Effect of bubble shell nonlinearity on ultrasound nonlinear propagation through microbubble populations

3D Acoustic Wave Sparsely Activated Localization Microscopy With Phase Change Contrast Agents

OBJECTIVE

The aim of this study is to demonstrate 3-dimensional (3D) acoustic wave sparsely activated localization microscopy (AWSALM) of microvascular flow in vivo using phase change contrast agents (PCCAs).

MATERIALS AND METHODS

Three-dimensional AWSALM using acoustically activable PCCAs was evaluated on a crossed tube microflow phantom, the kidney of New Zealand White rabbits, and the brain of C57BL/6J mice through intact skull. A mixture of C 3 F 8 and C 4 F 10 low-boiling-point fluorocarbon gas was used to generate PCCAs with an appropriate activation pressure. A multiplexed 8-MHz matrix array connected to a 256-channel ultrasound research platform was used for transmitting activation and imaging ultrasound pulses and recording echoes. The in vitro and in vivo echo data were subsequently beamformed and processed using a set of customized algorithms for generating 3D super-resolution ultrasound images through localizing and tracking activated contrast agents.

RESULTS

With 3D AWSALM, the acoustic activation of PCCAs can be controlled both spatially and temporally, enabling contrast on demand and capable of revealing 3D microvascular connectivity. The spatial resolution of the 3D AWSALM images measured using Fourier shell correlation is 64 μm, presenting a 9-time improvement compared with the point spread function and 1.5 times compared with half the wavelength. Compared with the microbubble-based approach, more signals were localized in the microvasculature at similar concentrations while retaining sparsity and longer tracks in larger vessels. Transcranial imaging was demonstrated as a proof of principle of PCCA activation in the mouse brain with 3D AWSALM.

CONCLUSIONS

Three-dimensional AWSALM generates volumetric ultrasound super-resolution microvascular images in vivo with spatiotemporal selectivity and enhanced microvascular penetration.

Ultrasound-Responsive Nanocarriers for Breast Cancer Chemotherapy

Breast cancer is the most common type of cancer and it is treated with surgical intervention, radiotherapy, chemotherapy, or a combination of these regimens. Despite chemotherapy's ample use, it has limitations such as bioavailability, adverse side effects, high-dose requirements, low therapeutic indices, multiple drug resistance development, and non-specific targeting. Drug delivery vehicles or carriers, of which nanocarriers are prominent, have been introduced to overcome chemotherapy limitations. Nanocarriers have been preferentially used in breast cancer chemotherapy because of their role in protecting therapeutic agents from degradation, enabling efficient drug concentration in target cells or tissues, overcoming drug resistance, and their relatively small size. However, nanocarriers are affected by physiological barriers, bioavailability of transported drugs, and other factors. To resolve these issues, the use of external stimuli has been introduced, such as ultrasound, infrared light, thermal stimulation, microwaves, and X-rays. Recently, ultrasound-responsive nanocarriers have become popular because they are cost-effective, non-invasive, specific, tissue-penetrating, and deliver high drug concentrations to their target. In this paper, we review recent developments in ultrasound-guided nanocarriers for breast cancer chemotherapy, discuss the relevant challenges, and provide insights into future directions.

Toward development of PreVoid alerting system for nocturnal enuresis patients: A fuzzy-based approach for determining the level of liquid encased in urinary bladder

Preventive and accurate assessment of bladder voiding dysfunctions necessitates measuring the amount of liquid encapsulated within urinary bladder walls in a non-invasive and real-time manner. The real-time monitoring of urine levels helps patients with urological disorders such as Nocturnal Enuresis (NE) by preventing the occurrence of enuresis via a pre-void stage alerting system. Although some advances have been achieved toward developing a non-invasive approach for determining the amount of accumulated urine inside the bladder, there is still a lack of an easy-to-implement technique which is suitable to embed in a wearable pre-warning device. This study aims to develop a machine-learning empowered technique to quantify to what extent an individual's bladder is filled by observing the filling-voiding pattern of a patient over a training period. In this experiment, a pulse-echo sonar element is used to generate ultrasound pulses while the probe surface is positioned perpendicular to the bladder's position. From the reflected echoes, four features which show sufficient sensitiveness and therefore could be modulated noticeably by different levels of liquid encased in the bladder, are extracted. The extracted features are then fed into a novel intelligent decision support system- known as FECOC - which is based on hybridization of fuzzy inference systems (FIS) and error correcting output codes (ECOC). The proposed scheme tends to achieve better results when examined in real case studies.

Cationic gas-filled microbubbles for ultrasound-based nucleic acids delivery

The use of ultrasound has gained great interest for nucleic acids delivery. Ultrasound can reach deep tissues in non-invasive manner. The process of sonoporation is based on the use of low-frequency ultrasound combined with gas-filled microbubbles (MBs) allowing an improved delivery of molecules including nucleic acids in the insonified tissue. For in vivo gene transfer, the engineering of cationic MBs is essential for creating strong electrostatic interactions between MBs and nucleic acids leading to their protection against nucleases degradation and high concentration within the target tissue. Cationic MBs must be stable enough to withstand nucleic acids interaction, have a good size distribution for in vivo administration, and enough acoustic activity to be detected by echography. This review aims to summarize the basic principles of ultrasound-based delivery and new knowledge acquired in these recent years about this method. A focus is made on gene delivery by discussing reported studies made with cationic MBs including ours. They have the ability for efficient delivery of plasmid DNA (pDNA), mRNA or siRNA. Last, we discuss about the key challenges that have to be faced for a fine use of this delivery system.

Nonlinear acoustic propagation in bubbly liquids: Multiple scattering, softening and hardening phenomena

The weakly nonlinear propagation of acoustic waves in monodisperse bubbly liquids is investigated numerically. A hydrodynamic model based on the averaged two-phase fluid equations is coupled with the Rayleigh-Plesset equation to model the dynamics of bubbles at the local scale. The present model is validated in the linear regime by comparing with the Foldy approximation. The analysis of the pressure signals in the linear regime highlights two resonance frequencies: the Minnaert frequency and a multiple scattering resonance that strongly depends on the bubble concentration. For weakly nonlinear regimes, the generation of higher harmonics is observed only for the Minnaert frequency. Linear combinations between the Minnaert harmonics and the multiple scattering resonance are also observed. However, the most significant effect observed is the appearance of softening-hardening effects that share some similarities with those observed for sandstones or cracked materials. These effects are related to the multiple scattering resonance. Downward or upward resonance frequency shifts can be observed depending on the characteristic of the incident wave when increasing the excitation amplitude. It is shown that the frequency shift can be explained assuming that the acoustic wave velocity depends on a law different from those usually encountered for sandstones or cracked materials.

Dynamic acousto-elastic testing applied to a highly dispersive medium and evidence of shell buckling of lipid-coated gas microbubbles

Dynamic acousto-elastic testing is applied to a mixture of lipid-coated microbubbles in water. A dynamic change of ambient pressure is produced by a 16 kHz pressure wave having a peak pressure amplitude of 28 kPa. The induced changes of phase velocity and attenuation are captured by a sequence of short ultrasound pulses with a center frequency of 4 MHz. As a consequence of the dispersion brought about by the resonance of microbubbles at a frequency close to 2 MHz, time-domain approaches like the cross-correlation method are shown to be unsuited to determine the variation in ultrasound wavespeed. A frequency-domain analysis shows that the acousto-elastic effect (first order pressure derivative of ultrasound phase velocity) depends on the ultrasound frequency. The acousto-elastic effect tends to that measured in water for an ultrasound frequency above the resonance frequency of microbubbles, while it is two orders of magnitude larger for an ultrasound frequency close to or below the resonance frequency of microbubbles. Besides the large magnitude of the acousto-elastic effect observed for an ultrasound frequency below the resonance frequency of microbubbles, the first order pressure derivative of ultrasound phase velocity is negative. This supports the occurrence of shell buckling of lipid-coated microbubbles induced by the 16 kHz pressure wave.

Microbubble Void Imaging: A Non-invasive Technique for Flow Visualisation and Quantification of Mixing in Large Vessels Using Plane Wave Ultrasound and Controlled Microbubble Contrast Agent Destruction

There is increasing recognition of the influence of the flow field on the physiology of blood vessels and their development of pathology. Preliminary work is reported on a novel non-invasive technique, microbubble void imaging, which is based on ultrasound and controlled destruction of microbubble contrast agents, permitting flow visualisation and quantification of flow-induced mixing in large vessels. The generation of microbubble voids can be controlled both spatially and temporally using ultrasound parameters within the safety limits. Three different model vessel geometries-straight, planar-curved and helical-with known effects on the flow field and mixing were chosen to evaluate the technique. A high-frame-rate ultrasound system with plane wave transmission was used to acquire the contrast-enhanced ultrasound images, and an entropy measure was calculated to quantify mixing. The experimental results were cross-compared between the different geometries and with computational fluid dynamics. The results indicated that the technique is able to quantify the degree of mixing within the different configurations, with a helical geometry generating the greatest mixing, and a straight geometry, the lowest. There is a high level of concordance between the computational fluid dynamics and experimental results. The technique could also serve as a flow visualisation tool.

Correction of Non-Linear Propagation Artifact in Contrast-Enhanced Ultrasound Imaging of Carotid Arteries: Methods and in Vitro Evaluation

Non-linear propagation of ultrasound creates artifacts in contrast-enhanced ultrasound images that significantly affect both qualitative and quantitative assessments of tissue perfusion. This article describes the development and evaluation of a new algorithm to correct for this artifact. The correction is a post-processing method that estimates and removes non-linear artifact in the contrast-specific image using the simultaneously acquired B-mode image data. The method is evaluated on carotid artery flow phantoms with large and small vessels containing microbubbles of various concentrations at different acoustic pressures. The algorithm significantly reduces non-linear artifacts while maintaining the contrast signal from bubbles to increase the contrast-to-tissue ratio by up to 11 dB. Contrast signal from a small vessel 600 μm in diameter buried in tissue artifacts before correction was recovered after the correction.

Cumulative phase delay between second harmonic and fundamental components--a marker for ultrasound contrast agents

Several imaging techniques aimed at detecting ultrasound contrast agents (UCAs) echo signals, while suppressing signals coming from the surrounding tissue, have been developed. These techniques are especially relevant for blood flow, perfusion, or contrast dispersion quantification. However, despite several approaches being presented, improving the understanding of the ultrasound/UCAs interaction may support further development of imaging techniques. In this paper, the physical phenomena behind the formation of harmonic components in tissue and UCAs, respectively, are addressed as a possible way to recognize the origin of the echo signals. Simulations based on a modified Rayleigh, Plesset, Noltingk, Neppiras, and Poritsky equation and transmission and backscattering measurements of ultrasound propagating through UCAs performed with a single element transducer and a submergible hydrophone, are presented. Both numerical and in vitro results show the occurrence of a cumulative time delay between the second harmonic and fundamental component which increases with UCA concentration and propagation path length through UCAs, and that was clearly observable at frequencies ( f0 = 2.5 MHz) and pressure regimes (mechanical index = 0.1) of interest for imaging. Most importantly, this delay is not observed in the absence of UCAs. In conclusion, the reported phenomenon represents a marker for UCAs with potential application for imaging.

Evaluation of bias voltage modulation sequence for nonlinear contrast agent imaging using a capacitive micromachined ultrasonic transducer array

Many clinical diagnoses have now been improved thanks to the development of new techniques dedicated to contrast agent nonlinear imaging. Over the past few years, Capacitive Micromachined Ultrasonic Transducers (cMUTs) have emerged as a promising alternative to traditional piezoelectric transducers. One notable advantage of cMUTs is their wide frequency bandwidth. However, their use in nonlinear imaging approaches such as those used to detect contrast agents have been challenging due their intrinsic nonlinear character. We propose a new contrast imaging sequence, called bias voltage modulation (BVM), specifically developed for cMUTs to suppress their inherent nonlinear behavior. Theoretical and experimental results show that a complete cancellation of the nonlinear signal from the source can be reached when the BVM sequence is implemented. In-vitro validation of the sequence is performed using a cMUT probe connected to an open scanner and a flow phantom setup containing SonoVue microbubbles. Compared to the standard amplitude modulation imaging mode, a 6 dB increase of contrast-to-tissue ratio was achieved when the BVM sequence is applied. These results reveal that the problem of cMUT nonlinearity can be addressed, thus expanding the potential of this new transducer technology for nonlinear contrast agent detection and imaging.

CREANUIS: a non-linear radiofrequency ultrasound image simulator

Nonlinear ultrasound methods are widely used in clinical applications for tissue or contrast harmonic imaging. Accurate non-linear imaging simulation tools are required in research studies for the development of new methods. However, in existing simulators, the possible inhomogeneity of the coefficient of non-linearity, which is generally observed in tissue and in particular when contrast agents are involved, has not yet been implemented. This article describes a new ultrasound simulator, called CREANUIS, devoted to the computation of B-mode images where both linear and non-linear propagation in media is considered, with a possible inhomogeneous coefficient of non-linearity. The resulting fundamental images, based on a spatially variant and non-linear point spread function, are in accordance with those obtained through the reference linear FieldII simulator, with computation time reduced by a factor of at least 1.8. Non-linear images of media exhibiting inhomogeneous coefficients of non-linearity are also provided. The simulation software can be freely downloaded from our website.

Modeling and optimization of an acoustic diode based on micro-bubble nonlinearity

The first acoustic diode (AD), which is composed by integrating a super lattice (SL) with a nonlinear medium (NLM), has recently been proposed to make a one-way street for the acoustic energy flux. This device prohibits the acoustic waves from one direction, but allows the transmission of the second harmonic wave (generated from the NLM) from the other direction. To improve its performance, it is crucial to transfer more acoustic energy from the stop-band of the acoustic filter (i.e., the SL) to its pass-band with the help of the NLM. In this work, a finite difference time domain model is developed to study the dynamic behaviors of the AD, in which a micro-bubble suspension takes the role of the NLM. Based on this model, the method of optimizing the nonlinearity-based AD is investigated by examining its performance with respect to several parameters, such as the periodicity number of the SL, the bubble size distribution, the bubble shell parameters, and the bubble concentration. It is also suggested that, instead of the rectification ratio, it might be more reasonable to characterize the performance of the AD with the energy attenuation coefficients (or transmission loss) for both incident directions.

Ambient pressure dependence of the ultra-harmonic response from contrast microbubbles

Sub-harmonic response from ultrasound contrast agent microbubbles has been demonstrated to be an effective modality for noninvasive pressure measurement. In the present study, the dependence of ultra-harmonic response on the ambient overpressure was investigated by both experimental measurements and simulations. In the measurements, the microbubbles were exposed to Gaussian pulses with varied driving frequencies and pulse lengths, at an acoustic pressure of 0.3 MPa. The amplitudes of sub- and ultra-harmonic components were measured when the ambient overpressures varied from 0-25 kPa. At the driving frequency of 1.33 MHz, the ultra-harmonic energy decreased but the sub-harmonic energy increased with the increasing overpressure; while at the driving frequency of 4 MHz, both the sub- and ultra-harmonic components showed the same tendency that the corresponding energy decreased as the overpressure was increased. A 4-MHz Gaussian pulse with 64 cycles could provide an ultra-harmonic response with both good ambient pressure sensitivity and high linearity. Furthermore, the effects of shell parameters of a microbubble on the generation of ultra- and sub-harmonic responses were discussed based on simulations using Marmottant's model. This study suggests that the ultra-harmonic response from contrast microbubbles might be applicable for noninvasive pressure measurement.

Quantitative contrast-enhanced ultrasound imaging: a review of sources of variability

Ultrasound provides a valuable tool for medical diagnosis offering real-time imaging with excellent spatial resolution and low cost. The advent of microbubble contrast agents has provided the additional ability to obtain essential quantitative information relating to tissue vascularity, tissue perfusion and even endothelial wall function. This technique has shown great promise for diagnosis and monitoring in a wide range of clinical conditions such as cardiovascular diseases and cancer, with considerable potential benefits in terms of patient care. A key challenge of this technique, however, is the existence of significant variations in the imaging results, and the lack of understanding regarding their origin. The aim of this paper is to review the potential sources of variability in the quantification of tissue perfusion based on microbubble contrast-enhanced ultrasound images. These are divided into the following three categories: (i) factors relating to the scanner setting, which include transmission power, transmission focal depth, dynamic range, signal gain and transmission frequency, (ii) factors relating to the patient, which include body physical differences, physiological interaction of body with bubbles, propagation and attenuation through tissue, and tissue motion, and (iii) factors relating to the microbubbles, which include the type of bubbles and their stability, preparation and injection and dosage. It has been shown that the factors in all the three categories can significantly affect the imaging results and contribute to the variations observed. How these factors influence quantitative imaging is explained and possible methods for reducing such variations are discussed.