Theoretical derivation of SNR, CNR and spatial resolution for a local adaptive strain estimator for elastography

Calculation of strain images of a breast-mimicking phantom from 3D CT image data

PURPOSE

Elastography is a medical imaging modality to visualize the elasticity of soft tissues. Ultrasound and MRI have been exclusively used for elastography of soft tissues since they can sensitize the tissues' minute displacements of an order of μm. It is known that ultrasound and MRI elastography show cancerous tissues with much higher contrast than conventional ultrasound and MRI. To evaluate possibility of combining elastography with x-ray imaging, we have calculated strain images of a breast-mimicking phantom from its 3D CT image data.

METHODS

We first simulated the x-ray elastography using a FEM model which incorporated both the elasticity and x-ray attenuation behaviors of breast tissues. After validating the x-ray elastography scheme by simulation, we made a breast-mimicking phantom that contained a hard inclusion against soft background. With a micro-CT, we took 3D images of the phantom twice, changing the compressing force to the phantom. From the two 3D phantom images taken with two different compression ratios, we calculated the displacement vector maps that represented the compression-induced pixel displacements. In calculating the displacement vectors, we tracked the movements of image feature patterns from the less-compressed-phantom images to the more-compressed-phantom images using the 3D image correlation technique. We obtained strain images of the phantom by differentiating the displacement vector maps.

RESULTS

The FEM simulation has shown that x-ray strain imaging is possible by tracking image feature patterns in the 3D CT images of the breast-mimicking phantom. The experimental displacement and strain images of a breast-mimicking phantom, obtained from the 3D micro-CT images taken with 0%-3% compression ratios, show behaviors similar to the FEM simulation results. The contrast and noise performance of the strain images improves as the phantom compression ratio increases.

CONCLUSIONS

We have experimentally shown that we can improve x-ray strain image quality by applying 3D image correlation to the two sets of 3D CT images taken with different compression ratios. But, we need further investigations to evaluate the strain imaging performance considering the noise and decorrelation effects as well as the extra dose caused by two scans.

Medical ultrasound: imaging of soft tissue strain and elasticity

After X-radiography, ultrasound is now the most common of all the medical imaging technologies. For millennia, manual palpation has been used to assist in diagnosis, but it is subjective and restricted to larger and more superficial structures. Following an introduction to the subject of elasticity, the elasticity of biological soft tissues is discussed and published data are presented. The basic physical principles of pulse-echo and Doppler ultrasonic techniques are explained. The history of ultrasonic imaging of soft tissue strain and elasticity is summarized, together with a brief critique of previously published reviews. The relevant techniques-low-frequency vibration, step, freehand and physiological displacement, and radiation force (displacement, impulse, shear wave and acoustic emission)-are described. Tissue-mimicking materials are indispensible for the assessment of these techniques and their characteristics are reported. Emerging clinical applications in breast disease, cardiology, dermatology, gastroenterology, gynaecology, minimally invasive surgery, musculoskeletal studies, radiotherapy, tissue engineering, urology and vascular disease are critically discussed. It is concluded that ultrasonic imaging of soft tissue strain and elasticity is now sufficiently well developed to have clinical utility. The potential for further research is examined and it is anticipated that the technology will become a powerful mainstream investigative tool.

Reconstructive compounding for IVUS palpography

This study proposes a novel algorithm for luminal strain reconstruction from sparse irregularly sampled strain measurements. It is based on the normalized convolution (NC) algorithm. The novel extension comprises the multilevel scheme, which takes into account the variable sampling density of the available strain measurements during the cardiac cycle. The proposed algorithm was applied to restore luminal strain values in intravascular ultrasound (IVUS) palpography. The procedure of reconstructing and averaging the strain values acquired during one cardiac cycle forms a technique, coined as reconstructive compounding. The accuracy of strain reconstruction was initially tested on the luminal strain map, computed from 3 in vivo IVUS pullbacks. The high quality of strain restoration was observed after systematically removing up to 90% of the initial elastographic measurements. The restored distributions accurately reproduced the original strain patterns and the error did not exceed 5%. The experimental validation of the reconstructed compounding technique was performed on 8 in vivo IVUS pullbacks. It demonstrated that the relative decrease in number of invalid strain estimates amounts to 92.05 +/- 6.03% and 99.17 +/- 0.92% for the traditional and reconstructive strain compounding schemes, respectively. In conclusion, implementation of the reconstructive compounding scheme boosts the diagnostic value of IVUS palpography.

Instantaneous frequency-based ultrasonic temperature estimation during focused ultrasound thermal therapy

Focused ultrasound thermal therapy relies on temperature monitoring for treatment guidance and assurance of targeting and dose control. One potential approach is to monitor temperature change through ultrasonic-backscattered signal processing. The current approach involves the detection of echo time-shifts based on cross-correlation processing from segmented radiofrequency (RF) data. In this study, we propose a novel ultrasonic temperature-measurement approach that detects changes in instantaneous frequency along the imaging beam direction. Focused ultrasound was used as the heating source, and the 1-D beamformed RF signals provided from an ultrasound imager were used to verify the proposed algorithm for temperature change estimation. For comparison, a conventional cross-correlation technique was also evaluated. Heating experiments testing tissue-mimicking phantoms and ex vivo porcine muscles were conducted. The results showed that temperature can be well estimated by the proposed algorithm in the temperature range, where the relationship of sound speed versus temperature is linear. Compared with the cross-correlation-based algorithm, the proposed new algorithm yields a six-fold increase in computational efficiency, along with comparable contrast-detection ability and precision. This new algorithm may serve as an alternative method for implementing temperature estimation into a clinical ultrasound imager for thermal therapy guidance.

Improving IVUS palpography by incorporation of motion compensation based on block matching and optical flow

Intravascular ultrasound (IVUS) strain imaging of the luminal layer in coronary arteries, coined as IVUS palpography, utilizes conventional radio frequency (RF) signals acquired at 2 different levels of a compressional load. The signals are cross-correlated to obtain the microscopic tissue displacements, which can be directly translated into local strain of the vessel wall. However, (apparent) tissue motion and nonuniform deformation of the vessel wall, due to catheter wiggling, reduce signal correlation and result in invalid strain estimates. Implications of probe motion were studied on the tissue-mimicking phantom. The measured circumferential tissue displacement and level of the speckle decorrelation amounted to 12 degrees and 0.58, respectively, for the catheter displacement of 456 microm. To compensate for the motion artifacts in IVUS palpography, a novel method based on the feature-based scale-space optical flow (OF), and classical block matching (BM) algorithm, were employed. The computed OF vector and BM displacement fields quantify the amount of local tissue misalignment in consecutive frames. Subsequently, the extracted circumferential displacements are used to realign the signals before strain computation. Motion compensation reduces the RF signal decorrelation and increases the number of valid strain estimates. The advantage of applying the motion correction in IVUS palpography was demonstrated in a midscale validation study on 14 in vivo pullbacks. Both methods substantially increase the number of valid strain estimates in the partial and compounded palpograms. Mean relative improvement in the number of valid strain estimates with motion compensation in comparison to one without motion compensation amounts to 28% and 14%, respectively. Implementation of motion compensation methods boosts the diagnostic value of IVUS palpography.

Radio-frequency ablation electrode displacement elastography: a phantom study

This article describes the evaluation of a novel method of tissue displacement for use in the elastographic visualization of radio-frequency (rf) ablation-induced lesions. The method involves use of the radio-frequency ablation electrode as a displacement device, which provides localized compression in the region of interest. This displacement mechanism offers the advantage of easy in vivo implementation since problems such as excessive lateral and elevational displacements present when using external compression are reduced with this approach. The method was tested on a single-inclusion tissue-mimicking phantom containing a radio-frequency ablation electrode rigidly attached to the inclusion center. Full-frame rf echo signals were acquired from the phantom before and after electrode displacements ranging from 0.05 to 0.2 mm. One-dimensional cross-correlation analysis between pre- and postcompression signals was used to measure tissue displacements, and strains were determined by computing the gradient of the displacement. The strain contrast, contrast-to-noise ratio, and signal-to-noise ratio were estimated from the resulting strain images. Comparisons are drawn between the elastographically measured dimensions and those known a priori for the single-inclusion phantom. Electrode displacement elastography was found to slightly underestimate the inclusion dimensions. The method was also tested on a second tissue-mimicking phantom and on in vitro rf-ablated lesions in canine liver tissue. The results validate previous in vivo findings that electrode displacement elastography is an effective method for monitoring rf ablation.

Elasticity imaging using conventional and high-frame rate ultrasound imaging: experimental study

High-frame rate ultrasound imaging is necessary to track fast deformation in ultrasound elasticity imaging, but the image quality may be degraded. Previously, we investigated the performance of strain imaging using numerical models of conventional and ultrafast ultrasound imaging techniques. In this paper, we performed experimental studies to quantitatively evaluate the strain images and elasticity maps obtained using conventional and high frame rate ultrasound imaging methods. The experiments were carried out using point target and tissue mimicking phantoms. The experimental results were compared with the results of numerical simulation. Our experimental studies confirm that the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and axial/lateral resolution of the displacement and strain images acquired using high-frame rate ultrasound imaging are slightly lower but comparable with those obtained using conventional imaging. Furthermore, the quality of elasticity images also exhibits similar trends. Thus, high-frame rate ultrasound imaging can be used reliably for static elasticity imaging to capture the internal tissue motion if the frame rate is critical.

Estimation of displacement location for enhanced strain imaging

Ultrasonic strain imaging usually begins with displacement estimates computed using finite-length sections of RF ultrasound signals. Amplitude variations in the ultrasound are known to perturb the location at which the displacement estimate is valid. If this goes uncorrected, it is a significant source of estimation noise, which is amplified when displacement fields are converted into strain images. We present a study of this effect based on theoretical analysis and practical experiments. A correction method based on the analysis is tested on phase zero and correlation coefficient strain imaging, and compared to the amplitude compression techniques of earlier studies. We also test adaptive strain estimation to provide a benchmark, but the performance of our new method matches or surpasses this benchmark under normal scanning conditions. Furthermore, the new correction is suitable for real time applications owing to its extreme computational simplicity.

Strain imaging using conventional and ultrafast ultrasound imaging: numerical analysis

In elasticity imaging, the ultrasound frames acquired during tissue deformation are analyzed to estimate the internal displacements and strains. If the deformation rate is high, high-frame-rate imaging techniques are required to avoid the severe decorrelation between the neighboring ultrasound images. In these high-frame-rate techniques, however, the broader and less focused ultrasound beam is transmitted and, hence, the image quality is degraded. We quantitatively compared strain images obtained using conventional and ultrafast ultrasound imaging methods. The performance of the elasticity imaging was evaluated using custom-designed, numerical simulations. Our results demonstrate that signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and spatial resolutions in displacement and strain images acquired using conventional and ultrafast ultrasound imaging are comparable. This study suggests that the high-frame-rate ultrasound imaging can be reliably used in elasticity imaging if frame rate is critical.

Resolution of axial shear strain elastography

The technique of mapping the local axial component of the shear strain due to quasi-static axial compression is defined as axial shear strain elastography. In this paper, the spatial resolution of axial shear strain elastography is investigated through simulations, using an elastically stiff cylindrical lesion embedded in a homogeneously softer background. Resolution was defined as the smallest size of the inclusion for which the strain value at the inclusion/background interface was greater than the average of the axial shear strain values at the interface and inside the inclusion. The resolution was measured from the axial shear strain profile oriented at 45 degrees to the axis of beam propagation, due to the absence of axial shear strain along the normal directions. The effects of the ultrasound system parameters such as bandwidth, beamwidth and transducer element pitch along with signal processing parameters such as correlation window length (W) and axial shift (DeltaW) on the estimated resolution were investigated. The results show that the resolution (at 45 degrees orientation) is determined by the bandwidth and the beamwidth. However, the upper bound on the resolution is limited by the larger of the beamwidth and the window length, which is scaled inversely to the bandwidth. The results also show that the resolution is proportional to the pitch and not significantly affected by the axial window shift.