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Since most developed countries are facing an increase in the number of patients per healthcare worker due to a declining birth rate and an aging population, relatively simple and safe diagnosis tasks may need to be performed using robotics and automation technologies, without specialists and hospitals. This study presents an automated robotic platform for remote auscultation, which is a highly cost-effective screening tool for detecting abnormal clinical signs. The developed robotic platform is composed of a 6-degree-of-freedom cooperative robotic arm, light detection and ranging (LiDAR) camera, and a spring-based mechanism holding an electric stethoscope. The platform enables autonomous stethoscope positioning based on external body information acquired using the LiDAR camera-based multi-way registration; the platform also ensures safe and flexible contact, maintaining the contact force within a certain range through the passive mechanism. Our preliminary results confirm that the robotic platform enables estimation of the landing positions required for cardiac examinations based on the depth and landmark information of the body surface. It also handles the stethoscope while maintaining the contact force without relying on the push-in displacement by the robotic arm., 8 pages, 11 figures

It has been recognized that tissue stiffness provides useful diagnostic information, as with palpation as a screening for diseases such as cancer. In recent years, shear wave elastography (SWE), a technique for evaluating and imaging tissue elasticity quantitatively and objectively in diagnostic imaging, has been put into practical use, and the amount of clinical knowledge about SWE has increased. In addition, some guidelines and review papers regarding technology and clinical applications have been published, and the status as a diagnostic technology is in the process of being established. However, there are still unclear points about the interpretation of shear wave speed (SWS) and converted elastic modulus in SWE. To clarify these, it is important to investigate the factors that affect the SWS and elastic modulus. Therefore, physical and engineering factors that potentially affect the SWS and elastic modulus are discussed in this review paper, based on the principles of SWE and a literature review. The physical factors include the propagation properties of shear waves, mechanical properties (viscoelasticity, nonlinearity, and anisotropy), and size and shape of target tissues. The engineering factors include the region of interest depth and signal processing. The aim of this review paper is not to provide an answer to the interpretation of SWS. It is to provide information for readers to formulate and verify the hypothesis for the interpretation. Therefore, methods to verify the hypothesis for the interpretation are also reviewed. Finally, studies on the safety of SWE are discussed.

In recent years, non-invasive measurement of tissue stiffness (hardness) using ultrasound elastography has attracted considerable attention. It has been used to evaluate muscle stiffness in the fields of rehabilitation, sports, and orthopedics. However, ultrasonic diagnostic devices with elastography systems are expensive and clinical use of such devices has been limited. In this study, we proposed a novel estimation method for vibration-based shear wave elastography measurement of human skeletal muscle, then determined its reproducibility and reliability. The coefficient of variation and correlation coefficient were used to determine reproducibility and reliability of the method by measuring the shear wave velocities in konjac phantom gels and agar phantom gels, as well as skeletal muscle. The intra-day, day-to-day, and inter-operator reliabilities were good when measuring the shear wave velocities in phantom gels. The intra-day and day-to-day reliabilities were good when measuring the shear wave velocities in skeletal muscle. The findings confirmed adequate reproducibility and reliability of the novel estimation method for vibration-based shear wave elastography. Therefore, the proposed measurement method may be a useful tool for evaluation of muscle stiffness.

In the Original publication of the article Table 3 was published incorrectly.

Purpose: Commonly used diffusion weighted (DW) imaging such as DW spin echo (SE) type echo planar imaging (DW-SE-EPI) is known to be a snapshot-like acquisition and to have a relatively high signal-to-noise ratio. Spiral MRI sequence (SPIRAL) has characteristics similar to these of EPI, but it has rarely been used for diffusion-weighted imaging (DWI). In vivo DW-SPIRAL of the rat brain has almost never been reported. Our purpose in this study was to examine the potential of SE-type two-dimensional (2D) multi-shot spiral acquisition MRI for apparent diffusion coefficient (ADC) mapping of the rat brain in vivo. Materials and Methods: We made an SE-type DW-2D-spiral MRI sequence (DW-SPIRAL) which was prepared on a 2.0-T animal-experiment MR scanner. Comparing the phantom experimental result of DW-SPIRAL with the phantom experimental result of DW SE-type echo-planar imaging (DW-SE-EPI) and conventional DW spin echo imaging (DW-SE), we estimated the characteristics of DW-SPIRAL and assessed the clinical application of DW-SPIRAL in an animal experiment on the rat brain. Results: There was not much difference between the calculated water/glycerol phantom diffusion coefficient of DW-SPIRAL and the calculated diffusion coefficient of DW-SE. This result shows that the DW-SPIRAL sequence is appropriate for use in diffusion weighted imaging. There were fewer phantom image distortions and ghosting artifacts with DW-SPIRAL than with DW-SE-EPI, and this tendency was similar in the animal experiment on the rat brain. Conclusion: The DW-SPIRAL sequence had been successfully tested in phantom experiments and rat brain experiments. It has been demonstrated that the DW-SPIRAL sequence is capable of producing in vivo rat brain DWI.

Objective Quantitative MR imaging techniques of degenerative cartilage have been reported as useful indicators of degenerative changes in cartilage extracellular matrix, which consists of proteoglycans, collagen, non-collagenous proteins, and water. Apparent diffusion coefficient (ADC) mapping of cartilage has been shown to correlate mainly with the water content of the cartilage. As the water content of the cartilage in turn correlates with its viscoelasticity, which directly affects the mechanical strength of articular cartilage, ADC can serve as a potentially useful indicator of the mechanical strength of cartilage. The aim of this study was to investigate the correlation between ADC and viscoelasticity as measured by indentation testing. Materials and methods Fresh porcine knee joints (n = 20, age 6 months) were obtained from a local abattoir. ADC of porcine knee cartilage was measured using a 3-Tesla MRI. Indentation testing was performed on an electromechanical precision-controlled system, and viscosity coefficient and relaxation time were measured as additional indicators of the viscoelasticity of cartilage. The relationship between ADC and viscosity coefficient as well as that between ADC and relaxation time were assessed. Results ADC was correlated with relaxation time and viscosity coefficient (R2 = 0.75 and 0.69, respectively, p

Introduction Acoustic Radiation Force Impulse[ARFI] ultrasound elastography has been widely introduced as a diagnostic modality for liver and breast masses. We previously reported that arrhythmias were observed at a mechanical index [MI] of 1.8 with ARFI and concomitant administration of an ultrasound contrast agent[UCA] in rabbits. The aim of this study was to identify the location of the arrhythmias in a heart using a new system (Microsonic co., Tokyo, Japan) which transmits ARFI from the probe used for B-mode imaging of the heart. Methods Under general anesthesia, seven rabbits were exposed to ARFI. Using the new transducer, cardiac B-mode images (4 chamber view, left ventricle long-axis view) were obtained through the intercostal space. We chose three points along the impulse conduction system of the heart: (1) right ventricle, (2) right atrium and (3) left ventricular wall.We confirmed the occurrence of arrhythmias and the shape of arrhythmias with and without UCA (perfluorobutane (SonazoidTM)). (at double the clinical dose). Two minutes after intravenous injection of the UCA, ARFI was transmitted with a 1.0 msec pulse duration delayed 200msec after the R wave. Thirty exposures were synchronized with one exposure per three heart beats. The MI of the ARFI exposure ranged from 0.84 to 1.16. Results Arrhythmias were not observed using ARFI without UCA. For ARFI exposure with UCA, an average of 2.85 arrhythmias were observed (range 0-7). There were no fatal arrhythmias. Arrythmias tend to occur from (1) and (2) rather than (3). The shape of arrhythmias were single ventricular or supraventricular extra-systolic waves. Arrhythmias from the right (1), (2) and left (3) heart had a reversed shape. Discussion Using this new system, the rabbit heart exposed to ARFI had more reliable focal positions. The MI used in this study was similar to that used in clinical setting of ARFI. There was no significant difference in the frequency of arrhythmias among the three points of ARFI exposure. However, reversed shape arrhythmias may indicate that ARFI exposure actually stimulated the right or left-sided impulse conduction system. Conclusion Extra-systolic activity at different origins was observed under similar clinical conditions using ARFI with infusion of an UCA. Ultrasound practitioners should know this adverse reaction, even if the MI is below the previously determined value of 1.9, especially when imaging near the conduction system.

In this work we report on the development of a novel technique for fat-saturated three-dimensional (3D) diffusion-weighted (DW) MRI sequence based upon 3D magnetization-prepared rapid gradient-echo (3D-MP-RAGE). In order to saturate fat, two kinds of procedures were competed CHESS-DW-3D-MP-RAGE sequence (CHESS -3D-DWI) and DW-3D-MP-WE-RAGE sequence (WE-3D-DWI) “chemical shift selective: CHESS method vs. water-excitation: WE method”. The CHESS-3D-DWI sequence and WE-3D-DWI sequence were compared in terms of their degree of fat suppression. In CHESS-3D-DWI sequence a preparation phase with a “CHESS-90ºRF-motion probing gradient: MPG-180ºRF-MPG-90ºRF” pulse-train was used to sensitize the magnetization to fat-saturated diffusion. In contrast, WE-3DDWI sequence a RAGE-excitation pulse with a “binominal -pulse 1-1 or 1-2-1” was selected to water-excited (fat-saturated) diffusion imaging. These imaging were done during in vivo studies using an animal experiment. From experimental results obtained with a phantom, the effect of diffusion weighting and the effect of fat-saturation were confirmed. Fat-saturation was much better in the WE-3D-DWI sequence than CHESS-3D-DWI sequence. From rat experimental results, fat-saturated diffusion-weighted image data were obtained. This sequence was useful for in vivo imaging., Date of Conference: 22-26 Aug. 2007

In order to detect the disease and degeneration of cartilage early, evaluations of acoustic properties are expected, but the physical meaning should be clarified. On the other hand, we have proposed a multimodal method using ultrasound (US) and magnetic resonance (MR) images for in vivo SOS measurement. In this study, the method was applied for the tissue-engineered cartilage, and the SOS was compared with T1, T2, apparent diffusion coefficient (ADC), attenuation coefficient (ATT), and Young’s modulus (YM). All procedures were approved by the Animal Care and Use Committee of our institution. 12-week-old male rats were used, and five different types of tissue-engineered cartilage was subcutaneously implanted in the back of rat (n = 30). Under anesthesia, MR and US images including same cross-sections were acquired separately, by using a MR imager of 2 Tesla and a US device of 13 MHz. At this time, T1, T2, ADC were also measured. The SOS was determined by the thickness measurement using the MR image and the...

The purpose of this study was to develop a new technique for a powerful compact MR elastography (MRE) actuator based on a pneumatic ball-vibrator. This is a compact actuator that generates powerful centrifugal force vibrations via high speed revolutions of an internal ball using compressed air. This equipment is easy to handle due to its simple principles and structure. Vibration frequency and centrifugal force are freely adjustable via air pressure changes (air flow volume), and replacement of the internal ball. In order to achieve MRI compatibility, all parts were constructed from non-ferromagnetic materials. Vibration amplitudes (displacements) were measured optically by a laser displacement sensor. From a bench test of displacement, even though the vibration frequency increased, the amount of displacement did not decrease. An essential step in MRE is the generation of mechanical waves within tissue via an actuator, and MRE sequences are synchronized to several phase offsets of vibration. In this system, the phase offset was detected by a four-channel optical-fiber sensor, and it was used as an MRI trigger signal. In an agarose gel phantom experiment, this actuator was used to make an MR elastogram. This study shows that the use of a ball actuator for MRE is feasible.