Thomas A Krouskop

Tissue-mimicking oil-in-gelatin dispersions for use in heterogeneous elastography phantoms.

A ten-month study is presented of materials for use in heterogeneous elastography phantoms. The materials consist of gelatin with or without a suspension of microscopic safflower oil droplets. The highest volume percent of oil in the materials is 50%. Thimerosal acts as a preservative. The greater the safflower oil concentration, the lower the Youngs modulus. Elastographic data for heterogeneous phantoms, in which the only variable is safflower oil concentration, demonstrate stability of inclusion geometry and elastic strain contrast. Youngs modulus ratios (elastic contrasts) producible in a heterogeneous phantom are as high as 2.7. The phantoms are particularly useful for ultrasound elastography. They can also be employed in MR elastography, although the highest achievable ratio of longitudinal to transverse relaxation times is considerably less than is the case for soft tissues.

Visualization of bonding at an inclusion boundary using axial-shear strain elastography : a feasibility study

Ultrasound elastography produces strain images of compliant tissues under quasi-static compression. In axial-shear strain elastography, the local axial-shear strain resulting from application of quasi-static axial compression to an inhomogeneous material is imaged. The overall hypothesis of this work is that the pattern of axial-shear strain distribution around the inclusion/background interface is completely determined by the bonding at the interface after normalization for inclusion size and applied strain levels, and that it is feasible to extract certain features from the axial-shear strain elastograms to quantify this pattern. The mechanical model used in this study consisted of a single stiff circular inclusion embedded in a homogeneous softer background. First, we performed a parametric study using finite-element analysis (FEA) (no ultrasound involved) to identify possible features that quantify the pattern of axial-shear strain distribution around an inclusion/background interface. Next, the ability to extract these features from axial-shear strain elastograms, estimated from simulated pre- and post-compression noisy RF data, was investigated. Further, the feasibility of extracting these features from in vivo breast data of benign and malignant tumors was also investigated. It is shown using the FEA study that the pattern of axial-shear strain distribution is determined by the degree of bonding at the inclusion/background interface. The results suggest the feasibility of using normalized features that capture the region of positive and negative axial-shear strain area to quantify the pattern of the axial-shear strain distribution. The simulation results showed that it was feasible to extract the features, as identified in the FEA study, from axial-shear strain elastograms. However, an effort must be made to obtain axial-shear strain elastograms with the highest signal-to-noise ratio (SNR(asse)) possible, without compromising the resolution. The in vivo results demonstrated the feasibility of producing and extracting features from the axial-shear strain elastograms from breast data. Furthermore, the in vivo axial-shear strain elastograms suggest an additional feature not identified in the simulations that may potentially be used for distinguishing benign from malignant tumors-the proximity of the axial-shear strain regions to the inclusion/background interface identified in the sonogram.

The feasibility of using poroelastographic techniques for distinguishing between normal and lymphedematous tissues in vivo

Lymphedema is a common condition involving an abnormal accumulation of lymphatic fluid in the interstitial space that causes swelling, most often in the arm(s) and leg(s). Lymphedema is a significant lifelong concern that can be congenital or develop following cancer treatment or cancer metastasis. Common methods of evaluation of lymphedema are mostly qualitative making it difficult to reliably assess the severity of the disease, a key factor in choosing the appropriate treatment. In this paper, we investigate the feasibility of using novel elastographic techniques to differentiate between lymphedematous and normal tissues. This study represents the first step of a larger study aimed at investigating the combined use of elastographic and sonographic techniques for the detection and staging of lymphedema. In this preliminary study, poroelastographic images were generated from the leg (8) and arm (4) subcutis of five normal volunteers and seven volunteers having lymphedema, and the results were compared using statistical analyses. The preliminary results reported in this paper suggest that it may be feasible to perform poroelastography in different lymphedematous tissues in vivo and that poroelastography techniques may be of help in differentiating between normal and lymphedematous tissues.

The feasibility of estimating and imaging the mechanical behavior of poroelastic materials using axial strain elastography

In this paper, we have investigated the feasibility of imaging the mechanical behavior of poroelastic materials using axial strain elastography. Cylindrical samples obtained from poroelastic materials having different elastic and permeability properties were subjected to a constant compression force (a classical creep experiment), during which poroelastographic data were acquired. For comparison, we also tested a few gelatin phantoms and non-homogeneous poroelastic phantoms constructed by combining different poroelastic materials. From the acquired data, we generated time-dependent sequences of axial strain elastograms and effective Poissons ratio elastograms, which were then used for generating axial strain and effective Poissons ratio time-constant elastograms. Thereafter, the various poroelastographic images were analyzed to evaluate the presence of statistically significant differences among the two types of poroelastic samples and for image quality analysis. The results of this study demonstrate that it is technically feasible to use axial strain elastography to distinguish among homogeneous poroelastic materials characterized by different elastic and permeability properties. They also show that the use of axial strain elastography instead of effective Poissons ratio elastography results in objectively higher quality poroelastograms of the temporal behavior of the poroelastic materials under loading. However, the use of effective Poissons ratio elastography may in any case be required to verify that the temporal changes occurring in the axial strains of the homogeneous poroelastic samples are also accompanied by temporal changes of the effective Poissons ratios and are therefore due to poroelastic behavior.

Noise Performance and Signal-to-Noise Ratio of Shear Strain Elastograms

In this paper, we develop a theoretical expression for the signal-to-noise ratio (SNR) of shear strain elastograms. The previously-developed ideas for the axial strain filter (ASF) and lateral strain filter (LSF) are extended to define the concept of the shear strain filter (SSF). Some of our theoretical results are verified using simulations and phantom experiments. The results indicate that the signal-to-noise ratio of shear-strain elastograms (SNR sse) improves with increasing shear strain and with improvements in system parameters such as the sonographic signal-to-noise ratio (SNR s) beamwidth, center frequency and fractional bandwidth. The results also indicate that the amount of axial strain present along with the shear strain is an important parameter that determines the upper bound on SNR sse. The SNR sse will be higher in the absence of additional deformation due to axial strain.

Signal-to-noise ratio, contrast-to-noise ratio and their trade-offs with resolution in axial-shear strain elastography

In axial-shear strain elastography, the local axial-shear strain resulting from the application of quasi-static axial compression to an inhomogeneous material is imaged. In this paper, we investigated the image quality of the axial-shear strain estimates in terms of the signal-to-noise ratio (SNR(asse)) and contrast-to-noise ratio (CNR(asse)) using simulations and experiments. Specifically, we investigated the influence of the system parameters (beamwidth, transducer element pitch and bandwidth), signal processing parameters (correlation window length and axial window shift) and mechanical parameters (Youngs modulus contrast, applied axial strain) on the SNR(asse) and CNR(asse). The results of the study show that the CNR(asse) (SNR(asse)) is maximum for axial-shear strain values in the range of 0.005-0.03. For the inclusion/background modulus contrast range considered in this study (<10), the CNR(asse) (SNR(asse)) is maximum for applied axial compressive strain values in the range of 0.005%-0.03%. This suggests that the RF data acquired during axial elastography can be used to obtain axial-shear strain elastograms, since this range is typically used in axial elastography as well. The CNR(asse) (SNR(asse)) remains almost constant with an increase in the beamwidth while it increases as the pitch increases. As expected, the axial shift had only a weak influence on the CNR(asse) (SNR(asse)) of the axial-shear strain estimates. We observed that the differential estimates of the axial-shear strain involve a trade-off between the CNR(asse) (SNR(asse)) and the spatial resolution only with respect to pitch and not with respect to signal processing parameters. Simulation studies were performed to confirm such an observation. The results demonstrate a trade-off between CNR(asse) and the resolution with respect to pitch.

Resolution of axial shear strain elastography

The technique of mapping the local axial component of the shear strain due to quasi-static axial compression is defined as axial shear strain elastography. In this paper, the spatial resolution of axial shear strain elastography is investigated through simulations, using an elastically stiff cylindrical lesion embedded in a homogeneously softer background. Resolution was defined as the smallest size of the inclusion for which the strain value at the inclusion/background interface was greater than the average of the axial shear strain values at the interface and inside the inclusion. The resolution was measured from the axial shear strain profile oriented at 45 degrees to the axis of beam propagation, due to the absence of axial shear strain along the normal directions. The effects of the ultrasound system parameters such as bandwidth, beamwidth and transducer element pitch along with signal processing parameters such as correlation window length (W) and axial shift (DeltaW) on the estimated resolution were investigated. The results show that the resolution (at 45 degrees orientation) is determined by the bandwidth and the beamwidth. However, the upper bound on the resolution is limited by the larger of the beamwidth and the window length, which is scaled inversely to the bandwidth. The results also show that the resolution is proportional to the pitch and not significantly affected by the axial window shift.

Assessing image quality in effective Poisson's ratio elastography and poroelastography: II

Poroelastography is a novel elastographic technique for imaging the time variation of the mechanical behaviour of poroelastic materials. Poroelastograms are generated as a series of time-sequenced effective Poissons ratio (EPR) elastograms, obtained from the imaged material under sustained compression. In the companion report (Righetti et al 2007 Phys. Med. Biol. 52 1303), we investigated image quality of EPR elastography starting from a theoretical analysis of the performance limitations of axial strain elastography and lateral strain elastography. In this report, we extend this analysis to poroelastography. The theoretical analysis reported in these two companion papers allows understanding the performance limitations of these novel techniques and identifying the fundamental parameters that control their signal-to-noise ratio, contrast-to-noise ratio and resolution. The results of these studies also indicate that EPR elastograms and poroelastograms of reasonable image quality can be generated in practical applications that may be of clinical interest provided that advanced elastographic techniques in combination with other commonly employed imaging methods to increase signal-to-noise and contrast-to-noise ratios are used.

A new method for generating poroelastograms in noisy environments

Poroelastography has been recently introduced as a new elastographic technique that may be used to describe the spatial and temporal behavior of poroelastic materials. The experimental methodology proposed thus far for phantoms and tissues in vitro requires the acquisition of a precompression rf frame, the application of a unit step strain compression to the sample and the acquisition of subsequent post-compression frames from the material. Elastograms and poroelastograms are generated by cross-correlating the sequentially-acquired postcompression frames with the reference precompression frame. The application of poroelastography to tissues in vivo must address the echo decorrelation problems that are encountered due to uncontrolled tissue motion, which may become significant shortly after the acquisition of the precompression frame. In this paper, we investigate the feasibility of performing poroelastography experiments using an alternative experimental scheme. In the proposed experimental methodology, the reference precompression frame is continuously moved while the time interval between the frames that are correlated is kept short. This allows long data acquisition times with simultaneous minimization of the decorrelation due to undesired tissue motion in vivo. We validated this new method using both a step and a ramp compression functions. We performed poroelastographic simulations and experiments in phantoms and in tissues in vivo. The results were compared to those obtained using the traditional acquisition methodology. This study shows that the two methods yield similar results in vitro and suggests that the new method may be more robust to decorrelation noise in applications in vivo.

Correlation of elastographic tissue strain images with mechanically scanned modulus images

Tissue stiffness is generally known to be associated with pathological changes. Elastography, on the other hand, is capable of imaging tissue strain, which may or may not be well correlated with tissue stiffness. Hence a quantitative comparison between the elastographic tissue strain images and the corresponding tissue modulus images needs to be performed to evaluate the usefulness of elastography in imaging tissue stiffness properties. We find that under certain conditions, such a quantitative comparison is feasible. Preliminary results indicate a correlation of at least 0.6 between tissue stiffness maps and strain maps in some typical bovine muscle tissues.