Elastography

Abstract: The emergence of ultrafast frame rates in ultrasonic imaging has been recently made possible by the development of new imaging modalities such as transient elastography. Data acquisition rates reaching more than thousands of images per second enable the real-time visualization of shear mechanical waves propagating in biological tissues, which convey information about local viscoelastic properties of tissues. The first proposed approach for reaching such ultrafast frame rates consists of transmitting plane waves into the medium. However, because the beamforming process is then restricted to the receive mode, the echographic images obtained in the ultrafast mode suffer from a low quality in terms of resolution and contrast and affect the robustness of the transient elastography mode. It is here proposed to improve the beamforming process by using a coherent recombination of compounded plane-wave transmissions to recover high-quality echographic images without degrading the high frame rate capabilities. A theoretical model is derived for the comparison between the proposed method and the conventional B-mode imaging in terms of contrast, signal-to-noise ratio, and resolution. Our model predicts that a significantly smaller number of insonifications, 10 times lower, is sufficient to reach an image quality comparable to conventional B-mode. Theoretical predictions are confirmed by in vitro experiments performed in tissue-mimicking phantoms. Such results raise the appeal of coherent compounds for use with standard imaging modes such as B-mode or color flow. Moreover, in the context of transient elastography, ultrafast frame rates can be preserved while increasing the image quality compared with flat insonifications. Improvements on the transient elastography mode are presented and discussed.

Abstract: Purpose: To evaluate the diagnostic performance of real-time freehand elastography by using the extended combined autocorrelation method (CAM) to differentiate benign from malignant breast lesions, with pathologic diagnosis as the reference standard. Materials and Methods: This study was approved by the University of Tsukuba Human Subjects Institutional Review Board; all patients gave informed consent. Conventional ultrasonography (US) and real-time US elastography with CAM were performed in 111 women (mean age, 49.4 years; age range, 27–91 years) who had breast lesions (59 benign, 52 malignant). Elasticity images were assigned an elasticity score according to the degree and distribution of strain induced by light compression. The area under the curve and cutoff point, both of which were obtained by using a receiver operating characteristic curve analysis, were used to assess diagnostic performance. Mean scores were examined by using a Student t test. Sensitivity, specificity, and accuracy were compared b...

Abstract: Elastography-based imaging techniques have received substantial attention in recent years for non-invasive assessment of tissue mechanical properties. These techniques take advantage of changed soft tissue elasticity in various pathologies to yield qualitative and quantitative information that can be used for diagnostic purposes. Measurements are acquired in specialized imaging modes that can detect tissue stiffness in response to an applied mechanical force (compression or shear wave). Ultrasound-based methods are of particular interest due to its many inherent advantages, such as wide availability including at the bedside and relatively low cost. Several ultrasound elastography techniques using different excitation methods have been developed. In general, these can be classified into strain imaging methods that use internal or external compression stimuli, and shear wave imaging that use ultrasound-generated traveling shear wave stimuli. While ultrasound elastography has shown promising results for non-invasive assessment of liver fibrosis, new applications in breast, thyroid, prostate, kidney and lymph node imaging are emerging. Here, we review the basic principles, foundation physics, and limitations of ultrasound elastography and summarize its current clinical use and ongoing developments in various clinical applications.

Abstract: Diagnostic Ultrasound Imaging provides a unified description of the physical principles of ultrasound imaging, signal processing, systems and measurements. This comprehensive reference is a core resource for both graduate students and engineers in medical ultrasound research and design. With continuing rapid technological development of ultrasound in medical diagnosis, it is a critical subject for biomedical engineers, clinical and healthcare engineers and practitioners, medical physicists, and related professionals in the fields of signal and image processing. The book contains 17 new and updated chapters covering the fundamentals and latest advances in the area, and includes four appendices, 450 figures (60 available in color on the companion website), and almost 1,500 references. In addition to the continual influx of readers entering the field of ultrasound worldwide who need the broad grounding in the core technologies of ultrasound, this book provides those already working in these areas with clear and comprehensive expositions of these key new topics as well as introductions to state-of-the-art innovations in this field. * Enables practicing engineers, students and clinical professionals to understand the essential physics and signal processing techniques behind modern imaging systems as well as introducing the latest developments that will shape medical ultrasound in the future* Suitable for both newcomers and experienced readers, the practical, progressively organized applied approach is supported by hands-on MATLAB code and worked examples that enable readers to understand the principles underlying diagnostic and therapeutic ultrasound* Covers the new important developments in the use of medical ultrasound: elastography and high-intensity therapeutic ultrasound. Many new developments are comprehensively reviewed and explained, including aberration correction, acoustic measurements, acoustic radiation force imaging, alternate imaging architectures, bioeffects: diagnostic to therapeutic, Fourier transform imaging, multimode imaging, plane wave compounding, research platforms, synthetic aperture, vector Doppler, transient shear wave elastography, ultrafast imaging and Doppler, functional ultrasound and viscoelastic models