Ultrasound attenuation measurements using a reference phantom with sound speed mismatch

Improving diagnostic accuracy of ultrasound texture features in detecting and quantifying hepatic steatosis using various beamforming sound speeds

Objective.While ultrasound image texture has been utilized to detect and quantify hepatic steatosis, the texture features extracted using a single (conventionally 1540 m s-1) beamforming speed of sound (SoS) failed to achieve reliable diagnostic performance. This study aimed to investigate if the texture features extracted using various beamforming SoSs can improve the accuracy of hepatic steatosis detection and quantification.Approach.Patients with suspected non-alcoholic fatty liver disease underwent liver biopsy or MRI proton density fat fraction (PDFF) as part of standard of care, were prospectively enrolled. The radio-frequency data from subjects' right and left liver lobes were collected using 6 beamforming SoSs: 1300, 1350, 1400, 1450, 1500 and 1540 m s-1and analyzed offline. The texture features, i.e. Contrast, Correlation, Energy and Homogeneity from gray-level co-occurrence matrix of normalized envelope were obtained from a region of interest in the liver parenchyma.Main results.Forty-three subjects (67.2%) were diagnosed with steatosis while 21 had no steatosis. Homogeneity showed the area under the curve (AUC) of 0.75-0.82 and 0.58-0.81 for left and right lobes, respectively with varying beamforming SoSs. The combined Homogeneity value over 1300-1540 m s-1from left and right lobes showed the AUC of 0.90 and 0.81, respectively. Furthermore, the combined Homogeneity values from left and right lobes over 1300-1540 m s-1improved the AUC to 0.94. The correlation between texture features and steatosis severity was improved by using the images from various beamforming SoSs. The combined Contrast values over 1300-1540 m s-1from left and right lobes demonstrated the highest correlation (r= 0.90) with the MRI PDFF while the combined Homogeneity values over 1300-1540 m s-1from left and right lobes showed the highest correlation with the biopsy grades (r= -0.81).Significance.The diagnostic accuracy of ultrasound texture features in detecting and quantifying hepatic steatosis was improved by combining its values extracted using various beamforming SoSs.

Recent Advances in Attenuation Estimation

This chapter reviews some of the recent advances in the estimation of the local and the total attenuation, with an emphasis on reducing the bias and variance of the estimates. A special focus is put on describing the effect of power spectrum estimation on bias and variance, the introduction of regularization strategies, as well as on eliminating the need to use reference phantoms for compensating for system dependent effects.

Regularized Ultrasound Phantom-Free Local Attenuation Coefficient Slope (ACS) Imaging in Homogeneous and Heterogeneous Tissues

Attenuation maps or measurements based on the local attenuation coefficient slope (ACS) in quantitative ultrasound (QUS) have shown potential for the diagnosis of liver steatosis. In liver cancers, tissue abnormalities and tumors detected using ACS are also of interest to provide new image contrast to clinicians. Current phantom-based approaches have the limitation of assuming a comparable speed of sound between the reference phantom and insonified tissues. Moreover, these methods present the inconvenience for operators to acquire data on phantoms and patients. The main goal was to alleviate these drawbacks by proposing a methodology for constructing phantom-free regularized (PF-R) local ACS maps and investigate the performance in both homogeneous and heterogeneous media. The proposed method was tested on two tissue-mimicking media with different ACS constructed as homogeneous phantoms, side-by-side and top-to-bottom phantoms, and inclusion phantoms with different attenuations. Moreover, an in vivo proof-of-concept was performed on healthy, steatotic, and cancerous human liver datasets. Modifications brought to previous works include: 1) a linear interpolation of the power spectrum in the log scale; 2) the relaxation of the underlying hypothesis on the diffraction factor; 3) a generalization to nonhomogeneous local ACS; and 4) an adaptive restriction of frequencies to a more reliable range than the usable frequency range. Regularization was formulated as a generalized least absolute shrinkage and selection operator (LASSO), and a variant of the Bayesian information criterion (BIC) was applied to estimate the Lagrangian multiplier on the LASSO constraint. In addition, we evaluated the proposed algorithm when applying median filtering before and after regularization. Tests conducted showed that the PF-R yielded robust results in all tested conditions, suggesting potential for additional validation as a diagnosis method.

US Attenuation for Liver Fat Quantification: An AIUM-RSNA QIBA Pulse-Echo Quantitative Ultrasound Initiative

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, with an estimated prevalence of up to 30% in the general population and higher in people with type 2 diabetes. The assessment of liver fat content is essential to help identify patients with or who are at risk for NAFLD and to follow their disease over time. The American Institute of Ultrasound in Medicine-RSNA Quantitative Imaging Biomarkers Alliance Pulse-Echo Quantitative Ultrasound Initiative was formed to help develop and standardize acquisition protocols and to better understand confounding factors of US-based fat quantification. The three quantitative US parameters explored by the initiative are attenuation, backscatter coefficient, and speed of sound. The purpose of this review is to present the current state of attenuation imaging for fat quantification and to provide expert opinion on examination performance and interpretation. US attenuation methods that need further study are outlined.

Correlation length ratio as a parameter for determination of fiber-like structures in soft tissues

Quantitative ultrasound methods can provide valuable information about the microstructure of a material or tissue. This works well when the common assumptions of homogeneity, isotropy, and diffuse scattering conditions are valid. In biological tissues, however, these assumptions are often violated because the microstructure of biological tissues is often heterogeneous and anisotropic. The microstructure of biological tissues can change with disease, and therefore accurate identification and description of a tissue's microstructure can offer important clinical insight. To address the challenge of evaluating the microstructure of biological tissues, here we introduce a novel parameter called the correlation length ratio (CLR), a ratio of lateral to axial correlation lengths for backscattered echo signals. We developed it to determine the presence of fiber-like structures in soft tissues by comparing this value in tissue to a threshold determined from a reference material that is homogeneous, isotropic, and provides diffuse scattering. We tested this novel parameter in phantoms with spherical scattering sources, in an anisotropic phantom (containing elongated fibers), and in human biceps muscle. We found that the CLR accurately detected the presence of elongated structures in both the anisotropic phantom and muscle. These results encourage further exploration of this novel parameter in microstructurally complex tissues.

Challenges of conducting quantitative ultrasound with a multimodal optical imaging system

High-frequency quantitative ultrasound is a potential non-invasive source of imaging cell-tissue scale biomarkers for major diseases such as heart disease, cancer, and preterm birth. However, one of the barriers to developing such biomarkers is that it is labor-intensive to compare quantitative ultrasound images to optical images of the tissue structure. We have previously developed a multiscale imaging system that can obtain registered qualitative ultrasound and optical images, but there are further technical challenges to obtaining quantitative data: System-specific details of obtaining and processing data with Verasonics high-frequency transducers; the need for high-frequency reference phantoms; and off-axis clutter from imaging above a glass coverslip. This paper provides a characterization of the Verasonics ultrasound system with the 18.5 MHz L22-14v and 28.5 MHz L38-22v transducers, describes the construction of high-frequency reference phantoms, and details methods for reducing off-axis clutter. The paper features a demonstration multiscale image of a wild type mouse mammary gland that incorporates quantitative ultrasound with both transducers and second harmonic generation microscopy. These advances demonstrate a way to obtain, on a single system with a cohesive and integrated pipeline, quantitative ultrasound data that is correlated with optical imaging without the need for extensive sample preparation.

Skull acoustic aberration correction in photoacoustic microscopy using a vector space similarity model: a proof-of-concept simulation study

Skull bone represents a highly acoustical impedance mismatch and a dispersive barrier for the propagation of acoustic waves. Skull distorts the amplitude and phase information of the received waves at different frequencies in a transcranial brain imaging. We study a novel algorithm based on vector space similarity model for the compensation of the skull-induced distortions in transcranial photoacoustic microscopy. The results of the algorithm tested on a simplified numerical skull phantom, demonstrate a fully recovered vasculature with the recovery rate of 91.9%.

Fluence-matching technique using photoacoustic radiofrequency spectra for improving estimates of oxygen saturation

Photoacoustic (PA) signals encode information about the optical absorption and spatial distribution of absorbing chromophores as well as the light distribution in the medium. The wavelength dependence of the latter affects the accuracy in chromophore quantification, including estimations of oxygen saturation (sO₂) with depth. We propose the use of the ratio of the PA radiofrequency (RF) spectral slopes (SS) at different optical wavelengths to generate frequency filters which can be used to match the fluence profiles across separate images generated with different optical wavelengths. Proof-of-principle experiments were carried on a plastic tube with blood of a known oxygenation inserted into a porcine tissue. The algorithm was tested in-vivo in the hind leg of six CD1 mice, each under three different breathing conditions (100 % O₂, room air and 100 % CO₂). Imaging was done using the VevoLAZR system at the wavelengths 720 and 870 nm. The SS was calculated from the linear fit of the ratio of the photoacoustic RF power spectra at the two wavelengths. An ultrasound frequency filter was designed and applied to each segmented PA signal in the frequency domain and inversely transformed into the time domain to correct for the differences in the fluence profiles at both wavelengths. Linear spectral unmixing was used to estimate sO₂ before and after applying the ultrasound frequency filter. The estimated blood sO₂ in the plastic tube for the porcine tissue experiment improved by 10.3% after applying the frequency filter when compared to the sO₂ measured by a blood gas analyzer. For the in-vivo mouse experiments, the applied sO₂ correction was 2.67, 1.33 and -3.33% for every mm of muscle tissue for mice breathing 100% O₂, room air and 100% CO₂, respectively. The approach presented here provides a new approach for fluence matching that can potentially improve the accuracy of sO₂ estimates by removing the fluence depth dependence at different optical wavelengths.

Cardiac Tissue-Mimicking Ballistic Gel Phantom for Ultrasound Imaging in Clinical and Research Applications

Ballistic gel was investigated as a tissue-mimicking material in an anthropomorphic cardiac phantom for ultrasound imaging. The gel was tested for its acoustic properties and its compatibility with conventional plastics molding techniques. Speed of sound and attenuation were evaluated in the range 2-12 MHz. The speed of sound was 1537 ± 39 m/s, close to typical values for cardiac tissue (∼1576 m/s). The attenuation coefficient was 1.07 dB/cm·MHz, within the range of values previously reported for cardiac tissue (0.81-1.81 dB/cm·MHz). A cardiac model based on human anatomy was developed using established image segmentation processes and conventional plastic molding techniques. Key anatomic features were observed, captured and identified in the model using an intracardiac ultrasound imaging system. These favorable results along with the material's durability and processes that allow for repetitive production of detailed whole-heart models at low cost are promising. There are numerous applications for geometrically complex phantoms in research, training, device development and clinical use.

Investigation of the Effect of the Skull in Transcranial Photoacoustic Imaging: A Preliminary Ex Vivo Study

Although transcranial photoacoustic imaging (TCPAI) has been used in small animal brain imaging, in animals with thicker skull bones or in humans both light illumination and ultrasound propagation paths are affected. Hence, the PA image is largely degraded and in some cases completely distorted. This study aims to investigate and determine the maximum thickness of the skull through which photoacoustic imaging is feasible in terms of retaining the imaging target structure without incorporating any post processing. We identify the effect of the skull on both the illumination path and acoustic propagation path separately and combined. In the experimental phase, the distorting effect of ex vivo sheep skull bones with thicknesses in the range of 0.7~1.3 mm are explored. We believe that the findings in this study facilitate the clinical translation of TCPAI.

Attenuation Coefficient Parameter Computations for Tissue Composition Assessment of Carotid Atherosclerotic Plaque in Vivo

Quantitative ultrasound has been used to assess carotid plaque tissue composition. Here, we compute the attenuation coefficient (AC) in vivo with the optimum power spectral shift estimator (OPSSE) and reference phantom method (RPM), extract AC parameters and form parametric maps. Differences between OPSSE and RPM AC parameters are computed. Relationships between AC parameters, surgical scores and histopathology assessments are examined. Kendall's τ correlations between OPSSE AC and surgical scores are significant, including those between cholesterol and Standard Deviation (adjusted p = 0.038); thrombus and Minimum (adjusted p = 0.002), Maximum (adjusted p = 0.021) and Standard Deviation (adjusted p = 0.001); ulceration and Average (adjusted p = 0.033), Median (unadjusted p = 0.013), Maximum (unadjusted p = 0.039) and Mode (adjusted p = 0.009). The strongest correlations with histopathology are percentage cholesterol and Median OPSSE (unadjusted p = 0.007); percentage hemorrhage and Minimum OPSSE (adjusted p < 0.001); hemosiderin score and Median OPSSE (adjusted p = 0.010); and percentage calcium and Percentage Non-physical RPM Pixels (unadjusted p = 0.014). Kruskal-Wallis H and Dunn's post hoc tests have the ability to distinguish between groups (p < 0.05). Results suggest AC parameters may assist in vivo evaluation of carotid plaque vulnerability.

Attenuation Coefficient Estimation of Normal Placentas

Attenuation coefficient estimation has the potential to be a useful tool for placental tissue characterization. A current challenge is the presence of inhomogeneities in biological tissue that result in a large variance in the attenuation coefficient estimate (ACE), restricting its clinical utility. In this work, we propose a new Attenuation Estimation Region Of Interest (AEROI) selection method for computing the ACE based on the (i) envelope signal-to-noise ratio deviation and (ii) coefficient of variation of the transmit pulse bandwidth. The method was first validated on a tissue-mimicking phantom, for which an 18%-21% reduction in the standard deviation of ACE and a 14%-24% reduction in the ACE error, expressed as a percentage of reported ACE, were obtained. A study on 59 post-delivery clinically normal placentas was then performed. The proposed AEROI selection method reduced the intra-subject standard deviation of ACE from 0.72 to 0.39 dB/cm/MHz. The measured ACE of 59 placentas was 0.77 ± 0.37 dB/cm/MHz, which establishes a baseline for future studies on placental tissue characterization.

Orthogonal Chirp Coded Excitation in a Capacitive Micro-machined Ultrasonic Transducer Array for Ultrasound Imaging: A Feasibility Study

It has been reported that the frequency bandwidth of capacitive micro-machined ultrasonic transducers (CMUTs) is relatively broader than that of other ceramic-based conventional ultrasonic transducers. In this paper, a feasibility study for orthogonal chirp coded excitation to efficiently make use of the wide bandwidth characteristic of CMUT array is presented. The experimental result shows that the two orthogonal chirps mixed and simultaneously fired in CMUT array can be perfectly separated in decoding process of the received echo signal without sacrificing the frequency bandwidth each chirp. The experimental study also shows that frequency band-divided orthogonal chirps are successfully compressed to two short pulses having the -6 dB axial beam-width of 0.26- and 0.31-micro second for high frequency and low frequency chirp, respectively. B-mode image simulations are performed using Field II to estimate the improvement of image quality assuming that the orthogonal chirps designed for the experiments are used for simultaneous transmission multiple-zone focusing (STMF) technique. The simulation results show that the STMF technique used in CMUT array can improve the lateral resolution up to 77.1% and the contrast resolution up to 74.7%, respectively. It is shown that the penetration depth also increases by more than 3 cm.

Skull's Photoacoustic Attenuation and Dispersion Modeling with Deterministic Ray-Tracing: Towards Real-Time Aberration Correction

Although transcranial photoacoustic imaging has been previously investigated by several groups, there are many unknowns about the distorting effects of the skull due to the impedance mismatch between the skull and underlying layers. The current computational methods based on finite-element modeling are slow, especially in the cases where fine grids are defined for a large 3-D volume. We develop a very fast modeling/simulation framework based on deterministic ray-tracing. The framework considers a multilayer model of the medium, taking into account the frequency-dependent attenuation and dispersion effects that occur in wave reflection, refraction, and mode conversion at the skull surface. The speed of the proposed framework is evaluated. We validate the accuracy of the framework using numerical phantoms and compare its results to k-Wave simulation results. Analytical validation is also performed based on the longitudinal and shear wave transmission coefficients. We then simulated, using our method, the major skull-distorting effects including amplitude attenuation, time-domain signal broadening, and time shift, and confirmed the findings by comparing them to several ex vivo experimental results. It is expected that the proposed method speeds up modeling and quantification of skull tissue and allows the development of transcranial photoacoustic brain imaging.

Power Spectrum Consistency among Systems and Transducers

Use of the reference phantom method for computing acoustic attenuation and backscatter is widespread. However, clinical application of these methods has been limited by the need to acquire reference phantom data. We determined that the data acquired from 11 transducers of the same model and five clinical ultrasound systems of the same model produce equivalent estimates of reference phantom power spectra. We describe that the contribution to power spectral density variance among systems and transducers equals that from speckle variance with 59 uncorrelated echo signals. Thus, when the number of uncorrelated lines of data is small, speckle variance will dominate the power spectral density estimate variance introduced by different systems and transducers. These results suggest that, at least for this particular transducer and imaging system combination, one set of reference phantom calibration data is highly representative of the average among equivalent transducers and systems that are in good working order.

Low Variance Estimation of Backscatter Quantitative Ultrasound Parameters Using Dynamic Programming

One of the main limitations of ultrasound imaging is that image quality and interpretation depend on the skill of the user and the experience of the clinician. Quantitative ultrasound (QUS) methods provide objective, system-independent estimates of tissue properties, such as acoustic attenuation and backscattering properties of tissue, which are valuable as objective tools for both diagnosis and intervention. Accurate and precise estimation of these properties requires correct compensation for intervening tissue attenuation. Prior attempts to estimate intervening-tissue attenuation based on minimizing cost functions that compared backscattered echo data to models have resulted in limited precision and accuracy. To overcome these limitations, in this paper, we incorporate the prior information of piecewise continuity of QUS parameters as a regularization term into our cost function. We further propose to calculate this cost function using dynamic programming (DP), a computationally efficient optimization algorithm that finds the global optimum. Our results on tissue-mimicking phantoms show that DP substantially outperforms a published least squares method in terms of both estimation bias and variance.

Quantifying Backscatter Anisotropy Using the Reference Phantom Method

Acoustic properties can be exploited to infer and evaluate tissue microstructure. However, common assumptions are that the medium of interest is homogeneous and isotropic, and that its underlying physical properties cause diffuse scattering. In this paper, we describe how we developed and tested novel parameters designed to address isotropy/anisotropy in backscattered echo signal power in complex biological tissues. Specifically, we explored isotropy/anisotropy in backscattered power in isotropic phantoms (spherical glass beads), an anisotropic phantom (dialysis phantom with rodlike fibers), and an in vivo human tissue with well-described anisotropy (bicep muscle). Our approach uses the reference phantom method to compensate for system transfer and diffraction losses when electronically beamsteering a linear array transducer. We define three parameters to quantify the presence and orientation of anisotropic scatterers, as well as address magnitude of anisotropy. We found that these parameters can detect and sense the degree of anisotropy in backscatter in both phantoms and bicep muscle. Bias of the summary anisotropy parameters, induced through a speed of sound mismatch of sample media and reference phantom, was less than 0.2 dB if the speed of sound was within ±20 m/s of the sample media. In summary, these new parameters may be useful for testing the assumption of isotropy as well as providing more detailed information about the underlying microstructural sources of backscatter in complex biological tissues.

Analysis of Coherent and Diffuse Scattering Using a Reference Phantom

The estimation of many spectral-based quantitative ultrasound parameters assumes that backscattered echo signals are from a stationary, incoherent scattering process. The accuracy of these assumptions in real tissue can limit the diagnostic value of these parameters and the physical insight about tissue microstructure they can convey. This work presents an empirical decision test to determine the presence of significant coherent contributions to echo signals and whether they are caused by low scatterer number densities or the presence of specular reflectors or scatterers with periodic spacing. This is achieved by computing parameters from echo signals that quantify stationary or nonstationary features related to coherent scattering, and then comparing their values to thresholds determined from a reference material providing diffuse scattering. The paper first presents a number of parameters with demonstrated sensitivity to coherent scattering and describes criteria to select those with the highest sensitivity using simulated and phantom-based echo data. Results showed that the echo amplitude signal-to-noise ratio and the multitaper-generalized spectrum were the parameters with the highest sensitivity to coherent scattering with stationary and nonstationary features, respectively. These parameters were incorporated into the reference-based decision test, which successfully identified regions in simulated and tissue-mimicking phantoms with different incoherent and coherent scattering conditions. When scatterers with periodic organization were detected, the combination of stationary and nonstationary analysis permitted the estimation of the mean spacing below and above the resolution limit imposed by the pulse size. Preliminary applications of this algorithm to human cervical tissue ex vivo showed correspondence between regions of B-mode images showing bright reflectors, tissue interfaces, and hypoechoic regions with regions classified as specular reflectors and low scatterer number density. These results encourage further application of the algorithm to more structurally complex phantoms and tissue.

In Vivo Estimation of Attenuation and Backscatter Coefficients From Human Thyroids

Fine-needle aspiration (FNA) remains the gold standard for the diagnosis of thyroid cancer. However, currently, a large number of FNA biopsies result in negative or undetermined diagnosis, which suggests that better noninvasive tools are needed for the clinical management of thyroid cancer. Spectral-based quantitative ultrasound (QUS) characterizations may offer a better diagnostic management as previously demonstrated in mouse cancer models ex vivo. As a first step toward understanding the potential of QUS markers for thyroid disease management, this paper deals with the spectral-based QUS estimation of healthy human thyroids in vivo. Twenty volunteers were inspected by a trained radiologist using two ultrasonic imaging systems, which allowed them to acquire radio-frequency data spanning the 3-16-MHz frequency range. Estimates of attenuation coefficient slope (ACS) using the spectral logarithmic difference method had an average value of [Formula: see text]) with a standard deviation of [Formula: see text]. Estimates of backscatter coefficient (BSC) using the reference-phantom method had an average value of [Formula: see text] over the useful frequency range. The intersubject variability when estimating BSCs was less than 1.5 dB over the analysis frequency range. Further, the effectiveness of three scattering models (i.e., fluid sphere, Gaussian, and exponential form factors) when fitting the experimentally estimated BSCs was assessed. The exponential form factor was found to provide the best overall goodness of fit ( R² = 0.917), followed by the Gaussian ( R² = 0.807) and the fluid-sphere models ( R² = 0.752). For all scattering models used in this study, average estimates of the effective scatterer diameter were between 44 and 56 μm. Overall, an excellent agreement in the estimated attenuation and BSCs with both scanners was exhibited.

Quantitative ultrasound assessment of breast tumor response to chemotherapy using a multi-parameter approach

PURPOSE

This study demonstrated the ability of quantitative ultrasound (QUS) parameters in providing an early prediction of tumor response to neoadjuvant chemotherapy (NAC) in patients with locally advanced breast cancer (LABC).

METHODS

Using a 6-MHz array transducer, ultrasound radiofrequency (RF) data were collected from 58 LABC patients prior to NAC treatment and at weeks 1, 4, and 8 of their treatment, and prior to surgery. QUS parameters including midband fit (MBF), spectral slope (SS), spectral intercept (SI), spacing among scatterers (SAS), attenuation coefficient estimate (ACE), average scatterer diameter (ASD), and average acoustic concentration (AAC) were determined from the tumor region of interest. Ultrasound data were compared with the ultimate clinical and pathological response of the patient's tumor to treatment and patient recurrence-free survival.

RESULTS

Multi-parameter discriminant analysis using the κ-nearest-neighbor classifier demonstrated that the best response classification could be achieved using the combination of MBF, SS, and SAS, with an accuracy of 60 ± 10% at week 1, 77 ± 8% at week 4 and 75 ± 6% at week 8. Furthermore, when the QUS measurements at each time (week) were combined with pre-treatment (week 0) QUS values, the classification accuracies improved (70 ± 9% at week 1, 80 ± 5% at week 4, and 81 ± 6% at week 8). Finally, the multi-parameter QUS model demonstrated a significant difference in survival rates of responding and non-responding patients at weeks 1 and 4 (p=0.035, and 0.027, respectively).

CONCLUSION

This study demonstrated for the first time, using new parameters tested on relatively large patient cohort and leave-one-out classifier evaluation, that a hybrid QUS biomarker including MBF, SS, and SAS could, with relatively high sensitivity and specificity, detect the response of LABC tumors to NAC as early as after 4 weeks of therapy. The findings of this study also suggested that incorporating pre-treatment QUS parameters of a tumor improved the classification results. This work demonstrated the potential of QUS and machine learning methods for the early assessment of breast tumor response to NAC and providing personalized medicine with regards to the treatment planning of refractory patients.

Acoustic Properties of Breast Fat

OBJECTIVES

The American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) atlas for ultrasound (US) qualitatively describes the echogenicity and attenuation of a mass, where fat lobules serve as a standard for comparison. This study aimed to estimate acoustic properties of breast fat under clinical imaging conditions to determine the degree to which properties vary among patients.

METHODS

Twenty-four women with solid breast masses scheduled for biopsy were scanned with a Siemens S2000 scanner and 18L6 linear array transducer (Siemens Medical Solutions, Malvern, PA). Offline analysis estimated the attenuation coefficient and backscatter coefficients (BSCs) from breast fat using the reference phantom method. The average BSC was calculated over 6 to 12 MHz to objectively quantify the BI-RADS US echo pattern descriptor, and effective scatterer diameters were also estimated.

RESULTS

A power law fit to the attenuation coefficient versus frequency yielded an attenuation coefficient of 1.28 dB·cm(-1) MHz(-0.73). The mean attenuation coefficient versus frequency slope ± SD at 7 MHz was 0.73 ± 0.23 dB·cm(-1) MHz(-1), in agreement with previously reported values. The BSC versus frequency showed close agreement among all patients, both in magnitude and frequency dependence, with a power law fit of (0.6 ± 0.25) ×10(-4) sr(-1) cm(-1) MHz(-2.49). The average backscatter in the 6-12-MHz range was 0.004 ± 0.002 sr(-1) cm(-1). The mean effective scatterer diameter for fat was 60.2 ± 9.5 μm.

CONCLUSIONS

The agreement in parameter estimates for breast fat among these patients supports the use of fat as a standard for comparison with tumors. Results also suggest that objective quantification of these BI-RADS US descriptors may reduce subjectivity when interpreting B-mode image data.

Variation of ultrasound image lateral spectrum with assumed speed of sound and true scatterer density

One method of estimating sound speed in diagnostic ultrasound imaging consists of choosing the speed of sound that generates the sharpest image, as evaluated by the lateral frequency spectrum of the squared B-mode image. In the current work, simulated and experimental data on a typical (47 mm aperture, 3.3-10.0 MHz response) linear array transducer are used to investigate the accuracy of this method. A range of candidate speeds of sound (1240-1740 m/s) was used, with a true speed of sound of 1490 m/s in simulations and 1488 m/s in experiments. Simulations of single point scatterers and two interfering point scatterers at various locations with respect to each other gave estimate errors of 0.0-2.0%. Simulations and experiments of scatterer distributions with a mean scatterer spacing of at least 0.5 mm gave estimate errors of 0.1-4.0%. In the case of lower scatterer spacing, the speed of sound estimates become unreliable due to a decrease in contrast of the sharpness measure between different candidate speeds of sound. This suggests that in estimating speed of sound in tissue, the region of interest should be dominated by a few, sparsely spaced scatterers. Conversely, the decreasing sensitivity of the sharpness measure to speed of sound errors for higher scatterer concentrations suggests a potential method for estimating mean scatterer spacing.

Scatterer number density considerations in reference phantom-based attenuation estimation

Attenuation estimation and imaging have the potential to be a valuable tool for tissue characterization, particularly for indicating the extent of thermal ablation therapy in the liver. Often the performance of attenuation estimation algorithms is characterized with numerical simulations or tissue-mimicking phantoms containing a high scatterer number density (SND). This ensures an ultrasound signal with a Rayleigh distributed envelope and a signal-to-noise ratio (SNR) approaching 1.91. However, biological tissue often fails to exhibit Rayleigh scattering statistics. For example, across 1647 regions of interest in five ex vivo bovine livers, we obtained an envelope SNR of 1.10 ± 0.12 when the tissue was imaged with the VFX 9L4 linear array transducer at a center frequency of 6.0 MHz on a Siemens S2000 scanner. In this article, we examine attenuation estimation in numerical phantoms, tissue-mimicking phantoms with variable SNDs and ex vivo bovine liver before and after thermal coagulation. We find that reference phantom-based attenuation estimation is robust to small deviations from Rayleigh statistics. However, in tissue with low SNDs, large deviations in envelope SNR from 1.91 lead to subsequently large increases in attenuation estimation variance. At the same time, low SND is not found to be a significant source of bias in the attenuation estimate. For example, we find that the standard deviation of attenuation slope estimates increases from 0.07 to 0.25 dB/cm-MHz as the envelope SNR decreases from 1.78 to 1.01 when estimating attenuation slope in tissue-mimicking phantoms with a large estimation kernel size (16 mm axially × 15 mm laterally). Meanwhile, the bias in the attenuation slope estimates is found to be negligible (<0.01 dB/cm-MHz). We also compare results obtained with reference phantom-based attenuation estimates in ex vivo bovine liver and thermally coagulated bovine liver.

Task-oriented comparison of power spectral density estimation methods for quantifying acoustic attenuation in diagnostic ultrasound using a reference phantom method

Reported here is a phantom-based comparison of methods for determining the power spectral density (PSD) of ultrasound backscattered signals. Those power spectral density values are then used to estimate parameters describing α(f), the frequency dependence of the acoustic attenuation coefficient. Phantoms were scanned with a clinical system equipped with a research interface to obtain radiofrequency echo data. Attenuation, modeled as a power law α(f)= α0 f (β), was estimated using a reference phantom method. The power spectral density was estimated using the short-time Fourier transform (STFT), Welch's periodogram, and Thomson's multitaper technique, and performance was analyzed when limiting the size of the parameter-estimation region. Errors were quantified by the bias and standard deviation of the α0 and β estimates, and by the overall power-law fit error (FE). For parameter estimation regions larger than ~34 pulse lengths (~1 cm for this experiment), an overall power-law FE of 4% was achieved with all spectral estimation methods. With smaller parameter estimation regions as in parametric image formation, the bias and standard deviation of the α0 and β estimates depended on the size of the parameter estimation region. Here, the multitaper method reduced the standard deviation of the α0 and β estimates compared with those using the other techniques. The results provide guidance for choosing methods for estimating the power spectral density in quantitative ultrasound methods.

Quantitative assessment of in vivo breast masses using ultrasound attenuation and backscatter

Clinical analysis of breast ultrasound imaging is done qualitatively, facilitated with the ultrasound breast imaging-reporting and data system (US BI-RADS) lexicon, which helps to standardize imaging assessments. Two descriptors in that lexicon, "posterior acoustic features" and the "echo pattern" within a mass, are directly related to quantitative ultrasound (QUS) parameters, namely, ultrasound attenuation and the average backscatter coefficient (BSC). The purpose of this study was to quantify ultrasound attenuation and backscatter in breast masses and to investigate these QUS properties as potential differential diagnostic markers. Radio frequency (RF) echo signals were from patients with breast masses during a special ultrasound imaging session prior to core biopsy. Data were also obtained from a well characterized phantom using identical system settings. Masses include 14 fibroadenomas and 10 carcinomas. Attenuation for the acoustic path lying proximal to the tumor was estimated offline using a least squares method with constraints. BSCs were estimated using a reference phantom method (RPM). The attenuation coefficient within each mass was assessed using both the RPM and a hybrid method, and effective scatterer diameters (ESDs) were estimated using a Gaussian form factor model. Attenuation estimates obtained with the RPM were consistent with estimates done using the hybrid method in all cases except for two masses. The mean slope of the attenuation coefficient versus frequency for carcinomas was 20% greater than the mean slope value for the fibroadenomas. The product of the attenuation coefficient and anteroposterior dimension of the mass was computed to estimate the total attenuation for each mass. That value correlated well with the BI-RADS assessment of "posterior acoustic features" judged qualitatively from gray scale images. Nearly all masses were described as "hypoechoic," so no strong statements could be made about the correlation of echo pattern findings in BI-RADS with the averaged BSC values. However, most carcinomas exhibited lower values for the frequency-average BSC than fibroadenomas. The mean ESD alone did not differentiate the mass type, but fibroadenomas had greater variability in ESDs within the ROI than that found for invasive ductal carcinomas. This study demonstrates the potential to use attenuation and QUS parameters associated with the BSC as quantitative descriptors.

Cross-imaging system comparison of backscatter coefficient estimates from a tissue-mimicking material

A key step toward implementing quantitative ultrasound techniques in a clinical setting is demonstrating that parameters such as the ultrasonic backscatter coefficient (BSC) can be accurately estimated independent of the clinical imaging system used. In previous studies, agreement in BSC estimates for well characterized phantoms was demonstrated across different laboratory systems. The goal of this study was to compare the BSC estimates of a tissue mimicking sample measured using four clinical scanners, each providing RF echo data in the 1-15 MHz frequency range. The sample was previously described and characterized with single-element transducer systems. Using a reference phantom for analysis, excellent quantitative agreement was observed across the four array-based imaging systems for BSC estimates. Additionally, the estimates from data acquired with the clinical systems agreed with theoretical predictions and with estimates from laboratory measurements using single-element transducers.