Acoustic radiation force optical coherence elastography for elasticity assessment of soft tissues

Non-contact elasticity contrast imaging using photon counting

Significance

Tissues' biomechanical properties, such as elasticity, are related to tissue health. Optical coherence elastography produces images of tissues based on their elasticity, but its performance is constrained by the laser power used, working distance, and excitation methods.

Aim

We develop a new method to reconstruct the elasticity contrast image over a long working distance, with only low-intensity illumination, and by non-contact acoustic wave excitation.

Approach

We combine single-photon vibrometry and quantum parametric mode sorting (QPMS) to measure the oscillating backscattered signals at a single-photon level and derive the phantoms' relative elasticity.

Results

We test our system on tissue-mimicking phantoms consisting of contrast sections with different concentrations and thus stiffness. Our results show that as the driving acoustic frequency is swept, the phantoms' vibrational responses are mapped onto the photon-counting histograms from which their mechanical properties-including elasticity-can be derived. Through lateral and longitudinal laser scanning at a fixed frequency, a contrast image based on samples' elasticity can be reliably reconstructed upon photon level signals.

Conclusions

We demonstrated the reliability of QPMS-based elasticity contrast imaging of agar phantoms in a long working distance, low-intensity environment. This technique has the potential for in-depth images of real biological tissue and provides a new approach to elastography research and applications.

In vivo endoscopic optical coherence elastography based on a miniature probe

Optical coherence elastography (OCE) is a functional extension of optical coherence tomography (OCT). It offers high-resolution elasticity assessment with nanoscale tissue displacement sensitivity and high quantification accuracy, promising to enhance diagnostic precision. However, in vivo endoscopic OCE imaging has not been demonstrated yet, which needs to overcome key challenges related to probe miniaturization, high excitation efficiency and speed. This study presents a novel endoscopic OCE system, achieving the first endoscopic OCE imaging in vivo. The system features the smallest integrated OCE probe with an outer diameter of only 0.9 mm (with a 1.2-mm protective tube during imaging). Utilizing a single 38-MHz high-frequency ultrasound transducer, the system induced rapid deformation in tissues with enhanced excitation efficiency. In phantom studies, the OCE quantification results match well with compression testing results, showing the system's high accuracy. The in vivo imaging of the rat vagina demonstrated the system's capability to detect changes in tissue elasticity continually and distinguish between normal tissue, hematomas, and tissue with increased collagen fibers precisely. This research narrows the gap for the clinical implementation of the endoscopic OCE system, offering the potential for the early diagnosis of intraluminal diseases.

Viscoelasticity quantification of cancerous tongue using intraoral optical coherence elastography: a preliminary study

Quantifying the biomechanical properties of the tongue is significant for early diagnosis of tongue carcinoma. Therefore, an intraoral optical coherence elastography system based on a miniature probe was proposed here to evaluate the viscoelasticity of in vivo tongue for the first time. Results of experiments with Sprague-Dawley rats indicate that considerable elasticity diversity occurred between cancerous and normal tongues, and the corresponding ratio of their Young's modulus was evaluated to be 3.74. It is also found that, viscosity in diseased tissue is smaller than that in normal tissue. Additionally, healthy, transitional and cancerous regions in the cancerous tongue can be distinguished easily by calculating viscoelasticity characteristics. Based on this preliminary attempt, our method with advantages of noninvasive, high-resolution, high-sensitivity and real-time detection and convenient operation may have good potential to become a useful tool for tongue carcinoma assessment after further optimization.

Quantitative assessment of corneal elasticity distribution after FS-LASIK using optical coherence elastography

Quantifying corneal elasticity after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) procedure plays an important role in improving surgical safety and quality, since some latent complications may occur ascribing to changes in postoperative corneal biomechanics. Nevertheless, it is suggested that current research has been severely constrained due to the lack of an accurate quantification method to obtain postoperative corneal elasticity distribution. In this paper, an acoustic radiation force optical coherence elastography system combined with the improved phase velocity algorithm was utilized to realize elasticity distribution images of the in vivo rabbit cornea after FS-LASIK under various intraocular pressure levels. As a result, elasticity variations within and between the regions of interest could be identified precisely. This is the first time that elasticity imaging of in vivo cornea after FS-LASIK surgery was demonstrated, and the results suggested that this technology may hold promise in further exploring corneal biomechanical properties after refractive surgery.

Noncontact longitudinal shear wave imaging for the evaluation of heterogeneous porcine brain biomechanical properties using optical coherence elastography

High-resolution quantification of heterogeneous brain biomechanical properties has long been an important topic. Longitudinal shear waves (LSWs) can be used to assess the longitudinal Young's modulus, but contact excitation methods have been used in most previous studies. We propose an air-coupled ultrasound transducer-based optical coherence elastography (AcUT-OCE) technique for noncontact excitation and detection of LSWs in samples and assessment of the nonuniformity of the brain's biomechanical properties. The air-coupled ultrasonic transducer (AcUT) for noncontact excitation of LSWs in the sample has a center frequency of 250 kHz. Phase-resolved Doppler optical coherence tomography (OCT) was used to image and reconstruct the propagation behavior of LSWs and surface ultrasound waves at high resolution. An agar phantom model was used to verify the feasibility of the experimental protocol, and experiments with ex vivo porcine brain samples were used to assess the nonuniformity of the brain biomechanical properties. LSWs with velocities of 0.83 ± 0.11 m/s were successfully excited in the agar phantom model. The perivascular elastography results in the prefrontal cortex (PFC) of the ex vivo porcine brains showed that the Young's modulus was significantly higher in the longitudinal and transverse directions on the left side of the cerebral vessels than on the right side and that the Young's modulus of the PFC decreased with increasing depth. The AcUT-OCE technique, as a new scheme for LSW applications in in vivo elastography, can be used for noncontact excitation of LSWs in brain tissue and high-resolution detection of heterogeneous brain biomechanical properties.

Real-Time Nondestructive Viscosity Measurement of Soft Tissue Based on Viscoelastic Response Optical Coherence Elastography

Viscoelasticity of the soft tissue is an important mechanical factor for disease diagnosis, biomaterials testing and fabrication. Here, we present a real-time and high-resolution viscoelastic response-optical coherence elastography (VisR-OCE) method based on acoustic radiation force (ARF) excitation and optical coherence tomography (OCT) imaging. The relationship between displacements induced by two sequential ARF loading-unloading and the relaxation time constant of the soft tissue-is established for the Kelvin-Voigt material. Through numerical simulation, the optimal experimental parameters are determined, and the influences of material parameters are evaluated. Virtual experimental results show that there is less than 4% fluctuation in the relaxation time constant values obtained when various Young's modulus and Poisson's ratios were given for simulation. The accuracy of the VisR-OCE method was validated by comparing with the tensile test. The relaxation time constant of phantoms measured by VisR-OCE differs from the tensile test result by about 3%. The proposed VisR-OCE method may provide an effective tool for quick and nondestructive viscosity testing of biological tissues.

Quantitative Evaluation of In Vivo Corneal Biomechanical Properties after SMILE and FLEx Surgery by Acoustic Radiation Force Optical Coherence Elastography

The purpose of this study is to quantitatively evaluate the differences in corneal biomechanics after SMILE and FLEx surgery using an acoustic radiation force optical coherence elastography system (ARF-OCE) and to analyze the effect of the corneal cap on the integrity of corneal biomechanical properties. A custom ring array ultrasound transducer is used to excite corneal tissue to produce Lamb waves. Depth-resolved elastic modulus images of the in vivo cornea after refractive surgery were obtained based on the phase velocity of the Lamb wave. After refractive surgery, the average elastic modulus of the corneal flap decreased (71.7 ± 24.6 kPa), while the elastic modulus of the corneal cap increased (219.5 ± 54.9 kPa). The average elastic modulus of residual stromal bed (RSB) was increased after surgery, and the value after FLEx (305.8 ± 48.5 kPa) was significantly higher than that of SMILE (221.3 ± 43.2 kPa). Compared with FLEx, SMILE preserved most of the anterior stroma with less change in corneal biomechanics, which indicated that SMILE has an advantage in preserving the integrity of the corneal biomechanical properties. Therefore, the biomechanical properties of the cornea obtained by the ARF-OCE system may be one of the essential indicators for evaluating the safety of refractive surgery.

Nondestructive testing of native and tissue-engineered medical products: adding numbers to pictures

Traditional destructive tests are used for quality assurance and control within manufacturing workflows. Their applicability to biomanufacturing is limited due to inherent constraints of the biomanufacturing process. To address this, photo- and acoustic-based nondestructive testing has risen in prominence to interrogate not only structure and function, but also to integrate quantitative measurements of biochemical composition to cross-correlate structural, compositional, and functional variances. We survey relevant literature related to single-mode and multimodal nondestructive testing of soft tissues, which adds numbers (quantitative measurements) to pictures (qualitative data). Native and tissue-engineered articular cartilage is highlighted because active biomanufacturing processes are being developed. Included are recent efforts and prominent trends focused on technologies for clinical and in-process biomanufacturing applications.

Wave-based optical coherence elastography: The 10-year perspective

After 10 years of progress and innovation, optical coherence elastography (OCE) based on the propagation of mechanical waves has become one of the major and the most studied OCE branches, producing a fundamental impact in the quantitative and nondestructive biomechanical characterization of tissues. Preceding previous progress made in ultrasound and magnetic resonance elastography; wave-based OCE has pushed to the limit the advance of three major pillars: (1) implementation of novel wave excitation methods in tissues, (2) understanding new types of mechanical waves in complex boundary conditions by proposing advance analytical and numerical models, and (3) the development of novel estimators capable of retrieving quantitative 2D/3D biomechanical information of tissues. This remarkable progress promoted a major advance in answering basic science questions and the improvement of medical disease diagnosis and treatment monitoring in several types of tissues leading, ultimately, to the first attempts of clinical trials and translational research aiming to have wave-based OCE working in clinical environments. This paper summarizes the fundamental up-to-date principles and categories of wave-based OCE, revises the timeline and the state-of-the-art techniques and applications lying in those categories, and concludes with a discussion on the current challenges and future directions, including clinical translation research.

Quantification of biomechanical properties of human corneal scar using acoustic radiation force optical coherence elastography

Biomechanical properties of corneal scar are strongly correlated with many corneal diseases and some types of corneal surgery, however, there is no elasticity information available about corneal scar to date. Here, we proposed an acoustic radiation force optical coherence elastography system to evaluate corneal scar elasticity. Elasticity quantification was first conducted on ex vivo rabbit corneas, and the results validate the efficacy of our system. Then, experiments were performed on an ex vivo human scarred cornea, where the structural features, the elastic wave propagations, and the corresponding Young's modulus of both the scarred region and the normal region were achieved and based on this, 2D spatial distribution of Young's modulus of the scarred cornea was depicted. Up to our knowledge, we realized the first elasticity quantification of corneal scar, which may provide a potent tool to promote clinical research on the disorders and surgery of the cornea.

In vivo non-contact measurement of human iris elasticity by optical coherence elastography

Quantifying the mechanical properties of the iris can offer valuable insights into the pathophysiology of primary angle closure glaucoma. However, current techniques for iris elastography remain ex vivo with limited clinical applications. This article describes a proposition for a non-contact and non-invasive air-puff optical coherence elastography (OCE) system that can evaluate iris elasticity in vivo. Ten eyes recruited from seven subjects underwent OCE imaging acquisition under three different illumination conditions. The Young's modulus of each eye was detected and shown to be inversely proportional to the iris length, indicating a relationship between mechanical properties and morphology of the iris. With its noninvasive and high-resolution features, this air-puff system shows great potential for applications in clinical ophthalmology.

An Intraocular Pressure Measurement Technique Based on Acoustic Radiation Force Using an Ultrasound Transducer: A Feasibility Study

High intraocular pressure (IOP) is one of the major risk factors for glaucoma, and thus accurate IOP measurements should be performed to diagnose and treat glaucoma early. In this study, a novel technique for measuring the IOP based on acoustic radiation force was proposed, and its potential was experimentally demonstrated. The proposed technique uses the acoustic radiation force to generate axial displacement on the ocular surface while simultaneously measuring the degree of deformation. In order to verify that the ocular displacement induced by the acoustic radiation force is related to the IOP, the experiment was conducted by fabricating a 5 MHz single element transducer and gelatin phantoms with different stiffness values. Our experimental results show that there is a close relationship between the ocular displacement by the acoustic radiation force and the IOP obtained by a commercial tonometer. Therefore, the proposed acoustic radiation force technique can be a promising candidate for measuring the IOP.

Quantification of iris elasticity using acoustic radiation force optical coherence elastography

Careful quantification of the changes in biomechanical properties of the iris can offer insight into the pathophysiology of some ocular diseases. However, to date there has not been much information available regarding this subject because clinical detection for iris elasticity remains challenging. To overcome this limitation, we explore, for the first time to our knowledge, the potential of measuring iris elasticity using acoustic radiation force optical coherence elastography (ARF-OCE). The resulting images and shear wave propagation, as well as the corresponding shear modulus and Young's modulus from ex vivo and in vivo rabbit models confirmed the feasibility of this method. With features of noninvasive imaging, micrometer-scale resolution, high acquisition speed and real-time processing, ARF-OCE is a promising method for reconstruction of iris elasticity and may have great potential to be applied in clinical ophthalmology with further refinement.

Four-dimensional (4D) phase velocity optical coherence elastography in heterogeneous materials and biological tissue

The variations of mechanical properties in soft tissues are biomarkers used for clinical diagnosis and disease monitoring. Optical coherence elastography (OCE) has been extensively developed to investigate mechanical properties of various biological tissues. These methods are generally based on time-domain data and measure the time-of-flight of the localized shear wave propagations to estimate the group velocity. However, there is considerable information that can be obtained from examining the mechanical properties such as wave propagation velocities at different frequencies. Here we propose a method to evaluate phase velocity, wave velocity at various frequencies, in four-dimensional space (x, y, z, f), called 4D-OCE phase velocity. The method enables local estimates of the phase velocity of propagating mechanical waves in a medium. We acquired and analyzed data with this method from a homogeneous reference phantom, a heterogeneous phantom material with four different excitation cases, and ex vivo porcine kidney tissue. The 3D-OCE group velocity was also estimated to compare with 4D-OCE phase velocity. Moreover, we performed numerical simulation of wave propagations to illustrate the boundary behavior of the propagating waves. The proposed 4D-OCE phase velocity is capable of providing further information in OCE to better understand the spatial variation of mechanical properties of various biological tissues with respect to frequency.

Advances in Doppler optical coherence tomography and angiography

Since the first demonstration of Doppler optical coherence tomography (OCT) in 1997, several functional extensions of Doppler OCT have been developed, including velocimetry, angiogram, and optical coherence elastography. These functional techniques have been widely used in research and clinical applications, particularly in ophthalmology. Here, we review the principles, representative methods, and applications of different Doppler OCT techniques, followed by discussion on the innovations, limitations, and future directions of each of these techniques.

Simultaneously imaging and quantifying in vivo mechanical properties of crystalline lens and cornea using optical coherence elastography with acoustic radiation force excitation

The crystalline lens and cornea comprise the eye's optical system for focusing light in human vision. The changes in biomechanical properties of the lens and cornea are closely associated with common diseases, including presbyopia and cataract. Currently, most in vivo elasticity studies of the anterior eye focus on the measurement of the cornea, while lens measurement remains challenging. To better understand the anterior segment of the eye, we developed an optical coherence elastography system utilizing acoustic radiation force excitation to simultaneously assess the elasticities of the crystalline lens and the cornea in vivo. A swept light source was integrated into the system to provide an enhanced imaging range that covers both the lens and the cornea. Additionally, the oblique imaging approach combined with orthogonal excitation also improved the image quality. The system was tested through first ex vivo and then in vivo experiments using a rabbit model. The elasticities of corneal and lens tissue in an excised normal whole-globe and a cold cataract model were measured to reveal that cataractous lenses have a higher Young's modulus. Simultaneous in vivo elasticity measurements of the lens and cornea were performed in a rabbit model to demonstrate the correlations between elasticity and intraocular pressure and between elasticity and age. To the best of our knowledge, we demonstrated the first in vivo elasticity of imaging of both the lens and cornea using acoustic radiation force-optical coherence elastography, thereby providing a potential powerful clinical tool to advance ophthalmic research in disorders affecting the lens and the cornea.