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Zheng H, Sechi LA, Navarese EP, Casu G, Vidili G. Metabolic dysfunction-associated steatotic liver disease and cardiovascular risk: a comprehensive review. Cardiovasc Diabetol 2024; 23:346. [PMID: 39342178 PMCID: PMC11439309 DOI: 10.1186/s12933-024-02434-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 09/09/2024] [Indexed: 10/01/2024] Open
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed nonalcoholic fatty liver disease (NAFLD), poses a significant global health challenge due to its increasing prevalence and strong association with cardiovascular disease (CVD). This comprehensive review summarizes the current knowledge on the MASLD-CVD relationship, compares analysis of how different terminologies for fatty liver disease affect cardiovascular (CV) risk assessment using different diagnostic criteria, explores the pathophysiological mechanisms connecting MASLD to CVD, the influence of MASLD on traditional CV risk factors, the role of noninvasive imaging techniques and biomarkers in the assessment of CV risk in patients with MASLD, and the implications for clinical management and prevention strategies. By incorporating current research and clinical guidelines, this review provides a comprehensive overview of the complex interplay between MASLD and cardiovascular health.
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Affiliation(s)
- Haixiang Zheng
- Department of Biomedical Sciences, University of Sassari, 07100, Sassari, Italy
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, 515041, Shantou, China
| | - Leonardo Antonio Sechi
- Department of Biomedical Sciences, University of Sassari, 07100, Sassari, Italy
- Complex Structure of Microbiology and Virology, AOU Sassari, 07100, Sassari, Italy
| | - Eliano Pio Navarese
- Clinical and Experimental Cardiology, Clinical and Interventional Cardiology, University of Sassari, Sassari, Italy
| | - Gavino Casu
- Clinical and Experimental Cardiology, Clinical and Interventional Cardiology, University of Sassari, Sassari, Italy
| | - Gianpaolo Vidili
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, Azienda Ospedaliero, 07100, Sassari, Italy.
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Caughey MC, Francis RO, Karafin MS. New and emerging technologies for pretransfusion blood quality assessment: A state-of-the-art review. Transfusion 2024. [PMID: 39325509 DOI: 10.1111/trf.18019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 08/14/2024] [Accepted: 09/07/2024] [Indexed: 09/27/2024]
Affiliation(s)
- Melissa C Caughey
- Joint Department of Biomedical Engineering, University of North Carolina and North Carolina State University, Chapel Hill, North Carolina, USA
| | - Richard O Francis
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Matthew S Karafin
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
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Bonacin YDS, Santos VJC, Maronezi MC, Aires LPN, Machado MP, Barbosa BL, Santana AM, Del’Aguila-Silva P, Canola PA, Feliciano MAR, Marques JA. Evaluation of ARFI elastography for detecting active mastitis in sheep with previous fibrous lesions: a study of mammary parenchyma and supramammary lymph nodes. Anim Reprod 2024; 21:e20230160. [PMID: 39371542 PMCID: PMC11452156 DOI: 10.1590/1984-3143-ar2023-0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 06/14/2024] [Indexed: 10/08/2024] Open
Abstract
The aim of the study was to evaluate the use of Acustic Radiation Force Impulse (ARFI) elastography in mammary parenchyma and supramammary lymph nodes, for detection of active mastitis in sheep with naturally infected chronic fibrous lesions. 27 female sheep were included and B-mode ultrasound and ARFI elastography images were obtained, acquiring qualitative (echogenicity and echotexture) and quantitative (shear rate, depth and short/long axis ratio) variables of 48 mammary glands. The glands were divided into three experimental groups: control group (CG) - healthy animals; LSCC- animals that presented fibrous lesions and SCC (somatic cell count) less than 500 x 103 cls/mL; HSCC: animals that presented fibrous lesions and SCC (somatic cell count) more than 500 x 103 cls/mL; The qualitative variables using B-mode ultrasonography, including echotexture and echogenicity, showed no significant differences between the evaluated groups and tissues (p = 0.9336 and p = 0.233, respectively) .In healthy areas of the gland, it was an increasing in shear wave velocity (SWV) in LSCC than in HSCC (p=0.04). When comparing the fibrosis in the LSCC and HSCC groups with their respective normal areas, the velocity increased in both groups: LSCC (p= 0,0007) and HSCC (p= 0,0001). When comparing the areas of fibrosis in LSCC and HSCC with the CG parenchyma, there was an increase in LSCC (p=0.001) and HSCC (p=0.0001). B-mode ultrasound indicate predominance of hypoechoic echogenicity in lymph nodes and reduced short/long axis ratio in cases of active subclinical mastitis. The supramammary lymph node showed increased SWV when comparing the CG with HSCC groups (p=0.02) and GC with LSCC (p=0.04). B-mode ultrasonography is useful for evaluating the mammary parenchyma, however, its application as a standalone diagnostic technique is not recommended. ARFI elastography indicates potential cutoff points for differentiating subclinical mastitis from healed mastitis, highlighting its importance as a tool for distinguishing normal areas from fibrous parenchymal areas. While this study did not establish specific cutoff points due to sample size limitations, further research with larger sample sizes could explore and define these critical thresholds.
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Affiliation(s)
- Yuri da Silva Bonacin
- Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Departamento de Clínica e Cirurgia Veterinária, Jaboticabal, SP, Brasil
| | - Victor José Correia Santos
- Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Departamento de Patologia, Reprodução e Saúde Única, Jaboticabal, SP, Brasil
| | - Marjury Cristina Maronezi
- Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Departamento de Clínica e Cirurgia Veterinária, Jaboticabal, SP, Brasil
| | - Luiz Paulo Nogueira Aires
- Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Departamento de Clínica e Cirurgia Veterinária, Jaboticabal, SP, Brasil
| | | | | | - André Marcos Santana
- Universidade Estadual de Maringá, Departamento de Medicina Veterinária, Maringá, PR, Brasil
| | - Priscila Del’Aguila-Silva
- Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Departamento de Clínica e Cirurgia Veterinária, Jaboticabal, SP, Brasil
| | - Paulo Aléscio Canola
- Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Departamento de Clínica e Cirurgia Veterinária, Jaboticabal, SP, Brasil
| | - Marcus Antônio Rossi Feliciano
- Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Departamento de Clínica e Cirurgia Veterinária, Jaboticabal, SP, Brasil
- Faculdade de Zootecnia e Engenharia de Alimentos, Universidade de São Paulo, Departamento de Medicina Veterinária, Pirassununga, SP, Brasil
| | - José Antônio Marques
- Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Departamento de Clínica e Cirurgia Veterinária, Jaboticabal, SP, Brasil
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Nguyen CD, Chen Y, Kaplan DL, Mallidi S. Multi-parametric Photoacoustic Imaging Combined with Acoustic Radiation Force Impulse Imaging for Applications in Tissue Engineering. Ann Biomed Eng 2024:10.1007/s10439-024-03617-7. [PMID: 39294465 DOI: 10.1007/s10439-024-03617-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 09/03/2024] [Indexed: 09/20/2024]
Abstract
Tissue engineering is a dynamic field focusing on the creation of advanced scaffolds for tissue and organ regeneration. These scaffolds are customized to their specific applications and are often designed to be complex, large structures to mimic tissues and organs. This study addresses the critical challenge of effectively characterizing these thick, optically opaque scaffolds that traditional imaging methods fail to fully image due to their optical limitations. We introduce a novel multi-modal imaging approach combining ultrasound, photoacoustic, and acoustic radiation force impulse imaging. This combination leverages its acoustic-based detection to overcome the limitations posed by optical imaging techniques. Ultrasound imaging is employed to monitor the scaffold structure, photoacoustic imaging is employed to monitor cell proliferation, and acoustic radiation force impulse imaging is employed to evaluate the homogeneity of scaffold stiffness. We applied this integrated imaging system to analyze melanoma cell growth within silk fibroin protein scaffolds with varying pore sizes and therefore stiffness over different cell incubation periods. Among various materials, silk fibroin was chosen for its unique combination of features including biocompatibility, tunable mechanical properties, and structural porosity which supports extensive cell proliferation. The results provide a detailed mesoscale view of the scaffolds' internal structure, including cell penetration depth and biomechanical properties. Our findings demonstrate that the developed multimodal imaging technique offers comprehensive insights into the physical and biological dynamics of tissue-engineered scaffolds. As the field of tissue engineering continues to advance, the importance of non-ionizing and non-invasive imaging systems becomes increasingly evident, and by facilitating a deeper understanding and better characterization of scaffold architectures, such imaging systems are pivotal in driving the success of future tissue-engineering solutions.
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Affiliation(s)
| | - Ying Chen
- Department of Biomedical Engineering, Tufts University, Medford, MA, 02155, USA
| | - David L Kaplan
- Department of Biomedical Engineering, Tufts University, Medford, MA, 02155, USA
| | - Srivalleesha Mallidi
- Department of Biomedical Engineering, Tufts University, Medford, MA, 02155, USA.
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Lee MS, Cho JY, Moon MH, Lee J, Lee JP, Shin N, Jin W, Cho A. Comprehensive ultrasonographic evaluation of normal and fibrotic kidneys in a mouse model with an ultra-high-frequency transducer. Ultrasonography 2024; 43:314-326. [PMID: 39113383 PMCID: PMC11374587 DOI: 10.14366/usg.24024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 06/21/2024] [Indexed: 09/04/2024] Open
Abstract
PURPOSE This study aimed to establish baseline morphological and functional data for normal mouse kidneys via a clinical 33 MHz ultra-high-frequency (UHF) transducer, compare the data with the findings from fibrotic mice, and assess correlations between ultrasonography (US) parameters and fibrosis-related markers. METHODS This retrospective study aggregated data from three separate experiments (obstructive nephropathy, diabetic nephropathy, and acute-to-chronic kidney injury models). Morphological parameters (kidney size, parenchymal thickness [PT]) and functional (shear-wave speed [SWS], stiffness, resistive index [RI], and microvascular imaging-derived vascular index [VI]) were assessed and compared between normal and fibrotic mouse kidneys. Semi-quantitative histopathologic scores were calculated and molecular markers (epithelial cadherin), Collagen 1A1 [Col1A1], transforming growth factor-β, and α-smooth muscle actin [α-SMA]) were evaluated using western blots. Correlations with US parameters were explored. RESULTS Clinical UHF US successfully imaged the kidneys of the experimental mice. A three-layer configuration was prevalent in the normal mouse kidney parenchyma (34/35) but was blurred in most fibrotic mouse kidneys (33/40). US parameters, including size (11.14 vs. 10.70 mm), PT (2.07 vs. 1.24 mm), RI (0.64 vs. 0.77), VI (22.55% vs. 11.47%, only for non-obstructive kidneys), SWS (1.67 vs. 2.06 m/s), and stiffness (8.23 vs. 12.92 kPa), showed significant differences between normal and fibrotic kidneys (P<0.001). These parameters also demonstrated strong discriminative ability in receiver operating characteristic curve analysis (area under the curve, 0.76 to 0.95; P<0.001). PT, VI, and RI were significantly correlated with histological fibrosis markers (ρ=-0.64 to -0.68 for PT and VI, ρ=0.71-0.76 for RI, P<0.001). VI exhibited strong negative correlations with Col1A1 (ρ=-0.76, P=0.006) and α-SMA (ρ=-0.75, P=0.009). CONCLUSION Clinical UHF US effectively distinguished normal and fibrotic mouse kidneys, indicating the potential of US parameters, notably VI, as noninvasive markers for tracking fibrosis initiation and progression in mouse kidney fibrosis models.
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Affiliation(s)
- Myoung Seok Lee
- Department of Radiology, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jeong Yeon Cho
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Min Hoan Moon
- Department of Radiology, Seoul National University Boramae Medical Center, Seoul, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Jeonghwan Lee
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Pyo Lee
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Translational Medicine Major, Seoul National University College of Medicine, Seoul, Korea
| | - Nayeon Shin
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Wencheng Jin
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ara Cho
- Translational Medicine Major, Seoul National University College of Medicine, Seoul, Korea
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Di W, Zhang R, Gui Z, Shang Y. Acoustomotive diffuse correlation spectroscopy for sensing mechanical stiffness in tissue-mimicking phantoms. BIOMEDICAL OPTICS EXPRESS 2024; 15:5328-5348. [PMID: 39296393 PMCID: PMC11407260 DOI: 10.1364/boe.531963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 08/09/2024] [Accepted: 08/09/2024] [Indexed: 09/21/2024]
Abstract
Many diseases, such as inflammation, dropsy, or tumors, often cause alterations in the mechanical stiffness of human tissues. Ultrasound-based techniques are commonly adopted in clinics for stiffness assessment, whereas optical methodologies hold promise for sensing strain changes and providing optical information pertaining to the microcirculatory network, thereby facilitating comprehensive measurements of tissue physiopathology. Diffuse correlation spectroscopy (DCS), an emerging dynamic light scattering technique, has been used to capture the enhanced motion of light scatterers induced by acoustic radiation force (ARF). Theoretically, the amplitude of this enhanced scatterers motion is related to the medium stiffness. Based on this relationship, we report a light coherent technique that combines ARF and DCS to qualitatively evaluate changes in the stiffness of medium. We experimentally demonstrate the accuracy and feasibility of this technique for probing stiffness in homogeneous phantom by comparing it with independent ultrasound methods. Additionally, we explore a potential application of this technique in distinguishing between fluid filled lesion and homogeneous tissue through heterogeneous phantom experiments. This unique combination of ARF and DCS, namely, acoustomotive DCS (AM-DCS), would provide an alternative way to measure particle-motion related stiffness, thereby assisting in the diagnosis and treatment of diseases.
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Affiliation(s)
- Wenqi Di
- State Key Laboratory of Dynamic Measurement Technology, North University of China , No. 3 Xueyuan Road, Taiyuan 030051, China
| | - Ruizhi Zhang
- State Key Laboratory of Dynamic Measurement Technology, North University of China , No. 3 Xueyuan Road, Taiyuan 030051, China
| | - Zhiguo Gui
- State Key Laboratory of Dynamic Measurement Technology, North University of China , No. 3 Xueyuan Road, Taiyuan 030051, China
| | - Yu Shang
- School of Life and Health Technology, Dongguan University of Technology, Daxue Road, Songshan Lake District, Dongguan 523808, China
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Nathani A, Keshishyan S, Cho RJ. Advancements in Interventional Pulmonology: Harnessing Ultrasound Techniques for Precision Diagnosis and Treatment. Diagnostics (Basel) 2024; 14:1604. [PMID: 39125480 PMCID: PMC11312290 DOI: 10.3390/diagnostics14151604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 07/03/2024] [Accepted: 07/05/2024] [Indexed: 08/12/2024] Open
Abstract
Medical ultrasound has emerged as an indispensable tool within interventional pulmonology, revolutionizing diagnostic and procedural practices through its non-invasive nature and real-time visualization capabilities. By harnessing the principles of sound waves and employing a variety of transducer types, ultrasound facilitates enhanced accuracy and safety in procedures such as transthoracic needle aspiration and pleural effusion drainage, consequently leading to improved patient outcomes. Understanding the fundamentals of ultrasound physics is paramount for clinicians, as it forms the basis for interpreting imaging results and optimizing interventions. Thoracic ultrasound plays a pivotal role in diagnosing conditions like pleural effusions and pneumothorax, while also optimizing procedures such as thoracentesis and biopsy by providing precise guidance. Advanced ultrasound techniques, including endobronchial ultrasound, has transformed the evaluation and biopsy of lymph nodes, bolstered by innovative features like elastography, which contribute to increased procedural efficacy and patient safety. Peripheral ultrasound techniques, notably radial endobronchial ultrasound (rEBUS), have become essential for assessing pulmonary nodules and evaluating airway structures, offering clinicians valuable insights into disease localization and severity. Neck ultrasound serves as a crucial tool in guiding supraclavicular lymph node biopsy and percutaneous dilatational tracheostomy procedures, ensuring safe placement and minimizing associated complications. Ultrasound technology is suited for further advancement through the integration of artificial intelligence, miniaturization, and the development of portable devices. These advancements hold the promise of not only improving diagnostic accuracy but also enhancing the accessibility of ultrasound imaging in diverse healthcare settings, ultimately expanding its utility and impact on patient care. Additionally, the integration of enhanced techniques such as contrast-enhanced ultrasound and 3D imaging is anticipated to revolutionize personalized medicine by providing clinicians with a more comprehensive understanding of anatomical structures and pathological processes. The transformative potential of medical ultrasound in interventional pulmonology extends beyond mere technological advancements; it represents a paradigm shift in healthcare delivery, empowering clinicians with unprecedented capabilities to diagnose and treat pulmonary conditions with precision and efficacy. By leveraging the latest innovations in ultrasound technology, clinicians can navigate complex anatomical structures with confidence, leading to more informed decision-making and ultimately improving patient outcomes. Moreover, the portability and versatility of modern ultrasound devices enable their deployment in various clinical settings, from traditional hospital environments to remote or resource-limited areas, thereby bridging gaps in healthcare access and equity.
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Affiliation(s)
| | | | - Roy Joseph Cho
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Minnesota, Minneapolis, MN 55455, USA; (A.N.); (S.K.)
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Norouzi Ghehi E, Fallah A, Rashidi S, Mehdizadeh Dastjerdi M. Evaluating the effect of tissue stimulation at different frequencies on breast lesion classification based on nonlinear features using a novel radio frequency time series approach. Heliyon 2024; 10:e33133. [PMID: 39027586 PMCID: PMC11255572 DOI: 10.1016/j.heliyon.2024.e33133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 07/20/2024] Open
Abstract
Objective Radio Frequency Time Series (RF TS) is a cutting-edge ultrasound approach in tissue typing. The RF TS does not provide dynamic insights into the propagation medium; when the tissue and probe are fixed. We previously proposed the innovative RFTSDP method in which the RF data are recorded while stimulating the tissue. Applying stimulation can unveil the mechanical characteristics of the tissue in RF echo. Materials and methods In this study, an apparatus was developed to induce vibrations at different frequencies to the medium. Data were collected from four PVA phantoms simulating the nonlinear behaviors of healthy, fibroadenoma, cyst, and cancerous breast tissues. Raw focused, raw, and beamformed ultrafast data were collected under conditions of no stimulation, constant force, and various vibrational stimulations using the Supersonic Imagine Aixplorer clinical/research ultrasound imaging system. Time domain (TD), spectral, and nonlinear features were extracted from each RF TS. Support Vector Machine (SVM), Random Forest, and Decision Tree algorithms were employed for classification. Results The optimal outcome was achieved using the SVM classifier considering 19 features extracted from beamformed ultrafast data recorded while applying vibration at the frequency of 65 Hz. The classification accuracy, specificity, and precision were 98.44 ± 0.20 %, 99.49 ± 0.01 %, and 98.53 ± 0.04 %, respectively. Applying RFTSDP, a notable 24.45 % improvement in accuracy was observed compared to the case of fixed probe assessing the recorded raw focused data. Conclusions External vibration at an appropriate frequency, as applied in RFTSDP, incorporates beneficial information about the medium and its dynamic characteristics into the RF TS, which can improve tissue characterization.
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Affiliation(s)
- Elaheh Norouzi Ghehi
- Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Ali Fallah
- Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Saeid Rashidi
- Faculty of Medical Sciences and Technologies, Science and Research Branch, Islamic Azad University, Tehran, Iran
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Martikkala L, Pemmari A, Himanen SL, Mäkelä K. Median Nerve Shear Wave Elastography Is Associated With the Neurophysiological Severity of Carpal Tunnel Syndrome. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:1253-1263. [PMID: 38516753 DOI: 10.1002/jum.16450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/08/2024] [Accepted: 03/08/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES This study examines the associations between the median nerve (MN) shear wave elastography (SWE), the MN cross-sectional area (CSA), patient's symptoms, and the neurophysiological severity of carpal tunnel syndrome (CTS). The most appropriate site to perform SWE was also tested. METHODS This prospective study comprised 86 wrists of 47 consecutive patients who volunteered for MN ultrasound after an electrodiagnostic study. The neurophysiological severity of CTS was assessed according to the results of a nerve conduction study (NCS). The MN CSA was measured at the carpal tunnel inlet (wCSA) and the forearm (fCSA). SWE was performed on the MN in a longitudinal orientation at the wrist crease (wSWE), at the forearm (fSWE), and within the carpal tunnel (tSWE). RESULTS The wCSA and wSWE correlated positively with the neurophysiological severity of CTS (r = .619, P < .001; r = .582, P < .001, respectively). The optimal cut-off values to discriminate the groups with normal NCS and with findings indicating CTS were 10.5 mm2 for the wCSA and 4.12 m/s for the wSWE. With these cut-off values, wCSA had a sensitivity of 80% and specificity of 87% and wSWE a sensitivity of 88% and specificity of 76%. Neither tSWE nor fSWE correlated with the neurophysiological severity of CTS or differed between NCS negative and positive groups (P = .429, P = .736, respectively). CONCLUSION Shear wave velocity in the MN at the carpal tunnel inlet increases in CTS and correlates to the neurophysiological CTS severity equivalently to CSA measured at the same site.
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Affiliation(s)
- Lauri Martikkala
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Antti Pemmari
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Clinical Neurophysiology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Sari-Leena Himanen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Clinical Neurophysiology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Katri Mäkelä
- Department of Clinical Neurophysiology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
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Patil PV, Jain S. Point Shear Wave Elastography for Splenic Assessment: A Comparative Study of Splenomegaly and Normal Spleens. Cureus 2024; 16:e62869. [PMID: 39040771 PMCID: PMC11262765 DOI: 10.7759/cureus.62869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 06/21/2024] [Indexed: 07/24/2024] Open
Abstract
Background The spleen, a key immunological organ, plays a crucial role in filtering aged or damaged red blood cells. Splenomegaly, an enlargement of the spleen, can arise from a variety of physiological and pathological conditions, including hematological disorders, hepatic diseases, and infections. Accurate diagnosis and evaluation of splenomegaly are essential for effective treatment. Objectives The objective of this study was to evaluate splenic stiffness in patients with splenomegaly using point shear wave elastography (pSWE) and compare the findings with those of individuals with normal spleen. Materials and methods This hospital-based observational study was conducted at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, India, from October 2022 to December 2023. The study included 56 participants, divided into two groups: 28 patients with splenomegaly and 28 healthy controls. Spleen stiffness was measured using a Samsung HS70A ultrasound machine (Samsung Electronics Pvt. Ltd., Seoul, South Korea), and pSWE was performed with a curvilinear probe. Data were analyzed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States), and the significance of differences was assessed using an independent t-test with a p-value of <0.05, considered statistically significant. Results The mean spleen stiffness, measured in kilopascals (kPa), was significantly higher in individuals with splenomegaly (32.05 ± 12.54 kPa) compared to controls (22.9 ± 9.49 kPa) (p = 0.003). A positive correlation (rho = 0.482, p < 0.001) was observed between spleen diameter and spleen stiffness. Conclusion This study demonstrates that pSWE is an effective, non-invasive tool for assessing spleen stiffness. The higher spleen stiffness in splenomegaly patients underscores pSWE's diagnostic utility, with a positive correlation between spleen diameter and stiffness. Further multi-center studies are recommended to validate these findings, highlighting pSWE's promise in evaluating and monitoring splenic disorders.
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Affiliation(s)
- Parag V Patil
- Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Saksham Jain
- Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
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Masud AA, Liu J. Ultrasonic surface acoustic wave elastography: A review of basic theories, technical developments, and medical applications. Med Phys 2024; 51:3220-3244. [PMID: 38597908 DOI: 10.1002/mp.17063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 02/19/2024] [Accepted: 03/18/2024] [Indexed: 04/11/2024] Open
Abstract
Physiological and pathological changes in tissues often cause changes in tissue mechanical properties, making tissue elastography an effective modality in medical imaging. Among the existing elastography methods, ultrasound elastography is of great interest due to the inherent advantages of ultrasound imaging technology, such as low cost, portability, safety, and wide availability. However, most current ultrasound elastography methods are based on the bulk shear wave; they can image deep tissues but cannot image superficial tissues. To address this challenge, ultrasonic elastography methods based on surface acoustic waves have been proposed. In this paper, we present a comprehensive review of ultrasound-based surface acoustic wave elastography techniques, including their theoretical foundations, technical implementations, and existing medical applications. The goal is to provide a concise summary of the state-of-the-art of this field, hoping to offer a reliable reference for the further development of these techniques and foster the expansion of their medical applications.
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Affiliation(s)
- Abdullah Al Masud
- Biomedical Acoustics Research Laboratory, Department of Mechanical Engineering, Texas Tech University, Lubbock, Texas, USA
| | - Jingfei Liu
- Biomedical Acoustics Research Laboratory, Department of Mechanical Engineering, Texas Tech University, Lubbock, Texas, USA
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Chen X, Li X, Turco S, van Sloun RJG, Mischi M. Ultrasound Viscoelastography by Acoustic Radiation Force: A State-of-the-Art Review. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2024; 71:536-557. [PMID: 38526897 DOI: 10.1109/tuffc.2024.3381529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Ultrasound elastography (USE) is a promising tool for tissue characterization as several diseases result in alterations of tissue structure and composition, which manifest as changes in tissue mechanical properties. By imaging the tissue response to an applied mechanical excitation, USE mimics the manual palpation performed by clinicians to sense the tissue elasticity for diagnostic purposes. Next to elasticity, viscosity has recently been investigated as an additional, relevant, diagnostic biomarker. Moreover, since biological tissues are inherently viscoelastic, accounting for viscosity in the tissue characterization process enhances the accuracy of the elasticity estimation. Recently, methods exploiting different acquisition and processing techniques have been proposed to perform ultrasound viscoelastography. After introducing the physics describing viscoelasticity, a comprehensive overview of the currently available USE acquisition techniques is provided, followed by a structured review of the existing viscoelasticity estimators classified according to the employed processing technique. These estimators are further reviewed from a clinical usage perspective, and current outstanding challenges are discussed.
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13
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Kim YH, Kang KC, Kim JN, Park KK, Firouzi K, Khuri-Yakub BT. High-spatial-resolution transcranial focused ultrasound neuromodulation using frequency-modulated pattern interference radiation force. ULTRASONICS 2024; 140:107298. [PMID: 38531115 DOI: 10.1016/j.ultras.2024.107298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 07/28/2023] [Accepted: 03/13/2024] [Indexed: 03/28/2024]
Abstract
Stimulating the brain in a precise location is crucial in ultrasound neuromodulation. However, improving the resolution proves a challenge owing to the characteristics of transcranial focused ultrasound. In this paper, we present a new neuromodulation system that overcomes the existing limitations based on an acoustic radiation force with a frequency-modulated waveform and standing waves. By using the frequency-modulated pattern interference radiation force (FM-PIRF), the axial spatial resolution can be reduced to a single wavelength level and the target location can be controlled in axial direction electronically. A linear frequency-modulated chirp waveform used in the experiment was designed based on the simulation results. The displacement of the polydimethylsiloxane (PDMS) cantilever was measured at intervals of 0.1 mm to visualize the distribution of radiation force. These results and methods experimentally show that FM-PIRF has improved spatial resolution and capability of electrical movement.
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Affiliation(s)
- Young Hun Kim
- Mechanical Convergence Engineering, Hanyang University, Seoul 04763, Republic of Korea; Edward. L. Ginzton Lab, Stanford University, Stanford, CA 94305, USA
| | - Ki Chang Kang
- Mechanical Convergence Engineering, Hanyang University, Seoul 04763, Republic of Korea
| | - Jeong Nyeon Kim
- Edward. L. Ginzton Lab, Stanford University, Stanford, CA 94305, USA
| | - Kwan Kyu Park
- Edward. L. Ginzton Lab, Stanford University, Stanford, CA 94305, USA.
| | - Kamyar Firouzi
- Edward. L. Ginzton Lab, Stanford University, Stanford, CA 94305, USA
| | - Butrus T Khuri-Yakub
- Department of Electrical Engineering, Stanford University, Stanford, CA 94305, USA.
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14
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Nguyen CD, Chen Y, Kaplan DL, Mallidi S. Multi-spectral photoacoustic imaging combined with acoustic radiation force impulse imaging for applications in tissue engineering. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.23.590806. [PMID: 38712117 PMCID: PMC11071356 DOI: 10.1101/2024.04.23.590806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Tissue engineering is a dynamic field focusing on the creation of advanced scaffolds for tissue and organ regeneration. These scaffolds are customized to their specific applications and are often designed to be complex, large structures to mimic tissues and organs. This study addresses the critical challenge of effectively characterizing these thick, optically opaque scaffolds that traditional imaging methods fail to fully image due to their optical limitations. We introduce a novel multi-modal imaging approach combining ultrasound, photoacoustic, and acoustic radiation force impulse imaging. This combination leverages its acoustic-based detection to overcome the limitations posed by optical imaging techniques. Ultrasound imaging is employed to monitor the scaffold structure, photoacoustic imaging is employed to monitor cell proliferation, and acoustic radiation force impulse imaging is employed to evaluate the homogeneity of scaffold stiffness. We applied this integrated imaging system to analyze melanoma cell growth within silk fibroin protein scaffolds with varying pore sizes and therefore stiffness over different cell incubation periods. Among various materials, silk fibroin was chosen for its unique combination of features including biocompatibility, tunable mechanical properties, and structural porosity which supports extensive cell proliferation. The results provide a detailed mesoscale view of the scaffolds' internal structure, including cell penetration depth and biomechanical properties. Our findings demonstrate that the developed multimodal imaging technique offers comprehensive insights into the physical and biological dynamics of tissue-engineered scaffolds. As the field of tissue engineering continues to advance, the importance of non-ionizing and non-invasive imaging systems becomes increasingly evident, and by facilitating a deeper understanding and better characterization of scaffold architectures, such imaging systems are pivotal in driving the success of future tissue-engineering solutions.
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15
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Kim GS, Moon HH, Lee HS, Jeong JS. Compound Acoustic Radiation Force Impulse Imaging of Bovine Eye by Using Phase-Inverted Ultrasound Transducer. SENSORS (BASEL, SWITZERLAND) 2024; 24:2700. [PMID: 38732804 PMCID: PMC11085659 DOI: 10.3390/s24092700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024]
Abstract
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.
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Affiliation(s)
| | | | | | - Jong Seob Jeong
- Department of Biomedical Engineering, Dongguk University, Seoul 04620, Republic of Korea; (G.S.K.); (H.H.M.); (H.S.L.)
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16
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Billy J, Bensamoun SF, Mercier J, Durand S. Applications of ultrasound elastography to hand and upper limb disorders. HAND SURGERY & REHABILITATION 2024; 43:101636. [PMID: 38215880 DOI: 10.1016/j.hansur.2024.101636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/22/2023] [Accepted: 12/24/2023] [Indexed: 01/14/2024]
Abstract
Ultrasound elastography is a recently developed method for accurate measurement of soft tissue stiffness in addition to the clinician's subjective evaluation. The present review briefly describes the ultrasound elastography techniques and outlines clinical applications for tendon, muscle, nerve, skin and other soft tissues of the hand and upper limb. Strain elastography provides a qualitative evaluation of the stiffness, and shear-wave elastography generates quantitative elastograms superimposed on a B-mode image. The stiffness in degenerative tendinopathy and/or tendon injury was significantly lower than in a normal tendon in several studies. Elastography is also a reliable method to evaluate functional muscle activity, compared to conventional surface electromyography. The median nerve is consistently stiffer in patients with carpal tunnel syndrome than in healthy subjects, on whatever ultrasound elastography technique. Elastography distinguishes normal skin from scars and can be used to evaluate scar severity and treatment. Elastography has huge clinical applications in musculoskeletal tissues. Continued development of systems and increased training of clinicians will expand our knowledge of elastography and its clinical applications in the future.
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Affiliation(s)
- Jessica Billy
- Department of Hand Surgery, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Sabine F Bensamoun
- Sorbonne University, Université de Technologie de Compiègne, CNRS UMR 7338, Biomechanics and Bioengineering, Compiègne, France
| | - Julie Mercier
- Department of Hand Surgery, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Sébastien Durand
- Department of Hand Surgery, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland.
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17
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Alapati R, Bon Nieves A, Wagoner S, Lawrence A, Jones J, Bur AM. Quantitative measurements of radiation-induced fibrosis for head and neck cancer: A narrative review. Laryngoscope Investig Otolaryngol 2024; 9:e1249. [PMID: 38651078 PMCID: PMC11034491 DOI: 10.1002/lio2.1249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/23/2024] [Accepted: 03/30/2024] [Indexed: 04/25/2024] Open
Abstract
Objectives To provide a comprehensive summary of the different modalities available to measure soft tissue fibrosis after radiotherapy in head and neck cancer patients. Data Sources PubMed, Scopus, and Web of Sciences. Review Methods A search was conducted using a list of medical subject headings and terms related to head and neck oncology, radiation fibrosis, and quantitative measurements, including bioimpedance, MRI, and ultrasound. Original research related to quantitative measurement of neck fibrosis post-radiotherapy was included without time constraints, while reviews, case reports, non-English texts, and inaccessible studies were excluded. Discrepancies during the review were resolved by discussing with the senior author until consensus was reached. Results A total of 284 articles were identified and underwent title and abstract screening. Seventeen articles had met our criteria for full-text review based on relevance, of which nine had met our inclusion criteria. Young's modulus (YM) and viscoelasticity measures have demonstrated efficacy in quantifying neck fibrosis, with fibrotic tissues displaying significantly higher YM values and altered viscoelastic properties such as increased stiffness rate-sensitivity and prolonged stress-relaxation post-radiation. Intravoxel incoherent motion offers detailed insights into tissue changes by assessing the diffusion of water molecules and blood perfusion, thereby differentiating fibrosed from healthy tissues. Shear wave elastography has proven to be an effective technique for quantifying radiation-induced fibrosis in the head and neck region by measuring shear wave velocity. Conclusion There are various modalities to measure radiation-induced fibrosis, each with its unique strengths and limitations. Providers should be aware of these implications and decide on methodologies based on their specific clinical workflow. Level of Evidence Step 5.
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Affiliation(s)
- Rahul Alapati
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Antonio Bon Nieves
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Sarah Wagoner
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Amelia Lawrence
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Jill Jones
- Department of RadiologyUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Andrés M. Bur
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
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18
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Cihan A, Holko K, Wei L, Vos HJ, Debbaut C, Caenen A, Segers P. Effect of interstitial fluid pressure on shear wave elastography: an experimental and computational study. Phys Med Biol 2024; 69:075001. [PMID: 38412537 DOI: 10.1088/1361-6560/ad2d80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/27/2024] [Indexed: 02/29/2024]
Abstract
Objective. An elevated interstitial fluid pressure (IFP) can lead to strain-induced stiffening of poroelastic biological tissues. As shear wave elastography (SWE) measures functional tissue stiffness based on the propagation speed of acoustically induced shear waves, the shear wave velocity (SWV) can be used as an indirect measurement of the IFP. The underlying biomechanical principle for this stiffening behavior with pressurization is however not well understood, and we therefore studied how IFP affects SWV through SWE experiments and numerical modeling.Approach. For model set-up and verification, SWE experiments were performed while dynamically modulating IFP in a chicken breast. To identify the confounding factors of the SWV-IFP relationship, we manipulated the material model (linear poroelastic versus porohyperelastic), deformation assumptions (geometric linearity versus nonlinearity), and boundary conditions (constrained versus unconstrained) in a finite element model mimicking the SWE experiments.Main results. The experiments demonstrated a statistically significant positive correlation between the SWV and IFP. The model was able to reproduce a similar SWV-IFP relationship by considering an unconstrained porohyperelastic tissue. Material nonlinearity was identified as the primary factor contributing to this relationship, whereas geometric nonlinearity played a smaller role. The experiments also highlighted the importance of the dynamic nature of the pressurization procedure, as indicated by a different observed SWV-IFP for pressure buildup and relaxation, but its clinical relevance needs to be further investigated.Significance. The developed model provides an adaptable framework for SWE of poroelastic tissues and paves the way towards non-invasive measurements of IFP.
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Affiliation(s)
- Ariana Cihan
- Institute of Biomedical Engineering and Technology, Ghent University, Ghent, Belgium
| | - Kristyna Holko
- Institute of Biomedical Engineering and Technology, Ghent University, Ghent, Belgium
- Department of Structural Engineering, Norwegian University of Science and Technology, Trondheim, Norway
| | - Luxi Wei
- Cardiovascular Institute, Thorax Center, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Hendrik J Vos
- Cardiovascular Institute, Thorax Center, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Charlotte Debbaut
- Institute of Biomedical Engineering and Technology, Ghent University, Ghent, Belgium
| | - Annette Caenen
- Institute of Biomedical Engineering and Technology, Ghent University, Ghent, Belgium
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Patrick Segers
- Institute of Biomedical Engineering and Technology, Ghent University, Ghent, Belgium
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19
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Caenen A, Bézy S, Pernot M, Nightingale KR, Vos HJ, Voigt JU, Segers P, D'hooge J. Ultrasound Shear Wave Elastography in Cardiology. JACC Cardiovasc Imaging 2024; 17:314-329. [PMID: 38448131 DOI: 10.1016/j.jcmg.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 11/14/2023] [Accepted: 12/07/2023] [Indexed: 03/08/2024]
Abstract
The advent of high-frame rate imaging in ultrasound allowed the development of shear wave elastography as a noninvasive alternative for myocardial stiffness assessment. It measures mechanical waves propagating along the cardiac wall with speeds that are related to stiffness. The use of cardiac shear wave elastography in clinical studies is increasing, but a proper understanding of the different factors that affect wave propagation is required to correctly interpret results because of the heart's thin-walled geometry and intricate material properties. The aims of this review are to give an overview of the general concepts in cardiac shear wave elastography and to discuss in depth the effects of age, hemodynamic loading, cardiac morphology, fiber architecture, contractility, viscoelasticity, and system-dependent factors on the measurements, with a focus on clinical application. It also describes how these factors should be considered during acquisition, analysis, and reporting to ensure an accurate, robust, and reproducible measurement of the shear wave.
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Affiliation(s)
- Annette Caenen
- Institute for Biomedical Engineering and Technology, Ghent University, Ghent, Belgium; Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Stéphanie Bézy
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Mathieu Pernot
- Physics for Medicine, INSERM, CNRS, ESPCI, PSL University, Paris, France
| | | | - Hendrik J Vos
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jens-Uwe Voigt
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium.
| | - Patrick Segers
- Institute for Biomedical Engineering and Technology, Ghent University, Ghent, Belgium
| | - Jan D'hooge
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
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20
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Ciuffreda G, Bueno-Gracia E, Albarova-Corral I, Montaner-Cuello A, Pérez-Rey J, Pardos-Aguilella P, Malo-Urriés M, Estébanez-de-Miguel E. In Vivo Effects of Joint Movement on Nerve Mechanical Properties Assessed with Shear-Wave Elastography: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2024; 14:343. [PMID: 38337859 PMCID: PMC10855485 DOI: 10.3390/diagnostics14030343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/02/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
Peripheral nerves are subjected to mechanical tension during limb movements and body postures. Nerve response to tensile stress can be assessed in vivo with shear-wave elastography (SWE). Greater tensile loads can lead to greater stiffness, which can be quantified using SWE. Therefore, this study aimed to conduct a systematic review and meta-analysis to perform an overview of the effect of joint movements on nerve mechanical properties in healthy nerves. The initial search (July 2023) yielded 501 records from six databases (PubMed, Embase, Scopus, Web of Science, Cochrane, and Science Direct). A total of 16 studies were included and assessed with a modified version of the Downs and Black checklist. Our results suggest an overall tendency for stiffness increase according to a pattern of neural tensioning. The main findings from the meta-analysis showed a significant increase in nerve stiffness for the median nerve with wrist extension (SMD [95%CI]: 3.16 [1.20, 5.12]), the ulnar nerve with elbow flexion (SMD [95%CI]: 2.91 [1.88, 3.95]), the sciatic nerve with ankle dorsiflexion (SMD [95%CI]: 1.13 [0.79, 1.47]), and the tibial nerve with both hip flexion (SMD [95%CI]: 2.14 [1.76, 2.51]) and ankle dorsiflexion (SMD [95%CI]: 1.52 [1.02, 2.02]). The effect of joint movement on nerve stiffness also depends on the nerve segment, the amount of movement of the joint mobilized, and the position of other joints comprised in the entirety of the nerve length. However, due to the limited number of studies, many aspects of nerve behavior together with the effect of using different ultrasound equipment or transducers for nerve stiffness evaluation still need to be fully investigated.
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Affiliation(s)
- Gianluca Ciuffreda
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
| | - Elena Bueno-Gracia
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain
| | - Isabel Albarova-Corral
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain
| | - Alberto Montaner-Cuello
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain
| | - Jorge Pérez-Rey
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain
| | - Pilar Pardos-Aguilella
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain
| | - Miguel Malo-Urriés
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain
| | - Elena Estébanez-de-Miguel
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain
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21
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Kerensky MJ, Paul A, Routkevitch D, Hersh AM, Kempski Leadingham KM, Davidar AD, Judy BF, Punnoose J, Williams A, Kumar A, Lehner K, Smith B, Son JK, Azadi JR, Shekhar H, Mercado-Shekhar KP, Thakor NV, Theodore N, Manbachi A. Tethered spinal cord tension assessed via ultrasound elastography in computational and intraoperative human studies. COMMUNICATIONS MEDICINE 2024; 4:4. [PMID: 38182729 PMCID: PMC10770351 DOI: 10.1038/s43856-023-00430-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 12/19/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Tension in the spinal cord is a trademark of tethered cord syndrome. Unfortunately, existing tests cannot quantify tension across the bulk of the cord, making the diagnostic evaluation of stretch ambiguous. A potential non-destructive metric for spinal cord tension is ultrasound-derived shear wave velocity (SWV). The velocity is sensitive to tissue elasticity and boundary conditions including strain. We use the term Ultrasound Tensography to describe the acoustic evaluation of tension with SWV. METHODS Our solution Tethered cord Assessment with Ultrasound Tensography (TAUT) was utilized in three sub-studies: finite element simulations, a cadaveric benchtop validation, and a neurosurgical case series. The simulation computed SWV for given tensile forces. The cadaveric model with induced tension validated the SWV-tension relationship. Lastly, SWV was measured intraoperatively in patients diagnosed with tethered cords who underwent treatment (spinal column shortening). The surgery alleviates tension by decreasing the vertebral column length. RESULTS Here we observe a strong linear relationship between tension and squared SWV across the preclinical sub-studies. Higher tension induces faster shear waves in the simulation (R2 = 0.984) and cadaveric (R2 = 0.951) models. The SWV decreases in all neurosurgical procedures (p < 0.001). Moreover, TAUT has a c-statistic of 0.962 (0.92-1.00), detecting all tethered cords. CONCLUSIONS This study presents a physical, clinical metric of spinal cord tension. Strong agreement among computational, cadaveric, and clinical studies demonstrates the utility of ultrasound-induced SWV for quantitative intraoperative feedback. This technology is positioned to enhance tethered cord diagnosis, treatment, and postoperative monitoring as it differentiates stretched from healthy cords.
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Affiliation(s)
- Max J Kerensky
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- HEPIUS Innovation Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Abhijit Paul
- Discipline of Biological Engineering, Indian Institute of Technology Gandhinagar, Gujarat, India
| | - Denis Routkevitch
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- HEPIUS Innovation Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew M Hersh
- HEPIUS Innovation Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kelley M Kempski Leadingham
- HEPIUS Innovation Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A Daniel Davidar
- HEPIUS Innovation Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Brendan F Judy
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joshua Punnoose
- HEPIUS Innovation Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Autumn Williams
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Avisha Kumar
- HEPIUS Innovation Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Kurt Lehner
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Beth Smith
- HEPIUS Innovation Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer K Son
- HEPIUS Innovation Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Javad R Azadi
- HEPIUS Innovation Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Himanshu Shekhar
- Discipline of Electrical Engineering, Indian Institute of Technology Gandhinagar, Gujarat, India
| | - Karla P Mercado-Shekhar
- Discipline of Biological Engineering, Indian Institute of Technology Gandhinagar, Gujarat, India
| | - Nitish V Thakor
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- HEPIUS Innovation Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicholas Theodore
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- HEPIUS Innovation Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amir Manbachi
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- HEPIUS Innovation Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA.
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD, USA.
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22
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Hristov B, Nacheva-Georgieva E, Stanchev D, Kraev K, Uchikov P, Kostov G, Valova S, Tilkiyan E, Doykova K, Doykov M. Estimating reference values of parenchymal stiffness of normal pancreatic parenchyma by means of point shear wave elastography. Folia Med (Plovdiv) 2023; 65:958-968. [PMID: 38351786 DOI: 10.3897/folmed.65.e106764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/21/2023] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION There are numerous imaging modalities available to describe pancreatic parenchyma. None of the broadly accepted diagnostic methods uses elasticity as an indicator of tissue damage.
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23
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Götschi T, Snedeker JG, Fitze DP, Sarto F, Spörri J, Franchi MV. Three-dimensional mapping of ultrasound-derived skeletal muscle shear wave velocity. Front Bioeng Biotechnol 2023; 11:1330301. [PMID: 38179131 PMCID: PMC10764491 DOI: 10.3389/fbioe.2023.1330301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/08/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction: The mechanical properties of skeletal muscle are indicative of its capacity to perform physical work, state of disease, or risk of injury. Ultrasound shear wave elastography conducts a quantitative analysis of a tissue's shear stiffness, but current implementations only provide two-dimensional measurements with limited spatial extent. We propose and assess a framework to overcome this inherent limitation by acquiring numerous and contiguous measurements while tracking the probe position to create a volumetric scan of the muscle. This volume reconstruction is then mapped into a parameterized representation in reference to geometric and anatomical properties of the muscle. Such an approach allows to quantify regional differences in muscle stiffness to be identified across the entire muscle volume assessed, which could be linked to functional implications. Methods: We performed shear wave elastography measurements on the vastus lateralis (VL) and the biceps femoris long head (BFlh) muscle of 16 healthy volunteers. We assessed test-retest reliability, explored the potential of the proposed framework in aggregating measurements of multiple subjects, and studied the acute effects of muscular contraction on the regional shear wave velocity post-measured at rest. Results: The proposed approach yielded moderate to good reliability (ICC between 0.578 and 0.801). Aggregation of multiple subject measurements revealed considerable but consistent regional variations in shear wave velocity. As a result of muscle contraction, the shear wave velocity was elevated in various regions of the muscle; showing pre-to-post regional differences for the radial assessement of VL and longitudinally for BFlh. Post-contraction shear wave velocity was associated with maximum eccentric hamstring strength produced during six Nordic hamstring exercise repetitions. Discussion and Conclusion: The presented approach provides reliable, spatially resolved representations of skeletal muscle shear wave velocity and is capable of detecting changes in three-dimensional shear wave velocity patterns, such as those induced by muscle contraction. The observed systematic inter-subject variations in shear wave velocity throughout skeletal muscle additionally underline the necessity of accurate spatial referencing of measurements. Short high-effort exercise bouts increase muscle shear wave velocity. Further studies should investigate the potential of shear wave elastography in predicting the muscle's capacity to perform work.
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Affiliation(s)
- Tobias Götschi
- Orthopaedic Biomechanics Laboratory, Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
- Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jess G. Snedeker
- Orthopaedic Biomechanics Laboratory, Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Daniel P. Fitze
- Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Orthopaedics, University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Fabio Sarto
- Department of Biomedical Sciences, Institute of Physiology, University of Padua, Padua, Italy
| | - Jörg Spörri
- Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Orthopaedics, University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Martino V. Franchi
- Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Biomedical Sciences, Institute of Physiology, University of Padua, Padua, Italy
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24
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Fang X, Yin Y, Lun H, Su S, Zhu S. Assessment of the effects of transforming growth factor beta1 (TGF-β1)-Smad2/3 on fibrosis in rat myofascial trigger points using point shear wave elastography. PeerJ 2023; 11:e16588. [PMID: 38077437 PMCID: PMC10710175 DOI: 10.7717/peerj.16588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
Background & Aims Myofascial trigger points (MTrPs) are highly sensitive irritated points within a tense belt of skeletal muscle, and are the main cause of muscle pain and dysfunction. MTrPs can also cause paraesthesia and autonomic nervous dysfunction. Furthermore, long-term and chronic MTrPs can cause muscle atrophy and even disability, seriously affecting the quality of life and mental health of patients, and increasing the social and economic burden. However, to date, there have been few studies on fibrogenesis and changes in MTrPs. Therefore, this study investigated whether transforming growth factor beta1 (TGF-β1)-Smad2/3 participates in the formation of MTrPs and how it affects fibrosis using point shear wave elastography. Methods Forty Sprague‒Dawley rats were randomly divided into the MTrPs group and the control group. Blunt injury combined with eccentric exercise was used to establish an MTrPs model. Electromyography (EMG), haematoxylin and eosin (H&E) staining and transmission electron microscopy (TEM) were used to verify the model. The collagen volume fraction was measured by Masson staining, the protein expression of TGF-β1 and p-Smad2/3 was measured by Western blotting (WB) and immunohistochemistry (IHC), and the shear wave velocity (SWV) was measured by point shear wave elastography. Results EMG, H&E and TEM examination indicated that the modelling was successful. The collagen volume fraction and the protein expression of TGF-β1 and p-Smad2/3 were higher in the MTrPs group than in the control group. The SWV of the MTrPs group was also higher than that of the control group. These differences suggest that MTrPs may exhibit fibrosis. The correlations between the collagen volume fraction and SWV and between the collagen volume fraction and TGF-β1 were positive. Conclusion Fibrotic conditions may be involved in the formation of MTrPs. Ultrasound point shear wave elastography and assessment of TGF-β1 and p-Smad2/3 expression can reflect the degree of MTrPs fibrosis to some extent. Further exploration of the important role of TGF-β1 and Smad2/3 in the pathogenesis of MTrPs will be of great significance for clinical treatment.
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Affiliation(s)
- Xin Fang
- Department of Medical Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yalong Yin
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Haimei Lun
- Department of Ultrasound, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Shitao Su
- Department of Medical Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Shangyong Zhu
- Department of Medical Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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25
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Lin CW, Shieh JY, Tsui PH, Chen CL, Lu CH, Hung YH, Lee HY, Weng WC, Gau SSF. Acoustic radiation force impulse shear wave elastography quantifies upper limb muscle in patients with Duchenne muscular dystrophy. ULTRASONICS SONOCHEMISTRY 2023; 101:106661. [PMID: 37924615 PMCID: PMC10641721 DOI: 10.1016/j.ultsonch.2023.106661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/09/2023] [Accepted: 10/26/2023] [Indexed: 11/06/2023]
Abstract
We investigated whether the upper limb muscle stiffness quantified by the acoustic radiation force impulse shear wave elastography (ARFI/SWE) is a potential biomarker for age-related muscle alteration and functional decline in patients with Duchenne muscular dystrophy (DMD). 37 patients with DMD and 30 typically developing controls (TDC) were grouped by age (3-8, 9-11, and 12-18 years). ARFI/SWE measured the biceps and deltoid muscle's shear wave velocities (SWVs). Performance of Upper Limb Module (PUL 1.2 module) assessed muscle function in DMD patients. Mann Whitney test compared muscle SWVs between DMD and TDC, stratified by three age groups. We used analysis of variance with Bonferroni correction to compare muscle SWVs between DMD and TDC and correlated muscle SWVs with PUL results in the DMD group. Results showed that the SWVs of biceps differentiated DMD patients from TDC across age groups. Younger DMD patients (3-8 years) exhibited higher SWVs (p = 0.013), but older DMD patients (12-18 years) showed lower SWVS (p = 0.028) than same-aged TDC. DMD patients had decreasing biceps SWVs with age (p < 0.001), with no such age effect in TDC. The SWVs of deltoid and biceps positively correlated with PUL scores (r = 0.527 ∼ 0.897, P < 0.05) and negatively correlated with PUL timed measures (r = -0.425 ∼ -0.542, P < 0.05) in DMD patients. Our findings suggest that ARFI/SWE quantifying the SWVs in upper limb muscle could be a potential biomarker to differentiate DMD from TDC across ages and that DMD patients showed age-related muscle alteration and limb functional decline.
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Affiliation(s)
- Chia-Wei Lin
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, and College of Medicine, National Taiwan University, No. 7 Chung-Shan South Road, Taipei 10002, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, No.1, Chang-Te St., Taipei 10048, Taipei, Taiwan
| | - Jeng-Yi Shieh
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, and College of Medicine, National Taiwan University, No. 7 Chung-Shan South Road, Taipei 10002, Taiwan
| | - Po-Hsiang Tsui
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Dist, Tao-Yuan City 33302, Taiwan
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, and College of Medicine, National Taiwan University, No. 7 Chung-Shan South Road, Taipei 10002, Taiwan
| | - Chun-Hao Lu
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Dist, Tao-Yuan City 33302, Taiwan
| | - Yi-Hsuan Hung
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, and College of Medicine, National Taiwan University, No. 7 Chung-Shan South Road, Taipei 10002, Taiwan
| | - Hsiao-Yuan Lee
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, No. 2, Sec. 1, Shengyi Rd., Zhubei City, Hsinchu County 302, Taiwan
| | - Wen-Chin Weng
- Department of Pediatrics, National Taiwan University Hospital, and College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei, Taiwan 10002, Taiwan; Department of Pediatric Neurology, National Taiwan University Children's Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan 10002, Taiwan.
| | - Susan Shur-Fen Gau
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, No.1, Chang-Te St., Taipei 10048, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, and College of Medicine, No. 7 Chung-Shan South Road, Taipei 10002, Taiwan; Graduate Institute of Brain and Mind Sciences, National Taiwan University, No.1 Jen Ai road section 1, Taipei 100 Taiwan.
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26
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Izak Ghasemian S, Reuter F, Fan Y, Rose G, Ohl CD. Shear wave generation from non-spherical bubble collapse in a tissue phantom. SOFT MATTER 2023. [PMID: 37990644 DOI: 10.1039/d3sm01077e] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
Elastography is a non-invasive technique to detect tissue anomalies via the local elastic modulus using shear waves. Commonly shear waves are produced via acoustic focusing or the use of mechanical external sources, shear waves may result also naturally from cavitation bubbles during medical intervention, for example from thermal ablation. Here, we measure the shear wave emitted from a well-controlled single laser-induced cavitation bubble oscillating near a rigid boundary. The bubbles are generated in a transparent tissue-mimicking hydrogel embedded with tracer particles. High-speed imaging of the tracer particles and the bubble shape allow quantifying the shear wave and relate it to the bubble dynamics. It is found that different stages of the bubble dynamics contribute to the shear wave generation and the mechanism of shear wave emission, its direction and the efficiency of energy converted into the shear wave depend crucially on the bubble to wall stand-off distance.
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Affiliation(s)
- Saber Izak Ghasemian
- Institute of Physics, Otto-von-Guericke Universität, Magdeburg, Germany.
- Research Campus STIMULATE, Otto-von-Guericke Universität, Magdeburg, Germany
| | - Fabian Reuter
- Institute of Physics, Otto-von-Guericke Universität, Magdeburg, Germany.
| | - Yuzhe Fan
- Research Campus STIMULATE, Otto-von-Guericke Universität, Magdeburg, Germany
| | - Georg Rose
- Research Campus STIMULATE, Otto-von-Guericke Universität, Magdeburg, Germany
- Institute of Medical Engineering, Otto-von-Guericke Universität, Magdeburg, Germany
| | - Claus-Dieter Ohl
- Institute of Physics, Otto-von-Guericke Universität, Magdeburg, Germany.
- Research Campus STIMULATE, Otto-von-Guericke Universität, Magdeburg, Germany
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27
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Gu Y, Kumar V, Dayavansha EK, Schoen S, Feleppa E, Tadross R, Wang MH, Washburn MJ, Thomenius K, Samir AE. Acoustic diffraction-resistant adaptive profile technology (ADAPT) for elasticity imaging. SCIENCE ADVANCES 2023; 9:eadi6129. [PMID: 37910613 PMCID: PMC10619922 DOI: 10.1126/sciadv.adi6129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/28/2023] [Indexed: 11/03/2023]
Abstract
Acoustic beam shaping with high degrees of freedom is critical for applications such as ultrasound imaging, acoustic manipulation, and stimulation. However, the ability to fully control the acoustic pressure profile over its propagation path has not yet been achieved. Here, we demonstrate an acoustic diffraction-resistant adaptive profile technology (ADAPT) that can generate a propagation-invariant beam with an arbitrarily desired profile. By leveraging wave number modulation and beam multiplexing, we develop a general framework for creating a highly flexible acoustic beam with a linear array ultrasonic transducer. The designed acoustic beam can also maintain the beam profile in lossy material by compensating for attenuation. We show that shear wave elasticity imaging is an important modality that can benefit from ADAPT for evaluating tissue mechanical properties. Together, ADAPT overcomes the existing limitation of acoustic beam shaping and can be applied to various fields, such as medicine, biology, and material science.
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Affiliation(s)
- Yuyang Gu
- Department of Radiology, Massachusetts General Hospital, Center for Ultrasound Research and Translation, Boston, MA 02114, USA
- Harvard Medical School, Cambridge, MA 02115, USA
| | - Viksit Kumar
- Department of Radiology, Massachusetts General Hospital, Center for Ultrasound Research and Translation, Boston, MA 02114, USA
- Harvard Medical School, Cambridge, MA 02115, USA
| | - E. G. Sunethra K. Dayavansha
- Department of Radiology, Massachusetts General Hospital, Center for Ultrasound Research and Translation, Boston, MA 02114, USA
- Harvard Medical School, Cambridge, MA 02115, USA
| | - Scott Schoen
- Department of Radiology, Massachusetts General Hospital, Center for Ultrasound Research and Translation, Boston, MA 02114, USA
- Harvard Medical School, Cambridge, MA 02115, USA
| | - Ernest Feleppa
- Department of Radiology, Massachusetts General Hospital, Center for Ultrasound Research and Translation, Boston, MA 02114, USA
- Harvard Medical School, Cambridge, MA 02115, USA
| | - Rimon Tadross
- General Electric Healthcare, Wauwatosa, WI 53226, USA
| | | | | | - Kai Thomenius
- Department of Radiology, Massachusetts General Hospital, Center for Ultrasound Research and Translation, Boston, MA 02114, USA
- Harvard Medical School, Cambridge, MA 02115, USA
| | - Anthony E. Samir
- Department of Radiology, Massachusetts General Hospital, Center for Ultrasound Research and Translation, Boston, MA 02114, USA
- Harvard Medical School, Cambridge, MA 02115, USA
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28
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Cho A, Jin W, Lee J, Shin N, Lee MS, Li L, Yang SH, Park KS, Yang CW, Kim DK, Oh YK, Lim CS, Lee JP. Periostin deficiency attenuates kidney fibrosis in diabetic nephropathy by improving pancreatic β-cell dysfunction and reducing kidney EMT. Sci Rep 2023; 13:17599. [PMID: 37845302 PMCID: PMC10579313 DOI: 10.1038/s41598-023-44177-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 10/04/2023] [Indexed: 10/18/2023] Open
Abstract
Diabetic nephropathy (DN) is associated with kidney fibrosis. A previous study revealed that periostin (POSTN) contributes to kidney fibrosis. This study examined the role of POSTN in DN. The urinary concentrations of POSTN and TNC increased according to the severity of DN in human samples. Streptozotocin (STZ) was administered after unilateral nephrectomy (UNXSTZ) to induce DN in wild-type and Postn-null mice. Four experimental groups were generated: wild-typeham (WT Sham), wild-type UNXSTZ (WT STZ), Postn-null Sham (KO Sham), and Postn-null UNXSTZ (KO STZ). After 20 weeks, the KO STZ group had lower levels of urine albumin excretion, glomerular sclerosis, and interstitial fibrosis than those of the WT STZ group. Additionally, the KO STZ group had lower expression of fibrosis markers, including TNC. The KO STZ group showed better glucose regulation than the WT STZ model. Furthermore, the KO STZ group exhibited significantly preserved pancreatic islet integrity and insulin expression. HK-2 cells were used to observe the aggravation of fibrosis caused by POSTN under TGF-β conditions. We stimulated INS-1 cells with streptozotocin and evaluated the viability of these cells. The anti-POSTN antibody treatment of INS-1 cells with streptozotocin resulted in higher cell viability than that with treatment with streptozotocin alone. The absence of POSTN in DN contributes to renal fibrosis alleviation by improving pancreatic β-cell function. Additionally, there is an association between POSTN and TNC.
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Affiliation(s)
- Ara Cho
- Translational Medicine Major, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Wencheng Jin
- Department of Internal Medicine, Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jeonghwan Lee
- Department of Internal Medicine, Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Nayeon Shin
- Department of Internal Medicine, Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Myoung Seok Lee
- Department of Radiology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Lilin Li
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Critical Care Medicine, Yanbian University Hospital, Yanji, Jilin, China
| | - Seung Hee Yang
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Kidney Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Kyong Soo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chul Woo Yang
- Transplantation Research Center, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yun Kyu Oh
- Department of Internal Medicine, Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chun Soo Lim
- Department of Internal Medicine, Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung Pyo Lee
- Translational Medicine Major, Seoul National University College of Medicine, Seoul, Republic of Korea.
- Department of Internal Medicine, Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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29
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Einen C, Price SEN, Ulvik K, Gjennestad MA, Hansen R, Kjelstrup S, Davies CDL. Nanoparticle Dynamics in Composite Hydrogels Exposed to Low-Frequency Focused Ultrasound. Gels 2023; 9:771. [PMID: 37888344 PMCID: PMC10606116 DOI: 10.3390/gels9100771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 10/28/2023] Open
Abstract
Pulsed focused ultrasound (FUS) in combination with microbubbles has been shown to improve delivery and penetration of nanoparticles in tumors. To understand the mechanisms behind this treatment, it is important to evaluate the contribution of FUS without microbubbles on increased nanoparticle penetration and transport in the tumor extracellular matrix (ECM). A composite agarose hydrogel was made to model the porous structure, the acoustic attenuation and the hydraulic conductivity of the tumor ECM. Single-particle tracking was used as a novel method to monitor nanoparticle dynamics in the hydrogel during FUS exposure. FUS exposure at 1 MHz and 1 MPa was performed to detect any increase in nanoparticle diffusion or particle streaming at acoustic parameters relevant for FUS in combination with microbubbles. Results were compared to a model of acoustic streaming. The nanoparticles displayed anomalous diffusion in the hydrogel, and FUS with a duty cycle of 20% increased the nanoparticle diffusion coefficient by 23%. No increase in diffusion was found for lower duty cycles. FUS displaced the hydrogel itself at duty cycles above 10%; however, acoustic streaming was found to be negligible. In conclusion, pulsed FUS alone cannot explain the enhanced penetration of nanoparticles seen when using FUS and microbubbles for nanoparticle delivery, but it could be used as a tool to enhance diffusion of particles in the tumor ECM.
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Affiliation(s)
- Caroline Einen
- Porelab and Department of Physics, The Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Sebastian E. N. Price
- Porelab and Department of Chemistry, The Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Kim Ulvik
- Department of Physics, The Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | | | - Rune Hansen
- Department of Health Research at SINTEF, 7465 Trondheim, Norway
- Department of Circulation and Medical Imaging, The Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Signe Kjelstrup
- Porelab and Department of Chemistry, The Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Catharina de Lange Davies
- Department of Physics, The Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
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30
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Feng L, Shi X, Zhou F, Chen Y, Zhou X. Technical note: Evaluation of the acoustic radiation force imaging for predicting HIFU focus with in vitro and ex vivo experiments. Med Phys 2023; 50:5449-5459. [PMID: 37345709 DOI: 10.1002/mp.16565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/07/2023] [Accepted: 06/02/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND High-intensity focused ultrasound (HIFU) is currently used for the treatment of various diseases, but it still lacks a reliable technique in the preoperative stage to accurately place its "energy blade" onto diseased targets. Acoustic radiation force imaging (ARFI) was recently introduced to tackle this issue, but its applicability and limitations were not clear. PURPOSE The aim of this study was to evaluate the performance of ARFI method in prediction of HIFU focal location at the preoperative stage. METHODS A point spread function (PSF) localization method, which was borrowed from the ultrasound super resolution field, was used to validate the core autocorrelation-based motion estimation algorithm in the ARFI procedure. Accuracy of the ARFI method for estimating the HIFU focus were tested with in vitro and ex vivo experiments with a clinically equivalent HIFU system. Comparisons were made between the estimated focal locations and those of the damaged area after the testing objects were cut open. RESULTS Results showed that the PSF localization was able to serve as a validating method for motion detection only when the tissue displacement was large. With the ARFI method, location of the HIFU focus could be accurately predicted by a 2D motion map preoperatively, and the axial spatial errors were less than 0.5 mm. However, the derived 2D motion maps can only be valuable when the acoustic stimulation in ARFI were strong enough, which was probably due to the fact that the HIFU focal locations were at large depths and the ultrasound imaging signal had low signal to noise ratio. CONCLUSION The ARFI method was indeed an accurate technique for preoperatively predicting HIFU focus in vitro and ex vivo. If clinical applications were to be considered, particularly in deep tissues, efforts might need to be made to improve ability of the ultrasound motion estimation technique.
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Affiliation(s)
- Lian Feng
- State Key Laboratory of Ultrasound Engineering in Medicine, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Xinwang Shi
- State Key Laboratory of Ultrasound Engineering in Medicine, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Fang Zhou
- State Key Laboratory of Ultrasound Engineering in Medicine, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Yanhua Chen
- State Key Laboratory of Ultrasound Engineering in Medicine, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Xiaowei Zhou
- State Key Laboratory of Ultrasound Engineering in Medicine, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
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31
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Barchi A, D'Amico F, Zilli A, Furfaro F, Parigi TL, Fiorino G, Peyrin-Biroulet L, Danese S, Dal Buono A, Allocca M. Recent advances in the use of ultrasound in Crohn's disease. Expert Rev Med Devices 2023; 20:1119-1129. [PMID: 37961790 DOI: 10.1080/17434440.2023.2283166] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/09/2023] [Indexed: 11/15/2023]
Abstract
INTRODUCTION A clear consensus exists on the role of IUS for the assessment and monitoring of Crohn's disease (CD) in the 'treat-to-target' strategy. AREAS COVERED IUS is an accurate tool for the management of CD. It is noninvasive and well tolerated. IUS has good-to-optimal inter-operator reliability either for assessing disease activity or for evaluating treatment response, especially combining Bowel Wall Thickness (BWT) and Color Doppler Signals (CDS). IUS is able to evaluate transmural remission (TR), the ultimate goal of the 'treat-to-target' strategy. Several studies confirmed its accuracy in the assessment of the post-operative recurrence (POR). Thanks to recent advances in trans-perineal ultrasound technique (TPUS), it allows to characterize peri-anal disease and its complications. Small intestine contrast ultrasound (SICUS) and contrast-enhancement ultrasound (CEUS) may improve IUS performance, particularly in stricturing or penetrating CD. Ultrasound elastography (USE) is raising interest for its accuracy in differentiating CD phenotypes (fibrotic versus inflamed). EXPERT OPINION IUS is a pivotal step in the management of CD, in early assessment as in therapeutic monitoring, with advantages of evaluating transmural response. Development and validation of novel ultrasound biomarkers of activity and fibrosis, especially those linked to advanced ultrasound techniques, are expected in the coming years.
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Affiliation(s)
- Alberto Barchi
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy
| | - Ferdinando D'Amico
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Alessandra Zilli
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy
| | - Federica Furfaro
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy
| | - Tommaso Lorenzo Parigi
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy
| | - Gionata Fiorino
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France
- Department of Gastroenterology, Nancy University Hospital, Vandœuvre-lès-Nancy, France
- INFINY Institute, Nancy University Hospital, Vandœuvre-lès-Nancy, France
- FHU-CURE, Nancy University Hospital, Vandœuvre-lès-Nancy, France
- Groupe Hospitalier privé Ambroise Paré - Hartmann, Paris IBD center, Neuilly sur Seine, France
- Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Silvio Danese
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy
| | - Arianna Dal Buono
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- IBD Center, Humanitas Research Hospital - IRCCS, Rozzano, Milan, Italy
| | - Mariangela Allocca
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy
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Anand KS, Torres G, Homeister JW, Caughey MC, Gallippi CM. Comparing Focused-Tracked and Plane Wave-Tracked ARFI Log(VoA) In Silico and in Application to Human Carotid Atherosclerotic Plaque, Ex Vivo. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:636-652. [PMID: 37216241 PMCID: PMC10330788 DOI: 10.1109/tuffc.2023.3278495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A significant risk factor for ischemic stroke is carotid atherosclerotic plaque that is susceptible to rupture, with rupture potential conveyed by plaque morphology. Human carotid plaque composition and structure have been delineated noninvasively and in vivo by evaluating log(VoA), a parameter derived as the decadic log of the second time derivative of displacement induced by an acoustic radiation force impulse (ARFI). In prior work, ARFI-induced displacement was measured using conventional focused tracking; however, this requires a long data acquisition period, thereby reducing framerate. We herein evaluate if ARFI log(VoA) framerate can be increased without a reduction in plaque imaging performance using plane wave tracking instead. In silico, both focused- and plane wave-tracked log(VoA) decreased with increasing echobrightness, quantified as signal-to-noise ratio (SNR), but did not vary with material elasticity for SNRs below 40 dB. For SNRs of 40-60 dB, both focused- and plane wave-tracked log(VoA) varied with SNR and material elasticity. Above 60 dB SNR, both focused- and plane wave-tracked log(VoA) varied with material elasticity alone. This suggests that log(VoA) discriminates features according to a combination of their echobrightness and mechanical property. Further, while both focused- and plane-wave tracked log(VoA) values were artifactually inflated by mechanical reflections at inclusion boundaries, plane wave-tracked log(VoA) was more strongly impacted by off-axis scattering. Applied to three excised human cadaveric carotid plaques with spatially aligned histological validation, both log(VoA) methods detected regions of lipid, collagen, and calcium (CAL) deposits. These findings support that plane wave tracking performs comparably to focused tracking for log(VoA) imaging and that plane wave-tracked log(VoA) is a viable approach to discriminating clinically relevant atherosclerotic plaque features at a 30-fold higher framerate than by focused tracking.
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Kim YH, Lee CH, Firouzi K, Park BH, Pyun JY, Kim JN, Park KK, Khuri-Yakub BT. Acoustic radiation force for analyzing the mechanical stress in ultrasound neuromodulation. Phys Med Biol 2023; 68:10.1088/1361-6560/acdbb5. [PMID: 37366067 PMCID: PMC10404470 DOI: 10.1088/1361-6560/acdbb5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023]
Abstract
Objective. Although recent studies have shown that mechanical stress plays an important role in ultrasound neuromodulation, the magnitude and distribution of the mechanical stress generated in tissues by focused ultrasound transducers have not been adequately examined. Various acoustic radiation force (ARF) equations used in previous studies have been evaluated based on the tissue displacement results and are suitable for estimating the displacement. However, it is unclear whether mechanical stress can be accurately determined. This study evaluates the mechanical stress predicted by various AFR equations and suggests the optimal equation for estimating the mechanical stress in the brain tissue.Approach. In this paper, brain tissue responses are compared through numerical finite element simulations by applying the three most used ARF equations-Reynolds stress force ((RSF)), momentum flux density tensor force, and attenuation force. Three ARF fields obtained from the same pressure field were applied to the linear elastic model to calculate the displacement, mechanical stress, and mean pressure generated inside the tissue. Both the simple pressure field using a single transducer and the complex standing wave pressure field using two transducers were simulated.Main results. For the case using a single transducer, all three ARFs showed similar displacement. However, when comparing the mechanical stress results, only the results using the RSF showed a strong stress tensor at the focal point. For the case of using two transducers, the displacement and stress tensor field of the pattern related to the standing wave were calculated only from the results using the RSF.Significance. The model using RSF equation allows accurate analysis on stress tensor inside the tissue for ultrasound neuromodulation.
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Affiliation(s)
- Young Hun Kim
- Mechanical Convergence Engineering, Hanyang University, Seoul, Republic of Korea
| | - Chang Hoon Lee
- Mechanical Convergence Engineering, Hanyang University, Seoul, Republic of Korea
| | - Kamyar Firouzi
- Edward. L. Ginzton Lab, Stanford University, Stanford, CA 94305, United States of America
| | - Beom Hoon Park
- Mechanical Convergence Engineering, Hanyang University, Seoul, Republic of Korea
| | - Joo Young Pyun
- Mechanical Convergence Engineering, Hanyang University, Seoul, Republic of Korea
| | - Jeong Nyeon Kim
- Edward. L. Ginzton Lab, Stanford University, Stanford, CA 94305, United States of America
| | - Kwan Kyu Park
- Mechanical Convergence Engineering, Hanyang University, Seoul, Republic of Korea
| | - Butrus T Khuri-Yakub
- Department of Electrical Engineering, Stanford University, Stanford, CA 94305, United States of America
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Peng L, Wu Y, Lakshminarayanan K, Zhang A, Gan Y, Li Y, Yao Y. The relationship between shear wave velocity in transverse carpal ligament and carpal tunnel pressure: A finite element analysis. Med Eng Phys 2023; 116:103995. [PMID: 37230698 DOI: 10.1016/j.medengphy.2023.103995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 05/27/2023]
Abstract
Elevated carpal tunnel pressure in carpal tunnel syndrome (CTS) patients is one of the major causes of nerve damage but cannot be measured non-invasively. This study proposed to use shear wave velocity (SWV) in the transverse carpal ligament (TCL) to measure the surrounding carpal tunnel pressure. The relationship between the carpal tunnel pressure and the SWV in the TCL was investigated through a subject-specific carpal tunnel finite element model reconstrued by MRI imaging. Parametric analysis was conducted to study the effect of TCL Young's modulus and carpal tunnel pressure on the TCL SWV. The SWV in TCL was found to be strongly dependent on the carpal tunnel pressure and TCL Young's modulus. The calculated SWV ranged from 8.0 m/s to 22.6 m/s under a combination of carpal tunnel pressure (0-200 mmHg) and TCL Young's modulus (1.1-11 MPa). An empirical equation was used to fit the relationship between the SWV in TCL and carpal tunnel pressure, with TCL Young's modulus as a confounding factor. The equation proposed in this study provided an approach to estimate carpal tunnel pressure by measuring the SWV in the TCL for a potential non-invasive diagnosis of CTS and may shed light on the mechanical nerve damage mechanism.
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Affiliation(s)
- Linjing Peng
- School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China
| | - Yu Wu
- School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China; Olin College of Engineering, 1000 Olin Way, Needham, 02492, US
| | - Kishor Lakshminarayanan
- Department of Sensors and Biomedical Engineering, Vellore Institute of Technology, Ranipet Katpadi Road Vellore, 632 014, Tamil Nadu, India
| | - Aili Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China
| | - Yaokai Gan
- Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China; Department of Orthopedics, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China, 200011
| | - Yiming Li
- Department of Orthopedics, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China, 200011
| | - Yifei Yao
- School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.
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Kemper P, Karageorgos GM, Fodera D, Lee N, Meshram N, Weber RA, Nauleau P, Mobadersany N, Kwon N, Myers K, Konofagou EE. Pulse wave and vector flow Imaging for atherosclerotic disease progression in hypercholesterolemic swine. Sci Rep 2023; 13:6305. [PMID: 37072435 PMCID: PMC10113229 DOI: 10.1038/s41598-023-32358-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/27/2023] [Indexed: 05/03/2023] Open
Abstract
Non-invasive monitoring of atherosclerosis remains challenging. Pulse Wave Imaging (PWI) is a non-invasive technique to measure the local stiffness at diastolic and end-systolic pressures and quantify the hemodynamics. The objective of this study is twofold, namely (1) to investigate the capability of (adaptive) PWI to assess progressive change in local stiffness and homogeneity of the carotid in a high-cholesterol swine model and (2) to assess the ability of PWI to monitor the change in hemodynamics and a corresponding change in stiffness. Nine (n=9) hypercholesterolemic swine were included in this study and followed for up to 9 months. A ligation in the left carotid was used to cause a hemodynamic disturbance. The carotids with detectable hemodynamic disturbance showed a reduction in wall shear stress immediately after ligation (2.12 ± 0.49 to 0.98 ± 0.47 Pa for 40-90% ligation (Group B) and 1.82 ± 0.25 to 0.49 ± 0.46 Pa for >90% ligation (Group C)). Histology revealed subsequent lesion formation after 8-9 months, and the type of lesion formation was dependent on the type of the induced ligation, with more complex plaques observed in the carotids with a more significant ligation (C: >90%). The compliance progression appears differed for groups B and C, with an increase in compliance to 2.09 ± 2.90×10-10 m2 Pa-1 for group C whereas the compliance of group B remained low at 8 months (0.95 ± 0.94×10-10 m2 Pa-1). In summary, PWI appeared capable of monitoring a change in wall shear stress and separating two distinct progression pathways resulting in distinct compliances.
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Affiliation(s)
- Paul Kemper
- Department of Biomedical Engineering, Columbia University, New York, 10027, USA.
| | | | - Daniella Fodera
- Department of Biomedical Engineering, Columbia University, New York, 10027, USA
| | - Nicole Lee
- Department of Mechanical Engineering, Columbia University, New York, 10027, USA
| | - Nirvedh Meshram
- Department of Biomedical Engineering, Columbia University, New York, 10027, USA
| | - Rachel A Weber
- Department of Biomedical Engineering, Columbia University, New York, 10027, USA
| | - Pierre Nauleau
- Department of Biomedical Engineering, Columbia University, New York, 10027, USA
| | - Nima Mobadersany
- Department of Biomedical Engineering, Columbia University, New York, 10027, USA
| | - Nancy Kwon
- Department of Biomedical Engineering, Columbia University, New York, 10027, USA
| | - Kristin Myers
- Department of Mechanical Engineering, Columbia University, New York, 10027, USA
| | - Elisa E Konofagou
- Department of Biomedical Engineering, Columbia University, New York, 10027, USA.
- Department of Radiology, Columbia University, New York, 10027, USA.
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Taru MG, Neamti L, Taru V, Procopciuc LM, Procopet B, Lupsor-Platon M. How to Identify Advanced Fibrosis in Adult Patients with Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH) Using Ultrasound Elastography-A Review of the Literature and Proposed Multistep Approach. Diagnostics (Basel) 2023; 13:diagnostics13040788. [PMID: 36832276 PMCID: PMC9955630 DOI: 10.3390/diagnostics13040788] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD), and its progressive form, non-alcoholic steatohepatitis (NASH), represent, nowadays, real challenges for the healthcare system. Liver fibrosis is the most important prognostic factor for NAFLD, and advanced fibrosis is associated with higher liver-related mortality rates. Therefore, the key issues in NAFLD are the differentiation of NASH from simple steatosis and identification of advanced hepatic fibrosis. We critically reviewed the ultrasound (US) elastography techniques for the quantitative characterization of fibrosis, steatosis, and inflammation in NAFLD and NASH, with a specific focus on how to differentiate advanced fibrosis in adult patients. Vibration-controlled transient elastography (VCTE) is still the most utilized and validated elastography method for liver fibrosis assessment. The recently developed point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) techniques that use multiparametric approaches could bring essential improvements to diagnosis and risk stratification.
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Affiliation(s)
- Madalina-Gabriela Taru
- Hepatology Department, Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
| | - Lidia Neamti
- Hepatology Department, Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Vlad Taru
- Hepatology Department, Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, 1090 Vienna, Austria
- Christian Doppler Lab for Portal Hypertension and Liver Fibrosis, Medical University of Vienna, 1090 Vienna, Austria
| | - Lucia Maria Procopciuc
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Bogdan Procopet
- Hepatology Department, Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Monica Lupsor-Platon
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Medical Imaging Department, Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania
- Correspondence:
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Götschi T, Schärer Y, Gennisson JL, Snedeker JG. Investigation of the relationship between tensile viscoelasticity and unloaded ultrasound shear wave measurements in ex vivo tendon. J Biomech 2023; 146:111411. [PMID: 36509025 DOI: 10.1016/j.jbiomech.2022.111411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 11/24/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
Mechanical properties of biological tissues are of key importance for proper function and in situ methods for mechanical characterization are sought after in the context of both medical diagnosis as well as understanding of pathophysiological processes. Shear wave elastography (SWE) and accompanying physical modelling methods provide valid estimates of stiffness in quasi-linear viscoelastic, isotropic tissue but suffer from limitations in assessing non-linear viscoelastic or anisotropic material, such as tendon. Indeed, mathematical modelling predicts the longitudinal shear wave velocity to be unaffected by the tensile but rather the shear viscoelasticity. Here, we employ a heuristic experimental testing approach to the problem to assess the most important potential confounders, namely tendon mass density and diameter, and to investigate associations between tendon tensile viscoelasticity with shear wave descriptors. Small oscillatory testing of animal flexor tendons at two baseline stress levels over a large frequency range comprehensively characterized tensile viscoelastic behavior. A broad set of shear wave descriptors was retrieved on the unloaded tendon based on high frame-rate plane wave ultrasound after applying an acoustic deformation impulse. Tensile modulus and strain energy dissipation increased logarithmically and linearly, respectively, with the frequency of the applied strain. Shear wave descriptors were mostly unaffected by tendon diameter but were highly sensitive to tendon mass density. Shear wave group and phase velocity showed no association with tensile elasticity or strain rate-stiffening but did show an association with tensile strain energy dissipation. The longitudinal shear wave velocity may not characterize tensile elasticity but rather tensile viscous properties of transversely isotropic collagenous tissues.
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Affiliation(s)
- Tobias Götschi
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Switzerland; Institute for Biomechanics, ETH Zurich, Switzerland.
| | | | - Jean-Luc Gennisson
- Université Paris-Saclay, Inserm, CNRS, CEA, Laboratoire d'Imagerie Biomédicale Multimodale (BioMaps), Service Hospitalier Frédéric Joliot, 4 place du général Leclerc, 91401 ORSAY, France
| | - Jess G Snedeker
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Switzerland; Institute for Biomechanics, ETH Zurich, Switzerland
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Deeba F, Hu R, Lessoway V, Terry J, Pugash D, Hutcheon J, Mayer C, Salcudean S, Rohling R. SWAVE 2.0 Imaging of Placental Elasticity and Viscosity: Potential Biomarkers for Placenta-Mediated Disease Detection. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:2486-2501. [PMID: 36180312 DOI: 10.1016/j.ultrasmedbio.2022.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 07/27/2022] [Accepted: 08/02/2022] [Indexed: 06/16/2023]
Abstract
Pregnancy complications such as pre-eclampsia (PE) and intrauterine growth restriction (IUGR) are associated with structural and functional changes in the placenta. Different elastography techniques with an ability to assess the mechanical properties of tissue can identify and monitor the pathological state of the placenta. Currently available elastography techniques have been used with promising results to detect placenta abnormalities; however, limitations include inadequate measurement depth and safety concerns from high negative pressure pulses. Previously, we described a shear wave absolute vibro-elastography (SWAVE) method by applying external low-frequency mechanical vibrations to generate shear waves and studied 61 post-delivery clinically normal placentas to explore the feasibility of SWAVE for placental assessment and establish a measurement baseline. This next phase of the study, namely, SWAVE 2.0, improves the previous system and elasticity reconstruction by incorporating a multi-frequency acquisition system and using a 3-D local frequency estimation (LFE) method. Compared with its 2-D counterpart, the proposed system using 3-D LFE was found to reduce the bias and variance in elasticity measurements in tissue-mimicking phantoms. In the aim of investigating the potential of improved SWAVE 2.0 measurements to identify placental abnormalities, we studied 46 post-delivery placentas, including 26 diseased (16 IUGR and 10 PE) and 20 normal control placentas. By use of a 3.33-MHz motorized curved-array transducer, multi-frequency (80,100 and 120 Hz) elasticity measures were obtained with 3-D LFE, and both IUGR (15.30 ± 2.96 kPa, p = 3.35e-5) and PE (12.33 ± 4.88 kPa, p = 0.017) placentas were found to be significantly stiffer compared with the control placentas (8.32 ± 3.67 kPa). A linear discriminant analysis (LDA) classifier was able to classify between healthy and diseased placentas with a sensitivity, specificity and accuracy of 87%, 78% and 83% and an area under the receiver operating curve of 0.90 (95% confidence interval: 0.8-0.99). Further, the pregnancy outcome in terms of neonatal intensive care unit admission was predicted with a sensitivity, specificity and accuracy of 70%, 71%, 71%, respectively, and area under the receiver operating curve of 0.78 (confidence interval: 0.62-0.93). A viscoelastic characterization of placentas using a fractional rheological model revealed that the viscosity measures in terms of viscosity parameter n were significantly higher in IUGR (2.3 ± 0.21) and PE (2.11 ± 0.52) placentas than in normal placentas (1.45 ± 0.65). This work illustrates the potential relevance of elasticity and viscosity imaging using SWAVE 2.0 as a non-invasive technology for detection of placental abnormalities and the prediction of pregnancy outcomes.
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Affiliation(s)
- Farah Deeba
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Ricky Hu
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada
| | - Victoria Lessoway
- Department of Ultrasound, BC Women's Hospital, Vancouver, British Columbia, Canada
| | - Jefferson Terry
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Denise Pugash
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer Hutcheon
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chantal Mayer
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Septimiu Salcudean
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada
| | - Robert Rohling
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada; Department of Mechanical Engineering, University of British Columbia, Vancouver, British Columbia, Canada
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Vuorenmaa AS, Siitama EMK, Mäkelä KS. Inter-operator and inter-device reproducibility of shear wave elastography in healthy muscle tissues. J Appl Clin Med Phys 2022; 23:e13717. [PMID: 35793227 PMCID: PMC9512333 DOI: 10.1002/acm2.13717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/06/2022] [Accepted: 06/09/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose The study aimed to assess whether the more limiting factor in reproducibility of shear wave elastography (SWE) would be the operator dependency or the incompatibility of different ultrasound (US) devices. The interrater agreement with less experienced operators was studied. Methods A total of 24 healthy volunteers participated in the study (18 females, 6 males; range of age 27–55 years). SWE of biceps brachii (BB) and tibialis anterior (TA) muscles was performed on both sides from all participants in both longitudinal and transverse orientation of the transducer in respect to muscle fibers. Two operators repeated the SWE with two different US devices from different manufacturers (scanners 1 and 2). Results Intraclass correlation coefficient between the two operators was 0.91 (CI 0.88–0.93) for scanner 1 and 0.81 (CI 0.74–0.86) for scanner 2, respectively. Instead, there were significant differences in the SWE measurements between the two scanners, emphasizing in transverse orientation of the transducer. In the transverse transducer orientation, the mean shear wave velocity (SWV) in TA was 1.45 m/s (standard deviation [SD] ± 0.35 m/s) with scanner 1 and 2.35 m/s (SD ± 0.83 m/s) with scanner 2 (p < 0.001). In BB, the mean transverse SWV was 1.49 m/s (SD ± 0.35 m/s) with scanner 1 and 2.29 m/s (SD ± 0.63 m/s) with scanner 2 (p < 0.001). In longitudinal transducer orientation, the mean SWV in TA was 3.00 m/s (SD ± 0.73 m/s) with scanner 1 and 3.26 m/s (SD ± 0.42 m/s) with scanner 2 (p = 0.050). In BB, the mean longitudinal SWV was 3.60 m/s (SD ± 0.77 m/s) with scanner 1 and 3.96 m/s (SD ± 0.62 m/s) with scanner 2 (p = 0.019). The presented mean values were obtained by operator 1, there were no significant differences in the SWE measurements performed by the two operators. Conclusion The results implicate that the reproducibility of the SWE measurements depends rather on the used US device than on the operator. It is recommendable that clinics collect reference values with their own US device and consider threshold values presented in previous studies only directional.
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Affiliation(s)
- Anna S Vuorenmaa
- Department of Medical Physics, Medical Imaging Center, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
| | - Eetu M K Siitama
- Department of Medical Physics, Medical Imaging Center, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
| | - Katri S Mäkelä
- Department of Clinical Neurophysiology, Medical Imaging Center and Hospital Pharmacy, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
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Wei X, Wang Y, Ge L, Peng B, He Q, Wang R, Huang L, Xu Y, Luo J. Unsupervised Convolutional Neural Network for Motion Estimation in Ultrasound Elastography. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:2236-2247. [PMID: 35500076 DOI: 10.1109/tuffc.2022.3171676] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
High-quality motion estimation is essential for ultrasound elastography (USE). Traditional motion estimation algorithms based on speckle tracking such as normalized cross correlation (NCC) or regularization such as global ultrasound elastography (GLUE) are time-consuming. In order to reduce the computational cost and ensure the accuracy of motion estimation, many convolutional neural networks have been introduced into USE. Most of these networks such as radio-frequency modified pyramid, warping and cost volume network (RFMPWC-Net) are supervised and need many ground truths as labels in network training. However, the ground truths are laborious to collect for USE. In this study, we proposed a MaskFlownet-based unsupervised convolutional neural network (MF-UCNN) for fast and high-quality motion estimation in USE. The inputs to MF-UCNN are the concatenation of RF, envelope, and B-mode images before and after deformation, while the outputs are the axial and lateral displacement fields. The similarity between the predeformed image and the warped image (i.e., the postdeformed image compensated by the estimated displacement fields) and the smoothness of the estimated displacement fields were incorporated in the loss function. The network was compared with modified pyramid, warping and cost volume network (MPWC-Net)++, RFMPWC-Net, GLUE, and NCC. Results of simulations, breast phantom, and in vivo experiments show that MF-UCNN obtains higher signal-to-noise ratio (SNR) and higher contrast-to-noise ratio (CNR). MF-UCNN achieves high-quality motion estimation with significantly reduced computation time. It is unsupervised and does not need any ground truths as labels in the training, and, thus, has great potential for motion estimation in USE.
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Seo KI, Hwang H, Yun BC, Moon HH, Choi YI, Shin DH, Yoon M. A prospective study of the correlation between hepatic fibrosis and noninvasively measured fibrosis markers including serum M2BPGi and acoustic radiation force impulse elastography. KOSIN MEDICAL JOURNAL 2022. [DOI: 10.7180/kmj.22.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Mac-2 binding protein glycosylation isomer (M2BPGi) was introduced as a noninvasively measurable serologic marker for liver fibrosis. Acoustic radiation force impulse imaging (ARFI) elastography is another noninvasive method of measuring hepatic fibrosis. There are limited data about the correlations between histologic fibrosis grade and noninvasively measured markers, including M2BPGi and ARFI.Methods: This prospective study was conducted among patients admitted consecutively for liver resection, cholecystectomy, or liver biopsy. ARFI elastography, serum M2BPGi levels, and the AST to Platelet Ratio Index (APRI) score were evaluated before histologic evaluation. Histologic interpretation was performed by a single pathologist using the METAVIR scoring system.Results: In patients with high METAVIR scores, M2BPGi levels and ARFI values showed statistically significant differences between patients with fibrosis and those without fibrosis. In 41 patients with hepatocellular carcinoma, as METAVIR scores increased, M2BPGi levels also tended to increase (p=0.161). ARFI values changed significantly as METAVIR scores increased (p=0.039). In 33 patients without hepatocellular carcinoma, as METAVIR scores increased, M2BPGi levels significantly increased (p=0.040). ARFI values also changed significantly as METAVIR scores increased (p=0.033). M2BPGi levels were significantly correlated with ARFI values (r=0.604, p<0.001), and APRI values (r=0.704, p<0.001), respectively. Conclusions: Serum M2BPGi levels increased with liver fibrosis severity and could be a good marker for diagnosing advanced hepatic fibrosis regardless of the cause of liver disease.
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Götschi T, Hanimann J, Schulz N, Huser S, Held V, Frey WO, Snedeker JG, Spörri J. Patellar Tendon Shear Wave Velocity Is Higher and has Different Regional Patterns in Elite Competitive Alpine Skiers than in Healthy Controls. Front Bioeng Biotechnol 2022; 10:858610. [PMID: 35757800 PMCID: PMC9218688 DOI: 10.3389/fbioe.2022.858610] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
Competitive alpine skiers are exposed to enormous forces acting on their bodies–particularly on the knee joint and hence the patellar tendon - during both the off-season preparation and in-season competition phases. However, factors influencing patellar tendon adaptation and regional pattern differences between alpine skiers and healthy controls are not yet fully understood, but are essential for deriving effective screening approaches and preventative countermeasures. Thirty elite competitive alpine skiers, all members of the Swiss Alpine Ski Team, and 38 healthy age-matched controls were recruited. A set of two-dimensional shear wave elastography measurements of the PT was acquired and projected into three-dimensional space yielding a volumetric representation of the shear wave velocity profile of the patellar tendon. Multivariate linear models served to quantify differences between the two cohorts and effects of other confounding variables with respect to regional shear wave velocity. A significant (p < 0.001) intergroup difference was found between skiers (mean ± SD = 10.4 ± 1.32 m/s) and controls (mean ± SD = 8.9 ± 1.59 m/s). A significant sex difference was found within skiers (p = 0.024), but no such difference was found in the control group (p = 0.842). Regional SWV pattern alterations between skiers and controls were found for the distal region when compared to the mid-portion (p = 0.023). Competitive alpine skiers exhibit higher SWV in all PT regions than healthy controls, potentially caused by long-term adaptations to heavy tendon loading. The presence of sex-specific differences in PT SWV in skiers but not in controls indicates that sex effects have load-dependent dimensions. Alterations in regional SWV patterns between skiers and controls suggest that patellar tendon adaptation is region specific. In addition to the implementation of 3D SWE, deeper insights into long-term tendon adaptation and normative values for the purpose of preventative screening are provided.
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Affiliation(s)
- Tobias Götschi
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Jonas Hanimann
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Nicole Schulz
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Simon Huser
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Victoria Held
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Walter O Frey
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jess G Snedeker
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
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Yazdani L, Bhatt M, Rafati I, Tang A, Cloutier G. The Revisited Frequency-Shift Method for Shear Wave Attenuation Computation and Imaging. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:2061-2074. [PMID: 35404815 DOI: 10.1109/tuffc.2022.3166448] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Ultrasound (US) shear wave (SW) elastography has been widely studied and implemented on clinical systems to assess the elasticity of living organs. Imaging of SW attenuation reflecting viscous properties of tissues has received less attention. A revisited frequency shift (R-FS) method is proposed to improve the robustness of SW attenuation imaging. Performances are compared with the FS method that we originally proposed and with the two-point frequency shift (2P-FS) and attenuation measuring US SW elastography (AMUSE) methods. In the proposed R-FS method, the shape parameter of the gamma distribution fitting SW spectra is assumed to vary with distance, in contrast to FS. Second, an adaptive random sample consensus (A-RANSAC) line fitting method is used to prevent outlier attenuation values in the presence of noise. Validation was made on ten simulated phantoms with two viscosities (0.5 and 2 Pa [Formula: see text]) and different noise levels (15 to -5 dB), two experimental homogeneous gel phantoms, and six in vivo liver acquisitions on awake ducks (including three normal and three fatty duck livers). According to the conducted experiments, R-FS revealed mean reductions in coefficients of variation (CV) of 62.6% on simulations, 62.5% with phantoms, and 62.3% in vivo compared with FS. Corresponding reductions compared with 2P-FS were 45.4%, 77.1%, and 62.0%, respectively. Reductions in normalized root-mean-square errors for simulations were 63.9% and 48.7% with respect to FS and 2P-FS, respectively.
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Phipps MA, Jonathan S, Yang PF, Chen LM, Grissom W, Caskey CF. A reduced aperture allows for transcranial focus localization at lower pressure. JASA EXPRESS LETTERS 2022; 2:062001. [PMID: 35782333 PMCID: PMC9245740 DOI: 10.1121/10.0011695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
Localizing the focus during transcranial focused ultrasound procedures is important to ensure accurate targeting of specific brain regions and interpretation of results. Magnetic resonance acoustic radiation force imaging uses the displacement induced by the ultrasound focus in the brain to localize the beam, but the high pressure required to displace brain tissue may cause damage or confounds during subsequent neuromodulatory experiments. Here, reduced apertures were applied to a phased array transducer to generate comparable displacement to the full aperture but with 20% lower free field pressure.
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Affiliation(s)
- M Anthony Phipps
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA
| | - Sumeeth Jonathan
- Biomedical Engineering, Vanderbilt University, Nashville, Tennessee 37232, USA , , , , ,
| | - Pai-Feng Yang
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA
| | - Li Min Chen
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA
| | - William Grissom
- Biomedical Engineering, Vanderbilt University, Nashville, Tennessee 37232, USA , , , , ,
| | - Charles F Caskey
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA
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Kim YH, Kang KC, Kim JN, Pai CN, Zhang Y, Ghanouni P, Park KK, Firouzi K, Khuri-Yakub BT. Patterned Interference Radiation Force for Transcranial Neuromodulation. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:497-511. [PMID: 34955292 DOI: 10.1016/j.ultrasmedbio.2021.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 11/06/2021] [Accepted: 11/10/2021] [Indexed: 06/14/2023]
Abstract
Compared with the conventional method of transcranial focused ultrasound stimulation using a single transducer or a focused beam, the compression and tensile forces are generated from the high-pressure gradient of a standing wave that can generate increased stimulation. We experimentally verified a neuromodulation system using patterned interference radiation force (PIRF) and propose a method for obtaining the magnitude of the radiation force, which is considered the main factor influencing ultrasound neuromodulation. The radiation forces generated using a single focused transducer and a standing wave created via two focused transducers were compared using simulations. Radiation force was calculated based on the relationship between the acoustic pressure, radiation force and time-averaged second-order pressure obtained using an acoustic streaming simulation. The presence of the radiation force was verified by measuring the time-averaged second-order pressure generated due to the radiation force, by using a glass tube.
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Affiliation(s)
- Young Hun Kim
- E. L. Ginzton Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California, USA; Mechanical Convergence Engineering, Hanyang University, Seoul, Republic of Korea
| | - Ki Chang Kang
- E. L. Ginzton Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California, USA; Mechanical Convergence Engineering, Hanyang University, Seoul, Republic of Korea
| | - Jeong Nyeon Kim
- E. L. Ginzton Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Chi Nan Pai
- E. L. Ginzton Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California, USA; Department of Mechatronics Engineering, Polytechnic School of the University of Sao Paulo, Sao Paulo, Brazil
| | - Yichi Zhang
- E. L. Ginzton Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Pejman Ghanouni
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Kwan Kyu Park
- E. L. Ginzton Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California, USA; Mechanical Convergence Engineering, Hanyang University, Seoul, Republic of Korea.
| | - Kamyar Firouzi
- E. L. Ginzton Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Burtus T Khuri-Yakub
- E. L. Ginzton Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California, USA
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Kubelick KP, Mehrmohammadi M. Magnetic particles in motion: magneto-motive imaging and sensing. Theranostics 2022; 12:1783-1799. [PMID: 35198073 PMCID: PMC8825589 DOI: 10.7150/thno.54056] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 11/22/2021] [Indexed: 11/05/2022] Open
Abstract
Superparamagnetic nanoparticles have become an important tool in biomedicine. Their biocompatibility, controllable small size, and magnetic properties allow manipulation with an external magnetic field for a variety of diagnostic and therapeutic applications. Recently, the magnetically-induced motion of superparamagnetic nanoparticles has been investigated as a new source of imaging contrast. In magneto-motive imaging, an external, time-varying magnetic field is applied to move a magnetically labeled subject, such as labeled cells or tissue. Several major imaging modalities such as ultrasound, photoacoustic imaging, optical coherence tomography, and laser speckle tracking can utilize magneto-motive contrast to monitor biological events at smaller scales with enhanced contrast and sensitivity. In this review article, an overview of magneto-motive imaging techniques is presented, including synthesis of superparamagnetic nanoparticles, fundamental principles of magneto-motive force and its utility to excite labeled tissue within a viscoelastic medium, current capabilities of magneto-motive imaging modalities, and a discussion of the challenges and future outlook in the magneto-motive imaging domain.
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Affiliation(s)
- Kelsey P. Kubelick
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University School of Medicine, Georgia, USA
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Georgia, USA
| | - Mohammad Mehrmohammadi
- Department of Biomedical Engineering, Wayne State University, Michigan, USA
- Barbara Ann Karmanos Cancer Institute, Michigan, USA
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Takaya Y, Nakamura K, Nakayama R, Ohtsuka H, Amioka N, Kondo M, Akazawa K, Ohno Y, Ichikawa K, Saito Y, Akagi S, Yoshida M, Miyoshi T, Ito H. Efficacy of shear wave elasticity for evaluating myocardial hypertrophy in hypertensive rats. Sci Rep 2021; 11:22812. [PMID: 34819579 PMCID: PMC8613270 DOI: 10.1038/s41598-021-02271-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/11/2021] [Indexed: 12/19/2022] Open
Abstract
Shear wave (SW) imaging is a novel ultrasound-based technique for assessing tissue characteristics. SW elasticity may be useful to assess the severity of hypertensive left ventricular (LV) hypertrophy. This study aimed to evaluate the efficacy of SW elasticity for assessing the degree of myocardial hypertrophy using hypertensive rats. Rats were divided into hypertension group and control group. SW elasticity was measured on the excised heart. Myocardial hypertrophy was assessed histologically. LV weight was greater in hypertension group. An increase in interventricular septum and LV free wall thicknesses was observed in hypertension group. SW elasticity was significantly higher in hypertension group than in control group (14.6 ± 4.3 kPa vs. 6.5 ± 1.1 kPa, P < 0.01). The cross-sectional area of cardiomyocytes was larger in hypertension group than in control group (397 ± 50 μm2 vs. 243 ± 14 μm2, P < 0.01), and SW elasticity was positively correlated with the cross-sectional area of cardiomyocytes (R = 0.96, P < 0.01). This study showed that SW elasticity was higher in hypertensive rats and was closely correlated with the degree of myocardial hypertrophy, suggesting the efficacy of SW elasticity for estimating the severity of hypertensive LV hypertrophy.
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Affiliation(s)
- Yoichi Takaya
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Rie Nakayama
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Hiroaki Ohtsuka
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Naofumi Amioka
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Megumi Kondo
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Kaoru Akazawa
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Yuko Ohno
- Kawasaki University of Medical Welfare, Okayama, Japan
| | - Keishi Ichikawa
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Yukihiro Saito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Satoshi Akagi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Masashi Yoshida
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Toru Miyoshi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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Laroia ST, Vellore Srinivasan S, Yadav K, Rastogi A, Kumar S, Kumar G, Kumar M. Performance of shear wave elastography: A single centre pilot study of mixed etiology liver disease patients with normal BMI. Australas J Ultrasound Med 2021; 24:120-136. [PMID: 34765422 DOI: 10.1002/ajum.12244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/21/2021] [Accepted: 03/28/2021] [Indexed: 02/06/2023] Open
Abstract
Purpose To assess the performance of shear wave ultrasound elastography (SWE) for non-invasive grading of fibrosis in normal BMI patients with varied aetiology chronic liver disease. Method Prospective SWE liver and spleen stiffness (LS, SS respectively) of 124 patients (94 men, mean age 45.4 ± 12.4 years, mean BMI 19.66 ± 1.49) with CLD of mixed aetiology, who underwent liver biopsy, between January 2019-20 was analysed using receiver operating curve (ROC) and classification analysis regression tree (CART) to determine fibrosis cut-off values and nominal logistical regression to quantify fibrosis. Results Of 124 patients, 50 (40%) had non-alcoholic steatohepatitis (NASH), 31 (25%) chronic hepatitis B (CHB) and 43 (35%) alcoholic liver disease (ALD) on biopsy. Overall mean LS and SS of the study population was 11.81 ± 5.9 and 16.88 ± 10.8 kPa, respectively. LS cut-off value <8 kPa was consistent with F0, 9-14 kPa for F1-F2 and >14.9 kPa for F3-F4 fibrosis on biopsy. On application of CART, LS value < 5.3 kPa was discriminative for NASH, 5.32 to <12.64 kPa for CHB, >12.64 kPa for ALD, SS <15.3 kPa was discriminative for NASH, 15.3-30 kPa for CHB and >30 kPa for ALD in our study population. Conclusion SWE is a viable non-invasive tool for assessment of liver fibrosis grading in a population of mixed aetiology CLD. LS values in conjunction with SS are promising predictors of F2-F3 fibrosis with potential to discriminate select categories like CHB and NASH in such a population.
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Affiliation(s)
- Shalini Thapar Laroia
- Department of Radiology Institute of Liver and Biliary Sciences Sector D-1 Vasant Kunj New Delhi 110070 India
| | - Shyam Vellore Srinivasan
- Department of Radiology Institute of Liver and Biliary Sciences Sector D-1 Vasant Kunj New Delhi 110070 India
| | - Komal Yadav
- Department of Radiology Institute of Liver and Biliary Sciences Sector D-1 Vasant Kunj New Delhi 110070 India
| | - Archana Rastogi
- Department of Clinical and Hepato-Pathology Institute of Liver and Biliary Sciences Sector D-1 Vasant Kunj New Delhi 110070 India
| | - Senthil Kumar
- Department of HPB Surgery and Liver Transplantation Institute of Liver & Biliary Sciences Sector D-1 Vasant Kunj New Delhi 110070 India
| | - Guresh Kumar
- Department of Research Institute of Liver & Biliary Sciences Sector D-1 Vasant Kunj New Delhi 110070 India
| | - Manoj Kumar
- Department of Hepatology Institute of Liver & Biliary Sciences Sector D-1 Vasant Kunj New Delhi 110070 India
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Sarvazyan AP, Rudenko OV, Fatemi M. Acoustic Radiation Force: A Review of Four Mechanisms for Biomedical Applications. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:3261-3269. [PMID: 34520353 DOI: 10.1109/tuffc.2021.3112505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Radiation force is a universal phenomenon in any wave motion where the wave energy produces a static or transient force on the propagation medium. The theory of acoustic radiation force (ARF) dates back to the early 19th century. In recent years, there has been an increasing interest in the biomedical applications of ARF. Following a brief history of ARF, this article describes a concise theory of ARF under four physical mechanisms of radiation force generation in tissue-like media. These mechanisms are primarily based on the dissipation of acoustic energy of propagating waves, the reflection of the incident wave, gradients of the compressional wave speeds, and the spatial variations of energy density in standing acoustic waves. Examples describing some of the practical applications of ARF under each mechanism are presented. This article concludes with a discussion on selected ideas for potential future applications of ARF in biomedicine.
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50
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Chouhan MD, Fitzke HE, Bainbridge A, Atkinson D, Halligan S, Davies N, Lythgoe MF, Mookerjee RP, Menys A, Taylor SA. Cardiac-induced liver deformation as a measure of liver stiffness using dynamic imaging without magnetization tagging-preclinical proof-of-concept, clinical translation, reproducibility and feasibility in patients with cirrhosis. Abdom Radiol (NY) 2021; 46:4660-4670. [PMID: 34148103 DOI: 10.1007/s00261-021-03168-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE MR elastography and magnetization-tagging use liver stiffness (LS) measurements to diagnose fibrosis but require physical drivers, specialist sequences and post-processing. Here we evaluate non-rigid registration of dynamic two-dimensional cine MRI images to measure cardiac-induced liver deformation (LD) as a measure of LS by (i) assessing preclinical proof-of-concept, (ii) clinical reproducibility and inter-reader variability, (iii) the effects of hepatic hemodynamic changes and (iv) feasibility in patients with cirrhosis. METHODS Sprague-Dawley rats (n = 21 bile duct ligated (BDL), n = 17 sham-operated controls) and fasted patients with liver cirrhosis (n = 11) and healthy volunteers (HVs, n = 10) underwent spoiled gradient-echo short-axis cardiac cine MRI studies at 9.4 T (rodents) and 3.0 T (humans). LD measurements were obtained from intrahepatic sub-cardiac regions-of-interest close to the diaphragmatic margin. One-week reproducibility and prandial stress induced hemodynamic changes were assessed in healthy volunteers. RESULTS Normalized LD was higher in BDL (1.304 ± 0.062) compared with sham-operated rats (1.058 ± 0.045, P = 0.0031). HV seven-day reproducibility Bland-Altman (BA) limits-of-agreement (LoAs) were ± 0.028 a.u. and inter-reader variability BA LoAs were ± 0.030 a.u. Post-prandial LD increases were non-significant (+ 0.0083 ± 0.0076 a.u., P = 0.3028) and uncorrelated with PV flow changes (r = 0.42, p = 0.2219). LD measurements successfully obtained from all patients were not significantly higher in cirrhotics (0.102 ± 0.0099 a.u.) compared with HVs (0.080 ± 0.0063 a.u., P = 0.0847). CONCLUSION Cardiac-induced LD is a conceptually reasonable approach from preclinical studies, measurements demonstrate good reproducibility and inter-reader variability, are less likely to be affected by hepatic hemodynamic changes and are feasible in patients with cirrhosis.
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Affiliation(s)
- Manil D Chouhan
- Division of Medicine, Centre for Medical Imaging, University College London (UCL), London, UK.
| | - Heather E Fitzke
- Division of Medicine, Centre for Medical Imaging, University College London (UCL), London, UK
- Wingate Institute of Neurogastroenterology, Neuroscience and Trauma, Queen Mary University of London (QMUL), London, UK
| | - Alan Bainbridge
- Department of Medical Physics, University College London Hospitals NHS Trust, London, UK
| | - David Atkinson
- Division of Medicine, Centre for Medical Imaging, University College London (UCL), London, UK
| | - Steve Halligan
- Division of Medicine, Centre for Medical Imaging, University College London (UCL), London, UK
| | - Nathan Davies
- Division of Medicine, Institute for Liver and Digestive Health, University College London (UCL), London, UK
| | - Mark F Lythgoe
- Division of Medicine, Centre for Advanced Biomedical Imaging, University College London (UCL), London, UK
| | - Rajeshwar P Mookerjee
- Division of Medicine, Institute for Liver and Digestive Health, University College London (UCL), London, UK
| | - Alex Menys
- Division of Medicine, Centre for Medical Imaging, University College London (UCL), London, UK
- Motilent, London, UK
| | - Stuart A Taylor
- Division of Medicine, Centre for Medical Imaging, University College London (UCL), London, UK
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