High-resolution ultrasound imaging of human skin in vivo by using three-dimensional ultrasound microscopy

High Acoustic Impedance and Attenuation Backing for High-Frequency Focused P(VDF-TrFE)-Based Transducers

Backing materials with tailored acoustic properties are beneficial for miniaturized ultrasonic transducer design. Whereas piezoelectric P(VDF-TrFE) films are common elements in high-frequency (>20 MHz) transducer design, their low coupling coefficient limits their sensitivity. Defining a suitable sensitivity-bandwidth trade-off for miniaturized high-frequency applications requires backings with impedances of >25 MRayl and strongly attenuating to account for miniaturized requirements. The motivation of this work is related to several medical applications such as small animal, skin or eye imaging. Simulations showed that increasing the acoustic impedance of the backing from 4.5 to 25 MRayl increases transducer sensitivity by 5 dB but decreases the bandwidth, which nevertheless remains high enough for the targeted applications. In this paper, porous sintered bronze material with spherically shaped grains, size-adapted for 25-30 MHz frequency, was impregnated with tin or epoxy resin to create multiphasic metallic backings. Microstructural characterizations of these new multiphasic composites showed that impregnation was incomplete and that a third air phase was present. The selected composites, sintered bronze-tin-air and sintered bronze-epoxy-air, at 5-35 MHz characterization, produced attenuation coefficients of 1.2 and >4 dB/mm/MHz and impedances of 32.4 and 26.4 MRayl, respectively. High-impedance composites were adopted as backing (thickness = 2 mm) to fabricate focused single-element P(VDF-TrFE)-based transducers (focal distance = 14 mm). The center frequency was 27 MHz, while the bandwidth at -6 dB was 65% for the sintered-bronze-tin-air-based transducer. We evaluated imaging performance using a pulse-echo system on a tungsten wire (diameter = 25 μm) phantom. Images confirmed the viability of integrating these backings in miniaturized transducers for imaging applications.

Noninvasive optoacoustic microangiography reveals dose and size dependency of radiation-induced deep tumor vasculature remodeling

Tumor microvascular responses may provide a sensitive readout indicative of radiation therapy efficacy, its time course and dose dependencies. However, direct high-resolution observation and longitudinal monitoring of large-scale microvascular remodeling in deep tissues remained challenging with the conventional microscopy approaches.

We report on a non-invasive longitudinal study of morphological and functional neovascular responses by means of scanning optoacoustic (ОА) microangiography. In vivo imaging of CT26 tumor response to a single irradiation at varying dose (6, 12, and 18 Gy) has been performed over ten days following treatment. Tumor oxygenation levels were further estimated using diffuse optical spectroscopy (DOS) with a contact fiber probe.

OA revealed the formation of extended vascular structures on the whole tumor scale during its proliferation, whereas only short fragmented vascular regions were identified following irradiation. On the first day post treatment, a decrease in the density of small (capillary-sized) and medium-sized vessels was revealed, accompanied by an increase in their fragmentation. Larger vessels exhibited an increase in their density accompanied by a decline in the number of vascular segments. Short-lasting response has been observed after 6 and 12 Gy irradiations, whereas 18 Gy treatment resulted in prolonged responses, up to the tenth day after irradiation. DOS measurements further revealed a delayed increase of tumor oxygenation levels for 18 Gy irradiations, commencing on the sixth day post treatment. The ameliorated oxygenation is attributed to diminished oxygen consumption by inhibited tumor cells but not to the elevation of oxygen supply.

This work is the first to demonstrate the differential (size-dependent) nature of vascular responses to radiation treatments at varying doses in vivo. The OA approach thus facilitates the study of radiation-induced vascular changes in an unperturbed in vivo environment while enabling deep tissue high-resolution observations at the whole tumor scale.

A Linear Piezoelectric Actuator Using "A-Shaped" Structure

A new design of linear piezoelectric actuator using "A-shaped" structure was proposed, designed, fabricated, and tested. By fusion design of the piezoelectric transducer and the mechanical structure, the proposed actuator only uses the first bending vibration of the center piezoelectric transducer to work. Frequency degeneration is no longer needed, which enables the actuator to adjust its structural parameters according to the application conditions. When applying an alternating voltage at resonance frequency, the center piezoelectric transducer will be stimulated in the first bending vibration. The vibration energy transmitted to the two driving arms generates alternating tilting movements with a phase difference of 180° between the two driving feet, which enables the actuator to push the linear guide when a vertical preload is applied. Under the preload of 120 N, the actuator gained a maximum thrust force of 9.8 N and a maximum output power of 0.62 W with a self-weight of 0.061 kg. The maximum output thrust density and the maximum output power density were 160.6 N/kg and 10.2 W/kg, respectively.

Optimized integrated design of a high-frequency medical ultrasound transducer with genetic algorithm

Designing efficient acoustic stack and elements for high-frequency (HF) medical ultrasound (US) transducers involves various interrelated parameters. So far, optimizing spatial resolution and acoustic field intensity simultaneously has been a daunting task in the area of HF medical US imaging. Here, we introduce optimized design for a 50-MHz US probe for skin tissue imaging. We have developed an efficient design and simulation approach using Krimholtz, Leedom and Matthaei (KLM) equivalent circuit model and spatial impulse response method by means of Field II software. These KLM model and Field II software are integrated, and a GA algorithm is used to optimize the design of the US transducer to obtain the best imaging performance. As a result, a 50-MHz single element probe is effectively optimized with 5 mm acoustic focal length, 72 $$\upmu {\text{m}}$$ μ m lateral, and 42 $$\upmu {\text{m}}$$ μ m axial imaging resolution, with an enhancement in imaging resolution over the conventionally designed and simulated probe by 10%. This work has the potential to benefit many applications that require a fast, high-resolution and strong US focus in skin imaging.

Analysis and Design of High-Frequency 1-D CMUT Imaging Arrays in Noncollapsed Mode

High-frequency ultrasound imaging arrays are important for a broad range of applications, from small animal imaging to photoacoustics. Capacitive micromachined ultrasonic transducer (CMUT) arrays are particularly attractive for these applications as low noise receiver electronics can be integrated for an overall improved performance. In this paper, we present a comprehensive analysis of high-frequency CMUT arrays based on an experimentally verified CMUT array simulation tool. The results obtained on an example, a 40-MHz 1-D CMUT array for intravascular imaging, are used to obtain key design insights and tradeoffs for receive only and pulse-echo imaging. For the receiver side, thermal mechanical current noise, plane wave pressure sensitivity, and pressure noise spectrum are extracted from simulations. Using these parameters, we find that the receiver performance of CMUT arrays can be close to an ideal piston, independent of gap thickness, and applied dc bias, when coupled to low noise electronics with arrays utilizing smaller membranes performing better. For pulse-echo imaging, thermal mechanical current noise limited signal-to-noise ratio is observed to be dependent on the maximum available voltage and gap thickness. In terms of bandwidth, we find that the Bragg resonance of the array, related to the fill factor, is a significant determinant of the high frequency limit and the fluid loaded single membrane resonance determines the lower limit. Based on these results, we present design guidelines requiring only fluid loaded single membrane simulations and membrane pitch to achieve a desired pulse-echo response. We also provide a design example and discuss limitations of the approach.

Gender- and age-related differences in facial sebaceous glands in Asian skin, as observed by non-invasive analysis using three-dimensional ultrasound microscopy

BACKGROUND

While determining sebaceous gland morphology is useful in the treatment of skin disorders such as acne, a non-invasive assessment method has not been developed. Since age and gender affect sebum level, differences in sebaceous gland morphology according to these factors were investigated.

METHODS

Facial skin was measured using a high-frequency three-dimensional ultrasound microscope. First, the ultrasound images were compared with skin sections. Next, we assessed sebaceous gland morphology. Images of sebaceous gland in the cheeks of young male, young female and elderly female subjects were obtained using ultrasound microscopy, and en face images were processed to measure the sebaceous gland area.

RESULTS

In the ultrasound images, sebaceous glands and also thin collagen fibers, which surrounded the glands, could be detected as low-intensity regions. We called them sebaceous units. In young male subjects, the sebaceous unit areas 900-μm beneath the skin surface were larger than those at 700 μm. In contrast, depth-dependent differences in sebaceous unit area were not observed in young female subjects, indicating that males had cauliflower-shaped sebaceous glands while young females had somewhat more cylindrical and smaller sebaceous glands than the young males. Regarding age, the areas of sebaceous units at 900 μm were diminished and the depth of maximum area was shallower in elderly female subjects compared to young female subjects. Hence, sebaceous glands are considered to shrink with age.

CONCLUSION

Differences in facial sebaceous unit morphology between genders as well as by age groups could be observed using high-frequency ultrasound microscopy.

The Structure of Human Sebaceous Glands and Its Relation to Skin Viscoelasticity

High-frequency ultrasound has realized high-resolution observation of deep part of the dermis in vivo. The size of sebaceous glands was evaluated by three-dimensional ultrasound microscopy with the ultrasonic frequency of 120 MHz. The viscoelasticity of the same regions was measured by well-established biomechanical equipment. There was no significant difference between the size of sebaceous glands in cheek and forearm. The skin's ability to recover to its initial position after deformation was significantly higher in forearm than in cheek. Both sizes of sebaceous glands in cheek and forearm were positively correlated with the parameter of viscoelasticity. The size of the sebaceous glands in the deep part of the dermis can be a parameter of skin viscoelasticity. High-frequency ultrasound imaging contributes to the evaluation of human skin morphology as well as functions.

Potential use of OCT-based microangiography in clinical dermatology

BACKGROUND

Optical coherence tomography (OCT) is a revolutionary imaging technique used commonly in ophthalmology, and on the way to become clinically viable alternative in dermatology due to its capability of acquiring histopathology level details of in vivo tissue, non-invasively. In this study, we demonstrate the capabilities of OCT-based microangiography in detecting high resolution, three-dimensional structural, and microvascular features of in vivo human skin with various conditions.

METHODS

A swept-source OCT system that operates on a central wavelength of 1310 nm with an A-line rate of 100 kHz is used in this study. We apply optical microangiography (OMAG) technique to visualize the structural and microvascular changes in tissue.

RESULTS

OMAG images provide detailed visualization of functional microvasculature of healthy human skin from cheek and forehead areas, abnormal skin conditions from face, chest and belly. Moreover, OMAG is capable of monitoring the progress of wound healing on human skin from arm, delivering unprecedented detail of microstructural and microvascular information during longitudinal wound healing process.

CONCLUSION

The presented results promise the clinical use of OCT angiography, aiming to treat prevalent cutaneous diseases, by detecting blood perfusion, and structural changes within human skin, in vivo.

[Methods for measuring skin aging]

Aging affects human skin and is becoming increasingly important with regard to medical, social and aesthetic issues. Detection of intrinsic and extrinsic components of skin aging requires reliable measurement methods. Modern techniques, e.g., based on direct imaging, spectroscopy or skin physiological measurements, provide a broad spectrum of parameters for different applications.

Methods of Melanoma Detection

Detection and removal of melanoma, before it has metastasized, dramatically improves prognosis and survival. The purpose of this chapter is to (1) summarize current methods of melanoma detection and (2) review state-of-the-art detection methods and technologies that have the potential to reduce melanoma mortality. Current strategies for the detection of melanoma range from population-based educational campaigns and screening to the use of algorithm-driven imaging technologies and performance of assays that identify markers of transformation. This chapter will begin by describing state-of-the-art methods for educating and increasing awareness of at-risk individuals and for performing comprehensive screening examinations. Standard and advanced photographic methods designed to improve reliability and reproducibility of the clinical examination will also be reviewed. Devices that magnify and/or enhance malignant features of individual melanocytic lesions (and algorithms that are available to interpret the results obtained from these devices) will be compared and contrasted. In vivo confocal microscopy and other cellular-level in vivo technologies will be compared to traditional tissue biopsy, and the role of a noninvasive "optical biopsy" in the clinical setting will be discussed. Finally, cellular and molecular methods that have been applied to the diagnosis of melanoma, such as comparative genomic hybridization (CGH), fluorescent in situ hybridization (FISH), and quantitative reverse transcriptase polymerase chain reaction (qRT-PCR), will be discussed.

Ultrasound biomicroscopy (UBM) and scanning acoustic microscopy (SAM) for the assessment of hernia mesh integration: a comparison to standard histology in an experimental model

BACKGROUND

Mesh integration is a key parameter for reliable and safe hernia repair. So far, its assessment is based on histology obtained from rare second-look operations or experimental research. Therefore, non-invasive high-resolution imaging techniques would be of great value. Ultrasound biomicroscopy (UBM) and scanning acoustic microscopy (SAM) have shown potential in the imaging of hard and soft tissues. This experimental study compared the detection of mesh integration, foreign body reaction and scar formation in UBM/SAM with standard histology.

MATERIALS AND METHODS

Ten titanized polypropylene meshes were implanted in rats in a model of onlay repair. 17 days postoperative animals were killed and samples were paraffin embedded for histology (H&E, Cresyl violet) or processed for postmortem UBM/SAM. The observation period was uneventful and meshes appeared well integrated.

RESULTS

Relocation of neighboring cross-sectional levels could easily be achieved with the 40-MHz UBM and granulation tissue could be distinguished from adjacent muscle tissue layers. The spatial resolution of approximately 8 μm of the 200-MHz UBM system images was comparable to standard histology (2.5-5× magnification) and allowed a clear identification of mesh fibers and different tissue types, e.g., scar, fat, granulation, and muscle tissues, as well as vessels, abscedations, and foreign body giant cell clusters.

CONCLUSION

This pilot study demonstrates the potential of high-frequency ultrasound to assess hernia mesh integration non-invasively. Although the methods lack cell-specific information, tissue integration could reliably be assessed. The possibility of conducting UBM in vivo advocates this method as a guidance tool for the indication of second-look operations and subsequent elaborate histological analyses.

Relation between morphology of sebaceous glands inside human skin and viscoelastic properties

Three-dimensional ultrasound microscopy with the central frequency of 120 MHz made it possible to observe in vivo sebaceous glands at the deep part of the dermis at microscopic level. The deformation displacements were measured by an established testing device, and the viscoelasticity was estimated from the measured displacements and Voigt model. The occupancy, density or average size of sebaceous glands was compared with the viscoleasticity. There were three major findings in the comparisons. First, the occupancy of sebaceous gland showed negative correlation with the elasticity. Second, the density of sebaceous glands showed positive correlation with the viscosity. Third, the average size of sebaceous glands showed negative correlation with the viscosity. In conclusion, viscoelastic property of human skin is strongly influenced by the morphology of the sebaceous glands.