Bayat, Mahdi

Vibrational characteristics of bone are directly dependent on its physical properties. In this study, a vibrational method for bone evaluation is introduced. We propose a new type of quantitative vibro-acoustic method based on the acoustic radiation force of ultrasound for bone characterization in persons with fracture. Using this method, we excited the clavicle or ulna by an ultrasound radiation force pulse which induces vibrations in the bone, resulting in an acoustic wave that is measured by a hydrophone placed on the skin. The acoustic signals were used for wave velocity estimation based on a cross-correlation technique. To further separate different vibration characteristics, we adopted a variational mode decomposition technique to decompose the received signal into an ensemble of band-limited intrinsic mode functions, allowing analysis of the acoustic signals by their constitutive components. This prospective study included 15 patients: 12 with clavicle fractures and three with ulna fractures. Contralateral intact bones were used as controls. Statistical analysis demonstrated that fractured bones can be differentiated from intact ones with a detection probability of 80%. Additionally, we introduce a “healing factor” to quantify the bone healing progress which successfully tracked the progress of healing in 80% of the clavicle fractures in the study.

While conventional filtering techniques can effectively exclude tissue-related Doppler shifts from those resulting from blood motions in large vessels (flow rates ~ cm/s), significant spectral overlap can hinder proper clutter filtering in imaging slow flows (flow rates ~ mm/s or tenths of mm/s). Recently, several groups have proposed clutter filtering via processing of echo ensembles in the rank space instead of frequency domain. Though significant Doppler content can result from fast moving tissues, global coherence of the induced variations enables a low rank representation. In this talk, we first provide a brief overview of the low rank clutter removal methods. We then present a new framework for the analysis of Doppler ensembles using multi-linear decomposition of a tensor comprising Doppler ensembles at different rates. The model results in a high dimensional tensor from which, after proper rank selection, images of flow at different speeds can be extracted along different fibers. Using simulation models, we demonstrate the superior performance of the proposed method over singular value clutter filtering in imaging small vessels embedded in moving tissue undergoing both translational and shearing motions. We also present in vivo examples where the proposed method provides significant blood to clutter + noise ratio enhancement compared to singular value clutter filtering.

We hypothesize that pattern of microvasculature in the thyroid nodules can be a biomarker of thyroid cancer. In this study, morphological features of microvasculature networks are assessed as potential biomarkers for differentiation of benign, suspicious and malignant thyroid nodules. This prospective study included n = 81 patients, with a total of 61 benign, 12 suspicious and 8 malignant nodules verfied by pathology and cytology findings. Thyroid nodules were first identified using conventional B-mode ultrasound. A sequence of raw ultrasound data were acquired from each nodule site in two perpendicular planes at ~600 frames/sec. Power Doppler image of the microvasculature was formed using singular value decomposition clutter removal filtering. Gross images were further processed using a combination of morphology and Hessian-based vessel enhancement filtering. Background-free images of the microvasculature networks were segmented (vessels segment length >385μm and diameter >90μm) for morphological analysis. Using a Bayesian framework, measures of vessels density, diameter and tortuosity were tested for significant differences in the three groups. Among all measures, the probability of vessel diameter >600μm in benign cases was significantly higher than that in malignant cases with the p-value <0.01 using Wilcoxon-Rank-Sum test, suggesting reliable cancer detection performance of the proposed method. [Acknowledgment: NIH Grant EB17213.]

Early detection of osteopenia and osteoporosis is critical in identifying at-risk groups and manage necessary therapy. In this paper, a new noninvasive and quantitative vibro-acoustic method is proposed for detection of osteoporosis and osteopenia. In this method, we excite the bone by an ultrasound radiation force (URF) pulse. The URF pulse induces a vibration in the bone, resulting an acoustic wave that is received by a hydrophone placed on the skin. This prospective study included n = 23 volunteers. The number of volunteers with osteopenia and osteoporosis were 7, 6, respectively, and the number of volunteers with normal bone was 10. URF excitations were applied at four equi-distance points on the bone. The resulting acoustic signals were used for wave velocity estimation based on cross-correlation technique. In general, the hydrophone signal may be modeled as a superposition of different modes of bone vibration. Based on this model, we used variational mode decomposition (VMD) as an efficient technique to decompose the received signal into an ensemble of band-limited intrinsic mode functions. Statistical analysis demonstrates that osteopenia and osteoporosis bones can be differentiated from normal bone with p< 0.001 using Wilcoxon rank-sum test on estimated velocity of the modes with maximum power.

Bladder wall mechanical properties are important indicators of bladder compliance. This study compares the effectiveness of the Kelvin-Voigt, Maxwell, and fractional Kelvin-Voigt rheological models in capturing the mechanical properties of normal (compliant) and aberrant (non-compliant) ex-vivo pig bladder walls. Bladders were filled to different volumes, varying their thickness and internal pressure, and excited by the acoustic radiation force. Pulse-echo ultrasound imaged anti-symmetrical Lamb waves traveling along the bladder wall. Two-dimensional Fourier analysis generated velocity-frequency dispersion curves for the Lamb wave propagation. Fitting these experimental curves against theoretical curves from the models yielded values for bladder elasticity and viscosity. Pressure, measured simultaneously, was used as a point of comparison with elasticity. Our findings indicate an increasing trend in both elasticity for the rheological models and recorded pressure with increasing volume. This rate was observed to be significantly higher in aberrant bladders than intact bladders for the Maxwell and fractional Kelvin-Voigt models (p-value of 0.0082). Additionally, all three models showed a similar strong correlation (greater than 0.9) between pressure and elasticity. These findings provide a foundation for selecting an appropriate bladder wall rheology model which can potentially be used in evaluation of human bladder mechanical properties. [Work supported by NIH grant DK99231.]

Healthy human bladder is a viscoelastic shell capable of expanding to allow storage of urine at low pressures. The ability to maintain low pressures as the urine volume increases is called bladder compliance. Compliance is a key in proper functioning of urinary system. Spinal cord injuries and other neurogenic diseases can cause deterioration in bladder expansion capability (e.g., through excessive growth of fibrotic tissue), which in turn can increase the rigidity of the wall and reduce bladder compliance. Urodynamic study (UDS) is the clinical standard for evaluation of the bladder compliance through observation of bladder pressure-volume behavior. However, this method is costly and invasive. Ultrasound bladder vibrometry (UBV) has been introduced as noninvasive technique for evaluation of bladder viscoelasticity through excitation of the bladder using ultrasound radiation force and tracking the resulting Lamb waves. Here, we present the results of UBV from 44 patients undergoing concurrent UDS and UBV studies. Our results show that elasticity parameters obtained from the UBV closely correlate with the UDS pressure-volume data with a median Pearson’s correlation value of more than 0.8. These results prove the potential utility of UBV as an alternative noninvasive method for bladder compliance assessment. [Work supported by NIH grant DK99231.]

There is an urgent need for a noninvasive but more accurate method to assess breast masses before referring the patient to biopsy. In this study, we use the slow viscoelastic creep response to evaluate breast masses at low (<1 Hz) frequencies. This method uses an automated ramp-and-hold compression device and a high-frame-rate ultrasound imaging to track tissue strain. The study cohort included 30 pre-biopsy patients with suspicious masses. Sequential high-frame-rate images were recorded during the ramp-and-hold process. The data were used to calculate the creep response at each point. Then, using a classic linear model, the retardation-time map was created within the field of view. The resulting retardation-time maps exhibited clear distinction of the mass margins. The results showed that benign breast lesions appear with an increase in creep retardation-time compared to surrounding breast glandular tissue, and the opposite trend was true for the malignant lesions. Statistical analysis of the viscoelasticity features revealed that a contrast feature based on the retardation-time is an accurate classifier of malignant and benign masses (P<0.0003). It is concluded that the retardation time is a promising biomarker for differentiation of breast masses. [Work supported by NIH Grant CA168575.]

Ultrasound transient elastography has emerged as a promising imaging modality for noninvasive evaluation of tissue mechanical properties. Most of the established techniques, however, rely on a pointwise measurement of the induced shear wave speed based on a localized planar wave propagation assumption. This assumption is not always true as most tissues exhibit heterogamous characteristics. Complex interaction of different geometries, boundary conditions, and tissue composition limit the ability of these techniques such that additional spatial-temporal filtering and signal truncations are required. These signal conditionings might lead to improvement in elasticity estimation for some cases (e.g. certain geometries, material properties) but the fact that they do not stem from a comprehensive framework can lead to unrealistic mechanical properties in more complex scenarios. We present a generalized framework based on inverse solution of the elasto-dynamic equations which can simultaneously solve for material properties and geometries without requiring any prior knowledge of the wave types. The method is based on a modified error in constitutive equation (MECE) without requiring additional filtering. We present the results of standard phantom studies based on acoustic radiation force excitation and fast ultrasound tracking where MECE technique successfully estimated the elastic moduli and geometry. [Work supported by NIH grant CA174723.]

Low frequency harmonic force excitation can be used for both imaging and tissue characterization. This type of excitation can be achieved via intersecting two beams that slightly differ in frequency. One requirement of this technique is creating focused intersecting beams using available hardware. Previous studies have suggested different configurations for creating harmonic radiation force using linear arrays. However, these methods rely on identical frequency response assumption across all elements of the aperture. In practice, this assumption can be easily violated, especially if the transmit frequencies are not around the center frequency of the probe. When using electronic steering and focusing at different locations, this can result in a non-uniform radiation force pattern due to frequency changes in the sub-aperture. When used for vibro-acoustography, this manifests as vertical streaks in the final image that can severely degrade the quality of the image. We present a novel technique that minimizes element transmit frequency switching which in turn results in a more uniform excitation intensity. The results of applying this aperture configuration for vibro-acoustography imaging of breast phantoms with hard inclusions show significant improvements over previous methods. [This work was supported by NIH Grant R01 EB17213.]