Integration of crawling waves in an ultrasound imaging system. Part 1: system and design considerations

Controllable Angle Shear Wavefront Reconstruction Based on Image Fusion Method for Shear Wave Elasticity Imaging

The generation and measurement of shear waves are critical in ultrasonic elasticity imaging. Generally, the resulting wavefront direction is very important for accurately measuring the shear speed and estimating the medium elasticity. In this article, the proposed method can generate a compound shear wavefront with the same direction as speed reconstruction and zero angles between the wavefront and the focus direction, which can improve the estimation accuracy of shear wave velocity. Also, this method, called time-division multipoint excitation image fusion (TDMPEIF), can reconstruct the shear wave propagation images acquired at different depths of a medium according to the frame sequence to produce the shear waves front with a regulable angle. Moreover, the shear wave speed and the elasticity of a medium can be mapped quantitatively with this method. The results demonstrate that the TDMPEIF can improve the quality of the shear wave velocity images, which has wide application value and good promotion prospects for quantitative evaluation of tissue elasticity.

Analysis of Transient Shear Wave in Lossy Media

The propagation of shear waves from impulsive forces is an important topic in elastography. Observations of shear wave propagation can be obtained with numerous clinical imaging systems. Parameter estimations of the shear wave speed in tissues, and more generally the viscoelastic parameters of tissues, are based on some underlying models of shear wave propagation. The models typically include specific choices of the spatial and temporal shape of the impulsive force and the elastic or viscoelastic properties of the medium. In this work, we extend the analytical treatment of 2-D shear wave propagation in a biomaterial. The approach applies integral theorems relevant to the solution of the generalized Helmholtz equation, and does not depend on a specific rheological model of the tissue's viscoelastic properties. Estimators of attenuation and shear wave speed are derived from the analytical solutions, and these are applied to an elastic phantom, a viscoelastic phantom and in vivo liver using a clinical ultrasound scanner. In these samples, estimated shear wave group velocities ranged from 1.7 m/s in the liver to 2.5 m/s in the viscoelastic phantom, and these are lower-bounded by independent measurements of phase velocity.

GPU-based Green's function simulations of shear waves generated by an applied acoustic radiation force in elastic and viscoelastic models

Shear wave calculations induced by an acoustic radiation force are very time-consuming on desktop computers, and high-performance graphics processing units (GPUs) achieve dramatic reductions in the computation time for these simulations. The acoustic radiation force is calculated using the fast near field method and the angular spectrum approach, and then the shear waves are calculated in parallel with Green's functions on a GPU. This combination enables rapid evaluation of shear waves for push beams with different spatial samplings and for apertures with different f/#. Relative to shear wave simulations that evaluate the same algorithm on an Intel i7 desktop computer, a high performance nVidia GPU reduces the time required for these calculations by a factor of 45 and 700 when applied to elastic and viscoelastic shear wave simulation models, respectively. These GPU-accelerated simulations also compared to measurements in different viscoelastic phantoms, and the results are similar. For parametric evaluations and for comparisons with measured shear wave data, shear wave simulations with the Green's function approach are ideally suited for high-performance GPUs.

Characterizing the Acoustic Output of an Ultrasonic Propulsion Device for Urinary Stones

A noninvasive ultrasound (US) system to facilitate the passage of small kidney stones has been developed. The device incorporates a software-based US platform programmed with brightness mode and Doppler for visualizing stones, plus long duration focused pulses for repositioning stones using the same transducer. This paper characterizes the acoustic outputs of the ultrasonic propulsion device. Though the application and outputs are unique, measurements were performed based on the regulatory standards for both diagnostic US and extracorporeal lithotripters. The extended length of the pulse, time varying pressure output over the pulse, the use of focused targeting, and the need to regulate the output at shallow depths, however, required modifications to the traditional acoustic measurement methods. Output parameters included spatial-peak intensities, mechanical index (MI), thermal index, pulse energy, focal geometry, and target accuracy. The imaging and Doppler operating modes of the system meet the Food and Drug Administration acoustic power and intensity limits for diagnostic US device. Push mode operates at a maximum MI of 2.2, which is above the limit of 1.9 for diagnostic US, but well below any lithotripsy device and an ISPTA of 548 mW/cm2, which is below the 720-mW/cm2 limit for diagnostic US.

Multi-source and multi-directional shear wave generation with intersecting steered ultrasound push beams

Elasticity imaging is becoming established as a means of assisting in diagnosis of certain diseases. Shear wave-based methods have been developed to perform elasticity measurements in soft tissue. Comb-push ultrasound shear elastography (CUSE) is one of these methods that apply acoustic radiation force to induce the shear wave in soft tissues. CUSE uses multiple ultrasound beams that are transmitted simultaneously to induce multiple shear wave sources into the tissue, with improved shear wave SNR and increased shear wave imaging frame rate. We propose a novel method that uses steered push beams (SPB) that can be applied for beam formation for shear wave generation. In CUSE beamforming, either unfocused or focused beams are used to create the propagating shear waves. In SPB methods we use unfocused beams that are steered at specific angles. The interaction of these steered beams causes shear waves to be generated in more of a random nature than in CUSE. The beams are typically steered over a range of 3 to 7° and can either be steered to the left (-θ) or right (+θ).We performed simulations of 100 configurations using Field II and found the best configurations based on spatial distribution of peaks in the resulting intensity field. The best candidates were ones with a higher number of the intensity peaks distributed over all depths in the simulated beamformed results. Then these optimal configurations were applied on a homogeneous phantom and two different phantoms with inclusions. In one of the inhomogeneous phantoms we studied two spherical inclusions with 10 and 20 mm diameters, and in the other phantom we studied cylindrical inclusions with diameters ranging from 2.53 to 16.67 mm. We compared these results with those obtained using conventional CUSE with unfocused and focused beams. The mean and standard deviation of the resulting shear wave speeds were used to evaluate the accuracy of the reconstructions by examining bias with nominal values for the phantoms as well as the contrast-to-noise ratio in the inclusion phantom results. In general the contrast-to-noise ratio (CNR) was higher and the bias was lower using the SPB method compared with the CUSE realizations except in the largest inclusions. In the cylindrical inclusion with 10.4 mm diameter, the CNR in CUSE methods ranged between 18.52 and 22.02 and the bias ranged between 5.50 and 11.12%, whereas for SPB methods provided CNR values between 23.07 and 48.90 and bias values between 3.78 and 9.22%. In a smaller cylindrical inclusion with diameter of 4.05 mm, CUSE methods gave CNR between 14.69 and 22.28 and bias ranging between 28.95 and 29.28%, whereas the SPB methods provided CNR values between 16.7 and 25.2 and bias values varying from 25.54 to 30.44%. The SPB method provides a flexible framework to produce shear wave sources that are widely distributed within the field-of-view for robust shear wave speed imaging.

Two-dimensional shear-wave elastography on conventional ultrasound scanners with time-aligned sequential tracking (TAST) and comb-push ultrasound shear elastography (CUSE)

Two-dimensional shear-wave elastography presents 2-D quantitative shear elasticity maps of tissue, which are clinically useful for both focal lesion detection and diffuse disease diagnosis. Realization of 2-D shear-wave elastography on conventional ultrasound scanners, however, is challenging because of the low tracking pulse-repetition-frequency (PRF) of these systems. Although some clinical and research platforms support software beamforming and plane-wave imaging with high PRF, the majority of current clinical ultrasound systems do not have the software beamforming capability, which presents a critical challenge for translating the 2-D shear-wave elastography technique from laboratory to clinical scanners. To address this challenge, this paper presents a time-aligned sequential tracking (TAST) method for shear-wave tracking on conventional ultrasound scanners. TAST takes advantage of the parallel beamforming capability of conventional systems and realizes high-PRF shear-wave tracking by sequentially firing tracking vectors and aligning shear wave data in the temporal direction. The comb-push ultrasound shear elastography (CUSE) technique was used to simultaneously produce multiple shear wave sources within the field-of-view (FOV) to enhance shear wave SNR and facilitate robust reconstructions of 2-D elasticity maps. TAST and CUSE were realized on a conventional ultrasound scanner. A phantom study showed that the shear-wave speed measurements from the conventional ultrasound scanner were in good agreement with the values measured from other 2-D shear wave imaging technologies. An inclusion phantom study showed that the conventional ultrasound scanner had comparable performance to a state-of-the-art shear-wave imaging system in terms of bias and precision in measuring different sized inclusions. Finally, in vivo case analysis of a breast with a malignant mass, and a liver from a healthy subject demonstrated the feasibility of using the conventional ultrasound scanner for in vivo 2-D shear-wave elastography. These promising results indicate that the proposed technique can enable the implementation of 2-D shear-wave elastography on conventional ultrasound scanners and potentially facilitate wider clinical applications with shear-wave elastography.

Ultrasound elastography: the new frontier in direct measurement of muscle stiffness

The use of brightness-mode ultrasound and Doppler ultrasound in physical medicine and rehabilitation has increased dramatically. The continuing evolution of ultrasound technology has also produced ultrasound elastography, a cutting-edge technology that can directly measure the mechanical properties of tissue, including muscle stiffness. Its real-time and direct measurements of muscle stiffness can aid the diagnosis and rehabilitation of acute musculoskeletal injuries and chronic myofascial pain. It can also help monitor outcomes of interventions affecting muscle in neuromuscular and musculoskeletal diseases, and it can better inform the functional prognosis. This technology has implications for even broader use of ultrasound in physical medicine and rehabilitation practice, but more knowledge about its uses and limitations is essential to its appropriate clinical implementation. In this review, we describe different ultrasound elastography techniques for studying muscle stiffness, including strain elastography, acoustic radiation force impulse imaging, and shear-wave elastography. We discuss the basic principles of these techniques, including the strengths and limitations of their measurement capabilities. We review the current muscle research, discuss physiatric clinical applications of these techniques, and note directions for future research.

The Gaussian shear wave in a dispersive medium

In "imaging the biomechanical properties of tissues," a number of approaches analyze shear wave propagation initiated by a short radiation force push. Unfortunately, it has been experimentally observed that the displacement-versus-time curves for lossy tissues are rapidly damped and distorted in ways that can confound simple tracking approaches. This article addresses the propagation, decay and distortion of pulses in lossy and dispersive media, to derive closed-form analytic expressions for the propagating pulses. The theory identifies key terms that drive the distortion and broadening of the pulse. Furthermore, the approach taken is not dependent on any particular viscoelastic model of tissue, but instead takes a general first-order approach to dispersion. Examples with a Gaussian beam pattern and realistic dispersion parameters are given along with general guidelines for identifying the features of the distorting wave that are the most compact.

Mouse liver dispersion for the diagnosis of early-stage Fatty liver disease: a 70-sample study

The accumulation of fat droplets within the liver is an important marker of liver disease. This study assesses gradations of steatosis in mouse livers using crawling waves, which are interfering patterns of shear waves introduced into the liver by external sources. The crawling waves are detected by Doppler ultrasound imaging techniques, and these are analyzed to estimate the shear wave speed as a function of frequency between 200 and 360 Hz. In a study of 70 mice with progressive increases in steatosis from 0% to >60%, increases in steatosis are found to increase the dispersion, or frequency dependence, of shear wave speed. This finding confirms an earlier, smaller study and points to the potential of a scoring system for steatosis based on shear wave dispersion.

Optimized shear wave generation using hybrid beamforming methods

Elasticity imaging is a medical imaging modality that measures tissue elasticity as an aid in the diagnosis of certain diseases. Shear wave-based methods have been developed to perform elasticity measurements in soft tissue. These methods often use the radiation force mechanism of focused ultrasound to induce shear waves in soft tissue such as liver, kidney, breast, thyroid and skeletal muscle. The efficiency of the ultrasound beam in producing broadband extended shear waves in soft tissue is very important to the widespread use of this modality. Hybrid beamforming combines two types of focusing, conventional spherical focusing and axicon focusing, to produce a beam for generating a shear wave that has increased depth-of-field (DOF) so that measurements can be made with a shear wave with a consistent wave front. Spherical focusing is used in many applications to achieve high lateral resolution, but has low DOF. Axicon focusing, with a cone-shaped transducer, can provide good lateral resolution with large DOF. We describe our linear aperture design and beam optimization performed using angular spectrum simulations. We performed a large parametric simulation study in which we varied the focal depth for the spherical focusing portion of the aperture, the numbers of elements devoted to the spherical and axicon focusing portions of the aperture and the opening angle used for axicon focusing. The hybrid beamforming method was experimentally tested in two phantoms, and shear wave speed measurement accuracy and DOF for each hybrid beam were evaluated. We compared our results with those for shear waves generated using only spherical focusing. The results of this study indicate that hybrid beamforming is capable of producing a beam with increased DOF over which accurate shear wave speed measurements can be made for different-size apertures and at different focal depths.

Comb-push ultrasound shear elastography (CUSE) with various ultrasound push beams

Comb-push ultrasound shear elastography (CUSE) has recently been shown to be a fast and accurate 2-D elasticity imaging technique that can provide a full field-of-view (FOV) shear wave speed map with only one rapid data acquisition. The initial version of CUSE was termed U-CUSE because unfocused ultrasound push beams were used. In this paper, we present two new versions of CUSE-focused CUSE (F-CUSE) and marching CUSE (M-CUSE), which use focused ultrasound push beams to improve acoustic radiation force penetration and produce stronger shear waves in deep tissues (e.g., kidney and liver). F-CUSE divides transducer elements into several subgroups which transmit multiple focused ultrasound beams simultaneously. M-CUSE uses more elements for each focused push beam and laterally marches the push beams. Both F-CUSE and M-CUSE can generate comb-shaped shear wave fields that have shear wave motion at each imaging pixel location so that a full FOV 2-D shear wave speed map can be reconstructed with only one data acquisition. Homogeneous phantom experiments showed that U-CUSE, F-CUSE, and M-CUSE can all produce smooth shear wave speed maps with accurate shear wave speed estimates. An inclusion phantom experiment showed that all CUSE methods could provide good contrast between the inclusion and background with sharp boundaries while F-CUSE and M-CUSE require shorter push durations to achieve shear wave speed maps with comparable SNR to U-CUSE. A more challenging inclusion phantom experiment with a very stiff and deep inclusion shows that better shear wave penetration could be gained by using F-CUSE and M-CUSE. Finally, a shallow inclusion experiment showed that good preservations of inclusion shapes could be achieved by both U-CUSE and F-CUSE in the near field. Safety measurements showed that all safety parameters are below FDA regulatory limits for all CUSE methods. These promising results suggest that, using various push beams, CUSE is capable of reconstructing a 2-D full FOV shear elasticity map using only one push-detection data acquisition in a wide range of depths for soft tissue elasticity imaging.

Acoustic waves in medical imaging and diagnostics

Up until about two decades ago acoustic imaging and ultrasound imaging were synonymous. The term ultrasonography, or its abbreviated version sonography, meant an imaging modality based on the use of ultrasonic compressional bulk waves. Beginning in the 1990s, there started to emerge numerous acoustic imaging modalities based on the use of a different mode of acoustic wave: shear waves. Imaging with these waves was shown to provide very useful and very different information about the biological tissue being examined. We discuss the physical basis for the differences between these two basic modes of acoustic waves used in medical imaging and analyze the advantages associated with shear acoustic imaging. A comprehensive analysis of the range of acoustic wavelengths, velocities and frequencies that have been used in different imaging applications is presented. We discuss the potential for future shear wave imaging applications.

Acoustic radiation force elasticity imaging in diagnostic ultrasound

The development of ultrasound-based elasticity imaging methods has been the focus of intense research activity since the mid-1990s. In characterizing the mechanical properties of soft tissues, these techniques image an entirely new subset of tissue properties that cannot be derived with conventional ultrasound techniques. Clinically, tissue elasticity is known to be associated with pathological condition and with the ability to image these features in vivo; elasticity imaging methods may prove to be invaluable tools for the diagnosis and/or monitoring of disease. This review focuses on ultrasound-based elasticity imaging methods that generate an acoustic radiation force to induce tissue displacements. These methods can be performed noninvasively during routine exams to provide either qualitative or quantitative metrics of tissue elasticity. A brief overview of soft tissue mechanics relevant to elasticity imaging is provided, including a derivation of acoustic radiation force, and an overview of the various acoustic radiation force elasticity imaging methods.

Design of a phased array for the generation of adaptive radiation force along a path surrounding a breast lesion for dynamic ultrasound elastography imaging

This work demonstrates, with numerical simulations, the potential of an octagonal probe for the generation of radiation forces in a set of points following a path surrounding a breast lesion in the context of dynamic ultrasound elastography imaging. Because of the in-going wave adaptive focusing strategy, the proposed method is adapted to induce shear wave fronts to interact optimally with complex lesions. Transducer elements were based on 1-3 piezocomposite material. Three-dimensional simulations combining the finite element method and boundary element method with periodic boundary conditions in the elevation direction were used to predict acoustic wave radiation in a targeted region of interest. The coupling factor of the piezocomposite material and the radiated power of the transducer were optimized. The transducer's electrical impedance was targeted to 50 Ω. The probe was simulated by assembling the designed transducer elements to build an octagonal phased-array with 256 elements on each edge (for a total of 2048 elements). The central frequency is 4.54 MHz; simulated transducer elements are able to deliver enough power and can generate the radiation force with a relatively low level of voltage excitation. Using dynamic transmitter beamforming techniques, the radiation force along a path and resulting acoustic pattern in the breast were simulated assuming a linear isotropic medium. Magnitude and orientation of the acoustic intensity (radiation force) at any point of a generation path could be controlled for the case of an example representing a heterogeneous medium with an embedded soft mechanical inclusion.

Comb-push ultrasound shear elastography (CUSE): a novel method for two-dimensional shear elasticity imaging of soft tissues

Fast and accurate tissue elasticity imaging is essential in studying dynamic tissue mechanical properties. Various ultrasound shear elasticity imaging techniques have been developed in the last two decades. However, to reconstruct a full field-of-view 2-D shear elasticity map, multiple data acquisitions are typically required. In this paper, a novel shear elasticity imaging technique, comb-push ultrasound shear elastography (CUSE), is introduced in which only one rapid data acquisition (less than 35 ms) is needed to reconstruct a full field-of-view 2-D shear wave speed map (40 × 38 mm). Multiple unfocused ultrasound beams arranged in a comb pattern (comb-push) are used to generate shear waves. A directional filter is then applied upon the shear wave field to extract the left-to-right (LR) and right-to-left (RL) propagating shear waves. Local shear wave speed is recovered using a time-of-flight method based on both LR and RL waves. Finally, a 2-D shear wave speed map is reconstructed by combining the LR and RL speed maps. Smooth and accurate shear wave speed maps are reconstructed using the proposed CUSE method in two calibrated homogeneous phantoms with different moduli. Inclusion phantom experiments demonstrate that CUSE is capable of providing good contrast (contrast-to-noise ratio ≥ 25 dB) between the inclusion and background without artifacts and is insensitive to inclusion positions. Safety measurements demonstrate that all regulated parameters of the ultrasound output level used in CUSE sequence are well below the FDA limits for diagnostic ultrasound.