Abstract

Quantitative ultrasound (QUS) aims at quantifying interactions between ultrasound and biological tissues. QUS techniques extract fundamental physical properties of tissues based on interactions between ultrasound waves and tissue microstructure. These techniques provide quantitative information on sub-resolution properties that are not visible on grayscale (B-mode) imaging. Quantitative data may be represented either as a global measurement or as parametric maps overlaid on B-mode images. Recently, major ultrasound manufacturers have released speed of sound, attenuation, and backscatter packages for tissue characterization and imaging. Established and emerging clinical applications are currently limited and include liver fibrosis staging, liver steatosis grading, and breast cancer characterization. On the other hand, most biological tissues have been studied using experimental QUS methods, and quantitative datasets are available in the literature. This educational review addresses the general topic of biological soft tissue characterization using QUS, with a focus on disseminating technical concepts for clinicians and specialized QUS materials for medical physicists. Advanced but simplified technical descriptions are also provided in separate subsections identified as such. To understand QUS methods, this article reviews types of ultrasound waves, basic concepts of ultrasound wave propagation, ultrasound image formation, point spread function, constructive and destructive wave interferences, radiofrequency data processing, and a summary of different imaging modes. For each major QUS technique, topics include: concept, illustrations, clinical examples, pitfalls, and future directions.

Highlights

  • The field of quantitative ultrasound (QUS) imaging has been active for more than 50 years and it is only recently that ultrasound manufacturers have started implementing some of these biomarkers on clinical scanners

  • The recent introduction of dedicated instruments using Quantitative ultrasound (QUS) techniques and implementation of speed of sound, local attenuation, and backscatter statistical packages on clinical scanners should contribute to their clinical adoption

  • Backscatter coefficient packages may become available soon on clinical scanners. This educational review emphasized the fact that the ultrasound image texture is determined by the relationship between the spatial distribution of acoustic scatterers, their acoustic impedance discrepancy with respect to surrounding tissues, and characteristics of the ultrasound source

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Summary

Key points

Quantitative ultrasound (QUS) provides images on interactions between ultrasound waves and biological tissues. Tissue-specific speed of sound images can be produced for QUS tissue characterization. Quantitative ultrasound (QUS) provides images on interactions between ultrasound waves and biological tissues. Tissue-specific speed of sound images can be produced for QUS tissue characterization. Acoustic attenuation is used in QUS as biomarkers to produce images independent of ultrasound system characteristics and settings. Backscatter coefficient is independent of ultrasound system characteristics and settings for tissue characterization

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