Assessing and improving acoustic radiation force image quality using a 1.5-D transducer design

Compound Acoustic Radiation Force Impulse Imaging of Bovine Eye by Using Phase-Inverted Ultrasound Transducer

In general, it is difficult to visualize internal ocular structure and detect a lesion such as a cataract or glaucoma using the current ultrasound brightness-mode (B-mode) imaging. This is because the internal structure of the eye is rich in moisture, resulting in a lack of contrast between tissues in the B-mode image, and the penetration depth is low due to the attenuation of the ultrasound wave. In this study, the entire internal ocular structure of a bovine eye was visualized in an ex vivo environment using the compound acoustic radiation force impulse (CARFI) imaging scheme based on the phase-inverted ultrasound transducer (PIUT). In the proposed method, the aperture of the PIUT is divided into four sections, and the PIUT is driven by the out-of-phase input signal capable of generating split-focusing at the same time. Subsequently, the compound imaging technique was employed to increase signal-to-noise ratio (SNR) and to reduce displacement error. The experimental results demonstrated that the proposed technique could provide an acoustic radiation force impulse (ARFI) image of the bovine eye with a broader depth-of-field (DOF) and about 80% increased SNR compared to the conventional ARFI image obtained using the in-phase input signal. Therefore, the proposed technique can be one of the useful techniques capable of providing the image of the entire ocular structure to diagnose various eye diseases.

Displacement Imaging During Focused Ultrasound Median Nerve Modulation: A Preliminary Study in Human Pain Sensation Mitigation

Focused ultrasound (FUS)-based viscoelastic imaging techniques using high frame rate (HFR) ultrasound to track tissue displacement can be used for mechanistic monitoring of FUS neuromodulation. However, a majority of techniques avoid imaging during the active push transmit (interleaved or postpush acquisitions) to mitigate ultrasound interference, which leads to missing temporal information of ultrasound effects when FUS is being applied. Furthermore, critical for clinical translation, use of both axial steering and real-time (<1 s) capabilities for optimizing acoustic parameters for tissue engagement are largely missing. In this study, we describe a method of noninterleaved, single Vantage imaging displacement within an active FUS push with simultaneous axial steering and real-time capabilities using a single ultrasound acquisition machine. Results show that the pulse sequence can track micron-sized displacements using frame rates determined by the calculated time-of-flight (TOF), without interleaving the FUS pulses and imaging acquisition. Decimation by 3-7 frames increases signal-to-noise ratio (SNR) by 15.09±7.03 dB. Benchmarking tests of CUDA-optimized code show increase in processing speed of 35- and 300-fold in comparison with MATLAB parallel processing GPU and CPU functions, respectively, and we can estimate displacement from steered push beams ±10 mm from the geometric focus. Preliminary validation of displacement imaging in humans shows that the same driving pressures led to variable nerve engagement, demonstrating important feedback to improve transducer coupling, FUS incident angle, and targeting. Regarding the use of our technique for neuromodulation, we found that FUS altered thermal perception of thermal pain by 0.9643 units of pain ratings in a single trial. Additionally, 5 [Formula: see text] of nerve displacement was shown in on-target versus off-target sonications. The initial feasibility in healthy volunteers warrants further study for potential clinical translation of FUS for pain suppression.

Ultrasonic transducers for medical diagnostic imaging

Over the past decades, ultrasound imaging technology has made tremendous progress in obtaining important diagnostic information from patients in a rapid, noninvasive manner. Although the technology has benefited from sophisticated signal processing technology and imaging system integration, much of this progress has been derived from the development of ultrasonic transducers that are in direct contact with patients. An overview of medical ultrasonic imaging transducers is presented in this review that describes their structure, types, and application fields. The structural components of a typical transducer are presented in detail including an active layer, acoustic matching layers, a backing block, an acoustic lens, and kerfs. The types of transducers are classified according to the dimensions of ultrasound images: one-dimensional array, mechanical wobbling, and two-dimensional array transducers. Advantages of each transducer over the other and the technical issues for further performance enhancement are described. Application of the transducers to various clinical imaging fields is also reviewed.

Shear Wave Elastography Quantifies Stiffness in Ex Vivo Porcine Artery with Stiffened Arterial Region

Five small porcine aortas were used as a human carotid artery model, and their stiffness was estimated using shear wave elastography (SWE) in the arterial wall and a stiffened artery region mimicking a stiff plaque. To optimize the SWE settings, shear wave bandwidth was measured with respect to acoustic radiation force push length and number of compounded angles used for motion detection with plane wave imaging. The mean arterial wall and simulated plaque shear moduli varied from 41 ± 5 to 97 ± 10 kPa and from 86 ± 13 to 174 ± 35 kPa, respectively, over the pressure range 20-120 mmHg. The results revealed that a minimum bandwidth of approximately 1500 Hz is necessary for consistent shear modulus estimates, and a high pulse repetition frequency using no image compounding is more important than a lower pulse repetition frequency with better image quality when estimating arterial wall and plaque stiffness using SWE.

Improving Displacement Signal-to-Noise Ratio for Low-Signal Radiation Force Elasticity Imaging Using Bayesian Techniques

Radiation force-based elasticity imaging is currently being investigated as a possible diagnostic modality for a number of clinical tasks, including liver fibrosis staging and the characterization of cardiovascular tissue. In this study, we evaluate the relationship between peak displacement magnitude and image quality and propose using a Bayesian estimator to overcome the challenge of obtaining viable data in low displacement signal environments. Displacement data quality were quantified for two common radiation force-based applications, acoustic radiation force impulse imaging, which measures the displacement within the region of excitation, and shear wave elasticity imaging, which measures displacements outside the region of excitation. Performance as a function of peak displacement magnitude for acoustic radiation force impulse imaging was assessed in simulations and lesion phantoms by quantifying signal-to-noise ratio (SNR) and contrast-to-noise ratio for varying peak displacement magnitudes. Overall performance for shear wave elasticity imaging was assessed in ex vivo chicken breast samples by measuring the displacement SNR as a function of distance from the excitation source. The results show that for any given displacement magnitude level, the Bayesian estimator can increase the SNR by approximately 9 dB over normalized cross-correlation and the contrast-to-noise ratio by a factor of two. We conclude from the results that a Bayesian estimator may be useful for increasing data quality in SNR-limited imaging environments.

Toward Standardized Acoustic Radiation Force (ARF)-Based Ultrasound Elasticity Measurements With Robotic Force Control

OBJECTIVE

Acoustic radiation force (ARF)-based approaches to measure tissue elasticity require transmission of a focused high-energy acoustic pulse from a stationary ultrasound probe and ultrasound-based tracking of the resulting tissue displacements to obtain stiffness images or shear wave speed estimates. The method has established benefits in biomedical applications such as tumor detection and tissue fibrosis staging. One limitation, however, is the dependence on applied probe pressure, which is difficult to control manually and prohibits standardization of quantitative measurements. To overcome this limitation, we built a robot prototype that controls probe contact forces for shear wave speed quantification.

METHODS

The robot was evaluated with controlled force increments applied to a tissue-mimicking phantom and in vivo abdominal tissue from three human volunteers.

RESULTS

The root-mean-square error between the desired and measured forces was 0.07 N in the phantom and higher for the fatty layer of in vivo abdominal tissue. The mean shear wave speeds increased from 3.7 to 4.5 m/s in the phantom and 1.0 to 3.0 m/s in the in vivo fat for compressive forces ranging from 2.5 to 30 N. The standard deviation of shear wave speeds obtained with the robotic approach were low in most cases ( 0.2 m/s) and comparable to that obtained with a semiquantitative landmark-based method.

CONCLUSION

Results are promising for the introduction of robotic systems to control the applied probe pressure for ARF-based measurements of tissue elasticity.

SIGNIFICANCE

This approach has potential benefits in longitudinal studies of disease progression, comparative studies between patients, and large-scale multidimensional elasticity imaging.

Viscoelastic response (VisR) imaging for assessment of viscoelasticity in Voigt materials

Viscoelastic response (VisR) imaging is presented as a new acoustic radiation force (ARF)-based elastographic imaging method. Exploiting the Voigt model, VisR imaging estimates displacement in only the ARF region of excitation from one or two successive ARF impulses to estimate τσ, the relaxation time for constant stress. Double-push VisR τσ estimates were not statistically significantly different (p < 0.02) from those of shearwave dispersion ultrasound vibrometry (SDUV) or monitored steady-state excitation recovery (MSSER) ultrasound in six homogeneous viscoelastic tissue mimicking phantoms with elastic moduli ranging from 3.92 to 15.34 kPa and coefficients of viscosity ranging from 0.87 to 14.06 Pa·s. In two-dimensional imaging, double-push VisR τσ images discriminated a viscous spherical inclusion in a structured phantom with higher CNR over a larger axial range than single-push VisR or conventional acoustic radiation force impulse (ARFI) ultrasound. Finally, 2-D in vivo double-push VisR images in normal canine semitendinosus muscle were compared with spatially matched histochemistry to corroborate lower double-push VisR τσ values in highly collagenated connective tissue than in muscle, suggesting double-push VisR's in vivo relevance to diagnostic imaging, particularly in muscle. The key advantages and disadvantages to VisR, including lack of compensation for inertial terms, are discussed.

Shear forces from flow are responsible for a distinct statistical signature of adherent microbubbles in large vessels

Real-time ultrasound-based targeted molecular imaging in large blood vessels holds promise for early detection and diagnosis of stroke risk by identifying early markers for atherosclerosis prior to plaque formation. Singular spectrum-based targeted molecular (SiSTM) imaging is a recently proposed method that uses changes in statistical dimensionality-quantified by a normalized singular spectrum area (NSSA)-to image receptor-ligand-bound adherent microbubbles. However, the precise physical mechanism responsible for the distinct statistical signature was previously unknown. In this study, in vitro flow phantom experiments were performed to elucidate the physical mechanism in large blood vessel environments. In the absence of flow, an increase in the NSSA of adherent microbubbles with respect to tissue was not observed with increased microbubble concentration or pulse length (p > .23; n  =  5) but was observed with increased flow rate (p < .01; n  =  10). When observing the dynamics of the adherent microbubble statistics, a good correlation was observed between the NSSA and the derivative of image intensity (R2 > .97). In addition, a monotonic relationship between the NSSA and decorrelation was demonstrated. These findings confirm the hypothesis that the statistical signature of adherent microbubbles is derived from frame-to-frame decorrelation, which is induced by flow shear forces.

Experimental validation of displacement underestimation in ARFI ultrasound

Acoustic radiation force impulse (ARFI) imaging is an elastography technique that uses ultrasonic pulses to displace and track tissue motion. Previous modeling studies have shown that ARFI displacements are susceptible to underestimation due to lateral and elevational shearing that occurs within the tracking resolution cell. In this study, optical tracking was utilized to experimentally measure the displacement underestimation achieved by acoustic tracking using a clinical ultrasound system. Three optically translucent phantoms of varying stiffness were created, embedded with subwavelength diameter microspheres, and ARFI excitation pulses with F/1.5 or F/3 lateral focal configurations were transmitted from a standard linear array to induce phantom motion. Displacements were tracked using confocal optical and acoustic methods. As predicted by earlier finite element method studies, significant acoustic displacement underestimation was observed for both excitation focal configurations; the maximum underestimation error was 35% of the optically measured displacement for the F/1.5 excitation pulse in the softest phantom. Using higher F/#, less tightly focused beams in the lateral dimension improved accuracy of displacements by approximately 10 percentage points. This work experimentally demonstrates limitations of ARFI implemented on a clinical scanner using a standard linear array and sets up a framework for future displacement tracking validation studies.

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.