intralesional catheter and rtPA.

Micron-sized PFOB liquid core droplets stabilized with tailored-made perfluorinated surfactants as a new class of endovascular sono-sensitizers for focused ultrasound thermotherapy

The effect of micro-droplet concentration on HIFU beam absorption.

Acoustic Streaming in a Soft Tissue Microenvironment

We demonstrated that sound can push fluid through a tissue-mimicking material. Although acoustic streaming in tissue has been proposed as a mechanism for biomedical ultrasound applications, such as neuromodulation and enhanced drug penetration, streaming in tissue or acoustic phantoms has not been directly observed. We developed a material that mimics the porous structure of tissue and used a dye and a video camera to track fluid movement. When applied above an acoustic intensity threshold, a continuous focused ultrasound beam (spatial peak time average intensity: 238 W/cm², centre frequency: 5 MHz) was found to push the dye axially, that is, in the direction of wave propagation and in the radial direction. Dye clearance increased with ultrasound intensity and was modelled using an adapted version of Eckart's acoustic streaming velocity equation. No microstructural changes were observed in the sonicated region when assessed using scanning electron microscopy. Our study indicates that acoustic streaming can occur in soft porous materials and provides a mechanistic basis for future use of streaming for therapeutic or diagnostic purposes.

Rapid inhibition of atherosclerotic plaque progression by sonodynamic therapy

Aims

Currently, efficient regimens to reverse atherosclerotic plaques are not available in the clinic. Herein, we present sonodynamic therapy (SDT) as a novel methodology to rapidly inhibit progression of atherosclerotic plaques.

Methods and results

In atherosclerotic rabbit and apoE-deficient mouse models, SDT efficiently decreased the atherosclerotic burden within 1 week, revealing a decrease in the size of the atherosclerotic plaque and enlarged lumen. The shrunken atherosclerotic plaques displayed compositional alterations, with a reduction in lesional macrophages and lipids. The rapid efficacy of SDT may be due to its induction of macrophage apoptosis, enhancement of efferocytosis, and amelioration of inflammation in the atherosclerotic plaque. Compared with atorvastatin, the standard of care for atherosclerosis, SDT showed more significant plaque shrinkage and lumen enlargement during 1 week treatment. Furthermore, SDT displayed good safety without obvious side effects. In a pilot clinical trial recruiting the patients suffering atherosclerotic peripheral artery disease, combination therapy of SDT with atorvastatin efficiently reduced progression of atherosclerotic plaque within 4 weeks, and its efficacy was able to last for at least 40 weeks.

Conclusion

SDT is a non-invasive and efficacious regimen to inhibit atherosclerotic plaque progression.

Feasibility Analysis on the Use of Ultrasonic Communications for Body Sensor Networks

Ultrasonic waves have good propagation in the human body and have been widely applied in biomedical device design without any reported side effects. Therefore, ultrasonic waves can provide an alternative method as an information carrier for body sensor networks (BSNs). This paper presents a novel wireless communication method that uses ultrasonic sound waves as a medium for healthcare systems. We investigated the feasibility of our proposal by testing it in a real digital communication experimental setup. To find an acceptable modulation method, the functionality of the proposed ultrasound-based digital communication approach was tested involving three principal modulation methods: amplitude shift keying (ASK), frequency shift keying (FSK), and phase shift keying (PSK). The modulated digital signals obtained from the experiments were compared with the simulated signals. Analysis of the results shows that ultrasonic waves are feasible and can be used for digital communication.

Development of a Tissue-Mimicking Phantom of the Brain for Ultrasonic Studies

Constructing tissue-mimicking phantoms of the brain for ultrasonic studies is complicated by the low backscatter coefficient of brain tissue, causing difficulties in simultaneously matching the backscatter and attenuation properties. In this work, we report on the development of a polyvinyl alcohol-based tissue-mimicking phantom with properties approaching those of human brain tissue. Polyvinyl alcohol was selected as the base material for the phantom as its properties can be varied by freeze-thaw cycling, variations in concentration and the addition of scattering inclusions, allowing some independent control of backscatter and attenuation. The ultrasonic properties (including speed of sound, attenuation and backscatter) were optimized using these methods with talc powder as an additive. It was determined that the ultrasonic properties of the phantom produced in this study are best matched to brain tissue in the frequency range 1-3 MHz, indicating its utility for laboratory ultrasonic studies in this frequency range.

Ultrasound Acoustic Radiation Force Impulse imaging for High Intensity Focused Ultrasound focal spot localization

Focal spot precise localization highly contributes to the accuracy and safety of High Intensity Focused Ultrasound (HIFU) therapies, and it is usually performed by means of Magnetic Resonance-Acoustic Radiation Force Impulse imaging (MR-ARFI). Acoustic Radiation Force Impulse imaging using ultrasound (US-ARFI) is herein proposed as a valid alternative to MR-ARFI for an accurate and non-destructive detection of the focal spot position during the pre-treatment phase. To this aim, a system composed of a HIFU transducer for generating the acoustic radiation force and a 2D confocal ultrasound probe for measuring the induced micro-displacement have been used. Then, an algorithm based on the Normalized Cross Correlation was implemented for the creation of a displacement map in which the highest displacement area, corresponding to the focal spot region, is unequivocally visualized. The feasibility of the proposed USARFI method for HIFU focal spot localization was successfully demonstrated in a tissue mimicking phantom model.

Observation of Guided Acoustic Waves in a Human Skull

Human skull poses a significant barrier for the propagation of ultrasound waves. Development of methods enabling more efficient ultrasound transmission into and from the brain is therefore critical for the advancement of ultrasound-mediated transcranial imaging or actuation techniques. We report on the first observation of guided acoustic waves in the near field of an ex vivo human skull specimen in the frequency range between 0.2 and 1.5MHz. In contrast to what was previously observed for guided wave propagation in thin rodent skulls, the guided wave observed in a higher-frequency regime corresponds to a quasi-Rayleigh wave, confined mostly to the cortical bone layer. The newly discovered near-field properties of the human skull are expected to facilitate the development of more efficient diagnostic and therapeutic techniques based on transcranial ultrasound.

Acoustic Transmission Factor through the Rat Skull as a Function of Body Mass, Frequency and Position

In many transcranial ultrasound studies on rats, the transmission factor is assumed to be independent of animal weight and losses resulting from non-normal incidence angles of the beam are not accounted for. In this study, we measured acoustic transmission factors through 13 excised skulls of male Sprague-Dawley rats weighing between 90 and 520g, at different positions on each skull and at 1, 1.25, 1.5, 1.75 and 2MHz. Our results revealed that insertion loss through rat skull increases linearly with both body mass and frequency and strongly depends on the position, decreasing from the front to the back and from the midline to the lateral sides. Skull thickness also scales linearly with body mass. Reflection explains the main part of the insertion loss compared with attenuation and aberration. These data are helpful in predicting the acoustic pressure at the focus in the brain.

PVCP-based anthropomorphic breast phantoms containing structures similar to lactiferous ducts for ultrasound imaging: A comparison with human breasts

The purpose of this work was to obtain an anthropomorphic phantom with acoustic properties similar to those of breast tissue, possessing lactiferous duct-like structures, which would be a first for this type of phantom. Breast lesions usually grow in glandular tissues or lactiferous ducts. Shape variations in these structures are detectable by using ultrasound imaging. To increase early diagnosis, it is important to develop computer-aided diagnosis (CAD) systems and improve medical training. Using tissue-like materials that mimic known internal structures can help achieve both of these goals. However, most breast ultrasound phantoms described in the literature emulate only fat tissues and lesion-like masses. In addition, commercially available phantoms claim to be realistic, but do not contain lactiferous duct structures. In this work, we collected reference images from both breasts of ten healthy female volunteers aged between 20 and 30 years using a 10 MHz linear transducer of a B-mode medical ultrasound system. Histograms of the grey scale distribution of each tissue component of interest, the grey level means, and standard deviations of the regions of interest were obtained. Phantoms were produced using polyvinyl chloride plastisol (PVCP) suspensions. The lactiferous duct-like structures were prepared using pure PVCP. Solid scatterers, such as alumina (mesh #100) and graphite powders (mesh #140) were added to the phantom matrix to mimic glandular and fat tissue, respectively. The phantom duct-like structure diameters observed on B-mode images (1.92 mm ± 0.44) were similar to real measures obtained with a micrometer (2.08 mm ± 0.23). The phantom ducts are easy to produce and are largely stable for at least one year. This phantom allows the researchers to elaborate the structure at their will and may be used in training and as a reference for development of CAD systems.

Comparison of ultrasound imaging and cone-beam computed tomography for examination of the alveolar bone level: A systematic review

Background and objective

The current methods to image alveolar bone in humans include intraoral 2D radiography and cone-beam computed tomography (CBCT). However, these methods expose the subject to ionizing radiation. Therefore, ultrasound imaging has been investigated as an alternative technique, as it is both non-invasive and free from ionizing radiation. In order to assess the validity and reliability of ultrasonography in visualizing alveolar bone, a systematic review was conducted comparing ultrasound imaging to CBCT for examination of the alveolar bone level.

Study design

Seven databases were searched. Studies addressing examination of alveolar bone level via CBCT and ultrasound were selected. Risk of bias under Cochrane guidelines was used as a methodological quality assessment tool.

Results

All the four included studies were ex vivo studies that used porcine or human cadaver samples. The alveolar bone level was measured by the distance from the alveolar bone crest to certain landmarks such as cemento-enamel junction or gingival margin. The risk of bias was found as low. The mean difference between ultrasound and CBCT measurements ranged from 0.07 mm to 0.68 mm, equivalent to 1.6% - 8.8%.

Conclusions

There is currently preliminary evidence to support the use of ultrasonography as compared to CBCT for the examination of alveolar bone level. Further studies comparing ultrasound to gold standard methods would be necessary to help validate the accuracy of ultrasonography as a diagnostic technique in periodontal imaging.

A contactless approach for monitoring the mechanical properties of swollen hydrogels

Using a customized ultrasound setup we investigate the feasibility of using a contactless approach to study the bulk mechanical properties of swollen hydrogels. The study involved two different hydrogels, gelatin methacrylate (GelMa) and green algae extract methacrylate (GAEM), which were prepared to provide materials with varying modulus and different swelling properties. Two approaches have been developed. In the first case, ultrasound was compared to Young's modulus measured by indentation. It was found that can be linearly related to indentation modulus values only when the hydrogel swelling ratio is taken into account. In the second approach, an exponential dependency between swelled thickness and indentation modulus was found. This is representative for each hydrogel and purification method in addition to being independent of the conditions used within the toughness range explored. The results of this study indicate that a simple thickness measurement via the proposed approach can provide a direct relationship to Young's modulus upon calibration.

Influence of Magnetic Nanoparticles on the Focused Ultrasound Hyperthermia

Ultrasound hyperthermia is a medical treatment used to increase temperature of tissues. It can be used independently or as a supportive method for an anticancer treatment. The therapeutic efficacy of focused ultrasound hyperthermia can be improved using sonosensitizers, nanoparticles enhancing the attenuation and dissipation of acoustic energy. As sonosensitizers, we propose magnetic nanoparticles owing to their biodegradability, biocompatibility, and simple positioning in tissues using a magnetic field. Focused ultrasound hyperthermia studies were performed using tissue-mimicking phantoms. Temperature changes were measured at various ultrasound powers and distances from the center of the ultrasound focus. Specific absorption rate (SAR) values, describing the power deposition in the tissues during the hyperthermia treatment, were evaluated for the center of the focus point and for various distances from it. The results show that the addition of nanoparticles increases the SAR almost two times compared to that for the pure phantom. The highest SAR is obtained in the ultrasound focus; it decreases with the increase of the distance from the focus.

Dependence of inertial cavitation induced by high intensity focused ultrasound on transducer F-number and nonlinear waveform distortion

Pulsed high intensity focused ultrasound was shown to enhance chemotherapeutic drug uptake in tumor tissue through inertial cavitation, which is commonly assumed to require peak rarefactional pressures to exceed a certain threshold. However, recent studies have indicated that inertial cavitation activity also correlates with the presence of shocks at the focus. The shock front amplitude and corresponding peak negative pressure (p -) in the focal waveform are primarily determined by the transducer F-number: less focused transducers produce shocks at lower p -. Here, the dependence of inertial cavitation activity on the transducer F-number was investigated in agarose gel by monitoring broadband noise emissions with a coaxial passive cavitation detector (PCD) during pulsed exposures (pulse duration 1 ms, pulse repetition frequency 1 Hz) with p- varying within 1-15 MPa. Three 1.5 MHz transducers with the same aperture, but different focal distances (F-numbers 0.77, 1.02, 1.52) were used. PCD signals were processed to extract cavitation probability, persistence, and mean noise level. At the same p -, all metrics indicated enhanced cavitation activity at higher F-numbers; specifically, cavitation probability reached 100% when shocks formed at the focus. These results provide further evidence supporting the excitation of inertial cavitation at reduced p - by waveforms with nonlinear distortion and shocks.