Quantitative diagnostics of soft tissue through viscoelastic characterization using time-based instrumented palpation

Biomechanical properties of the human superficial fascia: Site-specific variability and anisotropy of abdominal and thoracic regions

Superficial fascia is a fibrofatty tissue found throughout the body. Initially described in relation to hernias, it has only recently received attention from the scientific community due to new evidence on its role in force transmission and structural integrity of the body. Considering initial difficulties in its anatomical identification, to date, a characterization of the superficial fascia through mechanical tests is still lacking. The mechanical properties of human superficial fasciae of abdominal and thoracic districts (back) of different subjects (n = 4) were then investigated, focusing on anisotropy and viscoelasticity. Experimental tests were performed on samples taken in two perpendicular directions according to body planes (cranio-caudal and latero-medial axes). Data collected from two different uniaxial tensile protocols, failure (i.e., ultimate tensile strength and strain at break, Young's modulus and toughness) and stress-relaxation (i.e., residual stress), were processed and then grouped for statistical analysis. Failure tests confirmed tissue anisotropy, revealing the stiffer nature of the latero-medial direction compared to the cranio-caudal one, for both the districts (with a ratio of the respective Young's moduli close to 2). Furthermore, the thoracic region exhibited significantly greater strength and resultant Young's modulus compared to the abdomen (with greater results along the latero-medial direction, such as 6.13 ± 3.11 MPa versus 0.85 ± 0.39 MPa and 24.87 ± 15.23 MPa versus 3.19 ± 1.62 MPa, respectively). On the contrary, both regions displayed similar strain at break (varying between 38 and 47%), with no clear dependence from the loading directions. Stress-relaxation tests highlighted the viscous behavior of the superficial fascia, with no significant differences in the stress decay between directions and districts (35-38% of residual stress after 300 s). All these collected results represent the starting point for a more in-depth knowledge of the mechanical characterization of the superficial fascia, which can have direct implications in the design, implementation, and effectiveness of site-specific treatments.

A Minimally Invasive Robotic Tissue Palpation Device

OBJECTIVE

Robot-assisted minimally invasive surgery remains limited by the absence of haptic feedback, which surgeons routinely rely on to assess tissue stiffness. This limitation hinders surgeons' ability to identify and treat abnormal tissues, such as tumors, during robotic surgery.

METHODS

To address this challenge, we developed a robotic tissue palpation device capable of rapidly and non-invasively quantifying the stiffness of soft tissues, allowing surgeons to make objective and data-driven decisions during minimally invasive procedures. We evaluated the effectiveness of our device by measuring the stiffness of phantoms as well as lung, heart, liver, and skin tissues obtained from both rats and swine.

RESULTS

Results demonstrated that our device can accurately determine tissue stiffness and identify tumor mimics. Specifically, in swine lung, we determined elastic modulus (E) values of 9.1 ± 2.3, 16.8 ± 1.8, and 26.0 ± 3.6 kPa under different internal pressure of the lungs (PIP) of 2, 25, and 45 cmH2O, respectively. Using our device, we successfully located a 2-cm tumor mimic embedded at a depth of 5 mm in the lung subpleural region. Additionally, we measured E values of 33.0 ± 5.4, 19.2 ± 2.2, 33.5 ± 8.2, and 22.6 ± 6.0 kPa for swine heart, liver, abdominal skin, and muscle, respectively, which closely matched existing literature data.

CONCLUSION/SIGNIFICANCE

Results suggest that our robotic palpation device can be utilized during surgery, either as a stand-alone or additional tool integrated into existing robotic surgical systems, to enhance treatment outcomes by enabling accurate intraoperative identification of abnormal tissue.

Active viscoelastic models for cell and tissue mechanics

Living cells are out of equilibrium active materials. Cell-generated forces are transmitted across the cytoskeleton network and to the extracellular environment. These active force interactions shape cellular mechanical behaviour, trigger mechano-sensing, regulate cell adaptation to the microenvironment and can affect disease outcomes. In recent years, the mechanobiology community has witnessed the emergence of many experimental and theoretical approaches to study cells as mechanically active materials. In this review, we highlight recent advancements in incorporating active characteristics of cellular behaviour at different length scales into classic viscoelastic models by either adding an active tension-generating element or adjusting the resting length of an elastic element in the model. Summarizing the two groups of approaches, we will review the formulation and application of these models to understand cellular adaptation mechanisms in response to various types of mechanical stimuli, such as the effect of extracellular matrix properties and external loadings or deformations.

Noninvasive identification of directionally-dependent elastic properties of soft tissues using full-field optical data

This paper introduces an innovative approach for elastic property characterization of soft tissues, having directional-dependent material behavior, via their vibration response measurement and interpretation. The full-field time-dependent surface displacements as a result of externally excited soft tissues are collected through digital image correlation (DIC). A developed analytical model, capturing the low-amplitude vibration behavior of anisotropic layered human skin with the incorporation of the influence of subcutaneous elasticity and inertia, is employed to accurately predict its resonant frequencies and pertaining displacement field images. An efficient solution approach for the model is implemented into an inverse algorithm to rapidly characterize the anisotropic elastic properties based on importing the vibration characteristics. To show the merit of the approach, a 3-D finite element (FE) simulation model was used to generate full-field data, detected and matched with a set of specific vibration modes via modal assurance criterion (MAC). The validity of the model implemented into the inverse characterization algorithm is demonstrated through a comparison of predicted vibration frequencies and mode-shapes simulated via the 3-D FE model for different cases with anisotropic elastic properties in different layers of the skin. It is shown that modes are influenced differently when anisotropic properties are introduced to the model. Thus, the established inverse characterization algorithm is capable of rapidly predicting the elastic material properties of anisotropic soft sheets with adequate accuracy.

Experimental validation for the interconversion between generalized Kelvin-Voigt and Maxwell models using human skin tissues

Mechanical properties of biological systems provide essential insights into their component, physiological function, and disease mechanism under various conditions, such as age, health, and other environmental factors. Viscoelasticity is one of the most important and investigated properties to study biomaterials, cells, and tissues, as they exhibit the characteristics of both fluid-like behavior, viscosity, and solid-like behavior, elasticity. Various mathematical models, such as the Kelvin-Voigt and Maxwell models, have been developed and practiced to estimate and extract viscoelastic properties. However, one of the inherent challenges with the use of these models is the poor transferability of mathematically estimated viscoelastic properties across different models, largely due to variations in constituent elements and their arrangements within each model. This issue impedes the interconversion of parameters of one model to another and complicates comparison across models. In this study, we demonstrate the equivalence between the generalized Maxwell and generalized Kelvin-Voigt models through two distinct approaches: indirect, Maxwell model-based Kelvin-Voigt model estimation and direct, curve fitting-based Kelvin-Voigt model estimation. We utilized human melanoma skin tissues to estimate viscoelastic properties using the Prony series. The estimated parameters and resulting viscoelastic properties revealed no significant difference between the two approaches and between the two patients. This study is the first experimental validation of the mathematical interconversion of the two models, signifying that this approach will enable an accurate and objective analysis and comparison of mechanical properties across various viscoelastic models.

Piezoresistivity modeling of soft tissue electrical-mechanical properties: A validation study

In general, the electrical property of soft tissues is sensitive to the force applied to their surface. To further study the relationship between the force and the electrical property of soft tissues, this paper attempts to investigate the effect of static and higher-order stresses on electrical properties. Overall, a practical experimental platform is designed to acquire the force information and the electrical property of soft tissues during a contact procedure, which is featured different compression stimuli, such as constant pressing force, constant pressing speed, and step-force compression, etc. Furthermore, the piezoresistive characteristic is innovatively introduced to model the mechanical-electrical properties of soft tissue. Finite Element Modeling (FEM) is adopted to fit the static piezoresistivity of the soft tissue. Finally, experimental studies were performed to demonstrate the effect of stress on the electrical properties and the feasibility of the proposed piezoresistive model to describe soft tissues' mechanical and electrical properties.

Locating and sizing tumor nodules in human prostate using instrumented probing - computational framework and experimental validation

Detection of tumor nodules is key to early cancer diagnosis. This study investigates the potential of using the mechanical data, acquired from probing the prostate for detecting the existence, and, more importantly, characterizing the size and depth, from the posterior surface, of the prostate cancer (PCa) nodules. A computational approach is developed to quantify the uncertainty of nodule detectability and is based on identifying stiffness anomalies in the profiles of point force measurements across transverse sections of the prostate. The capability of the proposed method was assessed firstly using a 'training' dataset of in silico models including PCa nodules with random size, depth and location, followed by a clinical feasibility study, involving experimental data from 13 ex vivo prostates from patients who had undergone radical prostatatectomy. Promising levels of sensitivity and specificity were obtained for detecting the PCa nodules in a total of 44 prostate sections. This study has shown that the proposed methods could be a useful complementary tool to exisiting diagnostic methods of PCa. The future study will involve implementing the proposed measurement and detection strategies in vivo, with the help of a miniturized medical device.

Constitutive Equations for Analyzing Stress Relaxation and Creep of Viscoelastic Materials Based on Standard Linear Solid Model Derived with Finite Loading Rate

The viscoelastic properties of materials such as polymers can be quantitatively evaluated by measuring and analyzing the viscoelastic behaviors such as stress relaxation and creep. The standard linear solid model is a classical and commonly used mathematical model for analyzing stress relaxation and creep behaviors. Traditionally, the constitutive equations for analyzing stress relaxation and creep behaviors based on the standard linear solid model are derived using the assumption that the loading is a step function, implying that the loading rate used in the loading process of stress relaxation and creep tests is infinite. Using such constitutive equations may cause significant errors in analyses since the loading rate must be finite (no matter how fast it is) in a real stress relaxation or creep experiment. The purpose of this paper is to introduce the constitutive equations for analyzing stress relaxation and creep behaviors based on the standard linear solid model derived with a finite loading rate. The finite element computational simulation results demonstrate that the constitutive equations derived with a finite loading rate can produce accurate results in the evaluation of all viscoelastic parameters regardless of the loading rate in most cases. It is recommended that the constitutive equations derived with a finite loading rate should replace the traditional ones derived with an infinite loading rate to analyze stress relaxation and creep behaviors for quantitatively evaluating the viscoelastic properties of materials.

Preliminary study of reliability of transcutaneous sensors in measuring intraabdominal pressure

Early recognition of elevated intraabdominal pressure (IAP) in critically ill patients is essential, since it can result in abdominal compartment syndrome, which is a life-threatening condition. The measurement of intravesical pressure is currently considered the gold standard for IAP assessment. Alternative methods have been proposed, where IAP assessment is based on measuring abdominal wall tension, which reflects the pressure in the abdominal cavity. The aim of this study was to evaluate the feasibility of using patch-like transcutaneous sensors to estimate changes in IAP, which could facilitate the monitoring of IAP in clinical practice. This study was performed with 30 patients during early postoperative care. All patients still had an indwelling urinary catheter postoperatively. Four wearable sensors were attached to the outer surface of the abdominal region to detect the changes in abdominal wall tension. Additionally, surface EMG was used to monitor the activity of the abdominal muscles. The thickness of the subcutaneous tissue was measured with ultrasound. Patients performed 4 cycles of the Valsalva manoeuvre, with a resting period in between (the minimal resting period was 30 s, with a prolongation as necessary to ensure that the fluid level in the measuring system had equilibrated). The IAP was estimated with intravesical pressure measurements during all resting periods and all Valsalva manoeuvres, while the sensors continuously measured changes in abdominal wall tension. The association between the subcutaneous thickness and tension changes on the surface and the intraabdominal pressure was statistically significant, but a large part of the variability was explained by individual patient factors. As a consequence, the predictions of IAP using transcutaneous sensors were not biased, but they were quite variable. The specificity of detecting intraabdominal pressure of 20 mmHg and above is 88%, with an NPV of 96%, while its sensitivity and PPV are currently far lower. There are inherent limitations of the chosen preliminary study design that directly caused the low sensitivity of our method as well as the poor agreement with the gold standard method; in spite of that, we have shown that these sensors have the potential to be used to monitor intraabdominal pressure. We are planning a study that would more closely resemble the intended clinical use and expect it to show more consistent results with a far smaller error.

Viscoelastic parameters of invasive breast cancer in correlation with porous structure and elemental analysis data

BACKGROUND AND OBJECTIVE

Invasive ductal carcinoma (IDC) is the most common and aggressive type of breast cancer. As many clinical diagnoses are concerned with the tumor behavior at the compression, the IDC characterization using a compression test is performed in the present study. In the field of tissue characterization, most of the previous studies have focused on healthy and cancerous breast tissues at the cellular level; however, characterization of cancerous tissue at the tissue level has been under-represented, which is the target of the present study.

METHODS

Throughout this article, 18 IDC samples are tested using a ramp-relaxation test. The strain rate in the ramp phase is similar for all samples, whereas the strain level is set at 2,4 and 6%. The experimental stress-time data is interpolated by a viscoelastic model. Two relaxation times, as well as the instantaneous and long-term shear moduli, are calculated for each specimen.

RESULTS

The results show that the long-term and instantaneous shear moduli vary in the range of 0.31-17.03 kPa and 6.03-55.13 kPa, respectively. Our assessment of the viscoelastic parameters is accompanied by observing structural images of the IDCs and inspecting their elemental composition. It is concluded that IDCs with lower Magnesium to Calcium ratio (Mg:Ca) have smaller shear modulus and longer relaxation time, with a p-value of 0.001 and 0.01 for the correlation between Mg:Ca and long-term shear modulus, and Mg:Ca and early relaxation time.

CONCLUSIONS

Our identification of the IDC viscoelastic parameters can contribute to the IDC inspection at the tissue level. The results also provide useful information for modeling of breast cancer.

In-vivoviscoelastic properties estimation in subcutaneous adipose tissue by integration of poroviscoelastic-mass transport model (pve-MTM) into wearable electrical impedance tomography (w-EIT)

In-vivoviscoelastic properties have been estimated in human subcutaneous adipose tissue (SAT) by integration of poroviscoelastic-mass transport model (pve-MTM) into wearable electrical impedance tomography (w-EIT) under the influence of external compressive pressure-P.Thepve-MTM predicts the ion concentration distributioncmod(t)by coupling the poroviscoelastic and mass transport model to describe the hydrodynamics, rheology, and transport phenomena inside SAT. Thew-EIT measures the time-difference conductivity distribution∆γ(t)in SAT resulted from the ion transport. Based on the integration, the two viscoelastic properties which are viscoelastic shear modulus of SATGvand relaxation time of SATτvare estimated by applying an iterative curve-fitting between the normalized average ion concentration distributioncˆmod(t)predicted frompve-MTM and the experimental normalized average ion concentration distributioncˆexp(t)derived fromw-EIT. Thein-vivoexperiments were conducted by applying external compressive pressure-Pon human calf boundary to induce interstitial fluid flow and ion movement in SAT. As a result, the value ofGvwas range from 4.9-6.3 kPa and the value ofτvwas range from 27.50-38.5 s with the value of average goodness-of-fit curve fittingR² > 0.76. These values ofGvandτvwere compared to the human and animal tissue from the literature in order to verify this method. The results frompve-MTM provide evidence thatGvandτvplay a role in the predicted value ofcˆmod.

Ramp-Creep Ultrasound Viscoelastography for Measuring Viscoelastic Parameters of Materials

Several ultrasound-based methods have been developed to evaluate the viscoelastic properties of materials. The purpose of this study is to introduce a novel viscoelastography method based on ultrasound acoustic radiation force for measuring the parameters relevant to the viscoelastic properties of materials, named ramp-creep ultrasound viscoelastography (RC viscoelastography). RC viscoelastography uses two different ultrasound excitation modes to cause ramp and creep strain responses in the material. By combining and analyzing the information obtained from these two modes of excitation, the viscoelastic parameters of the material can be quantitatively evaluated. Finite element computer simulation demonstrated that RC viscoelastography can accurately evaluate the viscoelastic parameters of the material, including the relaxation and creep time constants as well as the ratio of viscous fluids to solids in the material, except for the region near the top surface of the material. The novelty of RC viscoelastography is that there is no need to know the magnitude of acoustic radiation force and induced stress in the material in order to evaluate the viscoelastic parameters. In the future, experiments are necessary to test the performance of RC viscoelastography in real biomaterials and biological tissues.

Identification of tumor nodule in soft tissue: An inverse finite-element framework based on mechanical characterization

Identification and characterization of nodules in soft tissue, including their size, shape, and location, provide a basis for tumor identification. This study proposes an inverse finite-element (FE) based computational framework, for characterizing the size of examined tissue sample and detecting the presence of embedded tumor nodules using instrumented palpation, without a priori anatomical knowledge. The inverse analysis was applied to a model system, the human prostate, and was based on the reaction forces which can be obtained by trans-rectal mechanical probing and those from an equivalent FE model, which was optimized iteratively, by minimizing an error function between the two cases, toward the target solution. The tumor nodule can be identified through its influence on the stress state of the prostate. The effectiveness of the proposed method was further verified using a realistic prostate model reconstructed from magnetic resonance (MR) images. The results show the proposed framework to be capable of characterizing the key geometrical indices of the prostate and identifying the presence of cancerous nodules. Therefore, it has potential, when combined with instrumented palpation, for primary diagnosis of prostate cancer, and, potentially, solid tumors in other types of soft tissue.

Fractional viscoelastic models for power-law materials

Soft materials often exhibit a distinctive power-law viscoelastic response arising from broad distribution of time-scales present in their complex internal structure. A promising tool to accurately describe the rheological behaviour of soft materials is fractional calculus. However, its use in the scientific community remains limited due to the unusual notation and non-trivial properties of fractional operators. This review aims to provide a clear and accessible description of fractional viscoelastic models for a broad audience and to demonstrate the ability of these models to deliver a unified approach for the characterisation of power-law materials. The use of a consistent framework for the analysis of rheological data would help classify the empirical behaviours of soft and biological materials, and better understand their response.

Why Are Viscosity and Nonlinearity Bound to Make an Impact in Clinical Elastographic Diagnosis?

The adoption of multiscale approaches by the biomechanical community has caused a major improvement in quality in the mechanical characterization of soft tissues. The recent developments in elastography techniques are enabling in vivo and non-invasive quantification of tissues' mechanical properties. Elastic changes in a tissue are associated with a broad spectrum of pathologies, which stems from the tissue microstructure, histology and biochemistry. This knowledge is combined with research evidence to provide a powerful diagnostic range of highly prevalent pathologies, from birth and labor disorders (prematurity, induction failures, etc.), to solid tumors (e.g., prostate, cervix, breast, melanoma) and liver fibrosis, just to name a few. This review aims to elucidate the potential of viscous and nonlinear elastic parameters as conceivable diagnostic mechanical biomarkers. First, by providing an insight into the classic role of soft tissue microstructure in linear elasticity; secondly, by understanding how viscosity and nonlinearity could enhance the current diagnosis in elastography; and finally, by compounding preliminary investigations of those elastography parameters within different technologies. In conclusion, evidence of the diagnostic capability of elastic parameters beyond linear stiffness is gaining momentum as a result of the technological and imaging developments in the field of biomechanics.

Data-Driven Elasticity Imaging Using Cartesian Neural Network Constitutive Models and the Autoprogressive Method

Quasi-static elasticity imaging techniques rely on model-based mathematical inverse methods to estimate mechanical parameters from force-displacement measurements. These techniques introduce simplifying assumptions that preclude exploration of unknown mechanical properties with potential diagnostic value. We previously reported a data-driven approach to elasticity imaging using artificial neural networks (NNs) that circumvents limitations associated with model-based inverse methods. NN constitutive models can learn stress-strain behavior from force-displacement measurements using the autoprogressive (AutoP) method without prior assumptions of the underlying constitutive model. However, information about internal structure was required. We invented Cartesian NN constitutive models (CaNNCMs) that learn the spatial variations of material properties. We are presenting the first implementation of CaNNCMs trained with AutoP to develop data-driven models of 2-D linear-elastic materials. Both simulated and experimental force-displacement data were used as input to AutoP to show that CaNNCMs are able to model both continuous and discrete material property distributions with no prior information of internal object structure. Furthermore, we demonstrate that CaNNCMs are robust to measurement noise and can reconstruct reasonably accurate Young's modulus images from a sparse sampling of measurement data. CaNNCMs are an important step toward clinical use of data-driven elasticity imaging using AutoP.

Viscoelastic biomarker for differentiation of benign and malignant breast lesion in ultra- low frequency range

Benign and malignant tumors differ in the viscoelastic properties of their cellular microenvironments and in their spatiotemporal response to very low frequency stimuli. These differences can introduce a unique viscoelastic biomarker in differentiation of benign and malignant tumors. This biomarker may reduce the number of unnecessary biopsies in breast patients. Although different methods have been developed so far for this purpose, none of them have focused on in vivo and in situ assessment of local viscoelastic properties in the ultra-low (sub-Hertz) frequency range. Here we introduce a new, noninvasive model-free method called Loss Angle Mapping (LAM). We assessed the performance results on 156 breast patients. The method was further improved by detection of out-of-plane motion using motion compensation cross correlation method (MCCC). 45 patients met this MCCC criterion and were considered for data analysis. Among this population, we found 77.8% sensitivity and 96.3% specificity (p < 0.0001) in discriminating between benign and malignant tumors using logistic regression method regarding the pre known information about the BIRADS number and size. The accuracy and area under the ROC curve, AUC, was 88.9% and 0.94, respectively. This method opens new avenues to investigate the mechanobiology behavior of different tissues in a frequency range that has not yet been explored in any in vivo patient studies.

Correlation between stress drop and applied strain as a biomarker for tumor detection

This is the first study to measure the viscoelastic behavior of tumor tissues using stepwise compression-relaxation testing, and investigate the measured (Δσ-ε) relation between stress drop (Δσ) and applied strain (ε) as a biomarker for tumor detection. Stepwise compression-relaxation testing was implemented via a 2D tactile sensor to measure stress drop at each applied strain of a sample. Pearson correlation analysis was conducted to quantify the measured Δσ-ε relation as slope of stress drop versus applied strain (m=Δσ/ε) and coefficient of determination (R²). The measured results on soft materials revealed no dependency of coefficient of determination on the testing parameters and dependency of slope on them. Three groups of tissues: five mouse breast tumor (BT) tissues ex vivo, two mouse pancreatic tumor (PT) tissues in vivo and six normal tissues, were measured by using different testing parameters. Coefficient of determination was found to show significant difference among the center, edge and outside sites of all the BT tissues, and no difference between the BT outside sites and the normal tissues. Coefficient of determination also revealed significant difference between before and after treatment of the PT tissues, and no difference between the PT tissues after treatment and the normal tissues. Moreover, coefficient of determination of the PT tissues before treatment was found to be significantly different from that of the BT center sites, but slope failed to capture their difference. Dummy tumors made of silicon rubbers were found to behave differently from the native tumors. By removing the need of fitting the time-dependent data with a viscoelastic model, this study offered a time-efficient solution to quantifying the viscosity for tumor detection.

Enhanced Frequency Difference of Tumor inside Vibrated Tissue by a Compression Cylinder

Breast cancer diagnosis has been mostly accomplished by imaging technologies. These methods have the great advantages of detecting the presence and location of breast cancer. However, it's difficult to distinguish between a benign and malignant tumor in a deep position because both tumor types look similar. In this paper, we vibrated the tissue including tumor from skin with a compression cylinder to analyze the frequency difference for distinguishing the tissue type. Before distinguishing a benign and malignant tumor, it's necessary to validate to distinguish between normal tissue and tumor. The objective is to validate the feasibility of using a compression cylinder that emphasizes the differences in frequency between normal tissue and tumor. In two experiments, we measured the displacement on the surface of a breast phantom vibrated by an impulse hammer. We compared the frequency difference with and without a cylinder. We also studied the frequency changes in the relationship between tumor and cylinder position. We found a 5.0 Hz difference in compliance between normal tissue and the simulated tumor using a compression cylinder. The difference in frequency correlated negatively with distance from the simulated tumor to a compression cylinder. We concluded that a compression cylinder would enhance the frequency difference between normal tissue and a simulated tumor with appropriate configuration.

A novel method for rapid and quantitative mechanical assessment of soft tissue for diagnostic purposes: A computational study

Biological tissues often experience drastic changes in their microstructure due to their pathophysiological conditions. Such microstructural changes could result in variations in mechanical properties, which can be used in diagnosing or monitoring a wide range of diseases, most notably cancer. This paves the avenue for non-invasive diagnosis by instrumented palpation although challenges remain in quantitatively assessing the amount of diseased tissue by means of mechanical characterization. This paper presents a framework for tissue diagnosis using a quantitative and efficient estimation of the fractions of cancerous and non-cancerous tissue without a priori knowledge of tissue microstructure. First, the sample is tested in a creep or stress relaxation experiment, and the behavior is characterized using a single term Prony series. A rule of mixtures, which relates tumor fraction to the apparent mechanical properties, is then obtained by minimizing the difference between strain energy of a heterogeneous system and an equivalent homogeneous one. Finally, the percentage of each tissue constituent is predicted by comparing the observed relaxation time with that calculated from the rule of mixtures. The proposed methodology is assessed using models reconstructed from histological samples and magnetic resonance imaging of prostate. Results show that estimation of cancerous tissue fraction can be obtained with a maximum error of 12% when samples of different sizes, geometries, and tumor fractions are presented. The proposed framework has the potential to be applied to a wide range of diseases such as rectal polyps, cirrhosis, or breast and prostate cancer whose current primary diagnosis remains qualitative.

Tissue perfusion rate estimation with compression-based photoacoustic-ultrasound imaging

Tissue perfusion is essential for transporting blood oxygen and nutrients. Measurement of tissue perfusion rate would have a significant impact in clinical and preclinical arenas. However, there are few techniques to image this important parameter and they typically require contrast agents. A label-free methodology based on tissue compression and imaging with a high-frequency photoacoustic-ultrasound system is introduced for estimating and visualizing tissue perfusion rates. Experiments demonstrate statistically significant differences in depth-resolved perfusion rates in a human subject with various temperature exposure conditions.

Quantitative mechanical assessment of the whole prostate gland ex vivo using dynamic instrumented palpation

An instrumented palpation sensor, designed for measuring the dynamic modulus of tissue in vivo, has been developed and trialled on ex vivo whole prostate glands. The sensor consists of a flexible membrane sensor/actuator with an embedded strain gauge and is actuated using a dynamically varying airflow at frequencies of 1 and 5 Hz. The device was calibrated using an indentation stiffness measurement rig and gelatine samples with a range of static modulus similar to that reported in the literature for prostate tissue. The glands were removed from patients with diagnosed prostate cancer scheduled for radical prostatectomy, and the stiffness was measured within 30 min of surgical removal. Each prostate was later examined histologically in a column immediately below each indentation point and graded into one of the four groups; normal, benign prostatic hyperplasia, cancerous and mixed cancer and benign prostatic hyperplasia. In total, 11 prostates were assessed using multiple point probing, and the complex modulus at 1 and 5 Hz was calculated on a point-by-point basis. The device yielded values of quasi-static modulus of 15 ± 0.5 kPa and dynamic modulus of 20 ± 0.5 kPa for whole prostates, and a sensitivity of up to 80% with slightly lower specificity was achieved on diagnosis of prostate cancer using a combination of mechanical measures. This assessment did not take into account some obvious factors such as edge effects, overlap and clinical significance of the cancer, all of which would improve performance. The device, as currently configured, is immediately deployable in vivo. A number of improvements are also identified which could improve the sensitivity and specificity in future embodiments of the probe.

Viscoelastic Properties of Human Tracheal Tissues

The physiological performance of trachea is highly dependent on its mechanical behavior, and therefore, the mechanical properties of its components. Mechanical characterization of trachea is key to succeed in new treatments such as tissue engineering, which requires the utilization of scaffolds which are mechanically compatible with the native human trachea. In this study, after isolating human trachea samples from brain-dead cases and proper storage, we assessed the viscoelastic properties of tracheal cartilage, smooth muscle, and connective tissue based on stress relaxation tests (at 5% and 10% strains for cartilage and 20%, 30%, and 40% for smooth muscle and connective tissue). After investigation of viscoelastic linearity, constitutive models including Prony series for linear viscoelasticity and quasi-linear viscoelastic, modified superposition, and Schapery models for nonlinear viscoelasticity were fitted to the experimental data to find the best model for each tissue. We also investigated the effect of age on the viscoelastic behavior of tracheal tissues. Based on the results, all three tissues exhibited a (nonsignificant) decrease in relaxation rate with increasing the strain, indicating viscoelastic nonlinearity which was most evident for cartilage and with the least effect for connective tissue. The three-term Prony model was selected for describing the linear viscoelasticity. Among different models, the modified superposition model was best able to capture the relaxation behavior of the three tracheal components. We observed a general (but not significant) stiffening of tracheal cartilage and connective tissue with aging. No change in the stress relaxation percentage with aging was observed. The results of this study may be useful in the design and fabrication of tracheal tissue engineering scaffolds.

Regionally variant collagen alignment correlates with viscoelastic properties of the disc of the human temporomandibular joint

OBJECTIVE

To determine the regionally variant quality of collagen alignment in human TMJ discs and its statistical correlation with viscoelastic properties.

DESIGN

For quantitative analysis of the quality of collagen alignment, horizontal sections of human TMJ discs with Pricrosirius Red staining were imaged under circularly polarized microscopy. Mean angle and angular deviation of collagen fibers in each region were analyzed using a well-established automated image-processing for angular gradient. Instantaneous and relaxation moduli of each disc region were measured under stress-relaxation test both in tensile and compression. Then Spearman correlation analysis was performed between the angular deviation and the moduli. To understand the effect of glycosaminoglycans on the correlation, TMJ disc samples were treated by chondroitinase ABC (C-ABC).

RESULTS

Our imaging processing analysis showed the region-variant direction of collagen alignment, consistently with previous findings. Interestingly, the quality of collagen alignment, not only the directions, was significantly different in between the regions. The angular deviation of fiber alignment in the anterior and intermediate regions were significantly smaller than the posterior region. Medial and lateral regions showed significantly bigger angular deviation than all the other regions. The regionally variant angular deviation values showed statistically significant correlation with the tensile instantaneous modulus and the relaxation modulus, partially dependent on C-ABC treatment.

CONCLUSION

Our findings suggest the region-variant degree of collagen fiber alignment is likely attributed to the heterogeneous viscoelastic properties of TMJ disc that may have significant implications in development of regenerative therapy for TMJ disc.

Epithelial Monolayers Coalesce on a Viscoelastic Substrate through Redistribution of Vinculin

The mechanical properties of the microenvironment play a large role in influencing cellular behavior. In particular, the tradeoff between substrate viscosity and elasticity on collective cell migration by adherent cells is highly physiologically relevant, but remains poorly understood. To investigate the specific effects of viscous substrates, we plated epithelial monolayers onto polydimethylsiloxane substrata with a range of viscosities and elasticities. We found that on viscoelastic substrates the monolayers underwent rapid and coordinated movement to generate cell-free areas. To understand the molecular mechanism of this coordinated movement, we imaged various structural and signaling proteins at cell-cell and cell-matrix junctions. Through quantitative image analysis of monolayer disruption and subcellular protein redistribution, we show that the mechanosensor protein, vinculin, is necessary and sufficient for this viscous response, during which it is lost from focal adhesions and recruited by the cadherin complex to intercellular junctions. In addition, the viscous response is dependent upon and enhanced by actomyosin contractility. Our results implicate vinculin translocation in a molecular switching mechanism that senses substrate viscoelasticity and associates with actomyosin contractility.

Automated Compression Device for Viscoelasticity Imaging

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

Histology-based homogenization analysis of soft tissue: application to prostate cancer

It is well known that the changes in tissue microstructure associated with certain pathophysiological conditions can influence its mechanical properties. Quantitatively relating the tissue microstructure to the macroscopic mechanical properties could lead to significant improvements in clinical diagnosis, especially when the mechanical properties of the tissue are used as diagnostic indices such as in digital rectal examination and elastography. In this study, a novel method of imposing periodic boundary conditions in non-periodic finite-element meshes is presented. This method is used to develop quantitative relationships between tissue microstructure and its apparent mechanical properties for benign and malignant tissue at various length scales. Finally, the inter-patient variation in the tissue properties is also investigated. Results show significant changes in the statistical distribution of the mechanical properties at different length scales. More importantly the loss of the normal differentiation of glandular structure of cancerous tissue has been demonstrated to lead to changes in mechanical properties and anisotropy. The proposed methodology is not limited to a particular tissue or material and the example used could help better understand how changes in the tissue microstructure caused by pathological conditions influence the mechanical properties, ultimately leading to more sensitive and accurate diagnostic technologies.

Point of impact: the effect of size and speed on puncture mechanics

The use of high-speed puncture mechanics for prey capture has been documented across a wide range of organisms, including vertebrates, arthropods, molluscs and cnidarians. These examples span four phyla and seven orders of magnitude difference in size. The commonality of these puncture systems offers an opportunity to explore how organisms at different scales and with different materials, morphologies and kinematics perform the same basic function. However, there is currently no framework for combining kinematic performance with cutting mechanics in biological puncture systems. Our aim here is to establish this framework by examining the effects of size and velocity in a series of controlled ballistic puncture experiments. Arrows of identical shape but varying in mass and speed were shot into cubes of ballistic gelatine. Results from high-speed videography show that projectile velocity can alter how the target gel responds to cutting. Mixed models comparing kinematic variables and puncture patterns indicate that the kinetic energy of a projectile is a better predictor of penetration than either momentum or velocity. These results form a foundation for studying the effects of impact on biological puncture, opening the door for future work to explore the influence of morphology and material organization on high-speed cutting dynamics.

Multi-Indenter Device for in Vivo Biomechanical Tissue Measurement

Biomechanical tissue properties have been hypothesized to play a critical role in the quantification of prosthetic socket production for individuals with limb amputation. In this investigation, a novel indenter platform is presented and its performance evaluated for the purposes of residual-limb tissue characterization. The indenter comprised 14 position- and force-controllable actuators that circumferentially surround a biological residuum to form an actuator ring. Each indenter actuator was individually controllable in position ( [Formula: see text] accuracy) and force (330 mN accuracy) at a PC controller feedback rate of 500 Hz, allowing for a range of measurement across a residual stump. Data were collected from 162 sensors over an EtherCAT fieldbus to characterize the mechanical hyperviscoelastic tissue response of two transtibial residual-limbs from a study participant with bilateral amputations. At five distinct anatomical locations across the residual-limb, force versus deflection data-including hyperviscoelastic tissue properties-are presented, demonstrating the accuracy and versatility of the multi-indenter platform for residual-limb tissue characterization.

Ramp-hold relaxation solutions for the KVFD model applied to soft viscoelastic media

The standard step-hold load-relaxation profile can yield variable estimates of mechanical properties due to the difficulty in achieving a step strain experimentally. A ramp-hold profile overcomes this limitation if appropriate model functions can be derived. Utilizing Boltzmann hereditary integral operators for two indentation geometries, analytical ramp solutions for load-relaxation were developed based on the Kelvin-Voigt fractional derivative (KVFD) model. The results identify three model parameters for characterizing viscoelastic behavior from a single model curve fit to the data: the elastic modulus E₀, fractional-order parameter α, and relaxation time constant τ. The quantitative nature of the analysis was validated through measurements on gelatin emulsion samples exhibiting viscoelastic behavior. KVFD-model-based solutions provide mathematically simple and experimentally flexible descriptions of load-relaxation behavior for a range of viscoelastic properties and experimental conditions; e.g. one closed-form solution can fit the ramp and the hold phases of the relaxation time series. Experiments show that the solution for a spherical indenter and plate compressor each fit well to the corresponding experimental relaxation curves with a coefficient of determination R² > 0.98. Parameters obtained from the spherical-tip indentation and plate-compression geometries agree within one standard deviation, confirming that the ramp solution based KVFD model yields consistent measurements for characterizing viscoelastic materials.

Dynamic estimation of myocardial deformation using ultrasound RF-data: A preliminary study

Analytic minimization (AM) is one of elastography algorithms. In this study, a healthy male volunteer lying in lateral position was examined by an ultrasound system. The left ventricular long-axis view of the heart was acquired and the ultrasound radio frequency (RF) data were stored for estimation of myocardial deformation. The methods of AM and Linear polynomial curve fitting were used to calculate the displacement and strain, respectively. The myocardial deformation was dynamically estimated. The strain maps at approximately 50ms, 140ms, and 240ms after the beginning of the ventricle systole indicate the contraction of different myocardial segments. This study provides a potential method to assess the survival myocardium in patients with myocardial infarction in future study.

Development of a phantom mimicking the functional and structural behaviors of the thigh muscles characterized with magnetic resonance elastography technique

Magnetic Resonance Elastography (MRE) is a non invasive technique based on the propagation of shear waves in soft tissues providing the quantification of the mechanical properties [1]. MRE was successfully applied to healthy and pathological muscles. However, the MRE muscle methods must be further improved to characterize the deep muscles. A way will be to develop phantom mimicking the muscle behavior in order to set up new MRE protocol. Thus, the purpose of this study is to create a phantom composed of a similar skeletal muscle architecture (fiber, aponorosis) and equivalent elastic properties as a function of the muscle state (passive or active). Two homogeneous phantoms were manufactured with different concentrations of plastisol to simulate the elastic properties in relaxed (50% of plastisol) and contracted (70% of plastisol) muscle conditions. Moreover, teflon tubing pipes (D = 0.9 mm) were thread in the upper part of the phantom (50%) to represent the muscle fibers and a plastic sheet (8 × 15 cm) was also included in the middle of the phantom to mimic the aponeurosis structure. Subsequently, MRE tests were performed with two different pneumatic drivers, tube and round, (f = 90Hz) to analyze the effect of the type of driver on the wave propagation. Then, the wavelength was measured from the phase images to obtain the elastic properties (shear modulus). Both phantoms revealed elastic properties which were in the same range as in vivo muscle in passive (μ(50%) = 2.40 ± 0.18 kPa ) and active (6.24 ± 0.21 kPa) states. The impact of the type of driver showed higher values (about 1.2kPa) with the tube. The analysis of the wave behavior revealed a sliding along the plastic sheet as it was observed for in vivo muscle study. The wave was also sensitive to the presence of the fibers where gaps were identified. The present study demonstrates the ability of the phantom to mimic the structural and functional properties of the muscle.

Patient specific modeling of palpation-based prostate cancer diagnosis: effects of pelvic cavity anatomy and intrabladder pressure

Computational modeling has become a successful tool for scientific advances including understanding the behavior of biological and biomedical systems as well as improving clinical practice. In most cases, only general models are used without taking into account patient-specific features. However, patient specificity has proven to be crucial in guiding clinical practice because of disastrous consequences that can arise should the model be inaccurate. This paper proposes a framework for the computational modeling applied to the example of the male pelvic cavity for the purpose of prostate cancer diagnostics using palpation. The effects of patient specific structural features on palpation response are studied in three selected patients with very different pathophysiological conditions whose pelvic cavities are reconstructed from MRI scans. In particular, the role of intrabladder pressure in the outcome of digital rectal examination is investigated with the objective of providing guidelines to practitioners to enhance the effectiveness of diagnosis. Furthermore, the presence of the pelvic bone in the model is assessed to determine the pathophysiological conditions in which it has to be modeled. The conclusions and suggestions of this work have potential use not only in clinical practice and also for biomechanical modeling where structural patient-specificity needs to be considered. © 2015 The Authors. International Journal for Numerical Methods in Biomedical Engineering published by John Wiley & Sons Ltd.

Quantifying the Elastic Property of Nine Thigh Muscles Using Magnetic Resonance Elastography

BACKGROUND

Pathologies of the muscles can manifest different physiological and functional changes. To adapt treatment, it is necessary to characterize the elastic property (shear modulus) of single muscles. Previous studies have used magnetic resonance elastography (MRE), a technique based on MRI technology, to analyze the mechanical behavior of healthy and pathological muscles. The purpose of this study was to develop protocols using MRE to determine the shear modulus of nine thigh muscles at rest.

METHODS

Twenty-nine healthy volunteers (mean age = 26 ± 3.41 years) with no muscle abnormalities underwent MRE tests (1.5 T MRI). Five MRE protocols were developed to quantify the shear moduli of the nine following thigh muscles at rest: rectus femoris (RF), vastus medialis (VM), vastus intermedius (VI), vastus lateralis (VL), sartorius (Sr), gracilis (Gr), semimembranosus (SM), semitendinosus (ST), and biceps (BC). In addition, the shear modulus of the subcutaneous adipose tissue was analyzed.

RESULTS

The gracilis, sartorius, and semitendinosus muscles revealed a significantly higher shear modulus (μ_Gr = 6.15 ± 0.45 kPa, μ_ Sr = 5.15 ± 0.19 kPa, and μ_ ST = 5.32 ± 0.10 kPa, respectively) compared to other tissues (from μ_ RF = 3.91 ± 0.16 kPa to μ_VI = 4.23 ± 0.25 kPa). Subcutaneous adipose tissue had the lowest value (μ_adipose tissue = 3.04 ± 0.12 kPa) of all the tissues tested.

CONCLUSION

The different elasticities measured between the tissues may be due to variations in the muscles' physiological and architectural compositions. Thus, the present protocol could be applied to injured muscles to identify their behavior of elastic property. Previous studies on muscle pathology found that quantification of the shear modulus could be used as a clinical protocol to identify pathological muscles and to follow-up effects of treatments and therapies. These data could also be used for modelling purposes.