Continuous Shear Wave Elastography for Liver Using Frame-to-Frame Equalization of Complex Amplitude.

This study addresses a crucial necessity in the field of noninvasive liver fibrosis diagnosis by introducing the concept of continuous shear wave elastography (C-SWE), utilizing an external vibration source and color Doppler imaging. However, an application of C-SWE to assess liver elasticity, a deep region within the human body, arises an issue of signal instability in the obtained data. To tackle this challenge, this work proposes a method involving the acquisition of multiple frames of datasets, which are subsequently compressed. Furthermore, the proposed frame-to-frame equalization method compensates discrepancies in the initial phase that might exist among multiple-frame datasets, thereby significantly enhancing signal stability. The experimental validation of this approach encompasses both phantom tests and in vivo experiments. In the phantom tests, the proposed technique is validated through a comparison with the established shear wave elastography (SWE) technique. The results demonstrate a remarkable agreement, with an error in shear wave velocity of less than 4.2%. Additionally, the efficacy of the proposed method is confirmed through in vivo tests. As a result, the stabilization of observed shear waves using the frame-to-frame equalization technique exhibits promising potential for accurately assessing human liver elasticity. These findings collectively underscore the viability of C-SWE as a potential diagnostic instrument for liver fibrosis.

Examination of rapid adjustment system based on screen score obtained using continuous shear wave elastography.

PURPOSE: Continuous shear wave elastography (C-SWE) can be expected to be applied to portable muscle elasticity diagnosis. To establish diagnostic technology, it will be necessary to improve measurement techniques and quantitative measurement accuracy. METHODS: In this study, we investigated two screen scores: the quality index (Q-index), which determines whether the intensity of a power Doppler image is appropriate, and the shear wave propagation direction index (SWDI), which determines the uniformity of shear wave propagation. RESULTS: First, we performed numerical simulations with white noise and found that the coefficient of variation of shear wave velocity estimation was less than 5% when the normalized Q-index was greater than 0.27. Furthermore, regarding the SWDI, we clarified the relationship between the standard deviation in shear wave propagation direction and the SWDI. Next, the relationship between the Q-index and coefficient of variation of estimated shear wave velocity was evaluated through experiments using a tissue-mimicking phantom. The results showed that there was a negative correlation between the Q-index and the coefficient of variation, and the fluctuation of the propagation velocity could be inferred from the Q-index. Finally, we showed the results of applying the screen scores to muscle relaxation monitoring and confirmed its usefulness in clinical applications. CONCLUSION: By applying the screen scores, we showed improved stability in speed estimation in C-SWE, and demonstrated the possibility of clinical applicability.

B-line Elastography Measurement of Lung Parenchymal Elasticity.

This paper proposes a method to determine the elasticity of the lung parenchyma from the B-line Doppler signal observed using continuous shear wave elastography, which uses a small vibrator placed on the tissue surface to propagate continuous shear waves with a vibration frequency of approximately 100 Hz. Since the B-line is generated by multiple reflections in fluid-storing alveoli near the lung surface, the ultrasonic multiple-reflection signal from the B-line is affected by the Doppler shift due to shear waves propagating in the lung parenchyma. When multiple B-lines are observed, the propagation velocity can be estimated by measuring the difference in propagation time between the B-lines. Therefore, continuous shear wave elastography can be used to determine the elasticity of the lung parenchyma by measuring the phase difference of shear wave between the B-lines. In this study, three elastic sponges (soft, medium, and hard) with embedded glass beads were used to simulate fluid-storing alveoli. Shear wave velocity measured using the proposed method was compared with that calculated using Young's modulus obtained from compression measurement. Using the proposed method, the measured shear wave velocities (mean ± S.D.) were 3.78 ± 0.23, 4.24 ± 0.12, and 5.06 ± 0.05 m/s for soft, medium, and hard sponges, respectively, which deviated by a maximum of 5.37% from the values calculated using the measured Young's moduli. The shear wave velocities of the sponge phantom were in a velocity range similar to the mean shear wave velocities of healthy and diseased lungs reported by magnetic resonance elastography (3.25 and 4.54 m/s, respectively). B-line elastography may enable emergency diagnoses of acute lung disease using portable ultrasonic echo devices.

Observing Bubble Cavitation by Back-Propagation of Acoustic Emission Signals.

Temporal- and spatial-resolved observations of microbubble cavitation generated through high-intensity ultrasound irradiation are key in improving both the efficiency and efficacy of ultrasound-assisted drug delivery systems. A method of measuring bubble cavitation applying an image-reconstruction technique of back-propagation of an acoustic cavitation emission (ACE) signal is proposed. A high-intensity focused ultrasound wave (pump wave) irradiates the bubble synchronously using ultrasound recording equipment to acquire the timing of the RF signal, which is produced when the bubble radiates a secondary wave during bubble cavitation. The ACE signal source is reconstructed through ultrasound-wave back-propagation followed by amplitude deconvolution. The proposed method was applied to microbubbles of an ultrasound contrast agent by changing the sound pressure of the pump wave. The method reliability of the temporal resolution was verified by simulating the amplitude-modulated signal of the virtual sound source. The temporal transition of the ACE signal exhibited sub-microsecond-order fluctuations in the signal intensity. From the amplitude signal image and the instantaneous frequency image reconstruction of the proposed method, two different ACE phenomena were visualized. One is the periodic pattern by the beat signals from the harmonic and ultraharmonic component of nonlinear oscillation under low-intensity ultrasound conditions. The other is the nonperiodic temporal and spatial distributions of this irradiation under high-intensity ultrasound conditions.

Shear Wave Imaging of Breast Tissue by Color Doppler Shear Wave Elastography.

Shear wave elastography is a distinctive method to access the viscoelastic characteristic of the soft tissue that is difficult to obtain by other imaging modalities. This paper proposes a novel shear wave elastography [color Doppler shear wave imaging (CD SWI)] for breast tissue. Continuous shear wave is produced by a small lightweight actuator, which is attached to the tissue surface. Shear wave wavefront that propagates in tissue is reconstructed as a binary pattern that consists of zero and the maximum flow velocities on color flow image (CFI). Neither any modifications of the ultrasound color flow imaging instrument nor a high frame rate ultrasound imaging instrument is required to obtain the shear wave wavefront map. However, two conditions of shear wave displacement amplitude and shear wave frequency are needed to obtain the map. However, these conditions are not severe restrictions in breast imaging. This is because the minimum displacement amplitude is [Formula: see text] for an ultrasonic wave frequency of 12 MHz and the shear wave frequency is available from several frequencies suited for breast imaging. Fourier analysis along time axis suppresses clutter noise in CFI. A directional filter extracts shear wave, which propagates in the forward direction. Several maps, such as shear wave phase, velocity, and propagation maps, are reconstructed by CD SWI. The accuracy of shear wave velocity measurement is evaluated for homogeneous agar gel phantom by comparing with the acoustic radiation force impulse method. The experimental results for breast tissue are shown for a shear wave frequency of 296.6 Hz.

Control of a thin catheter bending at bifurcation points in artificial blood vessel by using acoustic radiation force.

In this paper, control of a thin catheter bending by using acoustic radiation force was carried out to develop precise and noninvasive surgery in small blood vessel. First, it was elucidated that the acting force to a thin catheter made from perfluoroalkoxy (PFA) copolymer could be obtained from the cantilever equation in the effective range, where the displacement of the catheter divided by the cube of the length of the catheter was less than 1.0×10(-5) mm(-2). Next, under the above cantilever theory, acoustic radiation force acting to the catheter was measured in the condition of the continuous ultrasound radiation. Furthermore, it was observed that the force depended on the ultrasound frequency. We confirmed that the force was obtained in the practical condition by the experiment and controlled it bending in artificial blood vessel including multiple bifurcations. It was suggested that the therapy using thin catheter and ultrasound is fully promising.

Active control of microbubbles stream in multi-bifurcated flow by using 2D phased array ultrasound transducer.

We have previously reported our attempt to propel microbbles in flow by a primary Bjerknes force, which is a physical phenomenon where an acoustic wave pushes an obstacle along its direction of propagation. However, when ultrasound was emitted from surface of the body, controlling bubbles in against flow was needed. It is unpractical to use multiple transducers to produce the same number of focal points because single element transducer cannot produce more than two focal points. In this study, we introduced a complex artificial blood vessel according to a capillary model and a 2D array transducer to produce multiple focal points for active control of microbubbles in against flow. Furthermore, we investigated bubble control in viscous fluid. As the results, we confirmed clearly path selection of MBs in viscous fluid as well as in water.

Production of acoustic field with multiple focal points to control high amount of microbubbles in flow using a 2D array transducer.

We have newly developed a 2D array transducer to control the behavior of microbubbles, which is different from that for HIFU therapy, to emit continuous wave by designing acoustic field including multiple focal points. In the experiment using a straight path model, we have confirmed that higher concentration of acoustic energy does not result more aggregation. We also have confirmed the trapped areas of microbubbles are located not in the peak of the distribution of sound pressure, but in the middle range. The dispersion of acoustic energy is important because there was a relation in the trapping performance of microbubbles and the shape of acoustic field.

Observation of flow variation in capillaries of artificial blood vessel by producing microbubble aggregations.

Microbubbles form their aggregations between the neighboring microbubbles by the effect of secondary Bjerknes force under ultrasound exposure. However, because of the difficulty to reproduce a capillary-mimicking artificial blood vessel, the behavior of aggregations in a capillary has not been predicted. Thus we prepared artificial blood vessels including a capillary model, which was made of poly(vinyl alcohol) (PVA) by grayscale lithography method, with minimum diameter of the path of 0.5 mm. By using this model we investigated the possibility of artificial embolization, where the microbubble aggregations might block entire vessels not to penetrate flow in downstream. Confirming that the sizes of flown aggregation were greater than the section area of the minimum path in the capillary model, we investigated the probability of path block in it. As the results we confirmed the probability increased in proportion to sound pressure and inversely to flow velocity. We are going to investigate with more kinds of parameters to enhance the possibility of artificial embolization.

Dependence of aggregate formation of microbubbles upon ultrasound condition and exposure time.

We have previously reported our attempts to control microbubbles (microcapsules) behavior in flow by primary Bjerknes force to increase the local concentration of the bubbles at a diseased part. However, there was a limitation in efficiency to propel bubbles of µm-order size. Thus we consider that forming aggregates of bubbles is effective to be propelled before entering into an ultrasound field by making use of secondary Bjerknes force under continuous ultrasound exposure. In this study, we observed the phenomena of aggregates formation by confirming variation of diameter and density of aggregates under various conditions of ultrasound exposure. Then we elucidated frequency dependence of the size of aggregates of micro-bubbles.