Shear Wave Speed Estimation Research Articles

Minimal effect of scanning parameters on ultrasound shear wave elastography variability in tendons.

Ultrasound shear wave elastography has potential use in assessing tendon tissue; however, reducing measurement variability remains challenging. The primary purpose of this study was to identify the amount of variability accounted for by ultrasound parameter (frequency, harmonics and CrossXBeam) settings on shear wave speed at two testing sites. Shear wave elastography images of the Achilles tendon were obtained from individuals with healthy tendons (n = 28) at two testing sites with standardised image acquisition/postprocessing protocols. Images were acquired at a range of frequencies (7-15 MHz) with CrossXBeam (a filtering technique) and harmonics settings toggled on and off. Variance decomposition analysis was performed to identify the amount of variability in shear wave speed accounted for by scan acquisition settings and testing sites. Shear wave speed variance was primarily attributed to participants (56.87% of variance; residual error: 35%). All scanning parameters, testing site and interaction terms each accounted for less than 2.5% of the variance. A statistically significant, negative relationship was observed between shear wave speed and image quality (p = 0.001) suggesting poor image quality yields higher shear wave speed estimates. The findings of this study suggest that natural variation in Achilles tendon mechanics between individuals without tendon pathology accounts for most of the shear wave speed variability. Optimising image quality, which may be observed in higher frequencies, should be considered to improve shear wave speed estimation. Clinically, this study highlights the need to take multiple images, maintain consistent ultrasound settings when tracking patient progress over time and use caution when comparing raw values from tendon scans performed in different clinics with shear wave elastography. Level III.

Angular Integral Autocorrelation for Speed Estimation in Shear-Wave Elastography

The utilization of a reverberant shear-wave field in shear-wave elastography has emerged as a promising technique for achieving robust shear-wave speed (SWS) estimation. However, many types of estimators cannot accurately measure SWS within such a complicated 3D wave field. This study introduces an advanced autocorrelation estimator based on angular integration known as the angular integral autocorrelation (AIA) approach to address this issue. The AIA approach incorporates all the autocorrelation data from various angles during measurements, resulting in enhanced robustness to both noise and imperfect distributions in SWS estimation. The effectiveness of the AIA estimator for SWS estimation is first validated using a k-Wave simulation of a stiff branching tube in a uniform background. Furthermore, the AIA estimator is applied to ultrasound elastography experiments, magnetic resonance imaging (MRI) experiments, and optical coherence tomography (OCT) studies across a range of different excitation frequencies on tissues and phantoms, including in vivo scans. The results verify the capacity of the AIA approach to enhance the accuracy of SWS estimation and the signal-to-noise ratio (SNR), even within an imperfect reverberant shear-wave field. Compared to simple autocorrelation approaches, the AIA approach can also successfully visualize and define lesions while significantly improving the estimated SWS and SNR in homogeneous background materials and providing improved elastic contrast between structures within the scans. These findings demonstrate the robustness and effectiveness of the AIA approach across a wide range of applications, including ultrasound elastography, magnetic resonance elastography (MRE), and optical coherence elastography (OCE), for accurately identifying the elastic properties of biological tissues in diverse excitation scenarios.

Integrated Difference Autocorrelation: A Novel Approach to Estimate Shear Wave Speed in the Presence of Compression Waves.

In share wave elastography (SWE), the aim is to measure the velocity of shear waves, however unwanted compression waves and bulk tissue motion pose challenges in evaluating tissue stiffness. Conventional approaches often struggle to discriminate between shear and compression waves, leading to inaccurate shear wave speed (SWS) estimation. In this study, we propose a novel approach known as the integrated difference autocorrelation (IDA) estimator to accurately estimate reverberant SWS in the presence of compression waves and noise. The IDA estimator, unlike conventional techniques, computes the subtraction of velocity between neighboring particles, effectively minimizing the impact of long wavelength compression waves and other wide-area movements such as those caused by respiration. We evaluated the effectiveness of IDA by: (1) using k-Wave simulations of a branching cylinder in a soft background, (2) using ultrasound elastography on a breast phantom, (3) using ultrasound elastography in the human liver-kidney region, and (4) using magnetic resonance elastography (MRE) on a brain phantom. By applying IDA to unfiltered contaminated wave fields of simulation and elastography experiments, the estimated SWSs are in good agreement with the ground truth values (i.e., less than 2% error for the simulation, 9% error for ultrasound elastography of the breast phantom and 19% error for MRE). Our results demonstrate that IDA accurately estimates SWS, revealing the existence of a lesion, even in the presence of strong compression waves. IDA exhibits consistency in SWS estimation across different modalities and excitation scenarios, highlighting its robustness and potential clinical utility.

High frequency ultrasound vibrational shear wave elastography for preclinical research

Preclinical evaluation of novel therapies using models of cancer is an important tool in cancer research, where imaging can provide non-invasive tools to characterise the internal structure and function of tumours. The short propagation paths when imaging tumours and organs in small animals allow the use of high frequencies for both ultrasound and shear waves, providing the opportunity for high-resolution shear wave elastography and hence its use for studying the heterogeneity of tissue elasticity, where heterogeneity may be a predictor of tissue response. Here we demonstrate vibrational shear wave elastography (VSWE) using a mechanical actuator to produce high frequency (up to 1000 Hz) shear waves in preclinical tumours, an alternative to the majority of preclinical ultrasound SWE studies where an acoustic radiation force impulse is required to create a relatively low-frequency broad-band shear-wave pulse. We implement VSWE with a high frequency (17.8 MHz) probe running a focused line-by-line ultrasound imaging sequence which as expected was found to offer improved detection of 1000 Hz shear waves over an ultrafast planar wave imaging sequence in a homogenous tissue-mimicking phantom. We test the VSWE in an ex vivo tumour xenograft, demonstrating the ability to detect shear waves up to 10 mm from the contactor position at 1000 Hz. By reducing the kernel size used for shear wave speed estimation to 1 mm we are able to produce shear wave speed images with spatial resolution of this order. Finally, we present VSWE data from xenograft tumours in vivo, demonstrating the feasibility of the technique in mice under isoflurane sedation. Mean shear wave speeds in the tumours are in good agreements with those reported by previous authors. Characterising the frequency dependence of shear wave speed demonstrates the potential to quantify the viscoelastic properties of tumours in vivo.

Feasibility of a Deep Learning approach to estimate Shear Wave Speed using the framework of Reverberant Shear Wave Elastography: A numerical simulation study.

Reverberant Shear Wave Elastography (RSWE) is an ultrasound elastography technique that offers great advantages, however, current estimators generate underestimations and time-consuming issues. As well, the involvement of Deep Learning into the medical imaging field with new tools to assess complex problems, makes it a great candidate to serve as a new approach for a RSWE estimator. This work addresses the application of a Deep Neural Network (DNN) for the estimation of Shear Wave Speed (SWS) maps from particle velocity using numerically simulated data. The architecture of the proposed network is based on a U-Net, which works with a custom loss function specifically adopted for the reconstruction task. Four DNNs were trained using four different databases: clean, noisy, acquired at variable frequency, and noisy and acquired at variable frequency data. After the training of the DNNs, the predicted SWS maps were evaluated based on different metrics related to segmentation, regression and similarity of images. The model for clean data showed better results with a Mean Absolute Error (MAE) of 0.011, Mean Square Error(MSE) of 0.001, modified Intersection over Union (mIoU) of 98.4%, Peak Signal to Noise Ratio (PSNR) of 32.925 and a Structural Similarity Index Measure (SSIM) of 0.99, for 250 (size of Testing Sets); while the other models delivered SSIM in the range of 0.87 to 0.96. It was concluded that noisy and clean data could be effectively handled by the model, while the other ones still need enhancement. Clinical Relevance- This work is focused on the application of a Deep Learning approach to accurately asses the Shear Wave Speed in numerical simulations of Reverberant Shear Wave Elastography approach. This novel estimator could be useful for future clinical experiments specially with real time applications to determine the status of living tissue such as detection of malignant or benign tumors located in breast cervix prostate or skin and in the diagnosis of other pathologies such us liver fibrosis.

Intra- and inter-observer agreement of cervical shear wave elasticity imaging for induction of labor

The Bishop score poorly predicts the chance of vaginal birth after labor induction, perhaps because it requires subjective assessment. While shear wave speed (SWS) in an objective measure of tissue stiffness, studies conflict on its clinical value. However, bias and variance of measurements in vivo has not been fully evaluated. Our objective was to determine intra- and inter-observer agreement of SWS estimates in pregnant patients and identify sources of estimate bias.

Shear Wave Elasticity Imaging Using Nondiffractive Bessel Apodized Acoustic Radiation Force.

The acoustic radiation force impulse (ARFI) has been widely used in transient shear wave elasticity imaging (SWEI). For SWEI based on focused ARFI, the highest image quality exists inside the focal zone due to the limitation of the depth of focus and diffraction. Consequently, the areas outside the focal zone and in the near field present poor image quality. To address the limitations of the focused beam, we introduce Bessel apodized ARFI that enhances image quality and improves the depth of focus. The objective of this study is to evaluate the feasibility of SWEI based on Bessel ARF in simulation and experiment. We report measurements of elastogram image quality and depth of field in tissue-mimicking phantoms and ex vivo liver tissue. Our results demonstrate improved depth of field, image quality, and shear wave speed (SWS) estimation accuracy using Bessel push beams. As a result, Bessel ARF enlarges the field of view of elastograms. The signal-to-noise ratio (SNR) of Bessel SWEI is improved 26% compared with focused SWEI in homogeneous phantom. The estimated SWS by Bessel SWEI is closer to the measured SWS from a clinical scanner with an error of 0.3% compared to 2.4% with a focused beam. In heterogeneous phantoms, the contrast-to-noise ratios (CNRs) of shallow and deep inclusions are improved by 8.79 and 3.33 dB, respectively, under Bessel ARF. We also compare the results between Bessel SWEI and supersonic shear imaging (SSI), and the SNR of Bessel SWEI is improved by 8.1%. Compared with SSI, Bessel SWEI shows more accurate SWS estimates in high stiffness inclusions. Finally, Bessel SWEI can generate higher quality elastograms with less energy than conventional SSI.

Practical settings for shear wave speed estimation using the framework of Reverberant Shear Wave Elastography: A numerical simulation study.

Reverberant shear wave elastography (RSWE) has become a promising approach to quantifying soft tissues' viscoelastic properties by the propagating shear wave speed (SWS) estimation based on the particle velocity autocorrelation. In this work, three different practical settings were evaluated for the SWS estimation by numerical simulations of an isotropic, homogenous, and elastic medium: first, the 2D representation of the particle velocity, second, the spatial autocorrelation computation, and third, the selection of the curve fitting domain. We conclude that the 2D autocorrelation function using the Wiener-Khinchin theorem provides up to 127 times faster results than traditional autocorrelation methods. Additionally, we state that extracting the magnitude and phase from the Fourier transform of the temporal domain, applying the 2D-autocorrelation on a mobile square window sized at least two wavelengths, and fitting the monotonically decreasing part of the autocorrelation profile's central lobe results in more accurate (13.2% of bias) and precise (5.3% of CV) estimations than other practical settings.Clinical relevance- Affections in soft tissues' biomechanical properties are related to pathologies, such as tumor cancer, muscular degenerative diseases, or fibrosis. These changes are quantified by the SWS and its derived viscoelastic parameters. RSWE is a promising approach for their characterization. In this work, we evaluated alternative elections of practical settings within the methodology. Numerical simulations indicate they lead to faster and more reliable local SWS estimations than conventional settings.

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.

A fast and quantitative measurement of shear wave speed and attenuation using (cross) modal assurance criterion for acoustic radiation force elasticity imaging

The measurement of shear wave speed (SWS) or attenuation in soft materials, especially in biological tissues, plays a crucial role in acoustic radiation force elasticity imaging which provides a quantitative measurement of elastic properties. In this study, with the first attempt to apply modal analysis theory to acoustic radiation force elasticity imaging, we propose a fast tracking algorithm based on the modal assurance criterion (MAC) including 2D SWS-MAC for SWS measurement and the signed cross modal assurance criterion (CrossMAC) for shear wave attenuation measurement. These approaches achieved high speedup with a framework of high-level parallelism. The FEM simulation results proved the accuracy of these two approaches. Phantom experiments showed that the 2D SWS-MAC approach had good consistency in SWS estimation compared to existing approaches and could accurately preserve the boundary contour of the inclusion with narrowed assurance intervals (quarter-width assurance intervals). An excised porcine liver experiment verified the effectiveness of shear wave attenuation estimation with Signed CrossMAC. These results demonstrate that the MAC based approaches improved both the shear wave motion measurement precision and the speedup rate of the measurement compared to conventional time domain cross-correlation or time-to-peak methods.

Shear Induced Non-Linear Elasticity Imaging: Elastography for Compound Deformations.

The goal of non-linear ultrasound elastography is to characterize tissue mechanical properties under finite deformations. Existing methods produce high contrast non-linear elastograms under conditions of pure uni-axial compression, but exhibit bias errors of 10-50% when the applied deformation deviates from the uni-axial condition. Since freehand transducer motion generally does not produce pure uniaxial compression, a motion-agnostic non-linearity estimator is desirable for clinical translation. Here we derive an expression for measurement of the Non-Linear Shear Modulus (NLSM) of tissue subject to combined shear and axial deformations. This method gives consistent nonlinear elasticity estimates irrespective of the type of applied deformation, with a reduced bias in NLSM values to 6-13%. The method combines quasi-static strain imaging with Single-Track Location-Shear Wave Elastography (STL-SWEI) to generate local estimates of axial strain, shear strain, and Shear Wave Speed (SWS). These local values were registered and non-linear elastograms reconstructed with a novel nonlinear shear modulus estimation scheme for general deformations. Results on tissue mimicking phantoms were validated with mechanical measurements and multiphysics simulations for all deformation types with an error in NLSM of 6-13%. Quantitative performance metrics with the new compound-motion tracking strategy reveal a 10-15 dB improvement in Signal-to-Noise Ratio (SNR) for simple shear versus pure compressive deformation for NLSM elastograms of homogeneous phantoms. Similarly, the Contrast-to-Noise Ratio (CNR) of NLSM elastograms of inclusion phantoms improved by 25-30% for simple shear over pure uni-axial compression. Our results show that high fidelity NLSM estimates may be obtained at ~30% lower strain under conditions of shear deformation as opposed axial compression. The reduction in strain required could reduce sonographer effort and improve scan safety.

Parallel Receive Beamforming Improves the Performance of Focused Transmit-Based Single-Track Location Shear Wave Elastography.

Single-track location shear wave elastography (STL-SWEI) is robust against speckle-induced noise in shear wave speed (SWS) estimates; however, it is not immune to other incoherent sources of noise (such as electronic noise) that increases the variance in SWS estimates. Although estimation averaging enabled by parallel receive beamforming adequately suppresses these noise sources, these beamforming techniques often rely on broad transmit beams (plane or diverging). While broad beam approaches, such as plane-wave imaging, are becoming ubiquitous in research ultrasound systems, clinical systems usually employ focused transmit beams due to compatibility with hardware beamforming and deeper penetration. Consequently, improving the noise robustness of focused transmit-based STL-SWEI may enable easier translation to clinical scenarios. In this article, we experimentally evaluated the performance of parallel beamforming for STL-SWEI using fixed or multiple transmit focus. By imaging tissue-mimicking phantoms, we found that parallel beamforming improved the focal zone elastographic signal-to-noise ratio (SNRe) by 40.9%. For a receive line spacing equivalent to transducer pitch, averaging estimates from three parallel lines produced peak SNRe at the focal zone (25 mm), while, at the shallower regions (< 20 mm), a larger number of parallel lines (>7) were needed. Increasing the beamforming line density by a factor of 8 increased the focal zone SNRe only by 13.2%. When SWS quantification was desirable at a fixed depth (such as within the push focal depth), using a deeper tracking focal zone enabled higher parallel line count and improved the peak SNRe by 33%. The multifocusing strategy produced a lower SNRe than the single-focus configurations. For a fixed tracking focal zone, a depth-dependent averaging based on the simulated transmit intensity adequately accounted for the transmit beamwidth. The results in this work demonstrated that STL-SWEI can be implemented using focused transmit beams with robust noise-suppression capability.

Quantitative Ultrasound Parameters Based on the Backscattered Echo Power Signal as Biomarkers of Cervical Remodeling: A Longitudinal Study in the Pregnant Rhesus Macaque

Clinical prediction and especially prevention of abnormal birth timing, particularly pre-term, is poor. The cervix plays a key role in birth timing; it first serves as a rigid barrier to protect the developing fetus, then becomes the pathway to delivery of that fetus. Imaging biomarkers to define this remodeling process could provide insights to improve prediction of birth timing and elucidate novel targets for preventive therapies. Quantitative ultrasound (QUS) approaches that appear promising for this purpose include shear wave speed (SWS) estimation to quantify softness, as well as parameters based on backscattered power, such as the mean backscattered power difference (mBSPD) and specific attenuation coefficient (SAC), to quantify the organization of tissue microstructure. Invasive studies in rodents demonstrated that as pregnancy advances, cervical microstructure disorganizes as tissue softness and compliance increase. Our non-invasive studies in pregnant women and rhesus macaques suggested that QUS can detect these microstructural changes in vivo. Our previous study in the same cohort showed a progressive decline in SWS during pregnancy, consistent with increasing tissue softness, and we hypothesized that backscatter parameters would also decrease, consistent with increasing microstructural disorganization. In this study, we analyzed the mBSPD and SAC in the cervices of rhesus macaques (n = 18). We found that both mBSPD and SAC decreased throughout pregnancy (p < 0.001 for both parameters) and that the former appears to be a more reliable biomarker. In summary, biomarkers that can characterize tissue microstructural organization are promising for comprehensive characterization of cervical remodeling in pregnancy.

RSNA/QIBA efforts to standardize shear wave speed as a biomarker for liver fibrosis staging

Commercial shear elasticity systems have been available to clinicians for several years for characterizing liver stiffness. The Radiological Society of North America (RSNA) established a Quantitative Imaging Biomarker Alliance (QIBA) committee on Ultrasound Shear Wave Speed to help achieve better consistency between the shear wave speed and elastic modulus values reported by different manufacturer systems. An inter-laboratory study of shear wave speed estimation was conducted at academic, industry and clinical laboratories using commercial ultrasound and magnetic resonance elastography systems in elastic (Phase I) and viscoelastic (Phase II) homogeneous, isotropic tissue-mimicking phantoms. In the elastic phantoms, shear wave speeds from different systems were within ±5% of the grand mean of all system measurements. Different appraisers and replicate measurements at a given site were not sources of significant variability in shear wave speed measurements. In the viscoelastic phantoms, shear wave speeds from different systems were within ±15% of the grand mean of all systems, with the stiffest phantoms at the deepest focal depth (7 cm) having the greatest measurement variance. Magnetic resonance elastography measurements at 140 Hz in the viscoelastic phantoms were consistent to within ±5% of thosemade with the ultrasound shear elasticity systems, while measurements made at 60 Hz had a mean bias of -2.6% relative to ultrasound systems. A method for reporting group shear wave velocities using both displacement and velocity data, along with shear wave phase velocity analysis, has been developed as a common calibration approach for the phantoms. An open-source repository of research scanner shear wave sequences and processing code has been created to allow manufacturers to have a calibration standard to assess compliance with the QIBA US shear wave speed profile and to achieve more consistent results to facilitate more rapid clinical adoption of this technology to evaluate liver fibrosis.

Fourier-Domain Shift Matching: A Robust Time-of-Flight Approach for Shear Wave Speed Estimation.

Our primary objective of this work was to design and test a new time-of-flight (TOF) method that allows measurements of shear wave speed (SWS) following impulsive excitation in soft tissues. Particularly, under the assumption of the local plane shear wave, this work named the Fourier-domain shift matching (FDSM) method, estimates SWS by aligning a series of shear waveforms either temporally or spatially using a solution space deduced by characteristic curves of the well-known 1-D wave equation. The proposed SWS estimation method was tested using computer-simulated data, and tissue-mimicking phantom and ex vivo tissue experiments. Its performance was then compared with three other known TOF methods: lateral time-to-peak (TTP) method with robust random sampling consensus (RANSAC) fitting method, Radon sum transformation method, and a modified cross correlation method. Hereafter, these three TOF methods are referred to as the TTP-RANSAC, Radon sum, and X-corr methods, respectively. In addition to an adapted form of the 2-D Fourier transform (2-D FT)-based method in which the (group) SWS was approximated by averaging phase SWS values was considered for comparison. Based on data evaluated, we found that the overall performance of the above-mentioned temporal implementation of the proposed FDSM method was most similar to the established Radon sum method (correlation = 0.99, scale factor = 1.03, and mean difference = 0.07 m/s), and the 2-D FT (correlation = 0.98, scale factor = 1.00, and mean difference = 0.10 m/s) at high signal quality. However, results obtained from the 2-D FT method diverged (correlation = 0.201) from these of the proposed temporal implementation in the presence of diminished signal quality, whereas the agreement between the Radon sum approach and the proposed temporal implementation largely remained the same (correlation = 0.98).

Anisotropy and Spatial Heterogeneity in Quantitative Ultrasound Parameters: Relevance to the Study of the Human Cervix

Imaging biomarkers based on quantitative ultrasound can offer valuable information about properties that inform tissue function and behavior such as microstructural organization (e.g., collagen alignment) and viscoelasticity (i.e., compliance). For example, the cervix feels softer as its microstructure remodels during pregnancy, an increase in compliance that can be objectively quantified with shear wave speed and therefore shear wave speed estimation is a potential biomarker of cervical remodeling. Other proposed biomarkers include parameters derived from the backscattered echo signal, such as attenuation and backscattered power loss, because such parameters can provide insight into tissue microstructural alignment and organization. Of these, attenuation values for the pregnant cervix have been reported, but large estimate variance reduces their clinical value. That said, parameter estimates based on the backscattered echo signal may be incorrect if assumptions they rely on, such as tissue isotropy and homogeneity, are violated. For that reason, we explored backscatter and attenuation parameters as potential biomarkers of cervical remodeling via careful investigation of the assumptions of isotropy and homogeneity in cervical tissue. Specifically, we estimated the angle- and spatial-dependence of parameters of backscattered power and acoustic attenuation in the ex vivo human cervix, using the reference phantom method and electronic steering of the ultrasound beam. We found that estimates are anisotropic and spatially heterogeneous, presumably because the tissue itself is anisotropic and heterogeneous. We conclude that appropriate interpretation of imaging biomarkers of cervical remodeling must account for tissue anisotropy and heterogeneity.

Speckle-free estimation of tissue elasticity with single track location shear wave elasticity imaging

Shear Wave Elasticity Imaging (SWEI) is commonly used to characterize tissue elasticity, but conventional, multiple-track-location SWEI (MTL-SWEI) techniques are resolution-limited by speckle. MTL-SWEI techniques use plane wave ultrasound to monitor an induced shear wave as it propagates across a set of tracking beams within a region of interest. The scattering process creates a random, yet stationary, spatial sensitivity pattern for each beamformed location, called speckle bias, which causes errors in MTL-SWEI shear wave speed estimates that cannot be improved through averaging. Single Track Location SWEI (STL-SWEI) overcomes speckle bias by using a single track beam, subsequently exciting and tracking different push locations, and comparing the timing of the recorded shear wave signals from different push locations to estimate shear wave speed. Two and three-dimensional STL-SWEI imaging techniques are presented and compared to MTL-SWEI and Acoustic Radiation Force Impulse (ARFI) imaging in phantoms and in vivo experiments. Tradeoffs and techniques for sequencing, beamforming, shear wave speed estimation, and image formation are discussed. For applications where tissue heating and motion are not limiting factors, STL-SWEI provides superior imaging in terms of lateral resolution and contrast-to-noise ratio compared to MTL-SWEI and ARFI. [This work was supported by NIHR37HL096023 and NIHR01EB01248.]Shear Wave Elasticity Imaging (SWEI) is commonly used to characterize tissue elasticity, but conventional, multiple-track-location SWEI (MTL-SWEI) techniques are resolution-limited by speckle. MTL-SWEI techniques use plane wave ultrasound to monitor an induced shear wave as it propagates across a set of tracking beams within a region of interest. The scattering process creates a random, yet stationary, spatial sensitivity pattern for each beamformed location, called speckle bias, which causes errors in MTL-SWEI shear wave speed estimates that cannot be improved through averaging. Single Track Location SWEI (STL-SWEI) overcomes speckle bias by using a single track beam, subsequently exciting and tracking different push locations, and comparing the timing of the recorded shear wave signals from different push locations to estimate shear wave speed. Two and three-dimensional STL-SWEI imaging techniques are presented and compared to MTL-SWEI and Acoustic Radiation Force Impulse (ARFI) imaging in phantoms and ...

Shear Wave Speed Estimation Using Reverberant Shear Wave Fields: Implementation and Feasibility Studies

Elastography is a modality that estimates tissue stiffness and, thus, provides useful information for clinical diagnosis. Attention has focused on the measurement of shear wave propagation; however, many methods assume shear wave propagation is unidirectional and aligned with the lateral imaging direction. Any deviations from the assumed propagation result in biased estimates of shear wave speed. To address these challenges, directional filters have been applied to isolate shear waves with different propagation directions. Recently, a new method was proposed for tissue stiffness estimation involving creation of a reverberant shear wave field propagating in all directions within the medium. These reverberant conditions lead to simple solutions, facile implementation and rapid viscoelasticity estimation of local tissue. In this work, this new approach based on reverberant shear waves was evaluated and compared with another well-known elastography technique using two calibrated elastic and viscoelastic phantoms. Additionally, the clinical feasibility of this technique was analyzed by assessing shear wave speed in human liver and breast tissues, in vivo. The results indicate that it is possible to estimate the viscoelastic properties in each scanned medium. Moreover, a better approach to estimation of shear wave speed was obtained when only the phase information was taken from the reverberant waves, which is equivalent to setting all magnitudes within the bandpass equal to unity: an idealization of a perfectly isotropic reverberant shear wave field.

Fetal adrenal gland biometry and cervical elastography as predictors of preterm birth: A comparative study.

Preterm birth is a major health problem in developing and developed countries leading to rising health care costs and long-term neurodevelopmental disability. The study aims to evaluate the role of new quantitative markers, like the elastography of cervix (shear wave speed estimation), fetal adrenal zone enlargement, and corrected fetal adrenal gland volume; in preterm birth prediction and analyze their relative importance. Thus, these markers may be beneficial in early preterm birth detection and prevent the related morbidities. Thirty pregnant females (from 28 to 37 weeks of gestational age), showing clinical signs and delivery outcome of preterm birth were included in the study with an equal number of not-in-labor antenatal females at ≥37 weeks as controls. These patients were categorized as preterm and term groups. Both the groups were subjected to trans-abdominal ultrasonography where cervical length, cervical shear wave speed (dynamic elastography) and fetal adrenal gland parameters were measured. Shear wave speed estimation of the antenatal cervix showed the highest sensitivity and specificity (96.7% and 87% respectively) in the prediction of preterm birth and also showed a strong correlation with fetal adrenal gland enlargement. Fetal adrenal zone enlargement was also shown to be a reliable marker of preterm birth, however, with reduced sensitivity and specificity than shear wave speed. The elastographic advancement and fetal adrenal biometry derived quantitative markers can be used as an objective and standard criterion for accurate prediction of preterm birth.

Detection of Changes in Cervical Softness Using Shear Wave Speed in Early versus Late Pregnancy: An in Vivo Cross-Sectional Study

The aim of this study was to assess the ability of shear wave elasticity imaging (SWEI) to detect changes in cervical softness between early and late pregnancy. Using a cross-sectional study design, shear wave speed (SWS) measurements were obtained from women in the first trimester (5–14 wk of gestation) and compared with estimates from a previous study of women at term (37–41 wk). Two sets of five SWS measurements were made using commercial SWEI applications on an ultrasound system equipped with a prototype catheter transducer (128 elements, 3-mm diameter, 14-mm aperture). Average SWS estimates were 4.42 ± 0.32 m/s (n = 12) for the first trimester and 2.13 ± 0.66 m/s (n = 18) for the third trimester (p < 0.0001). The area under the curve was 0.95 (95% confidence interval: 0.82–0.99) with a sensitivity and specificity of 83%. SWS estimates indicated that the third-trimester cervix is significantly softer than the first-trimester cervix. SWEI methods may be promising for assessing changes in cervical softness.