A review of tissue substitutes for ultrasound imaging

Ultrasound in Dentistry: Toward a Future of Radiation-Free Imaging

Ultrasonography (US) is a noninvasive, nonionizing, inexpensive, and painless imaging tool proven to be a valuable diagnostic tool in soft tissue assessment that also shows promise for hard tissue evaluation in dentistry. US has been investigated for its capability to identify carious lesions, tooth fractures or cracks, periodontal bony defects, maxillofacial fractures, and more. It has been used as a diagnostic aid in temporomandibular disorders, implant dentistry, and to measure muscle and soft tissue thickness. Unfortunately, the use of US in dentistry is still in its infancy; however, relevant research is promising.

Chemical Items Used for Preparing Tissue-Mimicking Material of Wall-Less Flow Phantom for Doppler Ultrasound Imaging

The wall-less flow phantoms with recognized acoustic features (attenuation and speed of sound), interior properties, and dimensions of tissue were prepared, calibrated, and characterized of Doppler ultrasound scanning demands tissue-mimicking materials (TMMs). TMM phantoms are commercially available and ready-made for medical ultrasound applications. Furthermore, the commercial TMM phantoms are proper for ultrasound purpose or estimation of diagnostic imaging techniques according to the chemical materials used for its preparation. However, preparing a desirable TMM for wall-less flow phantom using a specific chemical material according to the specific applications is required for different flow. In this review, TMM and wall-less flow phantoms prepared using different chemical materials and methods were described. The chemical materials used in Doppler ultrasound TMM and wall-less flow phantoms fabricated over the previous decades were of high interest in this review.

3D Printed Organ Models for Surgical Applications

Medical errors are a major concern in clinical practice, suggesting the need for advanced surgical aids for preoperative planning and rehearsal. Conventionally, CT and MRI scans, as well as 3D visualization techniques, have been utilized as the primary tools for surgical planning. While effective, it would be useful if additional aids could be developed and utilized in particularly complex procedures involving unusual anatomical abnormalities that could benefit from tangible objects providing spatial sense, anatomical accuracy, and tactile feedback. Recent advancements in 3D printing technologies have facilitated the creation of patient-specific organ models with the purpose of providing an effective solution for preoperative planning, rehearsal, and spatiotemporal mapping. Here, we review the state-of-the-art in 3D printed, patient-specific organ models with an emphasis on 3D printing material systems, integrated functionalities, and their corresponding surgical applications and implications. Prior limitations, current progress, and future perspectives in this important area are also broadly discussed.

Antidepressant-Like Effect of Low-Intensity Transcranial Ultrasound Stimulation

OBJECTIVE

Transcranial ultrasound stimulation (TUS) is a noninvasive neuromodulation technique with good spatial resolution and deep penetration. This study aims to investigate whether TUS has antidepressant-like effect to depressed rats.

METHODS

Rats were divided into five groups, including two groups (ST-Ctr and ST-Res) for evaluating the short-term impact of restraint stress and three groups (LT-Ctr-ShamTUS, LT-Res-ShamTUS and LT-Res-TUS) for studying the long-term effects of restraint and TUS stimulation. The TUS-treated rats were subjected to 15 min TUS stimulation to the prelimbic cortex every day for 2 weeks after the restraint. Then, depressive symptoms related behavioral outcomes were estimated in ST-Ctr and ST-Res groups (1 week after restraint), as well as in the other three groups (3 weeks after restraint).

RESULTS

The 48-h-restraint stress could lead to long lasting reduction of exploratory behavior (1 and 3 weeks after restraint) and protracted anhedonia (only observed 3 weeks after restraint). TUS application successfully reversed the core depressive phenotype, anhedonia, indicated by significantly higher sucrose preference index in LT-Res-TUS group [Formula: see text] than LT-Res-ShamTUS group [Formula: see text]. Furthermore, the brain derived neurotrophic factor expression in left hippocampus was significantly promoted in LT-Res-TUS group [Formula: see text] compared to LT-Res-ShamTUS group [Formula: see text]. In addition, the histologic results of hematoxylin and eosin staining showed no TUS-induced brain tissue injury.

CONCLUSION

These results demonstrated that low intensity TUS had antidepressant-like effect.

SIGNIFICANCE

TUS has been speculated to have therapeutic effect in depression. This study provide evidence for the antidepressant-like effects of TUS in rats for the first time.

3-D-Printed Phantom Fabricated by Photopolymer Jetting Technology for High-Frequency Ultrasound Imaging

In the field of high-frequency ultrasound imaging ( MHz), tools for characterizing the performance of imaging systems are lacking. Indeed, commercial phantoms are often inadequate for this frequency range. The development of homemade phantoms on the laboratory scale is often required but is hindered by the difficulty in making very small structures that must be distributed with high accuracy in 3-D space. We propose investigating the use of 3-D photopolymer printing to create resolution and calibration phantoms designed for high-frequency ultrasound imaging. The quality and importance of these phantoms are discussed from the point of view of ultrasound parameters and imaging. First, the compressional wave group velocity, acoustic impedance, and attenuation of six photopolymerized materials were measured using temporal and spectral methods in a substitution experimental setup. Measurements were performed on printed samples using a broadband-focused single-element transducer covering a large frequency range (15-55 MHz). Two 3-D phantoms incorporating different shapes and dimensions were designed and printed. Finally, 3-D acoustic images were obtained using either a mechanically driven single-element transducer or a high-frequency commercial imaging system. Three-dimensional printing enabled us to generate phantoms suitable for high-frequency imaging with complex geometry inclusions and with a surrounding material having acoustic properties close to those of human skin. The calculated SNR between the inclusion and surrounding media is approximately 50 dB. In conclusion, 3-D printing is a useful tool for directly, easily, and rapidly manufacturing ultrasound phantoms for ultrasound imaging system assessments and computational calibration or validation.

Compressibility and Density Weighting for Ultrasound Scattering Tomography

A novel reconstruction technique based on delay-and-sum ultrasound tomography algorithms is introduced. This reconstruction technique enables ultrasound tomographic systems to produce compressibility- and density-weighted images (D-WI) for spherically symmetric ultrasound scatterers. The efficacy of this reconstruction technique was demonstrated with simulation and phantom experiments. Separation between a dense wire target and a compressible thread target within a phantom was quantified, showing an increased signal of the wire target for D-WIs. The suppression of background scatter in D-WIs was also quantified. Resolution was calculated for these reconstruction techniques, exemplifying the half-wavelength diffraction-limited resolution capabilities of this ultrasound scattering tomography system. The proposed technique offers a enhanced minimum-detectable density-contrast sensitivity compared to traditional B-scan imaging for a 100- target. This enhanced detectability is expected to prove advantageous for microcalcification imaging.

Optimization of Transmit Parameters in Cardiac Strain Imaging With Full and Partial Aperture Coherent Compounding

Coherent compounding methods using the full or partial transmit aperture have been investigated as a possible means of increasing strain measurement accuracy in cardiac strain imaging; however, the optimal transmit parameters in either compounding approach have yet to be determined. The relationship between strain estimation accuracy and transmit parameters-specifically the subaperture, angular aperture, tilt angle, number of virtual sources, and frame rate-in partial aperture (subaperture compounding) and full aperture (steered compounding) fundamental mode cardiac imaging was thus investigated and compared. Field II simulation of a 3-D cylindrical annulus undergoing deformation and twist was developed to evaluate accuracy of 2-D strain estimation in cross-sectional views. The tradeoff between frame rate and number of virtual sources was then investigated via transthoracic imaging in the parasternal short-axis view of five healthy human subjects, using the strain filter to quantify estimation precision. Finally, the optimized subaperture compounding sequence (25-element subperture, 90° angular aperture, 10 virtual sources, 300-Hz frame rate) was compared to the optimized steered compounding sequence (60° angular aperture, 15° tilt, 10 virtual sources, 300-Hz frame rate) via transthoracic imaging of five healthy subjects. Both approaches were determined to estimate cumulative radial strain with statistically equivalent precision (subaperture compounding E(SNRe %) = 3.56, and steered compounding E(SNRe %) = 4.26).

Heating Induced by Therapeutic Ultrasound in the Presence of Magnetic Nanoparticles

The efficiency of ultrasound hyperthermia for anti-cancer treatments such as radiotherapy or chemotherapy can be improved by using sonosensitizers, which are materials that enhance the attenuation and dissipation of acoustic energy. We propose the use of magnetic nanoparticles as sonosensitizers because of their biocompatibility, nontoxicity, and common use in several medical applications. A magnetic material was synthetized and then incorporated in the form of a magnetic fluid in agar tissue-mimicking phantoms. Ultrasound hyperthermia studies were conducted at various ultrasound frequencies and concentrations of magnetic nanoparticles in the phantoms. The theoretical modeling based on a heat transfer equation and the experimental results show good agreement and confirm that the temperature rise during ultrasound heating in tissue-mimicking phantoms doped with sonosensitizers is greater than that in a pure agar phantom. Furthermore, on the basis of Pennes' bio-heat equation, which takes into consideration the blood perfusion and metabolic heat, the thermal dose and lesion shapes after sonication were determined for a hypothetical tissue.

Imaging beyond ultrasonically-impenetrable objects

Ultrasound images are severely degraded by the presence of obstacles such as bones and air gaps along the beam path. This paper describes a method for imaging structures that are distal to obstacles that are otherwise impenetrable to ultrasound. The method uses an optically-inspired holographic algorithm to beam-shape the emitted ultrasound field in order to bypass the obstacle and place the beam focus beyond the obstruction. The resulting performance depends on the transducer aperture, the size and position of the obstacle, and the position of the target. Improvement compared to standard ultrasound imaging is significant for obstacles for which the width is larger than one fourth of the transducer aperture and the depth is within a few centimeters of the transducer. For such cases, the improvement in focal intensity at the location of the target reaches 30-fold, and the improvement in peak-to-side-lobe ratio reaches 3-fold. The method can be implemented in conventional ultrasound systems, and the entire process can be performed in real time. This method has applications in the fields of cancer detection, abdominal imaging, imaging of vertebral structure and ultrasound tomography. Here, its effectiveness is demonstrated using wire targets, tissue mimicking phantoms and an ex vivo biological sample.

Multidirectional Estimation of Arterial Stiffness Using Vascular Guided Wave Imaging with Geometry Correction

We previously found that vascular guided wave imaging (VGWI) could non-invasively quantify transmural wall stiffness in both the longitudinal (r-z plane, 0°) and circumferential (r-θ plane, 90°) directions of soft hollow cylinders. Arterial stiffness estimation in multiple directions warrants further comprehensive characterization of arterial health, especially in the presence of asymmetric plaques, but is currently lacking. This study therefore investigated the multidirectional estimation of the arterial Young's modulus in a finite-element model, in vitro artery-mimicking phantoms and an excised porcine aorta. A longitudinal pre-stretch of 20% and/or lumen pressure (15 or 70 mm Hg) was additionally introduced to pre-condition the phantoms for emulating the intrinsic mechanical anisotropy of the real artery. The guided wave propagation was approximated by a zero-order antisymmetric Lamb wave model. Shape factor, which was defined as the ratio of inner radius to thickness, was calculated over the entire segment of each planar cross section of the hollow cylindrical structure at a full rotation (0°-360° at 10° increments) about the radial axis. The view-dependent geometry of the cross segment was found to affect the guided wave propagation, causing Young's modulus overestimation in four angular intervals along the propagation pathway, all of which corresponded to wall regions with low shape factors (<1.5). As validated by mechanical tensile testing, the results indicate not only that excluding the propagation pathway with low shape factors could correct the overestimation of Young's modulus, but also that VGWI could portray the anisotropy of hollow cylindrical structures and the porcine aorta based on the derived fractional anisotropy values from multidirectional modulus estimates. This study may serve as an important step toward 3-D assessment of the mechanical properties of the artery.

Ultrasound-mediation of self-illuminating reporters improves imaging resolution in optically scattering media

In vivo imaging of self-illuminating bio-and chemiluminescent reporters is used to observe the physiology of small animals. However, strong light scattering by biological tissues results in poor spatial resolution of the optical imaging, which also degrades the quantitative accuracy. To overcome this challenging problem, focused ultrasound is used to modulate the light from the reporter at the ultrasound frequency. This produces an ultrasound switchable light 'beacon' that reduces the influence of light scattering in order to improve spatial resolution. The experimental results demonstrate that apart from light modulation at the ultrasound frequency (AC signal at 3.5 MHz), ultrasound also increases the DC intensity of the reporters. This is shown to be due to a temperature rise caused by insonification that was minimized to be within acceptable mammalian tissue safety thresholds by adjusting the duty cycle of the ultrasound. Line scans of bio-and chemiluminescent objects embedded within a scattering medium were obtained using ultrasound modulated (AC) and ultrasound enhanced (DC) signals. Lateral resolution is improved by a factor of 12 and 7 respectively, as compared to conventional CCD imaging. Two chemiluminescent sources separated by ~10 mm at ~20 mm deep inside a 50 mm thick chicken breast have been successfully resolved with an average signal-to-noise ratio of approximately 8-10 dB.

A Low-Cost, Reusable, Ballistic Gelatin Ultrasound Phantom for Simulation of Glenohumeral Intraarticular Injections

BACKGROUND

Deliberate practice of invasive procedures on simulation phantoms has been recommended to teach trainees. For many departments, these task trainers can be prohibitively expensive. Sometimes, phantoms for specialized procedures are not commercially available at all. There are currently are no commercially available simulation phantoms for the purpose of ultrasound (US)-guided glenohumeral joint injection.

OBJECTIVES

The objective was to create a low-cost, reusable, homemade simulation phantom for US-guided glenohumeral joint injection using easily obtainable materials as well as to determine whether use of such a homemade model by novice learners is associated with increased self-reported comfort level and knowledge of the procedure.

METHODS

Fourth-year emergency medicine-bound medical students and PGY-1 residents were asked to participate in a hands-on 30-minute training session for US-guided glenohumeral joint injection using a homemade simulation phantom. Participants were assessed by pre- and postintervention survey of self-reported comfort levels with the procedure. Outcomes were measured on modified global rating scale (GRS; minimum = 1, maximum = 7). The primary outcome was learner comfort with US-guided glenohumeral joint injection. Secondary outcomes were comfort level in obtaining adequate US image and identifying landmarks of the glenohumeral joint as well as likelihood to perform US-guided injection of the glenohumeral joint in a clinical setting.

RESULTS

In the primary outcome, mean GRS scores in 13 participants for comfort with the procedure increased from 2.7 to 5.0 (p < 0.01) after intervention. Mean GRS for knowledge of anatomy increased from 2.8 to 5.4 (p < 0.01) and mean GRS for comfort in image acquisition increased from 2.8 to 5.3 (p < 0.01). Mean GRS for likelihood to perform the procedure trended toward increase from 4.6 to 5.5 (p = 0.25).

CONCLUSIONS

Use of a homemade, low-cost, ballistic gelatin US phantom for simulation of glenohumeral intraarticular injection was associated with increased learner comfort with the procedure.

Detection of atrial fibrillation during pulpal blood flow assessment using Doppler ultrasound: a case report

This report describes the case of a 52-year-old male patient who exhibited suspicious pulsation patterns during pulpal blood flow assessment using Doppler ultrasound. Initially, he was not aware of his cardiovascular problem; however, after referral to a medical clinic, he was diagnosed with atrial fibrillation. The patient was injured in a motor vehicle accident and referred to our clinic for management of multiple traumatized teeth. On clinical examination, several teeth exhibited negative responses to cold and electrical sensibility tests. For accurate diagnosis, pulpal blood flow assessment using a Doppler ultrasound device was performed. During the tests, irregular pulsation patterns were detected, indicating the possibility of a cardiovascular problem. As he denied any history of cardiovascular problems, he was recommended to visit a medical doctor for further evaluation. The following day, he visited a medical clinic, and a 12-lead electrocardiogram was performed. He was ultimately diagnosed with atrial fibrillation with idioventricular rhythm, and was started on anticoagulant medication for prevention of thrombogenesis, which is a possible complication of atrial fibrillation. As presented in this case, Doppler ultrasound can provide useful information, not only about blood flow in the dental pulp, but also about an individual's pulsation rhythm. When a patient presents with irregular pulsation patterns in certain situations, the possibility of cardiovascular problems should be considered.

Virtual craniotomy for high-resolution optoacoustic brain microscopy

Ultrasound-mediated transcranial images of the brain often suffer from acoustic distortions produced by the skull bone. In high-resolution optoacoustic microscopy, the skull-induced acoustic aberrations are known to impair image resolution and contrast, further skewing the location and intensity of the different absorbing structures. We present a virtual craniotomy deconvolution algorithm based on an ultrasound wave propagation model that corrects for the skull-induced distortions in optically-resolved optoacoustic transcranial microscopy data. The method takes advantage of the geometrical and spectral information of a pulse-echo ultrasound image of the skull simultaneously acquired by our multimodal imaging system. Transcranial mouse brain imaging experiments confirmed the ability to accurately account for the signal amplitude decay, temporal delay and pulse broadening introduced by the rodent's skull. Our study is the first to demonstrate skull-corrected transcranial optoacoustic imaging in vivo.

Acoustical structured illumination for super-resolution ultrasound imaging

Structured illumination microscopy is an optical method to increase the spatial resolution of wide-field fluorescence imaging beyond the diffraction limit by applying a spatially structured illumination light. Here, we extend this concept to facilitate super-resolution ultrasound imaging by manipulating the transmitted sound field to encode the high spatial frequencies into the observed image through aliasing. Post processing is applied to precisely shift the spectral components to their proper positions in k-space and effectively double the spatial resolution of the reconstructed image compared to one-way focusing. The method has broad application, including the detection of small lesions for early cancer diagnosis, improving the detection of the borders of organs and tumors, and enhancing visualization of vascular features. The method can be implemented with conventional ultrasound systems, without the need for additional components. The resulting image enhancement is demonstrated with both test objects and ex vivo rat metacarpals and phalanges.

Anatomically realistic ultrasound phantoms using gel wax with 3D printed moulds

Here we describe methods for creating tissue-mimicking ultrasound phantoms based on patient anatomy using a soft material called gel wax. To recreate acoustically realistic tissue properties, two additives to gel wax were considered: paraffin wax to increase acoustic attenuation, and solid glass spheres to increase backscattering. The frequency dependence of ultrasound attenuation was well described with a power law over the measured range of 3–10 MHz. With the addition of paraffin wax in concentrations of 0 to 8 w/w%, attenuation varied from 0.72 to 2.91 dB cm⁻¹ at 3 MHz and from 6.84 to 26.63 dB cm⁻¹ at 10 MHz. With solid glass sphere concentrations in the range of 0.025–0.9 w/w%, acoustic backscattering consistent with a wide range of ultrasonic appearances was achieved. Native gel wax maintained its integrity during compressive deformations up to 60%; its Young’s modulus was 17.4  ±  1.4 kPa. The gel wax with additives was shaped by melting and pouring it into 3D printed moulds. Three different phantoms were constructed: a nerve and vessel phantom for peripheral nerve blocks, a heart atrium phantom, and a placental phantom for minimally-invasive fetal interventions. In the first, nerves and vessels were represented as hyperechoic and hypoechoic tubular structures, respectively, in a homogeneous background. The second phantom comprised atria derived from an MRI scan of a patient with an intervening septum and adjoining vena cavae. The third comprised the chorionic surface of a placenta with superficial fetal vessels derived from an image of a post-partum human placenta. Gel wax is a material with widely tuneable ultrasound properties and mechanical characteristics that are well suited for creating patient-specific ultrasound phantoms in several clinical disciplines.

Spatial Compounding of 3-D Fetal Brain Ultrasound Using Probabilistic Maps

A new method to address the problem of shadowing in fetal brain ultrasound volumes is presented. The proposed approach is based on the spatial composition of multiple 3-D fetal head projections using the weighted Euclidean norm as an operator. A support vector machine, which is trained with optimal textural features, was used to assign weighting according to the posterior probabilities of brain tissue and shadows. Both phantom and real fetal head ultrasound volumes were compounded using previously reported operators and compared with the proposed composition method to validate it. The quantitative evaluations revealed increases in signal-to-noise ratio ≤35% and in contrast-to-noise ratio ≤135% using real data. Qualitative comparisons made by obstetricians indicated that this novel method adequately recovers brain tissue and improves the visibility of the main cerebral structures. This may prove useful both for fetal monitoring and in the diagnosis of brain defects. Overall this new approach outperforms spatial composition methods previously reported.

A review of the recommendations governing quality assurance of ultrasound systems used for guidance in prostate brachytherapy

Ultrasound guided brachytherapy for the treatment of prostate cancer has become a routine treatment option, due to many benefits including patient recovery and dose localisation [1]; however it is not clear whether the standards which govern the image quality for these systems are adequate. Upon review of the recommended standards for ultrasound systems used in prostate brachytherapy procedures, the recommended tests do not appear to be specific to the clinical application of ultrasound guided prostate brachytherapy. Rather they are generic and similar to those recommended for other clinical applications such as general abdominal scanning [2]. Furthermore, there is growing evidence that these tests should be specific to the clinical application [3,4] in order to gain meaningful data about the performance of the system for the application, and also to detect clinically relevant changes in quality control results. An additional problem is that there are no clinically relevant test phantom recommended for the quality assurance of ultrasound systems used in prostate brachytherapy. The image quality for this application of ultrasound needs to be monitored to ensure consistent levels of confidence in the procedure. This paper reviews the currently recommended test guidelines and test phantoms for ultrasound systems used in prostate brachytherapy from the different standard bodies and professional organisations. A critical analysis of those tests which are most reflective of the imaging and guidance tasks undertaken in an ultrasound guided prostate brachytherapy procedure will also be presented to inform the design of a TRUS quality assurance protocol.

Ultrasound Phantom Using Sodium Alginate as a Gelling Agent

For medical workers, ultrasound phantoms for human soft tissue are used not only for accuracy management of ultrasound diagnosis but also to aid ultrasound-guided needle and blind catheter insertion training without risk to real patients. For the phantoms, ultrasound characteristics and a texture are required to mimic the human soft tissue. The proposed phantom was composed of sodium alginate, calcium sulfate dihydrate, trisodium phosphate 12-hydrate, glycerol, and water. The propagation speed, attenuation coefficient, acoustic impedance, and texture of the proposed phantom were almost the same as those of human soft tissue. Expensive chemicals and special equipment are not required.

Toward a Standardization of Ultrasound Scanners for Dynamic Contrast-Enhanced Ultrasonography: Methodology and Phantoms

The standardization of ultrasound scanners for dynamic contrast-enhanced ultrasonography (DCE-US) is mandatory for evaluation of clinical multicenter studies. We propose a robust method using a phantom for measuring the variation of the harmonic signal intensity obtained from the area under the time-intensity curve versus various contrast-agent concentrations. The slope of this measured curve is the calibration parameter. We tested our method on two devices from the same manufacturer (AplioXV and Aplio500, Toshiba, Tokyo, Japan) using the same settings as defined for a French multicenter study. The Aplio500's settings were adjusted to match the slopes of the AplioXV, resulting in the following settings on the Aplio500: at 3.5 MHz: MI = 0.15; CG = 35 dB and at 8 MHz: MI = 0.10; CG = 32 dB. This calibration method is very important for future DCE-US multicenter studies.

Ultrasound Assessment of Bone Healing after Root-end Surgery: Echoes Back to Patient's Safety

INTRODUCTION

The aim of this study was to present ultrasound imaging (UI) techniques as promising and safe tools for the follow-up of root-end surgery (RES) in vivo.

METHODS

The study included 8 patients who underwent RES. All were followed up using UI at 1 week, 1 month, 2 months, 3 months, and 6 months (if necessary) after RES. The bony crypt was defined on the ultrasound image, and the following observations were made during follow-up: cortical bone interruption and surface area measurement of the residual echoic bony crypt image.

RESULTS

In all cases, the hypoechoic image became hyperechoic, indicating gradual bone healing of the crypt. Compared with baseline, at 3 months a remaining cortical opening of 51.2% (±12.6%) and a bony crypt surface area of 24.3% (±10.8%) was detected for all patients. For 50% of the patients, the echographic follow-up ended at 3 months because the ultrasound waves could no longer enter the bony crypt. For 4 patients who attended the 6-month recall, a remaining cortical disruption of 43.2% (±9.9%) and a bony crypt surface area of 17.2% (±7%) compared with the baseline was noted.

CONCLUSIONS

UI is a promising follow-up tool for RES. It helps clinicians understand the initial stages of bone healing, allows close healing monitoring, and is radiation free.

Anthropomorphic liver phantom with flow for multimodal image-guided liver therapy research and training

Purpose

The objective of this study was to develop a multimodal, permanent liver phantom displaying functional vasculature and common pathologies, for teaching, training and equipment development in laparoscopic ultrasound and navigation.

Methods

Molten wax was injected simultaneously into the portal and hepatic veins of a human liver. Upon solidification of the wax, the surrounding liver tissue was dissolved, leaving a cast of the vessels. A connection was established between the two vascular trees by manually manipulating the wax. The cast was placed, along with different multimodal tumor models, in a liver shaped mold, which was subsequently filled with a polymer. After curing, the wax was melted and flushed out of the model, thereby establishing a system of interconnected channels, replicating the major vasculature of the original liver. Thus, a liquid can be circulated through the model in a way that closely mimics the natural blood flow.

Results

Both the tumor models, i.e., the metastatic tumors, hepatocellular carcinoma and benign cyst, and the vessels inside the liver model, were clearly visualized by all the three imaging modalities: CT, MR and ultrasound. Doppler ultrasound images of the vessels proved the blood flow functionality of the phantom.

Conclusion

By a two-step casting procedure, we produced a multimodal liver phantom, with open vascular channels, and tumor models, that is the next best thing to practicing imaging and guidance procedures in animals or humans. The technique is in principle applicable to any organ of the body.

A Coaxial Dual-element Focused Ultrasound Probe for Guidance of Epidural Catheterization: An Experimental Study

Ultrasound guidance for epidural block has improved clinical blind-trial problems but the design of present ultrasonic probes poses operating difficulty of ultrasound-guided catheterization, increasing the failure rate. The purpose of this study was to develop a novel ultrasonic probe to avoid needle contact with vertebral bone during epidural catheterization. The probe has a central circular passage for needle insertion. Two focused annular transducers are deployed around the passage for on-axis guidance. A 17-gauge insulated Tuohy needle containing the self-developed fiber-optic-modified stylet was inserted into the back of the anesthetized pig, in the lumbar region under the guidance of our ultrasonic probe. The inner transducer of the probe detected the shallow echo signals of the peak-peak amplitude of 2.8 V over L3 at the depth of 2.4 cm, and the amplitude was decreased to 0.8 V directly over the L3 to L4 interspace. The outer transducer could detect the echoes from the deeper bone at the depth of 4.5 cm, which did not appear for the inner transducer. The operator tilted the probe slightly in left-right and cranial-caudal directions until the echoes at the depth of 4.5 cm disappeared, and the epidural needle was inserted through the central passage of the probe. The needle was advanced and stopped when the epidural space was identified by optical technique. The needle passed without bone contact. Designs of the hollow probe for needle pass and dual transducers with different focal lengths for detection of shallow and deep vertebrae may benefit operation, bone/nonbone identification, and cost.

Optical verification and in-vitro characterization of two commercially available acoustic bubble counters for cardiopulmonary bypass systems

Introduction:

Gaseous microemboli (GME) introduced during cardiac surgery are considered as a potential source of morbidity, which has driven the development of the first bubble counters. Two new generation bubble counters, introduced in the early 2000s, claim correct sizing and counting of GME. This in-vitro study aims to validate the accuracy of two bubble counters using monodisperse bubbles in a highly controlled setting at low GME concentrations.

Methods:

Monodisperse GME with a radius of 43 µm were produced in a microfluidic chip. Directly after their formation, they were injected one-by-one into the BCC200 and the EDAC sensors. GME size and count, measured with the bubble counters, were optically verified using high-speed imaging.

Results:

During best-case scenarios or low GME concentrations of GME with a size of 43 µm in radius in an in-vitro setup, the BCC200 overestimates GME size by a factor of 2 to 3 while the EDAC underestimates the average GME size by at least a factor of two. The BCC200 overestimates the GME concentration by approximately 20% while the EDAC overestimates the concentration by nearly one order of magnitude. Nevertheless, the calculated total GME volume is only over-predicted by a factor 2 since the EDAC underestimates the actual GME size. For the BCC200, the total GME volume was over-predicted by 25 times due to the over-estimation of GME size.

Conclusions:

The measured errors in the absolute sizing/counting of GME do not imply that all results obtained using the bubble counters are insignificant or invalid. A relative change in bubble size or bubble concentration can accurately be measured. However, care must be taken in the interpretation of the results and their absolute values. Moreover, the devices cannot be used interchangeably when reporting GME activity. Nevertheless, both devices can be used to study the relative air removal characteristics of CPB components or for the quantitative monitoring of GME production during CPB interventions.

Affinity interactions drive post-implantation drug filling, even in the presence of bacterial biofilm

Current post-operative standard of care for surgical procedures, including device implantations, dictates prophylactic antimicrobial therapy, but a percentage of patients still develop infections. Systemic antimicrobial therapy needed to treat such infections can lead to downstream tissue toxicities and generate drug-resistant bacteria. To overcome issues associated with systemic drug administration, a polymer incorporating specific drug affinity has been developed with the potential to be filled or refilled with antimicrobials, post-implantation, even in the presence of bacterial biofilm. This polymer can be used as an implant coating or stand-alone drug delivery device, and can be translated to a variety of applications, such as implanted or indwelling medical devices, and/or surgical site infections. The filling of empty affinity-based drug delivery polymer was analyzed in an in vitro filling/refilling model mimicking post-implantation tissue conditions. Filling in the absence of bacteria was compared to filling in the presence of bacterial biofilms of varying maturity to demonstrate proof-of-concept necessary prior to in vivo experiments. Antibiotic filling into biofilm-coated affinity polymers was comparable to drug filling seen in same affinity polymers without biofilm demonstrating that affinity polymers retain ability to fill with antibiotic even in the presence of biofilm. Additionally, post-implantation filled antibiotics showed sustained bactericidal activity in a zone of inhibition assay demonstrating post-implantation capacity to deliver filled antibiotics in a timeframe necessary to eradicate bacteria in biofilms. This work shows affinity polymers can fill high levels of antibiotics post-implantation independent of biofilm presence potentially enabling device rescue, rather than removal, in case of infection.

STATEMENT OF SIGNIFICANCE

Post-operative prophylactic antimicrobial therapy greatly reduces risk of infection, such as on biomedical implants, but does not totally eliminate infections, and the healthcare cost of these remaining infections remains a major concern. Systemic antimicrobial therapy to treat these infections can lead to tissue toxicity and drug-resistant bacteria. In order to treat only those patients who have developed infections, a customizable antimicrobial delivery system made of cyclodextrin-based affinity polymer has been developed that is capable of filling post-implantation and delivering the filled antibiotic in a sustained manner even when the delivery device covered in bacterial biofilm. These observations have the potential to be translated to a wide variety of applications, such as implanted or indwelling medical devices, and/or surgical site infections.

Broadband Acoustic Measurement of an Agar-Based Tissue-Mimicking-Material: A Longitudinal Study

Commercially available ultrasound quality assurance test phantoms rely on the long-term acoustic stability of the tissue-mimicking-material (TMM). Measurement of the acoustic properties of the TMM can be technically challenging, and it is important to ensure its stability. The standard technique is to film-wrap samples of TMM and to measure the acoustic properties in a water bath. In this study, a modified technique was proposed whereby the samples of TMM are measured in a preserving fluid that is intended to maintain their characteristics. The acoustic properties were evaluated using a broadband pulse-echo substitution technique over the frequency range 4.5-50 MHz at 0, 6 and 12 months using both techniques. For both techniques, the measured mean values for the speed of sound and attenuation were very similar and within the International Electrotechnical Commission-recommended value. However, the results obtained using the proposed modified technique exhibited greater stability over the 1-y period compared with the results acquired using the standard technique.

Acoustic and thermal characterization of agar based phantoms used for evaluating focused ultrasound exposures

Background

This study describes a series of experimental work completed towards characterizing candidate materials for fabricating brain and muscle tissue mimicking phantoms.

Methods

The acoustic speed, attenuation, impedance, thermal diffusivity, specific heat and thermal conductivity were measured.

Results

The resulting brain (2% w/v agar-1.2% w/v Silica Dioxide-25%v/v evaporated milk) and muscle tissue recipe (2% w/v agar-2% w/v Silica Dioxide-40%v/v evaporated milk) introduced a total attenuation coefficient of 0.59 dB/cm-MHz and 0.99 dB/cm-MHz respectively. Acrylonitrile Butadiene Styrene (ABS) possessed an attenuation coefficient of 16 dB/cm at 1 MHz which was found within the very wide range of attenuation coefficient values of human bones in literature. The thermal conductivity of the brain tissue phantom was estimated at 0.52 W/m°C and at 0.57 W/m.°Cfor the muscle. These values demonstrated that the proposed recipes conducted heat similar to the majority of most soft tissues found from bibliography. The soft tissue phantoms were also evaluated for their thermal repeatability after treating them repeatedly at different locations with the same sonication protocol and configuration. The average coefficient of variation of the maximum temperature at focus between the different locations was 2.6% for the brain phantom and 2.8% for the muscle phantom.

Conclusions

The proposed phantom closely matched the acoustic and thermal properties of tissues. Experiments using MR thermometry demonstrated the usefulness of this phantom to evaluate ultrasonic exposures.

Quantifying melanin concentration in retinal pigment epithelium using broadband photoacoustic microscopy

Melanin is the dominant light absorber in retinal pigment epithelium (RPE). The loss of RPE melanin is a sign of ocular senescence and is both a risk factor and a symptom of age-related macular degeneration (AMD). Quantifying the RPE melanin concentration provides insight into the pathological role of RPE in ocular aging and the onset and progression of AMD. The main challenge in accurate quantification of RPE melanin concentration is to distinguish this ten-micrometer-thick cell monolayer from the underlying choroid, which also contains melanin but carries different pathognomonic information. In this work, we investigated a three-dimensional photoacoustic microscopic (PAM) method with high axial resolution, empowered by broad acoustic detection bandwidth, to distinguish RPE from choroid and quantify melanin concentrations in the RPE ex vivo. We first conducted numerical simulation on photoacoustic generation in the RPE, which suggested that a PAM system with at least 100-MHz detection bandwidth provided sufficient axial resolution to distinguish the melanin in RPE from that in choroid. Based on simulation results, we integrated a transparent broadband micro-ring resonator (MRR) based detector in a homebuilt PAM system. We imaged ex vivo RPE-choroid complexes (RCCs) from both porcine and human eyes and quantified the absolute melanin concentrations in the RPE and choroid, respectively. In our study, the measured melanin concentrations were 14.7 mg/mL and 17.0 mg/mL in human and porcine RPE, and 12 mg/mL and 61 mg/mL in human and porcine choroid, respectively. This study suggests that broadband PAM is capable of quantifying the RPE melanin concentration from RCCs ex vivo.

Polyvinyl chloride as a multimodal tissue-mimicking material with tuned mechanical and medical imaging properties

PURPOSE

The mechanical and imaging properties of polyvinyl chloride (PVC) can be adjusted to meet the needs of researchers as a tissue-mimicking material. For instance, the hardness can be adjusted by changing the ratio of softener to PVC polymer, mineral oil can be added for lubrication in needle insertion, and glass beads can be added to scatter acoustic energy similar to biological tissue. Through this research, the authors sought to develop a regression model to design formulations of PVC with targeted mechanical and multimodal medical imaging properties.

METHODS

The design of experiment was conducted by varying three factors-(1) the ratio of softener to PVC polymer, (2) the mass fraction of mineral oil, and (3) the mass fraction of glass beads-and measuring the mechanical properties (elastic modulus, hardness, viscoelastic relaxation time constant, and needle insertion friction force) and the medical imaging properties [speed of sound, acoustic attenuation coefficient, magnetic resonance imaging time constants T₁ and T₂, and the transmittance of the visible light at wavelengths of 695 nm (T_λ695) and 532 nm (T_λ532)] on twelve soft PVC samples. A regression model was built to describe the relationship between the mechanical and medical imaging properties and the values of the three composition factors of PVC. The model was validated by testing the properties of a PVC sample with a formulation distinct from the twelve samples.

RESULTS

The tested soft PVC had elastic moduli from 6 to 45 kPa, hardnesses from 5 to 50 Shore OOO-S, viscoelastic stress relaxation time constants from 114.1 to 191.9 s, friction forces of 18 gauge needle insertion from 0.005 to 0.086 N/mm, speeds of sound from 1393 to 1407 m/s, acoustic attenuation coefficients from 0.38 to 0.61 (dB/cm)/MHz, T₁ relaxation times from 426.3 to 450.2 ms, T₂ relaxation times from 21.5 to 28.4 ms, T_λ695 from 46.8% to 92.6%, and T_λ532 from 41.1% to 86.3%. Statistically significant factors of each property were identified. The regression model relating the mechanical and medical imaging properties and their corresponding significant factors had a good fit. The validation tests showed a small discrepancy between the model predicted values and experimental data (all less than 5% except the needle insertion friction force).

CONCLUSIONS

The regression model developed in this paper can be used to design soft PVC with targeted mechanical and medical imaging properties.

Multilayered tissue mimicking skin and vessel phantoms with tunable mechanical, optical, and acoustic properties

PURPOSE

This paper describes the design, fabrication, and characterization of multilayered tissue mimicking skin and vessel phantoms with tunable mechanical, optical, and acoustic properties. The phantoms comprise epidermis, dermis, and hypodermis skin layers, blood vessels, and blood mimicking fluid. Each tissue component may be individually tailored to a range of physiological and demographic conditions.

METHODS

The skin layers were constructed from varying concentrations of gelatin and agar. Synthetic melanin, India ink, absorbing dyes, and Intralipid were added to provide optical absorption and scattering in the skin layers. Bovine serum albumin was used to increase acoustic attenuation, and 40 μm diameter silica microspheres were used to induce acoustic backscatter. Phantom vessels consisting of thin-walled polydimethylsiloxane tubing were embedded at depths of 2-6 mm beneath the skin, and blood mimicking fluid was passed through the vessels. The phantoms were characterized through uniaxial compression and tension experiments, rheological frequency sweep studies, diffuse reflectance spectroscopy, and ultrasonic pulse-echo measurements. Results were then compared to in vivo and ex vivo literature data.

RESULTS

The elastic and dynamic shear behavior of the phantom skin layers and vessel wall closely approximated the behavior of porcine skin tissues and human vessels. Similarly, the optical properties of the phantom tissue components in the wavelength range of 400-1100 nm, as well as the acoustic properties in the frequency range of 2-9 MHz, were comparable to human tissue data. Normalized root mean square percent errors between the phantom results and the literature reference values ranged from 1.06% to 9.82%, which for many measurements were less than the sample variability. Finally, the mechanical and imaging characteristics of the phantoms were found to remain stable after 30 days of storage at 21 °C.

CONCLUSIONS

The phantoms described in this work simulate the mechanical, optical, and acoustic properties of human skin tissues, vessel tissue, and blood. In this way, the phantoms are uniquely suited to serve as test models for multimodal imaging techniques and image-guided interventions.

Predicting bone strength with ultrasonic guided waves

Recent bone quantitative ultrasound approaches exploit the multimode waveguide response of long bones for assessing properties such as cortical thickness and stiffness. Clinical applications remain, however, challenging, as the impact of soft tissue on guided waves characteristics is not fully understood yet. In particular, it must be clarified whether soft tissue must be incorporated in waveguide models needed to infer reliable cortical bone properties. We hypothesize that an inverse procedure using a free plate model can be applied to retrieve the thickness and stiffness of cortical bone from experimental data. This approach is first validated on a series of laboratory-controlled measurements performed on assemblies of bone- and soft tissue mimicking phantoms and then on in vivo measurements. The accuracy of the estimates is evaluated by comparison with reference values. To further support our hypothesis, these estimates are subsequently inserted into a bilayer model to test its accuracy. Our results show that the free plate model allows retrieving reliable waveguide properties, despite the presence of soft tissue. They also suggest that the more sophisticated bilayer model, although it is more precise to predict experimental data in the forward problem, could turn out to be hardly manageable for solving the inverse problem.

Numerical study of a confocal ultrasonic setup for cavitation creation

Acoustic cavitation has found a wide range of applications in the last few decades. For potential applications involving cavitation, the acoustic characteristics of a confocal ultrasonic setup are studied: two high-intensity focused ultrasound transducers are mounted so that their focal points overlap. A mathematical simulator is developed that takes into account nonlinear propagation, absorption, and diffraction. Each one of these physical effects is solved in the frequency domain for successive planes. Comparing the confocal setup with equivalent single transducer setups, it is shown that, with the confocal configuration, nonlinear distortion of the waveform is reduced, resulting in a greater peak rarefactional pressure and a lower peak positive pressure. Furthermore, additional features are investigated for confocal configurations such as a greater spatial stability for the focal point, which can be maintained while increasing the pressure level, and a focal region consisting of interference acting as an acoustic trap.

Totally Implantable Wireless Ultrasonic Doppler Blood Flowmeters: Toward Accurate Miniaturized Chronic Monitors

Totally implantable wireless ultrasonic blood flowmeters provide direct-access chronic vessel monitoring in hard-to-reach places without using wired bedside monitors or imaging equipment. Although wireless implantable Doppler devices are accurate for most applications, device size and implant lifetime remain vastly underdeveloped. We review past and current approaches to miniaturization and implant lifetime extension for wireless implantable Doppler devices and propose approaches to reduce device size and maximize implant lifetime for the next generation of devices. Additionally, we review current and past approaches to accurate blood flow measurements. This review points toward relying on increased levels of monolithic customization and integration to reduce size. Meanwhile, recommendations to maximize implant lifetime should include alternative sources of power, such as transcutaneous wireless power, that stand to extend lifetime indefinitely. Coupling together the results will pave the way for ultra-miniaturized totally implantable wireless blood flow monitors for truly chronic implantation.

Comparison of Two Inexpensive Rapid Prototyping Methods for Manufacturing Filament Target Ultrasound Phantoms

Current use of 3-D printers to manufacture ultrasound phantoms is limited to relatively expensive photopolymer jetting printers. The present work investigates the feasibility of using two common and inexpensive 3-D printer technologies, fused deposition modeling (FDM) and digital light processing (DLP), to print custom filament target phantoms. Acoustic characteristics obtained from printed solid blocks indicated that the printing materials-acrylonitrile butadiene styrene and polylactic acid for FDM and a photopolymer for DLP printing-were appropriate for use as scatterers. A regular grid of filaments was printed to study printing accuracy. As a proof of concept of the phantom manufacturing process, a complex pattern of filament targets was placed in de-ionized water to create a phantom, which was then imaged using an ultrasound imager. The pattern was clearly identifiable, although multiple reflections were observed, which underscores the importance of future work to enhance printing resolution. This goal is deemed possible using improvement of the DLP printing setup.

High-Resolution Elastography for Thin-Layer Mechanical Characterization: Toward Skin Investigation

Interest in elasticity estimation for thin layers is increasing because of the various potential applications, including dermatology and cosmetology. In this context, we propose a dedicated elastographic system using 1-D high-frequency transient elastography (HF-TE) to estimate the 1-D Young's modulus through the dermis and hypodermis, which are the two human skin layers of interest in this study. An experimental validation of the HF-TE method was first carried out on two homogeneous tissue-mimicking hard and soft phantoms. The Young's modulus values obtained in these phantoms were compared with those obtained by two complementary shear wave propagation techniques: shear wave-induced resonance elastography (SWIRE) and supersonic shear imaging (SSI). A third two-layer thin phantom, with mechanical properties similar to those of skin, was used to validate the ability of HF-TE to distinguish layers and measure elasticity. Finally, preliminary in vivo experiments conducted on forearm and cheek skin revealed the promising performance of HF-TE in measuring elasticity in the dermis and hypodermis.

Ultrasonic 3-D Vector Flow Method for Quantitative In Vivo Peak Velocity and Flow Rate Estimation

Current clinical ultrasound (US) systems are limited to show blood flow movement in either 1-D or 2-D. In this paper, a method for estimating 3-D vector velocities in a plane using the transverse oscillation method, a 32×32 element matrix array, and the experimental US scanner SARUS is presented. The aim of this paper is to estimate precise flow rates and peak velocities derived from 3-D vector flow estimates. The emission sequence provides 3-D vector flow estimates at up to 1.145 frames/s in a plane, and was used to estimate 3-D vector flow in a cross-sectional image plane. The method is validated in two phantom studies, where flow rates are measured in a flow-rig, providing a constant parabolic flow, and in a straight-vessel phantom ( ∅=8 mm) connected to a flow pump capable of generating time varying waveforms. Flow rates are estimated to be 82.1 ± 2.8 L/min in the flow-rig compared with the expected 79.8 L/min, and to 2.68 ± 0.04 mL/stroke in the pulsating environment compared with the expected 2.57 ± 0.08 mL/stroke. Flow rates estimated in the common carotid artery of a healthy volunteer are compared with magnetic resonance imaging (MRI) measured flow rates using a 1-D through-plane velocity sequence. Mean flow rates were 333 ± 31 mL/min for the presented method and 346 ± 2 mL/min for the MRI measurements.

Freehand three-dimensional ultrasound imaging of carotid artery using motion tracking technology

Ultrasound imaging has been extensively used for determining the severity of carotid atherosclerotic stenosis. In particular, the morphological characterization of carotid plaques can be performed for risk stratification of patients. However, using 2D ultrasound imaging for detecting morphological changes in plaques has several limitations. Due to the scan was performed on a single longitudinal cross-section, the selected 2D image is difficult to represent the entire morphology and volume of plaque and vessel lumen. In addition, the precise positions of 2D ultrasound images highly depend on the radiologists' experience, it makes the serial long-term exams of anti-atherosclerotic therapies are difficult to relocate the same corresponding planes by using 2D B-mode images. This has led to the recent development of three-dimensional (3D) ultrasound imaging, which offers improved visualization and quantification of complex morphologies of carotid plaques. In the present study, a freehand 3D ultrasound imaging technique based on optical motion tracking technology is proposed. Unlike other optical tracking systems, the marker is a small rigid body that is attached to the ultrasound probe and is tracked by eight high-performance digital cameras. The probe positions in 3D space coordinates are then calibrated at spatial and temporal resolutions of 10μm and 0.01s, respectively. The image segmentation procedure involves Otsu's and the active contour model algorithms and accurately detects the contours of the carotid arteries. The proposed imaging technique was verified using normal artery and atherosclerotic stenosis phantoms. Human experiments involving freehand scanning of the carotid artery of a volunteer were also performed. The results indicated that compared with manual segmentation, the lowest percentage errors of the proposed segmentation procedure were 7.8% and 9.1% for the external and internal carotid arteries, respectively. Finally, the effect of handshaking was calibrated using the optical tracking system for reconstructing a 3D image.

Tuning acoustic and mechanical properties of materials for ultrasound phantoms and smart substrates for cell cultures

Materials with tailored acoustic properties are of great interest for both the development of tissue-mimicking phantoms for ultrasound tests and smart scaffolds for ultrasound mediated tissue engineering and regenerative medicine. In this study, we assessed the acoustic properties (speed of sound, acoustic impedance and attenuation coefficient) of three different materials (agarose, polyacrylamide and polydimethylsiloxane) at different concentrations or cross-linking levels and doped with different concentrations of barium titanate ceramic nanoparticles. The selected materials, besides different mechanical features (stiffness from few kPa to 1.6MPa), showed a wide range of acoustic properties (speed of sound from 1022 to 1555m/s, acoustic impedance from 1.02 to 1.67MRayl and attenuation coefficient from 0.2 to 36.5dB/cm), corresponding to ranges in which natural soft tissues can fall. We demonstrated that this knowledge can be used to build tissue-mimicking phantoms for ultrasound-based medical procedures and that the mentioned measurements enable to stimulate cells with a highly controlled ultrasound dose, taking into account the attenuation due to the cell-supporting scaffold. Finally, we were able to correlate for the first time the bioeffect on human fibroblasts, triggered by piezoelectric barium titanate nanoparticles activated by low-intensity pulsed ultrasound, with a precise ultrasound dose delivered. These results may open new avenues for the development of both tissue-mimicking materials for ultrasound phantoms and smart triggerable scaffolds for tissue engineering and regenerative medicine.

STATEMENT OF SIGNIFICANCE

This study reports for the first time the results of a systematic acoustic characterization of agarose, polyacrylamide and polydimethylsiloxane at different concentrations and cross-linking extents and doped with different concentrations of barium titanate nanoparticles. These results can be used to build tissue-mimicking phantoms, useful for many ultrasound-based medical procedures, and to fabricate smart materials for stimulating cells with a highly controlled ultrasound dose. Thanks to this knowledge, we correlated for the first time a bioeffect (the proliferation increase) on human fibroblasts, triggered by piezoelectric nanoparticles, with a precise US dose delivered. These results may open new avenues for the development of both tissue-mimicking phantoms and smart triggerable scaffolds for tissue engineering and regenerative medicine.

Pipe Phantoms With Applications in Molecular Imaging and System Characterization

Pipe (vessel) phantoms mimicking human tissue and blood flow are widely used for cardiovascular related research in medical ultrasound. Pipe phantom studies require the development of materials and liquids that match the acoustic properties of soft tissue, blood vessel wall, and blood. Over recent years, pipe phantoms have been developed to mimic the molecular properties of the simulated blood vessels. In this paper, the design, construction, and functionalization of pipe phantoms are introduced and validated for applications in molecular imaging and ultrasound imaging system characterization. There are three major types of pipe phantoms introduced: 1) a gelatin-based pipe phantom; 2) a polydimethylsiloxane-based pipe phantom; and 3) the "Edinburgh pipe phantom." These phantoms may be used in the validation and assessment of the dynamics of microbubble-based contrast agents and, in the case of a small diameter tube phantom, for assessing imaging system spatial resolution/contrast performance. The materials and procedures required to address each of the phantoms are described.

Stable phantom materials for ultrasound and optical imaging

Phantoms mimicking the specific properties of biological tissues are essential to fully characterize medical devices. Water-based materials are commonly used to manufacture phantoms for ultrasound and optical imaging techniques. However, these materials have disadvantages, such as easy degradation and low temporal stability. In this study, we propose an oil-based new tissue-mimicking material for ultrasound and optical imaging, with the advantage of presenting low temporal degradation. A styrene-ethylene/butylene-styrene (SEBS) copolymer in mineral oil samples was made varying the SEBS concentration between 5%-15%, and low-density polyethylene (LDPE) between 0%-9%. Acoustic properties, such as the speed of sound and the attenuation coefficient, were obtained using frequencies ranging from 1-10 MHz, and were consistent with that of soft tissues. These properties were controlled varying SEBS and LDPE concentration. To characterize the optical properties of the samples, the diffuse reflectance and transmittance were measured. Scattering and absorption coefficients ranging from 400 nm-1200 nm were calculated for each compound. SEBS gels are a translucent material presenting low optical absorption and scattering coefficients in the visible region of the spectrum, but the presence of LDPE increased the turbidity. Adding LDPE increased the absorption and scattering of the phantom materials. Ultrasound and photoacoustic images of a heterogeneous phantom made of LDPE/SEBS containing a spherical inclusion were obtained. Annatto dye was added to the inclusion to enhance the optical absorbance. The results suggest that copolymer gels are promising for ultrasound and optical imaging, making them also potentially useful for photoacoustic imaging.

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.