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Fan Y, Zheng H, Feng L, To MKT, Kuang GM, Yeung EHK, Cheung KMC, Liu L, Cheung JPY. Elasticity and cross-sectional thickness of paraspinal muscles in progressive adolescent idiopathic scoliosis. Front Pediatr 2024; 12:1323756. [PMID: 38516354 PMCID: PMC10954774 DOI: 10.3389/fped.2024.1323756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/22/2024] [Indexed: 03/23/2024] Open
Abstract
Objectives (1) Compare the cross-sectional thickness (CST) and shear wave speed (SWS) of paraspinal muscles (PSM) in adolescent idiopathic scoliosis (AIS) with and without curve progression; (2) investigate the relationship between CST/SWS and radiographic characteristics in AIS with curve progression; (3) compare the CST/SWS between AIS and non-scoliosis controls. Methods This cross-sectional study analyzed the CST and SWS of PSM in 48 AIS with mild to moderate curvature and 24 non-scoliosis participants. Participants with scoliosis greater than 45° of Cobb angles were excluded. The Change of Cobb angles within the last 6-months was retrieved to allocate AIS into progression and non-progression groups. The SWS and CST of multifidus; longissimus and iliocostalis of the major curve were measured using B-mode ultrasound image with an elastography mode. Discrepancies of the SWS (SWS-ratio: SWS on the convex side divided by SWS on the concave side) and CST (CST-ratio: CST on the convex side divided by CST on the concave side) at the upper/lower end and apical vertebrae were studied. Results A higher SWS at the apical vertebrae on the concave side of the major curve (multifidus: 3.9 ± 1.0 m/s vs. 3.1 ± 0.6 m/s; p < 0.01, longissimus: 3.3 ± 1.0 m/s vs. 3.0 ± 0.9 m/s; p < 0.01, iliocostalis: 2.8 ± 1.0 m/s vs. 2.5 ± 0.8 m/s; p < 0.01) was observed in AIS with curve progression. A lower SWS-ratio at apical vertebrae was detected with a greater vertebral rotation in participants with curve progression (multifidus [grade II]: 0.7 ± 0.1 vs. grade I: 0.9 ± 0.2; p = 0.03, longissimus [grade II]: 0.8 ± 0.2 vs. grade I: 1.1 ± 0.2; p < 0.01). CST was not different among the progressive, non-progressive AIS and non-scoliosis controls. Conclusions Increased SWS of PSM without change of CST was observed on the concave side of the major curve in participants with progressive AIS.
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Affiliation(s)
- Yunli Fan
- Department of Physiotherapy, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Haiping Zheng
- Department of Medical Imaging-Ultrasound Division, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Lin Feng
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Michael K T To
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Guan-Ming Kuang
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Eric H K Yeung
- Department of Physiotherapy, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Kenneth M C Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Li Liu
- Department of Medical Imaging-Ultrasound Division, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Jason P Y Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
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Bosio G, Destrempes F, Yazdani L, Roy Cardinal MH, Cloutier G. Resonance, Velocity, Dispersion, and Attenuation of Ultrasound-Induced Shear Wave Propagation in Blood Clot In Vitro Models. J Ultrasound Med 2024; 43:535-551. [PMID: 38108551 DOI: 10.1002/jum.16387] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/24/2023] [Accepted: 11/25/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Improve the characterization of mechanical properties of blood clots. Parameters derived from shear wave (SW) velocity and SW amplitude spectra were determined for gel phantoms and in vitro blood clots. METHODS Homogeneous phantoms and phantoms with gel or blood clot inclusions of different diameters and mechanical properties were analyzed. SW amplitude spectra were used to observe resonant peaks. Parameters derived from those resonant peaks were related to mimicked blood clot properties. Three regions of interest were tested to analyze where resonances occurred the most. For blood experiments, 20 samples from different pigs were analyzed over time during a 110-minute coagulation period using the Young modulus, SW frequency dispersion, and SW attenuation. RESULTS The mechanical resonance was manifested by an increase in the number of SW spectral peaks as the inclusion diameter was reduced (P < .001). In blood clot inclusions, the Young modulus increased over time during coagulation (P < .001). Descriptive spectral parameters (frequency peak, bandwidth, and distance between resonant peaks) were linearly correlated with clot elasticity values (P < .001) with R2 = .77 for the frequency peak, .60 for the bandwidth, and .48 for the distance between peaks. The SW dispersion and SW attenuation reflecting the viscous behavior of blood clots decreased over time (P < .001), mainly in the early stage of coagulation (first minutes). CONCLUSION The confined soft inclusion configuration favored SW mechanical resonances potentially challenging the computation of spectral-based parameters, such as the SW attenuation. The impact of resonances can be reduced by properly selecting the region of interest for data analysis.
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Affiliation(s)
- Guillaume Bosio
- Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - François Destrempes
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Ladan Yazdani
- Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Marie-Hélène Roy Cardinal
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Guy Cloutier
- Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
- Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montreal, Quebec, Canada
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Darwish OI, Gharib AM, Jeljeli S, Metwalli NS, Feeley J, Rotman Y, Brown RJ, Ouwerkerk R, Kleiner DE, Stäb D, Speier P, Sinkus R, Neji R. Single Breath-Hold 3-Dimensional Magnetic Resonance Elastography Depicts Liver Fibrosis and Inflammation in Obese Patients. Invest Radiol 2023; 58:413-419. [PMID: 36719974 PMCID: PMC10735168 DOI: 10.1097/rli.0000000000000952] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Three-dimensional (3D) magnetic resonance elastography (MRE) measures liver fibrosis and inflammation but requires several breath-holds that hamper clinical acceptance. The aim of this study was to evaluate the technical and clinical feasibility of a single breath-hold 3D MRE sequence as a means of measuring liver fibrosis and inflammation in obese patients. METHODS From November 2020 to December 2021, subjects were prospectively enrolled and divided into 2 groups. Group 1 included healthy volunteers (n = 10) who served as controls to compare the single breath-hold 3D MRE sequence with a multiple-breath-hold 3D MRE sequence. Group 2 included liver patients (n = 10) who served as participants to evaluate the clinical feasibility of the single breath-hold 3D MRE sequence in measuring liver fibrosis and inflammation. Controls and participants were scanned at 60 Hz mechanical excitation with the single breath-hold 3D MRE sequence to retrieve the magnitude of the complex-valued shear modulus (|G*| [kPa]), the shear wave speed (Cs [m/s]), and the loss modulus (G" [kPa]). The controls were also scanned with a multiple-breath-hold 3D MRE sequence for comparison, and the participants had histopathology (Ishak scores) for correlation with Cs and G". RESULTS For the 10 controls, 5 were female, and the mean age and body mass index were 33.1 ± 9.5 years and 23.0 ± 2.1 kg/m 2 , respectively. For the 10 participants, 8 were female, and the mean age and body mass index were 45.1 ± 16.5 years and 33.1 ± 4.0 kg/m 2 (obese range), respectively. All participants were suspected of having nonalcoholic fatty liver disease. Bland-Altman analysis of the comparison in controls shows there are nonsignificant differences in |G*|, Cs, and G" below 6.5%, suggesting good consensus between the 2 sequences. For the participants, Cs and G" correlated significantly with Ishak fibrosis and inflammation grades, respectively ( ρ = 0.95, P < 0.001, and ρ = 0.84, P = 0.002). CONCLUSION The single breath-hold 3D MRE sequence may be effective in measuring liver fibrosis and inflammation in obese patients.
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Affiliation(s)
- Omar Isam Darwish
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- INSERM U1148, LVTS, University Paris Diderot, Paris, France
- MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom
| | - Ahmed M. Gharib
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Sami Jeljeli
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Nader S. Metwalli
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Jenna Feeley
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Yaron Rotman
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Rebecca J. Brown
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Ronald Ouwerkerk
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | | | - Daniel Stäb
- MR Research Collaborations, Siemens Healthcare Limited, Melbourne, Australia
| | - Peter Speier
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Ralph Sinkus
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- INSERM U1148, LVTS, University Paris Diderot, Paris, France
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom
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Paverd C, Kupfer S, Kirchner IN, Nambiar S, Martin A, Korta Martiartu N, Frauenfelder T, Rominger MB, Ruby L. Impact of Breathing Phase, Liver Segment, and Prandial State on Ultrasound Shear Wave Speed, Shear Wave Dispersion, and Attenuation Imaging of the Liver in Healthy Volunteers. Diagnostics (Basel) 2023; 13. [PMID: 36900133 DOI: 10.3390/diagnostics13050989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 02/20/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVES Measurement location and patient state can impact noninvasive liver assessment and change clinical staging in ultrasound examinations. Research into differences exists for Shear Wave Speed (SWS) and Attenuation Imaging (ATI), but not for Shear Wave Dispersion (SWD). The aim of this study is to assess the effect of breathing phase, liver lobe, and prandial state on SWS, SWD, and ATI ultrasound measurements. METHODS Two experienced examiners performed SWS, SWD, and ATI measurements in 20 healthy volunteers using a Canon Aplio i800 system. Measurements were taken in the recommended condition (right lobe, following expiration, fasting state), as well as (a) following inspiration, (b) in the left lobe, and (c) in a nonfasting state. RESULTS SWS and SWD measurements were strongly correlated (r = 0.805, p < 0.001). Mean SWS was 1.34 ± 0.13 m/s in the recommended measurement position and did not change significantly under any condition. Mean SWD was 10.81 ± 2.05 m/s/kHz in the standard condition and significantly increased to 12.18 ± 1.41 m/s/kHz in the left lobe. Individual SWD measurements in the left lobe also had the highest average coefficient of variation (19.68%). No significant differences were found for ATI. CONCLUSION Breathing and prandial state did not significantly affect SWS, SWD, and ATI values. SWS and SWD measurements were strongly correlated. SWD measurements in the left lobe showed a higher individual measurement variability. Interobserver agreement was moderate to good.
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Nguyen KD, Bonner BP, Foster AN, Sadighi M, Nguyen CT. Asynchronous magnetic resonance elastography: Shear wave speed reconstruction using noise correlation of incoherent waves. Magn Reson Med 2023; 89:990-1001. [PMID: 36300861 PMCID: PMC9792433 DOI: 10.1002/mrm.29502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE The noninvasive measurement of biological tissue elasticity is an evolving technology that enables the robust characterization of soft tissue mechanics for a wide array of biomedical engineering and clinical applications. We propose, design, and implement here a new MRI technique termed asynchronous magnetic resonance elastography (aMRE) that pushes the measurement technology toward a driverless implementation. This technique can be added to clinical MRI scanners without any additional specialized hardware. THEORY Asynchronous MRE is founded on the theory of diffuse wavefields and noise correlation previously developed in ultrasound to reconstruct shear wave speeds using seemingly incoherent wavefields. Unlike conventional elastography methods that solve an inverse problem, aMRE directly reconstructs a pixel-wise mapping of wave speed using the spatial-temporal statistics of the measured wavefield. METHODS Incoherent finger tapping served as the wave-generating source for all aMRE measurements. Asynchronous MRE was performed on a phantom using a Siemens Prismafit as an experimental validation of the theory. It was further performed on thigh muscles as a proof-of-concept implementation of in vivo imaging using a Siemens Skyra scanner. RESULTS Numerical and phantom experiments show an accurate reconstruction of wave speeds from seemingly noisy wavefields. The proof-of-concept thigh experiments also show that the aMRE protocol can reconstruct a pixel-wise mapping of wave speeds. CONCLUSION Asynchronous MRE is shown to accurately reconstruct shear wave speeds in phantom experiments and remains at the proof-of-concept stage for in vivo imaging. After further validation and improvements, it has the potential to lower both the technical and monetary barriers of entry to measuring tissue elasticity.
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Affiliation(s)
- Khoi D. Nguyen
- Cardiovascular Innovation Research Center, Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH,Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| | - Benjamin P. Bonner
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| | - Anna N. Foster
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| | - Mehdi Sadighi
- Cardiovascular Innovation Research Center, Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH,Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| | - Christopher T. Nguyen
- Cardiovascular Innovation Research Center, Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH,Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA,Department of Diagnostic Radiology Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH,Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH,Corresponding author.
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Hirooka M, Koizumi Y, Nakamura Y, Yano R, Okazaki Y, Sunago K, Imai Y, Watanabe T, Yoshida O, Tokumoto Y, Abe M, Hiasa Y. Spleen stiffness in patients with chronic liver disease evaluated by 2-D shear wave elastography with ultrasound multiparametric imaging. Hepatol Res 2023; 53:93-103. [PMID: 36149642 DOI: 10.1111/hepr.13841] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/30/2022] [Accepted: 09/11/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND The novel 2-D shear wave elastography (2D-SWE) can measure two ultrasound parameters: shear wave dispersion (SWD) and shear wave speed (SWS). We investigated the ability of 2D-SWE in measuring spleen stiffness using ultrasound multiparametric imaging. METHODS This cross-sectional study included patients with chronic liver disease who underwent esophagogastroduodenoscopy and ultrasonographic examinations of the spleen between September 2018 and December 2021. In total, 157 patients were enrolled in this study: 81 and 67 patients were included in the pilot set for hepatic venous pressure gradient (HVPG) measurements and validation cohort without HVPG measurements, respectively. To confirm reproducibility between the two examiners, an additional 30 patients were enrolled. RESULTS The Bland-Altman plots revealed no significant bias in the SWD as measured by two examiners. The splenic SWS (r = 0.752) and SWD (r = 0.444) were correlated with the HVPG. Regarding high-risk varices, as per the Youden index, the cut-off value for splenic SWS was 3.30 m/s, with a sensitivity of 85.7%, specificity of 92.5%, positive predictive value of 85.7%, and negative predictive value of 92.4% in the pilot set. In the validation set, good diagnostic performance by the splenic SWS was observed. However, SWD did not perform as well as SWS. CONCLUSIONS The splenic SWS, measured using ultrasound multiparametric imaging, was closely correlated with the HVPG. Thus, SWS is a useful predictive marker for high-risk varices.
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Affiliation(s)
- Masashi Hirooka
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yohei Koizumi
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yoshiko Nakamura
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Ryo Yano
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yuki Okazaki
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Koutarou Sunago
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yusuke Imai
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Takao Watanabe
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Osamu Yoshida
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yoshio Tokumoto
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Masanori Abe
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yoichi Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
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Rayes A, Zhang J, Lu G, Qian X, Schroff ST, Ryu R, Jiang X, Zhou Q. Estimating Thrombus Elasticity by Shear Wave Elastography to Evaluate Ultrasound Thrombolysis for Thrombus With Different Stiffness. IEEE Trans Biomed Eng 2023; 70:135-143. [PMID: 35759590 PMCID: PMC10370280 DOI: 10.1109/tbme.2022.3186586] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE There is uncertainty about deep vein thrombosis standard treatment as thrombus stiffness alters each case. Here, we investigated thrombus' stiffness of different compositions and ages using shear wave elastography (SWE). We then studied the effectiveness of ultrasound-thrombolysis on different thrombus compositions. METHODS Shear waves generated through mechanical shaker and traveled along thrombus of different hematocrit (HCT) levels, whereas 18-MHz ultrasound array used to detect wave propagation. Thrombus' stiffness was identified by the shear wave speed (SWS). In thrombolysis, a 3.2 MHz focused transducer was applied to different thrombus compositions using different powers. The thrombolysis rate was defined as the percentage of weight loss. RESULTS The estimated average SWS of 20%, 40%, and 60% HCT thrombus were 0.75 m/s, 0.44 m/s, and 0.32 m/s, respectively. For Thrombolysis, the percentage weight loss at 8 MPa Negative pressure for the same HCT groups were 23.1%, 35.29%, and 39.66% respectively. CONCLUSION SWS is inversely related to HCT level and positively related to thrombus age. High HCT thrombus had higher weight loss compared to low HCT. However, the difference between 20% and 40% HCT was more significant than between 40% and 60% HCT in both studies. Our results suggest that thrombus with higher SWS require more power to achieve the same thrombolysis rate as thrombus with lower SWS. SIGNIFICANCE Characterizing thrombus elastic property undergoing thrombolysis enables evaluation of ultrasound efficacy for fractionating thrombus and reveals the appropriate ultrasound parameters selection to achieve a certain thrombolysis rate in the case of a specific thrombus stiffness.
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Affiliation(s)
- Adnan Rayes
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Junhang Zhang
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Gengxi Lu
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Xuejun Qian
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Stuart T. Schroff
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA
| | - Robert Ryu
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA
| | - Xiaoning Jiang
- department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA
| | - Qifa Zhou
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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Abstract
The microchannel flow model postulates that stress-strain behavior in soft tissues is influenced by the time constants of fluid-filled vessels related to Poiseuille’s law. A consequence of this framework is that changes in fluid viscosity and changes in vessel diameter (through vasoconstriction) have a measurable effect on tissue stiffness. These influences are examined through the theory of the microchannel flow model. Then, the effects of viscosity and vasoconstriction are demonstrated in gelatin phantoms and in perfused tissues, respectively. We find good agreement between theory and experiments using both a simple model made from gelatin and from living, perfused, placental tissue ex vivo.
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Affiliation(s)
- Sedigheh S. Poul
- Department of Mechanical Engineering, University of Rochester, Rochester, NY 14627, USA
| | - Juvenal Ormachea
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY 14627, USA
| | - Stefanie J. Hollenbach
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY 14623, USA
| | - Kevin J. Parker
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY 14627, USA
- Correspondence:
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Gültekin E, Wetz C, Braun J, Geisel D, Furth C, Hamm B, Sack I, Marticorena Garcia SR. Added Value of Tomoelastography for Characterization of Pancreatic Neuroendocrine Tumor Aggressiveness Based on Stiffness. Cancers (Basel) 2021; 13:cancers13205185. [PMID: 34680334 PMCID: PMC8533708 DOI: 10.3390/cancers13205185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/03/2021] [Accepted: 10/13/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary The prediction of pancreatic neuroendocrine tumor (PNET) aggressiveness is important for treatment planning. The aim of this study was to evaluate the diagnostic performance of magnetic resonance elastography (MRE) with tomoelastography postprocessing (tomoelastography) in differentiating PNET from healthy pancreatic tissue and to correlate PNET stiffness with aggressiveness using asphericity derived from positron emission tomography (PET) as reference. In this prospective study we showed in a group of 13 patients with PNET that tomoelastography detected PNET by increased stiffness (p < 0.01) with a high diagnostic performance (AUC = 0.96). PNET was positively correlated with PET derived asphericity (r = 0.81). Tomoelastography provides quantitative imaging markers for the detection of PNET and the prediction of greater tumor aggressiveness by increased stiffness. Abstract Purpose: To evaluate the diagnostic performance of tomoelastography in differentiating pancreatic neuroendocrine tumors (PNETs) from healthy pancreatic tissue and to assess the prediction of tumor aggressiveness by correlating PNET stiffness with PET derived asphericity. Methods: 13 patients with PNET were prospectively compared to 13 age-/sex-matched heathy volunteers (CTR). Multifrequency MR elastography was combined with tomoelastography-postprocessing to provide high-resolution maps of shear wave speed (SWS in m/s). SWS of pancreatic neuroendocrine tumor (PNET-T) were compared with nontumorous pancreatic tissue in patients with PNET (PNET-NT) and heathy pancreatic tissue (CTR). The diagnostic performance of tomoelastography was evaluated by ROC-AUC analysis. PNET-SWS correlations were calculated with Pearson’s r. Results: SWS was higher in PNET-T (2.02 ± 0.61 m/s) compared to PNET-NT (1.31 ± 0.18 m/s, p < 0.01) and CTR (1.26 ± 0.09 m/s, p < 0.01). An SWS-cutoff of 1.46 m/s distinguished PNET-T from PNET-NT (AUC = 0.89; sensitivity = 0.85; specificity = 0.92) and a cutoff of 1.49 m/s differentiated pancreatic tissue of CTR from PNET-T (AUC = 0.96; sensitivity = 0.92; specificity = 1.00). The SWS of PNET-T was positively correlated with PET derived asphericity (r = 0.81; p = 0.01). Conclusions: Tomoelastography provides quantitative imaging markers for the detection of PNET and the prediction of greater tumor aggressiveness by increased stiffness.
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Affiliation(s)
- Emin Gültekin
- Department of Radiology, Campus Virchow Klinikum, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (E.G.); (D.G.); (B.H.)
| | - Christoph Wetz
- Department of Nuclear Medicine, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 13353 Berlin, Germany; (C.W.); (C.F.)
| | - Jürgen Braun
- Institute for Medical Informatics, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany;
| | - Dominik Geisel
- Department of Radiology, Campus Virchow Klinikum, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (E.G.); (D.G.); (B.H.)
| | - Christian Furth
- Department of Nuclear Medicine, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 13353 Berlin, Germany; (C.W.); (C.F.)
| | - Bernd Hamm
- Department of Radiology, Campus Virchow Klinikum, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (E.G.); (D.G.); (B.H.)
- Department of Radiology, Campus Mitte, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany;
| | - Ingolf Sack
- Department of Radiology, Campus Mitte, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany;
| | - Stephan R. Marticorena Garcia
- Department of Radiology, Campus Mitte, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany;
- Correspondence: ; Tel.: +49-30-450-527082; Fax: +49-30-450-7527911
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Korta Martiartu N, Nakhostin D, Ruby L, Frauenfelder T, Rominger MB, Sanabria SJ. Speed of sound and shear wave speed for calf soft tissue composition and nonlinearity assessment. Quant Imaging Med Surg 2021; 11:4149-4161. [PMID: 34476195 DOI: 10.21037/qims-20-1321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/13/2021] [Indexed: 12/25/2022]
Abstract
Background The purpose of this study was threefold: (I) to study the correlation of speed-of-sound (SoS) and shear-wave-speed (SWS) ultrasound (US) in the gastrocnemius muscle, (II) to use reproducible tissue compression to characterize tissue nonlinearity effects, and (III) to compare the potential of SoS and SWS for tissue composition assessment. Methods Twenty gastrocnemius muscles of 10 healthy young subjects (age range, 23-34 years, two females and eight males) were prospectively examined with both clinical SWS (GE Logiq E9, in m/s) and a prototype system that measures SoS (in m/s). A reflector was positioned opposite the US probe as a timing reference for SoS, with the muscle in between. Reproducible tissue compression was applied by reducing probe-reflector distance in 5 mm steps. The Ogden hyperelastic model and the acoustoelastic theory were used to characterize SoS and SWS variations with tissue compression and extract novel metrics related to tissue nonlinearity. The body fat percentage (BF%) of the subjects was estimated using bioelectrical impedance analysis. Results A weak negative correlation was observed between SWS and SoS (r=-0.28, P=0.002). SWS showed an increasing trend with increasing tissue compression (P=0.10) while SoS values decayed nonlinearly (P<0.001). The acoustoelastic modeling showed a weak correlation for SWS (r=-0.36, P<0.001) but a very strong correlation for SoS (r=0.86, P<0.001), which was used to extract the SoS acoustoelastic parameter. SWS showed higher variability between both calves [intraclass correlation coefficient (ICC) =0.62, P=0.08] than SoS (ICC =0.91, P<0.001). Correlations with BF% were strong and positive for SWS (r=0.60, P<0.001), moderate and negative for SoS (r=-0.43, P=0.05), and moderate positive for SoS acoustoelastic parameter (r=0.48, P=0.03). Conclusions SWS and SoS provide independent information about tissue elastic properties. SWS correlated stronger with BF% than SoS, but measurements were less reliable. SoS enabled the extraction of novel metrics related to tissue nonlinearity with potential complementary information.
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Affiliation(s)
- Naiara Korta Martiartu
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland
| | - Dominik Nakhostin
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland
| | - Lisa Ruby
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland
| | - Thomas Frauenfelder
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland
| | - Marga B Rominger
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland
| | - Sergio J Sanabria
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland.,Deusto Institute of Technology, University of Deusto/IKERBASQUE, Basque Foundation for Science, Bilbao, Basque Country, Spain
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11
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Lok UW, Huang C, Zhou C, Yang L, Ling W, Tang S, Gong P, Madson TJ, Jensen MA, Gay RE, Chen S. Quantitative Shear Wave Speed Assessment for Muscles with the Diagnosis of Taut Bands and/or Myofascial Trigger Points Using Probe Oscillation Shear Wave Elastography: A Pilot Study. J Ultrasound Med 2021; 41:845-854. [PMID: 34085301 DOI: 10.1002/jum.15764] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 04/09/2021] [Accepted: 05/22/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To use probe oscillation shear wave elastography (PROSE) with two vibration sources to generate two shear waves in the imaging plane to quantitatively assess the shear wave speeds (SWSs) of muscles with and without the diagnosis of taut bands (TB) and/or myofascial trigger points (MTrPs). METHODS Thirty-three patients were scanned with the PROSE technique. Shear waves were generated through continuous vibration of the ultrasound probe, while the shear wave motions were detected using the same probe. SWSs for the sides with and without TBs and/or MTrPs were computed and compared. The pressure pain thresholds (PPTs) were measured as an indicator of maximum pain tolerance of patients. The statistical differences between the SWSs with and without TBs and/or MTrPs with different PPT values were analyzed using the nonparametric Wilcoxon rank-sum test. RESULTS The mean SWSs for the sides with TBs and/or MTrPs are faster than that of the contralateral side without TBs and/or MTrPs. A significant difference was observed between mean SWSs with and without TBs and/or MTrPs without any information of PPT, with rank-sum test P < .005. Additionally, with the information of PPT, a significant difference was observed between mean SWSs for the sides with and without TBs and/or MTrPs, for PPT values between 0 and 50 N/cm2 (P < .005), but for PPT values between 50 and 90 N/cm2 , it was difficult to differentiate mean SWSs with and without TBs and/or MTrPs. CONCLUSION Our preliminary results show that SWSs measured from patients had a significant difference between the mean SWSs with and without TBs and/or MTrPs.
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Affiliation(s)
- U-Wai Lok
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Chengwu Huang
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Chenyun Zhou
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lulu Yang
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wenwu Ling
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Shanshan Tang
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ping Gong
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Timothy J Madson
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - Mark A Jensen
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - Ralph E Gay
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - Shigao Chen
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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12
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Ariyurek C, Tasdelen B, Ider YZ, Atalar E. SNR Weighting for Shear Wave Speed Reconstruction in Tomoelastography. NMR Biomed 2021; 34:e4413. [PMID: 32956538 DOI: 10.1002/nbm.4413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 08/31/2020] [Accepted: 09/06/2020] [Indexed: 06/11/2023]
Abstract
In tomoelastography, to achieve a final wave speed map by combining reconstructions obtained from all spatial directions and excitation frequencies, the use of weights is inevitable. Here, a new weighting scheme, which maximizes the signal-to-noise ratio (SNR) of the final wave speed map, has been proposed. To maximize the SNR of the final wave speed map, the use of squares of estimated SNR values of reconstructed individual maps has been proposed. Therefore, derivations of the SNR of the reconstructed wave speed maps have become necessary. Considering the noise on the complex MRI signal, the SNR of the reconstructed wave speed map was formulated by an analytical approach assuming a high SNR, and the results were verified using Monte Carlo simulations (MCSs). It has been assumed that the noise remains approximately Gaussian when the image SNR is high enough, despite the nonlinear operations in tomoelastography inversion. Hence, the SNR threshold was determined by comparing the SNR computed by MCSs and analytical approximations. The weighting scheme was evaluated for accuracy, spatial resolution and SNR performances on simulated phantoms. MR elastography (MRE) experiments on two different phantoms were conducted. Wave speed maps were generated for simulated 3D human abdomen MRE data and experimental human abdomen MRE data. The simulation results demonstrated that the SNR-weighted inversion improved the SNR performance of the wave speed map by a factor of two compared to the performance of the original (i.e., amplitude-weighted) reconstruction. In the case of a low SNR, no bias occurred in the wave speed map when SNR weighting was used, whereas 10% bias occurred when the original weighting (i.e., amplitude weighting) was used. Thus, while not altering the accuracy or spatial resolution of the wave speed map with the proposed weighting method, the SNR of the wave speed map has been significantly improved.
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Affiliation(s)
- Cemre Ariyurek
- Department of Electrical and Electronics Engineering, Bilkent University, Ankara, Turkey
- National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey
| | - Bilal Tasdelen
- Department of Electrical and Electronics Engineering, Bilkent University, Ankara, Turkey
- National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey
| | - Yusuf Ziya Ider
- Department of Electrical and Electronics Engineering, Bilkent University, Ankara, Turkey
| | - Ergin Atalar
- Department of Electrical and Electronics Engineering, Bilkent University, Ankara, Turkey
- National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey
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13
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Carlson LC, Hall TJ, Rosado-Mendez IM, Mao L, Feltovich H. Quantitative assessment of cervical softening during pregnancy with shear wave elasticity imaging: an in vivo longitudinal study. Interface Focus 2019; 9:20190030. [PMID: 31485315 PMCID: PMC6710662 DOI: 10.1098/rsfs.2019.0030] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2019] [Indexed: 12/15/2022] Open
Abstract
We report here the results of a longitudinal study of cervix stiffness during pregnancy. Thirty women, ages ranging from 19 to 37 years, were scanned with ultrasound at five time points beginning at their normal first-trimester screening (8-13 weeks) through term pregnancy (nominally 40 week) using a clinical ultrasound imaging system modified with a special ultrasound transducer and system software. The system estimated the shear wave speed (its square proportional to the shear modulus under idealized conditions) in the cervix. We found a constant fractional reduction (about 4% per week) in shear wave speed with increasing gestational age. We also demonstrated a spatial gradient in shear wave speed along the length of the cervix (softest at the distal end). Results were consistent with our previous ex vivo and in vivo work in women. Shear wave elasticity imaging may be a potentially useful clinical tool for objective assessment of cervical softening in pregnancy.
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Affiliation(s)
- Lindsey C. Carlson
- Department of Medical Physics, University of Wisconsin, Madison, WI, USA
- Maternal Fetal Medicine, Intermountain Healthcare, Provo, UT, USA
| | - Timothy J. Hall
- Department of Medical Physics, University of Wisconsin, Madison, WI, USA
| | - Ivan M. Rosado-Mendez
- Department of Medical Physics, University of Wisconsin, Madison, WI, USA
- Institute of Physics, National Autonomous University of Mexico, Mexico City, Mexico
| | - Lu Mao
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, USA
| | - Helen Feltovich
- Department of Medical Physics, University of Wisconsin, Madison, WI, USA
- Maternal Fetal Medicine, Intermountain Healthcare, Provo, UT, USA
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Horinouchi T, Yoshizato T, Muto M, Fujii M, Kozuma Y, Shinagawa T, Morokuma S, Kakuma T, Ushijima K. Gestational age-related changes in shear wave speed of the uterine cervix in normal pregnancy at 12-35 weeks' gestation. J Perinat Med 2019; 47:393-401. [PMID: 30817303 DOI: 10.1515/jpm-2018-0250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 01/21/2019] [Indexed: 02/06/2023]
Abstract
Background This study aimed to analyze age-related changes in shear wave speed (SWS) of the normal uterine cervix. Methods We studied 362 women with a normal singleton pregnancy at 12-35 weeks' gestation. The SWS of the cervix was measured using transvaginal ultrasonography at the internal os region of the anterior cervix (IOA), posterior cervix (IOP) and cervical canal (IOC), and at the external os region of the anterior cervix (EOA), posterior cervix (EOP) and cervical canal (EOC). The following parameters were analyzed: (1) time trend of SWS of the individual sampling points, (2) comparison of SWS in the internal cervical region and SWS in the external cervical region, and (3) comparison of SWS between the internal and external cervical regions. Statistical analyses were performed using mixed-effects models. Results The SWS of IOP decreased in bilinear regression, with a critical change in the rate at 22 weeks, whereas the SWS of the remaining points decreased linearly. The estimated values of SWS of IOP at 84, 154 and 251 days were higher than those of IOA and IOC (P<0.001). The estimated values of SWS of IOP at 84 and 154 days were higher than those of EOP (P<0.001). Significant differences between IOP and EOP were shown until 244 days (P<0.05). The estimated value of SWS of IOC at 84 days was higher than that of EOC (P<0.001). Significant differences between IOC and EOC were shown until 210 days (P<0.05). Conclusion The SWS of the uterine cervix in pregnancy decreases with advancing gestation. The SWS of IOP had the highest value among the sampling points with unique characteristics.
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Affiliation(s)
- Takashi Horinouchi
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
| | - Toshiyuki Yoshizato
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
| | - Megumi Muto
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
| | - Masahiro Fujii
- Department of Biostatistics, School of Medicine, Kurume University, Kurume, Japan
| | - Yutaka Kozuma
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
| | - Takaaki Shinagawa
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
| | - Seiichi Morokuma
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tatsuyuki Kakuma
- Department of Biostatistics, School of Medicine, Kurume University, Kurume, Japan
| | - Kimio Ushijima
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
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Hofstetter LW, Odéen H, Bolster BD, Mueller A, Christensen DA, Payne A, Parker DL. Efficient shear wave elastography using transient acoustic radiation force excitations and MR displacement encoding. Magn Reson Med 2019; 81:3153-3167. [PMID: 30663806 PMCID: PMC6414262 DOI: 10.1002/mrm.27647] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 11/21/2018] [Accepted: 12/05/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE To present a novel MR shear wave elastography (MR-SWE) method that efficiently measures the speed of propagating wave packets generated using acoustic radiation force (ARF) impulses. METHODS ARF impulses from a focused ultrasound (FUS) transducer were applied sequentially to a preselected set of positions and motion encoded MRI was used to acquire volumetric images of the propagating shear wavefront emanating from each point. The wavefront position at multiple propagation times was encoded in the MR phase image using a train of motion encoding gradient lobes. Generating a transient propagating wavefront at multiple spatial positions and sampling each at multiple time-points allowed for shear wave speed maps to be efficiently created. MR-SWE was evaluated in tissue mimicking phantoms and ex vivo bovine liver tissue before and after ablation. RESULTS MR-SWE maps, covering an in-plane area of ~5 × 5 cm, were acquired in 12 s for a single slice and 144 s for a volumetric scan. MR-SWE detected inclusions of differing stiffness in a phantom experiment. In bovine liver, mean shear wave speed significantly increased from 1.65 ± 0.18 m/s in normal to 2.52 ± 0.18 m/s in ablated region (n = 581 pixels; P-value < 0.001). CONCLUSION MR-SWE is an elastography technique that enables precise targeting and excitation of the desired tissue of interest. MR-SWE may be particularly well suited for treatment planning and endpoint assessment of MR-guided FUS procedures because the same device used for therapy can be used as an excitation source for tissue stiffness quantification.
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Affiliation(s)
- Lorne W Hofstetter
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
| | - Henrik Odéen
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
| | | | - Alexander Mueller
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
| | - Douglas A Christensen
- Department of Bioengineering, University of Utah, Salt Lake City, Utah
- Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, Utah
| | - Allison Payne
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
| | - Dennis L Parker
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
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16
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Rosen D, Jiang J. Fourier-Domain Shift Matching: A Robust Time-of-Flight Approach for Shear Wave Speed Estimation. IEEE Trans Ultrason Ferroelectr Freq Control 2018; 65:729-740. [PMID: 29733277 PMCID: PMC6190720 DOI: 10.1109/tuffc.2018.2811738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Our primary objective of this work was to design and test a new time-of-flight (TOF) method that allows measurements of shear wave speed (SWS) following impulsive excitation in soft tissues. Particularly, under the assumption of the local plane shear wave, this work named the Fourier-domain shift matching (FDSM) method, estimates SWS by aligning a series of shear waveforms either temporally or spatially using a solution space deduced by characteristic curves of the well-known 1-D wave equation. The proposed SWS estimation method was tested using computer-simulated data, and tissue-mimicking phantom and ex vivo tissue experiments. Its performance was then compared with three other known TOF methods: lateral time-to-peak (TTP) method with robust random sampling consensus (RANSAC) fitting method, Radon sum transformation method, and a modified cross correlation method. Hereafter, these three TOF methods are referred to as the TTP-RANSAC, Radon sum, and X-corr methods, respectively. In addition to an adapted form of the 2-D Fourier transform (2-D FT)-based method in which the (group) SWS was approximated by averaging phase SWS values was considered for comparison. Based on data evaluated, we found that the overall performance of the above-mentioned temporal implementation of the proposed FDSM method was most similar to the established Radon sum method (correlation = 0.99, scale factor = 1.03, and mean difference = 0.07 m/s), and the 2-D FT (correlation = 0.98, scale factor = 1.00, and mean difference = 0.10 m/s) at high signal quality. However, results obtained from the 2-D FT method diverged (correlation = 0.201) from these of the proposed temporal implementation in the presence of diminished signal quality, whereas the agreement between the Radon sum approach and the proposed temporal implementation largely remained the same (correlation = 0.98).
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17
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Chotar-Vasseur Y, Cachon T, Ponsard B, Carozzo C, Viguier E. In vitro comparison between mechanical properties and elastographic characterization of porcine intervertebral disc. Comput Methods Biomech Biomed Engin 2015; 18:1906-1907. [PMID: 26252473 DOI: 10.1080/10255842.2015.1072417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Y Chotar-Vasseur
- a ICE (UPSP 2011.03.101) , Campus vétérinaire de Lyon, VetAgro Sup , Marcy l'Etoile , France
| | - T Cachon
- a ICE (UPSP 2011.03.101) , Campus vétérinaire de Lyon, VetAgro Sup , Marcy l'Etoile , France
| | - B Ponsard
- b LTDS (UMR CNRS 5513) , Ecole Centrale de Lyon , Ecully , France
| | - C Carozzo
- a ICE (UPSP 2011.03.101) , Campus vétérinaire de Lyon, VetAgro Sup , Marcy l'Etoile , France
| | - E Viguier
- a ICE (UPSP 2011.03.101) , Campus vétérinaire de Lyon, VetAgro Sup , Marcy l'Etoile , France
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18
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Carlson LC, Romero ST, Palmeri ML, Muñoz Del Rio A, Esplin SM, Rotemberg VM, Hall TJ, Feltovich H. Changes in shear wave speed pre- and post-induction of labor: a feasibility study. Ultrasound Obstet Gynecol 2015; 46:93-8. [PMID: 25200374 PMCID: PMC4363009 DOI: 10.1002/uog.14663] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 08/08/2014] [Accepted: 08/26/2014] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To explore the feasibility of using shear wave speed (SWS) estimates to detect differences in cervical softening pre- and post-ripening in women undergoing induction of labor. METHODS Subjects at 37-41 weeks' gestation undergoing cervical ripening before induction of labor were recruited (n = 20). Examinations, performed prior to administration of misoprostol and 4 h later included Bishop score, transvaginal ultrasound measurement of cervical length, and 10 replicate SWS measurements using an ultrasound system equipped with a prototype transducer (128 element, 3 mm diameter, 14 mm aperture) attached to the clinician's hand. Subjects were divided into two groups, 'not-in-labor' and 'marked-progression', based on cervical evaluation at the second examination. Measurements were compared via individual paired hypotheses tests and using a linear mixed model, with the latter also used to compare groups. Spearman's rank correlation coefficient was used to compare SWS with Bishop score. The linear mixed model can take into account clustered data and accommodate multiple predictors simultaneously. RESULTS The Wilcoxon signed-rank paired test established a significant difference in pre- and post-ripening SWS, with mean SWS estimates of 2.53 ± 0.75 and 1.54 ± 0.31 m/s, respectively (P < 0.001) in the not-in-labor group (decrease in stiffness) and 1.58 ± 0.33 and 2.35 ± 0.65 m/s for the marked-progression group (increase in stiffness). The linear mixed model corroborated significant differences in pre- and post-ripening measurements in individual subjects (P < 0.001) as well as between groups (P < 0.0001). SWS estimates were significantly correlated with digitally-assessed cervical softness and marginally correlated with Bishop score as assessed by Spearman's rank correlation coefficient. CONCLUSIONS In-vivo SWS estimates detected stiffness differences before and after misoprostol-induced softening in term pregnancies. This ultrasonic shear elasticity imaging technique shows promise for assessing cervical softness.
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Affiliation(s)
- L C Carlson
- Medical Physics Department, University of Wisconsin, Madison, WI, USA
| | - S T Romero
- Division of Maternal Fetal Medicine, Intermountain Healthcare, Murray, UT, USA
| | - M L Palmeri
- Biomedical Engineering Department, Duke University, Durham, NC, USA
| | - A Muñoz Del Rio
- Medical Physics Department, University of Wisconsin, Madison, WI, USA
| | - S M Esplin
- Division of Maternal Fetal Medicine, Intermountain Healthcare, Murray, UT, USA
| | - V M Rotemberg
- Biomedical Engineering Department, Duke University, Durham, NC, USA
| | - T J Hall
- Medical Physics Department, University of Wisconsin, Madison, WI, USA
| | - H Feltovich
- Medical Physics Department, University of Wisconsin, Madison, WI, USA
- Maternal Fetal Medicine Department, Intermountain Healthcare, Provo, UT, USA
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Zhao H, Song P, Meixner DD, Kinnick RR, Callstrom MR, Sanchez W, Urban MW, Manduca A, Greenleaf JF, Chen S. External vibration multi-directional ultrasound shearwave elastography (EVMUSE): application in liver fibrosis staging. IEEE Trans Med Imaging 2014; 33:2140-8. [PMID: 25020066 PMCID: PMC4216646 DOI: 10.1109/tmi.2014.2332542] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Shear wave speed can be used to assess tissue elasticity, which is associated with tissue health. Ultrasound shear wave elastography techniques based on measuring the propagation speed of the shear waves induced by acoustic radiation force are becoming promising alternatives to biopsy in liver fibrosis staging. However, shear waves generated by such methods are typically very weak. Therefore, the penetration may become problematic, especially for overweight or obese patients. In this study, we developed a new method called external vibration multi-directional ultrasound shearwave elastography (EVMUSE), in which external vibration from a loudspeaker was used to generate a multi-directional shear wave field. A directional filter was then applied to separate the complex shear wave field into several shear wave fields propagating in different directions. A 2-D shear wave speed map was reconstructed from each individual shear wave field, and a final 2-D shear wave speed map was constructed by compounding these individual wave speed maps. The method was validated using two homogeneous phantoms and one multi-purpose tissue-mimicking phantom. Ten patients undergoing liver magnetic resonance elastography (MRE) were also studied with EVMUSE to compare results between the two methods. Phantom results showed EVMUSE was able to quantify tissue elasticity accurately with good penetration. In vivo EVMUSE results were well correlated with MRE results, indicating the promise of using EVMUSE for liver fibrosis staging.
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Affiliation(s)
- Heng Zhao
- Mayo Clinic College of Medicine, Rochester, MN 55905 USA. He is now with Sonavation Inc., Palm Beach Gardens, FL 33410 USA
| | - Pengfei Song
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Duane D. Meixner
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Randall R. Kinnick
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Matthew R. Callstrom
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - William Sanchez
- Department of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Matthew W. Urban
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Armando Manduca
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - James F. Greenleaf
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Shigao Chen
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
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Carlson LC, Feltovich H, Palmeri ML, del Rio AM, Hall TJ. Statistical analysis of shear wave speed in the uterine cervix. IEEE Trans Ultrason Ferroelectr Freq Control 2014; 61:1651-60. [PMID: 25392863 PMCID: PMC4245153 DOI: 10.1109/tuffc.2014.006360] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Although cervical softening is critical in pregnancy, there currently is no objective method for assessing the softness of the cervix. Shear wave speed (SWS) estimation is a noninvasive tool used to measure tissue mechanical properties such as stiffness. The goal of this study was to determine the spatial variability and assess the ability of SWS to classify ripened versus unripened tissue samples. Ex vivo human hysterectomy samples (n = 22) were collected; a subset (n = 13) were ripened. SWS estimates were made at 4 to 5 locations along the length of the canal on both anterior and posterior halves. A linear mixed model was used for a robust multivariate analysis. Receiver operating characteristic (ROC) analysis and the area under the ROC curve (AUC) were calculated to describe the utility of SWS to classify ripened versus unripened tissue samples. Results showed that all variables used in the linear mixed model were significant ( p < 0.05). Estimates at the mid location for the unripened group were 3.45 ± 0.95 m/s (anterior) and 3.56 ± 0.92 m/s (posterior), and 2.11 ± 0.45 m/s (anterior) and 2.68 ± 0.57 m/s (posterior) for the ripened ( p < 0.001). The AUCs were 0.91 and 0.84 for anterior and posterior, respectively, suggesting that SWS estimates may be useful for quantifying cervical softening.
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Carlson LC, Feltovich H, Palmeri ML, Dahl JJ, Munoz del Rio A, Hall TJ. Estimation of shear wave speed in the human uterine cervix. Ultrasound Obstet Gynecol 2014; 43:452-8. [PMID: 23836486 PMCID: PMC3894258 DOI: 10.1002/uog.12555] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/28/2013] [Indexed: 05/03/2023]
Abstract
OBJECTIVES To explore spatial variability within the cervix and the sensitivity of shear wave speed (SWS) to assess softness/stiffness differences in ripened (softened) vs unripened tissue. METHODS We obtained SWS estimates from hysterectomy specimens (n = 22), a subset of which were ripened (n = 13). Multiple measurements were made longitudinally along the cervical canal on both the anterior and posterior sides of the cervix. Statistical tests of differences in the proximal vs distal, anterior vs posterior and ripened vs unripened cervix were performed with individual two-sample t-tests and a linear mixed model. RESULTS Estimates of SWS increase monotonically from distal to proximal longitudinally along the cervix, they vary in the anterior compared to the posterior cervix and they are significantly different in ripened vs unripened cervical tissue. Specifically, the mid position SWS estimates for the unripened group were 3.45 ± 0.95 m/s (anterior; mean ± SD) and 3.56 ± 0.92 m/s (posterior), and 2.11 ± 0.45 m/s (anterior) and 2.68 ± 0.57 m/s (posterior) for the ripened group (P < 0.001). CONCLUSIONS We propose that SWS estimation may be a valuable research and, ultimately, diagnostic tool for objective quantification of cervical stiffness/softness.
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Affiliation(s)
- L C Carlson
- Medical Physics Department, University of Wisconsin, Madison, WI, USA
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22
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Zhao H, Song P, Urban MW, Kinnick RR, Yin M, Greenleaf JF, Chen S. Bias observed in time-of-flight shear wave speed measurements using radiation force of a focused ultrasound beam. Ultrasound Med Biol 2011; 37:1884-92. [PMID: 21924817 PMCID: PMC3199321 DOI: 10.1016/j.ultrasmedbio.2011.07.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 06/03/2011] [Accepted: 07/23/2011] [Indexed: 05/12/2023]
Abstract
Measurement of shear wave propagation speed has important clinical applications because it is related to tissue stiffness and health state. Shear waves can be generated in tissues by the radiation force of a focused ultrasound beam (push beam). Shear wave speed can be measured by tracking its propagation laterally from the push beam focus using the time-of-flight principle. This study shows that shear wave speed measurements with such methods can be transducer, depth and lateral tracking range dependent. Three homogeneous phantoms with different stiffness were studied using curvilinear and linear array transducer. Shear wave speed measurements were made at different depths, using different aperture sizes for push and at different lateral distance ranges from the push beam. The curvilinear transducer shows a relatively large measurement bias that is depth dependent. The possible causes of the bias and options for correction are discussed. These bias errors must be taken into account to provide accurate and precise time-of-flight shear wave speed measurements for clinical use.
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Affiliation(s)
- Heng Zhao
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN
| | - Pengfei Song
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN
| | - Matthew W. Urban
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN
| | - Randall R. Kinnick
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN
| | - Meng Yin
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN
| | - James F. Greenleaf
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN
| | - Shigao Chen
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN
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Abstract
Acoustic radiation force based elasticity imaging methods are under investigation by many groups. These methods differ from traditional ultrasonic elasticity imaging methods in that they do not require compression of the transducer, and are thus expected to be less operator dependent. Methods have been developed that utilize impulsive (i.e. < 1 ms), harmonic (pulsed), and steady state radiation force excitations. The work discussed herein utilizes impulsive methods, for which two imaging approaches have been pursued: 1) monitoring the tissue response within the radiation force region of excitation (ROE) and generating images of relative differences in tissue stiffness (Acoustic Radiation Force Impulse (ARFI) imaging); and 2) monitoring the speed of shear wave propagation away from the ROE to quantify tissue stiffness (Shear Wave Elasticity Imaging (SWEI)). For these methods, a single ultrasound transducer on a commercial ultrasound system can be used to both generate acoustic radiation force in tissue, and to monitor the tissue displacement response. The response of tissue to this transient excitation is complicated and depends upon tissue geometry, radiation force field geometry, and tissue mechanical and acoustic properties. Higher shear wave speeds and smaller displacements are associated with stiffer tissues, and slower shear wave speeds and larger displacements occur with more compliant tissues. ARFI images have spatial resolution comparable to that of B-mode, often with greater contrast, providing matched, adjunctive information. SWEI images provide quantitative information about the tissue stiffness, typically with lower spatial resolution. A review these methods and examples of clinical applications are presented herein.
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Affiliation(s)
- Kathy Nightingale
- Department of Biomedical Engineering, Duke University Box 90281, Durham, NC 27708-0281, USA telephone:(919)660-5175, fax:(919)684-4488, kathy.nightingaleduke.edu
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