Clinical Ultrasound Scanner Research Articles

Investigation Into the Subharmonic Response of Three Contrast Agents in Static and Dynamic Flow Environments Using a Commercially Available Diagnostic Ultrasound Scanner

ObjectiveThe objective of this study was to investigate the subharmonic response of Lumason (also known as SonoVue; Bracco, Milan, Italy) to static and dynamic ambient pressures, with a direct comparison to Sonazoid (GE HealthCare, Oslo, Norway) and Definity (Lantheus Medical Imaging, MA, USA). The subharmonic responses of contrast agents can be exploited to perform subharmonic-aided pressure estimation. MethodsThe subharmonic response of each ultrasound contrast agent was evaluated in both a static and dynamic tank using a commercially available Logiq E10 clinical ultrasound scanner (GE HealthCare) equipped with subharmonic imaging (SHI) and an acoustic power-optimization algorithm. A C1-6 curvilinear array that transmits at 2.5 MHz and receives at 1.25 MHz in SHI mode was used to acquire the subharmonic signals. Data was transferred offline into MATLAB (MathWorks) to perform linear regression analysis and statistical testing for significance of the slopes (i.e., agent sensitivity). ResultsSonazoid and Definity showed an inverse linear dependency between subharmonic signal and hydrostatic pressure at all pressure ranges (static and dynamic) tested, with maximum sensitivity under 50 mmHg in the static tank (−0.190 and −0.194 dB/mmHg for Sonazoid and Definity, respectively). Lumason exhibited a tri-phasic subharmonic behavior, beginning with a linear trend from 0 to 90 mmHg (sensitivity = 0.069 dB/mmHg), followed by a plateau from 100 to 130 mmHg, and an inverse linear trend from 140 to 200 mmHg (sensitivity = −0.137 dB/mmHg). ConclusionThe subharmonic response of Lumason is tri-phasic and differs from Sonazoid and Definity. Further investigation is needed to solidify understanding of the subharmonic behavior of Lumason to identify its usefulness for subharmonic-aided pressure estimation.

Development and Characterization of Hemoglobin Microbubbles for Acoustic Blood Oxygen Level Dependent Imaging.

Oxygen levels in tissues and organs are crucial for their normal functioning, and approaches to monitor them non-invasively have wide biological and clinical applications. In this study, we developed a method of acoustically detecting oxygenation using contrast-enhanced ultrasound (CEUS) imaging. Our approach involved the use of specially designed hemoglobin-based microbubbles (HbMBs) that reversibly bind to oxygen and alter the state-dependent acoustic response. We confirmed that the bioactivity of hemoglobin remained intact after the microbubble shell was formed, and we did not observe any significant loss of heme. We conducted passive cavitation detection (PCD) experiments to confirm whether the acoustic properties of HbMBs vary based on the level of oxygen present. The experiments involved driving the HbMBs with a 1.1 MHz focused ultrasound transducer. Through the PCD data collected, we observed significant differences in the subharmonic and harmonic responses of the HbMBs when exposed to an oxygen-rich environment versus an oxygen-depleted one. We used a programmable ultrasound system to capture high-frame rate B mode videos of HbMBs in both oxy and deoxy conditions at the same time in a two-chambered flow phantom and observed that the mean pixel intensity of deoxygenated HbMB was greater than in the oxygenated state using B-mode imaging. Finally, we demonstrated that HbMBs can circulate in vivo and are detectable by a clinical ultrasound scanner. To summarize, our results indicate that CEUS imaging with HbMB has the potential to detect changes in tissue oxygenation and could be a valuable tool for clinical purposes in monitoring regional blood oxygen levels.

Modulating Nonlinear Acoustic Response of Phospholipid-Coated Microbubbles with pH for Ultrasound Imaging.

Activatable microbubble contrast agents for contrast-enhanced ultrasound have a potential role for measuring physiologic and pathologic states in deep tissues, including tumor acidosis. In this study, we describe a novel observation of increased harmonic oscillation of phosphatidylcholine microbubbles (PC-MBs) in response to lower ambient pH using a clinical ultrasound scanner. MB echogenicity and nonlinear echoes were monitored at neutral and acidic pH using B-mode and Cadence contrast pulse sequencing (CPS), a harmonic imaging technique at 7.0 and 1.5 MHz. A 3-fold increase in harmonic signal intensity was observed when the pH of PC-MB suspensions was decreased from 7.4 to 5.5 to mimic normal and pathophysiological levels that can be encountered in vivo. This pH-mediated activation is tunable based on the chemical structure and length of phospholipids composing the MB shell. It is also reliant on the presence of phosphate groups, as the use of lipids without phosphate instead of phospholipids completely abrogated this phenomenon. The increased harmonic signal likely is the result of increased MB oscillation caused by a decrease of the interfacial tension induced at a lower pH, altering the lipid conformation. While relative signal changes are interpreted clinically as mostly related to blood flow, pH effects could be significant contributors, particularly when imaging tumors. While our observation can be used clinically, it requires further research to isolate the effect of pH from other variables. These findings could pave the way toward for the development of new smart ultrasound contrast agents that expand the clinical utility of contrast-enhanced ultrasound.

Review of Deep Learning Approaches for Interleaved Photoacoustic and Ultrasound (PAUS) Imaging.

Photoacoustic (PA) imaging provides optical contrast at relatively large depths within the human body, compared to other optical methods, at ultrasound (US) spatial resolution. By integrating real-time PA and US (PAUS) modalities, PAUS imaging has the potential to become a routine clinical modality bringing the molecular sensitivity of optics to medical US imaging. For applications where the full capabilities of clinical US scanners must be maintained in PAUS, conventional limited view and bandwidth transducers must be used. This approach, however, cannot provide high-quality maps of PA sources, especially vascular structures. Deep learning (DL) using data-driven modeling with minimal human design has been very effective in medical imaging, medical data analysis, and disease diagnosis, and has the potential to overcome many of the technical limitations of current PAUS imaging systems. The primary purpose of this article is to summarize the background and current status of DL applications in PAUS imaging. It also looks beyond current approaches to identify remaining challenges and opportunities for robust translation of PAUS technologies to the clinic.

Automated 2-D and 3-D Left Atrial Volume Measurements Using Deep Learning

Echocardiography, a critical tool for assessing left atrial (LA) volume, often relies on manual or semi-automated measurements. This study introduces a fully automated, real-time method for measuring LA volume in both 2-D and 3-D imaging, in the aim of offering accuracy comparable to that of expert assessments while saving time and reducing operator variability. We developed an automated pipeline comprising a network to identify the end-systole (ES) time point and robust 2-D and 3-D U-Nets for segmentation. We employed data sets of 789 2-D images and 286 3-D recordings and explored various training regimes, including recurrent networks and pseudo-labeling, to estimate volume curves. Our baseline results revealed an average volume difference of 2.9 mL for 2-D and 7.8 mL for 3-D, respectively, compared with manual methods. The application of pseudo-labeling to all frames in the cine loop generally led to more robust volume curves and notably improved ES measurement in cases with limited data. Our results highlight the potential of automated LA volume estimation in clinical practice. The proposed prototype application, capable of processing real-time data from a clinical ultrasound scanner, provides valuable temporal volume curve information in the echo lab.

Delivery of ultrasound cavitation therapy with a modified clinical scanner

Ultrasound-induced bioeffects from stable and inertial cavitation of microbubbles in tumors have been shown to enhance systemic drug delivery. However, the high pressures and long cycle lengths needed for cavitation treatment are not available on current clinical ultrasound scanners. Here, we implement acoustic conditions (1.6 MHz, 12-500 cycles, <3 MPa, 10-200 Hz PRF) suitable for cavitation treatments (USCTx) on the S5-1 probe of a Philips EPIQ scanner. Hydrophone measurements confirmed the acoustic conditions. Passive cavitation detection (PCD) in solutions and tissue mimicking phantoms containing microbubbles demonstrated the spatial and temporal extent of the produced cavitation with 20 consecutive pulses. Inertial cavitation was observed at peak negative pressures of ∼0.5 MPa and ∼0.9 MPa in the solutions and phantoms, respectively. At low PRFs (<100 Hz), inertial cavitation was only observed within the first 5-10 pulses for both media, suggesting USCTx may generate most bioeffects in the first few pulses. The higher PRFs sustained cavitation activity for a greater duration, consistent with gas diffusion of micron size bubbles after shell disruption with the first pulse. Having implemented USCTx with a clinical scanner and confirmed the produced cavitation in vitro, we plan to evaluate this technique in an upcoming mouse study.

Machine Independence of Ultrasound-Based Quantification of Vitreous Echodensities.

Quantitative ultrasound (QUS) provides objective indices of Vision Degrading Myodesopsia (VDM) that correlate with contrast sensitivity (CS). To date, QUS methods were only tested on a single ultrasound machine. Here, we evaluate whether QUS measurements are machine independent. In this cross-sectional study, 47 eyes (24 subjects; age = 53.2 ± 14.4 years) were evaluated with Freiburg acuity contrast testing (%Weber), and ultrasonography using 2 machines: one with a 15-MHz single-element transducer and one with a 5-ring, 20-MHz annular-array. Images were acquired from each system in sequential scans. Artifact-free, log-compressed envelope data were processed to yield three parameters (mean amplitude, M; energy, E; and percentage filled by echodensities, P50) and a composite score (C). A B-mode normalization method was applied to the 20-MHz datasets to match QUS parameters at both frequencies. Statistical analyses were performed to evaluate correlations among CS, E, M, P50, and C for both machines. QUS parameters from each machine correlated with CS (R ≥ 0.57, P < 0.001) and there was correlation between machines (R ≥ 0.84, P < 0.001). Correlations between CS and QUS parameters were statistically similar for both machines (P ≥ 0.14) except when the 20-MHz data were normalized (P = 0.04). Reproducibility of QUS parameters computed from 20-MHz data were satisfactory (52.3%-96.3%) with intraclass correlation values exceeding 0.80 (P < 0.001). The high correlation between QUS parameters from both machines combined with a statistically similar correlation to CS suggests QUS is an effective, machine-independent, quantitative measure of vitreous echodensities. QUS may be applied across clinical ophthalmic ultrasound scanners and imaging frequencies to effectively evaluate VDM.

In Vivo Ultrasound Imaging of Macrophages Using Acoustic Vaporization of Internalized Superheated Nanodroplets.

Activating patients' immune cells, either by reengineering them or treating them with bioactive molecules, has been a breakthrough in the field of immunotherapy and has revolutionized treatment, especially against cancer. As immune cells naturally home to tumors or injured tissues, labeling such cells holds promise for non-invasive tracking and biologic manipulation. Our study demonstrates that macrophages loaded with extremely low boiling point perfluorocarbon nanodroplets not only survive ultrasound-induced phase change but also maintain their phagocytic function. Unlike observations made when using higher boiling point perfluorocarbon nanodroplets, our results show that phase change occurs intracellularly at a low mechanical index using a clinical scanner operating within the energy limit set by the Food and Drug Administration (FDA). After nanodroplet-loaded macrophages were given intravenously to nude rats, they were invisible in the liver when imaged at a very low mechanical index using a clinical ultrasound scanner. They became visible when power was increased but still within the FDA limits up to 8 h after administration. The acoustic labeling and in vivo detection of macrophages using a clinical ultrasound scanner represent a paradigm shift in the field of cell tracking and pave the way for potential therapeutic strategies in the clinical setting.

Influence of Measurement Depth and Acquisition Parameters on Shear Wave Speed and Shear Wave Dispersion in Certified Phantoms Using a Canon Aplio Clinical Ultrasound Scanner.

The aim of the work described here was to investigate the relative contribution of confounding factors on liver shear wave speed (SWS) and shear wave dispersion slope (SWDS) measurements in three certified phantoms using a Canon Aplio clinical ultrasound scanner. A Canon Aplio i800 i-series ultrasound system (Canon Medical Systems Corporation, Otawara, Tochigi, Japan) with i8CX1 convex array (center frequency=4 MHz) was used to examine dependencies caused by the depth, width and height of the acquisition box (AQB), the depth and size of the region of interest (ROI), the AQB angle and the pressure of the ultrasound probe on the surface of the phantom. Results revealed that depth is the most significant confounder in both SWS and SWDS measurements. AQB angle, height and width and ROI size exhibited minimal confounding effects on measurements. For SWS, the most consistent measurement depth is when the top of the AQB is placed between 2 and 4 cm, and the ROI is located between 3 and 7 cm deep. For SWDS, results indicate that measurement values significantly decrease with depth from the surface of the phantom until approximately 7 cm deep, and consequently no stable area of AQB placement or ROI depth exists. In contrast to SWS, the same ideal acquisition depth range cannot necessarily be applied to SWDS measurements because of a significant depth dependency.

Reconstructing the Spatial Distribution of the Relative Shear Modulus in Quasi-static Ultrasound Elastography: Plane Stress Analysis.

Quasi-static ultrasound elastography (QSUE) is an imaging technique that mainly provides axial strain maps of tissues when the latter are subjected to compression. In this article, a method for reconstructing the relative shear modulus distribution within a linear elastic and isotropic medium, in QSUE, is introduced. More specifically, the plane stress inverse problem is considered. The proposed method is based on the variational formulation of the equilibrium equations and on the choice of adapted discretization spaces, and only requires displacement fields in the analyzed media to be determined. Results from plane stress and 3-D numerical simulations, as well as from phantom experiments, showed that the method is able to reconstruct the different regions within a medium, with shear modulus contrasts that unambiguously reveal whether inclusions are stiffer or softer than the surrounding material. More specifically, for the plane stress simulations, inclusion-to-background modulus ratios were found to be very accurately estimated, with an error lower than 3%. For the 3-D simulations, for which the plane stress conditions are no longer satisfied, these ratios were, as expected, less accurate, with an error that remained lower than 10% for two of the three cases analyzed but was around 34% for the last case. Concerning the phantom experiments, a comparison with a shear wave elastography technique from a clinical ultrasound scanner was also made. Overall, the inclusion-to-background shear modulus ratios obtained with our approach were found to be closer to those given by the phantom manufacturer than the ratios provided by the clinical system.

Ultrasound localization microscopy of the human kidney allograft on a clinical ultrasound scanner

Chronic kidney disease is a major medical problem, causing more than a million deaths each year worldwide. Peripheral kidney microvascular damage characterizes most chronic kidney diseases, yet noninvasive and quantitative diagnostic tools to measure this are lacking. Ultrasound Localization Microscopy (ULM) can assess tissue microvasculature with unprecedented resolution. Here, we optimized methods on 35 kidney transplants and studied the feasibility of ULM in seven human kidney allografts with a standard low frame rate ultrasound scanner to access microvascular damage. Interlobar, arcuate, cortical radial vessels, and part of the medullary organization were visible on ULM density maps. The medullary vasa recta can be seen but are not as clear as the cortical vessels. Acquisition parameters were derived from Contrast-Enhanced Ultrasound examinations by increasing the duration of the recorded clip at the same plane. ULM images were compared with Color Doppler, Advanced Dynamic Flow, and Superb Microvascular Imaging with a contrast agent. Despite some additional limitations due to movement and saturation artifacts, ULM identified vessels two to four times thinner compared with Doppler modes. The mean ULM smallest analyzable vessel cross section was 0.3 ± 0.2 mm in the seven patients. Additionally, ULM was able to provide quantitative information on blood velocities in the cortical area. Thus, this proof-of-concept study has shown ULM to be a promising imaging technique for qualitative and quantitative microvascular assessment. Imaging native kidneys in patients with kidney diseases will be needed to identify their ULM biomarkers.

Ultrasound insonation angle and scanning imaging modes for imaging dental implant structures: A benchtop study.

High frequency ultrasound has shown as a promising imaging modality to evaluate peri-implant tissues. It is not known if the ultrasound imaging settings might influence ultrasound's ability to differentiate implant structures. The aim of this benchtop study was to evaluate the dependence of ultrasound on imaging angles and modes to measure implant geometry-related parameters. A clinical ultrasound scanner (ZS3, Mindray) with an intraoral probe (L30-8) offering combinations of harmonic and compound imaging modes was employed for imaging 16 abutments and 4 implants. The samples were mounted to a micro-positioning system in a water tank, which allowed a range of -30 to 30-degree imaging angles in 5-degree increment between the probe and samples. The abutment angle, implant thread pitch and depth were measured on ultrasound, compared to the reference readings. The errors were computed as a function of the image angles and modes. All samples were replicated 3 times for 3 image modes and 11 image angles, thus resulting in 2,340 images. The mean errors of ultrasound to estimate 16 abutment angles, compared to the reference values, were between -1.8 to 2.7 degrees. The root mean squared error (RMSE) ranged from 1.5 to 4.6 degrees. Ultrasound significantly overestimated the thread pitch by 26.1 μm to 36.2 μm. The error in thread depth measurements were in a range of -50.5 μm to 39.6 μm, respectively. The RMSE of thread pitch and depth of the tested 4 implants was in a range of 34.7 to 56.9 μm and 51.0 to 101.8 μm, respectively. In most samples, these errors were independent of the image angle and modes. Within the limitations of this study, high-frequency ultrasound was feasible in imaging abutments and implant fixtures independent of scanning angle within ±30° of normal incidence and for compounding and non-compounding-based imaging modes.

Human clinical trial using diagnostic ultrasound and microbubbles to enhance neoadjuvant chemotherapy in HER2- negative breast cancer.

In vivo and in vitro experiments have demonstrated that diagnostic ultrasound combined with microbubbles (USMB) can enhance tumor chemotherapy, but few clinical studies have explored the effect of USMB in human HER2-negative breast cancer. We aimed to compare USMB combined with neoadjuvant chemotherapy (NAC) with NAC alone in the treatment of human HER2-negative breast cancer. Patients (n=10) enrolled in the study were treated with TAC (taxane - (docetaxel), anthracycline - (epirubicin or doxorubicin liposomes), and cyclophosphamide) and ultrasound using a commercial clinical ultrasound scanner for 20min after each chemotherapy session, followed by intermittent injections of SonoVue® to induce sonoporation and enhance therapeutic efficacy. Contrast-enhanced ultrasound (CEUS) was used to record tumor perfusion before and after ultrasound treatment. After completion of chemotherapy, the maximum tumor diameter of patients in the combined treatment group (n=10) was significantly smaller than that in the control group (n=16) (p=0.017). Although the combined treatment group had higher overall response and clinical benefit rates than those in the control group, there was no statistically significant difference in RECIST between the combined treatment group and the control groups (p=0.590). More patients in the combination therapy group achieved pathologic complete response than in the control group (p=0.014). For combined treatment, CEUS revealed that the peak intensity, mean transit time, and area under the curve were higher after treatment than before treatment (p<0.001, p<0.001, p=0.003, respectively). Combined therapy did not cause additional toxicity or increase side effects. USMB and chemotherapy can be combined in a clinical setting using commercially available equipment, without additional toxicity, and may improve the efficacy of NAC in HER2-negative breast cancer.

In vivo ultrasound imaging of macrophages using acoustic vaporization of internalized superheated nanodroplets

Ultrasound (US) not only detects but also interacts with its contrast agents, potentially allowing the use of perfluorocarbon-filled nanodroplets (NDs) or microbubbles (MBs) for both the detection and treatment of deep-seated tumors. Cells labeled using MBs to allow their detection in vivo with clinical ultrasound scanner presents several advantages over PET and MRI: Ultrasound is 2–3 orders of magnitude more sensitive and can detect a single acoustically labeled cell in vivo. Furthermore, with high ultrasound intensities, drugs or genes that are loaded on NDs or MBs can be delivered with spatiotemporal control. Although the acoustic labeling of stem cells for in vivo imaging using MBs has been reported, the ability to load and image internalized low boiling point NDs has not been explored yet. We used perfluorobutane NDs to acoustically label macrophages, which were viable following post internalization and ultrasound-mediated phase change. We documented that internalized NDs are stable for at least 8 h, which is needed for macrophages to accumulate to diseased sites. Labeled macrophage accumulated in the liver of healthy rats as stable intracellular NDs were vaporized into MBs using a clinical scanner (Siemens ACUSON Sequoia, 10L4 transducer at 4 MHz, 1.4 MI) and remained visible after vaporization.

A Comparison of the Sensitivity of Contrast-Specific Imaging Modes on Clinical and Preclinical Ultrasound Scanners.

Ultrasonic contrast agents are used routinely to aid clinical diagnosis. All premium- and mid-range scanners utilise contrast-specific imaging techniques to preferentially isolate and display the nonlinear signals generated from the microbubbles when insonated with a series of ultrasound pulses. In this manuscript the abilities of four premium ultrasound scanners to detect and display the ultrasound signal from two commercially available contrast agents—SonoVue and DEFINITY®—are compared. A flow phantom was built using tubes with internal diameters of 1.6 mm and 3.2 mm, suspended at depths of 1, 5 and 8 cm and embedded in tissue-mimicking material. Dilute solutions of SonoVue and DEFINITY® were pumped through the phantom at 0.25 mL/s and 1.5 mL/s. Four transducers were used to scan the tubes—a GE Logiq E9 (C2-9) curvilinear probe, a Philips iU22 L9-3 linear array probe, an Esaote MyLab Twice linear array LA523 (4–13 MHz) and a Fujifilm VisualSonics Vevo3100 MX250 (15–30 MHz) linear array probe. We defined a new parameter to compare the ability of the ultrasound scanners to display the contrast enhancement. This was defined as the ratio of grey-scale intensity ratio in contrast-specific imaging mode relative to the B-mode intensity from the same region-of-interest within the corresponding B-mode image. The study demonstrated that the flow rates used in this study had no effect on the contrast-specific imaging mode to B-mode (CSIM-BM) ratio for the three clinical scanners studied, with SonoVue demonstrating broadly similar CSIM-BM ratios across all 3 clinical scanners. DEFINITY® also displayed similar results to SonoVue except when insonated with the Esaote MyLab Twice LA523 transducer, where it demonstrated significantly higher CSIM-BM ratios at superficial depths.

Novel intraoral ultrasonography to assess midpalatal suture anatomy

<h3>Background</h3> Evaluation of the midpalatal suture is key when planning for skeletal maxillary expansion with orthodontic appliances in young adults. Non-ionizing ultrasonography is a promising alternative to cone beam computed tomography (CBCT) to assess suture patency. <h3>Objective</h3> The objective of this study was to investigate and validate the accuracy of intraoral ultrasound (iUS) to assess the midpalatal suture in animal models. The null hypothesis is that iUS is as accurate as the CBCT to assess midpalatal suture. <h3>Study Design</h3> The sample comprised the cadaveric maxillae of 4 piglets and 5 young pigs. iUS scans were performed using a clinical ultrasound scanner (ZS3, Mindray) paired with our prototype probe (L25-8). Multiple cineloops along the midpalatal suture were acquired at a speed of 2mm/s. CBCT scans (J.Morita) and intraoral (IO) scans (3Shape Trios) were also obtained for each maxilla. 3D Slicer software was used to obtain multiplanar reconstructions of iUS, superimpose then on the CBCT and IO images, and measure the width of the patent suture and soft tissue thickness on the iUS and CBCT scans. <h3>Results</h3> Suture patency was identified on iUS as a hypoechoic gap between the two hyperechoic palatal bony plates (≥6 dB contrast difference), with end-to-end, beveled, or overlapped appearance. Suture patency was clearly visualized in the most anterior portion of the premaxilla in all CBCT images. Limited width (0.4mm) of the suture was noted in the posterior aspect of the premaxilla and an interdigitated suture was observed towards the posterior maxilla. In iUS, the suture was visible with a soft tissue thickness of 2.444mm, but not visible when thicker than 3.636mm. Suture patency width measurement differences between iUS and CBCT ranged from 0.0076mm-0.15mm. <h3>Conclusion</h3> The iUS is a feasible method to assess patency of the midpalatal suture when soft tissue thickness is <3.5mm, but may have limitations when sutures are interdigitated. <b>Statement of Ethical Review</b> Ethical Review or exemption was not warranted for this study

Shear wave elastography imaging in a porcine tendinopathy model.

To quantify the effect of structural damage in an ex vivo animal tendinopathy model using shear wave elastography (SWE). Sixteen porcine flexor tendons were injected with a 0.05mL bolus of 1.5% collagenase solution to induce focal structural damage without surfacing tears. Control tendons were injected with saline (n = 16). Eight tendons from each group were incubated at 37°C for 3.5h while the remaining 8 from each group were incubated for 7h. Tendons were mechanically stretched to 0% and 1% strain. Simultaneously, SWE was acquired proximal to, at, and distal to the injection site using a clinical ultrasound scanner. There were significant differences in SWS (saline > collagenase) at 1% strain and 7-h incubation for all three locations (PROX p = 0.0031, ROI p = 0.001, DIST p = 0.0043). There were also significant differences at 0% strain and 7h, but only at (p = 0.0005), and distal to (p = 0.0035), the injection site. No statistically significant differences were observed for 3.5-h incubation, at 0% or 1% strain. Collagenase-mediated structural damage does appear to convey decreased tissue elasticity on SWE when ex vivo tendons are incubated for 7h. These findings suggest that SWE may be a useful tool for predicting ultimate tissue strength in tendinopathic tissues. Pull-to-failure testing should be performed in the future and are expected to show that tendons with decreased SWS, and, therefore, decreased elasticity, rupture at lower pulls forces.

Reconstructing the shear modulus contrast of linear elastic and isotropic media in quasi-static ultrasound elastography.

This study focuses on the reconstruction of the shear modulus contrast in linear elastic and isotropic media, in quasi-static ultrasound elastography. The method proposed is based on the variational formulation of the equilibrium equations and on the choice of adapted discretization spaces to estimate the parameters of interest. Experimental results obtained with CIRS phantoms are presented, for which regions with different mechanical properties can be clearly identified in the stiffness contrast maps. Elastic modulus images collected with a shear-wave elastography technique from a clinical ultrasound scanner (Aixplorer) are also provided for comparison. Results show very similar values for the modulus ratios determined by the two elastography approaches.

Phase-Aberration Correction in Shear-Wave Elastography Imaging Using Local Speed-of-Sound Adaptive Beamforming

Shear wave elasticity imaging (SWEI) is a non-invasive imaging modality that provides tissue elasticity information by measuring the travelling speed of an induced shear-wave. It is commercially available on clinical ultrasound scanners and popularly used in the diagnosis and staging of liver disease and breast cancer. In conventional SWEI methods, a sequence of acoustic radiation force (ARF) pushes are used for inducing a shear-wave, which is tracked using high frame-rate multi-angle plane wave imaging (MA-PWI) to estimate the shear-wave speed (SWS). Conventionally, these plane waves are beamformed using a constant speed-of-sound (SoS), assuming an a-priori known and homogeneous tissue medium. However, soft tissues are inhomogeneous, with intrinsic SoS variations. In this work, we study the SoS effects and inhomogeneities on SWS estimation, using simulation and phantoms experiments with porcine muscle as an abbarator, and show how these aberrations can be corrected using local speed-of-sound adaptive beamforming. For shear-wave tracking, we compare standard beamform with spatially constant SoS values to software beamforming with locally varying SoS maps. We show that, given SoS aberrations, traditional beamforming using a constant SoS, regardless of the utilized SoS value, introduces a substantial bias in the resulting SWS estimations. Average SWS estimation disparity for the same material was observed over 4.3 times worse when a constant SoS value is used compared to that when a known SoS map is used for beamforming. Such biases are shown to be corrected by using a local SoS map in beamforming, indicating the importance of and the need for local SoS reconstruction techniques.

Vascular Imaging in Small Animals Using Clinical Ultrasound Scanners.

Conventional ultrasound with frequency (2-15MHz) has been a global diagnostic and therapeutic tool in clinical medicine, and high-frequency ultrasound (>30MHz) has been a powerful investigative device for preclinical studies such as cardiovascular research. In this chapter, we describe the use of conventional ultrasound with a 2.5-10MHz transducer as an investigative device for the measurement/detection of blood flow in rabbit model. The chapter will describe the procedures for the preparation of sonographer, imaging locations, and the details of the rabbits used as well as detailed imaging steps for the preoperative, immediately after operation, and postoperative follow-up ultrasound for vascular surgery, using a vascular graft implantation as an example. We also provide useful notes to avoid pitfalls for successful imaging. The overall goal of this chapter is to deliver the steps in using low-cost, non-invasive, and highly versatile clinical ultrasound imaging in preclinical small animal testing.