Jingfeng Jiang

Linear and nonlinear elasticity imaging of soft tissue in vivo: demonstration of feasibility.

We establish the feasibility of imaging the linear and nonlinear elastic properties of soft tissue using ultrasound. We report results for breast tissue where it is conjectured that these properties may be used to discern malignant tumors from benign tumors. We consider and compare three different quantities that describe nonlinear behavior, including the variation of strain distribution with overall strain, the variation of the secant modulus with overall applied strain and finally the distribution of the nonlinear parameter in a fully nonlinear hyperelastic model of the breast tissue.

A finite-element approach for Young's modulus reconstruction

Modulus imaging has great potential in soft-tissue characterization since it reveals intrinsic mechanical properties. A novel Youngs modulus reconstruction algorithm that is based on finite-element analysis is reported here. This new method overcomes some limitations in other Youngs modulus reconstruction methods. Specifically, it relaxes the force boundary condition requirements so that only the force distribution at the compression surface is necessary, thus making the new method more practical. The validity of the new method is demonstrated and the performance of the algorithm with noise in the input data is tested using numerical simulations. Details of how to apply this method under clinical conditions is also discussed.

A parallelizable real-time motion tracking algorithm with applications to ultrasonic strain imaging

Ultrasound-based mechanical strain imaging systems utilize signals from conventional diagnostic ultrasound systems to image tissue elasticity contrast that provides new diagnostically valuable information. Previous works (Hall et al 2003 Ultrasound Med. Biol. 29 427, Zhu and Hall 2002 Ultrason. Imaging 24 161) demonstrated that uniaxial deformation with minimal elevation motion is preferred for breast strain imaging and real-time strain image feedback to operators is important to accomplish this goal. The work reported here enhances the real-time speckle tracking algorithm with two significant modifications. One fundamental change is that the proposed algorithm is a column-based algorithm (a column is defined by a line of data parallel to the ultrasound beam direction, i.e. an A-line), as opposed to a row-based algorithm (a row is defined by a line of data perpendicular to the ultrasound beam direction). Then, displacement estimates from its adjacent columns provide good guidance for motion tracking in a significantly reduced search region to reduce computational cost. Consequently, the process of displacement estimation can be naturally split into at least two separated tasks, computed in parallel, propagating outward from the center of the region of interest (ROI). The proposed algorithm has been implemented and optimized in a Windows system as a stand-alone ANSI C++ program. Results of preliminary tests, using numerical and tissue-mimicking phantoms, and in vivo tissue data, suggest that high contrast strain images can be consistently obtained with frame rates (10 frames s(-1)) that exceed our previous methods.

Linear and Nonlinear Elastic Modulus Imaging: An Application to Breast Cancer Diagnosis

We reconstruct the in vivo spatial distribution of linear and nonlinear elastic parameters in ten patients with benign (five) and malignant (five) tumors. The mechanical behavior of breast tissue is represented by a modified Veronda-Westmann model with one linear and one nonlinear elastic parameter. The spatial distribution of these elastic parameters is determined by solving an inverse problem within the region of interest (ROI). This inverse problem solution requires the knowledge of the displacement fields at small and large strains. The displacement fields are measured using a free-hand ultrasound strain imaging technique wherein, a linear array ultrasound transducer is positioned on the breast and radio frequency echo signals are recorded within the ROI while the tissue is slowly deformed with the transducer. Incremental displacement fields are determined from successive radio-frequency frames by employing cross-correlation techniques. The rectangular regions of interest were subjectively selected to obtain low noise displacement estimates and therefore were variables that ranged from 346 to 849.6 mm . It is observed that malignant tumors stiffen at a faster rate than benign tumors and based on this criterion nine out of ten tumors were correctly classified as being either benign or malignant.

A novel performance descriptor for ultrasonic strain imaging: a preliminary study

Ultrasonic strain imaging that uses signals from conventional diagnostic ultrasound systems is capable of showing the contrast of tissue elasticity, which provides new diagnostically valuable information. To assess and improve the diagnostic performance of ultrasonic strain imaging, it is essential to have a quantitative measure of image quality. Moreover, it is useful if the image quality measure is simple to interpret and can be used for visual feedback while scanning and as a training tool for operator performance evaluation. This report describes the development of a novel quantitative method for systematic performance assessment that is based on the combination of measures of the accuracy of motion tracking and consistency among consecutive strain fields. The accuracy of motion tracking assesses the reliability of strain images. The consistency among consecutive strain images assesses the signal quality in strain images. The clinical implications of the proposed method to differentiate good or poor strain images are discussed. Results of experiments with tissue-mimicking phantoms and in vivo breast-tissue data demonstrate that the performance measure is a useful method for automatically rating elasticity image quality.

Three-Dimensional Electrode Displacement Elastography Using the Siemens C7F2 fourSight Four-Dimensional Ultrasound Transducer

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.

A generalized speckle tracking algorithm for ultrasonic strain imaging using dynamic programming.

This study developed an improved motion estimation algorithm for ultrasonic strain imaging that employs a dynamic programming technique. In this article, we model the motion estimation task as an optimization problem. Since tissue motion under external mechanical stimuli often should be reasonably continuous, a set of cost functions combining correlation and various levels of motion continuity constraint were used to regularize the motion estimation. To solve the optimization problem with a reasonable computational load, a dynamic programming technique that does not require iterations was used to obtain displacement vectors in integer precision. Then, a subsample estimation algorithm was used to calculate local displacements in fractional precision. Two implementation schemes were investigated with in vivo ultrasound echo data sets. We found that the proposed algorithm provides more accurate displacement estimates than our previous algorithm for in vivo clinical data. In particular, the new algorithm is capable of tracking motion in more complex anatomy and increases strain image consistency in a sequence of images. Preliminary results also suggest that a significantly longer sequence of high contrast strain images could be obtained with the new algorithm compared with the previous algorithm. The new algorithm can also tolerate larger motion discontinuities (e.g., cavity in an anthropomorphic uterine phantom).

Spherical lesion phantoms for testing the performance of elastography systems

A set of three cubic one-litre phantoms containing spherical simulated lesions was produced for use in comparing lesion detection performance of different elastography systems. The materials employed are known to be stable in heterogeneous configurations regarding geometry and elastic contrast identical with (storage modulus of lesion material) / (storage modulus of background material), and regarding ultrasound and NMR properties. The materials mimic soft tissues in terms of elastic, ultrasound and NMR properties. Each phantom has only one value of elastic contrast (3.3, 4.6 or 5.5) and contains arrays of 1.6 mm, 2 mm, 3 mm and 4 mm diameter spherical simulated lesions. All the spheres of a given diameter are arranged in a regular array with coplanar centres. Elastograms of an array made with ultrasound allow determination of the depth range over which lesions of that diameter and elastic contrast can be detected. Two phantoms are made from agar-plus-gelatin-based materials, and one is made from oil-in-gelatin dispersions. The methods for producing the phantoms are described in detail. Lesion detection performances for two ultrasound systems, both operating at about 7.5 MHz and focused at about 5 cm, were quantified with distinctions between the two systems demonstrated. Neither system was capable of detecting any of the 1.6 mm lesions. Phantoms such as these should be useful in research labs that are refining hardware and/or software for elastography.

Young's Modulus Reconstruction for Radio-Frequency Ablation Electrode-Induced Displacement Fields: A Feasibility Study

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 Youngs 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 Youngs modulus reconstruction technique with edge-preserving regularization was developed to estimate the Youngs 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.

A nonlinear elasticity phantom containing spherical inclusions

The strain image contrast of some in vivo breast lesions changes with increasing applied load. This change is attributed to differences in the nonlinear elastic properties of the constituent tissues suggesting some potential to help classify breast diseases by their nonlinear elastic properties. A phantom with inclusions and long-term stability is desired to serve as a test bed for nonlinear elasticity imaging method development, testing, etc. This study reports a phantom designed to investigate nonlinear elastic properties with ultrasound elastographic techniques. The phantom contains four spherical inclusions and was manufactured from a mixture of gelatin, agar and oil. The phantom background and each of the inclusions have distinct Youngs modulus and nonlinear mechanical behavior. This phantom was subjected to large deformations (up to 20%) while scanning with ultrasound, and changes in strain image contrast and contrast-to-noise ratio between inclusion and background, as a function of applied deformation, were investigated. The changes in contrast over a large deformation range predicted by the finite element analysis (FEA) were consistent with those experimentally observed. Therefore, the paper reports a procedure for making phantoms with predictable nonlinear behavior, based on independent measurements of the constituent materials, and shows that the resulting strain images (e.g., strain contrast) agree with that predicted with nonlinear FEA.