Gregg E. Trahey

Acoustic radiation force impulse imaging: in vivo demonstration of clinical feasibility.

The clinical viability of a method of acoustic remote palpation, capable of imaging local variations in the mechanical properties of soft tissue using acoustic radiation force impulse (ARFI) imaging, is investigated in vivo. In this method, focused ultrasound (US) is used to apply localized radiation force to small volumes of tissue (2 mm(3)) for short durations (less than 1 ms) and the resulting tissue displacements are mapped using ultrasonic correlation-based methods. The tissue displacements are inversely proportional to the stiffness of the tissue and, thus, a stiffer region of tissue exhibits smaller displacements than a more compliant region. Due to the short duration of the force application, this method provides information about the mechanical impulse response of the tissue, which reflects variations in tissue viscoelastic characteristics. In this paper, experimental results are presented demonstrating that displacements on the order of 10 microm can be generated and detected in soft tissues in vivo using a single transducer on a modified diagnostic US scanner. Differences in the magnitude of displacement and the transient response of tissue are correlated with tissue structures in matched B-mode images. The results comprise the first in vivo ARFI images, and support the clinical feasibility of a radiation force-based remote palpation imaging system.

On the feasibility of remote palpation using acoustic radiation force.

A method of acoustic remote palpation, capable of imaging local variations in the mechanical properties of tissue, is under investigation. In this method, focused ultrasound is used to apply localized (on the order of 2 mm3) radiation force within tissue. and the resulting tissue displacements are mapped using ultrasonic correlation based methods. The tissue displacements are inversely proportional to the stiffness of the tissue, and thus a stiffer region of tissue exhibits smaller displacements than a more compliant region. In this paper, the feasibility of remote palpation is demonstrated experimentally using breast tissue phantoms with spherical lesion inclusions, and in vitro liver samples. A single diagnostic transducer and modified ultrasonic imaging system are used to perform remote palpation. The displacement images are directly correlated to local variations in tissue stiffness with higher contrast than the corresponding B-mode images. Relationships between acoustic beam parameters, lesion characteristics and radiation force induced tissue displacement patterns are investigated and discussed. The results show promise for the clinical implementation of remote palpation.

A novel method for angle independent ultrasonic imaging of blood flow and tissue motion

A simple algorithm for angle independent motion imaging is described. This method requires only one absolute difference operation per pixel, compared to eight operations for normalized cross correlation. Quantitative studies using speckle-generating targets translated by fixed amounts both axially and laterally indicate that the technique tracks moving speckle as accurately as correlation. Color flow images generated from clinical blood and liver data highlight the success of the technique for tracking both large and small motions in two dimensions. The algorithms suitability for implementation in digital hardware makes possible the development of clinical instruments for angle independent ultrasonic imaging of blood flow and tissue motion in real time.<<ETX>>

A fundamental limit on delay estimation using partially correlated speckle signals

Delay estimation is used in ultrasonic imaging to estimate blood or soft tissue motion, to measure echo arrival time differences for phase aberration correction, and to estimate displacement for tissue elasticity measurements. In each of these applications delay estimation is performed using speckle signals which are at least partially decorrelated relative to one another. Delay estimates which utilize such data are subject to large errors known as false peaks and smaller magnitude errors known as jitter. While false peaks can sometimes be removed through nonlinear processing, jitter errors place a fundamental limit on the performance of delay estimation techniques. The authors apply the Cramer-Rao Lower Bound to derive an analytical expression which predicts the magnitude of jitter errors incurred when estimating delays using radio frequency (RF) data from speckle targets. The analytical expression presented includes the effects of signal decorrelation due to physical processes, corruption by electronic noise, and a number of other factors. Simulation results are presented which show that the performance of the normalized cross correlation algorithm closely matches theoretical predictions. These results indicate that for poor signal to noise ratios (0 dB) a small improvement in signal to noise ratio can dramatically reduce jitter magnitude. At high signal to noise ratios (30 dB) small amounts of signal decorrelation can significantly increase the magnitude of jitter errors.<<ETX>>

Angle Independent Ultrasonic Detection of Blood Flow

We present a new technique for blood velocity imaging based on tracking the motion of the speckle pattern produced by blood. Unlike Doppler velocity determinations, these are angle independent. Initial in vivo experiments yield promising results.

Phase aberration correction in medical ultrasound using speckle brightness as a quality factor

Medical ultrasonic images are degraded by tissues with inhomogeneous acoustic velocities. The resulting phase aberration raises the off-peak response of the imaging systems point spread function (PSF), decreasing dynamic range. In extreme cases, multiple images of a single target are displayed. Phase aberration may become a limiting factor to image quality as ultrasonic frequency and aperture size are increased in order to improve spatial resolution. A method is proposed to correct for unknown phase aberration, which uses speckle brightness as a quality factor. The phase delays of a phased array transducer are modified, element by element, to maximize mean speckle brightness in a region of interest. The technique proposed is analogous to the correction technique used by Muller and Buffington [J. Opt. Soc. Am. 64 (9), 1200-1209 (1974)] to adaptively focus incoherent optical telescopes. The method is demonstrated using a computer model with several different simulated aberration profiles. With this model, mean speckle brightness is calculated using the two-dimensional PSF. Experiments have also been conducted in which speckle brightness is shown to increase as the phase delays of an ultrasonic scanner are modified in order to compensate for a rippled aberrating layer made of silicone rubber. The characteristics of the proposed method, and the possibility of employing it clinically to correct for unknown inhomogeneities in acoustic velocity, are discussed.

Speckle Pattern Correlation with Lateral Aperture Translation: Experimental Results and Implications for Spatial Compounding

In order to design improved spatial compounding ultra- sound scanning systems it is necessary to determine the correlation of speckle patterns as a function of aperture translation. We have con- ducted experiments measuring the speckle correlation with lateral ap- erture translation for linear phased array pulse-echo ultrasonic im- aging systems. Results are presented for variable frequency, range, transducer length, focus error, and reflecting material. Tests were con- ducted on two commercially availahle and one research imaging sys- tem. The measured rates of correlation coefficient decrease are inde- pendent of frequency, reflecting material, and target range when the target is in the focal zone. The experimentally determined correlations are used to derive the optimal spatial separation of images for speckle reduction.

Speckle tracking for multi-dimensional flow estimation.

Speckle tracking methods overcome the major limitations of current Doppler methods for flow imaging and quantification: angle dependence and aliasing. In this paper, we review the development of speckle tracking, with particular attention to the advantages and limitations of two-dimensional algorithms that use a single transducer aperture. Ensemble tracking, a recent speckle tracking method based upon parallel receive processing, is described. Experimental results with ensemble tracking indicate the ability to measure laminar flow in a phantom at a beam-vessel angle of 60 degrees, which had not been possible with previous 2D speckle tracking methods. Finally, important areas for future research in speckle tracking are briefly summarized.

In vivo visualization of abdominal malignancies with acoustic radiation force elastography

The utility of acoustic radiation force impulse (ARFI) imaging for real-time visualization of abdominal malignancies was investigated. Nine patients presenting with suspicious masses in the liver (n = 7) or kidney (n = 2) underwent combined sonography/ARFI imaging. Images were acquired of a total of 12 tumors in the nine patients. In all cases, boundary definition in ARFI images was improved or equivalent to boundary definition in B-mode images. Displacement contrast in ARFI images was superior to echo contrast in B-mode images for each tumor. The mean contrast for suspected hepatocellular carcinomas (HCCs) in B-mode images was 2.9 dB (range: 1.5-4.2) versus 7.5 dB (range: 3.1-11.9) in ARFI images, with all HCCs appearing more compliant than regional cirrhotic liver parenchyma. The mean contrast for metastases in B-mode images was 3.1 dB (range: 1.2-5.2) versus 9.3 dB (range: 5.7-13.9) in ARFI images, with all masses appearing less compliant than regional non-cirrhotic liver parenchyma. ARFI image contrast (10.4 dB) was superior to B-mode contrast (0.9 dB) for a renal mass. To our knowledge, we present the first in vivo images of abdominal malignancies in humans acquired with the ARFI method or any other technique of imaging tissue elasticity.

Acoustic radiation force elasticity imaging in diagnostic ultrasound

The development of ultrasound-based elasticity imaging methods has been the focus of intense research activity since the mid-1990s. In characterizing the mechanical properties of soft tissues, these techniques image an entirely new subset of tissue properties that cannot be derived with conventional ultrasound techniques. Clinically, tissue elasticity is known to be associated with pathological condition and with the ability to image these features in vivo; elasticity imaging methods may prove to be invaluable tools for the diagnosis and/or monitoring of disease. This review focuses on ultrasound-based elasticity imaging methods that generate an acoustic radiation force to induce tissue displacements. These methods can be performed noninvasively during routine exams to provide either qualitative or quantitative metrics of tissue elasticity. A brief overview of soft tissue mechanics relevant to elasticity imaging is provided, including a derivation of acoustic radiation force, and an overview of the various acoustic radiation force elasticity imaging methods.