Development and characterization of a vitreous mimicking material for radiation force imaging

Integrating a Fundus Camera with High-Frequency Ultrasound for Precise Ocular Lesion Assessment

Ultrasound A-scan is an important tool for quantitative assessment of ocular lesions. However, its usability is limited by the difficulty of accurately localizing the ultrasound probe to a lesion of interest. In this study, a transparent LiNbO3 single crystal ultrasound transducer was fabricated, and integrated with a widefield fundus camera to guide the ultrasound local position. The electrical impedance, phase spectrum, pulse-echo performance, and optical transmission spectrum of the ultrasound transducer were validated. The novel fundus camera-guided ultrasound probe was tested for in vivo measurement of rat eyes. Anterior and posterior segments of the rat eye could be unambiguously differentiated with the fundus photography-guided ultrasound measurement. A model eye was also used to verify the imaging performance of the prototype device in the human eye. The prototype shows the potential of being used in the clinic to accurately measure the thickness and echogenicity of ocular lesions in vivo.

Deformable mapping technique to correlate lesions in digital breast tomosynthesis and automated breast ultrasound images

PURPOSE

To develop a deformable mapping technique to match corresponding lesions between digital breast tomosynthesis (DBT) and automated breast ultrasound (ABUS) images.

METHODS

External fiducial markers were attached to the surface of two CIRS multi-modality compressible breast phantoms (A and B) containing multiple simulated lesions. Both phantoms were imaged with DBT (upright positioning with cranial-caudal compression) and ABUS (supine positioning with anterior-to-chest wall compression). The lesions and markers were manually segmented by three different readers. Reader segmentation similarity and reader reproducibility were assessed using Dice similarity coefficients (DSC) and distances between centers of mass (d_COM ). For deformable mapping between the modalities each reader's segmented dataset was processed with an automated deformable mapping algorithm as follows: First, Morfeus, a finite element (FE) based multi-organ deformable image registration platform, converted segmentations into triangular surface meshes. Second, Altair HyperMesh, a FE pre-processor, created base FE models for the ABUS and DBT data sets. All deformation is performed on the DBT image data; the ABUS image sets remain fixed throughout the process. Deformation was performed on the external skin contour (DBT image set) to match the external skin contour on the ABUS set, and the locations of the external markers were used to morph the skin contours to be within a user-defined distance. Third, the base DBT-FE model was deformed with the FE analysis solver, Optistruct. Deformed DBT lesions were correlated with matching lesions in the base ABUS FE model. Performance (lesion correlation) was assessed with d_COM for all corresponding lesions and lesion overlap. Analysis was performed to determine the minimum number of external fiducial markers needed to create the desired correlation and the improvement of correlation with the use of external markers.

RESULTS

Average DSC for reader similarity ranged from 0.88 to 0.91 (ABUS) and 0.57 to 0.83 (DBT). Corresponding d_COM ranged from 0.20 to 0.36 mm (ABUS) and 0.11 to 1.16 mm (DBT). Lesion correlation is maximized when all corresponding markers are within a maximum distance of 5 mm. For deformable mapping of phantom A, without the use of external markers, only two of six correlated lesions showed overlap with an average lesion d_COM of 6.8 ± 2.8 mm. With use of three external fiducial markers, five of six lesions overlapped and average d_COM improved to 4.9 ± 2.4 mm. For deformable mapping of Phantom B without external markers analysis, four lesions were correlated of seven with overlap between only one of seven lesions, and an average lesion d_COM of 9.7 ± 3.5 mm. With three external markers, all seven possible lesions were correlated with overlap between four of seven lesions. The average d_COM was 8.5 ± 4.0 mm.

CONCLUSION

This work demonstrates the potential for a deformable mapping technique to relate corresponding lesions in DBT and ABUS images by showing improved lesion correspondence and reduced lesion registration errors with the use of external fiducial markers. The technique should improve radiologists' characterization of breast lesions which can reduce patient callbacks, misdiagnoses and unnecessary biopsies.

Development of a training phantom for compression breast elastography-comparison of various elastography systems and numerical simulations

The elastic properties of tissue are related to tissue composition and pathological changes. It has been observed that many pathological processes increase the elastic modulus of soft tissue compared to normal. Ultrasound compression elastography is a method of characterization of elastic properties that has been the focus of many research efforts in the last two decades. In medical radiology, compression elastography is provided as an additional tool with ultrasound B-mode in the existing scanners, and the combined features of elastography and echography act as a promising diagnostic method in breast cancer detection. However, the full capability of the ultrasound elastography technique together with B-mode has not been utilized by novice radiologists due to the nonavailability of suitable, appropriately designed tissue-mimicking phantoms. Since different commercially available ultrasound elastographic scanners follow their own unique protocols, training novice radiologists is becoming cumbersome. The main focus of this work is to develop a tissue-like agar-based phantom, which mimics breast tissue with common abnormal lesions like fibroadenoma and invasive ductal carcinoma in a clinically perceived way and compares the sonographic and elastographic appearances using different commercially available systems. In addition, the developed phantoms are simulated using the finite-element method, and ideal strain images are generated. Strain images from experiment and simulation are compared based on image contrast parameters, namely contrast transfer efficiency (CTE) and observed strain, and they are in good agreement. The strain image contrast of malignant inclusions is significantly improved compared to benign inclusions, and the trend of CTE is similar for all elastographic scanners under investigation.

Integration of acoustic radiation force and optical imaging for blood plasma clot stiffness measurement

Despite the life-preserving function blood clotting serves in the body, inadequate or excessive blood clot stiffness has been associated with life-threatening diseases such as stroke, hemorrhage, and heart attack. The relationship between blood clot stiffness and vascular diseases underscores the importance of quantifying the magnitude and kinetics of blood's transformation from a fluid to a viscoelastic solid. To measure blood plasma clot stiffness, we have developed a method that uses ultrasound acoustic radiation force (ARF) to induce micron-scaled displacements (1-500 μm) on microbeads suspended in blood plasma. The displacements were detected by optical microscopy and took place within a micro-liter sized clot region formed within a larger volume (2 mL sample) to minimize container surface effects. Modulation of the ultrasound generated acoustic radiation force allowed stiffness measurements to be made in blood plasma from before its gel point to the stage where it was a fully developed viscoelastic solid. A 0.5 wt % agarose hydrogel was 9.8-fold stiffer than the plasma (platelet-rich) clot at 1 h post-kaolin stimulus. The acoustic radiation force microbead method was sensitive to the presence of platelets and strength of coagulation stimulus. Platelet depletion reduced clot stiffness 6.9 fold relative to platelet rich plasma. The sensitivity of acoustic radiation force based stiffness assessment may allow for studying platelet regulation of both incipient and mature clot mechanical properties.

Acoustical characterization of polysaccharide polymers tissue-mimicking materials

Tissue-mimicking phantoms play a crucial role in medical ultrasound research because they can simulate biological soft tissues. In last years, many types of polymeric tissues have been proposed and characterized from an acoustical and a thermal point of view, but, rarely, a deep discussion about the quality of the measurements, in terms of the uncertainty evaluation, has been reported. In this work, considering the necessity to develop laboratory standards for the measurement of ultrasonic exposure and dose quantities, a detailed description of the experimental apparatuses for the sound speed and the attenuation coefficient measurements is given, focusing the attention on the uncertainty evaluation both of the results and analysis algorithms. In particular, this algorithm reveals a novel empirical relation, fixing a limit to the energy content (therefore limits the number of cycles) of the three parts in which the authors have proposed to divide the acoustical signal. Furthermore, the realisation of multi-components phantoms, Agar and Phytagel based tissue-mimicking gels along with others long chain molecules (dextrane or polyvinyl alcohol) and scattering materials (silicon carbide and kieselguhr) are investigated. This paper reports accurate speed of sound and attenuation coefficient measurements. Speed of sound is measured by a pulse-echo technique in far-field condition, using an optical glass buffer rod; while attenuation coefficient is determined by an insertion technique, using demineralized water as reference material. The experimental sound speed results are subjected to an overall estimated relative uncertainty of about 1.5% and the attenuation coefficient uncertainty is less than 2.5%. For the development of laboratory standards, a detailed analysis of the measurement uncertainty is fundamental to make sample properties comparable. The authors believe this study could represent the right direction to make phantoms characterizations referable and traceable.

Study of ultrasound stiffness imaging methods using tissue mimicking phantoms

A pilot study was carried out to investigate the performance of ultrasound stiffness imaging methods namely Ultrasound Elastography Imaging (UEI) and Acoustic Radiation Force Impulse (ARFI) Imaging. Specifically their potential for characterizing different classes of solid mass lesions was analyzed using agar based tissue mimicking phantoms. Composite tissue mimicking phantom was prepared with embedded inclusions of varying stiffness from 50 kPa to 450 kPa to represent different stages of cancer. Acoustic properties such as sound speed, attenuation coefficient and acoustic impedance were characterized by pulse echo ultrasound test at 5 MHz frequency and they are ranged from (1564 ± 88 to 1671 ± 124 m/s), (0.6915 ± 0.123 to 0.8268 ± 0.755 db cm(-1)MHz(-1)) and (1.61 × 10(6) ± 0.127 to 1.76 × 10(6) ± 0.045 kg m(-2)s(-1)) respectively. The elastic property Young's Modulus of the prepared samples was measured by conducting quasi static uni axial compression test under a strain rate of 0.5mm/min upto 10 % strain, and the values are from 50 kPa to 450 kPa for a variation of agar concentration from 1.7% to 6.6% by weight. The composite phantoms were imaged by Siemens Acuson S2000 (Siemens, Erlangen, Germany) machine using linear array transducer 9L4 at 8 MHz frequency; strain and displacement images were collected by UEI and ARFI. Shear wave velocity 4.43 ± 0.35 m/s was also measured for high modulus contrast (18 dB) inclusion and X.XX m/s was found for all other inclusions. The images were pre processed and parameters such as Contrast Transfer Efficiency and lateral image profile were computed and reported. The results indicate that both ARFI and UEI represent the abnormalities better than conventional US B mode imaging whereas UEI enhances the underlying modulus contrast into improved strain contrast. The results are corroborated with literature and also with clinical patient images.

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.

Tissue-mimicking bladder wall phantoms for evaluating acoustic radiation force-optical coherence elastography systems

PURPOSE

Acoustic radiation force-optical coherence elastography (ARF-OCE) systems are novel imaging systems that have the potential to simultaneously quantify and characterize the optical and mechanical properties of in vivo tissues. This article presents the construction of bladder wall phantoms for use in ARF-OCE systems. Mechanical, acoustic, and optical properties are reported and compared to published values for the urinary bladder.

METHODS

The phantom consisted of 0.2000 +/- 0.0089 and 6.0000 +/- 0.2830 microm polystyrene microspheres (Polysciences Inc., Warrington, PA, Catalog Nos. 07304 and 07312), 7.5 +/- 1.5 microm copolymer microspheres composed of acrylonitrile and vinylidene chloride, (Expancel, Duluth, GA, Catalog No. 461 DU 20), and bovine serum albumin within a gelatin matrix. Young's modulus was measured by successive compression of the phantom and obtaining the slope of the resulting force-displacement data. Acoustic measurements were performed using the transmission method. The phantoms were submerged in a water bath and placed between transmitting and receiving 13 mm diameter unfocused transducers operating at a frequency of 3.5 MHz. A MATLAB algorithm to extract the optical scattering coefficient from optical coherence tomography (OCT) images of the phantom was used.

RESULTS

The phantoms possess a Young's modulus of 17.12 +/- 2.72 kPa, a mass density of 1.05 +/- 0.02 g/cm3, an acoustic attenuation coefficient of 0.66 +/- 0.08 dB/cm/MHz, a speed of sound of 1591 +/- 8.76 m/s, and an optical scattering coefficient of 1.80 +/- 0.23 mm(-1). Ultrasound and OCT images of the bladder wall phantom are presented.

CONCLUSIONS

A material that mimics the mechanical, optical, and acoustic properties of healthy bladder wall has been developed. This tissue-mimicking bladder wall phantom was developed as a control tool to investigate the feasibility of using ARF-OCE to detect the mechanical and optical changes that may be indicative of the onset or development of cancer in the urinary bladder. By following the methods used in this article, phantoms matching the optical, acoustic, and mechanical properties of other biological tissues can also be constructed.

Copolymer-in-oil phantom materials for elastography

Phantoms that mimic mechanical and acoustic properties of soft biological tissues are essential to elasticity imaging investigation and to elastography device characterization. Several materials including agar/gelatin, polyvinyl alcohol and polyacrylamide gels have been used successfully in the past to produce tissue phantoms, as reported in the literature. However, it is difficult to find a phantom material with a wide range of stiffness, good stability over time and high resistance to rupture. We aim at developing and testing a new copolymer-in-oil phantom material for elastography. The phantom is composed of a mixture of copolymer, mineral oil and additives for acoustic scattering. The mechanical properties of phantoms were evaluated with a mechanical test instrument and an ultrasound-based elastography technique. The acoustic properties were investigated using a through-transmission water-substituting method. We showed that copolymer-in-oil phantoms are stable over time. Their mechanical and acoustic properties mimic those of most soft tissues: the Young's modulus ranges from 2.2-150 kPa, the attenuation coefficient from 0.4-4.0 dB.cm(-1) and the ultrasound speed from 1420-1464 m/s. Their density is equal to 0.90 +/- 0.04 g/cm3. The results suggest that copolymer-in-oil phantoms are attractive materials for elastography.

Vibro-acoustography imaging of permanent prostate brachytherapy seeds in an excised human prostate--preliminary results and technical feasibility

OBJECTIVE

The objective in this work is to investigate the feasibility of using a new imaging tool called vibro-acoustography (VA) as a means of permanent prostate brachytherapy (PPB) seed localization to facilitate post-implant dosimetry (PID).

METHODS AND MATERIALS

Twelve OncoSeed (standard) and eleven EchoSeed (echogenic) dummy seeds were implanted in a human cadaver prostate. Seventeen seeds remained after radical retropubic prostatectomy. VA imaging was conducted on the prostate that was cast in a gel phantom and placed in a tank of degassed water. 2-D magnitude and phase VA image slices were obtained at different depths within the prostate showing location and orientation of the seeds.

RESULTS

VA demonstrates that twelve of seventeen (71%) seeds implanted were visible in the VA image, and the remainder were obscured by intra-prostatic calcifications. Moreover, it is shown here that VA is capable of imaging and locating PPB seeds within the prostate independent of seed orientation, and the resulting images are speckle free.

CONCLUSION

The results presented in this research show that VA allows seed detection within a human prostate regardless of their orientation, as well as imaging intra-prostatic calcifications.

MUlti-Dimensional Spline-Based Estimator (MUSE) for motion estimation: algorithm development and initial results

Image registration and motion estimation play central roles in many fields, including RADAR, SONAR, light microscopy, and medical imaging. Because of its central significance, estimator accuracy, precision, and computational cost are of critical importance. We have previously presented a highly accurate, spline-based time delay estimator that directly determines sub-sample time delay estimates from sampled data. The algorithm uses cubic splines to produce a continuous representation of a reference signal and then computes an analytical matching function between this reference and a delayed signal. The location of the minima of this function yields estimates of the time delay. In this paper we describe the MUlti-dimensional Spline-based Estimator (MUSE) that allows accurate and precise estimation of multi-dimensional displacements/strain components from multi-dimensional data sets. We describe the mathematical formulation for two- and three-dimensional motion/strain estimation and present simulation results to assess the intrinsic bias and standard deviation of this algorithm and compare it to currently available multi-dimensional estimators. In 1000 noise-free simulations of ultrasound data we found that 2D MUSE exhibits maximum bias of 2.6 x 10(-4) samples in range and 2.2 x 10(-3) samples in azimuth (corresponding to 4.8 and 297 nm, respectively). The maximum simulated standard deviation of estimates in both dimensions was comparable at roughly 2.8 x 10(-3) samples (corresponding to 54 nm axially and 378 nm laterally). These results are between two and three orders of magnitude better than currently used 2D tracking methods. Simulation of performance in 3D yielded similar results to those observed in 2D. We also present experimental results obtained using 2D MUSE on data acquired by an Ultrasonix Sonix RP imaging system with an L14-5/38 linear array transducer operating at 6.6 MHz. While our validation of the algorithm was performed using ultrasound data, MUSE is broadly applicable across imaging applications.

Motion of a solid sphere in a viscoelastic medium in response to applied acoustic radiation force: Theoretical analysis and experimental verification

The motion of a rigid sphere in a viscoelastic medium in response to an acoustic radiation force of short duration was investigated. Theoretical and numerical studies were carried out first. To verify the developed model, experiments were performed using rigid spheres of various diameters and densities embedded into tissue-like, gel-based phantoms of varying mechanical properties. A 1.5 MHz, single-element, focused transducer was used to apply the desired radiation force. Another single-element, focused transducer operating at 25 MHz was used to track the displacements of the sphere. The results of this study demonstrate good agreement between theoretical predictions and experimental measurements. The developed theoretical model accurately describes the displacement of the solid spheres in a viscoelastic medium in response to the acoustic radiation force.

3D prostate elastography: algorithm, simulations and experiments

A multi-resolution hybrid strain estimator is presented. The estimator is locally initialized by the B-mode tracking stage. Nonlinear and linear stretching regimes are applied in successive RF tracking stages for refining the estimated axial and lateral displacements. A staggering operator is used to derive the strain images from the reconstructed axial displacements. Simulations and experiments, conducted at a center frequency of 12 MHz, 40% fractional bandwidth, on a 128 element transducer with 0.2 mm pitch, with elastographic window length of 2 mm and overlap of 90%, demonstrate a 3-6 dB improvement in the elastographic contrast-to-noise ratio over the results obtained using conventional multi-stage stretching based strain estimators. The average image cross-correlation coefficient obtained using the proposed algorithm was improved by 6-8%. 3D elastographic simulations conducted to study the performance of a 3D elastographic imaging framework predict achievable axial and lateral resolutions of approximately five and ten wavelengths, respectively. A close correspondence between inclusions reconstructed from experimental elastograms and the known physical shape of actual 3D inclusions demonstrates the potential application of 3D elastography for identifying and classifying the detected lesions (invisible in sonograms) on the basis of their shape.

Free-hand ultrasound scanning approaches for volume quantification of the mouse heart Left ventricle

Two approaches for free-hand motion tracking that enable volumetric quantification of the murine heart were investigated. One approach used an instrumented, multijointed articulated arm attached to a 14 MHz ultrasound transducer array. A second approach used an E-beam transducer--a modified linear transducer array containing a main imaging array adjacent to three perpendicular tracking arrays. Motion between successive B-mode image frames was computed by tracking image speckle in each tracking array. Both tracking systems produced accurate results in a phantom validation study (4.50% error and 3.75% error for estimates derived using the articulated arm and E-beam tracking techniques, respectively). The tracking approaches also were tested in vivo on three mice. Results were compared to values obtained by mounting each mouse on a micromanipulator, adjusting its position by 0.5-mm increments, and acquiring B-mode images using a high-resolution ultrasound scanner. Left ventricular end diastolic volume (LVEDV) estimates differed from values obtained using the high-resolution scanner by a mean error of 18.2% and 2.60% for eight scans conducted on each of two mice using the articulated arm, and a mean error of 13.6%, 6.53%, and 12.58% for eight scans conducted on each of three mice using the E-beam.

Estimating localized oscillatory tissue motion for assessment of the underlying mechanical modulus

The technique of harmonic motion imaging (HMI) uses the localized stimulus of the oscillatory ultrasonic radiation force as produced by two overlapping beams of distinct frequencies, and estimates the resulting harmonic displacement in the tissue in order to assess its underlying mechanical properties. In this paper, we studied the relationship between measured displacement and stiffness in gels and tissues in vitro. Two focused ultrasound transducers with a 100 mm focal length were used at frequencies of 3.7500 MHz and either 3.7502 (or 3.7508 MHz), respectively, in order to produce an oscillatory motion at 200 Hz in the gel or tissue. A 1.1 MHz diagnostic transducer (Imasonics, Inc.) was also focused at 100 mm and acquired 5 ms RF signals (pulse repetition frequency (PRF)=3.5 kHz) at 100 MHz sampling frequency during radiation force application. First, three 50x50 mm(2) acrylamide gels were prepared at concentrations of 4%, 8% and 16%. The resulting displacement was estimated using crosscorrelation techniques between successively acquired RF signals with a 2 mm window and 80% window overlap at 1260 W/cm(2). A normal 1-D indentation instrument (TeMPeST) applied oscillatory loads at 0.1-200 Hz with a 5 mm-diameter flat indenter. Then, 12 displacement measurements in 6 porcine muscle specimens (two measurements/case, as above) were made in vitro, before and after ablation which was performed for 10 s at 1260 W/cm(2). In all gel cases, the harmonic displacement was found to linearly increase with intensity and exponentially decrease with gel concentration. The TeMPeST measurements showed that the elastic moduli for the 4%, 8% and 16% gels equaled 3.93+/-0.06, 17.1+/-0.2 and 75+/-2 kPa, respectively, demonstrating that the HMI displacement estimate depends directly on the gel stiffness. Finally, in the tissues samples, the mean displacement amplitude showed a twofold decrease between non-ablated and ablated tissue, demonstrating a correspondence between the HMI response and an increase in stiffness measured with the TeMPeST instrument.

Detection of lesions using differential rates of speckle decorrelation

Breast lesions that may be cancerous generally possess a higher elastic modulus than the surrounding tissue. Thus, they are sensed to move differently from the surrounding tissue during finger-based palpation. Since the palpation is subjective in nature, a method using ultrasound for detection of the differential motion associated with hard lesions is proposed. It is intended that regions of detected 'lump' be highlighted on top of a conventional B-mode image so that the user can positively associate palpated lumps with specific regions on the anatomical B-mode image. We detect the differential motion associated with a lesion by detecting a local abnormality in a map of image-to-image correlations as the transducer is swept in an elevational direction. Experiments were performed with three different tissue mimicking phantoms. The results indicate that the location of the mobile lesion can be successfully estimated whereas immobile lesions are not very detectable. This approach is simple and requires only a short period of time for each scan. It has practically no theoretical incremental cost.

Radiation force imaging of viscoelastic properties with reduced artifacts

It is well-known that changes in the mechanical properties of tissues are correlated with the presence of disease. In the eye, for example, the vitreous body undergoes dramatic changes in mechanical properties during age-related degradation. These changes may play a significant role in the formation of retinal detachment or other vitreoretinal diseases. We previously presented a noninvasive method called kinetic acoustic vitreoretial examination (KAVE), which may be used to detect these mechanical changes. KAVE uses acoustic radiation force as a means to produce small, localized displacements within the tissues. Returning echoes are processed using ultrasonic motion tracking so that the response of the tissue to the induced force can be evaluated. By repeating this process at a number of locations, images depicting viscoelastic properties of tissues can be formed. Through the combination of appropriate mechanical modeling and signal processing, we are able to generate images of parameters such as relative mass, relative elasticity, and relative viscosity. These parameters are called relative because they depend on the force applied, which is typically unknown. In this paper, we present new force-free images depicting the time constant tau, the damping ratio xi, and the natural frequency omega of the phantom material. These images are significant in that they lack the artifacts common in the relative property images. Experiments were conducted on a set of three acrylamide-based phantoms with varying gel concentrations. We present images depicting B-mode echogenicity, maximum radiation force-induced displacement, relative material parameters, and force-free characteristics of the series of phantoms. The presented force-free images depict mechanical properties without artifacts from local force variation due to acoustic reflection, refraction, and attenuation. Force-free images should prove particularly useful for in vivo imaging through inhomogeneous tissues.