Cardiac 2-D Shear Wave Imaging Using a New Dedicated Clinical Ultrasound System: A Phantom Study.

OBJECTIVE: The purpose of this study was to assess cardiac shear wave imaging implemented in a new MACH 30 ultrasound machine (SuperSonic Imaging, Aix-en-Provence, France) and interfaced with a linear probe and a phased array probe, in comparison with a previously validated Aixplorer system connected to a linear probe (SuperSonic Imaging) using Elasticity QA phantoms (Models 039 and 049, CIRS Inc., Norfolk, VA, USA). METHODS: Quantile-quantile plots were used for distribution agreement. The accuracy of stiffness measurement was assessed by the percentage error and the mean percentage error (MPE), and its homogeneity, by the standard deviation of the MPE. A p value <0.01 was considered to indicate statistical significance. RESULTS: The accuracy of dedicated cardiac sequences for linear probes was similar for the two systems with an MPE of 8 ± 14% versus 20 ± 21% (p = not significant) with the SuperSonic MACH 30 and Aixplorer, respectively, and was influenced by target stiffness and location of the measurement in the field of view, but without drift over time. The optimal transthoracic cardiac probe workspace was located between 4 and 10 cm, with an MPE of 29.5 ± 25% compared with 93.3 ± 130% outside this area (p < 0.0001). In this area, stiffness below 20 kPa was significantly different from the reference (p < 0.0001). The sectorial probe revealed no MPE difference in any of the measurement areas, with no significant lateral or axial gradient. CONCLUSION: The new Supersonic MACH 30 system upgraded with a sectorial probe and specific cardiac settings provided homogenous stiffness measurements, especially when operating at depths between 4 and 10 cm. These phantom results may be useful in designing future in vivo studies.

In plane quantification ofin vivomuscle elastic anisotropy factor by steered ultrasound pushing beams.

Objective.Skeletal muscles are organized into distinct layers and exhibit anisotropic characteristics across various scales. Assessing the arrangement of skeletal muscles may provide valuable biomarkers for diagnosing muscle-related pathologies and evaluating the efficacy of clinical interventions.Approach. In this study, we propose a novel ultrafast ultrasound sequence constituted of steered pushing beams was proposed for ultrasound elastography applications in transverse isotropic muscle. Based on the propagation of the shear wave vertical mode, it is possible to fit the experimental results to retrieve in the same imaging plane, the shear modulus parallel to fibers as well as the elastic anisotropy factor (ratio of Young's moduli times the shear modulus perpendicular to fibers).Main results. The technique was demonstratedin vitroin phantoms andex vivoin fusiform beef muscles. At last, the technique was appliedin vivoon fusiform muscles (biceps brachii) and mono-pennate muscles (gastrocnemius medialis) during stretching and contraction.Significance. This novel sequence provides access to new structural and mechanical biomarkers of muscle tissue, including the elastic anisotropy factor, within the same imaging plane. Additionally, it enables the investigation of multiples parameters during muscle active and passive length changes.

Comparison of ultrasound elastography, magnetic resonance elastography and finite element model to quantify nonlinear shear modulus.

Objective. The aim of this study is to validate the estimation of the nonlinear shear modulus (A) from the acoustoelasticity theory with two experimental methods, ultrasound (US) elastography and magnetic resonance elastography (MRE), and a finite element method.Approach. Experiments were performed on agar (2%)-gelatin (8%) phantom considered as homogeneous, elastic and isotropic. Two specific setups were built to ensure a uniaxial stress step by step on the phantom, one for US and a nonmagnetic version for MRE. The stress was controlled identically in both imaging techniques, with a water tank placed on the top of the phantom and filled with increasing masses of water during the experiment. In US, the supersonic shear wave elastography was implemented on an ultrafast US device, driving a 6 MHz linear array to measure shear wave speed. In MRE, a gradient-echo sequence was used in which the three spatial directions of a 40 Hz continuous wave displacement generated with an external driver were encoded successively. Numerically, a finite element method was developed to simulate the propagation of the shear wave in a uniaxially stressed soft medium.Main results. Similar shear moduli were estimated at zero stress using experimental methods,µ0US= 12.3 ± 0.3 kPa andµ0MRE= 11.5 ± 0.7 kPa. Numerical simulations were set with a shear modulus of 12 kPa and the resulting nonlinear shear modulus was found to be -58.1 ± 0.7 kPa. A very good agreement between the finite element model and the experimental models (AUS= -58.9 ± 9.9 kPa andAMRE= -52.8 ± 6.5 kPa) was obtained.Significance. These results show the validity of such nonlinear shear modulus measurement quantification in shear wave elastography. This work paves the way to develop nonlinear elastography technique to get a new biomarker for medical diagnosis.

Resistivity index mapping in Kidney based on ultrasensitive Pulsed-Wave Doppler and automatic spectrogram envelope detection.

In recent years, ultrasensitive Pulsed-Wave Doppler (uPWD) ultrasound (US) has emerged as an alternative imaging approach for microcirculation imaging and as a complementary tool to other imaging modalities, such as positron emission tomography (PET). uPWD is based on the acquisition of a large set of highly spatiotemporally coherent frames, which allows high-quality images of a wide field of view to be obtained. In addition, these acquired frames allow calculation of the resistivity index (RI) of the pulsatile flow detected over the entire field of view, which is of great interest to clinicians, for example, in monitoring the transplanted kidney course. This work aims to develop and evaluate a method to automatically obtain an RI map of the kidney based on the uPWD approach. The effect of time gain compensation (TGC) on the visualization of vascularization and aliasing on the blood flow frequency response, was also assessed. A pilot study conducted in patients referred for renal transplant Doppler examination showed that the proposed method provided relative errors of about 15% for RI measurements with respect to conventional pulsed-wave (PW) Doppler.

Pulse-echo speed-of-sound imaging using convex probes.

Computed ultrasound tomography in echo mode (CUTE) is a new ultrasound (US)-based medical imaging modality with promise for diagnosing various types of disease based on the tissue's speed of sound (SoS). It is developed for conventional pulse-echo US using handheld probes and can thus be implemented in state-of-the-art medical US systems. One promising application is the quantification of the liver fat fraction in fatty liver disease. So far, CUTE was using linear array probes where the imaging depth is comparable to the aperture size. For liver imaging, however, convex probes are preferred since they provide a larger penetration depth and a wider view angle allowing to capture a large area of the liver. With the goal of liver imaging in mind, we adapt CUTE to convex probes, with a special focus on discussing strategies that make use of the convex geometry in order to make our implementation computationally efficient. We then demonstrate in an abdominal imaging phantom that accurate quantitative SoS using convex probes is feasible, in spite of the smaller aperture size in relation to the image area compared to linear arrays. A preliminaryin vivoresult of liver imaging confirms this outcome, but also indicates that deep quantitative imaging in the real liver can be more challenging, probably due to the increased complexity of the tissue compared to phantoms.

Fourier-Domain Beamforming and Structure-Based Reconstruction for Plane-Wave Imaging.

Ultrafast imaging based on coherent plane-wave compounding is one of the most important recent developments in medical ultrasound. It significantly improves the image quality and allows for much faster image acquisition. This technique, however, requires large computational load motivating methods for sampling and processing rate reduction. In this work, we extend the recently proposed frequency-domain beamforming (FDBF) framework to plane-wave imaging. Beamforming in frequency yields the same image quality while using fewer samples. It achieves at least fourfold sampling and processing rate reduction by avoiding oversampling required by standard processing. To further reduce the rate, we exploit the structure of the beamformed signal and use compressed sensing methods to recover the beamformed signal from its partial frequency data obtained at a sub-Nyquist rate. Our approach obtains tenfold rate reduction compared with standard time-domain processing. We verify performance in terms of spatial resolution and contrast based on the scans of a tissue mimicking the phantom obtained by a commercial Aixplorer system. In addition, in vivo carotid and thyroid scans processed using standard beamforming and FDBF are presented for qualitative evaluation and visual comparison. Finally, we demonstrate the use of FDBF for shear-wave elastography by generating velocity maps from the beamformed data processed at sub-Nyquist rates.