Contrast Transfer Efficiency Research Articles

Further characterization of changes in axial strain elastograms due to the presence of slippery tumor boundaries.

.Elastography measures tissue strain, which can be interpreted under certain simplifying assumptions to be representative of the underlying stiffness distribution. This is useful in cancer diagnosis where tumors tend to have a different stiffness to healthy tissue and has also shown potential to provide indication of the degree of bonding at tumor–tissue boundaries, which is clinically useful because of its dependence on tumor pathology. We consider the changes in axial strain for the case of a symmetrical model undergoing uniaxial compression, studied by characterizing changes in tumor contrast transfer efficiency (CTE), inclusion to background strain contrast and strain contrast generated by slip motion, as a function of Young’s modulus contrast and applied strain. We present results from a finite element simulation and an evaluation of these results using tissue-mimicking phantoms. The simulation results show that a discontinuity in displacement data at the tumor boundary, caused by the surrounding tissue slipping past the tumor, creates a halo of “pseudostrain” across the tumor boundary. Mobile tumors also appear stiffer on elastograms than adhered tumors, to the extent that tumors that have the same Young’s modulus as the background may in fact be visible as low-strain regions, or those that are softer than the background may appear to be stiffer than the background. Tumor mobility also causes characteristic strain heterogeneity within the tumor, which exhibits low strain close to the slippery boundary and increasing strain toward the center of the tumor. These results were reproduced in phantom experiments. In addition, phantom experiments demonstrated that when fluid lubrication is present at the boundary, these effects become applied strain-dependent as well as modulus-dependent, in a systematic and characteristic manner. The knowledge generated by this study is expected to aid interpretation of clinical strain elastograms by helping to avoid misinterpretation as well as provide additional diagnostic criteria stated in the paper and stimulate further research into the application of elastography to tumor mobility assessment.

Virtual Breast Quasi-static Elastography (VBQE).

Viscoelasticity Imaging (VEI) has been proposed to measure relaxation time constants for characterization of in vivo breast lesions. In this technique, an external compression force on the tissue being imaged is maintained for a fixed period of time to induce strain creep. A sequence of ultrasound echo signals is then utilized to generate time-resolved strain measurements. Relaxation time constants can be obtained by fitting local time-resolved strain measurements to a viscoelastic tissue model (e.g., a modified Kevin-Voigt model). In this study, our primary objective is to quantitatively evaluate the contrast transfer efficiency (CTE) of VEI, which contains useful information regarding image interpretations. Using an open-source simulator for virtual breast quasi-static elastography (VBQE), we conducted a case study of contrast transfer efficiency of VEI. In multiple three-dimensional (3D) numerical breast phantoms containing various degrees of heterogeneity, finite element (FE) simulations in conjunction with quasi-linear viscoelastic constitutive tissue models were performed to mimic data acquisition of VEI under freehand scanning. Our results suggested that there were losses in CTE, and the losses could be as high as -18 dB. FE results also qualitatively corroborated clinical observations, for example, artifacts around tissue interfaces.

Development of a training phantom for compression breast elastography-comparison of various elastography systems and numerical simulations.

The elastic properties of tissue are related to tissue composition and pathological changes. It has been observed that many pathological processes increase the elastic modulus of soft tissue compared to normal. Ultrasound compression elastography is a method of characterization of elastic properties that has been the focus of many research efforts in the last two decades. In medical radiology, compression elastography is provided as an additional tool with ultrasound B-mode in the existing scanners, and the combined features of elastography and echography act as a promising diagnostic method in breast cancer detection. However, the full capability of the ultrasound elastography technique together with B-mode has not been utilized by novice radiologists due to the nonavailability of suitable, appropriately designed tissue-mimicking phantoms. Since different commercially available ultrasound elastographic scanners follow their own unique protocols, training novice radiologists is becoming cumbersome. The main focus of this work is to develop a tissue-like agar-based phantom, which mimics breast tissue with common abnormal lesions like fibroadenoma and invasive ductal carcinoma in a clinically perceived way and compares the sonographic and elastographic appearances using different commercially available systems. In addition, the developed phantoms are simulated using the finite-element method, and ideal strain images are generated. Strain images from experiment and simulation are compared based on image contrast parameters, namely contrast transfer efficiency (CTE) and observed strain, and they are in good agreement. The strain image contrast of malignant inclusions is significantly improved compared to benign inclusions, and the trend of CTE is similar for all elastographic scanners under investigation.

Efficient phase contrast imaging in STEM using a pixelated detector. Part II: Optimisation of imaging conditions

In Part I of this series of two papers, we demonstrated the formation of a high efficiency phase-contrast image at atomic resolution using a pixelated detector in the scanning transmission electron microscope (STEM) with ptychography. In this paper we explore the technique more quantitatively using theory and simulations. Compared to other STEM phase contrast modes including annular bright field (ABF) and differential phase contrast (DPC), we show that the ptychographic phase reconstruction method using pixelated detectors offers the highest contrast transfer efficiency and superior low dose performance. Applying the ptychographic reconstruction method to DPC segmented detectors also improves the detector contrast transfer and results in less noisy images than DPC images formed using difference signals. We also find that using a minimum array of 16×16 pixels is sufficient to provide the highest signal-to-noise ratio (SNR) for imaging beam sensitive weak phase objects. Finally, the convergence angle can be adjusted to enhance the contrast transfer based on the spatial frequencies of the specimen under study.

Contrast Transfer Efficiency of Ultrasound Elastography—A Simulation Study

Contrast Transfer Efficiency of Ultrasound Elastography—A Simulation Study

Study of ultrasound stiffness imaging methods using tissue mimicking phantoms

A pilot study was carried out to investigate the performance of ultrasound stiffness imaging methods namely Ultrasound Elastography Imaging (UEI) and Acoustic Radiation Force Impulse (ARFI) Imaging. Specifically their potential for characterizing different classes of solid mass lesions was analyzed using agar based tissue mimicking phantoms. Composite tissue mimicking phantom was prepared with embedded inclusions of varying stiffness from 50kPa to 450kPa to represent different stages of cancer. Acoustic properties such as sound speed, attenuation coefficient and acoustic impedance were characterized by pulse echo ultrasound test at 5 MHz frequency and they are ranged from (1564±88 to 1671±124m/s), (0.6915±0.123 to 0.8268±0.755dbcm-1MHz-1) and (1.61×106±0.127 to 1.76×106±0.045kgm-2s-1) respectively. The elastic property Young’s Modulus of the prepared samples was measured by conducting quasi static uni axial compression test under a strain rate of 0.5mm/min upto 10 % strain, and the values are from 50kPa to 450kPa for a variation of agar concentration from 1.7% to 6.6% by weight. The composite phantoms were imaged by Siemens Acuson S2000 (Siemens, Erlangen, Germany) machine using linear array transducer 9L4 at 8MHz frequency; strain and displacement images were collected by UEI and ARFI. Shear wave velocity 4.43±0.35m/s was also measured for high modulus contrast (18 dB) inclusion and X.XX m/s was found for all other inclusions. The images were pre processed and parameters such as Contrast Transfer Efficiency and lateral image profile were computed and reported. The results indicate that both ARFI and UEI represent the abnormalities better than conventional US B mode imaging whereas UEI enhances the underlying modulus contrast into improved strain contrast. The results are corroborated with literature and also with clinical patient images.

A novel breast software phantom for biomechanical modeling of elastography

In developing breast imaging technologies, testing is done with phantoms. Physical phantoms are normally used but their size, shape, composition, and detail cannot be modified readily. These difficulties can be avoided by creating a software breast phantom. Researchers have created software breast phantoms using geometric and/or mathematical methods for applications like image fusion. The authors report a 3D software breast phantom that was built using a mechanical design tool, to investigate the biomechanics of elastography using finite element modeling (FEM). The authors propose this phantom as an intermediate assessment tool for elastography simulation; for use after testing with commonly used phantoms and before clinical testing. The authors design the phantom to be flexible in both, the breast geometry and biomechanical parameters, to make it a useful tool for elastography simulation. The authors develop the 3D software phantom using a mechanical design tool based on illustrations of normal breast anatomy. The software phantom does not use geometric primitives or imaging data. The authors discuss how to create this phantom and how to modify it. The authors demonstrate a typical elastography experiment of applying a static stress to the top surface of the breast just above a simulated tumor and calculate normal strains in 3D and in 2D with plane strain approximations with linear solvers. In particular, they investigate contrast transfer efficiency (CTE) by designing a parametric study based on location, shape, and stiffness of simulated tumors. The authors also compare their findings to a commonly used elastography phantom. The 3D breast software phantom is flexible in shape, size, and location of tumors, glandular to fatty content, and the ductal structure. Residual modulus, maps, and profiles, served as a guide to optimize meshing of this geometrically nonlinear phantom for biomechanical modeling of elastography. At best, low residues (around 1-5 KPa) were found within the phantom while errors were elevated (around 10-30 KPa) at tumor and lobule boundaries. From our FEM analysis, the breast phantom generated a superior CTE in both 2D and in 3D over the block phantom. It also showed differences in CTE values and strain contrast for deep and shallow tumors and showed significant change in CTE when 3D modeling was used. These changes were not significant in the block phantom. Both phantoms, however, showed worsened CTE values for increased input tumor-background modulus contrast. Block phantoms serve as a starting tool but a next level phantom, like the proposed breast phantom, will serve as a valuable intermediate for elastography simulation before clinical testing. Further, given the CTE metrics for the breast phantom are superior to the block phantom, and vary for tumor shape, location, and stiffness, these phantoms would enhance the study of elastography contrast. Further, the use of 2D phantoms with plane strain approximations overestimates the CTE value when compared to the true CTE achieved with 3D models. Thus, the use of 3D phantoms, like the breast phantom, with no approximations, will assist in more accurate estimation of modulus, especially valuable for 3D elastography systems.

Mapping the local shear modulus and viscosity using a transient finite-amplitude modulated radiation force

Localized narrowband low-frequency shear waves can be non-invasively generated within tissue, by a modulated finite-amplitude radiation force, resulting from the interference of two focused quasi-CW ultrasound beams of slightly different frequencies. Assuming a Voigt viscoelastic model, this paper describes the use of a finite-element-method model, to simulate two-dimensional shear-wave propagation in viscoelastic media, containing circular inclusions (lesions). Using this model, an inverse approach is used to extract maps of the local shear modulus and viscosity. The performance is evaluated based on three metrics: the lesion contrast, the contrast-transfer-efficiency (CTE), and the contrast-to-noise ratio (CNR). Modified definitions of these metrics are proposed and used in order to account for the time-varying nature of the shear waves and the inverse reconstruction algorithm. In the absence of any noise, it is shown that accurate reconstruction can be achieved not only with the fundamental, but also with the higher harmonics, as well as, with a low-frequency component that occurs for high viscosity and high modulation frequencies. For low-viscosity conditions, the lesion contrast, CTE, and CNR are shown to exhibit very good performance not only for the fundamental, but also, for the higher harmonics. In the case of increased viscosities and modulation frequencies, the generated low-frequency component is shown to provide superior contrast performance even when compared to that of the fundamental. The effects of noise on the reconstruction quality are examined. Depending on the lesion and background properties, it is shown that noise can seriously degrade reconstruction from the higher harmonics.

Simulation Study of Amplitude-Modulated (AM) Harmonic Motion Imaging (HMI) for Stiffness Contrast Quantification with Experimental Validation

The objective of this study is to show that Harmonic Motion Imaging (HMI) can be used as a reliable tumor-mapping technique based on the tumor's distinct stiffness at the early onset of disease. HMI is a radiation-force-based imaging method that generates a localized vibration deep inside the tissue to estimate the relative tissue stiffness based on the resulting displacement amplitude. In this paper, a finite-element model (FEM) study is presented, followed by an experimental validation in tissue-mimicking polyacrylamide gels and excised human breast tumors ex vivo. This study compares the resulting tissue motion in simulations and experiments at four different gel stiffnesses and three distinct spherical inclusion diameters. The elastic moduli of the gels were separately measured using mechanical testing. Identical transducer parameters were used in both the FEM and experimental studies, i.e., a 4.5-MHz single-element focused ultrasound (FUS) and a 7.5-MHz diagnostic (pulse-echo) transducer. In the simulation, an acoustic pressure field was used as the input stimulus to generate a localized vibration inside the target. Radiofrequency (rf) signals were then simulated using a 2D convolution model. A one-dimensional cross-correlation technique was performed on the simulated and experimental rf signals to estimate the axial displacement resulting from the harmonic radiation force. In order to measure the reliability of the displacement profiles in estimating the tissue stiffness distribution, the contrast-transfer efficiency (CTE) was calculated. For tumor mapping ex vivo, a harmonic radiation force was applied using a 2D raster-scan technique. The 2D HMI images of the breast tumor ex vivo could detect a malignant tumor (20 x 10 mm2) surrounded by glandular and fat tissues. The FEM and experimental results from both gels and breast tumors ex vivo demonstrated that HMI was capable of detecting and mapping the tumor or stiff inclusion with various diameters or stiffnesses. HMI may thus constitute a promising technique in tumor detection (>3 mm in diameter) and mapping based on its distinct stiffness.

Contrast-transfer improvement for electrode displacement elastography

Electrode displacement elastography is a strain imaging method that can be used for in-vivo imaging of radiofrequency ablation-induced lesions in abdominal organs such as the liver and kidney. In this technique, tissue motion or deformation is introduced by displacing the same electrode used to create the lesion. Minute displacements (on the order of a fraction of a millimetre) are applied to the thermal lesion through the electrode, resulting in localized tissue deformation. Ultrasound echo signals acquired before and after the electrode-induced displacements are then utilized to generate strain images. However, these local strains depend on the modulus distribution of the tissue region being imaged. Therefore, a quantitative evaluation of the conversion efficiency from modulus contrast to strain contrast in electrode-displacement elastograms is warranted. The contrast-transfer efficiency is defined as the ratio (in dB) of the observed elastographic strain contrast and the underlying true modulus contrast. It represents a measure of the efficiency with which elastograms depict the underlying modulus distribution in tissue. In this paper, we develop a contrast-transfer efficiency formalism for electrode displacement elastography (referred to as contrast-transfer improvement). Changes in the contrast-transfer improvement as a function of the underlying true modulus contrast and the depth of the inclusion in the simulated phantom are studied. We present finite element analyses obtained using a two-dimensional mechanical deformation and tissue motion model. The results obtained using finite element analyses are corroborated using experimental analysis and an ultrasound simulation program so as to incorporate noise artifacts.

Elasticity reconstruction for ultrasound elastography using a radial compression: An inverse approach

To reduce the inherent mechanical artifacts in the strain images, many groups have investigated solutions to the inverse problem in elastography. However, in prostate elastography or intravascular elastography where the compression direction is radial, the inverse problem has not been studied thoroughly. In this paper, an iterative approach is proposed to reconstruct tissue elasticity for ultrasound elastography using a radial compression. The method is based upon the stress–strain relations in the polar coordinates. Computer simulations in an intravascular model are performed to illustrate the feasibility of this method in reducing the mechanical artifacts of the strain images. The reconstructed elasticity error and the contrast-transfer efficiency (CTE) as a function of the iteration number show that the inverse approach converges with a few iterations.

Comparative evaluation of strain-based and model-based modulus elastography

Elastography based on strain imaging currently endures mechanical artefacts and limited contrast transfer efficiency. Solving the inverse elasticity problem (IEP) should obviate these difficulties; however, this approach to elastography is often fraught with problems because of the ill-posed nature of the IEP. The aim of the present study was to determine how the quality of modulus elastograms computed by solving the IEP compared with those produced using standard strain imaging methodology. Strain-based modulus elastograms ( i.e., modulus elastograms computed by simply inverting strain elastograms based on the assumption of stress uniformity) and model-based modulus elastograms ( i.e., modulus elastograms computed by solving the IEP) were computed from a common cohort of simulated and gelatin-based phantoms that contained inclusions of varying size and modulus contrast. The ensuing elastograms were evaluated by employing the contrast-to-noise ratio (CNR e) and the contrast transfer efficiency (CTE e) performance metrics. The results demonstrated that, at a fixed spatial resolution, the CNR e of strain-based modulus elastograms was statistically equivalent to those computed by solving the IEP. At low modulus contrast, the CTE e of both elastographic imaging approaches was comparable; however, at high modulus, the CTE e of model-based modulus elastograms was superior. (E-mail: marvin.m.doyley@dartmouth.edu)

Tradeoffs in elastographic imaging.

This paper presents the tradeoffs in elastographic imaging. Elastography is viewed as a new imaging modality and presented in terms of three fundamental concepts that constitute the basis for the elastographic imaging process. These are the tissue elastic deformation process, the statistical analysis of strain estimation and the image characterization. The first concept involves the use of the contrast transfer efficiency (CTE) that describes the mapping of a distribution of local tissue elastic moduli into a distribution of local longitudinal tissue strains. The second concept defines the elastographic system and the relationship between ultrasonic and signal processing parameters. This process is described in terms of a stochastic framework (the strain filter) that provides upper and practical performance bounds and their dependence on the various system parameters. Finally, the output image, the elastogram, is characterized by its image parameters, such as signal-to-noise ratio, contrast-to-noise ratio, dynamic range and resolution. Finite-element simulations are used to generate examples of elastograms that are confirmed by the theoretical prediction tools.

Contrast-transfer efficiency for continuously varying tissue moduli: simulation and phantom validation

This study consisted of two parts. In the first part, the contrast-transfer efficiency (CTE) in elastography was extended to account for continuous changes of modulus distribution. It was shown that, for a finite size background, the strain contrast approaches the modulus contrast in the case of Gaussian distributions. Thus, an increase in the CTE was obtained. For a fixed background size, it was shown that the CTE increases as the SD of the Gaussian distribution increases. This property was explained by the redistribution of strain concentrations at the inclusion/background interface. In the second part of the study, the CTE was verified experimentally. Six gelatin/agar/water-based phantoms embedding inclusions with modulus contrast varying between ± 6 dB were manufactured. It was shown that the modulus at the interface inclusion/background was continuous and, in turn, resulted in an increase of the CTE as compared to the known case of a sharp boundary. The continuous inclusion/background interface was explained by the existence of an osmotic pressure gradient. (E-mail: Faouzi.Kallel@uth.tmc.edu)

Elastographic imaging

Elastographic imaging

An analysis of elastographic contrast-to-noise ratio

We present a theoretical formalism and simulation results that allow the incorporation of the elastic contrast properties of tissues with simple geometries into the elastographic noise models developed previously. This analysis results in the computation of the elastographic contrast-to–noise ratio ( CNR e ). The CNR e in elastography is an important quantity that is related to the detectability of a lesion or inhomogeneity. In this paper, the upper bound on the elastographic CNR e is derived for both a one-dimensional (1-D) and 2-D analytic plane-strain tissue model. The CNR e in the elastogram depends on the contrast-transfer efficiency (CTE) for both the 1-D and 2-D geometries discussed in this paper. The 1-D model is used to characterize layered structures and the 2-D model is derived for circular inclusion within a background of uniform elasticity. A previously derived classical analytic solution of the elasticity equations, for a circular inclusion embedded in an infinite medium and subjected to a uniaxial compression, is used to compute the upper bound of the CNR e . Monte Carlo simulations illustrate the close correspondence between the theoretical and simulation results.

Elastographic Imaging of Low-Contrast Elastic Modulus Distributions in Tissue

Elastography is a new ultrasonic imaging technique that produces images of the strain distribution in compliant tissues. This strain distribution is derived from ultrasonically estimated longitudinal internal motion induced by an external compression of the tissue. The displayed two-dimensional (2-D) images are called elastograms. In this paper, it is demonstrated that, when signal-to-noise ratio-enhancing techniques are used, elastography is capable of imaging low-contrast elastic modulus tissue structures with high contrast-to-noise ratios. This is demonstrated using both computer simulations and data obtained from 3 days postmortem ovine kidneys in vitro. The elastograms of such organs suggest that the modulus slowly decays from the renal cortex (RC) to the interior of the renal sinus (RS). Such modulus variation is corroborated by independent measurements of the Young’s moduli. It is found that the RC is approximately twice as hard as the interior of the RS. We invoke our previous results on elastographic contrast-transfer efficiency to demonstrate that, at low contrast, the elastogram may be interpreted as a quantitative image of the relative Young’s modulus distribution.

Elastography: A systems approach

We present a review of elastography from a systems point of view. We show that elastography can be viewed as a cascade of two distinct processes. The first process involves the mapping of the distribution of local elastic moduli in the target into a distribution of local longitudinal strains. This process is governed by the theory of elasticity as applied to a particular experimental setup under some specific boundary conditions and some assumptions. Since this process involves errors due to the simplified mechanical model used, artifacts such as target hardening, stress concentrations, and limited contrast-transfer efficiency are usually encountered. These errors may be recursively minimized by solving the inverse problem, thus increasing the contrast-transfer efficiency such that a more accurate modulus image may be obtained. The second process involves the production of the strain image (elastogram) from ultrasonically estimated values of local strains. Here, the limitations of the ultrasound system [such as time-bandwidth product, center frequency, and sonographic signal-to-noise ratio (SNR)] as well as the signal-processing algorithms used to process the signals cause additional corruption of the data through the introduction of constraints in the attainable elastographic SNR, resolution, sensitivity, and strain dynamic range. This process is described in terms of a stochastic strain filter. These two system components are discussed in detail, and it is concluded that both must be optimized in a specific order to result in quality elastograms. © 1997 John Wiley & Sons, Inc. Int J Imaging Syst Technol, 8, 89–103, 1997

Fundamental limitations on the contrast-transfer efficiency in elastography: An analytic study

Elastography is a new ultrasonic imaging technique introduced to produce images of the Young's modulus distribution of compliant tissue. This Young's modulus distribution is derived from the ultrasonically estimated longitudinal internal strains induced by an external compression of the tissue. The displayed two-dimensional images are called elastograms. Recently, contrast-transfer efficiency, defined as the ratio of elasticity contrast as measured from elastogram to the true contrast, was used to illustrate by simulation the fundamental limitation of elastography in displaying the elastic modulus contrast of soft inclusion in a hard background and vice versa. In this paper, using a classical analytic solution of the elasticity equations derived for an infinite medium subjected to a uniaxial compression, we confirm such earlier simulations results. For this purpose we derive an analytic expression predicting the observed contrast in elastograms.

Fundamental mechanical limitations on the visualization of elasticity contrast in elastography

Elastography is a new ultrasonic imaging technique that produces images (elastograms) of the elastic properties of compliant tissue. To determine the Young's modulus it is necessary to measure or estimate any five of seven relevant variables. In elastography, the measured quantity is the normal strain component in the direction of the applied load, and the three normal components of stress may be estimated using the modified Love's analytical models while assuming a value close to 0.5 (incompressible) for Poisson's ratio. The distribution of Young's moduli can thus be computed and displayed in the form of two-dimensional images called elastograms. The analytical models used for the estimation of the three normal components of stress assume that the target is semi-infinite and homogeneous in composition. The objective of this article is to determine some of the errors associated with the assumption of homogeneity of the target. Experiments using computer simulations were performed to study the efficiency with which elastograms display the contrast in the Young's modulus of a lesion or target, with respect to its background under certain conditions. It was observed (using the definition of contrast-transfer efficiency of elastography as the ratio of the elasticity contrast as measured from an elastogram, to the true contrast) that elastograms were consistently efficient in quantitatively depicting the elasticity contrast of hard lesions; however, they showed suboptimal contrast-transfer efficiency in cases of soft lesions in a hard background. In general, elastograms are efficient in displaying the elasticity contrast of hard or soft lesions which have a low contrast level with respect to the surroundings, irrespective of their size and location.