Shear Wave Motion Research Articles

Modeling Ultrasound Propagation in the Moving Brain: Applications to Shear Shock Waves and Traumatic Brain Injury.

Traumatic brain injury (TBI) studies on the living human brain are experimentally infeasible due to ethical reasons and the elastic properties of the brain degrade rapidly postmortem. We present a simulation approach that models ultrasound propagation in the human brain, while it is moving due to the complex shear shock wave deformation from a traumatic impact. Finite difference simulations can model ultrasound propagation in complex media such as human tissue. Recently, we have shown that the fullwave finite difference approach can also be used to represent displacements that are much smaller than the grid size, such as the motion encountered in shear wave propagation from ultrasound elastography. However, this subresolution displacement model, called impedance flow, was only implemented and validated for acoustical media composed of randomly distributed scatterers. Herein, we propose a generalization of the impedance flow method that describes the continuous subresolution motion of structured acoustical maps, and in particular of acoustical maps of the human brain. It is shown that the average error in simulating subresolution displacements using impedance flow is small when compared to the acoustical wavelength ( λ /1702). The method is then applied to acoustical maps of the human brain with a motion that is imposed by the propagation of a shear shock wave. This motion is determined numerically with a custom piecewise parabolic method that is calibrated to ex vivo observations of shear shocks in the porcine brain. Then the fullwave simulation tool is used to model transmit-receive imaging sequences based on an L7-4 imaging transducer. The simulated radio frequency data are beamformed using a conventional delay-and-sum method and a normalized cross-correlation method designed for shock wave tracking is used to determine the tissue motion. This overall process is an in silico reproduction of the experiments that were previously performed to observe shear shock waves in fresh porcine brain. It is shown that the proposed generalized impedance flow method accurately captures the shear wave motion in terms of the wave profile, shock front characteristics, odd harmonic spectrum generation, and acceleration at the shear shock front. We expect that this approach will lead to improvements in image sequence design that takes into account the aberration and multiple reflections from the brain and in the design of tracking algorithms that can more accurately capture the complex brain motion that occurs during a traumatic impact. These methods of modeling ultrasound propagation in moving media can also be applied to other displacements, such as those generated by shear wave elastography or blood flow.

Sound transmission in human thorax through airway insonification: an experimental and computational study with diagnostic applications.

Pulmonary diseases and injury lead to structural and functional changes in the lung parenchyma and airways, often resulting in measurable sound transmission changes on the chest wall surface. Additionally, noninvasive imaging of externally driven mechanical wave motion in the chest (e.g., using magnetic resonance elastography) can provide information about lung stiffness and other structural property changes which may be of diagnostic value. In the present study, a comprehensive computational simulation (in silico) model was developed to simulate sound wave propagation in the airways, parenchyma, and chest wall under normal and pathological conditions that create distributed structural (e.g., pneumothoraces) and diffuse material (e.g., fibrosis) changes, as well as a localized structural and material changes as may be seen with a neoplasm. Experiments were carried out in normal subjects to validate the baseline model. Sound waves with frequency content from 50 to 600 Hz were introduced into the airways of three healthy human subjects through the mouth, and transthoracic transmitted waves were measured by scanning laser Doppler vibrometry at the chest wall surface. The computational model predictions of a frequency-dependent decreased sound transmission due to pneumothorax were consistent with experimental measurements reported in previous work. Predictions for the case of fibrosis show that while shear wave motion is altered, changes to compression wave propagation are negligible, and thus insonification, which primarily drives compression waves, is not ideal to detect the presence of fibrosis. Results from the numerical simulation of a tumor show an increase in the wavelength of propagating waves in the immediate vicinity of the tumor region.

Evaluation of Reconstruction Parameters for 2-D Comb-Push Ultrasound Shear Wave Elastography

Shear wave elastography (SWE) is a noninvasive ultrasound imaging modality used in the assessment of the mechanical properties of tissues such as the liver, kidney, skeletal muscle, thyroid, and the breast. Among the methods used to perform SWE is the comb-push ultrasound shear elastography method. This method uses multiple focused ultrasound beams to generate push beams with acoustic radiation force. Applying these push beams generates propagating shear waves. The propagation motion is measured with ultrafast ultrasound imaging. The shear wave motion data are directionally filtered, and a 2-D shear wave velocity (SWV) algorithm is applied to create group velocity maps. This algorithm uses a moving window and a specified patch for performing cross-correlations of time-domain signals. We performed a parametric study of how the choice of the patch and window size affected the reconstruction of the SWV in homogeneous and inclusion phantoms. We quantified the mean velocity and coefficient of variation in the homogeneous phantoms. We measured the contrast-to-noise ratio and bias in the inclusion phantoms. In each of these cases, we found that particular combinations of the patch and window provided optimal values of these evaluation metrics for the phantoms tested. This study provides a basis to construct algorithms to produce optimal SWV reconstructions for various clinical applications.

Analytical solution for converging elliptic shear wave in a bounded transverse isotropic viscoelastic material with nonhomogeneous outer boundary.

Dynamic elastography methods-based on optical, ultrasonic, or magnetic resonance imaging-are being developed for quantitatively mapping the shear viscoelastic properties of biological tissues, which are often altered by disease and injury. These diagnostic imaging methods involve analysis of shear wave motion in order to estimate or reconstruct the tissue's shear viscoelastic properties. Most reconstruction methods to date have assumed isotropic tissue properties. However, application to tissues like skeletal muscle and brain white matter with aligned fibrous structure resulting in local transverse isotropic mechanical properties would benefit from analysis that takes into consideration anisotropy. A theoretical approach is developed for the elliptic shear wave pattern observed in transverse isotropic materials subjected to axisymmetric excitation creating radially converging shear waves normal to the fiber axis. This approach, utilizing Mathieu functions, is enabled via a transformation to an elliptic coordinate system with isotropic properties and a ratio of minor and major axes matching the ratio of shear wavelengths perpendicular and parallel to the plane of isotropy in the transverse isotropic material. The approach is validated via numerical finite element analysis case studies. This strategy of coordinate transformation to equivalent isotropic systems could aid in analysis of other anisotropic tissue structures.

Analytical solution for elliptic shear standing wave pattern in a bounded transversely isotropic viscoelastic material

Dynamic elastography methods—based on photonic, ultrasonic, or magnetic resonance imaging—are being developed for quantitatively mapping the shear viscoelastic properties of biological tissues, which are often altered by disease and injury. These diagnostic imaging methods involve analysis of shear wave motion in order to estimate or reconstruct the tissue’s shear viscoelastic properties. Most reconstruction methods to date have assumed isotropic tissue properties. But, application to tissues like skeletal muscle and brain white matter with aligned fibrous structure resulting in local transverse isotropic mechanical properties would benefit from analysis that takes into consideration anisotropy. A theoretical approach is developed for the elliptic shear wave pattern observed in transverse isotropic materials subjected to axisymmetric excitation normal to the fiber axis. This approach, utilizing Mathieu functions, is enabled via a transformation to an elliptic coordinate system with isotropic properties and a ratio of minor and major axes matching the ratio of shear wavelengths perpendicular and parallel to the plane of isotropy in the transverse isotropic material. The approach is validated via finite element analysis cases studies. This strategy of coordinate transformation to equivalent isotropic systems could aid in analysis of other anisotropic tissue structures. (Grant support: NIH AR071162.)

Magnetoelastic waves in a soft electrically conducting solid in a strong magnetic field

Shear wave motion of a soft, electrically conducting solid in the presence of a strong magnetic field excites eddy currents in the solid. These, in turn, give rise to Lorentz forces that resist the wave motion. We derive a mathematical model for linear elastic wave propagation in a soft electrically conducting solid in the presence of a strong magnetic field. The model reduces to an effective anisotropic dissipation term resembling an anisotropic viscous foundation. We consider the application to magnetic resonance elastography, which uses strong magnetic fields to measure shear wave speed in soft tissues for diagnostic purposes. We find that for typical values of magnetic field, mass density, and electrical conductivity of soft tissues, eddy current dissipation is negligible. For materials with higher conductivity (e.g., metals), the effect can be stronger.

Improved shear wave motion detection using coded excitation for transient elastography

Transient elastography (TE) is well adapted for use in studying liver elasticity. However, because the shear wave motion signal is extracted from the ultrasound signal, the weak ultrasound signal can significantly deteriorate the shear wave motion tracking process and make it challenging to detect the shear wave motion in a severe noise environment, such as within deep tissues and within obese patients. This paper, therefore, investigated the feasibility of implementing coded excitation in TE for shear wave detection, with the hypothesis that coded ultrasound signals can provide robustness to weak ultrasound signals compared with traditional short pulse. The Barker 7, Barker 13, and short pulse were used for detecting the shear wave in the TE application. Two phantom experiments and one in vitro liver experiment were done to explore the performances of the coded excitation in TE measurement. The results show that both coded pulses outperform the short pulse by providing superior shear wave signal-to-noise ratios (SNR), robust shear wave speed measurement, and higher penetration intensity. In conclusion, this study proved the feasibility of applying coded excitation in shear wave detection for TE application. The proposed method has the potential to facilitate robust shear elasticity measurements of tissue.

Probe Oscillation Shear Elastography (PROSE): A High Frame-Rate Method for Two-Dimensional Ultrasound Shear Wave Elastography.

Ultrasound shear wave elastography (SWE) utilizes the propagation of induced shear waves to characterize the shear modulus of soft tissue. Many methods rely on an acoustic radiation force (ARF) "push beam" to generate shear waves. However, specialized hardware is required to generate the push beams, and the thermal stress that is placed upon the ultrasound system, transducer, and tissue by the push beams currently limits the frame-rate to about 1 Hz. These constraints have limited the implementation of ARF to high-end clinical systems. This paper presents Probe Oscillation Shear Elastography (PROSE) as an alternative method to measure tissue elasticity. PROSE generates shear waves using a harmonic mechanical vibration of an ultrasound transducer, while simultaneously detecting motion with the same transducer under pulse-echo mode. Motion of the transducer during detection produces a "strain-like" compression artifact that is coupled with the observed shear waves. A novel symmetric sampling scheme is proposed such that pulse-echo detection events are acquired when the ultrasound transducer returns to the same physical position, allowing the shear waves to be decoupled from the compression artifact. Full field-of-view (FOV) two-dimensional (2D) shear wave speed images were obtained by applying a local frequency estimation (LFE) technique, capable of generating a 2D map from a single frame of shear wave motion. The shear wave imaging frame rate of PROSE is comparable to the vibration frequency, which can be an order of magnitude higher than ARF based techniques. PROSE was able to produce smooth and accurate shear wave images from three homogeneous phantoms with different moduli, with an effective frame rate of 300 Hz. An inclusion phantom study showed that increased vibration frequencies improved the accuracy of inclusion imaging, and allowed targets as small as 6.5 mm to be resolved with good contrast (contrast-to-noise ratio ≥ 19 dB) between the target and background.

Improvement of Shear Wave Motion Detection Using Harmonic Imaging in Healthy Human Liver

Quantification of liver elasticity is a major application of shear wave elasticity imaging (SWEI) to non-invasive assessment of liver fibrosis stages. SWEI measurements can be highly affected by ultrasound image quality. Ultrasound harmonic imaging has exhibited a significant improvement in ultrasound image quality as well as for SWEI measurements. This was previously illustrated in cardiac SWEI. The purpose of this study was to evaluate liver shear wave particle displacement detection and shear wave velocity (SWV) measurements with fundamental and filter-based harmonic ultrasound imaging. In a cohort of 17 patients with no history of liver disease, a 2.9-fold increase in maximum shear wave displacement, a 0.11 m/s decrease in the overall interquartile range and median SWV and a 17.6% increase in the success rate of SWV measurements were obtained when filter-based harmonic imaging was used instead of fundamental imaging.

Concurrent 3D acquisition of diffusion tensor imaging and magnetic resonance elastography displacement data (DTI-MRE): Theory and in vivo application.

To introduce a newly developed technique (DTI-MRE) for the simultaneous acquisition of diffusion tensor imaging (DTI) and 3D-vector field magnetic resonance elastography (MRE) data, and to demonstrate its feasibility when applied in vivo to the mouse brain. In DTI-MRE, simultaneous encoding is achieved by using a series of diffusion/motion-sensitizing gradients (dMSGs) with specific timing and directions. By adjusting the duration of the dMSGs with the diffusion time and with the mechanical vibration frequency, the shear wave motion and diffusion are encoded into the MR phase and MR magnitude signals, respectively. The dMSGs are applied in a noncollinear and noncoplanar manner that optimizes the capture of both the DTI signal attenuation and the three-dimensional MRE displacements. In this work, the feasibility of the DTI-MRE technique was demonstrated on in vivo mouse brains (n=3) using a 9.4T animal MRI scanner. The DTI-MRE derived parameters (MD, mean diffusivity; FA, fractional anisotropy; MRE displacement fields; and shear modulus |G|) were compared with those acquired using conventional, separate MRE and diffusion methods. The averaged (MD, FA, and |G|) values for three mice are (0.580 ± 0.050 µm2 /ms, 0.43 ± 0.02, and 4.80 ± 0.06 kPa) and (0.583 ± 0.035 µm2 /ms, 0.46 ± 0.02, and 4.91 ± 0.19 kPa) for DTI-MRE, and conventional DTI and 3D-vector field MRE measurements, respectively. All derived parameters (MD, FA, |G|, and displacement) obtained using the combined DTI-MRE method and conventional methods were significantly correlated with P < 0.05. Simultaneous acquisition of DTI and 3D-vector field MRE is feasible in vivo and reduces the scan time by up to 50% compared with conventional, separate acquisitions, while providing an immediate co-registration of maps of diffusion properties and stiffness. Magn Reson Med 77:273-284, 2017. © 2016 Wiley Periodicals, Inc.

Enabling real-time ultrasound imaging of soft tissue mechanical properties by simplification of the shear wave motion equation.

Ultrasound based shear wave elastography (SWE) is a technique used for non-invasive characterization and imaging of soft tissue mechanical properties. Robust estimation of shear wave propagation speed is essential for imaging of soft tissue mechanical properties. In this study we propose to estimate shear wave speed by inversion of the first-order wave equation following directional filtering. This approach relies on estimation of first-order derivatives which allows for accurate estimations using smaller smoothing filters than when estimating second-order derivatives. The performance was compared to three current methods used to estimate shear wave propagation speed: direct inversion of the wave equation (DIWE), time-to-peak (TTP) and cross-correlation (CC). The shear wave speed of three homogeneous phantoms of different elastic moduli (gelatin by weight of 5%, 7%, and 9%) were measured with each method. The proposed method was shown to produce shear speed estimates comparable to the conventional methods (standard deviation of measurements being 0.13 m/s, 0.05 m/s, and 0.12 m/s), but with simpler processing and usually less time (by a factor of 1, 13, and 20 for DIWE, CC, and TTP respectively). The proposed method was able to produce a 2-D speed estimate from a single direction of wave propagation in about four seconds using an off-the-shelf PC, showing the feasibility of performing real-time or near real-time elasticity imaging with dedicated hardware.

Coded excitation plane wave imaging for shear wave motion detection.

Plane wave imaging has greatly advanced the field of shear wave elastography thanks to its ultrafast imaging frame rate and the large field-of-view (FOV). However, plane wave imaging also has decreased penetration due to lack of transmit focusing, which makes it challenging to use plane waves for shear wave detection in deep tissues and in obese patients. This study investigated the feasibility of implementing coded excitation in plane wave imaging for shear wave detection, with the hypothesis that coded ultrasound signals can provide superior detection penetration and shear wave SNR compared with conventional ultrasound signals. Both phase encoding (Barker code) and frequency encoding (chirp code) methods were studied. A first phantom experiment showed an approximate penetration gain of 2 to 4 cm for the coded pulses. Two subsequent phantom studies showed that all coded pulses outperformed the conventional short imaging pulse by providing superior sensitivity to small motion and robustness to weak ultrasound signals. Finally, an in vivo liver case study on an obese subject (body mass index = 40) demonstrated the feasibility of using the proposed method for in vivo applications, and showed that all coded pulses could provide higher SNR shear wave signals than the conventional short pulse. These findings indicate that by using coded excitation shear wave detection, one can benefit from the ultrafast imaging frame rate and large FOV provided by plane wave imaging while preserving good penetration and shear wave signal quality, which is essential for obtaining robust shear elasticity measurements of tissue.

Characterization of transverse isotropy in compressed tissue-mimicking phantoms.

Tissues such as skeletal muscle and kidneys have well-defined structure that affects the measurements of mechanical properties. As an approach to characterize the material properties of these tissues, different groups have assumed that they are transversely isotropic (TI) and measure the shear wave velocity as it varies with angle with respect to the structural architecture of the organ. To refine measurements in these organs, it is desirable to have tissue-mimicking phantoms that exhibit similar anisotropic characteristics. Some approaches involve embedding fibers into a material matrix. However, if a homogeneous solid is under compression due to a static stress, an acoustoelastic effect can manifest that makes the measured wave velocities change with the compression stress. We propose to exploit this characteristic to demonstrate that stressed tissue mimicking phantoms can be characterized as a TI material. We tested six phantoms made with different concentrations of gelatin and agar. Stress was applied by the weight of a water container centered on top of a plate on top of the phantom. A linear array transducer and a V-1 Verasonics system were used to induce and measure shear waves in the phantoms. The shear wave motion was measured using a compound plane wave imaging technique. Autocorrelation was applied to the received in-phase/quadrature data. The shear wave velocity, c, was estimated using a Radon transform method. The transducer was mounted on a rotating stage so measurements were made every 10° over a range of 0° to 360°, where the stress is applied along 0° to 180° direction. The shear moduli were estimated. A TI model was fit to the data and the fractional anisotropy was evaluated. This approach can be used to explore many configurations of transverse isotropy with the same phantom, simply by applying stress to the tissue-mimicking phantom.

Simulation of ultrasound radiation force induced shear wave propagation in viscoelastic media using a mapped Chebyshev pseudospectral method

We implemented a three-dimensional solver for simulating the ultrasound radiation force induced shear wave motion in viscoelastic media using a mapped Chebyshev pseudospectral method. The solver used a body force field that is simulated by the Field II program as the excitation. Then, a velocity-stress formulation was used to calculate the shear wave motion. We used a Voigt model to describe tissue viscoelasticity, and the viscosity is introduced by memory variables and auxiliary differential equations. The top boundary of the domain had a fixed boundary condition to mimic the interaction between an ultrasound probe and the tissue surface. All other sides of the domain were surrounded by perfectly matched layers to minimize the reflections. Time stepping was implemented with the LSODE integrator with variable step sizes. Results show that the waveform of the simulated shear wave is close to experimental observations and equivalent FEM simulations. We used a Fourier-based method to estimate the phase velocities of the shear waves between 100–1000 Hz and a nonlinear regression to estimate the Voigt model parameters. The reconstructions matched within 10% error compared with the true values.

Measuring viscoelasticity of soft tissues using shear and guided waves

Elasticity imaging has emerged as a viable clinical tool for assisting in diagnosis of certain diseases such as liver fibrosis and cancer. Many methods have been developed for generating and measuring shear waves in soft tissues. The advantage of using shear waves is that the shear wave velocity is proportional to the mechanical material properties of the tissues under investigation. Soft tissues are inherently viscoelastic and considerable effort has been made to quantify the dispersion, or variation of frequency, of the velocity and attenuation of shear waves. This is accomplished by measuring the shear wave motion and using Fourier-based techniques to extract the shear wave velocity and attenuation. Additional considerations are made in tissues where geometric dispersion is also present such as in the heart. Viscoelastic characterization of the shear viscoelasticity of soft tissues in vivo such as human liver, human kidney, and swine heart will be shown. We will also demonstrate parameterization of the results by using a model-free approach or by fitting the shear wave velocity dispersion to rheological models. The diagnostic value of the viscoelastic parameters will be discussed for each particular application. [This work was supported in part by NIH Grant Nos. DK092255, DK082408, and EB002167.]

Simultaneous MR elastography and diffusion acquisitions: Diffusion-MRE (dMRE)

To present a new technique for concurrent MR elastography (MRE) and diffusion MRI: diffusion-MRE (dMRE). In dMRE, shear wave motion and MR signal decay due to diffusion are encoded into the phase and magnitude components of the MR signal by using a pair of bipolar gradients for both motion-sensitization and diffusion encoding. The pulse sequence timing is adjusted so that the bipolar gradients are sensitive to both coherent and incoherent intravoxel motions. The shape, number, and duration of the gradient lobes can be adjusted to provide flexibility and encoding efficiency. In this proof-of-concept study, dMRE was validated using a tissue phantom composed of a gel bead embedded in a hydrated mixture of agarose and gelatin. The apparent diffusion coefficient (ADC) and shear stiffness measured using dMRE were compared with results obtained from separate, conventional spin-echo (SE) diffusion and SE-MRE acquisitions. The averaged ADC values (n = 3) for selected ROIs in the beads were (1.75 ± 0.16) μm(2) /ms and (1.74 ± 0.16) μm(2) /ms for SE-diffusion and dMRE methods, respectively. The corresponding shear stiffness values in the beads were (2.45 ± 0.23) kPa and (2.42 ± 0.20) kPa. Simultaneous MRE and diffusion acquisition is feasible and can be implemented with no observable interference between the two methods.

Mechanical Characterization of Tissue-Engineered Cartilage Using Microscopic Magnetic Resonance Elastography

Knowledge of mechanical properties of tissue-engineered cartilage is essential for the optimization of cartilage tissue engineering strategies. Microscopic magnetic resonance elastography (μMRE) is a recently developed MR-based technique that can nondestructively visualize shear wave motion. From the observed wave pattern in MR phase images the tissue mechanical properties (e.g., shear modulus or stiffness) can be extracted. For quantification of the dynamic shear properties of small and stiff tissue-engineered cartilage, μMRE needs to be performed at frequencies in the kilohertz range. However, at frequencies greater than 1 kHz shear waves are rapidly attenuated in soft tissues. In this study μMRE, with geometric focusing, was used to overcome the rapid wave attenuation at high frequencies, enabling the measurement of the shear modulus of tissue-engineered cartilage. This methodology was first tested at a frequency of 5 kHz using a model system composed of alginate beads embedded in agarose, and then applied to evaluate extracellular matrix development in a chondrocyte pellet over a 3-week culture period. The shear stiffness in the pellet was found to increase over time (from 6.4 to 16.4 kPa), and the increase was correlated with both the proteoglycan content and the collagen content of the chondrocyte pellets (R(2)=0.776 and 0.724, respectively). Our study demonstrates that μMRE when performed with geometric focusing can be used to calculate and map the shear properties within tissue-engineered cartilage during its development.

Robust shear wave motion tracking using ultrasound harmonic imaging

Robust shear-wave motion detection is essential for producing reliable shear elasticity measurements for ultrasound shear-wave elastography (SWE). However, because shear-wave motion is extracted from radiofrequency signals which can be heavily contaminated by noise, shear-wave motion detection can be very challenging, especially for in vivo applications. This study investigated the implementation of harmonic imaging (HI) to facilitate more robust shear-wave tracking based on HI’s effectiveness in suppressing imaging noise associated with ultrasound reverberation, phase aberration, and clutter noise. A HI shear-wave tracking sequence was developed combining the pulse-inversion HI method with the plane wave imaging technique to transmit phase-inverted pulses at a high frame rate of several kilohertz. The backscattered ultrasound signals from phase-inverted pulses were added to suppress the fundamental and enhance the second harmonic component, from which the shear-wave motion was extracted. A pork belly phantom experiment showed that HI could significantly improve shear-wave motion detection by producing almost three-fold less underestimation of shear-wave motion and over ten-fold more precision for shear-wave speed measurements than fundamental imaging. An in vivo transthoracic case study of a human heart showed that HI substantially improved the success rate of shear-wave motion detection and could provide consistent estimates of the left ventricle myocardium stiffness.

Evaluation of frequency characteristics of shear waves produced by unfocused and focused beams

Measurements of viscoelasticity with shear wave velocity dispersion requires measurements over a large bandwidth. In this study, we explored the parameters that modulate the frequency characteristics of shear waves induced using radiation force push beams. We used a Verasonics ultrasound scanner equipped with a linear array transducer. We performed measurements of shear wave motion induced using both focused and unfocused ultrasound beams. Measurements were made in elastic phantoms with shear moduli of 1, 4, and 16 kPa. The number of elements used for the unfocused beams were varied from 8 to 24, and for the focused beams from 16 to 128. The shear wave motion was tracked using plane wave imaging, and a one-dimensional autocorrelation algorithm applied to the acquired in-phase/quadrature data. At each pixel we calculated the fast Fourier transform of the data and found the center frequency, center-of-gravity, and −3 dB bandwidth. We compared the frequency characteristics from the different push beams. The frequency characteristics were found to be spatially variant and dependent on the number of elements used as well as the shear modulus of the medium. The center frequency, center-of-gravity, and the bandwidth were found to be correlated to one another, and strongly associated with the stiffness of the medium.

Improved Shear Wave Motion Detection Using Pulse-Inversion Harmonic Imaging With a Phased Array Transducer

Ultrasound tissue harmonic imaging is widely used to improve ultrasound B-mode imaging quality thanks to its effectiveness in suppressing imaging artifacts associated with ultrasound reverberation, phase aberration, and clutter noise. In ultrasound shear wave elastography (SWE), because the shear wave motion signal is extracted from the ultrasound signal, these noise sources can significantly deteriorate the shear wave motion tracking process and consequently result in noisy and biased shear wave motion detection. This situation is exacerbated in in vivo SWE applications such as heart, liver, and kidney. This paper, therefore, investigated the possibility of implementing harmonic imaging, specifically pulse-inversion harmonic imaging, in shear wave tracking, with the hypothesis that harmonic imaging can improve shear wave motion detection based on the same principles that apply to general harmonic B-mode imaging. We first designed an experiment with a gelatin phantom covered by an excised piece of pork belly and show that harmonic imaging can significantly improve shear wave motion detection by producing less underestimated shear wave motion and more consistent shear wave speed measurements than fundamental imaging. Then, a transthoracic heart experiment on a freshly sacrificed pig showed that harmonic imaging could robustly track the shear wave motion and give consistent shear wave speed measurements of the left ventricular myocardium while fundamental imaging could not. Finally, an in vivo transthoracic study of seven healthy volunteers showed that the proposed harmonic imaging tracking sequence could provide consistent estimates of the left ventricular myocardium stiffness in end-diastole with a general success rate of 80% and a success rate of 93.3% when excluding the subject with Body Mass Index higher than 25. These promising results indicate that pulse-inversion harmonic imaging can significantly improve shear wave motion tracking and thus potentially facilitate more robust assessment of tissue elasticity by SWE.