Search PubMed⌕ Search

Biomedical subjects

E E Konofagou

Publications and source records attributed to E E Konofagou.

10 recordsLinked to original sources

Quo vadis elasticity imaging?

In the past decade, an important field that has emerged as complementary to ultrasonic imaging is that of elasticity imaging. The term encompasses a variety of techniques that can depict a mechanical response or property of tissues. In ultrasound, its premise is built on two important facts: (a) that significant differences between mechanical properties of several tissue components exist and (b) that the information contained in the coherent scattering, or speckle, is sufficient to depict these differences following an external or internal mechanical stimulus. Parameters, such as velocity of vibration, displacement, strain, strain rate, velocity of wave propagation and elastic modulus, have all been demonstrated feasible in their estimation and have resulted in the accurate depiction of stiffer tissue masses, such as tumors, high-intensity focused ultrasound (HIFU) lesions and atherosclerotic plaques. More recently, through the development of ultrafast algorithms tailored to suitable hardware as well as the familiarity of the physician with the sensitivity of the methods used, one elasticity imaging technique in particular, elastography, has been shown applicable in a typical clinical ultrasound setting. In other words, elastograms can currently be obtained at quasi real-time (approximately at a frame rate of 8 frames/s) and with the use of a hand-held transducer (as opposed to the previously used frame-suspended setup) during and simultaneously with an ultrasound exam of, e.g., the breast or the prostate. The higher frame rate available with certain clinical ultrasound scanners has also resulted in the successful application of elasticity imaging techniques on the myocardium and monitoring its deformation over several cardiac cycles for the detection of ischemic regions. As a result, elasticity imaging with its ever increasing number of applications and demonstrated applicability in a typical, clinical ultrasound setting promises to make an important contribution to the ultrasound practice as we know it.

Elasticity↗

Estimating localized oscillatory tissue motion for assessment of the underlying mechanical modulus.

The technique of harmonic motion imaging (HMI) uses the localized stimulus of the oscillatory ultrasonic radiation force as produced by two overlapping beams of distinct frequencies, and estimates the resulting harmonic displacement in the tissue in order to assess its underlying mechanical properties. In this paper, we studied the relationship between measured displacement and stiffness in gels and tissues in vitro. Two focused ultrasound transducers with a 100 mm focal length were used at frequencies of 3.7500 MHz and either 3.7502 (or 3.7508 MHz), respectively, in order to produce an oscillatory motion at 200 Hz in the gel or tissue. A 1.1 MHz diagnostic transducer (Imasonics, Inc.) was also focused at 100 mm and acquired 5 ms RF signals (pulse repetition frequency (PRF)=3.5 kHz) at 100 MHz sampling frequency during radiation force application. First, three 50x50 mm(2) acrylamide gels were prepared at concentrations of 4%, 8% and 16%. The resulting displacement was estimated using crosscorrelation techniques between successively acquired RF signals with a 2 mm window and 80% window overlap at 1260 W/cm(2). A normal 1-D indentation instrument (TeMPeST) applied oscillatory loads at 0.1-200 Hz with a 5 mm-diameter flat indenter. Then, 12 displacement measurements in 6 porcine muscle specimens (two measurements/case, as above) were made in vitro, before and after ablation which was performed for 10 s at 1260 W/cm(2). In all gel cases, the harmonic displacement was found to linearly increase with intensity and exponentially decrease with gel concentration. The TeMPeST measurements showed that the elastic moduli for the 4%, 8% and 16% gels equaled 3.93+/-0.06, 17.1+/-0.2 and 75+/-2 kPa, respectively, demonstrating that the HMI displacement estimate depends directly on the gel stiffness. Finally, in the tissues samples, the mean displacement amplitude showed a twofold decrease between non-ablated and ablated tissue, demonstrating a correspondence between the HMI response and an increase in stiffness measured with the TeMPeST instrument.

Animals↗

Poroelastography: imaging the poroelastic properties of tissues.

In the field of elastography, biological tissues are conveniently assumed to be purely elastic solids. However, several tissues, including brain, cartilage and edematous soft tissues, have long been known to be poroelastic. The objective of this study is to show the feasibility of imaging the poroelastic properties of tissue-like materials. A poroelastic material is a material saturated with fluid that flows relative to a deforming solid matrix. In this paper, we describe a method for estimating the poroelastic attributes of tissues. It has been analytically shown that during stress relaxation of a poroelastic material (i.e., sustained application of a constant applied strain over time), the lateral-to-axial strain ratio decreases exponentially with time toward the Poisson's ratio of the solid matrix. The time constant of this variation depends on the elastic modulus of the solid matrix, its permeability and its dimension along the direction of fluid flow. Recently, we described an elastographic method that can be used to map axial and lateral tissue strains. In this study, we use the same method in a stress relaxation case to measure the time-dependent lateral-to-axial strain ratio in poroelastic materials. The resulting time-sequenced images (poroelastograms) depict the spatial distribution of the fluid within the solid at each time instant, and help to differentiate poroelastic materials of distinct Poisson's ratios and permeabilities of the solid matrix. Results are shown from finite-element simulations.

Elasticity↗

Spectral estimators in elastography.

Like velocity, strain induces a time delay and a time scaling to the received signal. Elastography typically uses time delay techniques to indirectly (i.e. via the displacement estimate) measure tissue strain induced by an applied compression, and considers time scaling as a source of distortion. More recently, we have shown that the time scaling factor can also be spectrally estimated and used as a direct measure of strain. Strain causes a Doppler-like frequency shift and a change in bandwidth of the bandpass power spectrum of the echo signal. Two frequency shift strain estimators are described that have been proven to be more robust but less precise when compared to time delay estimators, both in simulations and experiments. The increased robustness is due to the insensitivity of the spectral techniques to phase decorrelation noise. In this paper we discuss and compare the theoretical and experimental findings obtained with traditional time delay estimators and with the newly proposed spectral methods.

Blood Flow Velocity↗

Shear strain estimation and lesion mobility assessment in elastography.

Elastography typically measures and images the normal strain component along the insonification/compression axis, i.e., in the axial direction. We have recently shown that, by using interpolation and cross-correlation methods of transversely displaced RF echo segments, it is possible to measure and image displacement and strain transversely to the beam with good precision. This enables the estimation and imaging of all three principal normal strain components. Generally, motion in a direction other than that in which strain is estimated may result in decorrelation noise, severely corrupting the estimates. Therefore, a correction method is applied to correct the displacement and strain estimates for decorrelating motion. In this paper, we show how corrected displacement estimates can also be used to estimate and image the shear strain components. This may allow us to identify regions of decorrelation noise in the normal strain measurement that are due to shear strain. Shear strain estimates provide supplementary information, which can characterize different tissue elements based on their mobility. In the case of breast lesions, low mobility is related to malignancy. Following an in vivo case, we show with 2D simulations how assessment of tumor mobility can be achieved with shear strain estimation.

Breast Neoplasms↗

Direct strain estimation in elastography using spectral cross-correlation.

Spectral estimation of tissue strain has been performed previously by using the centroid shift of the power spectrum or by estimating the variation in the mean scatterer spacing in the spectral domain. The centroid shift method illustrates the robustness of the direct, incoherent strain estimator. In this paper, we present a strain estimator that uses spectral cross-correlation of the pre- and postcompression power spectrum. The centroid shift estimator estimates strain from the mean center frequency shift, while the spectral cross-correlation estimates the shift over the entire spectrum. Spectral cross-correlation is shown to be more sensitive to small shifts in the power spectrum and, thus, provides better estimation for smaller strains when compared to the spectral centroid shift. Spectral cross-correlation shares all the advantages gained using the spectral centroid shift, in addition to providing accurate and precise strain estimation for small strains. The variance and noise properties of the spectral strain estimators quantified by their respective strain filters are also presented.

Acoustics↗

Precision estimation and imaging of normal and shear components of the 3D strain tensor in elastography.

In elastography we have previously developed a tracking and correction method that estimates the axial and lateral strain components along and perpendicular to the compressor/scanning axis following an externally applied compression. However, the resulting motion is a three-dimensional problem. Therefore, in order to fully describe this motion we need to consider a 3D model and estimate all three principal strain components, i.e. axial, lateral and elevational (out-of-plane), for a full 3D tensor description. Since motion is coupled in all three dimensions, the three motion components have to be decoupled prior to their estimation. In this paper, we describe a method that estimates and corrects motion in three dimensions, which is an extension of the 2D motion tracking and correction method discussed before. In a similar way as in the 2D motion estimation, and by assuming that ultrasonic frames are available in more than one parallel elevational plane, we used methods of interpolation and cross-correlation between elevationally displaced RF echo segments to estimate the elevational displacement and strain. In addition, the axial, lateral and elevational displacements were used to estimate all three shear strain components that, together with the normal strain estimates, fully describe the full 3D normal strain tensor resulting from the uniform compression. Results of this method from three-dimensional finite-element simulations are shown.

Computer Simulation↗

Theoretical bounds on the estimation of transverse displacement, transverse strain and Poisson's ratio in elastography.

The Cramér-Rao Lower Bounds (CRLB) are derived for the displacement and strain estimation in directions orthogonal to the ultrasonic beam axis, using a previously-described recorrelation method of axial, lateral and elevational motion estimation. We also compare it to the lateral tracking method that involves the sole use of the axial signal in the transverse direction. Our theoretical results, verified with simulations and phantom experiments, show that elastography is capable of measuring axial and transverse strain at up to 10% axially applied compression. Finally, we predict the performance of the estimation of the Poisson's ratio using decoupled axial and lateral estimates that result from the recorrelation method.

Computer Simulation↗

Power spectral strain estimators in elastography.

Elastography can produce quality strain images in vitro and in vivo. Standard elastography uses a coherent cross-correlation technique to estimate tissue displacement and tissue strain using a subsequent gradient operator. Although coherent estimation methods generally have the advantage of being highly accurate and precise, even relatively small undesired motions are likely to cause enough signal decorrelation to produce significant degradation of the elastogram. For elastography to become more universally practical in such applications as hand-held, intravascular and abdominal imaging, the limitations associated with coherent strain estimation methods that require tissue and system stability, must be overcome. In this paper, we propose the use of a spectral-shift method that uses a centroid shift estimate to measure local strain directly. Furthermore, we also show theoretically that a spectral bandwidth method can also provide a direct strain estimation. We demonstrate that strain estimation using the spectral-shift technique is moderately less precise, but far more robust than the cross-correlation method. A theoretical analysis, simulations and experimental results are used to illustrate the properties associated with this method.

Elasticity↗

Elastographic dynamic range expansion using variable applied strains.

In elastography, we want to image the entire range of stiffnesses of the elastic components found in inhomogeneous tissues. In order to achieve this, the elastographic dynamic range should equal the entire stiffness dynamic range in the target. Various sources of noise limit the dynamic range of elastography. The recently-defined strain filter concept offers an analytical and graphical way of observing these limitations. In this paper, we describe a method that achieves the expansion of the elastographic dynamic range. It involves the application of variable strains in combination with selective storage of strain data that have optimal elastographic signal-to-noise ratios. This expands the current dynamic range of elastography by orders of magnitude when compared to single compression elastography. The process is explained theoretically using the strain filter framework, and 1 D as well as 2D tissue simulations are used to corroborate the theory.

Algorithms↗