Timothy J. Hall

Elastic moduli of breast and prostate tissues under compression

To evaluate the dynamic range of tissue imaged by elastography, the mechanical behavior of breast and prostate tissue samples subject to compression loading has been investigated. A model for the loading was validated and used to guide the experimental design for data collection. The model allowed the use of small samples that could be considered homogeneous; this assumption was confirmed by histological analysis. The samples were tested at three strain rates to evaluate the viscoelastic nature of the material and determine the validity of modeling the tissue as an elastic material for the strain rates of interest. For loading frequencies above 1 Hz, the storage modulus accounted for over 93 percent of the complex modulus. The data show that breast fat tissue has a constant modulus over the strain range tested while the other tissues have a modulus that is dependent on the strain level. The fibrous tissue samples from the breast were found to be 1 to 2 orders of magnitude stiffer than fat tissue. Normal glandular breast tissue was found to have an elastic modulus similar to that of fat at low strain levels, but the modulus of the glandular tissue increased by an order of magnitude above fat at high strain levels. Carcinomas from the breast were stiffer than the other tissues at the higher strain level; intraductal in situ carcinomas were like fat at the low strain level and much stiffer than glandular tissue at the high strain level. Infiltrating ductal carcinomas were much stiffer than any of the other breast tissues. Normal prostate tissue has a modulus that is lower than the modulus of the prostate cancers tested. Tissue from prostate with benign prostatic hyperplasia (BPH) had modulus values significantly lower than normal tissue. There was a constant but not significant difference in the modulus of tissues taken from the anterior and posterior portions of the gland.

Phantom materials for elastography

Acoustic and mechanical properties are reported for gelatin materials used to construct tissue-like phantoms for elasticity imaging (elastography). A device and procedure for measuring elastic properties are described. The measured compression forces were comparable to results obtained from finite element analysis when linear elastic media are assumed. Also measured were the stress relaxation, temporal stability, and melting point of the materials. Aldehyde concentration was used to increase the stiffness of the gelatin by controlling the amount of collagen cross-linking. A broad range of tissue-like elastic properties was achieved with these materials, although gels continued to stiffen for several weeks. The precision for elastic modulus measurements ranged from less than 0.1% for 100 kPa samples to 8.9% for soft (<10 kPa), sticky samples.

Describing small‐scale structure in random media using pulse‐echo ultrasound

A method for estimating structural properties of random media is described. The size, number density, and scattering strength of particles are estimated from an analysis of the radio frequency (rf) echo signal power spectrum. Simple correlation functions and the accurate scattering theory of Faran [J.J. Faran, J. Acoust. Soc. Am. 23, 405-418 (1951)], which includes the effects of shear waves, were used separately to model backscatter from spherical particles and thereby describe the structures of the medium. These methods were tested using both glass sphere-in-agar and polystyrene sphere-in-agar scattering media. With the appropriate correlation function, it was possible to measure glass sphere diameters with an accuracy of 20%. It was not possible to accurately estimate the size of polystyrene spheres with the simple spherical and Gaussian correlation models examined because of a significant shear wave contribution. Using the Faran scattering theory for spheres, however, the accuracy for estimating diameters was improved to 10% for both glass and polystyrene scattering media. It was possible to estimate the product of the average scattering particle number density and the average scattering strength per particle, but with lower accuracy than the size estimates. The dependence of the measurement accuracy on the inclusion of shear waves, the wavelength of sound, and medium attenuation are considered, and the implications for describing the structure of biological soft tissues are discussed.

2-D companding for noise reduction in strain imaging

Companding is a signal preprocessing technique for improving the precision of correlation-based time delay measurements. In strain imaging, companding is applied to warp 2-D or 3-D ultrasonic echo fields to improve coherence between data acquired before and after compression. It minimizes decorrelation errors, which are the dominant source of strain image noise. The word refers to a spatially variable signal scaling that compresses and expands waveforms acquired in an ultrasonic scan plane or volume. Temporal stretching by the applied strain is a single-scale (global), 1-D companding process that has been used successfully to reduce strain noise. This paper describes a two-scale (global and local), 2-D companding technique that is based on a sum-absolute-difference (SAD) algorithm for blood velocity estimation. Several experiments are presented that demonstrate improvements in target visibility for strain imaging. The results show that, if tissue motion can be confined to the scan plane of a linear array transducer, displacement variance can be reduced two orders of magnitude using 2-D local companding relative to temporal stretching.

WFUMB Guidelines and Recommendations for Clinical Use of Ultrasound Elastography: Part 2: Breast

The World Federation for Ultrasound in Medicine and Biology (WFUMB) has produced these guidelines for the use of elastography techniques in liver disease. For each available technique, the reproducibility, results, and limitations are analyzed, and recommendations are given. Finally, recommendations based on the international literature and the findings of the WFUMB expert group are established as answers to common questions. The document has a clinical perspective and is aimed at assessing the usefulness of elastography in the management of liver diseases.

AN OVERVIEW OF ELASTOGRAPHY – AN EMERGING BRANCH OF MEDICAL IMAGING

From times immemorial manual palpation served as a source of information on the state of soft tissues and allowed detection of various diseases accompanied by changes in tissue elasticity. During the last two decades, the ancient art of palpation gained new life due to numerous emerging elasticity imaging (EI) methods. Areas of applications of EI in medical diagnostics and treatment monitoring are steadily expanding. Elasticity imaging methods are emerging as commercial applications, a true testament to the progress and importance of the field.In this paper we present a brief history and theoretical basis of EI, describe various techniques of EI and, analyze their advantages and limitations, and overview main clinical applications. We present a classification of elasticity measurement and imaging techniques based on the methods used for generating a stress in the tissue (external mechanical force, internal ultrasound radiation force, or an internal endogenous force), and measurement of the tissue response. The measurement method can be performed using differing physical principles including magnetic resonance imaging (MRI), ultrasound imaging, X-ray imaging, optical and acoustic signals.Until recently, EI was largely a research method used by a few select institutions having the special equipment needed to perform the studies. Since 2005 however, increasing numbers of mainstream manufacturers have added EI to their ultrasound systems so that today the majority of manufacturers offer some sort of Elastography or tissue stiffness imaging on their clinical systems. Now it is safe to say that some sort of elasticity imaging may be performed on virtually all types of focal and diffuse disease. Most of the new applications are still in the early stages of research, but a few are becoming common applications in clinical practice.

Parametric ultrasound imaging from backscatter coefficient measurements: Image formation and interpretation

A broadband method for measuring backscatter coefficients σ b and other acoustic parameters is described. From the σ b measurements, using a commercially-available imaging system, four high-resolution parametric ultrasound images are formed in a C-scan image plane. Scatterer size images are computed from the frequency dependence of σ b and a correlation model function that describes the structure and elastic properties of the medium. Scattering strength images are computed from the absolute magnitude of σ b . Chi-square images are generated to display how well the correlation model represents the interrogated medium. Integrated backscatter coefficient images are formed over the transducer bandwidth. All four images are generated simultaneously and compared with the corresponding B-mode image. Test samples with known physical properties were used to demonstrate experimentally that accurate parametric images are possible if an accurate correlation model is used. Local variations in attenuation, the center frequency and bandwidth of the transducer, and the distribution of scatterer sizes greatly influence the accuracy of estimates and the appearance of the image, thus demonstrating the importance of these factors in parametric image interpretation.

Interlaboratory comparison of ultrasonic backscatter, attenuation, and speed measurements.

In a study involving 10 different sites, independent results of measurements of ultrasonic properties on equivalent tissue‐mimicking samples are reported and compared. The properties measured were propagation speed, attenuation coefficients, and backscatter coefficients. Reasonably good agreement exists for attenuation coefficients, but less satisfactory results were found for propagation speeds. As anticipated, agreement was not impressive in the case of backscatter coefficients. Results for four sites agreed rather well in both absolute values and frequency dependence, and results from other sites were lower by as much as an order of magnitude. The study is valuable for laboratories doing quantitative studies.

Application of autoregressive spectral analysis to cepstral estimation of mean scatterer spacing

The problem of estimation of mean scatterer spacing in an object containing regularly spaced structures is addressed. An autoregressive (AR) spectral estimation method is compared with a conventional fast Fourier transform (FFT)-based approach for this task. Regularly spaced structures produce a periodicity in the power spectrum of ultrasonic backscatter. This periodicity is manifested as a peak in the cepstrum. A phantom was constructed for comparison of the two methods. It contained regularly spaced nylon filaments. It also contained randomly positioned glass spheres that produced incoherent backscatter. In an experiment in which this target was interrogated using broadband ultrasound, the AR spectral estimate offered considerable improvement over the FFT when the analysis gate length was on the order of the structural dimension. Advantages included improved resolution, reduction in bias and variance of scatterer spacing estimates, and greater resistance to ringing artifacts. Data were also acquired from human liver in vivo. AR spectral estimates on human data exhibited a decreased dependence on gate length. These results offer promise for enhanced spatial resolution and accuracy in ultrasonic tissue characterization and nondestructive evaluation of materials.<<ETX>>

Viscoelastic characterization of in vitro canine tissue

Mechanical properties of biological tissues are of interest for assessing the performance of elastographic methods that evaluate the stiffness characteristics of tissue. The mechanical properties of interest include the frequency-dependent complex moduli, storage and loss moduli of tissues. Determination of the mechanical properties of biological tissues is often limited by proper geometry of the sample, as well as homogeneity of the stress-strain relationship. Measurements were performed on in vitro canine liver tissue specimens, over a frequency range from 0.1 to 400 Hz. Tests were conducted using an EnduraTEC ELF 3200, a dynamic testing system for determining the mechanical properties of materials. Both normal tissues and thermal lesions prepared by radio frequency ablation were tested. Experiments were conducted by uniaxially compressing tissue samples using Plexiglas platens larger than the specimens and measuring the load response. The resulting moduli spectra were then fit to a modified Kelvin-Voigt model, called the Kelvin-Voigt fractional derivative model. The data agree well with the model and in comparing the results from the normal tissue with that of the thermal lesions, the concept of a complex modulus contrast is introduced and its applications to elastography are discussed.