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Minimally invasive treatments such as microwave ablation (MWA) have been growing in popularity for extending liver cancer survival rates in patients, when surgery is not an option. As a non-ionizing, real-time alternative to contrast-enhanced computed tomography, electrode displacement elastography (EDE) has shown promise as an imaging modality for MWA. Despite imaging efficacy, motion artifacts caused by physiological motion result in unintended speckle pattern variance, thereby inhibiting consistent and accurate ablated region visualization. To combat these unavoidable motion artifacts, a Lagrangian deformation tracking (LDT) approach based on freehand EDE was developed to track tissue movement and better define tissue properties. For validating LDT efficacy, a spherical inclusion phantom as well as seven in vivo data sets were processed, and strain tensor images were compared with identical time sampled images estimated using a traditional Eulerian approach. In vivo results revealed greater consistency among visualized LDT strain tensor images, with segmented ablated regions exhibiting standard deviation reductions of up to 98% when compared with Eulerian strain tensor images. Additionally, Lagrangian strain tensor images provided Dice coefficient improvements up to 25%, and success rates improved from approximately 50% to nearly 100% for ablated region visualization. [ABSTRACT FROM AUTHOR]

Cardiac elastography (CE) is an ultrasound-based technique utilizing radio-frequency (RF) signals for assessing global and regional myocardial function. In this work, a complete strain estimation pipeline for incorporating a Bayesian regularization-based hierarchical block-matching algorithm, with Lagrangian motion description and myocardial polar strain estimation is presented. The proposed regularization approach is validated using finite-element analysis (FEA) simulations of a canine cardiac deformation model that is incorporated into an ultrasound simulation program. Interframe displacements are initially estimated using a hierarchical motion estimation framework. Incremental displacements are then accumulated under a Lagrangian description of cardiac motion from end-diastole (ED) to end-systole (ES). In-plane Lagrangian finite strain tensors are then derived from the accumulated displacements. Cartesian to cardiac coordinate transformation is utilized to calculate radial and longitudinal strains for ease of interpretation. Benefits of regularization are demonstrated by comparing the same hierarchical block-matching algorithm with and without regularization. Application of Bayesian regularization in the canine FEA model provided improved ES radial and longitudinal strain estimation with statistically significant ($p < 0.001$) error reduction of 48.88% and 50.16%, respectively. Bayesian regularization also improved the quality of temporal radial and longitudinal strain curves with error reductions of 78.38% and 86.67% ($p < 0.001$), respectively. Qualitative and quantitative improvements were also visualized for in vivo results on a healthy murine model after Bayesian regularization. Radial strain elastographic signal-to-noise ratio (SNRe) increased from 3.83 to 4.76 dB, while longitudinal strain SNRe increased from 2.29 to 4.58 dB with regularization. [ABSTRACT FROM AUTHOR]

Objective: Ultrasound Lagrangian carotid strain imaging (LCSI) utilizes physiological deformation caused by arterial pressure variations to generate strain tensor maps of the vessel walls and plaques. LCSI has been criticized for the lack of normalization of magnitude-based strain indices to physiological stimuli, namely blood pressure. We evaluated the impact of normalization of magnitude-based strain indices to blood pressure measured immediately after the acquisition of radiofrequency (RF) data loops for LCSI.Materials and Methods: A complete clinical ultrasound examination along with RF data loops for LCSI was performed on 50 patients (30 males and 20 females) who presented with >60% carotid stenosis and were scheduled for carotid endarterectomy. Cognition was assessed using the 60-minute neuropsychological test protocol.Results: For axial strains correlation of maximum accumulated strain indices (MASI), cognition scores were -0.46 for non-normalized and -0.45, -0.49, -0.37, and -0.48 for systolic, diastolic, pulse pressure, and mean arterial pressure normalized data, respectively. The corresponding area under the curve (AUC) values for classifiers designed using maximum likelihood estimation of a binormal distribution with a median-split of the executive function cognition scores were 0.73, 0.70, 0.71, 0.70, and 0.71, respectively.Conclusions: No significant differences in the AUC estimates were obtained between normalized and non-normalized magnitude-based strain indices. [ABSTRACT FROM AUTHOR]

• Efficient 3D reconstruction of an ablated region from a sheaf of 2D images. • Matérn kernel provides a flexible yet objective way suppressing noise and artifacts. • Experimental results show improved image quality over existing interpolation method. Three-dimensional visualization of tumor ablation procedures have significant clinical value because the ability to accurately visualize ablated volumes can help clinicians gauge the extent of ablated tissue necrosis and plan future treatment steps. Better control over ablation volume can prevent recurrence of tumors treated using ablative procedures. This paper presents a kernel based smoothing algorithm called M atérn S mooth to reconstruct shear wave velocity maps from data acquired through ultrasound electrode vibration elastography. Shear wave velocity estimates are acquired on several intersecting imaging planes that share a common axis of intersection collinear with the ablation needle. An objective method of choosing smoothing parameters from underlying data is outlined through simulations. Experimental validation was performed on data acquired from a tissue mimicking phantom. Volume estimates were found to be within 20% of the true value. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma and liver metastases are common hepatic malignancies presenting with high mortality rates. Minimally invasive microwave ablation (MWA) yields high success rates similar to surgical resection. However, MWA procedures require accurate image guidance during the procedure and for post-procedure assessments. Ultrasound electrode displacement elastography (EDE) has demonstrated utility for non-ionizing imaging of regions of thermal necrosis created with MWA in the ablation suite. Three strategies for displacement vector tracking and strain tensor estimation, namely coupled subsample displacement estimation (CSDE), a multilevel 2-D normalized cross-correlation method, and quality-guided displacement tracking (QGDT) have previously shown accurate estimations for EDE. This paper reports on a qualitative and quantitative comparison of these three algorithms over 79 patients after an MWA procedure. Qualitatively, CSDE presents sharply delineated, clean ablated regions with low noise except for the distal boundary of the ablated region. Multilevel and QGDT contain more visible noise artifacts, but delineation is seen over the entire ablated region. Quantitative comparison indicates CSDE with more consistent mean and standard deviations of region of interest within the mass of strain tensor magnitudes and higher contrast, while Multilevel and QGDT provide higher CNR. This fact along with highest success rates of 89% and 79% on axial and lateral strain tensor images for visualization of thermal necrosis using the Multilevel approach leads to it being the best choice in a clinical setting. All methods, however, provide consistent and reproducible delineation for EDE in the ablation suite. [ABSTRACT FROM AUTHOR]

Ultrasound electrode displacement elastography (EDE) has demonstrated the potential to monitor ablated regions in human patients after minimally invasive microwave ablation procedures. Displacement estimation for EDE is commonly plagued by decorrelation noise artifacts degrading displacement estimates. In this paper, we propose a global dictionary learning approach applied to denoising displacement estimates with an adaptively learned dictionary from EDE phantom displacement maps. The resulting algorithm is one that represents displacement patches sparsely if they contain low noise and averages remaining patches thereby denoising displacement maps while retaining important edge information. The results of dictionary-represented displacements presented with a higher signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) with improved contrast, as well as improved phantom inclusion delineation when compared to initial displacements, median-filtered displacements, and spline smoothened displacements, respectively. In addition to visualized noise reduction, dictionary-represented displacements presented with the highest SNR, CNR, and improved contrast with values of 1.77, 4.56, and 4.35 dB, respectively, when compared to axial strain tensor images estimated using the initial displacements. Following EDE phantom imaging, we utilized dictionary representations from in vivo patient data, further validating efficacy. Denoising displacement estimates are a newer application for dictionary learning producing strong ablated region delineation with little degradation from denoising. [ABSTRACT FROM AUTHOR]

A multilevel Lagrangian carotid strain imaging algorithm is analyzed to identify computational bottlenecks for implementation on a graphics processing unit (GPU). Displacement tracking including regularization was found to be the most computationally expensive aspect of this strain imaging algorithm taking about 2.2 h for an entire cardiac cycle. This intensive displacement tracking was essential to obtain Lagrangian strain tensors. However, most of the computational techniques used for displacement tracking are parallelizable, and hence GPU implementation is expected to be beneficial. A new scheme for subsample displacement estimation referred to as a multilevel global peak finder was also developed since the Nelder–Mead simplex optimization technique used in the CPU implementation was not suitable for GPU implementation. GPU optimizations to minimize thread divergence and utilization of shared and texture memories were also implemented. This enables efficient use of the GPU computational hardware and memory bandwidth. Overall, an application speedup of $168.75\times $ was obtained enabling the algorithm to finish in about 50 s for a cardiac cycle. Last, comparison of GPU and CPU implementations demonstrated no significant difference in the quality of displacement vector and strain tensor estimation with the two implementations up to a 5% interframe deformation. Hence, a GPU implementation is feasible for clinical adoption and opens opportunity for other computationally intensive techniques. [ABSTRACT FROM AUTHOR]

We compared a quasi-static ultrasound elastography technique, referred to as electrode displacement elastography (EDE), with acoustic radiation force impulse imaging (ARFI) for monitoring microwave ablation (MWA) procedures on patients diagnosed with liver neoplasms. Forty-nine patients recruited to this study underwent EDE and ARFI with a Siemens Acuson S2000 system after an MWA procedure. On the basis of visualization results from two observers, the ablated region in ARFI images was recognizable on 20 patients on average in conjunction with B-mode imaging, whereas delineable ablation boundaries could be generated on 4 patients on average. With EDE, the ablated region was delineable on 40 patients on average, with less imaging depth dependence. Study of tissue-mimicking phantoms revealed that the ablation region dimensions measured on EDE and ARFI images were within 8%, whereas the image contrast and contrast-to-noise ratio with EDE was two to three times higher than that obtained with ARFI. This study indicated that EDE provided improved monitoring results for minimally invasive MWA in clinical procedures for liver cancer and metastases. [ABSTRACT FROM AUTHOR]

Percutaneous needle-based liver ablation procedures are becoming increasingly common for the treatment of small isolated tumors in hepatocellular carcinoma patients who are not candidates for surgery. Rapid 3-D visualization of liver ablations has potential clinical value, because it can enable interventional radiologists to plan and execute needle-based ablation procedures with real time feedback. Ensuring the right volume of tissue is ablated is desirable to avoid recurrence of tumors from residual untreated cancerous cells. Shear wave velocity (SWV) measurements can be used as a surrogate for tissue stiffness to distinguish stiffer ablated regions from softer untreated tissue. This paper extends the previously reported sheaf reconstruction method to generate complete 3-D visualizations of SWVs without resorting to an approximate intermediate step of reconstructing transverse $C$ planes. The noisy data are modeled using a Markov random field, and a computationally tractable reconstruction algorithm that can handle grids with millions of points is developed. Results from simulated ellipsoidal inclusion data show that this algorithm outperforms standard nearest neighbor interpolation by an order of magnitude in mean squared reconstruction error. Results from the phantom experiments show that it also provides a higher contrast-to-noise ratio by almost 2 dB and better signal-to-noise ratio in the stiff inclusion by over 2 dB compared with nearest neighbor interpolation and has lower computational complexity than linear and spline interpolation. [ABSTRACT FROM AUTHOR]

Purpose: Ultrasound strain imaging is a relatively low cost and portable modality for monitoring percutaneous thermal ablation of liver neoplasms. However, a 3D strain volume reconstruction from existing 2D strain images is necessary to fully delineate the thermal dose distribution. Tissue mimicking (TM) phantom experiments were performed to validate a novel volume reconstruction algorithm referred to as sheaf of ultrasound planes reconstruction (SOUPR), based on a series of 2D rotational imaging planes. Methods: Reconstruction using SOUPR was formulated as an optimization problem with constraints on data consistency with 2D strain images and data smoothness of the volume data. Reconstructed ablation inclusion dimensions, volume, and elastographic signal to noise ratio (SNRe) and contrast to noise ratio (CNRe) were compared with conventional 3D ultrasound strain imaging based on interpolating a series of quasiparallel 2D strain images with a wobbler transducer. Results: Volume estimates of the phantom inclusion were in a similar range for both acquisition approaches. SNRe and CNRe obtained with SOUPR were significantly higher on the order of 250% and 166%, respectively. The mean error of the inclusion dimension reconstructed with a wobbler transducer was on the order of 10.4%, 3.5%, and 19.0% along the X, Y, and Z axes, respectively, while the error with SOUPR was on the order of 2.6%, 2.8%, and 9.6%. A qualitative comparison of SOUPR and wobbler reconstruction was also performed using a thermally ablated region created in ex vivo bovine liver tissue. Conclusions: The authors have demonstrated using experimental evaluations with a TM phantom that the reconstruction results obtained with SOUPR were superior when compared with a conventional wobbler transducer in terms of inclusion shape preservation and detectability. [ABSTRACT FROM AUTHOR]

Purpose: This paper discusses an application of particle filtering for estimating shear wave velocity in tissue using ultrasound elastography data. Shear wave velocity estimates are of significant clinical value as they help differentiate stiffer areas from softer areas which is an indicator of potential pathology. Methods: Radio-frequency ultrasound echo signals are used for tracking axial displacements and obtaining the time-to-peak displacement at different lateral locations. These time-to-peak data are usually very noisy and cannot be used directly for computing velocity. In this paper, the denoising problem is tackled using a hidden Markov model with the hidden states being the unknown (noiseless) time-to-peak values. A particle filter is then used for smoothing out the time-to-peak curve to obtain a fit that is optimal in a minimum mean squared error sense. Results: Simulation results from synthetic data and finite element modeling suggest that the particle filter provides lower mean squared reconstruction error with smaller variance as compared to standard filtering methods, while preserving sharp boundary detail. Results from phantom experiments show that the shear wave velocity estimates in the stiff regions of the phantoms were within 20% of those obtained from a commercial ultrasound scanner and agree with estimates obtained using a standard method using least-squares fit. Estimates of area obtained from the particle filtered shear wave velocity maps were within 10% of those obtained from B-mode ultrasound images. Conclusions: The particle filtering approach can be used for producing visually appealing SWV reconstructions by effectively delineating various areas of the phantom with good image quality properties comparable to existing techniques. [ABSTRACT FROM AUTHOR]

Abstract: Ultrasound frame rates play a key role for accurate cardiac deformation tracking. Insufficient frame rates lead to an increase in signal de-correlation artifacts resulting in erroneous displacement and strain estimation. Joint probability density distributions generated from estimated axial strain and its associated signal-to-noise ratio provide a useful approach to assess the minimum frame rate requirements. Previous reports have demonstrated that bi-modal distributions in the joint probability density indicate inaccurate strain estimation over a cardiac cycle. In this study, we utilize similar analysis to evaluate a 2-D multi-level displacement tracking and strain estimation algorithm for cardiac strain imaging. The effect of different frame rates, final kernel dimensions and a comparison of radio frequency and envelope based processing are evaluated using echo signals derived from a 3-D finite element cardiac model and five healthy volunteers. Cardiac simulation model analysis demonstrates that the minimum frame rates required to obtain accurate joint probability distributions for the signal-to-noise ratio and strain, for a final kernel dimension of 1 λ by 3 A-lines, was around 42 Hz for radio frequency signals. On the other hand, even a frame rate of 250 Hz with envelope signals did not replicate the ideal joint probability distribution. For the volunteer study, clinical data was acquired only at a 34 Hz frame rate, which appears to be sufficient for radio frequency analysis. We also show that an increase in the final kernel dimensions significantly affect the strain probability distribution and joint probability density function generated, with a smaller effect on the variation in the accumulated mean strain estimated over a cardiac cycle. Our results demonstrate that radio frequency frame rates currently achievable on clinical cardiac ultrasound systems are sufficient for accurate analysis of the strain probability distribution, when a multi-level 2-D algorithm and kernel dimensions on the order of 1 λ by 3 A-lines or smaller are utilized. [Copyright &y& Elsevier]

Abstract: Echocardiographic strain imaging is a promising new method for quantifying and displaying the health of cardiac muscle. Accurate regional myocardial function analysis requires high spatial and temporal resolution in addition to fidelity to the underlying deformation. However, all current clinical approaches use speckle-tracking algorithms applied to B-mode images derived from envelope signals. Such approaches are inherently of lower spatial resolution, since they require larger data blocks for deformation tracking due to the absence of phase information. In this paper, we compare the strain estimation performance using B-mode, envelope and radiofrequency signals, utilizing data acquired from a uniformly elastic tissue mimicking phantom, cardiac simulation, and clinical in vivo data. Signal-to-noise ratio improvements using radiofrequency signals for linear and phased array geometries were 5.80dB and 9.48dB over that obtained with envelope signals (at peak strain) in phantom studies, respectively. Cardiac simulation studies demonstrate that when averaged over the two cardiac cycles, the mean standard deviation of estimated strain using envelope signals from two of the six segments for a short-axes view (anterior and anterolateral) were 48% and 44% higher than that obtained using radiofrequency signals. These segments were chosen since one was along while the other was situated lateral to the beam propagation direction. In a similar manner, in vivo analysis on a volunteer also indicate that the standard deviation of the estimated strain using B-mode and envelope signals were 16% and 42% higher than that obtained using radiofrequency signals in the anteroseptal segment, and 45% and 27% in the anterior segment. These results demonstrate the significant reduction in the variability of strain estimated along with improvements in the spatial resolution and signal-to-noise ratios obtained using radiofrequency signals. [Copyright &y& Elsevier]

Elastographic imaging can be used to monitor ablation procedures; however, confident and clear determination of the ablation boundary is essential to ensure complete treatment of the pathological target. To investigate the potential for ablation boundary representation on elastographic images, local variations in the viscoelastic properties in radiofrequency-ablated regions that were formed in vivo in porcine liver tissue were quantified using dynamic indentation. Spatial stiffness maps were then correlated to stained histology, the gold standard for the determination of the ablation periphery or boundary. Regions of interest in 11 radiofrequency ablation samples were indented at 18–24 locations each, including the central zone of complete necrosis and more peripheral transition zones including normal tissue. Storage modulus and the rate of stiffening were both greatest in the central ablation zone and decreased with radial distance away from the center. The storage modulus and modulus contrast at the ablation outer transition zone boundary were 3.1 ± 1.0 kPa and 1.6 ± 0.4, respectively, and 36.2 ± 9.1 kPa and 18.3 ± 5.5 at the condensation boundary within the ablation zone. Elastographic imaging modalities were then compared to gross pathology in ex vivo bovine liver tissue. Area estimated from strain, shear-wave velocity, and gross pathology images were 470, 560, and 574 mm^2, respectively, and ablation widths were 19.4, 20.7, and 23.0 mm. This study has provided insights into spatial stiffness distributions within radiofrequency ablations and suggests that low stiffness contrast on the ablation periphery leads to the observed underestimation of ablation extent on elastographic images. [ABSTRACT FROM PUBLISHER]

Radio-frequency (RF) ablation is a minimally invasive treatment for tumors in various abdominal organs. It is effective if good tumor localization and intraprocedural monitoring can be done. In this paper, we investigate the feasibility of using an ultrasound-based Young's modulus reconstruction algorithm to image an ablated region whose stiffness is elevated due to tissue coagulation. To obtain controllable tissue deformations for abdominal organs during and/or intermediately after the RF ablation, the proposed modulus imaging method is specifically designed for using tissue deformation fields induced by the RF electrode. We have developed a new scheme under which the reconstruction problem is simplified to a 2-D problem. Based on this scheme, an iterative Young's modulus reconstruction technique with edge-preserving regularization was developed to estimate the Young's modulus distribution. The method was tested in experiments using a tissue-mimicking phantom and on ex vivo bovine liver tissues. Our preliminary results suggest that high contrast modulus images can be successfully reconstructed. In both experiments, the geometries of the reconstructed modulus images of thermal ablation zones match well with the phantom design and the gross pathology image, respectively. [ABSTRACT FROM AUTHOR]

Two-dimensional (2D) cross-correlation algorithms are necessary to estimate local displacement vector information for strain imaging. However, most of the current two-dimensional cross-correlation algorithms were developed for linear array transducers. Although sector and phased array transducers are routinely used for clinical imaging of abdominal and cardiac applications, strain imaging for these applications has been performed using one-dimensional (1D) cross-correlation analysis. However, one-dimensional cross-correlation algorithms are unable to provide accurate and precise strain estimation along all the angular insonification directions which can range from -45° to 45° with sector and phased array transducers. In addition, since sector and phased array based images have larger separations between beam lines as the pulse propagates deeper into tissue, signal decorrelation artifacts with deformation or tissue motion are more pronounced. In this article, the authors propose a multilevel two-dimensional hybrid algorithm for ultrasound sector and phased array data that demonstrate improved tracking and estimation performance when compared to the traditional 1D cross-correlation or 2D cross-correlation based methods. Experimental results demonstrate that the signal-to-noise and contrast-to-noise ratio estimates improve significantly for smaller window lengths for the hybrid method when compared to the currently used one-dimensional or two-dimensional cross-correlation algorithms. Strain imaging results on ex vivo thermal lesions created in liver tissue and in vivo on cardiac short-axis views demonstrate the improved image quality obtained with this method. [ABSTRACT FROM AUTHOR]

Abstract: Shear stresses are always present during quasi-static strain imaging, since tissue slippage occurs along the lateral and elevational directions during an axial deformation. Shear stress components along the axial deformation axes add to the axial deformation while perpendicular components introduce both lateral and elevational rigid motion and deformation artifacts into the estimated axial and lateral strain tensor images. A clear understanding of these artifacts introduced into the normal and shear strain tensor images with shear deformations is essential. In addition, signal processing techniques for improved depiction of the strain distribution is required. In this paper, we evaluate the impact of artifacts introduced due to lateral shear deformations on the normal strain tensors estimated by varying the lateral shear angle during an axial deformation. Shear strains are quantified using the lateral shear angle during the applied deformation. Simulation and experimental validation using uniformly elastic and single inclusion phantoms were performed. Variations in the elastographic signal-to-noise and contrast-to-noise ratios for axial deformations ranging from 0% to 5%, and for lateral deformations ranging from 0 to 5° were evaluated. Our results demonstrate that the first and second principal component strain images provide higher signal-to-noise ratios of 20dB with simulations and 10dB under experimental conditions and contrast-to-noise ratio levels that are at least 20dB higher when compared to the axial and lateral strain tensor images, when only lateral shear deformations are applied. For small axial deformations, the lateral shear deformations significantly reduces strain image quality, however the first principal component provides about a 1–2dB improvement over the axial strain tensor image. Lateral shear deformations also significantly increase the noise level in the axial and lateral strain tensor images with larger axial deformations. Improved elastographic signal and contrast-to-noise ratios in the first principal component strain image are always obtained for both simulation and experimental data when compared to the corresponding axial strain tensor images in the presence of both axial and lateral shear deformations. [Copyright &y& Elsevier]

In the current practice of ultrasound elastography, only the axial component of the displacement vector is estimated and used to produce strain images. A method was recently proposed by our group to estimate both the axial and lateral components of a displacement vector using RF echo signal data acquired along multiple angular insonification directions of the ultrasound beam. Previous work has demonstrated that it is important to choose appropriate values for the maximum beam angle and angular increment to achieve optimal performance with this technique. In this paper, we present error propagation analysis using the least- square fitting process for the optimization of the angular increment and the maximum beam steered angle. Ultrasound simulations are performed to corroborate the theoretical prediction of the optimal values for the maximum beam angle and angular increment. Selection of the optimal parameters depends on system parameters, such as center frequency and aperture size. For typical system parameters, the optimal maximum beam angle is around 10° for axial strain estimation and around 15° for lateral strain estimation. The optimal angular increment is around 4°-6°, which indicates that only five to seven beam angles are required for this strain-tensor estimation technique. [ABSTRACT FROM AUTHOR]

Abstract: Cardiac elastography using radiofrequency echo signals can provide improved 2D strain information compared to B-mode image data, provided data are acquired at sufficient frame rates. In this paper, we evaluate ultrasound frame rate requirements for unbiased and robust estimation of tissue displacements and strain. Both tissue-mimicking phantoms under cyclic compressions at rates that mimic the contractions of the heart and in vivo results are presented. Sinusoidal compressions were applied to the phantom at frequencies ranging from 0.5 to 3.5 cycles/sec, with a maximum deformation of 5% of the phantom height. Local displacements and strains were estimated using both a two-step one-dimensional and hybrid two-dimensional cross-correlation method. Accuracy and repeatability of local strains were assessed as a function of the ultrasound frame rate based on signal-to-noise ratio values. The maximum signal-to-noise ratio obtained in a uniformly elastic phantom is 20dB for both a 1.26Hz and a 2Hz compression frequency when the radiofrequency echo acquisition is at least 12Hz and 20Hz respectively. However, for compression frequencies of 2.8Hz and 4Hz the maximum signal-to-noise ratio obtained is around 16dB even for a 40Hz frame rate. Our results indicate that unbiased estimation of displacements and strain require ultrasound frame rates greater than ten times the compression frequency, although a frame rate of about two times the compression frequency is sufficient to estimate the compression frequency imparted to the tissue-mimicking phantom. In vivo results derived from short-axis views of the heart acquired from normal human volunteers also demonstrate this frame rate requirement for elastography. [Copyright &y& Elsevier]

Abstract: Many ultrasonic parameters, primarily related to attenuation and scatterer size, have been used to characterize the composition of atherosclerotic plaque tissue. In this study, we combine elastographic (axial strain ratio) and ultrasonic tissue characterization parameters, namely the attenuation coefficient and a scattering parameter associated with an “equivalent” scatterer size to delineate between fibrous, calcified, and lipidic plaque tissue. We present results obtained from 44 ex vivo atherosclerotic plaque specimens obtained after carotid endarterectomy on human patients. Our results in the frequency range 2.5∼7.5 MHz indicate that softer plaques (with higher values of the strain ratio) are usually associated with larger equivalent scatterer size estimates (200 ∼500 μm) and lower values of the attenuation coefficient slope (<1 dB/cm/MHz). On the other hand, stiffer plaques (with lower strain ratio values) are associated with smaller equivalent scatterer size estimates (100 ∼200 μm) and higher values of the attenuation coefficient slope (1∼3 dB/cm/MHz). These results indicate that ultrasonic tissue characterization and strain parameters have the potential to differentiate between different plaque types. These parameters can be estimated from radio-frequency data acquired under in vivo conditions and may help the clinician decide on appropriate interventional techniques. (E-mail: tvarghese@wisc.edu) [Copyright &y& Elsevier]

This article describes the evaluation of a novel method of tissue displacement for use in the elastographic visualization of radio-frequency (rf) ablation-induced lesions. The method involves use of the radio-frequency ablation electrode as a displacement device, which provides localized compression in the region of interest. This displacement mechanism offers the advantage of easy in vivo implementation since problems such as excessive lateral and elevational displacements present when using external compression are reduced with this approach. The method was tested on a single-inclusion tissue-mimicking phantom containing a radio-frequency ablation electrode rigidly attached to the inclusion center. Full-frame rf echo signals were acquired from the phantom before and after electrode displacements ranging from 0.05 to 0.2 mm. One-dimensional cross-correlation analysis between pre-and postcompression signals was used to measure tissue displacements, and strains were determined by computing the gradient of the displacement. The strain contrast, contrast-to-noise ratio, and signal-to-noise ratio were estimated from the resulting strain images. Comparisons are drawn between the elastographically measured dimensions and those known a priori for the single-inclusion phantom. Electrode displacement elastography was found to slightly underestimate the inclusion dimensions. The method was also tested on a second tissue-mimicking phantom and on in vitro rf-ablated lesions in canine liver tissue. The results validate previous in vivo findings that electrode displacement elastography is an effective method for monitoring rf ablation. [ABSTRACT FROM AUTHOR]

Elastography or elasticity imaging techniques typically image local strains or Young’s modulus variations along the insonification direction. Recently, techniques that utilize angular displacement estimates obtained from multiple angular insonification of tissue have been reported. Angular displacement estimates obtained along different angular insonification directions have been utilized for spatial-angular compounding to reduce noise artifacts in axial-strain elastograms, and for estimating the axial and lateral components of the displacement vector and the corresponding strain tensors. However, these angular strain estimation techniques were based on the assumption that noise artifacts in the displacement estimates were independent and identically distributed and that the displacement estimates could be modeled using a zero-mean normal probability density function. Independent and identically distributed random variables refer to a collection of variables that have the same probability distribution and are mutually independent. In this article, a modified least-squares approach is presented that does not make any assumption regarding the noise in the angular displacement estimates and incorporates displacement noise artifacts into the strain estimation process using a cross-correlation matrix of the displacement noise artifacts. Two methods for estimating noise artifacts from the displacement images are described. Improvements in the strain tensor (axial and lateral) estimation performance are illustrated utilizing both simulation data obtained using finite-element analysis and experimental data obtained from a tissue-mimicking phantom. Improvements in the strain estimation performance are quantified in terms of the elastographic signal-to-noise and contrast-to-noise ratios obtained with and without the incorporation of the displacement noise artifacts into the least-squares strain estimator. [ABSTRACT FROM AUTHOR]

In this article we investigate the generation of shear strain elastograms induced using a lateral shear deformation. Ultrasound simulation and experimental results demonstrate that the shear strain elastograms obtained under shear deformation exhibit significant differences between bound and unbound inclusions in phantoms, when compared to shear strain images induced upon an axial compression. A theoretical model that estimates the decorrelation between pre- and postdeformation radio frequency signals, as a function of extent of shear deformation, is also developed. Signal-to-noise ratios of shear strain elastograms obtained at different shear angles are investigated theoretically and verified using ultrasound simulations on a uniformly elastic phantom. For the simulation and experiment, a two-dimensinal block-matching-based algorithm is used to estimate the axial and lateral displacement. Shear strains are obtained from the displacement vectors using a least-squares strain estimator. Our results indicate that the signal-to-noise ratio (SNR) of shear strain images increases to reach a maximum and saturates, and then decreases with increasing shear angle. Using typical system parameters, the maximum achievable SNR for shear strain elastography is around 8 (18 dB), which is comparable to conventional axial strain elastography induced by axial compression. Shear strain elastograms obtained experimentally using single inclusion tissue-mimicking phantoms with both bound and unbound inclusions (mimicking cancerous masses and benign fibroadenomas, respectively) demonstrate the characteristic differences in the depiction of these inclusions on the shear strain elastograms. [ABSTRACT FROM AUTHOR]

Abstract: Spatial-angular compounding is a new technique developed for improving the signal-to-noise ratio (SNR) in elastography. Under this method, elastograms of a region-of-interest (ROI) are obtained from a spatially weighted average of local strain estimated along different insonification angles. In this article, we investigate the improvements in the strain contrast and contrast-to-noise ratio (CNR) of the spatially compounded elastograms. Spatial angular compounding is also applied and evaluated in conjunction with global temporal stretching. Quantitative experimental results obtained using a single-inclusion tissue-mimicking phantom demonstrate that the strain contrast reduces slightly but the CNR improves by around 8 to 13 dB. We also present experimental spatial angular compounding results obtained from an in vitro thermal lesion in canine liver tissue embedded in a gelatin phantom that demonstrate the improved visual characteristics (due to the improved CNR) of the compound elastogram. The experimental results provide guidelines for the practical range of maximum insonification angles and estimates of the optimum angular increment. (E-mail: ) [Copyright &y& Elsevier]

Wavelet shrinkage denoising of the displacement estimates to reduce noise artefacts, especially at high overlaps in elastography, is presented in this paper. Correlated errors in the displacement estimates increase dramatically with an increase in the overlap between the data segments. These increased correlated errors (due to the increased correlation or similarity between consecutive displacement estimates) generate the so-called “worm” artefact in elastography. However, increases in overlap on the order of 90% or higher are essential to improve axial resolution in elastography. The use of wavelet denoising significantly reduces errors in the displacement estimates, thereby reducing the worm artefacts, without compromising on edge (high-frequency or detail) information in the elastogram. Wavelet denoising is a term used to characterize noise rejection by thresholding the wavelet coefficients. Worm artefacts can also be reduced using a low-pass filter; however, low-pass filtering of the displacement estimates does not preserve local information such as abrupt change in slopes, causing the smoothing of edges in the elastograms. Simulation results using the analytic 2-D model of a single inclusion phantom illustrate that wavelet denoising produces elastograms with the closest correspondence to the ideal mechanical strain image. Wavelet denoising applied to experimental data obtained from an in vitro thermal lesion phantom generated using radiofrequency (RF) ablation also illustrates the improvement in the elastogram noise characteristics. (E-mail: tvarghese@wisc.edu) [Copyright &y& Elsevier]

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 [ABSTRACT FROM AUTHOR]

Purpose: Quantification of stiffness changes may provide important diagnostic information and aid in the early detection of cancers. Shear wave elastography is an imaging technique that assesses tissue stiffness using acoustic radiation force as an alternate to manual palpation reported previously with quasistatic elastography. In this study, the elastic properties of tissue mimicking materials, including agar, polyacrylamide (PAA), and silicone, are evaluated with an objective to determine material characteristics which resemble normal and cancerous prostate tissue. Methods: Acoustic properties and stiffness of tissue mimicking phantoms were measured using compressional mechanical testing and shear wave elastography using supersonic shear imaging. The latter is based on the principles of shear waves generated using acoustic radiation force. The evaluation included tissue mimicking materials (TMMs) within the prostate at different positions and sizes that could mimic cancerous and normal prostate tissue. Patient data on normal and prostate cancer tissues quantified using biopsy histopathology were used to validate the findings. Pathologist reports on histopathology were blinded to mechanical testing and elastographic findings. Results: Young's modulus values of 86.2 ± 4.5 and 271.5 ± 25.7 kPa were obtained for PAA mixed with 2% Al2O3 particles and silicone, respectively. Young's modulus of TMMs from mechanical compression testing showed a clear trend of increasing stiffness with an increasing percentage of agar. The silicone material had higher stiffness values when compared with PAA with Al2O3. The mean Young's modulus value in cancerous tissue was 90.5 ± 4.5 kPa as compared to 93.8 ± 4.4 and 86.2 ± 4.5 kPa obtained with PAA with 2% Al2O3 phantom at a depth of 52.4 and 36.6 mm, respectively. Conclusions: PAA mixed with Al2O3 provides the most suitable tissue mimicking material for prostate cancer tumor material, while agar could form the surrounding background to simulate normal prostate tissue. [ABSTRACT FROM AUTHOR]

Microwave ablation has been used clinically as an alternative to surgical resection. However, lack of real-time imaging to assess treated regions may compromise treatment outcomes. We previously introduced electrode displacement elastography (EDE) for strain imaging and verified its feasibility in vivo on porcine animal models. In this study, we evaluated EDE on 44 patients diagnosed with hepatocellular carcinoma, treated using microwave ablation. The ablated region was identified on EDE images for 40 of the 44 patients. Ablation areas averaged 13.38 ± 4.99 cm 2 on EDE, compared with 7.61 ± 3.21 cm 2 on B-mode imaging. Contrast and contrast-to-noise ratios obtained with EDE were 232% and 98%, respectively, significantly higher than values measured on B-mode images ( p < 0.001). This study indicates that EDE is feasible in patients and provides improved visualization of the ablation zone compared with B-mode ultrasound. [ABSTRACT FROM AUTHOR]

Abstract: Instability in carotid vulnerable plaque can generate cerebral micro-emboli, which may be related to both stroke and eventual cognitive abnormality. Strain imaging to detect plaque vulnerability based on regions with large strain fluctuations, with arterial pulsation, may be able to determine the risk of cognitive impairment. Plaque instability may be characterized by increased strain variations over a cardiac cycle. Radiofrequency signals for ultrasound strain imaging were acquired from the carotid arteries of 24 human patients using a Siemens Antares with a VFX 13-5 linear array transducer. These patients underwent standardized cognitive assessment (Repeatable Battery for the Assessment of Neuropsychological Status [RBANS]). Plaque regions were segmented by a radiologist at end-diastole using the Medical Imaging Interaction Toolkit. A hierarchical block-matching motion tracking algorithm was used to estimate the cumulated axial, lateral and shear strains within the imaging plane. The maximum, minimum and peak-to-peak strain indices in the plaque computed from the mean cumulated strain over a small region of interest in the plaque with large deformations were obtained. The maximum and peak-to-peak mean cumulated strain indices over the entire plaque region were also computed. All strain indices were then correlated with RBANS Total performance. Overall cognitive performance (RBANS Total) was negatively associated with values of the maximum strain and the peak-to-peak for axial and lateral strains, respectively. There was no significant correlation between the RBANS Total score and shear strain and strain indices averaged over the entire identified plaque for this group of patients. However, correlation of maximum lateral strain was higher for symptomatic patients (r = −0.650, p = 0.006) than for asymptomatic patients (r = −0.115, p = 0.803). On the other hand, correlation of maximum axial strain averaged over the entire plaque region was significantly higher for asymptomatic patients (r = −0.817, p = 0.016) than for symptomatic patients (r = −0.224, p = 0.402). The results reveal a direct relationship between the maximum axial and lateral strain indices in carotid plaque and cognitive impairment. [Copyright &y& Elsevier]

Abstract: Axial strain imaging has been utilized for the characterization of breast masses for over a decade; however, another important feature namely the shear strain distribution around breast masses has only recently been used. In this article, we examine the feasibility of utilizing in vivo axial-shear strain imaging for differentiating benign from malignant breast masses. Radio-frequency data was acquired using a VFX 13-5 linear array transducer on 41 patients using a Siemens SONOLINE Antares real-time clinical scanner at the University of Wisconsin Breast Cancer Center. Free-hand palpation using deformations of up to 10% was utilized to generate axial strain and axial-shear strain images using a two-dimensional cross-correlation algorithm from the radio-frequency data loops. Axial-shear strain areas normalized to the lesion size, applied strain and lesion strain contrast was utilized as a feature for differentiating benign from malignant masses. The normalized axial-shear strain area feature estimated on eight patients with malignant tumors and 33 patients with fibroadenomas was utilized to demonstrate its potential for lesion differentiation. Biopsy results were considered the diagnostic standard for comparison. Our results indicate that the normalized axial-shear strain area is significantly larger for malignant tumors compared with benign masses such as fibroadenomas. Axial-shear strain pixel values greater than a specified threshold, including only those with correlation coefficient values greater than 0.75, were overlaid on the corresponding B-mode image to aid in diagnosis. A scatter plot of the normalized area feature demonstrates the feasibility of developing a linear classifier to differentiate benign from malignant masses. The area under the receiver operator characteristic curve utilizing the normalized axial-shear strain area feature was 0.996, demonstrating the potential of this feature to noninvasively differentiate between benign and malignant breast masses. (E-mail: tvarghese@wisc.edu) [Copyright &y& Elsevier]

Abstract: The viscoelastic characteristics of thermal lesions in ex vivo animal liver are investigated in this paper. Characterization of the moduli of thermal lesions prepared at several temperatures will provide additional information for the elastographic monitoring of radio frequency ablation of hepatic tumors. In this study, the frequency-dependent complex modulus of thermal lesions prepared at temperatures ranging from 60 to 90°C over a frequency range from 0.1 to 50Hz are presented. Lesions were prepared using either radio frequency ablation or double immersion boiling. It was found that both the magnitude and phase of the modulus increase with frequency, a behavior that has been noted in the literature. A new result reported shows that the modulus dependence on temperature reveals a local maximum around 70–75°C corresponding to the temperature at which tissue has released most of its water content. The modulus values at temperatures higher than 70°C continued to increase, but the extent of increase depend on animal species and other factors. [Copyright &y& Elsevier]

Abstract: Because ablation therapy alters the elastic modulus of tissues, emerging strain imaging methods may enable clinicians for the first time to have readily available, cost-effective, real-time guidance to identify the location and boundaries of thermal lesions. Electrode displacement elastography is a method of strain imaging tailored specifically to ultrasound-guided electrode-based ablative therapies (e.g., radio-frequency ablation). Here tissue deformation is achieved by applying minute perturbations to the unconstrained end of the treatment electrode, resulting in localized motion around the end of the electrode embedded in tissue. In this article, we present a method for three-dimensional (3D) elastographic reconstruction from volumetric data acquired using the C7F2 fourSight four-dimensional ultrasound transducer, provided by Siemens Medical Solutions USA, Inc. (Issaquah, WA, USA). Lesion reconstruction is demonstrated for a spherical inclusion centered in a tissue-mimicking phantom, which simulates a thermal lesion embedded in a normal tissue background. Elastographic reconstruction is also performed for a thermal lesion created in vitro in canine liver using radio-frequency ablation. Postprocessing is done on the acquired raw radio-frequency data to form surface-rendered 3D elastograms of the inclusion. Elastographic volume estimates of the inclusion compare reasonably well with the actual known inclusion volume, with 3D electrode displacement elastography slightly underestimating the true inclusion volume. (E-mail: tvarghese@wisc.edu) [Copyright &y& Elsevier]

Abstract: The cross-correlation algorithm used to compute the local strain components for elastographic imaging requires a minimum radio-frequency data segment length of around 10 wavelengths to obtain accurate and precise strain estimates with a reasonable signal-to-noise ratio. Shorter radio-frequency data segments generally introduce increased estimation errors as the information content in the data segment reduces. However, shorter data segments and increased overlaps are essential to improve the axial resolution in the strain image. In this paper, we propose a two-step cross-correlation technique that enables the use of window lengths on the order of a single wavelength to provide displacement and strain estimates with similar noise properties as those obtained with a 10 wavelength window. The first processing step utilizes a window length on the order of 10 wavelengths to obtain coarse displacement estimates between the pre- and postcompression radio frequency data frames. This coarse displacement is then interpolated and utilized as the initial guess-estimate for the second cross-correlation processing step using the smaller window. This step utilizes a single wavelength window to improve the axial resolution in strain estimation, without significantly compromising the noise properties of the image. Simulation and experimental results show that the signal-to-noise and contrast-to-noise ratio estimates improve significantly at the smaller window lengths with the two-step processing when compared with the use of a similar sized window in the currently utilized single window method. (E-mail: tvarghese@wisc.edu) [Copyright &y& Elsevier]

Abstract: Delineation of radiofrequency-ablation-induced coagulation (thermal lesion) boundaries is an important clinical problem that is not well addressed by conventional imaging modalities. Elastography, which produces images of the local strain after small, externally applied compressions, can be used for visualization of thermal coagulations. This paper presents an automated segmentation approach for thermal coagulations on 3-D elastographic data to obtain both area and volume information rapidly. The approach consists of a coarse-to-fine method for active contour initialization and a gradient vector flow, active contour model for deformable contour optimization with the help of prior knowledge of the geometry of general thermal coagulations. The performance of the algorithm has been shown to be comparable to manual delineation of coagulations on elastograms by medical physicists (r = 0.99 for volumes of 36 radiofrequency-induced coagulations). Furthermore, the automatic algorithm applied to elastograms yielded results that agreed with manual delineation of coagulations on pathology images (r = 0.96 for the same 36 lesions). This algorithm has also been successfully applied on in vivo elastograms. (E-mail: wuliu@wisc.edu) [Copyright &y& Elsevier]

Abstract: Intravascular ultrasound (US) elastography reveals the elastic properties of vascular tissue and plaque. However, misalignment of the US catheter in the vessel lumen can cause incorrect strain estimation in intravascular US elastography caused by strain projection artifacts. In this paper, we present a general theoretical solution where the impact of catheter eccentricity, tilt and noncoplanar errors on the strain estimates are derived. Appropriate corrections to strain estimates can then be applied with prior knowledge of the catheter position information to reduce the strain projection artifacts. Simulations using a frequency-domain–based algorithm that models intravascular US imaging before and after a specified deformation are presented. The simulations are used to verify the theoretical derivations for two displacement situations (linear and nonlinear) under intraluminal pressure, with and without stress decay. The linear displacement case demonstrates that the correction factor is dependent only on the angle between the US beam and the cross-sectional plane of the vessel. For the nonlinear displacement case, where a l/r stress decay in the displacement is modeled, the correction factor becomes a more complicated function of the azimuthal angle. (E-mail: tvarghese@wisc.edu) [Copyright &y& Elsevier]

Liver cancer is a leading cause of cancer-related deaths; however, primary treatment options such as surgical resection and liver transplant may not be viable for many patients. Minimally invasive image-guided microwave ablation (MWA) provides a locally effective treatment option for these patients with an impact comparable to that of surgery for both cancer-specific and overall survival. MWA efficacy is correlated with accurate image guidance; however, conventional modalities such as B-mode ultrasound and computed tomography have limitations. Alternatively, ultrasound elastography has been used to demarcate post-ablation zones, yet has limitations for pre-ablation visualization because of variability in strain contrast between cancer types. This study attempted to characterize both pre-ablation tumors and post-ablation zones using electrode displacement elastography (EDE) for 13 patients with hepatocellular carcinoma or liver metastasis. Typically, MWA ablation margins of 0.5-1.0 cm are desired, which are strongly correlated with treatment efficacy. Our results revealed an average estimated ablation margin inner quartile range of 0.54-1.21 cm with a median value of 0.84 cm. These treatment margins lie within or above the targeted ablative margin, indicating the potential to use EDE for differentiating index tumors and ablated zones during clinical ablations. We also obtained a high correlation between corresponding segmented cross-sectional areas from contrast-enhanced computed tomography, the current clinical gold standard, when compared with EDE strain images, with r2 values of 0.97 and 0.98 for pre- and post-ablation regions. [ABSTRACT FROM AUTHOR]

Vascular cognitive decline may be caused by micro-emboli generated by carotid plaque instability. We previously found that maximum strain indices in carotid plaque were significantly correlated with cognitive function. In the work described here, we examined these associations with a larger sample size, as well as evaluated the performance of these maximum strain indices in predicting cognitive impairment. Ultrasound-based strain imaging and cognition assessment were conducted on 75 human patients. Patients underwent one of two standardized cognitive test batteries, either the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) or the National Institute of Neurologic Disorder and Stroke-Canadian Stroke Network (NINDS-CSN) Vascular Cognitive Impairment Harmonization Standards (60 min). Scores were standardized within each battery to allow these data to be combined across all participants. Radiofrequency signals for ultrasound strain imaging were acquired on the carotid arteries using either a Siemens Antares with a VFX 13-5 linear array transducer or a Siemens S2000 with an 18 L6 linear array transducer. The same hierarchical block-matching motion tracking algorithm developed in our laboratory was used to estimate accumulated axial, lateral, and shear strain indices in carotid plaque, with inclusion of adventitia regardless of the ultrasound system and transducer used. Associations between cognitive z-scores and maximum strain indices were examined using Pearson's correlation coefficients. Maximum strain indices were also employed to predict cognitive impairment using receiver operating characteristic analysis. All correlations between maximum strain indices and total cognition were statistically significant (p < 0.05), indicating that these indices have good utility in predicting cognitive impairment. Maximum lateral strain indices provided an area under the curve of 0.85 for symptomatic patients and 0.68 for asymptomatic patients. Our results indicate the important relationship of maximum strain indices to cognitive function and the feasibility of using maximum strain indices to predict cognitive decline with inclusion of the adventitia layer into the segmentation of plaque. [ABSTRACT FROM AUTHOR]

Abstract: Two anthropomorphic uterine phantoms were developed that allow assessment and comparison of strain imaging systems adapted for use with saline-infused sonohysterography (SIS). Tissue-mimicking (TM) materials consist of dispersions of safflower oil in gelatin. TM fibroids are stiffer than the TM myometrium/cervix, and TM polyps are softer. The first uterine phantom has 3-mm-diameter TM fibroids distributed randomly in TM myometrium. The second uterine phantom has a 5-mm and 8-mm spherical TM fibroid, in addition to a 5-mm spherical and a 12.5-mm-long (medicine capsule–shaped) TM endometrial polyp protruding into the endometrial cavity; also, a 10-mm spherical TM fibroid projects from the serosal surface. Strain images using the first phantom show the stiffer 3-mm TM fibroids in the myometrium. Results from the second uterine phantom show that, as expected, parts of inclusions projecting into the uterine cavity will appear very stiff, whether they are stiff or soft. Results from both phantoms show that although there is a five-fold difference in the Young''s moduli values, there is not a significant difference in the strain in the transition from the TM myometrium to the TM fat. These phantoms allow for realistic comparison and evolution of SIS strain imaging techniques and can aid clinical personnel to develop skills for SIS strain imaging. (E-mail: mahobson@gmail.com) [Copyright &y& Elsevier]

Abstract: Two equivalent anthropomorphic breast phantoms were constructed, one for use in ultrasound elastography and the other in magnetic resonance (MR) elastography. A complete description of the manufacturing methods is provided. The materials used were oil-in-gelatin dispersions, where the volume percent oil differentiates the materials, primarily according to Young’s moduli. Values of Young’s moduli are in agreement with in vitro ranges for the corresponding normal and abnormal breast tissues. Ultrasound and nuclear magnetic resonance (NMR) properties are reasonably well represented. Phantoms of the type described promise to aid researchers who are developing hardware and software for elastography. Examples of ultrasound and MR elastograms of the phantoms are included to demonstrate the utility of the phantoms. Also, the level of stability of elastic properties of the component materials is quantified over a 15-month period. Such phantoms can serve as performance-assessing intermediaries between simple phantoms (consisting, for example, of homogeneous cylindrical inclusions in a homogeneous background) and a full-scale clinical trial. Thus, premature clinical trials may be avoided. (E-mail: elmadsen@wisc.edu) [Copyright &y& Elsevier]

Abstract: A set of five tissue-mimicking phantoms with cylindrical inclusions were produced for assessing long-term stability of geometry and elastic properties and assessing accuracy of determination of elastic properties. The base aqueous materials were either gelatin or a mixture of agar and gelatin. Stiffness was controlled by selection of the volume percent consisting of microscopic safflower oil droplets. Cylinder diameters remained unchanged within 1% or 2% over many months. Strain ratios from elastograms of the phantoms were stable over many months, implying that elastic contrasts were also stable. Test samples, called production samples, for measurement of Young’s moduli were made at the time of manufacture of each phantom and were stored separately from one another. Each production sample was homogeneous and consisted of either inclusion material or background material. For all five phantoms, it was found that the elastic contrast computed using Young’s modulus values determined using the production samples accurately represented the true elastic contrasts in the corresponding phantom. This finding was established by the fact that the (true) elastic contrasts determined using samples excised from the phantoms themselves agreed with the elastic contrasts obtained using the homogeneous production samples. (E-mail: elmadsen@wisc.edu) [Copyright &y& Elsevier]

Abstract: The variations in the stiffness or stiffness contrast of lesions resulting from radiofrequency (RF) ablation of canine liver tissue at different temperatures and for different ablation durations at a specified temperature are analyzed. Tissue stiffness, in general, increases with temperature; however, an anomaly exists around 80 ° C, where the stiffness of the lesion is lower than that of the lesion ablated at 70 °C. On the other hand, the stiffness increases monotonically with the duration of ablation. Plots illustrating the ratio of mean strains in normal canine liver tissue to mean strains in ablated thermal lesions demonstrate the variation in the stiffness contrast of the thermal lesions. The contrast-to-noise ratio (CNRe) of the lesions, which serves as an indicator of the detectability of the lesions under the different experimental imaging conditions described above, is also presented. The results presented in this paper show that the elastographic depiction of stiffer thermal lesions is better, in terms of the CNRe parameter. An important criterion in the elastographic depiction of RF-ablated regions of tissue is the trade-off between ablation temperature and duration of ablation. Tissue necrosis can occur either by ablating tissue to high temperatures for short durations or to lower temperatures for longer durations. In this paper, we attempt to characterize the elastographic depiction of thermal lesions under these different experimental conditions. This paper provides results that may be utilized by practitioners of RF ablation to decide the ablation temperature and duration, on the basis of the strain images of normal liver tissue and ablated thermal lesions discussed in this paper. (E-mail: tvarghese@wisc.edu) [Copyright &y& Elsevier]