Dual-scanning optical coherence elastography for rapid imaging of two tissue volumes (Conference Presentation)

NASA Astrophysics Data System (ADS)

Fang, Qi; Frewer, Luke; Wijesinghe, Philip; Hamzah, Juliana; Ganss, Ruth; Allen, Wes M.; Sampson, David D.; Curatolo, Andrea; Kennedy, Brendan F.

2017-02-01

In many applications of optical coherence elastography (OCE), it is necessary to rapidly acquire images in vivo, or within intraoperative timeframes, over fields-of-view far greater than can be achieved in one OCT image acquisition. For example, tumour margin assessment in breast cancer requires acquisition over linear dimensions of 4-5 centimetres in under 20 minutes. However, the majority of existing techniques are not compatible with these requirements, which may present a hurdle to the effective translation of OCE. To increase throughput, we have designed and developed an OCE system that simultaneously captures two 3D elastograms from opposite sides of a sample. The optical system comprises two interferometers: a common-path interferometer on one side of the sample and a dual-arm interferometer on the other side. This optical system is combined with scanning mechanisms and compression loading techniques to realize dual-scanning OCE. The optical signals scattered from two volumes are simultaneously detected on a single spectrometer by depth-encoding the interference signal from each interferometer. To demonstrate dual-scanning OCE, we performed measurements on tissue-mimicking phantoms containing rigid inclusions and freshly isolated samples of murine hepatocellular carcinoma, highlighting the use of this technique to visualise 3D tumour stiffness. These findings indicate that our technique holds promise for in vivo and intraoperative applications.

Mechanical characterization of the mouse diaphragm with optical coherence elastography reveals fibrosis-related change of direction-dependent muscle tissue stiffness

NASA Astrophysics Data System (ADS)

Wang, Shang; Loehr, James A.; Larina, Irina V.; Rodney, George G.; Larin, Kirill V.

2016-03-01

The diaphragm, composed of skeletal muscle, plays an important role in respiration through its dynamic contraction. Genetic and molecular studies of the biomechanics of mouse diaphragm can provide great insights into an improved understanding and potential treatment of the disorders that lead to diaphragm dysfunction (i.e. muscular dystrophy). However, due to the small tissue size, mechanical assessment of mouse diaphragm tissue under its proper physiological conditions has been challenging. Here, we present the application of noncontact optical coherence elastography (OCE) for quantitative elastic characterization of ex vivo mouse diaphragm. Phase-sensitive optical coherence tomography was combined with a focused air-puff system to capture and measure the elastic wave propagation from tissue surface. Experiments were performed on wildtype and dystrophic mouse diaphragm tissues containing different levels of fibrosis. The OCE measurements of elastic wave propagation were conducted along both the longitudinal and transverse axis of the muscle fibers. Cross-correlation of the temporal displacement profiles from different spatial locations was utilized to obtain the propagation time delay, which was used to calculate the wave group velocity and to further quantify the tissue Young's modulus. Prior to and after OCE assessment, peak tetanic force was measured to monitor viability of the tissue during the elasticity measurements. Our experimental results indicate a positive correlation between fibrosis level and tissue stiffness, suggesting this elastic-wave-based OCE method could be a useful tool to monitor mechanical properties of skeletal muscle under physiological and pathological conditions.

Dynamic phase-sensitive optical coherence elastography at a true kilohertz frame-rate

NASA Astrophysics Data System (ADS)

Singh, Manmohan; Wu, Chen; Liu, Chih-Hao; Li, Jiasong; Schill, Alexander; Nair, Achuth; Larin, Kirill V.

2016-03-01

Dynamic optical coherence elastography (OCE) techniques have rapidly emerged as a noninvasive way to characterize the biomechanical properties of tissue. However, clinical applications of the majority of these techniques have been unfeasible due to the extended acquisition time because of multiple temporal OCT acquisitions (M-B mode). Moreover, multiple excitations, large datasets, and prolonged laser exposure prohibit their translation to the clinic, where patient discomfort and safety are critical criteria. Here, we demonstrate the feasibility of noncontact true kilohertz frame-rate dynamic optical coherence elastography by directly imaging a focused air-pulse induced elastic wave with a home-built phase-sensitive OCE system. The OCE system was based on a 4X buffered Fourier Domain Mode Locked swept source laser with an A-scan rate of ~1.5 MHz, and imaged the elastic wave propagation at a frame rate of ~7.3 kHz. Because the elastic wave directly imaged, only a single excitation was utilized for one line scan measurement. Rather than acquiring multiple temporal scans at successive spatial locations as with previous techniques, here, successive B-scans were acquired over the measurement region (B-M mode). Preliminary measurements were taken on tissue-mimicking agar phantoms of various concentrations, and the results showed good agreement with uniaxial mechanical compression testing. Then, the elasticity of an in situ porcine cornea in the whole eye-globe configuration at various intraocular pressures was measured. The results showed that this technique can acquire a depth-resolved elastogram in milliseconds. Furthermore, the ultra-fast acquisition ensured that the laser safety exposure limit for the cornea was not exceeded.

Corneal elastic anisotropy and hysteresis as a function of IOP assessed by optical coherence elastography

NASA Astrophysics Data System (ADS)

Li, Jiasong; Singh, Manmohan; Han, Zhaolong; Wu, Chen; Raghunathan, Raksha; Liu, Chih-Hao; Nair, Achuth; Noorani, Shezaan; Aglyamov, Salavat R.; Twa, Michael D.; Larin, Kirill V.

2016-03-01

The mechanical anisotropic properties of the cornea can be an important indicator for determining the onset and severity of different diseases and can be used to assess the efficacy of various therapeutic interventions, such as cross-linking and LASIK surgery. In this work, we introduce a noncontact method of assessing corneal mechanical anisotropy as a function of intraocular pressure (IOP) using optical coherence elastography (OCE). A focused air-pulse induced low amplitude (<10 μm) elastic waves in fresh porcine corneas in the whole eye-globe configuration in situ. A phase-stabilized swept source optical coherence elastography (PhS-SSOCE) system imaged the elastic wave propagation at stepped radial angles, and the OCE measurements were repeated as the IOP was cycled. The elastic wave velocity was then quantified to determine the mechanical anisotropy and hysteresis of the cornea. The results show that the elastic anisotropy at the corneal of the apex of the cornea becomes more pronounced at higher IOPs, and that there are distinct radial angles of higher and lower stiffness. Due to the noncontact nature and small amplitude of the elastic wave, this method may be useful for characterizing the elastic anisotropy of ocular and other tissues in vivo completely noninvasively.

Development and Application of Optical Coherence Elastography for Detection of Mechanical Property Changes Occurring in Early Osteoarthritis

NASA Astrophysics Data System (ADS)

Hirota, Koji

We demonstrate a computationally-efficient method for optical coherence elastography (OCE) based on fringe washout method for a spectral-domain OCT (SD-OCT) system. By sending short pulses of mechanical perturbation with ultrasound or shock wave during the image acquisition of alternating depth profiles, we can extract cross-sectional mechanical assessment of tissue in real-time. This was achieved through a simple comparison of the intensity in adjacent depth profiles acquired during the states of perturbation and non-perturbation in order to quantify the degree of induced fringe washout. Although the results indicate that our OCE technique based on the fringe washout effect is sensitive enough to detect mechanical property changes in biological samples, there is some loss of sensitivity in comparison to previous techniques in order to achieve computationally efficiency and minimum modification in both hardware and software in the OCT system. The tissue phantom study was carried with various agar density samples to characterize our OCE technique. Young's modulus measurements were achieved with the atomic force microscopy (AFM) to correlate to our OCE assessment. Knee cartilage samples of monosodium iodoacetate (MIA) rat models were utilized to replicate cartilage damage of a human model. Our proposed OCE technique along with intensity and AFM measurements were applied to the MIA models to assess the damage. The results from both the phantom study and MIA model study demonstrated the strong capability to assess the changes in mechanical properties of the OCE technique. The correlation between the OCE measurements and the Young's modulus values demonstrated in the OCE data that the stiffer material had less magnitude of fringe washout effect. This result is attributed to the fringe washout effect caused by axial motion that the displacement of the scatterers in the stiffer samples in response to the external perturbation induces less fringe washout effect.

Dynamic and quantitative assessment of blood coagulation using optical coherence elastography

PubMed Central

Xu, Xiangqun; Zhu, Jiang; Chen, Zhongping

2016-01-01

Reliable clot diagnostic systems are needed for directing treatment in a broad spectrum of cardiovascular diseases and coagulopathy. Here, we report on non-contact measurement of elastic modulus for dynamic and quantitative assessment of whole blood coagulation using acoustic radiation force orthogonal excitation optical coherence elastography (ARFOE-OCE). In this system, acoustic radiation force (ARF) is produced by a remote ultrasonic transducer, and a shear wave induced by ARF excitation is detected by the optical coherence tomography (OCT) system. During porcine whole blood coagulation, changes in the elastic property of the clots increase the shear modulus of the sample, altering the propagating velocity of the shear wave. Consequently, dynamic blood coagulation status can be measured quantitatively by relating the velocity of the shear wave with clinically relevant coagulation metrics, including reaction time, clot formation kinetics and maximum shear modulus. The results show that the ARFOE-OCE is sensitive to the clot formation kinetics and can differentiate the elastic properties of the recalcified porcine whole blood, blood added with kaolin as an activator, and blood spiked with fibrinogen. PMID:27090437

Dynamic and quantitative assessment of blood coagulation using optical coherence elastography

NASA Astrophysics Data System (ADS)

Xu, Xiangqun; Zhu, Jiang; Chen, Zhongping

2016-04-01

Reliable clot diagnostic systems are needed for directing treatment in a broad spectrum of cardiovascular diseases and coagulopathy. Here, we report on non-contact measurement of elastic modulus for dynamic and quantitative assessment of whole blood coagulation using acoustic radiation force orthogonal excitation optical coherence elastography (ARFOE-OCE). In this system, acoustic radiation force (ARF) is produced by a remote ultrasonic transducer, and a shear wave induced by ARF excitation is detected by the optical coherence tomography (OCT) system. During porcine whole blood coagulation, changes in the elastic property of the clots increase the shear modulus of the sample, altering the propagating velocity of the shear wave. Consequently, dynamic blood coagulation status can be measured quantitatively by relating the velocity of the shear wave with clinically relevant coagulation metrics, including reaction time, clot formation kinetics and maximum shear modulus. The results show that the ARFOE-OCE is sensitive to the clot formation kinetics and can differentiate the elastic properties of the recalcified porcine whole blood, blood added with kaolin as an activator, and blood spiked with fibrinogen.

Noncontact phase-sensitive dynamic optical coherence elastography at megahertz rate

NASA Astrophysics Data System (ADS)

Singh, Manmohan; Wu, Chen; Liu, Chih-Hao; Li, Jiasong; Schill, Alexander; Nair, Achuth; Kistenev, Yury V.; Larin, Kirill V.

2016-03-01

Dynamic optical coherence elastography (OCE) techniques have shown great promise at quantitatively obtaining the biomechanical properties of tissue. However, the majority of these techniques have required multiple temporal OCT acquisitions (M-B mode) and corresponding excitations, which lead to clinically unfeasible acquisition times and potential tissue damage. Furthermore, the large data sets and extended laser exposures hinder their translation to the clinic, where patient discomfort and safety are critical criteria. In this work we demonstrate noncontact true kilohertz frame-rate dynamic optical coherence elastography by directly imaging a focused air-pulse induced elastic wave with a home-built phase-sensitive OCE system based on a 4X buffered Fourier Domain Mode Locked swept source laser with an A-scan rate of ~1.5 MHz. The elastic wave was imaged at a frame rate of ~7.3 kHz using only a single excitation. In contrast to previous techniques, successive B-scans were acquired over the measurement region (B-M mode) in this work. The feasibility of this method was validated by quantifying the elasticity of tissue-mimicking agar phantoms as well as porcine corneas ex vivo at different intraocular pressures. The results demonstrate that this method can acquire a depth-resolved elastogram in milliseconds. The reduced data set enabled a rapid elasticity assessment, and the ultra-fast acquisition speed allowed for a clinically safe laser exposure to the cornea.

Rapid, noninvasive quantitation of skin disease in systemic sclerosis using optical coherence elastography

NASA Astrophysics Data System (ADS)

Du, Yong; Liu, Chih-Hao; Lei, Ling; Singh, Manmohan; Li, Jiasong; Hicks, M. John; Larin, Kirill V.; Mohan, Chandra

2016-04-01

Systemic sclerosis (SSc) is a connective tissue disease that results in excessive accumulation of collagen in the skin and internal organs. Overall, SSc has a rare morbidity (276 cases per million adults in the United States), but has a 10-year survival rate of 55%. Currently, the modified Rodnan skin score (mRSS) is assessed by palpation on 17 sites on the body. However, the mRSS assessed score is subjective and may be influenced by the experience of the rheumatologists. In addition, the inherent elasticity of skin may bias the mRSS assessment in the early stage of SSc, such as oedematous. Optical coherence elastography (OCE) is a rapidly emerging technique, which can assess mechanical contrast in tissues with micrometer spatial resolution. In this work, the OCE technique is applied to assess the mechanical properties of skin in both control and bleomycin (BLM) induced SSc-like disease noninvasively. Young's modulus of the BLM-SSc skin was found be significantly higher than that of normal skin, in both the in vivo and in vitro studies (p<0.05). Thus, OCE is able to differentiate healthy and fibrotic skin using mechanical contrast. It is a promising new technology for quantifying skin involvement in SSc in a rapid, unbiased, and noninvasive manner.

Longitudinally polarized shear wave optical coherence elastography (Conference Presentation)

NASA Astrophysics Data System (ADS)

Miao, Yusi; Zhu, Jiang; Qi, Li; Qu, Yueqiao; He, Youmin; Gao, Yiwei; Chen, Zhongping

2017-02-01

Shear wave measurement enables quantitative assessment of tissue viscoelasticity. In previous studies, a transverse shear wave was measured using optical coherence elastography (OCE), which gives poor resolution along the force direction because the shear wave propagates perpendicular to the applied force. In this study, for the first time to our knowledge, we introduce an OCE method to detect a longitudinally polarized shear wave that propagates along the force direction. The direction of vibration induced by a piezo transducer (PZT) is parallel to the direction of wave propagation, which is perpendicular to the OCT beam. A Doppler variance method is used to visualize the transverse displacement. Both homogeneous phantoms and a side-by-side two-layer phantom were measured. The elastic moduli from mechanical tests closely matched to the values measured by the OCE system. Furthermore, we developed 3D computational models using finite element analysis to confirm the shear wave propagation in the longitudinal direction. The simulation shows that a longitudinally polarized shear wave is present as a plane wave in the near field of planar source due to diffraction effects. This imaging technique provides a novel method for the assessment of elastic properties along the force direction, which can be especially useful to image a layered tissue.

Quantitative assessment of the mechanical properties of prostate tissue with optical coherence elastography

NASA Astrophysics Data System (ADS)

Ling, Yuting; Li, Chunhui; Zhou, Kanheng; Guan, Guangying; Lang, Stephen; McGloin, David; Nabi, Ghulam; Huang, Zhihong

2018-02-01

Prostate cancer (PCa) is a heterogeneous disease with multifocal origin. In current clinical care, the Gleason scoring system is the well-established diagnosis by microscopic evaluation of the tissue from trans-rectal ultrasound (TRUS) guided biopsies. Nevertheless, the sensitivity and specificity in detecting PCa can range from 40 to 50% for conventional TRUS B-mode imaging. Tissue elasticity is associated with the disease progression and elastography technique has recently shown promise in aiding PCa diagnosis. However, many cancer foci in the prostate gland has very small size less than 1 mm and those detected by medical elastography were larger than 2 mm. Hereby, we introduce optical coherence elastography (OCE) to quantify the prostate stiffness with high resolution in the magnitude of 10 µm. Following our feasibility study of 10 patients reported previously, we recruited 60 more patients undergoing 12-core TRUS guided biopsies for suspected PCa with a total of 720 biopsies. The stiffness of cancer tissue was approximately 57.63% higher than that of benign ones. Using histology as reference standard and cut-off threshold of 600kPa, the data analysis showed sensitivity and specificity of 89.6% and 99.8% respectively. The method also demonstrated potential in characterising different grades of PCa based on the change of tissue morphology and quantitative mechanical properties. In conclusion, quantitative OCE can be a reliable technique to identify PCa lesion and differentiate indolent from aggressive cancer.

Detection of dermal systemic sclerosis using noncontact optical coherence elastography

NASA Astrophysics Data System (ADS)

Liu, Chih-Hao; Du, Yong; Singh, Manmohan; Li, Jiasong; Wu, Chen; Han, Zhaolong; Raghunathan, Raksha; Hsu, Thomas; Noorani, Shezaan; Hicks, M. John; Mohan, Chandra; Larin, Kirill V.

2016-03-01

Systemic sclerosis (SSc) is a connective tissue disease that results in excessive accumulation of collagen in the skin and internal organs. Overall, SSc is a rare disorder, but has a high mortality, particularly in last decade of life. To improve the survival rate, an accurate and early diagnosis is crucial. Currently, the modified Rodnan skin score (mRSS) is the gold standard for evaluating SSc progression based on clinical palpation at 17 sites on the body. However, this procedure can be time consuming, and the assessed score may be biased by the experience of the clinician, causing inter- and intraobserver variabilities. Moreover, the instrinsic elasticity of skin may further bias the mRSS assessment in the early stages of SSc, such as oedematous. To overcome these limitations, there is a need for a rapid, accurate, and objective assessment technique. Optical coherence elastography (OCE) is a novel, rapidly emerging technique, which can assess mechanical contrast in tissues with micrometer spatial resolution. In this work, we demonstrate the first use of OCE to assess the mechanical properties of control and SSc-like diseased skin non-invasively. A focused air-pulse induced an elastic wave in the skin, which was detected by a home-built OCE system. The elastic wave propagated significantly faster in SSc skin compared to healthy skin. The Young's modulus of the SSc skin was significantly higher than that of normal skin (P<0.05). Thus, OCE was able to objectively differentiate healthy and fibrotic skin completely noninvasively and is a promising and potentially useful new technology for quantifying skin involvement in SSc.

Wide-field optical coherence elastography for intraoperative assessment of tumour margins in breast cancer (Conference Presentation)

NASA Astrophysics Data System (ADS)

Allen, Wes M.; Chin, Lixin; Sampson, David D.; Kennedy, Brendan F.

2016-03-01

Incomplete excision of tumour margins is a major issue in breast-conserving surgery. Currently 20 - 60% of cases require a second surgical procedure required as a result of cancer recurrence. A number of techniques have been proposed to assess margin status, including frozen section analysis and imprint cytology. However, the recurrence rate after using these techniques remains very high. Over the last several years, our group has been developing optical coherence elastography (OCE) as a tool for the intraoperative assessment of tumour margins in breast cancer. We have reported a feasibility study on 65 ex vivo samples from patients undergoing mastectomy or wide local excision demonstrates the potential of OCE in differentiating benign from malignant tissue. In this study, malignant tissue was readily distinguished from surrounding relative tissue by a distinctive heterogeneous pattern in micro-elastograms. To date the largest field of view for a micro-elastogram is 20 x 20mm, however, lumpectomy samples are typically ~50 x 50 x 30mm. For OCE to progress as a useful clinical tool, elastograms must be acquired over larger areas to allow a greater portion of the surface area of lumpectomies to be assessed. Here, we propose a wide-field OCE scanner that utilizes a piezoelectric transducer with an internal diameter of 65mm. In this approach partially overlapped elastograms are stitched together forming a mosaic with overall dimensions of 50 x 50mm in a total acquisition time of 15 - 30 minutes. We present results using this approach on both tissue-mimicking phantoms and tissue, and discuss prospects for shorter acquisitions times.

In vivo optical elastography: stress and strain imaging of human skin lesions

NASA Astrophysics Data System (ADS)

Es'haghian, Shaghayegh; Gong, Peijun; Kennedy, Kelsey M.; Wijesinghe, Philip; Sampson, David D.; McLaughlin, Robert A.; Kennedy, Brendan F.

2015-03-01

Probing the mechanical properties of skin at high resolution could aid in the assessment of skin pathologies by, for example, detecting the extent of cancerous skin lesions and assessing pathology in burn scars. Here, we present two elastography techniques based on optical coherence tomography (OCT) to probe the local mechanical properties of skin. The first technique, optical palpation, is a high-resolution tactile imaging technique, which uses a complaint silicone layer positioned on the tissue surface to measure spatially-resolved stress imparted by compressive loading. We assess the performance of optical palpation, using a handheld imaging probe on a skin-mimicking phantom, and demonstrate its use on human skin. The second technique is a strain imaging technique, phase-sensitive compression OCE that maps depth-resolved mechanical variations within skin. We show preliminary results of in vivo phase-sensitive compression OCE on a human skin lesion.

Quantitative shear-wave optical coherence elastography with a programmable phased array ultrasound as the wave source.

PubMed

Song, Shaozhen; Le, Nhan Minh; Huang, Zhihong; Shen, Tueng; Wang, Ruikang K

2015-11-01

The purpose of this study is to implement a beam-steering ultrasound as the wave source for shear-wave optical coherence elastography (SW-OCE) to achieve an extended range of elastic imaging of the tissue sample. We introduce a linear phased array ultrasound transducer (LPAUT) as the remote and programmable wave source and a phase-sensitive optical coherence tomography (OCT) as the sensitive shear-wave detector. The LPAUT is programmed to launch acoustic radiation force impulses (ARFI) focused at desired locations within the range of OCT imaging, upon which the elasticity map of the entire OCT B-scan cross section is recovered by spatial compounding of the elastic maps derived from each launch of AFRIs. We also propose a directional filter to separate the shear-wave propagation at different directions in order to reduce the effect of tissue heterogeneity on the shear-wave propagation within tissue. The feasibility of this proposed approach is then demonstrated by determining the stiffness of tissue-mimicking phantoms with agarose concentrations of 0.5% and 1% and also by imaging the Young's modulus of retinal and choroidal tissues within a porcine eye ball ex vivo. The approach opens up opportunities to combine medical ultrasound imaging and SW-OCE for high-resolution localized quantitative assessment of tissue biomechanical property.

A comparative study of shear wave speed estimation techniques in optical coherence elastography applications

NASA Astrophysics Data System (ADS)

Zvietcovich, Fernando; Yao, Jianing; Chu, Ying-Ju; Meemon, Panomsak; Rolland, Jannick P.; Parker, Kevin J.

2016-03-01

Optical Coherence Elastography (OCE) is a widely investigated noninvasive technique for estimating the mechanical properties of tissue. In particular, vibrational OCE methods aim to estimate the shear wave velocity generated by an external stimulus in order to calculate the elastic modulus of tissue. In this study, we compare the performance of five acquisition and processing techniques for estimating the shear wave speed in simulations and experiments using tissue-mimicking phantoms. Accuracy, contrast-to-noise ratio, and resolution are measured for all cases. The first two techniques make the use of one piezoelectric actuator for generating a continuous shear wave propagation (SWP) and a tone-burst propagation (TBP) of 400 Hz over the gelatin phantom. The other techniques make use of one additional actuator located on the opposite side of the region of interest in order to create an interference pattern. When both actuators have the same frequency, a standing wave (SW) pattern is generated. Otherwise, when there is a frequency difference df between both actuators, a crawling wave (CrW) pattern is generated and propagates with less speed than a shear wave, which makes it suitable for being detected by the 2D cross-sectional OCE imaging. If df is not small compared to the operational frequency, the CrW travels faster and a sampled version of it (SCrW) is acquired by the system. Preliminary results suggest that TBP (error < 4.1%) and SWP (error < 6%) techniques are more accurate when compared to mechanical measurement test results.

Influence of corneal hydration on optical coherence elastography

NASA Astrophysics Data System (ADS)

Twa, Michael D.; Vantipalli, Srilatha; Singh, Manmohan; Li, Jiasong; Larin, Kirill V.

2016-03-01

Corneal biomechanical properties are influenced by several factors, including intraocular pressure, corneal thickness, and viscoelastic responses. Corneal thickness is directly proportional to tissue hydration and can influence corneal stiffness, but there is no consensus on the magnitude or direction of this effect. We evaluated the influence of corneal hydration on dynamic surface deformation responses using optical coherence elastography (OCE). Fresh rabbit eyes (n=10) were prepared by removing the corneal epithelium and dropping with 0.9% saline every 5 minutes for 1 hour, followed by 20% dextran solution every 5 minutes for one hour. Corneal thickness was determined from structural OCT imaging and OCE measurements were performed at baseline and every 20 minutes thereafter. Micron-scale deformations were induced at the apex of the corneal tissue using a spatially-focused (150μm) short-duration (<1ms) air-pulse delivery system. These dynamic tissue responses were measured non-invasively with a phase-stabilized swept source OCT system. The tissue surface deformation response (Relaxation Rate: RR) was quantified as the time constant, over which stimulated tissue recovered from the maximum deformation amplitude. Elastic wave group velocity (GV) was also quantified and correlated with change in corneal thickness due to hydration process. Corneal thickness rapidly increased and remained constant following epithelium removal and changed little thereafter. Likewise, corneal stiffness changed little over the first hour and then decreased sharply after Dextran application (thickness: -46% [-315/682 μm] RR: - 24% [-0.7/2.88 ms-1]; GV: -19% [-0.6/3.2 m/s]). Corneal thickness and corneal stiffness (RR) were well correlated (R2 = .66). Corneal biomechanical properties are highly correlated with tissue hydration over a wide range of corneal thickness and these changes in corneal stiffness are quantifiable using OCE.

Application of new optical coherence elastography to monitor the mineralization processing in bone tissue engineering constructs

NASA Astrophysics Data System (ADS)

Guan, Guangying; Song, Shaozhen; Huang, Zhihong; Yang, Ying

2015-03-01

Generation of functional tissue in vitro through tissue engineering technique is a promising direction to repair and replace malfunctioned organ and tissue in the modern medicine for various diseases which could not been treated well by conventional therapy. Similar to the embryo development, the generation of tissue in vitro is a highly dynamic processing. Obtaining the feedback of the processing real time is highly demanded. In this study, a new methodology has been explored aiming to monitor the morphological and mechanical property alteration of bone tissue engineering constructs simultaneously. Optical coherence elastography (OCE) equipped with a LDS V201 permanent magnet shaker and a modulated acoustic radiation force (ARF) to provide a vibration signal, has been used for the real time and non-destructive monitoring. A phantom construct system has been used to optimize the measurement conditions in which agar hydrogel with concentration from 0, 0.75 to 2% with/without hydroxyappatite particles have been injected to 3D porous poly (lactic acid) scaffolds to simulate the collagenous extracellular matrix (ECM) and mineralized ECM. The structural and elastography images of the constructs have clearly demonstrated the linear relation with the increased mechanical property versus the increase of agar concentration within the pores of the scaffolds. The MG63 bone cells seeded in the scaffolds and cultured for 4 weeks have been monitored by the established protocol exhibiting the increased mechanical strength in the pore wall where the ECM or mineralized ECM was assumed to be formed in comparison to empty pores. This study confirms that OCE-ARF could become a valuable tool in regenerative medicine to assess the biological events during in vitro culture and conditioning.

Imaging shear wave propagation for elastic measurement using OCT Doppler variance method

NASA Astrophysics Data System (ADS)

Zhu, Jiang; Miao, Yusi; Qu, Yueqiao; Ma, Teng; Li, Rui; Du, Yongzhao; Huang, Shenghai; Shung, K. Kirk; Zhou, Qifa; Chen, Zhongping

2016-03-01

In this study, we have developed an acoustic radiation force orthogonal excitation optical coherence elastography (ARFOE-OCE) method for the visualization of the shear wave and the calculation of the shear modulus based on the OCT Doppler variance method. The vibration perpendicular to the OCT detection direction is induced by the remote acoustic radiation force (ARF) and the shear wave propagating along the OCT beam is visualized by the OCT M-scan. The homogeneous agar phantom and two-layer agar phantom are measured using the ARFOE-OCE system. The results show that the ARFOE-OCE system has the ability to measure the shear modulus beyond the OCT imaging depth. The OCT Doppler variance method, instead of the OCT Doppler phase method, is used for vibration detection without the need of high phase stability and phase wrapping correction. An M-scan instead of the B-scan for the visualization of the shear wave also simplifies the data processing.

Measurement of time-varying displacement fields in cell culture for traction force optical coherence microscopy (Conference Presentation)

NASA Astrophysics Data System (ADS)

Mulligan, Jeffrey A.; Adie, Steven G.

2017-02-01

Mechanobiology is an emerging field which seeks to link mechanical forces and properties to the behaviors of cells and tissues in cancer, stem cell growth, and other processes. Traction force microscopy (TFM) is an imaging technique that enables the study of traction forces exerted by cells on their environment to migrate as well as sense and manipulate their surroundings. To date, TFM research has been performed using incoherent imaging modalities and, until recently, has been largely confined to the study of cell-induced tractions within two-dimensions using highly artificial and controlled environments. As the field of mechanobiology advances, and demand grows for research in physiologically relevant 3D culture and in vivo models, TFM will require imaging modalities that support such settings. Optical coherence microscopy (OCM) is an interferometric imaging modality which enables 3D cellular resolution imaging in highly scattering environments. Moreover, optical coherence elastography (OCE) enables the measurement of tissue mechanical properties. OCE relies on the principle of measuring material deformations in response to artificially applied stress. By extension, similar techniques can enable the measurement of cell-induced deformations, imaged with OCM. We propose traction force optical coherence microscopy (TF-OCM) as a natural extension and partner to existing OCM and OCE methods. We report the first use of OCM data and digital image correlation to track temporally varying displacement fields exhibited within a 3D culture setting. These results mark the first steps toward the realization of TF-OCM in 2D and 3D settings, bolstering OCM as a platform for advancing research in mechanobiology.

Noncontact optical coherence elastography of the posterior porcine sclera in situ as a function of IOP

NASA Astrophysics Data System (ADS)

Singh, Manmohan; Nair, Achuth; Aglyamov, Salavat R.; Wu, Chen; Han, Zhaolong; Lafon, Ericka; Larin, Kirill V.

2017-02-01

Recent work has shown that the biomechanical properties of tissues in the posterior eye have are critical for understanding the etiology and progression of ocular diseases. For instance, the primary risk for glaucoma is an elevated intraocular pressure (IOP). Weak tissues will deform under the large pressure, causing damage to vital tissues. In addition, scleral elasticity can influence the shape of the eye-globe, altering the axial length. In this work, we utilize a noncontact form of optical coherence elastography (OCE) to quantify the spatial distribution of biomechanical properties of the optic nerve, its surrounding tissues, and posterior sclera on the exterior of in situ porcine eyes in the whole eyeglobe configuration. The OCE measurements were taken at various IOPs to evaluate the biomechanical properties of the tissues as a function of IOP. The air-pulse induced dynamic response of the tissues was linked to Young's modulus by a simple kinematic equation by quantified the damped natural frequency (DNF). The results show that the posterior sclera is not as stiff as the optic nerve and its surrounding tissues ( 460 Hz and 894 Hz at 10 mmHg IOP, respectively). Moreover, the scleral stiffness was generally unaffected by IOP ( 460 Hz at 10 mmHg IOP as compared to 516 Hz at 20 mmHg), whereas the optic nerve and its surrounding tissues stiffened as IOP was increased ( 894 Hz at 10 mmHg to 1221 Hz at 20 mmHg).

Tissue-mimicking bladder wall phantoms for evaluating acoustic radiation force-optical coherence elastography systems.

PubMed

Ejofodomi, O'tega A; Zderic, Vesna; Zara, Jason M

2010-04-01

Acoustic radiation force-optical coherence elastography (ARF-OCE) systems are novel imaging systems that have the potential to simultaneously quantify and characterize the optical and mechanical properties of in vivo tissues. This article presents the construction of bladder wall phantoms for use in ARF-OCE systems. Mechanical, acoustic, and optical properties are reported and compared to published values for the urinary bladder. The phantom consisted of 0.2000 +/- 0.0089 and 6.0000 +/- 0.2830 microm polystyrene microspheres (Polysciences Inc., Warrington, PA, Catalog Nos. 07304 and 07312), 7.5 +/- 1.5 microm copolymer microspheres composed of acrylonitrile and vinylidene chloride, (Expancel, Duluth, GA, Catalog No. 461 DU 20), and bovine serum albumin within a gelatin matrix. Young's modulus was measured by successive compression of the phantom and obtaining the slope of the resulting force-displacement data. Acoustic measurements were performed using the transmission method. The phantoms were submerged in a water bath and placed between transmitting and receiving 13 mm diameter unfocused transducers operating at a frequency of 3.5 MHz. A MATLAB algorithm to extract the optical scattering coefficient from optical coherence tomography (OCT) images of the phantom was used. The phantoms possess a Young's modulus of 17.12 +/- 2.72 kPa, a mass density of 1.05 +/- 0.02 g/cm3, an acoustic attenuation coefficient of 0.66 +/- 0.08 dB/cm/MHz, a speed of sound of 1591 +/- 8.76 m/s, and an optical scattering coefficient of 1.80 +/- 0.23 mm(-1). Ultrasound and OCT images of the bladder wall phantom are presented. A material that mimics the mechanical, optical, and acoustic properties of healthy bladder wall has been developed. This tissue-mimicking bladder wall phantom was developed as a control tool to investigate the feasibility of using ARF-OCE to detect the mechanical and optical changes that may be indicative of the onset or development of cancer in the urinary bladder. By following the methods used in this article, phantoms matching the optical, acoustic, and mechanical properties of other biological tissues can also be constructed.

Quantitative shear wave imaging optical coherence tomography for noncontact mechanical characterization of myocardium

NASA Astrophysics Data System (ADS)

Wang, Shang; Lopez, Andrew L.; Morikawa, Yuka; Tao, Ge; Li, Jiasong; Larina, Irina V.; Martin, James F.; Larin, Kirill V.

2015-03-01

Optical coherence elastography (OCE) is an emerging low-coherence imaging technique that provides noninvasive assessment of tissue biomechanics with high spatial resolution. Among various OCE methods, the capability of quantitative measurement of tissue elasticity is of great importance for tissue characterization and pathology detection across different samples. Here we report a quantitative OCE technique, termed quantitative shear wave imaging optical coherence tomography (Q-SWI-OCT), which enables noncontact measurement of tissue Young's modulus based on the ultra-fast imaging of the shear wave propagation inside the sample. A focused air-puff device is used to interrogate the tissue with a low-pressure short-duration air stream that stimulates a localized displacement with the scale at micron level. The propagation of this tissue deformation in the form of shear wave is captured by a phase-sensitive OCT system running with the scan of the M-mode imaging over the path of the wave propagation. The temporal characteristics of the shear wave is quantified based on the cross-correlation of the tissue deformation profiles at all the measurement locations, and linear regression is utilized to fit the data plotted in the domain of time delay versus wave propagation distance. The wave group velocity is thus calculated, which results in the quantitative measurement of the Young's modulus. As the feasibility demonstration, experiments are performed on tissuemimicking phantoms with different agar concentrations and the quantified elasticity values with Q-SWI-OCT agree well with the uniaxial compression tests. For functional characterization of myocardium with this OCE technique, we perform our pilot experiments on ex vivo mouse cardiac muscle tissues with two studies, including 1) elasticity difference of cardiac muscle under relaxation and contract conditions and 2) mechanical heterogeneity of the heart introduced by the muscle fiber orientation. Our results suggest the potential of using Q-SWI-OCT as an essential tool for nondestructive biomechanical evaluation of myocardium.

Serial biomechanical comparison of edematous, normal, and collagen crosslinked human donor corneas using optical coherence elastography

PubMed Central

Ford, Matthew R.; Roy, Abhijit Sinha; Rollins, Andrew M.; Dupps, William J.

2014-01-01

PURPOSE To noninvasively evaluate the effects of corneal hydration and collagen crosslinking (CXL) on the mechanical behavior of the cornea. SETTING Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, USA. DESIGN Experimental study. METHODS An optical coherence elastography (OCE) technique was used to measure the displacement behavior of 5 pairs of debrided human donor globes in 3 serial states as follows: edematous, normal thickness, and after riboflavin–ultraviolet-A–mediated CXL. During micromotor-controlled axial displacements with a curved goniolens at physiologic intraocular pressure (IOP), serial optical coherence tomography scans were obtained to allow high-resolution intrastromal speckle tracking and displacement measurements over the central 4.0 mm of the cornea. RESULTS With no imposed increase in IOP, the mean lateral to imposed axial displacement ratios were 0.035 μm/μm ± 0.037 (SD) in edematous corneas, 0.021 ± 0.02 μm/μm in normal thickness corneas, and 0.014 ± 0.009 μm/μm in post-CXL corneas. The differences were statistically significant (P<.05, analysis of variance) and indicated a 40% increase in lateral stromal resistance with deturgescence and a further 33% mean increase in relative stiffness with CXL. CONCLUSIONS Serial perturbations of the corneal hydration state and CXL had significant effects on corneal biomechanical behavior. With an axially applied stress from a nonapplanating contact lens, displacements along the direction of the collagen lamellae were 2 orders of magnitude lower than axial deformations. These experiments show the ability of OCE to quantify clinically relevant mechanical property differences under physiologic conditions. Financial Disclosures Proprietary or commercial disclosures are listed after the references. PMID:24767794

Evaluating the Effects of Riboflavin/UV-A and Rose-Bengal/Green Light Cross-Linking of the Rabbit Cornea by Noncontact Optical Coherence Elastography

PubMed Central

Singh, Manmohan; Li, Jiasong; Han, Zhaolong; Vantipalli, Srilatha; Liu, Chih-Hao; Wu, Chen; Raghunathan, Raksha; Aglyamov, Salavat R.; Twa, Michael D.; Larin, Kirill V.

2016-01-01

Purpose The purpose of this study was to use noncontact optical coherence elastography (OCE) to evaluate and compare changes in biomechanical properties that occurred in rabbit cornea in situ after corneal collagen cross-linking by either of two techniques: ultraviolet-A (UV-A)/riboflavin or rose-Bengal/green light. Methods Low-amplitude (≤10 μm) elastic waves were induced in mature rabbit corneas by a focused air pulse. Elastic wave propagation was imaged by a phase-stabilized swept source OCE (PhS-SSOCE) system. Corneas were then cross-linked by either of two methods: UV-A/riboflavin (UV-CXL) or rose-Bengal/green light (RGX). Phase velocities of the elastic waves were fitted to a previously developed modified Rayleigh-Lamb frequency equation to obtain the viscoelasticity of the corneas before and after the cross-linking treatments. Micro-scale depth-resolved phase velocity distribution revealed the depth-wise heterogeneity of both cross-linking techniques. Results Under standard treatment settings, UV-CXL significantly increased the stiffness of the corneas by ∼47% (P < 0.05), but RGX did not produce statistically significant increases. The shear viscosities were unaffected by either cross-linking technique. The depth-wise phase velocities showed that UV-CXL affected the anterior ∼34% of the corneas, whereas RGX affected only the anterior ∼16% of the corneas. Conclusions UV-CXL significantly strengthens the cornea, whereas RGX does not, and the effects of cross-linking by UV-CXL reach deeper into the cornea than cross-linking effects of RGX under similar conditions. PMID:27409461

Towards intraoperative assessment of tumor margins in breast surgery using optical coherence elastography (Conference Presentation)

NASA Astrophysics Data System (ADS)

Kennedy, Brendan F.; Wijesinghe, Philip; Allen, Wes M.; Chin, Lixin; Latham, Bruce; Saunders, Christobel M.; Sampson, David D.

2016-03-01

Surgical excision of tumor is a critical factor in the management of breast cancer. The most common surgical procedure is breast-conserving surgery. The surgeon's goal is to remove the tumor and a rim of healthy tissue surrounding the tumor: the surgical margin. A major issue in breast-conserving surgery is the absence of a reliable tool to guide the surgeon in intraoperatively assessing the margin. A number of techniques have been proposed; however, the re-excision rate remains high and has been reported to be in the range 30-60%. New tools are needed to address this issue. Optical coherence elastography (OCE) shows promise as a tool for intraoperative tumor margin assessment in breast-conserving surgery. Further advances towards clinical translation are limited by long scan times and small fields of view. In particular, scanning over sufficient areas to assess the entire margin in an intraoperative timeframe has not been shown to be feasible. Here, we present a protocol allowing ~75% of the surgical margins to be assessed within 30 minutes. To achieve this, we have incorporated a 65 mm-diameter (internal), wide-aperture annular piezoelectric transducer, allowing the entire surface of the excised tumor mass to be automatically imaged in an OCT mosaic comprised of 10 × 10 mm tiles. As OCT is effective in identifying adipose tissue, our protocol uses the wide-field OCT to selectively guide subsequent local OCE scanning to regions of solid tissue which often present low contrast in OCT images. We present promising examples from freshly excised human breast tissue.

Swept-source anatomic optical coherence elastography of porcine trachea

NASA Astrophysics Data System (ADS)

Bu, Ruofei; Price, Hillel; Mitran, Sorin; Zdanski, Carlton; Oldenburg, Amy L.

2016-02-01

Quantitative endoscopic imaging is at the vanguard of novel techniques in the assessment upper airway obstruction. Anatomic optical coherence tomography (aOCT) has the potential to provide the geometry of the airway lumen with high-resolution and in 4 dimensions. By coupling aOCT with measurements of pressure, optical coherence elastography (OCE) can be performed to characterize airway wall stiffness. This can aid in identifying regions of dynamic collapse as well as informing computational fluid dynamics modeling to aid in surgical decision-making. Toward this end, here we report on an anatomic optical coherence tomography (aOCT) system powered by a wavelength-swept laser source. The system employs a fiber-optic catheter with outer diameter of 0.82 mm deployed via the bore of a commercial, flexible bronchoscope. Helical scans are performed to measure the airway geometry and to quantify the cross-sectional-area (CSA) of the airway. We report on a preliminary validation of aOCT for elastography, in which aOCT-derived CSA was obtained as a function of pressure to estimate airway wall compliance. Experiments performed on a Latex rubber tube resulted in a compliance measurement of 0.68+/-0.02 mm2/cmH2O, with R2=0.98 over the pressure range from 10 to 40 cmH2O. Next, ex vivo porcine trachea was studied, resulting in a measured compliance from 1.06+/-0.12 to 3.34+/-0.44 mm2/cmH2O, (R2>0.81). The linearity of the data confirms the elastic nature of the airway. The compliance values are within the same order-of-magnitude as previous measurements of human upper airways, suggesting that this system is capable of assessing airway wall compliance in future human studies.

Non-invasive structural and biomechanical imaging of the developing embryos (Conference Presentation)

NASA Astrophysics Data System (ADS)

Zhang, Jitao; Wu, Chen; Raghunathan, Raksha; Larin, Kirill V.; Scarcelli, Giuliano

2017-02-01

Embryos undergo dramatic changes in size, shape, and mechanical properties during development, which is regulated by both genetic and environmental factors. Quantifying mechanical properties of different embryonic tissues may represent good metrics for the embryonic health and proper development. Alternations and structure coupled with biomechanical information may provide a way for early diagnosis and drug treatment of various congenital diseases. Many methods have been developed to determine the mechanical properties of the embryo, such as atomic force microscopy (AFM), ultrasound elastography (UE), and optical coherent elastography (OCE). However, AFM is invasive and time-consuming. While UE and OCE are both non-invasive methods, the spatial resolutions are limited to mm to sub-mm, which is not enough to observe the details inside the embryo. Brillouin microscopy can potentially enable non-invasive measurement of the mechanical properties of a sample by measuring the spectra of acoustically induced light scattering therein. It has fast speed ( 0.1 second per point) and high resolution (sub-micron), and thus has been widely investigated for biomedical application, such as single cell and tissue. In this work, we utilized this technique to characterize the mechanical property of an embryo. A 2D elasticity imaging of the whole body of an E8 embryo was acquired by a Brillouin microscopy, and the stiffness changes between different organs (such as brain, heart, and spine) were shown. The elasticity maps were correlated with structural information provided by OCT.

Optical Elastography of Systemic Sclerosis Skin

DTIC Science & Technology

2017-09-01

1, the animal model of SSc has been successfully re-established. In addition, animals are being scheduled for the proposed treatment and monitoring...study. 15. SUBJECT TERMS Systemic Sclerosis, Imaging, Skin, Diagnostics, Animal Models, OCT, OCE 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF...Diagnostics, Animal Models, OCT, OCE 3.ACCOMPLISHMENTS: o What were the major goals of the project? The goals of Aim 1, as outlined in the SOW were

Functional optical coherence tomography: principles and progress

NASA Astrophysics Data System (ADS)

Kim, Jina; Brown, William; Maher, Jason R.; Levinson, Howard; Wax, Adam

2015-05-01

In the past decade, several functional extensions of optical coherence tomography (OCT) have emerged, and this review highlights key advances in instrumentation, theoretical analysis, signal processing and clinical application of these extensions. We review five principal extensions: Doppler OCT (DOCT), polarization-sensitive OCT (PS-OCT), optical coherence elastography (OCE), spectroscopic OCT (SOCT), and molecular imaging OCT. The former three have been further developed with studies in both ex vivo and in vivo human tissues. This review emphasizes the newer techniques of SOCT and molecular imaging OCT, which show excellent potential for clinical application but have yet to be well reviewed in the literature. SOCT elucidates tissue characteristics, such as oxygenation and carcinogenesis, by detecting wavelength-dependent absorption and scattering of light in tissues. While SOCT measures endogenous biochemical distributions, molecular imaging OCT detects exogenous molecular contrast agents. These newer advances in functional OCT broaden the potential clinical application of OCT by providing novel ways to understand tissue activity that cannot be accomplished by other current imaging methodologies.

Functional Optical Coherence Tomography: Principles and Progress

PubMed Central

Kim, Jina; Brown, William; Maher, Jason R.; Levinson, Howard; Wax, Adam

2015-01-01

In the past decade, several functional extensions of optical coherence tomography (OCT) have emerged, and this review highlights key advances in instrumentation, theoretical analysis, signal processing and clinical application of these extensions. We review five principal extensions: Doppler OCT (DOCT), polarization-sensitive OCT (PS-OCT), optical coherence elastography (OCE), spectroscopic OCT (SOCT), and molecular imaging OCT. The former three have been further developed with studies in both ex vivo and in vivo human tissues. This review emphasizes the newer techniques of SOCT and molecular imaging OCT, which show excellent potential for clinical application but have yet to be well reviewed in the literature. SOCT elucidates tissue characteristics, such as oxygenation and carcinogenesis, by detecting wavelength-dependent absorption and scattering of light in tissues. While SOCT measures endogenous biochemical distributions, molecular imaging OCT detects exogenous molecular contrast agents. These newer advances in functional OCT broaden the potential clinical application of OCT by providing novel ways to understand tissue activity that cannot be accomplished by other current imaging methodologies. PMID:25951836

Ultra-high speed OCT allows measurement of intraocular pressure, corneal geometry, and corneal stiffness using a single instrument

NASA Astrophysics Data System (ADS)

Singh, Manmohan; Han, Zhaolong; Nair, Achuth; Schill, Alexander; Twa, Michael D.; Larin, Kirill V.

2018-02-01

Screening for ocular diseases, such as glaucoma and keratoconus, includes measuring the eye-globe intraocular pressure (IOP) and corneal biomechanical properties. However, currently available clinical tools cannot quantify corneal tissue material parameters, which can provide critical information for detecting diseases and evaluating therapeutic outcomes. Here, we demonstrate measurement of eye-globe IOP, corneal elasticity, and corneal geometry of in situ porcine corneas with a technique termed applanation optical coherence elastography (Appl-OCE) with single instrument. We utilize an ultrafast phase-sensitive optical coherence tomography system comprised of a 4X buffered Fourier domain mode-locked swept source laser with an Ascan rate of 1.5 MHz and a 7.3 kHz resonant scanner. The IOP was measured by imaging the response of in situ porcine corneas to a large force air-puff. As with other noncontact tonometers, the time when the cornea was applanated during the inwards and outwards motion was correlated to a measure air-pressure temporal profile. The IOP was also measured with a commercially available rebound tonometer for comparison. The stiffness of the corneas was assessed by directly imaging and analyzing the propagation of a focused micro air-pulse induced elastic wave, and the corneal geometry was obtained from the OCT structural image. Our results show that corneal thickness decreased as IOP increased, and that corneal stiffness increased with IOP. Moreover, the IOP measurements made by Appl-OCE were more closely correlated with the artificially set IOP than the rebound tonometer, demonstrating the capabilities of Appl-OCE to measure corneal stiffness, eye-globe IOP, and corneal geometry with a single instrument.

Optical coherence tomography for image-guided dermal filler injection and biomechanical evaluation

NASA Astrophysics Data System (ADS)

Singh, Manmohan; Wang, Shang; Yee, Richard W.; Han, Zhaolong; Aglyamov, Salavat R.; Larin, Kirill V.

2017-02-01

Dermal fillers are a very popular anti-ag ing treatment with estimated sales in the billions of dollars and millions of procedures performed. As the aging population continues to grow, these figures are only e xpected to increase. Dermal fillers have various compositions depending on their intended applicati on. Reactions to dermal fillers can be severe, such as ischemic events and filler migration to the eyes. Howe ver, these adverse reactions are rare. Nevertheless, the capability to perform imag e-guided filler injections would minimize th e risk of such reacti ons. In addition, the biomechanical properties of various fillers have been evalua ted, but there has been no investigation on the effects of filler on the biomechanical properties of skin. In this work, we utilize optical cohe rence tomography (OCT) for visualizing dermal filler injections with micrometer-scale sp atial resolution. In addition, we utilize noncontact optical coherence elastography (OCE) to quantify the changes in the biomechan ical properties of pig skin after the dermal filler injections. OCT was successfully able to visualize the dermal filler injecti on process, and OCE showed that the viscoelasticity of the pig skin was increased locally at the filler injection sites. OCT may be able to provide real-time image guidance in 3D, and when combined with functional OCT techniques such as optical microangiography, could be used to avoid blood vessels during the injection.

Quantified elasticity mapping of ocular tissue using acoustic radiation force optical coherence elastography (Conference Presentation)

NASA Astrophysics Data System (ADS)

Qu, Yueqiao; He, Youmin; Zhang, Yi; Ma, Teng; Zhu, Jiang; Miao, Yusi; Dai, Cuixia; Silverman, Ronald; Humayun, Mark S.; Zhou, Qifa; Chen, Zhongping

2017-02-01

Age-related macular degeneration and keratoconus are two ocular diseases occurring in the posterior and anterior eye, respectively. In both conditions, the mechanical elasticity of the respective tissues changes during the early onset of disease. It is necessary to detect these differences and treat the diseases in their early stages to provide proper treatment. Acoustic radiation force optical coherence elastography is a method of elasticity mapping using confocal ultrasound waves for excitation and Doppler optical coherence tomography for detection. We report on an ARF-OCE system that uses modulated compression wave based excitation signals, and detects the spatial and frequency responses of the tissue. First, all components of the system is synchronized and triggered such that the signal is consistent between frames. Next, phantom studies are performed to validate and calibrate the relationship between the resonance frequency and the Young's modulus. Then the frequency responses of the anterior and posterior eye are detected for porcine and rabbit eyes, and the results correlated to the elasticity. Finally, spatial elastograms are obtained for a porcine retina. Layer segmentation and analysis is performed and correlated to the histology of the retina, where five distinct layers are recognized. The elasticities of the tissue layers will be quantified according to the mean thickness and displacement response for the locations on the retina. This study is a stepping stone to future in-vivo animal studies, where the elastic modulus of the ocular tissue can be quantified and mapped out accordingly.

Classifying murine glomerulonephritis using optical coherence tomography and optical coherence elastography.

PubMed

Liu, Chih-Hao; Du, Yong; Singh, Manmohan; Wu, Chen; Han, Zhaolong; Li, Jiasong; Chang, Anthony; Mohan, Chandra; Larin, Kirill V

2016-08-01

Acute glomerulonephritis caused by antiglomerular basement membrane marked by high mortality. The primary reason for this is delayed diagnosis via blood examination, urine analysis, tissue biopsy, or ultrasound and X-ray computed tomography imaging. Blood, urine, and tissue-based diagnoses can be time consuming, while ultrasound and CT imaging have relatively low spatial resolution, with reduced sensitivity. Optical coherence tomography is a noninvasive and high-resolution imaging technique that provides superior spatial resolution (micrometer scale) as compared to ultrasound and CT. Changes in tissue properties can be detected based on the optical metrics analyzed from the OCT signals, such as optical attenuation and speckle variance. Furthermore, OCT does not rely on ionizing radiation as with CT imaging. In addition to structural changes, the elasticity of the kidney can significantly change due to nephritis. In this work, OCT has been utilized to quantify the difference in tissue properties between healthy and nephritic murine kidneys. Although OCT imaging could identify the diseased tissue, its classification accuracy is clinically inadequate. By combining optical metrics with elasticity, the classification accuracy improves from 76% to 95%. These results show that OCT combined with OCE can be a powerful tool for identifying and classifying nephritis. Therefore, the OCT/OCE method could potentially be used as a minimally invasive tool for longitudinal studies during the progression and therapy of glomerulonephritis as well as complement and, perhaps, substitute highly invasive tissue biopsies. Elastic-wave propagation in mouse healthy and nephritic kidneys. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Assessing the changes in the spatial stiffness of the posterior sclera as a function of IOP with air-pulse OCE

NASA Astrophysics Data System (ADS)

Singh, Manmohan; Nair, Achuth; Aglyamov, Salavat R.; Wu, Chen; Han, Zhaolong; Lafon, Ericka; Larin, Kirill V.

2017-02-01

The mechanophysiology of tissues in the posterior eye have been implicated for diseases such as myopia and glaucoma. For example, the eye-globe shape, and consequently optical axial length, can be affected by scleral stiffness. In glaucoma, an elevated intraocular pressure is the primary risk factor for glaucoma, which is the 2nd most prevalent known cause of blindness. Recent work has shown that biomechanical properties of the optic nerve are critical for the onset and progression of glaucoma because weak tissues cause large displacements in the optic nerve, causing tissue damage. In this work, we utilize air-pulse optical coherence elastography (OCE) to quantify the spatial distribution of biomechanical properties of the optic nerve, its surrounding tissues, and the posterior sclera. Air-pulse measurements were made in a grid on in situ porcine eyes in the whole eye-globe configuration as various IOPs. The OCE-measured displacement process was linked to tissue stiffness by a simple kinematic equation. The results show that the optic nerve and peripapillary sclera are much stiffer than the surrounding sclera, and the stiffness of the optic nerve and peripapillary sclera increased as a function of IOP. However, the stiffness of the surrounding sclera did not dramatically increase. Our results show that understanding the dynamics of the biomechanical properties of the eye are critical to understand the aforementioned diseases and may provide additional information for assessing visual health and integrity.

Quantitative analysis of retina layer elasticity based on automatic 3D segmentation (Conference Presentation)

NASA Astrophysics Data System (ADS)

He, Youmin; Qu, Yueqiao; Zhang, Yi; Ma, Teng; Zhu, Jiang; Miao, Yusi; Humayun, Mark; Zhou, Qifa; Chen, Zhongping

2017-02-01

Age-related macular degeneration (AMD) is an eye condition that is considered to be one of the leading causes of blindness among people over 50. Recent studies suggest that the mechanical properties in retina layers are affected during the early onset of disease. Therefore, it is necessary to identify such changes in the individual layers of the retina so as to provide useful information for disease diagnosis. In this study, we propose using an acoustic radiation force optical coherence elastography (ARF-OCE) system to dynamically excite the porcine retina and detect the vibrational displacement with phase resolved Doppler optical coherence tomography. Due to the vibrational mechanism of the tissue response, the image quality is compromised during elastogram acquisition. In order to properly analyze the images, all signals, including the trigger and control signals for excitation, as well as detection and scanning signals, are synchronized within the OCE software and are kept consistent between frames, making it possible for easy phase unwrapping and elasticity analysis. In addition, a combination of segmentation algorithms is used to accommodate the compromised image quality. An automatic 3D segmentation method has been developed to isolate and measure the relative elasticity of every individual retinal layer. Two different segmentation schemes based on random walker and dynamic programming are implemented. The algorithm has been validated using a 3D region of the porcine retina, where individual layers have been isolated and analyzed using statistical methods. The errors compared to manual segmentation will be calculated.

Ultrahigh phase-stable swept-source optical coherence tomography as a cardiac imaging platform (Conference Presentation)

NASA Astrophysics Data System (ADS)

Ling, Yuye; Hendon, Christine P.

2016-02-01

Functional extensions to optical coherence tomography (OCT) provide useful imaging contrasts that are complementary to conventional OCT. Our goal is to characterize tissue types within the myocardial due to remodeling and therapy. High-speed imaging is necessary to extract mechanical properties and dynamics of fiber orientation changes in a beating heart. Functional extensions of OCT such as polarization sensitive and optical coherence elastography (OCE) require high phase stability of the system, which is a drawback of current mechanically tuned swept source OCT systems. Here we present a high-speed functional imaging platform, which includes an ultrahigh-phase-stable swept source equipped with KTN deflector from NTT-AT. The swept source does not require mechanical movements during the wavelength sweeping; it is electrically tuned. The inter-sweep phase variance of the system was measured to be less than 300 ps at a path length difference of ~2 mm. The axial resolution of the system is 20 µm and the -10 dB fall-off depth is about 3.2 mm. The sample arm has an 8 mmx8 mm field of view with a lateral resolution of approximately 18 µm. The sample arm uses a two-axis MEMS mirror, which is programmable and capable of scanning arbitrary patterns at a sampling rate of 50 kHz. Preliminary imaging results showed differences in polarization properties and image penetration in ablated and normal myocardium. In the future, we will conduct dynamic stretching experiments with strips of human myocardial tissue to characterize mechanical properties using OCE. With high speed imaging of 200 kHz and an all-fiber design, we will work towards catheter-based functional imaging.

Combined optical coherence tomography and optical coherence elastography for glomerulonephritis classification

NASA Astrophysics Data System (ADS)

Liu, Chih-Hao; Du, Yong; Singh, Manmohan; Wu, Chen; Han, Zhaolong; Li, Jiasong; Mohammadzai, Qais; Raghunathan, Raksha; Hsu, Thomas; Noorani, Shezaan; Chang, Anthony; Mohan, Chandra; Larin, Kirill V.

2016-03-01

Acute Glomerulonephritis caused by anti-glomerular basement membrane disease has a high mortality due to delayed diagnosis. Thus, an accurate and early diagnosis is critical for preserving renal function. Currently, blood, urine, and tissue-based diagnoses can be time consuming, while ultrasound and CT imaging have relatively low spatial resolution. Optical coherence tomography (OCT) is a noninvasive imaging technique that provides superior spatial resolution (micron scale) as compared to ultrasound and CT. Pathological changes in tissue properties can be detected based on the optical metrics analyzed from the OCT signal, such as optical attenuation and speckle variance. Moreover, OCT does not rely on ionizing radiation as with CT imaging. In addition to structural changes, the elasticity of the kidney can significantly change due to nephritis. In this work, we utilized OCT to detect the difference in tissue properties between healthy and nephritic murine kidneys. Although OCT imaging could identify the diseased tissue, classification accuracy using only optical metrics was clinically inadequate. By combining optical metrics with elasticity, the classification accuracy improved from 76% to 95%. These results show that OCT combined with OCE can be potentially useful for nephritis detection.

OCT-based approach to local relaxations discrimination from translational relaxation motions

NASA Astrophysics Data System (ADS)

Matveev, Lev A.; Matveyev, Alexandr L.; Gubarkova, Ekaterina V.; Gelikonov, Grigory V.; Sirotkina, Marina A.; Kiseleva, Elena B.; Gelikonov, Valentin M.; Gladkova, Natalia D.; Vitkin, Alex; Zaitsev, Vladimir Y.

2016-04-01

Multimodal optical coherence tomography (OCT) is an emerging tool for tissue state characterization. Optical coherence elastography (OCE) is an approach to mapping mechanical properties of tissue based on OCT. One of challenging problems in OCE is elimination of the influence of residual local tissue relaxation that complicates obtaining information on elastic properties of the tissue. Alternatively, parameters of local relaxation itself can be used as an additional informative characteristic for distinguishing the tissue in normal and pathological states over the OCT image area. Here we briefly present an OCT-based approach to evaluation of local relaxation processes in the tissue bulk after sudden unloading of its initial pre-compression. For extracting the local relaxation rate we evaluate temporal dependence of local strains that are mapped using our recently developed hybrid phase resolved/displacement-tracking (HPRDT) approach. This approach allows one to subtract the contribution of global displacements of scatterers in OCT scans and separate the temporal evolution of local strains. Using a sample excised from of a coronary arteria, we demonstrate that the observed relaxation of local strains can be reasonably fitted by an exponential law, which opens the possibility to characterize the tissue by a single relaxation time. The estimated local relaxation times are assumed to be related to local biologically-relevant processes inside the tissue, such as diffusion, leaking/draining of the fluids, local folding/unfolding of the fibers, etc. In general, studies of evolution of such features can provide new metrics for biologically-relevant changes in tissue, e.g., in the problems of treatment monitoring.

Optical coherence tomography detection of shear wave propagation in inhomogeneous tissue equivalent phantoms and ex-vivo carotid artery samples

PubMed Central

Razani, Marjan; Luk, Timothy W.H.; Mariampillai, Adrian; Siegler, Peter; Kiehl, Tim-Rasmus; Kolios, Michael C.; Yang, Victor X.D.

2014-01-01

In this work, we explored the potential of measuring shear wave propagation using optical coherence elastography (OCE) in an inhomogeneous phantom and carotid artery samples based on a swept-source optical coherence tomography (OCT) system. Shear waves were generated using a piezoelectric transducer transmitting sine-wave bursts of 400 μs duration, applying acoustic radiation force (ARF) to inhomogeneous phantoms and carotid artery samples, synchronized with a swept-source OCT (SS-OCT) imaging system. The phantoms were composed of gelatin and titanium dioxide whereas the carotid artery samples were embedded in gel. Differential OCT phase maps, measured with and without the ARF, detected the microscopic displacement generated by shear wave propagation in these phantoms and samples of different stiffness. We present the technique for calculating tissue mechanical properties by propagating shear waves in inhomogeneous tissue equivalent phantoms and carotid artery samples using the ARF of an ultrasound transducer, and measuring the shear wave speed and its associated properties in the different layers with OCT phase maps. This method lays the foundation for future in-vitro and in-vivo studies of mechanical property measurements of biological tissues such as vascular tissues, where normal and pathological structures may exhibit significant contrast in the shear modulus. PMID:24688822

Imaging and characterizing shear wave and shear modulus under orthogonal acoustic radiation force excitation using OCT Doppler variance method.

PubMed

Zhu, Jiang; Qu, Yueqiao; Ma, Teng; Li, Rui; Du, Yongzhao; Huang, Shenghai; Shung, K Kirk; Zhou, Qifa; Chen, Zhongping

2015-05-01

We report on a novel acoustic radiation force orthogonal excitation optical coherence elastography (ARFOE-OCE) technique for imaging shear wave and quantifying shear modulus under orthogonal acoustic radiation force (ARF) excitation using the optical coherence tomography (OCT) Doppler variance method. The ARF perpendicular to the OCT beam is produced by a remote ultrasonic transducer. A shear wave induced by ARF excitation propagates parallel to the OCT beam. The OCT Doppler variance method, which is sensitive to the transverse vibration, is used to measure the ARF-induced vibration. For analysis of the shear modulus, the Doppler variance method is utilized to visualize shear wave propagation instead of Doppler OCT method, and the propagation velocity of the shear wave is measured at different depths of one location with the M scan. In order to quantify shear modulus beyond the OCT imaging depth, we move ARF to a deeper layer at a known step and measure the time delay of the shear wave propagating to the same OCT imaging depth. We also quantitatively map the shear modulus of a cross-section in a tissue-equivalent phantom after employing the B scan.

High-resolution harmonic motion imaging (HR-HMI) for tissue biomechanical property characterization

PubMed Central

Ma, Teng; Qian, Xuejun; Chiu, Chi Tat; Yu, Mingyue; Jung, Hayong; Tung, Yao-Sheng; Shung, K. Kirk

2015-01-01

Background Elastography, capable of mapping the biomechanical properties of biological tissues, serves as a useful technique for clinicians to perform disease diagnosis and determine stages of many diseases. Many acoustic radiation force (ARF) based elastography, including acoustic radiation force impulse (ARFI) imaging and harmonic motion imaging (HMI), have been developed to remotely assess the elastic properties of tissues. However, due to the lower operating frequencies of these approaches, their spatial resolutions are insufficient for revealing stiffness distribution on small scale applications, such as cancerous tumor margin detection, atherosclerotic plaque composition analysis and ophthalmologic tissue characterization. Though recently developed ARF-based optical coherence elastography (OCE) methods open a new window for the high resolution elastography, shallow imaging depths significantly limit their usefulness in clinics. Methods The aim of this study is to develop a high-resolution HMI method to assess the tissue biomechanical properties with acceptable field of view (FOV) using a 4 MHz ring transducer for efficient excitation and a 40 MHz needle transducer for accurate detection. Under precise alignment of two confocal transducers, the high-resolution HMI system has a lateral resolution of 314 µm and an axial resolution of 
147 µm with an effective FOV of 2 mm in depth. Results The performance of this high resolution imaging system was validated on the agar-based tissue mimicking phantoms with different stiffness distributions. These data demonstrated the imaging system’s improved resolution and sensitivity on differentiating materials with varying stiffness. In addition, ex vivo imaging of a human atherosclerosis coronary artery demonstrated the capability of high resolution HMI in identifying layer-specific structures and characterizing atherosclerotic plaques based on their stiffness differences. Conclusions All together high resolution HMI appears to be a promising ultrasound-only technology for characterizing tissue biomechanical properties at the microstructural level to improve the image-based diseases diagnosis in multiple clinical applications. PMID:25694960

High-resolution harmonic motion imaging (HR-HMI) for tissue biomechanical property characterization.

PubMed

Ma, Teng; Qian, Xuejun; Chiu, Chi Tat; Yu, Mingyue; Jung, Hayong; Tung, Yao-Sheng; Shung, K Kirk; Zhou, Qifa

2015-02-01

Elastography, capable of mapping the biomechanical properties of biological tissues, serves as a useful technique for clinicians to perform disease diagnosis and determine stages of many diseases. Many acoustic radiation force (ARF) based elastography, including acoustic radiation force impulse (ARFI) imaging and harmonic motion imaging (HMI), have been developed to remotely assess the elastic properties of tissues. However, due to the lower operating frequencies of these approaches, their spatial resolutions are insufficient for revealing stiffness distribution on small scale applications, such as cancerous tumor margin detection, atherosclerotic plaque composition analysis and ophthalmologic tissue characterization. Though recently developed ARF-based optical coherence elastography (OCE) methods open a new window for the high resolution elastography, shallow imaging depths significantly limit their usefulness in clinics. The aim of this study is to develop a high-resolution HMI method to assess the tissue biomechanical properties with acceptable field of view (FOV) using a 4 MHz ring transducer for efficient excitation and a 40 MHz needle transducer for accurate detection. Under precise alignment of two confocal transducers, the high-resolution HMI system has a lateral resolution of 314 µm and an axial resolution of 
147 µm with an effective FOV of 2 mm in depth. The performance of this high resolution imaging system was validated on the agar-based tissue mimicking phantoms with different stiffness distributions. These data demonstrated the imaging system's improved resolution and sensitivity on differentiating materials with varying stiffness. In addition, ex vivo imaging of a human atherosclerosis coronary artery demonstrated the capability of high resolution HMI in identifying layer-specific structures and characterizing atherosclerotic plaques based on their stiffness differences. All together high resolution HMI appears to be a promising ultrasound-only technology for characterizing tissue biomechanical properties at the microstructural level to improve the image-based diseases diagnosis in multiple clinical applications.

Evaluation of posterior porcine sclera elasticity in situ as a function of IOP

NASA Astrophysics Data System (ADS)

Nair, Achuth; Wu, Chen; Singh, Manmohan; Liu, Chih Hao; Raghunathan, Raksha; Nguyen, Jennifer; Goh, Megan; Aglyamov, Salavat; Larin, Kirill V.

2018-02-01

The biomechanical properties of the sclera could provide key information regarding the progression and etiology of ocular diseases. For example, an elevated intraocular pressure is one of the most common risk factors for glaucoma and can cause pathological deformations in the tissues of the posterior eye, such as the sclera, potentially damaging these vital tissues. Previous work has evaluated scleral biomechanical response to global displacements with techniques such as inflation testing. However, these methods cannot provide localized biomechanical assessments. In this pilot work, we induce low amplitude (< 10 μm) elastic waves using acoustic radiation force in posterior scleral tissue of fresh porcine eyes (n=2) in situ. The wave propagation induced using an ultrasound transducer was detected across an 8 mm region using a phase-sensitive optical coherence elastography system (PhS-OCE). The elastographic measurements were taken at various artificially controlled intraocular pressures (IOP). The IOP was pre-cycled before being set to 10 mmHg for the first measurement. Subsequent measurements were taken at 20 mmHg and 30 mmHg for each sample. The results show an increase in the stiffness of the sclera as a function of IOP. Furthermore, we observed a variation in the elasticity based on direction, suggesting that the sclera has anisotropic biomechanical properties. Our results show that OCE is an effective method for evaluating the mechanical properties of the sclera, and reveals a new area for our future work.

Inverse methods for 3D quantitative optical coherence elasticity imaging (Conference Presentation)

NASA Astrophysics Data System (ADS)

Dong, Li; Wijesinghe, Philip; Hugenberg, Nicholas; Sampson, David D.; Munro, Peter R. T.; Kennedy, Brendan F.; Oberai, Assad A.

2017-02-01

In elastography, quantitative elastograms are desirable as they are system and operator independent. Such quantification also facilitates more accurate diagnosis, longitudinal studies and studies performed across multiple sites. In optical elastography (compression, surface-wave or shear-wave), quantitative elastograms are typically obtained by assuming some form of homogeneity. This simplifies data processing at the expense of smearing sharp transitions in elastic properties, and/or introducing artifacts in these regions. Recently, we proposed an inverse problem-based approach to compression OCE that does not assume homogeneity, and overcomes the drawbacks described above. In this approach, the difference between the measured and predicted displacement field is minimized by seeking the optimal distribution of elastic parameters. The predicted displacements and recovered elastic parameters together satisfy the constraint of the equations of equilibrium. This approach, which has been applied in two spatial dimensions assuming plane strain, has yielded accurate material property distributions. Here, we describe the extension of the inverse problem approach to three dimensions. In addition to the advantage of visualizing elastic properties in three dimensions, this extension eliminates the plane strain assumption and is therefore closer to the true physical state. It does, however, incur greater computational costs. We address this challenge through a modified adjoint problem, spatially adaptive grid resolution, and three-dimensional decomposition techniques. Through these techniques the inverse problem is solved on a typical desktop machine within a wall clock time of 20 hours. We present the details of the method and quantitative elasticity images of phantoms and tissue samples.

A first demonstration of audio-frequency optical coherence elastography of tissue

NASA Astrophysics Data System (ADS)

Adie, Steven G.; Alexandrov, Sergey A.; Armstrong, Julian J.; Kennedy, Brendan F.; Sampson, David D.

2008-12-01

Optical elastography is aimed at using the visco-elastic properties of soft tissue as a contrast mechanism, and could be particularly suitable for high-resolution differentiation of tumour from surrounding normal tissue. We present a new approach to measure the effect of an applied stimulus in the kilohertz frequency range that is based on optical coherence tomography. We describe the approach and present the first in vivo optical coherence elastography measurements in human skin at audio excitation frequencies.

Optical Coherence Elastography

NASA Astrophysics Data System (ADS)

Kennedy, Brendan F.; Kennedy, Kelsey M.; Oldenburg, Amy L.; Adie, Steven G.; Boppart, Stephen A.; Sampson, David D.

The mechanical properties of tissue are pivotal in its function and behavior, and are often modified by disease. From the nano- to the macro-scale, many tools have been developed to measure tissue mechanical properties, both to understand the contribution of mechanics in the origin of disease and to improve diagnosis. Optical coherence elastography is applicable to the intermediate scale, between that of cells and whole organs, which is critical in the progression of many diseases and not widely studied to date. In optical coherence elastography, a mechanical load is imparted to a tissue and the resulting deformation is measured using optical coherence tomography. The deformation is used to deduce a mechanical parameter, e.g., Young's modulus, which is mapped into an image, known as an elastogram. In this chapter, we review the development of optical coherence elastography and report on the latest developments. We provide a focus on the underlying principles and assumptions, techniques to measure deformation, loading mechanisms, imaging probes and modeling, including the inverse elasticity problem.

Confocal acoustic radiation force optical coherence elastography using a ring ultrasonic transducer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qi, Wenjuan; Department of Chemical Engineering and Materials Science, University of California, Irvine, Irvine, California 92697; Li, Rui

2014-03-24

We designed and developed a confocal acoustic radiation force optical coherence elastography system. A ring ultrasound transducer was used to achieve reflection mode excitation and generate an oscillating acoustic radiation force in order to generate displacements within the tissue, which were detected using the phase-resolved optical coherence elastography method. Both phantom and human tissue tests indicate that this system is able to sense the stiffness difference of samples and quantitatively map the elastic property of materials. Our confocal setup promises a great potential for point by point elastic imaging in vivo and differentiation of diseased tissues from normal tissue.

Improved measurement of vibration amplitude in dynamic optical coherence elastography

PubMed Central

Kennedy, Brendan F.; Wojtkowski, Maciej; Szkulmowski, Maciej; Kennedy, Kelsey M.; Karnowski, Karol; Sampson, David D.

2012-01-01

Abstract: Optical coherence elastography employs optical coherence tomography (OCT) to measure the displacement of tissues under load and, thus, maps the resulting strain into an image, known as an elastogram. We present a new improved method to measure vibration amplitude in dynamic optical coherence elastography. The tissue vibration amplitude caused by sinusoidal loading is measured from the spread of the Doppler spectrum, which is extracted using joint spectral and time domain signal processing. At low OCT signal-to-noise ratio (SNR), the method provides more accurate vibration amplitude measurements than the currently used phase-sensitive method. For measurements performed on a mirror at OCT SNR = 5 dB, our method introduces <3% error, compared to >20% using the phase-sensitive method. We present elastograms of a tissue-mimicking phantom and excised porcine tissue that demonstrate improvements, including a 50% increase in the depth range of reliable vibration amplitude measurement. PMID:23243565

Full skin quantitative optical coherence elastography achieved by combining vibration and surface acoustic wave methods

NASA Astrophysics Data System (ADS)

Li, Chunhui; Guan, Guangying; Huang, Zhihong; Wang, Ruikang K.; Nabi, Ghulam

2015-03-01

By combining with the phase sensitive optical coherence tomography (PhS-OCT), vibration and surface acoustic wave (SAW) methods have been reported to provide elastography of skin tissue respectively. However, neither of these two methods can provide the elastography in full skin depth in current systems. This paper presents a feasibility study on an optical coherence elastography method which combines both vibration and SAW in order to give the quantitative mechanical properties of skin tissue with full depth range, including epidermis, dermis and subcutaneous fat. Experiments are carried out on layered tissue mimicking phantoms and in vivo human forearm and palm skin. A ring actuator generates vibration while a line actuator were used to excited SAWs. A PhS-OCT system is employed to provide the ultrahigh sensitive measurement of the generated waves. The experimental results demonstrate that by the combination of vibration and SAW method the full skin bulk mechanical properties can be quantitatively measured and further the elastography can be obtained with a sensing depth from ~0mm to ~4mm. This method is promising to apply in clinics where the quantitative elasticity of localized skin diseases is needed to aid the diagnosis and treatment.

Diffuse shear wave imaging: toward passive elastography using low-frame rate spectral-domain optical coherence tomography

NASA Astrophysics Data System (ADS)

Nguyen, Thu-Mai; Zorgani, Ali; Lescanne, Maxime; Boccara, Claude; Fink, Mathias; Catheline, Stefan

2016-12-01

Optical coherence tomography (OCT) can map the stiffness of biological tissue by imaging mechanical perturbations (shear waves) propagating in the tissue. Most shear wave elastography (SWE) techniques rely on active shear sources to generate controlled displacements that are tracked at ultrafast imaging rates. Here, we propose a noise-correlation approach to retrieve stiffness information from the imaging of diffuse displacement fields using low-frame rate spectral-domain OCT. We demonstrated the method on tissue-mimicking phantoms and validated the results by comparison with classic ultrafast SWE. Then we investigated the in vivo feasibility on the eye of an anesthetized rat by applying noise correlation to naturally occurring displacements. The results suggest a great potential for passive elastography based on the detection of natural pulsatile motions using conventional spectral-domain OCT systems. This would facilitate the transfer of OCT-elastography to clinical practice, in particular, in ophthalmology or dermatology.

Diffuse shear wave imaging: toward passive elastography using low-frame rate spectral-domain optical coherence tomography.

PubMed

Nguyen, Thu-Mai; Zorgani, Ali; Lescanne, Maxime; Boccara, Claude; Fink, Mathias; Catheline, Stefan

2016-12-01

Optical coherence tomography (OCT) can map the stiffness of biological tissue by imaging mechanical perturbations (shear waves) propagating in the tissue. Most shear wave elastography (SWE) techniques rely on active shear sources to generate controlled displacements that are tracked at ultrafast imaging rates. Here, we propose a noise-correlation approach to retrieve stiffness information from the imaging of diffuse displacement fields using low-frame rate spectral-domain OCT. We demonstrated the method on tissue-mimicking phantoms and validated the results by comparison with classic ultrafast SWE. Then we investigated the in vivo feasibility on the eye of an anesthetized rat by applying noise correlation to naturally occurring displacements. The results suggest a great potential for passive elastography based on the detection of natural pulsatile motions using conventional spectral-domain OCT systems. This would facilitate the transfer of OCT-elastography to clinical practice, in particular, in ophthalmology or dermatology.

Biomechanical properties of crystalline lens as a function of intraocular pressure assessed noninvasively by optical coherence elastography

NASA Astrophysics Data System (ADS)

Wu, Chen; Aglyamov, Salavat R.; Liu, Chih-Hao; Han, Zhaolong; Singh, Manmohan; Larin, Kirill V.

2017-02-01

Many ocular diseases such as glaucoma and uveitis can lead to the elevation of intraocular pressure (IOP). Previous research implies a link between elevated IOP and lens disease. However, the relationship between IOP elevation and biomechanical properties of the crystalline lens has not been directly studied yet. In this work, we investigated the biomechanical properties of porcine lens as a function of IOP by acoustic radiation force optical coherence elastography.

Ultrahigh resolution optical coherence elastography using a Bessel beam for extended depth of field

NASA Astrophysics Data System (ADS)

Curatolo, Andrea; Villiger, Martin; Lorenser, Dirk; Wijesinghe, Philip; Fritz, Alexander; Kennedy, Brendan F.; Sampson, David D.

2016-03-01

Visualizing stiffness within the local tissue environment at the cellular and sub-cellular level promises to provide insight into the genesis and progression of disease. In this paper, we propose ultrahigh-resolution optical coherence elastography, and demonstrate three-dimensional imaging of local axial strain of tissues undergoing compressive loading. The technique employs a dual-arm extended focus optical coherence microscope to measure tissue displacement under compression. The system uses a broad bandwidth supercontinuum source for ultrahigh axial resolution, Bessel beam illumination and Gaussian beam detection, maintaining sub-2 μm transverse resolution over nearly 100 μm depth of field, and spectral-domain detection allowing high displacement sensitivity. The system produces strain elastograms with a record resolution (x,y,z) of 2×2×15 μm. We benchmark the advances in terms of resolution and strain sensitivity by imaging a suitable inclusion phantom. We also demonstrate this performance on freshly excised mouse aorta and reveal the mechanical heterogeneity of vascular smooth muscle cells and elastin sheets, otherwise unresolved in a typical, lower resolution optical coherence elastography system.

Dynamic measurement of local displacements within curing resin-based dental composite using optical coherence elastography

NASA Astrophysics Data System (ADS)

Tomlins, Peter H.; Rahman, Mohammed Wahidur; Donnan, Robert S.

2016-04-01

This study aimed to determine the feasibility of using optical coherence elastography to measure internal displacements during the curing phase of a light-activated, resin-based composite material. Displacement vectors were spatially mapped over time within a commercial dental composite. Measurements revealed that the orientation of cure-induced displacement vectors varied spatially in a complex manner; however, each vector showed a systematic evolution with time. Precision of individual displacements was estimated to be ˜1 to 2 μm, enabling submicrometer time-varying displacements to be detected.

Robust intravascular optical coherence elastography driven by acoustic radiation pressure

NASA Astrophysics Data System (ADS)

van Soest, Gijs; Bouchard, Richard R.; Mastik, Frits; de Jong, Nico; van der Steen, Anton F. W.

2007-07-01

High strain spots in the vessel wall indicate the presence of vulnerable plaques. The majority of acute cardiovascular events are preceded by rupture of such a plaque in a coronary artery. Intracoronary optical coherence tomography (OCT) can be extended, in principle, to an elastography technique, mapping the strain in the vascular wall. However, the susceptibility of OCT to frame-to-frame decorrelation, caused by tissue and catheter motion, inhibits reliable tissue displacement tracking and has to date obstructed the development of OCT-based intravascular elastography. We introduce a new technique for intravascular optical coherence elastography, which is robust against motion artifacts. Using acoustic radiation force, we apply a pressure to deform the tissue synchronously with the line scan rate of the OCT instrument. Radial tissue displacement can be tracked based on the correlation between adjacent lines, instead of subsequent frames in conventional elastography. The viability of the method is demonstrated with a simulation study. The root mean square (rms) error of the displacement estimate is 0.55 μm, and the rms error of the strain is 0.6%. It is shown that high-strain spots in the vessel wall, such as observed at the sites of vulnerable atherosclerotic lesions, can be detected with the technique. Experiments to realize this new elastographic method are presented. Simultaneous optical and ultrasonic pulse-echo tracking demonstrate that the material can be put in a high-frequency oscillatory motion with an amplitude of several micrometers, more than sufficient for accurate tracking with OCT. The resulting data are used to optimize the acoustic pushing sequence and geometry.

From supersonic shear wave imaging to full-field optical coherence shear wave elastography

NASA Astrophysics Data System (ADS)

Nahas, Amir; Tanter, Mickaël; Nguyen, Thu-Mai; Chassot, Jean-Marie; Fink, Mathias; Claude Boccara, A.

2013-12-01

Elasticity maps of tissue have proved to be particularly useful in providing complementary contrast to ultrasonic imaging, e.g., for cancer diagnosis at the millimeter scale. Optical coherence tomography (OCT) offers an endogenous contrast based on singly backscattered optical waves. Adding complementary contrast to OCT images by recording elasticity maps could also be valuable in improving OCT-based diagnosis at the microscopic scale. Static elastography has been successfully coupled with full-field OCT (FF-OCT) in order to realize both micrometer-scale sectioning and elasticity maps. Nevertheless, static elastography presents a number of drawbacks, mainly when stiffness quantification is required. Here, we describe the combination of two methods: transient elastography, based on speed measurements of shear waves induced by ultrasonic radiation forces, and FF-OCT, an en face OCT approach using an incoherent light source. The use of an ultrafast ultrasonic scanner and an ultrafast camera working at 10,000 to 30,000 images/s made it possible to follow shear wave propagation with both modalities. As expected, FF-OCT is found to be much more sensitive than ultrafast ultrasound to tiny shear vibrations (a few nanometers and micrometers, respectively). Stiffness assessed in gel phantoms and an ex vivo rat brain by FF-OCT is found to be in good agreement with ultrasound shear wave elastography.

Three-dimensional optical coherence micro-elastography of skeletal muscle tissue

PubMed Central

Chin, Lixin; Kennedy, Brendan F.; Kennedy, Kelsey M.; Wijesinghe, Philip; Pinniger, Gavin J.; Terrill, Jessica R.; McLaughlin, Robert A.; Sampson, David D.

2014-01-01

In many muscle pathologies, impairment of skeletal muscle function is closely linked to changes in the mechanical properties of the muscle constituents. Optical coherence micro-elastography (OCME) uses optical coherence tomography (OCT) imaging of tissue under a quasi-static, compressive mechanical load to map variations in tissue mechanical properties on the micro-scale. We present the first study of OCME on skeletal muscle tissue. We show that this technique can resolve features of muscle tissue including fibers, fascicles and tendon, and can also detect necrotic lesions in skeletal muscle from the mdx mouse model of Duchenne muscular dystrophy. In many instances, OCME provides better or additional contrast complementary to that provided by OCT. These results suggest that OCME could provide new understanding and opportunity for assessment of skeletal muscle pathologies. PMID:25401023

Ultrafast Harmonic Coherent Compound (UHCC) imaging for high frame rate echocardiography and Shear Wave Elastography

PubMed Central

Correia, Mafalda; Provost, Jean; Chatelin, Simon; Villemain, Olivier; Tanter, Mickael; Pernot, Mathieu

2016-01-01

Transthoracic shear wave elastography of the myocardium remains very challenging due to the poor quality of transthoracic ultrafast imaging and the presence of clutter noise, jitter, phase aberration, and ultrasound reverberation. Several approaches, such as, e.g., diverging-wave coherent compounding or focused harmonic imaging have been proposed to improve the imaging quality. In this study, we introduce ultrafast harmonic coherent compounding (UHCC), in which pulse-inverted diverging-waves are emitted and coherently compounded, and show that such an approach can be used to enhance both Shear Wave Elastography (SWE) and high frame rate B-mode Imaging. UHCC SWE was first tested in phantoms containing an aberrating layer and was compared against pulse-inversion harmonic imaging and against ultrafast coherent compounding (UCC) imaging at the fundamental frequency. In-vivo feasibility of the technique was then evaluated in six healthy volunteers by measuring myocardial stiffness during diastole in transthoracic imaging. We also demonstrated that improvements in imaging quality could be achieved using UHCC B-mode imaging in healthy volunteers. The quality of transthoracic images of the heart was found to be improved with the number of pulse-inverted diverging waves with reduction of the imaging mean clutter level up to 13.8-dB when compared against UCC at the fundamental frequency. These results demonstrated that UHCC B-mode imaging is promising for imaging deep tissues exposed to aberration sources with a high frame-rate. PMID:26890730

Shear wave elastography using amplitude-modulated acoustic radiation force and phase-sensitive optical coherence tomography

NASA Astrophysics Data System (ADS)

Nguyen, Thu-Mai; Arnal, Bastien; Song, Shaozhen; Huang, Zhihong; Wang, Ruikang K.; O'Donnell, Matthew

2015-01-01

Investigating the elasticity of ocular tissue (cornea and intraocular lens) could help the understanding and management of pathologies related to biomechanical deficiency. In previous studies, we introduced a setup based on optical coherence tomography for shear wave elastography (SWE) with high resolution and high sensitivity. SWE determines tissue stiffness from the propagation speed of shear waves launched within tissue. We proposed acoustic radiation force to remotely induce shear waves by focusing an ultrasound (US) beam in tissue, similar to several elastography techniques. Minimizing the maximum US pressure is essential in ophthalmology for safety reasons. For this purpose, we propose a pulse compression approach. It utilizes coded US emissions to generate shear waves where the energy is spread over a long emission, and then numerically compressed into a short, localized, and high-energy pulse. We used a 7.5-MHz single-element focused transducer driven by coded excitations where the amplitude is modulated by a linear frequency-swept square wave (1 to 7 kHz). An inverse filter approach was used for compression. We demonstrate the feasibility of performing shear wave elastography measurements in tissue-mimicking phantoms at low US pressures (mechanical index <0.6).

Shear wave elastography using amplitude-modulated acoustic radiation force and phase-sensitive optical coherence tomography

PubMed Central

Nguyen, Thu-Mai; Arnal, Bastien; Song, Shaozhen; Huang, Zhihong; Wang, Ruikang K.; O’Donnell, Matthew

2015-01-01

Abstract. Investigating the elasticity of ocular tissue (cornea and intraocular lens) could help the understanding and management of pathologies related to biomechanical deficiency. In previous studies, we introduced a setup based on optical coherence tomography for shear wave elastography (SWE) with high resolution and high sensitivity. SWE determines tissue stiffness from the propagation speed of shear waves launched within tissue. We proposed acoustic radiation force to remotely induce shear waves by focusing an ultrasound (US) beam in tissue, similar to several elastography techniques. Minimizing the maximum US pressure is essential in ophthalmology for safety reasons. For this purpose, we propose a pulse compression approach. It utilizes coded US emissions to generate shear waves where the energy is spread over a long emission, and then numerically compressed into a short, localized, and high-energy pulse. We used a 7.5-MHz single-element focused transducer driven by coded excitations where the amplitude is modulated by a linear frequency-swept square wave (1 to 7 kHz). An inverse filter approach was used for compression. We demonstrate the feasibility of performing shear wave elastography measurements in tissue-mimicking phantoms at low US pressures (mechanical index <0.6). PMID:25554970

Optical coherence elastography for cellular-scale stiffness imaging of mouse aorta

NASA Astrophysics Data System (ADS)

Wijesinghe, Philip; Johansen, Niloufer J.; Curatolo, Andrea; Sampson, David D.; Ganss, Ruth; Kennedy, Brendan F.

2017-04-01

We have developed a high-resolution optical coherence elastography system capable of estimating Young's modulus in tissue volumes with an isotropic resolution of 15 μm over a 1 mm lateral field of view and a 100 μm axial depth of field. We demonstrate our technique on healthy and hypertensive, freshly excised and intact mouse aortas. Our technique has the capacity to delineate the individual mechanics of elastic lamellae and vascular smooth muscle. Further, we observe global and regional vascular stiffening in hypertensive aortas, and note the presence of local micro-mechanical signatures, characteristic of fibrous and lipid-rich regions.

The emergence of optical elastography in biomedicine

NASA Astrophysics Data System (ADS)

Kennedy, Brendan F.; Wijesinghe, Philip; Sampson, David D.

2017-04-01

Optical elastography, the use of optics to characterize and map the mechanical properties of biological tissue, involves measuring the deformation of tissue in response to a load. Such measurements may be used to form an image of a mechanical property, often elastic modulus, with the resulting mechanical contrast complementary to the more familiar optical contrast. Optical elastography is experiencing new impetus in response to developments in the closely related fields of cell mechanics and medical imaging, aided by advances in photonics technology, and through probing the microscale between that of cells and whole tissues. Two techniques -- optical coherence elastography and Brillouin microscopy -- have recently shown particular promise for medical applications, such as in ophthalmology and oncology, and as new techniques in cell mechanics.

Shear wave pulse compression for dynamic elastography using phase-sensitive optical coherence tomography

NASA Astrophysics Data System (ADS)

Nguyen, Thu-Mai; Song, Shaozhen; Arnal, Bastien; Wong, Emily Y.; Huang, Zhihong; Wang, Ruikang K.; O'Donnell, Matthew

2014-01-01

Assessing the biomechanical properties of soft tissue provides clinically valuable information to supplement conventional structural imaging. In the previous studies, we introduced a dynamic elastography technique based on phase-sensitive optical coherence tomography (PhS-OCT) to characterize submillimetric structures such as skin layers or ocular tissues. Here, we propose to implement a pulse compression technique for shear wave elastography. We performed shear wave pulse compression in tissue-mimicking phantoms. Using a mechanical actuator to generate broadband frequency-modulated vibrations (1 to 5 kHz), induced displacements were detected at an equivalent frame rate of 47 kHz using a PhS-OCT. The recorded signal was digitally compressed to a broadband pulse. Stiffness maps were then reconstructed from spatially localized estimates of the local shear wave speed. We demonstrate that a simple pulse compression scheme can increase shear wave detection signal-to-noise ratio (>12 dB gain) and reduce artifacts in reconstructing stiffness maps of heterogeneous media.

Wave-Induced Momentum Flux over Wind-driven Surface Waves

NASA Astrophysics Data System (ADS)

Yousefi, Kianoosh; Veron, Fabrice; Buckley, Marc; Husain, Nyla; Hara, Tetsu

2017-11-01

In recent years, the exchange of momentum between the atmosphere and the ocean has been the subject of several investigations. Although the role of surface waves on the air-sea momentum flux is now well established, detailed quantitative measurements of wave-induced momentum fluxes are lacking. In the current study, using a combined Particle Image Velocimetry (PIV) and Laser Induced Fluorescence (LIF) system, we obtained laboratory measurements of the airflow velocity above surface waves for wind speeds ranging from 0.86 to 16.63 m s-1. The mean, turbulent, and wave-coherent velocity fields are then extracted from instantaneous measurements. Wave-induced stress can, therefore, be estimated. In strongly forced cases in high wind speeds, the wave-induced stress near the surface is a significant fraction of the total stress. At lower wind speeds and larger wave ages, the wave-induced stress is positive very close to the surface, below the critical height and decreases to a negative value further above the critical height. This indicates a shift in the direction of the wave-coherent momentum flux across the critical layer. NSF OCE1458977, NSF OCE1634051.

Elasticity measurement of nasal cartilage as a function of temperature using optical coherence elastography

NASA Astrophysics Data System (ADS)

Liu, Chih Hao; Skryabina, M. N.; Singh, Manmohan; Li, Jiasong; Wu, Chen; Sobol, E.; Larin, Kirill V.

2015-03-01

Current clinical methods of reconstruction surgery involve laser reshaping of nasal cartilage. The process of stress relaxation caused by laser heating is the primary method to achieve nasal cartilage reshaping. Based on this, a rapid, non-destructive and accurate elasticity measurement would allow for a more robust reshaping procedure. In this work, we have utilized a phase-stabilized swept source optical coherence elastography (PhSSSOCE) to quantify the Young's modulus of porcine nasal septal cartilage during the relaxation process induced by heating. The results show that PhS-SSOCE was able to monitor changes in elasticity of hyaline cartilage, and this method could potentially be applied in vivo during laser reshaping therapies.

Optical coherence elastography assesses tissue modifications in laser reshaping of cornea and cartilages

NASA Astrophysics Data System (ADS)

Zaitsev, V. Y.; Matveyev, A. L.; Matveev, L. A.; Gelikonov, G. V.; Omelchenko, A. I.; Shabanov, D. V.; Sovetsky, A. A.; Baum, O. I.; Vitkin, A.; Sobol, E. N.

2018-02-01

Non-surgical thermo-mechanical reshaping of avascular collagenous tissues (cartilages and cornea) using moderate heating by IR-laser irradiation is an emerging technology that can find important applications in visioncorrection problems and preparation of cartilaginous implants in otolaryngology. To estimate both transient interframe strains and cumulative resultant strains produced by the laser irradiation of the tissue we use and improved version of strain mapping developed in our previous work related to compressional phase-sensitive optical coherence tomography. To reveal microstructural changes in the tissue regions where irradiation-produced strains do not disappear after temperature equilibration, we apply compressional optical coherence elastography in order to visualize the resultant variations in the tissue stiffness. The so-found regions of the stiffness reduction are attributed to formation of microscopic pores, existence of which agree with independent data obtained using methods of high-resolution microscopy.

High resolution SAW elastography for ex-vivo porcine skin specimen

NASA Astrophysics Data System (ADS)

Zhou, Kanheng; Feng, Kairui; Wang, Mingkai; Jamera, Tanatswa; Li, Chunhui; Huang, Zhihong

2018-02-01

Surface acoustic wave (SAW) elastography has been proven to be a non-invasive, non-destructive method for accurately characterizing tissue elastic properties. Current SAW elastography technique tracks generated surface acoustic wave impulse point by point which are a few millimeters away. Thus, reconstructed elastography has low lateral resolution. To improve the lateral resolution of current SAW elastography, a new method was proposed in this research. A M-B scan mode, high spatial resolution phase sensitive optical coherence tomography (PhS-OCT) system was employed to track the ultrasonically induced SAW impulse. Ex-vivo porcine skin specimen was tested using this proposed method. A 2D fast Fourier transform based algorithm was applied to process the acquired data for estimating the surface acoustic wave dispersion curve and its corresponding penetration depth. Then, the ex-vivo porcine skin elastogram was established by relating the surface acoustic wave dispersion curve and its corresponding penetration depth. The result from the proposed method shows higher lateral resolution than that from current SAW elastography technique, and the approximated skin elastogram could also distinguish the different layers in the skin specimen, i.e. epidermis, dermis and fat layer. This proposed SAW elastography technique may have a large potential to be widely applied in clinical use for skin disease diagnosis and treatment monitoring.

Quantitative assessment of corneal viscoelasticity using optical coherence elastography and a modified Rayleigh-Lamb equation

NASA Astrophysics Data System (ADS)

Han, Zhaolong; Aglyamov, Salavat R.; Li, Jiasong; Singh, Manmohan; Wang, Shang; Vantipalli, Srilatha; Wu, Chen; Liu, Chih-hao; Twa, Michael D.; Larin, Kirill V.

2015-02-01

We demonstrate the use of a modified Rayleigh-Lamb frequency equation in conjunction with noncontact optical coherence elastography to quantify the viscoelastic properties of the cornea. Phase velocities of air-pulse-induced elastic waves were extracted by spectral analysis and used for calculating the Young's moduli of the samples using the Rayleigh-Lamb frequency equation (RLFE). Validation experiments were performed on 2% agar phantoms (n=3) and then applied to porcine corneas (n=3) in situ. The Young's moduli of the porcine corneas were estimated to be ˜60 kPa with a shear viscosity ˜0.33 Pa.s. The results demonstrate that the RLFE is a promising method for noninvasive quantification of the corneal biomechanical properties and may potentially be useful for clinical ophthalmological applications.

Measurement of the temperature dependence of Young's modulus of cartilage by phase-sensitive optical coherence elastography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, C H; Li, J; Singh, M

2014-08-31

The development of an effective system to monitor the changes in the elastic properties of cartilage tissue with increasing temperature in laser reconstruction is an urgent practical task. In this paper, the use of phase-sensitive optical coherence elastography for detection of elastic waves in the sample has allowed Young's modulus of cartilage tissue to be measured directly during heating. Young's modulus was calculated from the group velocity of propagation of elastic waves excited by means of a system supplying focused air pulses. The measurement results are in agreement with the results of measurements of the modulus of elasticity under mechanicalmore » compression. The technique developed allows for noninvasive measurements; its development is promising for the use in vivo. (laser biophotonics)« less

The potential of high intensity focused ultrasound (HIFU) combine phase-sensitive optical coherence tomography (PhS-OCT) for diseases diagnosis, treatment and monitoring

NASA Astrophysics Data System (ADS)

Zhou, Kanheng; Wang, Yan; Feng, Kairui; Li, Chunhui; Huang, Zhihong

2018-02-01

HIFU is a truly noninvasive, acoustic therapeutic technique that utilizes high intensity acoustic field in the focus to kill the targeted tissue for disease treatment purpose. The mechanical properties of targeted tissue changes before and after treatment, and this change can be accurately detected by shear wave elastography. Hence, shear wave elastography is usually used for monitoring HIFU treatment asynchronously. To improve the low spatial resolution in ultrasound shear wave elastography, and to perform diseases diagnosis, treatment and monitoring in the same system, a new setup that combines HIFU and PhS-OCT system was proposed in this study. This proposed setup could do 1) HIFU treatment when the transducer works at high energy level, 2) ultrasound induced shear wave optical coherence elastography for HIFU treatment asynchronous monitoring when the transducer works at low energy level. Ex-vivo bovine liver tissue was treated at the same energy level for different time (0s, 1s, 5s, 9s) in this research. Elastography was performed on the lesion area of the sample after HIFU treatment, and the elastogram was reconstructed by the time of flight time method. The elastogram results clearly show the boundary of HIFU lesion area and surrounding normal tissue, even for 1s treatment time. And the average elasticity of the lesion grows linearly as the treatment time increases. Combined with OCT needle probe, the proposed method has a large potential not only to be used for superficial diseases treatment, but also to be used for high-precision-demanded diseases treatment, e.g. nervous disease treatment.

Magnetomotive optical coherence elastography for relating lung structure and function in cystic fibrosis

NASA Astrophysics Data System (ADS)

Chhetri, Raghav K.; Carpenter, Jerome; Superfine, Richard; Randell, Scott H.; Oldenburg, Amy L.

2010-02-01

Cystic fibrosis (CF) is a genetic defect in the cystic fibrosis transmembrane conductance regulator protein and is the most common life-limiting genetic condition affecting the Caucasian population. It is an autosomal recessive, monogenic inherited disorder characterized by failure of airway host defense against bacterial infection, which results in bronchiectasis, the breakdown of airway wall extracellular matrix (ECM). In this study, we show that the in vitro models consisting of human tracheo-bronchial-epithelial (hBE) cells grown on porous supports with embedded magnetic nanoparticles (MNPs) at an air-liquid interface are suitable for long term, non-invasive assessment of ECM remodeling using magnetomotive optical coherence elastography (MMOCE). The morphology of ex vivo CF and normal lung tissues using OCT and correlative study with histology is also examined. We also demonstrate a quantitative measure of normal and CF airway elasticity using MMOCE. The improved understanding of pathologic changes in CF lung structure and function and the novel method of longitudinal in vitro ECM assessment demonstrated in this study may lead to new in vivo imaging and elastography methods to monitor disease progression and treatment in cystic fibrosis.

Coagulation monitoring based on blood elastic measurement using optical coherence tomography

NASA Astrophysics Data System (ADS)

Xu, Xiangqun; Zhu, Jiang; Chen, Zhongping

2017-02-01

Blood coagulation monitoring is important to diagnose hematological diseases and cardiovascular diseases and to predict the risk of bleeding and excessive clotting. In this study, we developed a system to dynamically monitor blood coagulation and quantitatively determine the coagulation function by blood elastic measurement. When blood forms a clot from a liquid, ultrasonic force induces a shear wave, which is detected by optical coherence tomography (OCT). The coagulation of porcine whole blood recalcified by calcium chloride is assessed using the metrics of reaction time, clot formation kinetics and maximum shear modulus. The OCE system can noninvasively monitor the blood coagulation and quantitatively determine the coagulation function.

Application of Elastography for the Noninvasive Assessment of Biomechanics in Engineered Biomaterials and Tissues

PubMed Central

Kim, Woong; Ferguson, Virginia L.; Borden, Mark; Neu, Corey P.

2016-01-01

The elastic properties of engineered biomaterials and tissues impact their post-implantation repair potential and structural integrity, and are critical to help regulate cell fate and gene expression. The measurement of properties (e.g., stiffness or shear modulus) can be attained using elastography, which exploits noninvasive imaging modalities to provide functional information of a material indicative of the regeneration state. In this review, we outline the current leading elastography methodologies available to characterize the properties of biomaterials and tissues suitable for repair and mechanobiology research. We describe methods utilizing magnetic resonance, ultrasound, and optical coherent elastography, highlighting their potential for longitudinal monitoring of implanted materials in vivo, in addition to spatiotemporal limits of each method for probing changes in cell-laden constructs. Micro-elastography methods now allow acquisitions at length scales approaching 5–100 μm in two and three dimensions. Many of the methods introduced in this review are therefore capable of longitudinal monitoring in biomaterials and tissues approaching the cellular scale. However, critical factors such as anisotropy, heterogeneity and viscoelasity—inherent in many soft tissues—are often not fully described and therefore require further advancements and future developments. PMID:26790865

Deformation-induced speckle-pattern evolution and feasibility of correlational speckle tracking in optical coherence elastography.

PubMed

Zaitsev, Vladimir Y; Matveyev, Alexandr L; Matveev, Lev A; Gelikonov, Grigory V; Gelikonov, Valentin M; Vitkin, Alex

2015-07-01

Feasibility of speckle tracking in optical coherence tomography (OCT) based on digital image correlation (DIC) is discussed in the context of elastography problems. Specifics of applying DIC methods to OCT, compared to processing of photographic images in mechanical engineering applications, are emphasized and main complications are pointed out. Analytical arguments are augmented by accurate numerical simulations of OCT speckle patterns. In contrast to DIC processing for displacement and strain estimation in photographic images, the accuracy of correlational speckle tracking in deformed OCT images is strongly affected by the coherent nature of speckles, for which strain-induced complications of speckle “blinking” and “boiling” are typical. The tracking accuracy is further compromised by the usually more pronounced pixelated structure of OCT scans compared with digital photographic images in classical DIC applications. Processing of complex-valued OCT data (comprising both amplitude and phase) compared to intensity-only scans mitigates these deleterious effects to some degree. Criteria of the attainable speckle tracking accuracy and its dependence on the key OCT system parameters are established.

Optimized phase gradient measurements and phase-amplitude interplay in optical coherence elastography

NASA Astrophysics Data System (ADS)

Zaitsev, Vladimir Y.; Matveyev, Alexander L.; Matveev, Lev A.; Gelikonov, Grigory V.; Sovetsky, Aleksandr A.; Vitkin, Alex

2016-11-01

In compressional optical coherence elastography, phase-variation gradients are used for estimating quasistatic strains created in tissue. Using reference and deformed optical coherence tomography (OCT) scans, one typically compares phases from pixels with the same coordinates in both scans. Usually, this limits the allowable strains to fairly small values < to 10-3, with the caveat that such weak phase gradients may become corrupted by stronger measurement noises. Here, we extend the OCT phase-resolved elastographic methodology by (1) showing that an order of magnitude greater strains can significantly increase the accuracy of derived phase-gradient differences, while also avoiding error-phone phase-unwrapping procedures and minimizing the influence of decorrelation noise caused by suprapixel displacements, (2) discussing the appearance of artifactual stiff inclusions in resultant OCT elastograms in the vicinity of bright scatterers due to the amplitude-phase interplay in phase-variation measurements, and (3) deriving/evaluating methods of phase-gradient estimation that can outperform conventionally used least-square gradient fitting. We present analytical arguments, numerical simulations, and experimental examples to demonstrate the advantages of the proposed optimized phase-variation methodology.

Anisotropic polyvinyl alcohol hydrogel phantom for shear wave elastography in fibrous biological soft tissue: a multimodality characterization

NASA Astrophysics Data System (ADS)

Chatelin, Simon; Bernal, Miguel; Deffieux, Thomas; Papadacci, Clément; Flaud, Patrice; Nahas, Amir; Boccara, Claude; Gennisson, Jean-Luc; Tanter, Mickael; Pernot, Mathieu

2014-11-01

Shear wave elastography imaging techniques provide quantitative measurement of soft tissues elastic properties. Tendons, muscles and cerebral tissues are composed of fibers, which induce a strong anisotropic effect on the mechanical behavior. Currently, these tissues cannot be accurately represented by existing elastography phantoms. Recently, a novel approach for orthotropic hydrogel mimicking soft tissues has been developed (Millon et al 2006 J. Biomed. Mater. Res. B 305-11). The mechanical anisotropy is induced in a polyvinyl alcohol (PVA) cryogel by stretching the physical crosslinks of the polymeric chains while undergoing freeze/thaw cycles. In the present study we propose an original multimodality imaging characterization of this new transverse isotropic (TI) PVA hydrogel. Multiple properties were investigated using a large variety of techniques at different scales compared with an isotropic PVA hydrogel undergoing similar imaging and rheology protocols. The anisotropic mechanical (dynamic and static) properties were studied using supersonic shear wave imaging technique, full-field optical coherence tomography (FFOCT) strain imaging and classical linear rheometry using dynamic mechanical analysis. The anisotropic optical and ultrasonic spatial coherence properties were measured by FFOCT volumetric imaging and backscatter tensor imaging, respectively. Correlation of mechanical and optical properties demonstrates the complementarity of these techniques for the study of anisotropy on a multi-scale range as well as the potential of this TI phantom as fibrous tissue-mimicking phantom for shear wave elastographic applications.

Vector method for strain estimation in phase-sensitive optical coherence elastography

NASA Astrophysics Data System (ADS)

Matveyev, A. L.; Matveev, L. A.; Sovetsky, A. A.; Gelikonov, G. V.; Moiseev, A. A.; Zaitsev, V. Y.

2018-06-01

A noise-tolerant approach to strain estimation in phase-sensitive optical coherence elastography, robust to decorrelation distortions, is discussed. The method is based on evaluation of interframe phase-variation gradient, but its main feature is that the phase is singled out at the very last step of the gradient estimation. All intermediate steps operate with complex-valued optical coherence tomography (OCT) signals represented as vectors in the complex plane (hence, we call this approach the ‘vector’ method). In comparison with such a popular method as least-square fitting of the phase-difference slope over a selected region (even in the improved variant with amplitude weighting for suppressing small-amplitude noisy pixels), the vector approach demonstrates superior tolerance to both additive noise in the receiving system and speckle-decorrelation caused by tissue straining. Another advantage of the vector approach is that it obviates the usual necessity of error-prone phase unwrapping. Here, special attention is paid to modifications of the vector method that make it especially suitable for processing deformations with significant lateral inhomogeneity, which often occur in real situations. The method’s advantages are demonstrated using both simulated and real OCT scans obtained during reshaping of a collagenous tissue sample irradiated by an IR laser beam producing complex spatially inhomogeneous deformations.

Environmental siting suitability analysis for commercial scale ocean renewable energy: A southeast Florida case study

NASA Astrophysics Data System (ADS)

Mulcan, Amanda

This thesis aims to facilitate the siting and implementation of Florida Atlantic University Southeast National Marine Renewable Energy Center (FAU SNMREC) ocean current energy (OCE) projects offshore southeastern Florida through the analysis of benthic anchoring conditions. Specifically, a suitability analysis considering all presently available biologic and geologic datasets within the legal framework of OCE policy and regulation was done. OCE related literature sources were consulted to assign suitability levels to each dataset, ArcGIS interpolations generated seafloor substrate maps, and existing submarine cable pathways were considered for OCE power cables. The finalized suitability map highlights the eastern study area as most suitable for OCE siting due to its abundance of sand/sediment substrate, existing underwater cable route access, and minimal biologic presence. Higher resolution datasets are necessary to locate specific OCE development locales, better understand their benthic conditions, and minimize potentially negative OCE environmental impacts.

Duration of use of oral cannabis extract in a cohort of pediatric epilepsy patients.

PubMed

Treat, Lauren; Chapman, Kevin E; Colborn, Kathryn L; Knupp, Kelly G

2017-01-01

Oral cannabis extracts (OCEs) are being used in the treatment of epilepsy with increasing rates in the United States following product legalization; however, no studies demonstrate clear efficacy. We evaluated the duration of use of OCEs as a measure of perceived benefit in a cohort of patients with pediatric epilepsy. Retrospective chart review was performed of children and adolescents who were given OCEs for treatment of epilepsy. Of the 119 patients included in the analysis, 71% terminated use of their OCE product during the study period. The average length of use of OCE was 11.7 months (range 0.3-57 months). Perceived seizure benefit was the only factor associated with longer duration of treatment with OCE (p < 0.01). Relocation to Colorado was associated with perceived benefit of OCEs for seizures (65% vs. 38%, p = 0.01), but was not independently associated with longer OCE use. Factors associated with shorter use included adverse effects (p = 0.03) and a diagnosis of Dravet syndrome (p = 0.02). Twenty-four percent of patients were considered OCE responders, which was defined by a parent's report of a > 50% reduction in seizures while on this therapy. Adverse events (AEs) were reported in 19% of patients, with the most common side effects being somnolence and worsening of seizures. Parental report of OCE use in refractory pediatric epilepsy suggests that some families perceive benefit from this therapy; however, discontinuation of these products is common. Duration appears to be affected by logical factors, such as perceived benefit and side effect profile. Surprisingly, families of patients with Dravet syndrome terminated use of OCEs more quickly than patients with other epilepsy syndromes. Results from this study highlight the need for rigorous clinical studies to characterize the efficacy and safety of OCEs, which can inform discussions with patients and families. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

Chinas Goldwater-Nichols Assessing PLA Organizational Reforms

DTIC Science & Technology

2016-04-01

Military Affairs (CSCMA), Institute for National Strategic Studies, at the National Defense University. Dr. Joel Wuthnow is a Research Fellow in...Chairman, Vice Chairmen, Members) CMC Subsidiary Organs General Oce Discipline Inspection Commission Audit Bureau General Sta Department State...Commission Science & Tech. Commission Strategic Planning Oce Reform & Organization Oce Int. Military Cooperation Oce Audit Bureau Organ Aairs Gen

Ultrahigh-resolution optical coherence elastography through a micro-endoscope: towards in vivo imaging of cellular-scale mechanics

PubMed Central

Fang, Qi; Curatolo, Andrea; Wijesinghe, Philip; Yeow, Yen Ling; Hamzah, Juliana; Noble, Peter B.; Karnowski, Karol; Sampson, David D.; Ganss, Ruth; Kim, Jun Ki; Lee, Woei M.; Kennedy, Brendan F.

2017-01-01

In this paper, we describe a technique capable of visualizing mechanical properties at the cellular scale deep in living tissue, by incorporating a gradient-index (GRIN)-lens micro-endoscope into an ultrahigh-resolution optical coherence elastography system. The optical system, after the endoscope, has a lateral resolution of 1.6 µm and an axial resolution of 2.2 µm. Bessel beam illumination and Gaussian mode detection are used to provide an extended depth-of-field of 80 µm, which is a 4-fold improvement over a fully Gaussian beam case with the same lateral resolution. Using this system, we demonstrate quantitative elasticity imaging of a soft silicone phantom containing a stiff inclusion and a freshly excised malignant murine pancreatic tumor. We also demonstrate qualitative strain imaging below the tissue surface on in situ murine muscle. The approach we introduce here can provide high-quality extended-focus images through a micro-endoscope with potential to measure cellular-scale mechanics deep in tissue. We believe this tool is promising for studying biological processes and disease progression in vivo. PMID:29188108

Anatomic optical coherence tomography for dynamic imaging of the upper airway

NASA Astrophysics Data System (ADS)

Bu, Ruofei; Balakrishnan, Santosh; Iftimia, Nicusor; Price, Hillel; Zdanski, Carlton; Oldenburg, Amy L.

2017-03-01

To aid in diagnosis and treatment of upper airway obstructive disorders (UAOD), we propose anatomic Optical Coherence Tomography (aOCT) for endoscopic imaging of the upper airway lumen with high speed and resolution. aOCT and CT scans are performed sequentially on in vivo swine to compare dynamic airway imaging data. The aOCT system is capable of capturing the dynamic deformation of the airway during respiration. This may lead to methods for airway elastography and aid in our understanding of dynamic collapse in UAOD.

Complementary and Alternative Medicine for Multiple Sclerosis

MedlinePlus

... Oral cannabis extract (OCE) – a cannabis pill • Synthetic tetrahydrocannabinol (THC) – a cannabis pill • Oromucosal cannabinoid spray – a spray ... Academy of Neurology AAN. com OCE and Synthetic THC OCE is taken orally (by mouth) in pill ...

Acoustic micro-tapping for non-contact 4D imaging of tissue elasticity.

PubMed

Ambroziński, Łukasz; Song, Shaozhen; Yoon, Soon Joon; Pelivanov, Ivan; Li, David; Gao, Liang; Shen, Tueng T; Wang, Ruikang K; O'Donnell, Matthew

2016-12-23

Elastography plays a key role in characterizing soft media such as biological tissue. Although this technology has found widespread use in both clinical diagnostics and basic science research, nearly all methods require direct physical contact with the object of interest and can even be invasive. For a number of applications, such as diagnostic measurements on the anterior segment of the eye, physical contact is not desired and may even be prohibited. Here we present a fundamentally new approach to dynamic elastography using non-contact mechanical stimulation of soft media with precise spatial and temporal shaping. We call it acoustic micro-tapping (AμT) because it employs focused, air-coupled ultrasound to induce significant mechanical displacement at the boundary of a soft material using reflection-based radiation force. Combining it with high-speed, four-dimensional (three space dimensions plus time) phase-sensitive optical coherence tomography creates a non-contact tool for high-resolution and quantitative dynamic elastography of soft tissue at near real-time imaging rates. The overall approach is demonstrated in ex-vivo porcine cornea.

Acoustic micro-tapping for non-contact 4D imaging of tissue elasticity

PubMed Central

Ambroziński, Łukasz; Song, Shaozhen; Yoon, Soon Joon; Pelivanov, Ivan; Li, David; Gao, Liang; Shen, Tueng T.; Wang, Ruikang K.; O’Donnell, Matthew

2016-01-01

Elastography plays a key role in characterizing soft media such as biological tissue. Although this technology has found widespread use in both clinical diagnostics and basic science research, nearly all methods require direct physical contact with the object of interest and can even be invasive. For a number of applications, such as diagnostic measurements on the anterior segment of the eye, physical contact is not desired and may even be prohibited. Here we present a fundamentally new approach to dynamic elastography using non-contact mechanical stimulation of soft media with precise spatial and temporal shaping. We call it acoustic micro-tapping (AμT) because it employs focused, air-coupled ultrasound to induce significant mechanical displacement at the boundary of a soft material using reflection-based radiation force. Combining it with high-speed, four-dimensional (three space dimensions plus time) phase-sensitive optical coherence tomography creates a non-contact tool for high-resolution and quantitative dynamic elastography of soft tissue at near real-time imaging rates. The overall approach is demonstrated in ex-vivo porcine cornea. PMID:28008920

Acoustic micro-tapping for non-contact 4D imaging of tissue elasticity

NASA Astrophysics Data System (ADS)

Ambroziński, Łukasz; Song, Shaozhen; Yoon, Soon Joon; Pelivanov, Ivan; Li, David; Gao, Liang; Shen, Tueng T.; Wang, Ruikang K.; O'Donnell, Matthew

2016-12-01

Elastography plays a key role in characterizing soft media such as biological tissue. Although this technology has found widespread use in both clinical diagnostics and basic science research, nearly all methods require direct physical contact with the object of interest and can even be invasive. For a number of applications, such as diagnostic measurements on the anterior segment of the eye, physical contact is not desired and may even be prohibited. Here we present a fundamentally new approach to dynamic elastography using non-contact mechanical stimulation of soft media with precise spatial and temporal shaping. We call it acoustic micro-tapping (AμT) because it employs focused, air-coupled ultrasound to induce significant mechanical displacement at the boundary of a soft material using reflection-based radiation force. Combining it with high-speed, four-dimensional (three space dimensions plus time) phase-sensitive optical coherence tomography creates a non-contact tool for high-resolution and quantitative dynamic elastography of soft tissue at near real-time imaging rates. The overall approach is demonstrated in ex-vivo porcine cornea.

Comparative study of shear wave-based elastography techniques in optical coherence tomography

NASA Astrophysics Data System (ADS)

Zvietcovich, Fernando; Rolland, Jannick P.; Yao, Jianing; Meemon, Panomsak; Parker, Kevin J.

2017-03-01

We compare five optical coherence elastography techniques able to estimate the shear speed of waves generated by one and two sources of excitation. The first two techniques make use of one piezoelectric actuator in order to produce a continuous shear wave propagation or a tone-burst propagation (TBP) of 400 Hz over a gelatin tissue-mimicking phantom. The remaining techniques utilize a second actuator located on the opposite side of the region of interest in order to create three types of interference patterns: crawling waves, swept crawling waves, and standing waves, depending on the selection of the frequency difference between the two actuators. We evaluated accuracy, contrast to noise ratio, resolution, and acquisition time for each technique during experiments. Numerical simulations were also performed in order to support the experimental findings. Results suggest that in the presence of strong internal reflections, single source methods are more accurate and less variable when compared to the two-actuator methods. In particular, TBP reports the best performance with an accuracy error <4.1%. Finally, the TBP was tested in a fresh chicken tibialis anterior muscle with a localized thermally ablated lesion in order to evaluate its performance in biological tissue.

Viscoelastic characterization of dispersive media by inversion of a general wave propagation model in optical coherence elastography

NASA Astrophysics Data System (ADS)

Zvietcovich, Fernando; Rolland, Jannick P.; Grygotis, Emma; Wayson, Sarah; Helguera, Maria; Dalecki, Diane; Parker, Kevin J.

2018-02-01

Determining the mechanical properties of tissue such as elasticity and viscosity is fundamental for better understanding and assessment of pathological and physiological processes. Dynamic optical coherence elastography uses shear/surface wave propagation to estimate frequency-dependent wave speed and Young's modulus. However, for dispersive tissues, the displacement pulse is highly damped and distorted during propagation, diminishing the effectiveness of peak tracking approaches. The majority of methods used to determine mechanical properties assume a rheological model of tissue for the calculation of viscoelastic parameters. Further, plane wave propagation is sometimes assumed which contributes to estimation errors. To overcome these limitations, we invert a general wave propagation model which incorporates (1) the initial force shape of the excitation pulse in the space-time field, (2) wave speed dispersion, (3) wave attenuation caused by the material properties of the sample, (4) wave spreading caused by the outward cylindrical propagation of the wavefronts, and (5) the rheological-independent estimation of the dispersive medium. Experiments were conducted in elastic and viscous tissue-mimicking phantoms by producing a Gaussian push using acoustic radiation force excitation, and measuring the wave propagation using a swept-source frequency domain optical coherence tomography system. Results confirm the effectiveness of the inversion method in estimating viscoelasticity in both the viscous and elastic phantoms when compared to mechanical measurements. Finally, the viscoelastic characterization of collagen hydrogels was conducted. Preliminary results indicate a relationship between collagen concentration and viscoelastic parameters which is important for tissue engineering applications.

Parental reporting of response to oral cannabis extracts for treatment of refractory epilepsy.

PubMed

Press, Craig A; Knupp, Kelly G; Chapman, Kevin E

2015-04-01

Oral cannabis extracts (OCEs) have been used in the treatment of epilepsy; however, no studies demonstrate clear efficacy. We report on a cohort of pediatric patients with epilepsy who were given OCE and followed in a single tertiary epilepsy center. A retrospective chart review of children and adolescents who were given OCE for treatment of their epilepsy was performed. Seventy-five patients were identified of which 57% reported any improvement in seizure control and 33% reported a >50% reduction in seizures (responders). If the family had moved to CO for OCE treatment, the responder rate was 47% vs. 22% for children who already were in CO. The responder rate varied based on epilepsy syndrome: Dravet 23%, Doose 0%, and Lennox-Gastaut syndrome (LGS) 88.9%. The background EEG of the 8 responders where EEG data were available was not improved. Additional benefits reported included: improved behavior/alertness (33%), improved language (10%), and improved motor skills (10%). Adverse events (AEs) occurred in 44% of patients including increased seizures (13%) and somnolence/fatigue (12%). Rare adverse events included developmental regression, abnormal movements, status epilepticus requiring intubation, and death. Our retrospective study of OCE use in pediatric patients with epilepsy demonstrates that some families reported patient improvement with treatment; however, we also found a variety of challenges and possible confounding factors in studying OCE retrospectively in an open-labeled fashion. We strongly support the need for controlled, blinded studies to evaluate the efficacy and safety of OCE for treatment of pediatric epilepsies using accurate seizure counts, formal neurocognitive assessments, as well as EEG as a biomarker. This study provides Class III evidence that OCE is well tolerated by children and adolescents with epilepsy. Copyright © 2015 Elsevier Inc. All rights reserved.

Optical Moorings-of-Opportunity for Validation of Ocean Color Satellites

DTIC Science & Technology

2008-01-01

at the midpoint of the two depths is given by: K , z d dz lnE , z , , d dλ λ λ λ ( ) = − ( )[ ] ( ) = − ( ) ( ) ( ) 4a 1 z ln E , z E , z 4bd 2 d 1...Biological Oceanography Program ( TD : OCE-9627281, OCE-9730471, OCE-9819477), NASA ( TD : NAS5-97127), the ONR Ocean Engineering and Marine Systems Program

Probing myocardium biomechanics using quantitative optical coherence elastography

NASA Astrophysics Data System (ADS)

Wang, Shang; Lopez, Andrew L.; Morikawa, Yuka; Tao, Ge; Li, Jiasong; Larina, Irina V.; Martin, James F.; Larin, Kirill V.

2015-03-01

We present a quantitative optical coherence elastographic method for noncontact assessment of the myocardium elasticity. The method is based on shear wave imaging optical coherence tomography (SWI-OCT), where a focused air-puff system is used to induce localized tissue deformation through a low-pressure short-duration air stream and a phase-sensitive OCT system is utilized to monitor the propagation of the induced tissue displacement with nanoscale sensitivity. The 1-D scanning of M-mode OCT imaging and the application of optical phase retrieval and mapping techniques enable the reconstruction and visualization of 2-D depth-resolved shear wave propagation in tissue with ultra-high frame rate. The feasibility of this method in quantitative elasticity measurement is demonstrated on tissue-mimicking phantoms with the estimated Young's modulus compared with uniaxial compression tests. We also performed pilot experiments on ex vivo mouse cardiac muscle tissues with normal and genetically altered cardiomyocytes. Our results indicate this noncontact quantitative optical coherence elastographic method can be a useful tool for the cardiac muscle research and studies.

Olfactory Cleft Endoscopy Scale correlates with olfactory metrics in patients with chronic rhinosinusitis

PubMed Central

Soler, Zachary M.; Hyer, J. Madison; Karnezis, Tom T.; Schlosser, Rodney J.

2015-01-01

Introduction Olfactory loss affects a majority of patients with chronic rhinosinusitis (CRS). Traditional objective measures of disease severity, including endoscopy scales, focus upon the paranasal sinuses and often have weak correlation to olfaction. Methods Adults with CRS were prospectively evaluated by blinded reviewers with a novel Olfactory Cleft Endoscopy Scale (OCES) that evaluated discharge, polyps, edema, crusting and scarring of the olfactory cleft. Objective olfactory function was assessed using “Sniffin’ Sticks testing, including composite threshold-discrimination-identification (TDI) scores. Olfactory-specific quality-of-life was evaluated using the short modified version of the Questionnaire of Olfactory Disorders (QOD-NS). Inter- and intra-rater reliability was assessed among 3 reviewers for OCES grading. Multivariate linear regression was then used to test associations between OCES scores and measures of olfaction, controlling for potential confounding factors. Results The OCES score was evaluated in 38 patients and had a high overall reliability (ICC=0.92; 95% CI: 0.91–0.96). The OCES significantly correlated with objective olfaction as measured by TDI score (p<0.001), with TDI score falling by 1.13 points for every 1 point increase in OCES score. Similar significant associations were found for threshold, discrimination, and identification scores (p<0.003 for all) after controlling for age, gender, race, and reviewer/review. The OCES was also highly associated with patient-reported QOD-NS scores (p=0.009). Conclusion A novel olfactory cleft endoscopy scale shows high reliability and correlates with both objective and patient-reported olfaction in patients with CRS. Further studies to determine prognostic value and responsiveness to change are warranted. PMID:26718315

Strategies to improve phase-stability of ultrafast swept source optical coherence tomography for single shot imaging of transient mechanical waves at 16 kHz frame rate

DOE Office of Scientific and Technical Information (OSTI.GOV)

Song, Shaozhen; Wei, Wei; Hsieh, Bao-Yu

We present single-shot phase-sensitive imaging of propagating mechanical waves within tissue, enabled by an ultrafast optical coherence tomography (OCT) system powered by a 1.628 MHz Fourier domain mode-locked (FDML) swept laser source. We propose a practical strategy for phase-sensitive measurement by comparing the phases between adjacent OCT B-scans, where the B-scan contains a number of A-scans equaling an integer number of FDML buffers. With this approach, we show that micro-strain fields can be mapped with ∼3.0 nm sensitivity at ∼16 000 fps. The system's capabilities are demonstrated on porcine cornea by imaging mechanical wave propagation launched by a pulsed UV laser beam, promisingmore » non-contact, real-time, and high-resolution optical coherence elastography.« less

Quantifying the effects of hydration on corneal stiffness with optical coherence elastography

NASA Astrophysics Data System (ADS)

Singh, Manmohan; Li, Jiasong; Han, Zhaolong; Vantipalli, Srilatha; Aglyamov, Salavat R.; Twa, Michael D.; Larin, Kirill V.

2018-02-01

Several methods have been proposed to assess changes in corneal biomechanical properties due to various factors, such as degenerative diseases, intraocular pressure, and therapeutic interventions (e.g. corneal collagen crosslinking). However, the effect of the corneal tissue hydration state on corneal stiffness is not well understood. In this work, we induce low amplitude (< 10 μm) elastic waves with a focused micro air-pulse in fresh in situ rabbit corneas (n = 10) in the whole eye-globe configuration at an artificially controlled intraocular pressure. The waves were then detected with a phase-stabilized swept source optical coherence elastography system. Baseline measurements were taken every 20 minutes for an hour while the corneas were hydrated with 1X PBS. After the measurement at 60 minutes, a 20% dextran solution was topically instilled to dehydrate the corneas. The measurements were repeated every 20 minutes again for an hour. The results showed that the elastic wave velocity decreased as the corneal thickness decreased. Finite element modeling (FEM) was performed using the corneal geometry and elastic wave propagation speed to assess the stiffness of the samples. The results show that the stiffness increased from 430 kPa during hydration with PBS to 500 kPa after dehydration with dextran, demonstrating that corneal hydration state, apart from geometry and intraocular pressure, can change the stiffness of the cornea.

Amplitude-modulated ultrasound radiation force combined with phase-sensitive optical coherence tomography for shear wave elastography

NASA Astrophysics Data System (ADS)

Nguyen, Thu-Mai; Song, Shaozhen; Arnal, Bastien; Wong, Emily Y.; Shen, Tueng T.; Wang, Ruikang K.; O'Donnell, Matthew

2015-03-01

Tissue stiffness can be measured from the propagation speed of shear waves. Acoustic radiation force (ARF) can generate shear waves by focusing ultrasound in tissue for ~100 μs. Safety considerations and electronics abilities limit ultrasound pressures. We previously presented shear wave elastography combining ARF and phase-sensitive optical coherence tomography (PhS-OCT) [1]. Here, we use amplitude-modulated ARF to enhance shear wave signal-to-noise ratio (SNR) at low pressures. Experiments were performed on tissue-mimicking phantoms. ARF was applied using a single-element transducer, driven by a 7.5 MHz, 3-ms, sine wave modulated in amplitude by a linear-swept frequency (1 to 7 kHz). Pressures between 1 to 3 MPa were tested. Displacements were tracked using PhS-OCT and numerically compressed using pulse compression methods detailed in previous work [2]. SNR was compared to that of 200-μs bursts. Stiffness maps were reconstructed using time-of-flight computations. 200-μs bursts give barely detectable displacements at 1 MPa (3.7 dB SNR). Pulse compression gives 36.2 dB at 1.5 MPa. In all cases with detectable displacements, shear wave speeds were determined in 5%-gelatin and 10%-gelatin phantoms and compared to literature values. Applicability to ocular tissues (cornea, intraocular lens) is under investigation.

Systematic review: Efficacy and safety of medical marijuana in selected neurologic disorders

PubMed Central

Koppel, Barbara S.; Brust, John C.M.; Fife, Terry; Bronstein, Jeff; Youssof, Sarah; Gronseth, Gary; Gloss, David

2014-01-01

Objective: To determine the efficacy of medical marijuana in several neurologic conditions. Methods: We performed a systematic review of medical marijuana (1948–November 2013) to address treatment of symptoms of multiple sclerosis (MS), epilepsy, and movement disorders. We graded the studies according to the American Academy of Neurology classification scheme for therapeutic articles. Results: Thirty-four studies met inclusion criteria; 8 were rated as Class I. Conclusions: The following were studied in patients with MS: (1) Spasticity: oral cannabis extract (OCE) is effective, and nabiximols and tetrahydrocannabinol (THC) are probably effective, for reducing patient-centered measures; it is possible both OCE and THC are effective for reducing both patient-centered and objective measures at 1 year. (2) Central pain or painful spasms (including spasticity-related pain, excluding neuropathic pain): OCE is effective; THC and nabiximols are probably effective. (3) Urinary dysfunction: nabiximols is probably effective for reducing bladder voids/day; THC and OCE are probably ineffective for reducing bladder complaints. (4) Tremor: THC and OCE are probably ineffective; nabiximols is possibly ineffective. (5) Other neurologic conditions: OCE is probably ineffective for treating levodopa-induced dyskinesias in patients with Parkinson disease. Oral cannabinoids are of unknown efficacy in non–chorea-related symptoms of Huntington disease, Tourette syndrome, cervical dystonia, and epilepsy. The risks and benefits of medical marijuana should be weighed carefully. Risk of serious adverse psychopathologic effects was nearly 1%. Comparative effectiveness of medical marijuana vs other therapies is unknown for these indications. PMID:24778283

Systematic review: efficacy and safety of medical marijuana in selected neurologic disorders: report of the Guideline Development Subcommittee of the American Academy of Neurology.

PubMed

Koppel, Barbara S; Brust, John C M; Fife, Terry; Bronstein, Jeff; Youssof, Sarah; Gronseth, Gary; Gloss, David

2014-04-29

To determine the efficacy of medical marijuana in several neurologic conditions. We performed a systematic review of medical marijuana (1948-November 2013) to address treatment of symptoms of multiple sclerosis (MS), epilepsy, and movement disorders. We graded the studies according to the American Academy of Neurology classification scheme for therapeutic articles. Thirty-four studies met inclusion criteria; 8 were rated as Class I. The following were studied in patients with MS: (1) Spasticity: oral cannabis extract (OCE) is effective, and nabiximols and tetrahydrocannabinol (THC) are probably effective, for reducing patient-centered measures; it is possible both OCE and THC are effective for reducing both patient-centered and objective measures at 1 year. (2) Central pain or painful spasms (including spasticity-related pain, excluding neuropathic pain): OCE is effective; THC and nabiximols are probably effective. (3) Urinary dysfunction: nabiximols is probably effective for reducing bladder voids/day; THC and OCE are probably ineffective for reducing bladder complaints. (4) Tremor: THC and OCE are probably ineffective; nabiximols is possibly ineffective. (5) Other neurologic conditions: OCE is probably ineffective for treating levodopa-induced dyskinesias in patients with Parkinson disease. Oral cannabinoids are of unknown efficacy in non-chorea-related symptoms of Huntington disease, Tourette syndrome, cervical dystonia, and epilepsy. The risks and benefits of medical marijuana should be weighed carefully. Risk of serious adverse psychopathologic effects was nearly 1%. Comparative effectiveness of medical marijuana vs other therapies is unknown for these indications.

78 FR 105 - Proposed Collection; Comment Request (60-Day FRN); A Generic Submission for Formative Research...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-02

..., it is beneficial for NCI through its Office of Communications and Education (OCE), to pretest NCI... NCI's OCE also is responsible for the design, implementation, and evaluation of education programs...

78 FR 14558 - Submission for OMB Review; 30-Day Comment Request: A Generic Submission for Formative Research...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... beneficial for NCI through its Office of Communications and Education (OCE), to pretest NCI communications...'s OCE is also responsible for the design, implementation, and evaluation of education programs over...

Coherent Structures and Evolution of Vorticity in Short-Crested Breaking Surface Waves

NASA Astrophysics Data System (ADS)

Kirby, James; Derakhti, Morteza

2017-11-01

We employ a multi-phase LES/VOF code to study turbulence and coherent structures generated during breaking of short-crested surface water waves. We examine the evolution of coherent vortex structures evolving at the scale of the width of the breaking event, and their long-time interaction with smaller vortex loops formed by the local instability of the breaking crest. Long-time results are often characterized by the detachment of the larger scale vortex loop from the surface and formation of a closed vortex ring. The evolution of circulation for the vortical flow field is examined. The initial concentration of forcing close to the free surface leads to spatial distributions of both span-wise and vertical vorticity distributions which are concentrated close to the surface. This result, which persists into shallow water, is at odds with the basic simplicity of the Peregrine mechanism, suggesting that even shallow flows such as the surf zone should be regarded as being forced (in dissipative situations) by a wave-induced surface stress rather than a uniform-over-depth body force. The localized forcing leads to the development of a complex pattern of stream-wise vorticity, comparable in strength to the vertical and span-wise components, and also persist into shallow water. NSF OCE-1435147.

Differential effects of hormone therapy on serotonin, vascular function and mood in the KEEPS.

PubMed

Raz, L; Hunter, L V; Dowling, N M; Wharton, W; Gleason, C E; Jayachandran, M; Anderson, L; Asthana, S; Miller, V M

2016-01-01

Serotonin (5-hydroxytryptamine, 5-HT) is modulated by sex steroid hormones and affects vascular function and mood. In the Kronos Early Estrogen Prevention Cognitive and Affective Ancillary Study (KEEPS-Cog), women randomized to oral conjugated equine estrogens (oCEE) showed greater benefit on affective mood states than women randomized to transdermal 17β-estradiol (tE2) or placebo (PL). This study examined the effect of these treatments on the platelet content of 5-HT as a surrogate measure of 5-HT synthesis and uptake in the brain. The following were measured in a subset (n = 79) of women enrolled in KEEPS-Cog: 5-HT by ELISA, carotid intima-medial thickness (CIMT) by ultrasound, endothelial function by reactive hyperemic index (RHI), and self-reported symptoms of affective mood states by the Profile of Mood States (POMS) questionnaire. Mean platelet content of 5-HT increased by 107.0%, 84.5% and 39.8%, in tE2, oCEE and PL groups, respectively. Platelet 5-HT positively correlated with estrone in the oCEE group and with 17β- estradiol in the tE2 group. Platelet 5-HT showed a positive association with RHI, but not CIMT, in the PL and oCEE groups. Reduction in mood scores for depression-dejection and anger-hostility was associated with elevations in platelet 5-HT only in the oCEE group (r = -0.5, p = 0.02). Effects of oCEE compared to tE2 on RHI and mood may be related to mechanisms involving platelet, and perhaps neuronal, uptake and release of 5-HT and reflect conversion of estrone to bioavailable 17β-estradiol in platelets and the brain.

OCE NEMP PROGRAM DEVELOPMENT OF CRITERIA FOR PROTECTION OF NIKE-X POWER PLANT AND FACILITIES ELECTRICAL SYSTEMS AGAINST NUCLEAR ELECTROMAGNETIC PULSE EFFECTS.

DTIC Science & Technology

technical backup material for the OCE NEMP PROGRAM, Development of Criteria for Protection of NIKE-X Power Plant and Facilities Electrical Systems Against Nuclear Electromagnetic Pulse Effects, Protective MEASURES. (Author)

Optimization of ultrasound-assisted extraction (UAE) of phenolic compounds from olive cake.

PubMed

Mojerlou, Zohreh; Elhamirad, Amirhhossein

2018-03-01

The use of ultrasound in ultrasound-assisted extraction (UAE) is one of the main applications of this technology in food industry. This study aimed to optimize UAE conditions for olive cake extract (OCE) through response surface methodology (RSM). The optimal UAE conditions were obtained with extraction temperature of 56 °C, extraction time of 3 min, duty cycle of 0.6 s, and solid to solvent ratio of 3.6%. At the optimum conditions, the total phenolic compounds (TPC) content and antioxidant activity (AA) were measured 4.04 mg/g and 68.9%, respectively. The linear term of temperature had the most effect on TPC content and AA of OCE prepared by UAE. Protocatechuic acid and cinnamic acid were characterized as the highest (19.5%) and lowest (1.6%) phenolic compound measured in OCE extracted by UAE. This research revealed that UAE is an effective method to extract phenolic compounds from olive cake. RSM successfully optimized UAE conditions for OCE.

The results of initial analysis of OSTA-1/Ocean Color Experiment (OCE) imagery

NASA Technical Reports Server (NTRS)

Kim, H. H.; Hart, W. D.

1982-01-01

Ocean view images from the Ocean Color Experiment (OCE) were produced at three widely separated locations on the Earth. Digital computer enhancement and band ratioing techniques were applied to radiometrically corrected OCE spectral data to emphasize patterns of chlorophyll distribution and, in one shallow, clear water case, bottom topography. The chlorophyll pattern in the Yellow Sea between China and Korea was evident in a scene produced from Shuttle Orbit 24. The effects of the discharge from the Yangtze and other rivers were also observed. Two scenes from orbits 30 and 32 revealed the movement of patches of plankton in the Gulf of Cadiz. Geometrical corrections to these images permitted the existing ocean current velocities in the vicinity to be deduced. The variability in water depth over the Grand Bahama Bank was estimated by using the blue-green OCE channel. The very clear water conditions in the area caused bottom reflected sunlight to produce a sensor signal which was related inversely to the depth of the water.

[Has application of the decree banning the use of cement with a high chromium VI content led to a reduction in occupational cement dermatitis in salaried workers in the construction industries?].

PubMed

Halioua, Bruno; Bensefa-Colas, Lynda; Crepy, Marie-Noëlle; Bouquiaux, Barbara; Assier, Haudrey; Billon, Stéphane; Chosidow, Olivier

2013-03-01

Active employees in the construction industry are particularly exposed to occupational cement eczema (OCE) which affects the hands in 80 to 90% of cases. The importance of OCE in France and the impact of the application of decree n(o). 2005-577 on 26 May 2005 were estimated from data collected by the Occupational risks division of the French national health insurance fund for salaried workers (CNAMTS). This decree prohibits the placing on the market and use of cement (and preparations containing it) with a chromium VI content above 0.0002% in order to reduce its hazardousness. All cases of OCE reported to and recognized by the CNAMTS between 1 January 2004 and 31 December 2008 among construction workers were selected. The following parameters were noted in each case: age, gender, industrial sector concerned, local French National health insurance agency, causal agent and the number of working days lost. The incidence per 100,000 salaried workers could be determined from the total number of salaried workers followed up by occupational medicine as well as those working in the construction industry. For the five years studied, 3698 cases of occupational eczema (OE) were reported in construction workers and this was 17.1% of the total number of cases of OE for all salaried employees (n=12.689). Cement was the causal agent most frequently involved in the construction sector (57.8%, 2139/3698). The annual incidence of OCE decreased from 37.8 to 21.1 new cases per 100,000 employees in the construction industry per year between 2004 and 2008. The total number of days lost from work due to OCE decreased by 39% during the study period. This descriptive study highlights the importance and socio-economic impact of OCE in the construction industry. Application of decree n(o). 2005-577 on 26 May 2005 may explain a reduction in OCE. Copyright © 2012. Published by Elsevier Masson SAS.

Ultrahigh resolution optical coherence elastography combined with a rigid micro-endoscope (Conference Presentation)

NASA Astrophysics Data System (ADS)

Fang, Qi; Curatolo, Andrea; Wijesinghe, Philip; Hamzah, Juliana; Ganss, Ruth; Noble, Peter B.; Karnowski, Karol; Sampson, David D.; Kim, Jun Ki; Lee, Wei M.; Kennedy, Brendan F.

2017-02-01

The mechanical forces that living cells experience represent an important framework in the determination of a range of intricate cellular functions and processes. Current insight into cell mechanics is typically provided by in vitro measurement systems; for example, atomic force microscopy (AFM) measurements are performed on cells in culture or, at best, on freshly excised tissue. Optical techniques, such as Brillouin microscopy and optical elastography, have been used for ex vivo and in situ imaging, recently achieving cellular-scale resolution. The utility of these techniques in cell mechanics lies in quick, three-dimensional and label-free mechanical imaging. Translation of these techniques toward minimally invasive in vivo imaging would provide unprecedented capabilities in tissue characterization. Here, we take the first steps along this path by incorporating a gradient-index micro-endoscope into an ultrahigh resolution optical elastography system. Using this endoscope, a lateral resolution of 2 µm is preserved over an extended depth-of-field of 80 µm, achieved by Bessel beam illumination. We demonstrate this combined system by imaging stiffness of a silicone phantom containing stiff inclusions and a freshly excised murine liver tissue. Additionally, we test this system on murine ribs in situ. We show that our approach can provide high quality extended depth-of-field images through an endoscope and has the potential to measure cell mechanics deep in tissue. Eventually, we believe this tool will be capable of studying biological processes and disease progression in vivo.

A Photometric Study of Three Eclipsing Binary Stars (Poster abstract)

NASA Astrophysics Data System (ADS)

Ryan, A.

2016-12-01

(Abstract only) As part of a program to study eclipsing binary stars that exhibit the O'Connell Effect (OCE) we are observing a selection of binary stars in a long term study. The OCE is a difference in maximum light across the ligthcurve possibly cause by starspots. We observed for 7 nights at McDonald Observatory using the 30-inch telescope in July 2015, and used the same telescope remotely for a total of 20 additional nights in August, October, December, and January. We will present lightcurves for three stars from this study, characterize the OCE for these stars, and present our model results for the physical parameters of the star making up each of these systems.

Assessment of preclinical problem-based learning versus lecture-based learning.

PubMed

Login, G R; Ransil, B J; Meyer, M; Truong, N T; Donoff, R B; McArdle, P J

1997-06-01

Academic performance on a standardized oral comprehensive exam (OCE) was compared for students taught basic science in a problem-based learning (PBL) curriculum and a lecture-based learning (LBL) curriculum. The OCE was administered to the graduating classes of 1991-1994 (n approximately 20/class) six months after completion of their basic science courses. The OCE contained six components including: Organization and Thoroughness, Diagnosis, Primary Treatment Plan, Alternate Treatment Plan, Science and Medical Knowledge, and Dental Knowledge. Six to eight examiners graded each of the students by using a standardized scoring system and by subjective comments. The class of 1991 was taught by LBL, classes of 1993 and 1994 by PBL, and the class of 1992 by an incomplete PBL teaching method. Mean OCE scores were not significantly different between classes; however, the Science and Medical Knowledge component score was significantly better for the class of 1994 than for 1991 (p < 0.05). There was a non-significant 40 percent increase (p = 0.07) in honors and a 269 percent (p < 0.001) increase in cumulative positive examiner comments between 1991 and 1994.

Brain structure and cognition 3 years after the end of an early menopausal hormone therapy trial

PubMed Central

Tosakulwong, Nirubol; Lesnick, Timothy G.; Zuk, Samantha M.; Lowe, Val J.; Fields, Julie A.; Gunter, Jeffrey L.; Senjem, Matthew L.; Settell, Megan L.; Gleason, Carey E.; Shuster, Lynne T.; Bailey, Kent R.; Dowling, N. Maritza; Asthana, Sanjay; Jack, Clifford R.; Rocca, Walter A.; Miller, Virginia M.

2018-01-01

Objective The effects of 2 frequently used formulations of menopausal hormone therapy (mHT) on brain structure and cognition were investigated 3 years after the end of a randomized, placebo-controlled trial in recently menopausal women with good cardiovascular health. Methods Participants (aged 42–56 years; 5–36 months past menopause) were randomized to one of the following: 0.45 mg/d oral conjugated equine estrogen (oCEE); 50 μg/d transdermal 17β-estradiol (tE2); or placebo pills and patch for 4 years. Oral progesterone (200 mg/d) was given to mHT groups for 12 days each month. MRIs were performed at baseline, at the end of 4 years of mHT, and 3 years after the end of mHT (n = 75). A subset of participants also underwent Pittsburgh compound B–PET (n = 68). Results Ventricular volumes increased more in the oCEE group compared to placebo during the 4 years of mHT, but the increase in ventricular volumes was not different from placebo 3 years after the discontinuation of mHT. Increase in white matter hyperintensity volume was similar in the oCEE and tE2 groups, but it was statistically significantly greater than placebo only in the oCEE group. The longitudinal decline in dorsolateral prefrontal cortex volumes was less in the tE2 group compared to placebo, which correlated with lower cortical Pittsburgh compound B uptake. Rates of global cognitive change in mHT groups were not different from placebo. Conclusions The effects of oCEE on global brain structure during mHT subside after oCEE discontinuation but white matter hyperintensities continue to increase. The relative preservation of dorsolateral prefrontal cortical volume in the tE2 group over 7 years indicates that mHT may have long-term effects on the brain. Classification of evidence This study provides Class III evidence that the rates of change in global brain volumes and cognitive function in recently menopausal women receiving mHT (tE2 or oCEE) were not significantly different from women receiving placebo, as measured 3 years after exposure to mHT. PMID:29661902

Brain structure and cognition 3 years after the end of an early menopausal hormone therapy trial.

PubMed

Kantarci, Kejal; Tosakulwong, Nirubol; Lesnick, Timothy G; Zuk, Samantha M; Lowe, Val J; Fields, Julie A; Gunter, Jeffrey L; Senjem, Matthew L; Settell, Megan L; Gleason, Carey E; Shuster, Lynne T; Bailey, Kent R; Dowling, N Maritza; Asthana, Sanjay; Jack, Clifford R; Rocca, Walter A; Miller, Virginia M

2018-04-17

The effects of 2 frequently used formulations of menopausal hormone therapy (mHT) on brain structure and cognition were investigated 3 years after the end of a randomized, placebo-controlled trial in recently menopausal women with good cardiovascular health. Participants (aged 42-56 years; 5-36 months past menopause) were randomized to one of the following: 0.45 mg/d oral conjugated equine estrogen (oCEE); 50 μg/d transdermal 17β-estradiol (tE2); or placebo pills and patch for 4 years. Oral progesterone (200 mg/d) was given to mHT groups for 12 days each month. MRIs were performed at baseline, at the end of 4 years of mHT, and 3 years after the end of mHT (n = 75). A subset of participants also underwent Pittsburgh compound B-PET (n = 68). Ventricular volumes increased more in the oCEE group compared to placebo during the 4 years of mHT, but the increase in ventricular volumes was not different from placebo 3 years after the discontinuation of mHT. Increase in white matter hyperintensity volume was similar in the oCEE and tE2 groups, but it was statistically significantly greater than placebo only in the oCEE group. The longitudinal decline in dorsolateral prefrontal cortex volumes was less in the tE2 group compared to placebo, which correlated with lower cortical Pittsburgh compound B uptake. Rates of global cognitive change in mHT groups were not different from placebo. The effects of oCEE on global brain structure during mHT subside after oCEE discontinuation but white matter hyperintensities continue to increase. The relative preservation of dorsolateral prefrontal cortical volume in the tE2 group over 7 years indicates that mHT may have long-term effects on the brain. This study provides Class III evidence that the rates of change in global brain volumes and cognitive function in recently menopausal women receiving mHT (tE2 or oCEE) were not significantly different from women receiving placebo, as measured 3 years after exposure to mHT. Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Practice guideline for the performance of breast ultrasound elastography.

PubMed

Lee, Su Hyun; Chang, Jung Min; Cho, Nariya; Koo, Hye Ryoung; Yi, Ann; Kim, Seung Ja; Youk, Ji Hyun; Son, Eun Ju; Choi, Seon Hyeong; Kook, Shin Ho; Chung, Jin; Cha, Eun Suk; Park, Jeong Seon; Jung, Hae Kyoung; Ko, Kyung Hee; Choi, Hye Young; Ryu, Eun Bi; Moon, Woo Kyung

2014-01-01

Ultrasound (US) elastography is a valuable imaging technique for tissue characterization. Two main types of elastography, strain and shear-wave, are commonly used to image breast tissue. The use of elastography is expected to increase, particularly with the increased use of US for breast screening. Recently, the US elastographic features of breast masses have been incorporated into the 2nd edition of the Breast Imaging Reporting and Data System (BI-RADS) US lexicon as associated findings. This review suggests practical guidelines for breast US elastography in consensus with the Korean Breast Elastography Study Group, which was formed in August 2013 to perform a multicenter prospective study on the use of elastography for US breast screening. This article is focused on the role of elastography in combination with B-mode US for the evaluation of breast masses. Practical tips for adequate data acquisition and the interpretation of elastography results are also presented.

Performance of real-time strain elastography, transient elastography, and aspartate-to-platelet ratio index in the assessment of fibrosis in chronic hepatitis C.

PubMed

Ferraioli, Giovanna; Tinelli, Carmine; Malfitano, Antonello; Dal Bello, Barbara; Filice, Gaetano; Filice, Carlo; Above, Elisabetta; Barbarini, Giorgio; Brunetti, Enrico; Calderon, Willy; Di Gregorio, Marta; Lissandrin, Raffaella; Ludovisi, Serena; Maiocchi, Laura; Michelone, Giuseppe; Mondelli, Mario; Patruno, Savino F A; Perretti, Alessandro; Poma, Gianluigi; Sacchi, Paolo; Zaramella, Marco; Zicchetti, Mabel

2012-07-01

The purpose of this article is to evaluate the diagnostic performance of transient elastography, real-time strain elastography, and aspartate-to-platelet ratio index in assessing fibrosis in patients with chronic hepatitis C by using histologic Metavir scores as reference standard. Consecutive patients with chronic hepatitis C scheduled for liver biopsy were enrolled. Liver biopsy was performed on the same day as transient elastography and real-time strain elastography. Transient elastography and real-time strain elastography were performed in the same patient encounter by a single investigator using a medical device based on elastometry and an ultrasound machine, respectively. Diagnostic performance was assessed by using receiver operating characteristic curves and area under the receiver operating characteristic curve (AUC) analysis. One hundred thirty patients (91 men and 39 women) were analyzed. The cutoff values for transient elastography, real-time strain elastography, and aspartate-to-platelet ratio index were 6.9 kPa, 1.82, and 0.37, respectively, for fibrosis score of 2 or higher; 7.3 kPa, 1.86, and 0.70, respectively, for fibrosis score of 3 or higher; and 9.3 kPa, 2.33, and 0.70, respectively, for fibrosis score of 4. AUC values of transient elastography, real-time strain elastography, aspartate-to-platelet ratio index were 0.88, 0.74, and 0.86, respectively, for fibrosis score of 2 or higher; 0.95, 0.80, and 0.89, respectively, for fibrosis score of 3 or higher; and 0.97, 0.80, and 0.84, respectively, for fibrosis score of 4. A combination of the three methods, when two of three were in agreement, showed AUC curves of 0.93, 0.95, and 0.95 for fibrosis scores of 2 or higher, 3 or higher, and 4, respectively. Transient elastography, real-time strain elastography, and aspartate-to-platelet ratio index values were correlated with histologic stages of fibrosis. Transient elastography offered excellent diagnostic performance in assessing severe fibrosis and cirrhosis. Real-time elastography does not yet have the potential to substitute for transient elastography in the assessment of liver fibrosis.

Association of Electrochemical Therapy With Optical, Mechanical, and Acoustic Impedance Properties of Porcine Skin.

PubMed

Moy, Wesley J; Su, Erica; Chen, Jason J; Oh, Connie; Jing, Joe C; Qu, Yueqiao; He, Youmin; Chen, Zhongping; Wong, Brian J F

2017-12-01

The classic management of burn scars and other injuries to the skin has largely relied on soft-tissue transfer to resurface damaged tissue with local tissue transfer or skin graft placement. In situ generation of electrochemical reactions using needle electrodes and an application of current may be a new approach to treat scars and skin. To examine the changes in optical, mechanical, and acoustic impedance properties in porcine skin after electrochemical therapy. This preclinical pilot study, performed from August 1, 2015, to November 1, 2016, investigated the effects of localized pH-driven electrochemical therapy of ex vivo porcine skin using 24 skin samples. Platinum-plated needle electrodes were inserted into fresh porcine skin samples. A DC power supply provided a voltage of 4 to 5 V with a 3-minute application time. Specimens were analyzed using optical coherence tomography, optical coherence elastography, and ultrasonography. Ultrasonography was performed under 3 conditions (n = 2 per condition), optical coherence tomography was performed under 2 conditions (n = 2 per condition), and optical coherence elastography was performed under 2 conditions (n = 2 per condition). The remaining samples were used for the positive and negative control groups (n = 10). Platinum-plated needle electrodes were inserted into fresh porcine skin samples. A DC power supply provided a voltage of 4 to 5 V with a 3-minute application. Tissue softening was observed at the anode and cathode sites as a result of electrochemical modification. Volumetric changes were noted using each optical and acoustic technique. A total of 24 ex vivo porcine skin samples were used for this pilot study. Optical coherence tomography measured spatial distribution of superficial tissue changes around each electrode site. At 4 V for 3 minutes, a total volumetric effect of 0.47 mm3 was found at the anode site and 0.51 mm3 at the cathode site. For 5 V for 3 minutes, a total volumetric effect of 0.85 mm3 was found at the anode site and 1.05 mm3 at the cathode site. Electrochemical therapy is a low-cost technique that is on par with the costs of suture and scalpel. The use of electrochemical therapy to create mechanical and physiologic changes in tissue has the potential to locally remodel the soft-tissue matrix, which ultimately may lead to an inexpensive scar treatment or skin rejuvenation therapy. NA.

Elastography for the pancreas: Current status and future perspective

PubMed Central

Kawada, Natsuko; Tanaka, Sachiko

2016-01-01

Elastography for the pancreas can be performed by either ultrasound or endoscopic ultrasound (EUS). There are two types of pancreatic elastographies based on different principles, which are strain elastography and shear wave elastography. The stiffness of tissue is estimated by measuring the grade of strain generated by external pressure in the former, whereas it is estimated by measuring propagation speed of shear wave, the transverse wave, generated by acoustic radiation impulse (ARFI) in the latter. Strain elastography is difficult to perform when the probe, the pancreas and the aorta are not located in line. Accordingly, a fine elastogram can be easily obtained in the pancreatic body but not in the pancreatic head and tail. In contrast, shear wave elastography can be easily performed in the entire pancreas because ARFI can be emitted to wherever desired. However, shear wave elastography cannot be performed by EUS to date. Recently, clinical guidelines for elastography specialized in the pancreas were published from Japanese Society of Medical Ultrasonics. The guidelines show us technical knacks of performing elastography for the pancreas. PMID:27076756

Elastography for the pancreas: Current status and future perspective.

PubMed

Kawada, Natsuko; Tanaka, Sachiko

2016-04-14

Elastography for the pancreas can be performed by either ultrasound or endoscopic ultrasound (EUS). There are two types of pancreatic elastographies based on different principles, which are strain elastography and shear wave elastography. The stiffness of tissue is estimated by measuring the grade of strain generated by external pressure in the former, whereas it is estimated by measuring propagation speed of shear wave, the transverse wave, generated by acoustic radiation impulse (ARFI) in the latter. Strain elastography is difficult to perform when the probe, the pancreas and the aorta are not located in line. Accordingly, a fine elastogram can be easily obtained in the pancreatic body but not in the pancreatic head and tail. In contrast, shear wave elastography can be easily performed in the entire pancreas because ARFI can be emitted to wherever desired. However, shear wave elastography cannot be performed by EUS to date. Recently, clinical guidelines for elastography specialized in the pancreas were published from Japanese Society of Medical Ultrasonics. The guidelines show us technical knacks of performing elastography for the pancreas.

Elastography in clinical practice.

PubMed

Barr, Richard G

2014-11-01

Elastography is a new technique that evaluates tissue stiffness. There are two elastography methods, strain and shear wave elastography. Both techniques are being used to evaluate a wide range of applications in medical imaging. Elastography of breast masses and prostates have been shown to have high accuracy for characterizing masses and can significantly decrease the need for biopsies. Shear wave elastography has been shown to be able to detect and grade liver fibrosis and may decrease the need for liver biopsy. Evaluation of other organs is still preliminary. This article reviews the principles of elastography and its potential clinical applications. Copyright © 2014 Elsevier Inc. All rights reserved.

Sonoelastography in the musculoskeletal system: Current role and future directions.

PubMed

Winn, Naomi; Lalam, Radhesh; Cassar-Pullicino, Victor

2016-11-28

Ultrasound is an essential modality within musculoskeletal imaging, with the recent addition of elastography. The elastic properties of tissues are different from the acoustic impedance used to create B mode imaging and the flow properties used within Doppler imaging, hence elastography provides a different form of tissue assessment. The current role of ultrasound elastography in the musculoskeletal system will be reviewed, in particular with reference to muscles, tendons, ligaments, joints and soft tissue tumours. The different ultrasound elastography methods currently available will be described, in particular strain elastography and shear wave elastography. Future directions of ultrasound elastography in the musculoskeletal system will also be discussed.

Elastography in Chronic Liver Disease: Modalities, Techniques, Limitations, and Future Directions

PubMed Central

Srinivasa Babu, Aparna; Wells, Michael L.; Teytelboym, Oleg M.; Mackey, Justin E.; Miller, Frank H.; Yeh, Benjamin M.; Ehman, Richard L.

2016-01-01

Chronic liver disease has multiple causes, many of which are increasing in prevalence. The final common pathway of chronic liver disease is tissue destruction and attempted regeneration, a pathway that triggers fibrosis and eventual cirrhosis. Assessment of fibrosis is important not only for diagnosis but also for management, prognostic evaluation, and follow-up of patients with chronic liver disease. Although liver biopsy has traditionally been considered the reference standard for assessment of liver fibrosis, noninvasive techniques are the emerging focus in this field. Ultrasound-based elastography and magnetic resonance (MR) elastography are gaining popularity as the modalities of choice for quantifying hepatic fibrosis. These techniques have been proven superior to conventional cross-sectional imaging for evaluation of fibrosis, especially in the precirrhotic stages. Moreover, elastography has added utility in the follow-up of previously diagnosed fibrosis, the assessment of treatment response, evaluation for the presence of portal hypertension (spleen elastography), and evaluation of patients with unexplained portal hypertension. In this article, a brief overview is provided of chronic liver disease and the tools used for its diagnosis. Ultrasound-based elastography and MR elastography are explored in depth, including a brief glimpse into the evolution of elastography. Elastography is based on the principle of measuring tissue response to a known mechanical stimulus. Specific elastographic techniques used to exploit this principle include MR elastography and ultrasonography-based static or quasistatic strain imaging, one-dimensional transient elastography, point shear-wave elastography, and supersonic shear-wave elastography. The advantages, limitations, and pitfalls of each modality are emphasized. ©RSNA, 2016 PMID:27689833

What we need to know when performing and interpreting US elastography

PubMed Central

Park, So Hyun; Kim, So Yeon; Suh, Chong Hyun; Lee, Seung Soo; Kim, Kyoung Won; Lee, So Jung; Lee, Moon-Gyu

2016-01-01

According to the increasing need for accurate staging of hepatic fibrosis, the ultrasound (US) elastography techniques have evolved significantly over the past two decades. Currently, US elastography is increasingly used in clinical practice. Previously published studies have demonstrated the excellent diagnostic performance of US elastography for the detection and staging of liver fibrosis. Although US elastography may seem easy to perform and interpret, there are many technical and clinical factors which can affect the results of US elastography. Therefore, clinicians who are involved with US elastography should be aware of these factors. The purpose of this article is to present a brief overview of US techniques with the relevant technology, the clinical indications, diagnostic performance, and technical and biological factors which should be considered in order to avoid misinterpretation of US elastography results. PMID:27729637

Non-contact single shot elastography using line field low coherence holography

PubMed Central

Liu, Chih-Hao; Schill, Alexander; Wu, Chen; Singh, Manmohan; Larin, Kirill V.

2016-01-01

Optical elastic wave imaging is a powerful technique that can quantify local biomechanical properties of tissues. However, typically long acquisition times make this technique unfeasible for clinical use. Here, we demonstrate non-contact single shot elastographic holography using a line-field interferometer integrated with an air-pulse delivery system. The propagation of the air-pulse induced elastic wave was imaged in real time, and required a single excitation for a line-scan measurement. Results on tissue-mimicking phantoms and chicken breast muscle demonstrated the feasibility of this technique for accurate assessment of tissue biomechanical properties with an acquisition time of a few milliseconds using parallel acquisition. PMID:27570694

Efficacy of ultrasound elastography in detecting active myositis in children: can it replace MRI?

PubMed

Berko, Netanel S; Hay, Arielle; Sterba, Yonit; Wahezi, Dawn; Levin, Terry L

2015-09-01

Juvenile idiopathic inflammatory myopathy is a rare yet potentially debilitating condition. MRI is used both for diagnosis and to assess response to treatment. No study has evaluated the performance of US elastography in the diagnosis of this condition in children. To assess the performance of compression-strain US elastography in detecting active myositis in children with clinically confirmed juvenile idiopathic inflammatory myopathy and to compare its efficacy to MRI. Children with juvenile idiopathic inflammatory myopathy underwent non-contrast MR imaging as well as compression-strain US elastography of the quadriceps muscles. Imaging findings from both modalities were compared to each other as well as to the clinical determination of active disease based on physical examination and laboratory data. Active myositis on MR was defined as increased muscle signal on T2-weighted images. Elastography images were defined as normal or abnormal based on a previously published numerical scale of muscle elastography in normal children. Muscle echogenicity was graded as normal or abnormal based on gray-scale sonographic images. Twenty-one studies were conducted in 18 pediatric patients (15 female, 3 male; age range 3-19 years). Active myositis was present on MRI in ten cases. There was a significant association between abnormal MRI and clinically active disease (P = 0.012). US elastography was abnormal in 4 of 10 cases with abnormal MRI and in 4 of 11 cases with normal MRI. There was no association between abnormal elastography and either MRI (P > 0.999) or clinically active disease (P > 0.999). Muscle echogenicity was normal in 11 patients; all 11 had normal elastography. Of the ten patients with increased muscle echogenicity, eight had abnormal elastography. There was a significant association between muscle echogenicity and US elastography (P < 0.001). The positive and negative predictive values for elastography in the determination of active myositis were 75% and 31%, respectively, with a sensitivity of 40% and specificity of 67%. Compression-strain US elastography does not accurately detect active myositis in children with juvenile idiopathic inflammatory myopathy and cannot replace MRI as the imaging standard for detecting myositis in these children. The association between abnormal US elastography and increased muscle echogenicity suggests that elastography is capable of detecting muscle derangement in patients with myositis; however further studies are required to determine the clinical significance of these findings.

The First Year of the Food and Drug Administration Oncology Center of Excellence: Landmark Approvals in a Dynamic Regulatory Environment.

PubMed

Goldberg, Kirsten B; Blumenthal, Gideon M; Pazdur, Richard

The Food and Drug Administration formally established the Oncology Center of Excellence (OCE) in January 2017, as authorized by the 21st Century Cures Act, to expedite the development and review of certain drugs, biologics, and devices for the treatment of cancer. In its first year, the OCE conducted the clinical reviews for several products, including the first 2 chimeric antigen receptor T-cell therapies approved for the treatment of advanced hematologic malignancies and an in vitro diagnostic next-generation sequencing panel, FoundationOne CDx. The OCE also worked with professional societies and patient advocates on efforts to modernize clinical trial eligibility criteria, resulting in recommendations regarding minimal age, brain metastases, organ dysfunction, and human immunodeficiency virus coinfection. Altogether in 2017, the Food and Drug Administration approved 16 new drug and biologic applications, 30 supplemental drug and biologic applications, and 2 biosimilar applications in oncology.

The Feasibility of Classifying Breast Masses Using a Computer-Assisted Diagnosis (CAD) System Based on Ultrasound Elastography and BI-RADS Lexicon.

PubMed

Fleury, Eduardo F C; Gianini, Ana Claudia; Marcomini, Karem; Oliveira, Vilmar

2018-01-01

To determine the applicability of a computer-aided diagnostic system strain elastography system for the classification of breast masses diagnosed by ultrasound and scored using the criteria proposed by the breast imaging and reporting data system ultrasound lexicon and to determine the diagnostic accuracy and interobserver variability. This prospective study was conducted between March 1, 2016, and May 30, 2016. A total of 83 breast masses subjected to percutaneous biopsy were included. Ultrasound elastography images before biopsy were interpreted by 3 radiologists with and without the aid of computer-aided diagnostic system for strain elastography. The parameters evaluated by each radiologist results were sensitivity, specificity, and diagnostic accuracy, with and without computer-aided diagnostic system for strain elastography. Interobserver variability was assessed using a weighted κ test and an intraclass correlation coefficient. The areas under the receiver operating characteristic curves were also calculated. The areas under the receiver operating characteristic curve were 0.835, 0.801, and 0.765 for readers 1, 2, and 3, respectively, without computer-aided diagnostic system for strain elastography, and 0.900, 0.926, and 0.868, respectively, with computer-aided diagnostic system for strain elastography. The intraclass correlation coefficient between the 3 readers was 0.6713 without computer-aided diagnostic system for strain elastography and 0.811 with computer-aided diagnostic system for strain elastography. The proposed computer-aided diagnostic system for strain elastography system has the potential to improve the diagnostic performance of radiologists in breast examination using ultrasound associated with elastography.

[Elastography as an additional tool in breast sonography. Technical principles and clinical applications].

PubMed

Rjosk-Dendorfer, D; Reichelt, A; Clevert, D-A

2014-03-01

In recent years the use of elastography in addition to sonography has become a routine clinical tool for the characterization of breast masses. Whereas free hand compression elastography results in qualitative imaging of tissue stiffness due to induced compression, shear wave elastography displays quantitative information of tissue displacement. Recent studies have investigated the use of elastography in addition to sonography and improvement of specificity in differentiating benign from malignant breast masses could be shown. Therefore, additional use of elastography could help to reduce the number of unnecessary biopsies in benign breast lesions especially in category IV lesions of the ultrasound breast imaging reporting data system (US-BI-RADS).

A randomized trial of transdermal and oral estrogen therapy in adolescent girls with hypogonadism.

PubMed

Shah, Sejal; Forghani, Nikta; Durham, Eileen; Neely, E Kirk

2014-01-01

Adolescent females with ovarian failure require estrogen therapy for induction of puberty and other important physiologic effects. Currently, health care providers have varying practices without evidence-based standards, thus investigating potential differences between oral and transdermal preparations is essential. The purpose of this study was to compare the differential effects of treatment with oral conjugated equine estrogen (OCEE), oral 17β estradiol (OBE), or transdermal 17β estradiol (TBE) on biochemical profiles and feminization in girls with ovarian failure. 20 prepubertal adolescent females with ovarian failure, ages 12-18 years, were randomized to OCEE (n = 8), OBE (n = 7), or TBE (n = 5) for 24 months. Estrogen replacement was initiated at a low dose (0.15 mg OCEE, 0.25 mg OBE, or 0.0125 mg TBE) and doubled every 6 months to a maximum dose of 0.625 mg/d OCEE, 1 mg/d OBE, or 0.05 mg/d TBE. At 18 months, micronized progesterone was added to induce menstrual cycles. Biochemical markers including sex hormones, inflammatory markers, liver enzymes, coagulation factors, and lipids were obtained at baseline and 6 month intervals. Differences in levels of treatment parameters between the groups were evaluated with one-way analysis of variance (ANOVA). The effect of progesterone on biochemical markers was evaluated with the paired t-test. Mean (±SE) estradiol levels at maximum estrogen dose (18 months) were higher in the TBE group (53 ± 19 pg/mL) compared to OCEE (14 ± 5 pg/mL) and OBE (12 ± 5 pg/mL) (p ≤ 0.01). The TBE and OBE groups had more effective feminization (100% Tanner 3 breast stage at 18 months). There were no statistical differences in other biochemical markers between treatment groups at 18 months or after the introduction of progesterone. Treatment with transdermal 17β estradiol resulted in higher estradiol levels and more effective feminization compared to oral conjugated equine estrogen but did not result in an otherwise different biochemical profile in this limited number of heterogeneous patients. OBE and TBE provide safe and effective alternatives to OCEE to induce puberty in girls, but larger prospective randomized trials are required. NCT01023178.

Ultrasound Elastography and MR Elastography for Assessing Liver Fibrosis: Part 2, Diagnostic Performance, Confounders, and Future Directions

PubMed Central

Tang, An; Cloutier, Guy; Szeverenyi, Nikolaus M.; Sirlin, Claude B.

2016-01-01

OBJECTIVE The purpose of the article is to review the diagnostic performance of ultrasound and MR elastography techniques for detection and staging of liver fibrosis, the main current clinical applications of elastography in the abdomen. CONCLUSION Technical and instrument-related factors and biologic and patient-related factors may constitute potential confounders of stiffness measurements for assessment of liver fibrosis. Future developments may expand the scope of elastography for monitoring liver fibrosis and predict complications of chronic liver disease. PMID:25905762

Eddy-Mean Flow Interactions in Western Boundary Current Jets

DTIC Science & Technology

2009-02-01

have had the honor of being Steve’s first student and Nelson’s last, and to each I owe much gratitude for all they have contributed towards my education ...given me so much happiness during my years here. It is because of you I am most sad to say goodbye. I thank my parents for their unconditional and...oceanographer. Funding was for this research and my education was provided by the MIT Pres- idential Fellowship and NSF grants OCE-0220161 and OCE-0825550. The

Hydrogenation of furfural at the dynamic Cu surface of CuOCeO2/Al2O3 in vapor phase packed bed reactor

USDA-ARS?s Scientific Manuscript database

The hydrogenation of furfural to furfuryl alcohol over a CuOCeO2/'-Al2O3 catalyst in a flow reactor is reported. The catalyst was prepared by the wet impregnation of Cu onto a CeO2/'-Al2O3 precursor. The calcined catalyst was then treated with HNO3 to remove surface CuO resulting in a mixed CuCe oxi...

Endoscopic Ultrasound Elastography: Current Clinical Use in Pancreas.

PubMed

Mondal, Utpal; Henkes, Nichole; Patel, Sandeep; Rosenkranz, Laura

2016-08-01

Elastography is a newer technique for the assessment of tissue elasticity using ultrasound. Cancerous tissue is known to be stiffer (hence, less elastic) than corresponding healthy tissue, and as a result, could be identified in an elasticity-based imaging. Ultrasound elastography has been used in the breast, thyroid, and cervix to differentiate malignant from benign neoplasms and to guide or avoid unnecessary biopsies. In the liver, elastography has enabled a noninvasive and reliable estimate of fibrosis. Endoscopic ultrasound has become a robust diagnostic and therapeutic tool for the management of pancreatic diseases. The addition of elastography to endoscopic ultrasound enabled further characterization of pancreas lesions, and several European and Asian studies have reported encouraging results. The current clinical role of endoscopic ultrasound elastography in the management of pancreas disorders and related literature are reviewed.

Technical Failure of MR Elastography Examinations of the Liver: Experience from a Large Single-Center Study.

PubMed

Wagner, Mathilde; Corcuera-Solano, Idoia; Lo, Grace; Esses, Steven; Liao, Joseph; Besa, Cecilia; Chen, Nelson; Abraham, Ginu; Fung, Maggie; Babb, James S; Ehman, Richard L; Taouli, Bachir

2017-08-01

Purpose To assess the determinants of technical failure of magnetic resonance (MR) elastography of the liver in a large single-center study. Materials and Methods This retrospective study was approved by the institutional review board. Seven hundred eighty-one MR elastography examinations performed in 691 consecutive patients (mean age, 58 years; male patients, 434 [62.8%]) in a single center between June 2013 and August 2014 were retrospectively evaluated. MR elastography was performed at 3.0 T (n = 443) or 1.5 T (n = 338) by using a gradient-recalled-echo pulse sequence. MR elastography and anatomic image analysis were performed by two observers. Additional observers measured liver T2* and fat fraction. Technical failure was defined as no pixel value with a confidence index higher than 95% and/or no apparent shear waves imaged. Logistic regression analysis was performed to assess potential predictive factors of technical failure of MR elastography. Results The technical failure rate of MR elastography at 1.5 T was 3.5% (12 of 338), while it was higher, 15.3% (68 of 443), at 3.0 T. On the basis of univariate analysis, body mass index, liver iron deposition, massive ascites, use of 3.0 T, presence of cirrhosis, and alcoholic liver disease were all significantly associated with failure of MR elastography (P < .004); but on the basis of multivariable analysis, only body mass index, liver iron deposition, massive ascites, and use of 3.0 T were significantly associated with failure of MR elastography (P < .004). Conclusion The technical failure rate of MR elastography with a gradient-recalled-echo pulse sequence was low at 1.5 T but substantially higher at 3.0 T. Massive ascites, iron deposition, and high body mass index were additional independent factors associated with failure of MR elastography of the liver with a two-dimensional gradient-recalled-echo pulse sequence. © RSNA, 2017.

Comparison and Combination of Strain and Shear Wave Elastography of Breast Masses for Differentiation of Benign and Malignant Lesions by Quantitative Assessment: Preliminary Study.

PubMed

Seo, Mirinae; Ahn, Hye Shin; Park, Sung Hee; Lee, Jong Beum; Choi, Byung Ihn; Sohn, Yu-Mee; Shin, So Youn

2018-01-01

To compare the diagnostic performance of strain and shear wave elastography of breast masses for quantitative assessment in differentiating benign and malignant lesions and to evaluate the diagnostic accuracy of combined strain and shear wave elastography. Between January and February 2016, 37 women with 45 breast masses underwent both strain and shear wave ultrasound (US) elastographic examinations. The American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) final assessment on B-mode US imaging was assessed. We calculated strain ratios for strain elastography and the mean elasticity value and elasticity ratio of the lesion to fat for shear wave elastography. Diagnostic performances were compared by using the area under the receiver operating characteristic curve (AUC). The 37 women had a mean age of 47.4 years (range, 20-79 years). Of the 45 lesions, 20 were malignant, and 25 were benign. The AUCs for elasticity values on strain and shear wave elastography showed no significant differences (strain ratio, 0.929; mean elasticity, 0.898; and elasticity ratio, 0.868; P > .05). After selectively downgrading BI-RADS category 4a lesions based on strain and shear wave elastographic cutoffs, the AUCs for the combined sets of B-mode US and elastography were improved (B-mode + strain, 0.940; B-mode + shear wave; 0.964; and B-mode, 0.724; P < .001). Combined strain and shear wave elastography showed significantly higher diagnostic accuracy than each individual elastographic modality (P = .031). These preliminary results showed that strain and shear wave elastography had similar diagnostic performance. The addition of strain and shear wave elastography to B-mode US improved diagnostic performance. The combination of strain and shear wave elastography results in a higher diagnostic yield than each individual elastographic modality. © 2017 by the American Institute of Ultrasound in Medicine.

Elastography using multi-stream GPU: an application to online tracked ultrasound elastography, in-vivo and the da Vinci Surgical System.

PubMed

Deshmukh, Nishikant P; Kang, Hyun Jae; Billings, Seth D; Taylor, Russell H; Hager, Gregory D; Boctor, Emad M

2014-01-01

A system for real-time ultrasound (US) elastography will advance interventions for the diagnosis and treatment of cancer by advancing methods such as thermal monitoring of tissue ablation. A multi-stream graphics processing unit (GPU) based accelerated normalized cross-correlation (NCC) elastography, with a maximum frame rate of 78 frames per second, is presented in this paper. A study of NCC window size is undertaken to determine the effect on frame rate and the quality of output elastography images. This paper also presents a novel system for Online Tracked Ultrasound Elastography (O-TRuE), which extends prior work on an offline method. By tracking the US probe with an electromagnetic (EM) tracker, the system selects in-plane radio frequency (RF) data frames for generating high quality elastograms. A novel method for evaluating the quality of an elastography output stream is presented, suggesting that O-TRuE generates more stable elastograms than generated by untracked, free-hand palpation. Since EM tracking cannot be used in all systems, an integration of real-time elastography and the da Vinci Surgical System is presented and evaluated for elastography stream quality based on our metric. The da Vinci surgical robot is outfitted with a laparoscopic US probe, and palpation motions are autonomously generated by customized software. It is found that a stable output stream can be achieved, which is affected by both the frequency and amplitude of palpation. The GPU framework is validated using data from in-vivo pig liver ablation; the generated elastography images identify the ablated region, outlined more clearly than in the corresponding B-mode US images.

Elastography Using Multi-Stream GPU: An Application to Online Tracked Ultrasound Elastography, In-Vivo and the da Vinci Surgical System

PubMed Central

Deshmukh, Nishikant P.; Kang, Hyun Jae; Billings, Seth D.; Taylor, Russell H.; Hager, Gregory D.; Boctor, Emad M.

2014-01-01

A system for real-time ultrasound (US) elastography will advance interventions for the diagnosis and treatment of cancer by advancing methods such as thermal monitoring of tissue ablation. A multi-stream graphics processing unit (GPU) based accelerated normalized cross-correlation (NCC) elastography, with a maximum frame rate of 78 frames per second, is presented in this paper. A study of NCC window size is undertaken to determine the effect on frame rate and the quality of output elastography images. This paper also presents a novel system for Online Tracked Ultrasound Elastography (O-TRuE), which extends prior work on an offline method. By tracking the US probe with an electromagnetic (EM) tracker, the system selects in-plane radio frequency (RF) data frames for generating high quality elastograms. A novel method for evaluating the quality of an elastography output stream is presented, suggesting that O-TRuE generates more stable elastograms than generated by untracked, free-hand palpation. Since EM tracking cannot be used in all systems, an integration of real-time elastography and the da Vinci Surgical System is presented and evaluated for elastography stream quality based on our metric. The da Vinci surgical robot is outfitted with a laparoscopic US probe, and palpation motions are autonomously generated by customized software. It is found that a stable output stream can be achieved, which is affected by both the frequency and amplitude of palpation. The GPU framework is validated using data from in-vivo pig liver ablation; the generated elastography images identify the ablated region, outlined more clearly than in the corresponding B-mode US images. PMID:25541954

Use of Ultrasound Elastography in the Assessment of the Musculoskeletal System.

PubMed

Paluch, Łukasz; Nawrocka-Laskus, Ewa; Wieczorek, Janusz; Mruk, Bartosz; Frel, Małgorzata; Walecki, Jerzy

2016-01-01

This article presents possible applications of ultrasound elastography in musculoskeletal imaging based on the available literature, as well as the possibility of extending indications for the use of elastography in the future. Ultrasound elastography (EUS) is a new method that shows structural changes in tissues following application of physical stress. Elastography techniques have been widely used to assess muscles and tendons in vitro since the early parts of the twentieth century. Only recently with the advent of new technology and creation of highly specialized ultrasound devices, has elastography gained widespread use in numerous applications. The authors performed a search of the Medline/PubMed databases for original research and reviewed publications on the application of ultrasound elastography for musculoskeletal imaging. All publications demonstrate possible uses of ultrasound elastography in examinations of the musculoskeletal system. The most widely studied areas include the muscles, tendons and rheumatic diseases. There are also reports on the employment in vessel imaging. The main limitation of elastography as a technique is above all the variability of applied pressure during imaging, which is operator-dependent. It would therefore be reasonable to provide clear guidelines on the technique applied, as well as clear indications for performing the test. It is important to develop methods for creating artifact-free, closed-loop, compression-decompression cycles. The main advantages include cost-effectiveness, short duration of the study, non-invasive nature of the procedure, as well as a potentially broader clinical availability. There are no clear guidelines with regard to indications as well as examination techniques. Ultrasound elastography is a new and still poorly researched method. We conclude, however, that it can be widely used in the examinations of musculoskeletal system. Therefore, it is necessary to conduct large, multi-center studies to determine the methodology, indications and technique of examination.

The diagnostic performance of shear-wave elastography for liver fibrosis in children and adolescents: A systematic review and diagnostic meta-analysis.

PubMed

Kim, Jeong Rye; Suh, Chong Hyun; Yoon, Hee Mang; Lee, Jin Seong; Cho, Young Ah; Jung, Ah Young

2018-03-01

To assess the diagnostic performance of shear-wave elastography for determining the severity of liver fibrosis in children and adolescents. An electronic literature search of PubMed and EMBASE was conducted. Bivariate modelling and hierarchical summary receiver-operating-characteristic modelling were performed to evaluate the diagnostic performance of shear-wave elastography. Meta-regression and subgroup analyses according to the modality of shear-wave imaging and the degree of liver fibrosis were also performed. Twelve eligible studies with 550 patients were included. Shear-wave elastography showed a summary sensitivity of 81 % (95 % CI: 71-88) and a specificity of 91 % (95 % CI: 83-96) for the prediction of significant liver fibrosis. The number of measurements of shear-wave elastography performed was a significant factor influencing study heterogeneity. Subgroup analysis revealed shear-wave elastography to have an excellent diagnostic performance according to each degree of liver fibrosis. Supersonic shear imaging (SSI) had a higher sensitivity (p<.01) and specificity (p<.01) than acoustic radiation force impulse imaging (ARFI). Shear-wave elastography is an excellent modality for the evaluation of the severity of liver fibrosis in children and adolescents. Compared with ARFI, SSI showed better diagnostic performance for prediction of significant liver fibrosis. • Shear-wave elastography is beneficial for determining liver fibrosis severity in children. • Shear-wave elastography showed summary sensitivity of 81 %, specificity of 91 %. • SSI showed better diagnostic performance than ARFI for significant liver fibrosis.

A randomized trial of transdermal and oral estrogen therapy in adolescent girls with hypogonadism

PubMed Central

2014-01-01

Background Adolescent females with ovarian failure require estrogen therapy for induction of puberty and other important physiologic effects. Currently, health care providers have varying practices without evidence-based standards, thus investigating potential differences between oral and transdermal preparations is essential. The purpose of this study was to compare the differential effects of treatment with oral conjugated equine estrogen (OCEE), oral 17β estradiol (OBE), or transdermal 17β estradiol (TBE) on biochemical profiles and feminization in girls with ovarian failure. Study design 20 prepubertal adolescent females with ovarian failure, ages 12–18 years, were randomized to OCEE (n = 8), OBE (n = 7), or TBE (n = 5) for 24 months. Estrogen replacement was initiated at a low dose (0.15 mg OCEE, 0.25 mg OBE, or 0.0125 mg TBE) and doubled every 6 months to a maximum dose of 0.625 mg/d OCEE, 1 mg/d OBE, or 0.05 mg/d TBE. At 18 months, micronized progesterone was added to induce menstrual cycles. Biochemical markers including sex hormones, inflammatory markers, liver enzymes, coagulation factors, and lipids were obtained at baseline and 6 month intervals. Differences in levels of treatment parameters between the groups were evaluated with one-way analysis of variance (ANOVA). The effect of progesterone on biochemical markers was evaluated with the paired t-test. Results Mean (±SE) estradiol levels at maximum estrogen dose (18 months) were higher in the TBE group (53 ± 19 pg/mL) compared to OCEE (14 ± 5 pg/mL) and OBE (12 ± 5 pg/mL) (p ≤ 0.01). The TBE and OBE groups had more effective feminization (100% Tanner 3 breast stage at 18 months). There were no statistical differences in other biochemical markers between treatment groups at 18 months or after the introduction of progesterone. Conclusions Treatment with transdermal 17β estradiol resulted in higher estradiol levels and more effective feminization compared to oral conjugated equine estrogen but did not result in an otherwise different biochemical profile in this limited number of heterogeneous patients. OBE and TBE provide safe and effective alternatives to OCEE to induce puberty in girls, but larger prospective randomized trials are required. Trial registration Clinical Trials Identifier: NCT01023178. PMID:24982681

Model-based elastography: a survey of approaches to the inverse elasticity problem

PubMed Central

Doyley, M M

2012-01-01

Elastography is emerging as an imaging modality that can distinguish normal versus diseased tissues via their biomechanical properties. This article reviews current approaches to elastography in three areas — quasi-static, harmonic, and transient — and describes inversion schemes for each elastographic imaging approach. Approaches include: first-order approximation methods; direct and iterative inversion schemes for linear elastic; isotropic materials; and advanced reconstruction methods for recovering parameters that characterize complex mechanical behavior. The paper’s objective is to document efforts to develop elastography within the framework of solving an inverse problem, so that elastography may provide reliable estimates of shear modulus and other mechanical parameters. We discuss issues that must be addressed if model-based elastography is to become the prevailing approach to quasi-static, harmonic, and transient elastography: (1) developing practical techniques to transform the ill-posed problem with a well-posed one; (2) devising better forward models to capture the transient behavior of soft tissue; and (3) developing better test procedures to evaluate the performance of modulus elastograms. PMID:22222839

Current status of musculoskeletal application of shear wave elastography.

PubMed

Ryu, JeongAh; Jeong, Woo Kyoung

2017-07-01

Ultrasonography (US) is a very powerful diagnostic modality for the musculoskeletal system due to the ability to perform real-time dynamic high-resolution examinations with the Doppler technique. In addition to acquiring morphologic data, we can now obtain biomechanical information by quantifying the elasticity of the musculoskeletal structures with US elastography. The earlier diagnosis of degeneration and the ability to perform follow-up evaluations of healing and the effects of treatment are possible. US elastography enables a transition from US-based inspection to US-based palpation in order to diagnose the characteristics of tissue. Shear wave elastography is considered the most suitable type of US elastography for the musculoskeletal system. It is widely used for tendons, ligaments, and muscles. It is important to understand practice guidelines in order to enhance reproducibility. Incorporating viscoelasticity and overcoming inconsistencies among manufacturers are future tasks for improving the capabilities of US elastography.

Current status of musculoskeletal application of shear wave elastography

PubMed Central

2017-01-01

Ultrasonography (US) is a very powerful diagnostic modality for the musculoskeletal system due to the ability to perform real-time dynamic high-resolution examinations with the Doppler technique. In addition to acquiring morphologic data, we can now obtain biomechanical information by quantifying the elasticity of the musculoskeletal structures with US elastography. The earlier diagnosis of degeneration and the ability to perform follow-up evaluations of healing and the effects of treatment are possible. US elastography enables a transition from US-based inspection to US-based palpation in order to diagnose the characteristics of tissue. Shear wave elastography is considered the most suitable type of US elastography for the musculoskeletal system. It is widely used for tendons, ligaments, and muscles. It is important to understand practice guidelines in order to enhance reproducibility. Incorporating viscoelasticity and overcoming inconsistencies among manufacturers are future tasks for improving the capabilities of US elastography. PMID:28292005

Strain Elastography - How To Do It?

PubMed Central

Dietrich, Christoph F.; Barr, Richard G.; Farrokh, André; Dighe, Manjiri; Hocke, Michael; Jenssen, Christian; Dong, Yi; Saftoiu, Adrian; Havre, Roald Flesland

2017-01-01

Tissue stiffness assessed by palpation for diagnosing pathology has been used for thousands of years. Ultrasound elastography has been developed more recently to display similar information on tissue stiffness as an image. There are two main types of ultrasound elastography, strain and shear wave. Strain elastography is a qualitative technique and provides information on the relative stiffness between one tissue and another. Shear wave elastography is a quantitative method and provides an estimated value of the tissue stiffness that can be expressed in either the shear wave speed through the tissues in meters/second, or converted to the Young’s modulus making some assumptions and expressed in kPa. Each technique has its advantages and disadvantages and they are often complimentary to each other in clinical practice. This article reviews the principles, technique, and interpretation of strain elastography in various organs. It describes how to optimize technique, while pitfalls and artifacts are also discussed. PMID:29226273

Multi-Channel Optical Coherence Elastography Using Relative and Absolute Shear-Wave Time of Flight

PubMed Central

Elyas, Eli; Grimwood, Alex; Erler, Janine T.; Robinson, Simon P.; Cox, Thomas R.; Woods, Daniel; Clowes, Peter; De Luca, Ramona; Marinozzi, Franco; Fromageau, Jérémie; Bamber, Jeffrey C.

2017-01-01

Elastography, the imaging of elastic properties of soft tissues, is well developed for macroscopic clinical imaging of soft tissues and can provide useful information about various pathological processes which is complementary to that provided by the original modality. Scaling down of this technique should ply the field of cellular biology with valuable information with regard to elastic properties of cells and their environment. This paper evaluates the potential to develop such a tool by modifying a commercial optical coherence tomography (OCT) device to measure the speed of shear waves propagating in a three-dimensional (3D) medium. A needle, embedded in the gel, was excited to vibrate along its long axis and the displacement as a function of time and distance from the needle associated with the resulting shear waves was detected using four M-mode images acquired simultaneously using a commercial four-channel swept-source OCT system. Shear-wave time of arrival (TOA) was detected by tracking the axial OCT-speckle motion using cross-correlation methods. Shear-wave speed was then calculated from inter-channel differences of TOA for a single burst (the relative TOA method) and compared with the shear-wave speed determined from positional differences of TOA for a single channel over multiple bursts (the absolute TOA method). For homogeneous gels the relative method provided shear-wave speed with acceptable precision and accuracy when judged against the expected linear dependence of shear modulus on gelatine concentration (R2 = 0.95) and ultimate resolution capabilities limited by 184μm inter-channel distance. This overall approach shows promise for its eventual provision as a research tool in cancer cell biology. Further work is required to optimize parameters such as vibration frequency, burst length and amplitude, and to assess the lateral and axial resolutions of this type of device as well as to create 3D elastograms. PMID:28107368

Comparison of acoustic radiation force impulse elastography and transient elastography for prediction of hepatocellular carcinoma recurrence after radiofrequency ablation.

PubMed

Yoon, Jun Sik; Lee, Yu Rim; Kweon, Young-Oh; Tak, Won Young; Jang, Se Young; Park, Soo Young; Hur, Keun; Park, Jung Gil; Lee, Hye Won; Chun, Jae Min; Han, Young Seok; Lee, Won Kee

2018-05-23

To compare the clinical value of acoustic radiation force impulse (ARFI) elastography and transient elastography (TE) for hepatocellular carcinoma (HCC) recurrence prediction after radiofrequency ablation (RFA) and to investigate other predictors of HCC recurrence. Between 2011 and 2016, 130 patients with HCC who underwent ARFI elastography and TE within 6 months before curative RFA were prospectively enrolled. Independent predictors of HCC recurrence were analyzed separately using ARFI elastography and TE. ARFI elastography and TE accuracy to predict HCC recurrence was determined by receiver operating characteristic curve analysis. Of all included patients (91 men; mean age, 63.5 years; range: 43-84 years), 51 (42.5%) experienced HCC recurrence during the follow-up period (median, 21.9 months). In multivariable analysis using ARFI velocity, serum albumin and ARFI velocity [hazard ratios: 2.873; 95% confidence interval (CI): 1.806-4.571; P<0.001] were independent predictors of recurrence, and in multivariable analysis using TE value, serum albumin and TE value (hazard ratios: 1.028; 95% CI: 1.013-1.043; P<0.001) were independent predictors of recurrence. The area under the receiver operating characteristic curve of ARFI elastography (0.821; 95% CI: 0.747-0.895) was not statistically different from that of TE (0.793; 95% CI: 0.712-0.874) for predicting HCC recurrence (P=0.827). The optimal ARFI velocity and TE cutoff values were 1.6 m/s and 14 kPa, respectively. ARFI elastography and TE yield comparable predictors of HCC recurrence after RFA.

Mechanics of ultrasound elastography

PubMed Central

Li, Guo-Yang

2017-01-01

Ultrasound elastography enables in vivo measurement of the mechanical properties of living soft tissues in a non-destructive and non-invasive manner and has attracted considerable interest for clinical use in recent years. Continuum mechanics plays an essential role in understanding and improving ultrasound-based elastography methods and is the main focus of this review. In particular, the mechanics theories involved in both static and dynamic elastography methods are surveyed. They may help understand the challenges in and opportunities for the practical applications of various ultrasound elastography methods to characterize the linear elastic, viscoelastic, anisotropic elastic and hyperelastic properties of both bulk and thin-walled soft materials, especially the in vivo characterization of biological soft tissues. PMID:28413350

Characterization of focal breast lesions by means of elastography.

PubMed

Fischer, T; Sack, I; Thomas, A

2013-09-01

The modern method of sonoelastography of the breast is used for differentiating focal lesions. This review gives an overview of the different techniques available and discusses their roles in the routine clinical setting. The presented techniques include compression or vibration elastography as well as shear wave elastography. Descriptions of the methods are supplemented by a discussion of the clinical role of each technique based on the most recent literature. We discuss by outlining two recent experimental approaches - MRI and tomosynthesis elastography. Currently available data suggest that elastography is an important supplementary tool for the differentiation of breast tumors under routine clinical conditions. The specificity improves with the immediate availability of additional diagnostic information using real-time techniques and/or the calculation of strain ratios (SR). Elastography is especially helpful in women with involuted breasts for differentiating BI-RADS-US 3 and 4 lesions and for evaluating very small cancers without the typical imaging features of malignancy. Here, elastography techniques are highly specific, while the sensitivity decreases compared to B-mode ultrasound. SR calculation is especially helpful in women who have a high risk of breast cancer and high pretest likelihood. B-mode ultrasound is still the first-line method for the initial evaluation of the breast. If suspicious findings are detected, elastography with or without SR calculation is the most crucial supplementary tool. © Georg Thieme Verlag KG Stuttgart · New York.

Diagnostic Performance of MR Elastography and Vibration-controlled Transient Elastography in the Detection of Hepatic Fibrosis in Patients with Severe to Morbid Obesity

PubMed Central

Chen, Jun; Yin, Meng; Talwalkar, Jayant A.; Oudry, Jennifer; Glaser, Kevin J.; Smyrk, Thomas C.; Miette, Véronique; Sandrin, Laurent

2017-01-01

Purpose To evaluate the diagnostic performance and examination success rate of magnetic resonance (MR) elastography and vibration-controlled transient elastography (VCTE) in the detection of hepatic fibrosis in patients with severe to morbid obesity. Materials and Methods This prospective and HIPAA-compliant study was approved by the institutional review board. A total of 111 patients (71 women, 40 men) participated. Written informed consent was obtained from all patients. Patients underwent MR elastography with two readers and VCTE with three observers to acquire liver stiffness measurements for liver fibrosis assessment. The results were compared with those from liver biopsy. Each pathology specimen was evaluated by two hepatopathologists according to the METAVIR scoring system or Brunt classification when appropriate. All imaging observers were blinded to the biopsy results, and all hepatopathologists were blinded to the imaging results. Examination success rate, interobserver agreement, and diagnostic accuracy for fibrosis detection were assessed. Results In this obese patient population (mean body mass index = 40.3 kg/m2; 95% confidence interval [CI]: 38.7 kg/m2, 41.8 kg/m2]), the examination success rate was 95.8% (92 of 96 patients) for MR elastography and 81.3% (78 of 96 patients) or 88.5% (85 of 96 patients) for VCTE. Interobserver agreement was higher with MR elastography than with biopsy (intraclass correlation coefficient, 0.95 vs 0.89). In patients with successful MR elastography and VCTE examinations (excluding unreliable VCTE examinations), both MR elastography and VCTE had excellent diagnostic accuracy in the detection of clinically significant hepatic fibrosis (stage F2–F4) (mean area under the curve: 0.93 [95% CI: 0.85, 0.97] vs 0.91 [95% CI: 0.83, 0.96]; P = .551). Conclusion In this obese patient population, both MR elastography and VCTE had excellent diagnostic performance for assessing hepatic fibrosis; MR elastography was more technically reliable than VCTE and had a higher interobserver agreement than liver biopsy. © RSNA, 2016 Online supplemental material is available for this article. An earlier incorrect version of this article appeared online. This article was corrected on January 25, 2017. PMID:27861111

Assessment of liver fibrosis with 2-D shear wave elastography in comparison to transient elastography and acoustic radiation force impulse imaging in patients with chronic liver disease.

PubMed

Gerber, Ludmila; Kasper, Daniela; Fitting, Daniel; Knop, Viola; Vermehren, Annika; Sprinzl, Kathrin; Hansmann, Martin L; Herrmann, Eva; Bojunga, Joerg; Albert, Joerg; Sarrazin, Christoph; Zeuzem, Stefan; Friedrich-Rust, Mireen

2015-09-01

Two-dimensional shear wave elastography (2-D SWE) is an ultrasound-based elastography method integrated into a conventional ultrasound machine. It can evaluate larger regions of interest and, therefore, might be better at determining the overall fibrosis distribution. The aim of this prospective study was to compare 2-D SWE with the two best evaluated liver elastography methods, transient elastography and acoustic radiation force impulse (point SWE using acoustic radiation force impulse) imaging, in the same population group. The study included 132 patients with chronic hepatopathies, in which liver stiffness was evaluated using transient elastography, acoustic radiation force impulse imaging and 2-D SWE. The reference methods were liver biopsy for the assessment of liver fibrosis (n = 101) and magnetic resonance imaging/computed tomography for the diagnosis of liver cirrhosis (n = 31). No significant difference in diagnostic accuracy, assessed as the area under the receiver operating characteristic curve (AUROC), was found between the three elastography methods (2-D SWE, transient elastography, acoustic radiation force impulse imaging) for the diagnosis of significant and advanced fibrosis and liver cirrhosis in the "per protocol" (AUROCs for fibrosis stages ≥2: 0.90, 0.95 and 0.91; for fibrosis stage [F] ≥3: 0.93, 0.95 and 0.94; for F = 4: 0.92, 0.96 and 0.92) and "intention to diagnose" cohort (AUROCs for F ≥2: 0.87, 0.92 and 0.91; for F ≥3: 0.91, 0.93 and 0.94; for F = 4: 0.88, 0.90 and 0.89). Therefore, 2-D SWE, ARFI imaging and transient elastography seem to be comparably good methods for non-invasive assessment of liver fibrosis. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Shear Wave Elastography May Add a New Dimension to Ultrasound Evaluation of Thyroid Nodules: Case Series with Comparative Evaluation

PubMed Central

Slapa, Rafal Z.; Piwowonski, Antoni; Jakubowski, Wieslaw S.; Bierca, Jacek; Szopinski, Kazimierz T.; Slowinska-Srzednicka, Jadwiga; Migda, Bartosz; Mlosek, R. Krzysztof

2012-01-01

Although elastography can enhance the differential diagnosis of thyroid nodules, its diagnostic performance is not ideal at present. Further improvements in the technique and creation of robust diagnostic criteria are necessary. The purpose of this study was to compare the usefulness of strain elastography and a new generation of elasticity imaging called supersonic shear wave elastography (SSWE) in differential evaluation of thyroid nodules. Six thyroid nodules in 4 patients were studied. SSWE yielded 1 true-positive and 5 true-negative results. Strain elastography yielded 5 false-positive results and 1 false-negative result. A novel finding appreciated with SSWE, were punctate foci of increased stiffness corresponding to microcalcifications in 4 nodules, some not visible on B-mode ultrasound, as opposed to soft, colloid-inspissated areas visible on B-mode ultrasound in 2 nodules. This preliminary paper indicates that SSWE may outperform strain elastography in differentiation of thyroid nodules with regard to their stiffness. SSWE showed the possibility of differentiation of high echogenic foci into microcalcifications and inspissated colloid, adding a new dimension to thyroid elastography. Further multicenter large-scale studies of thyroid nodules evaluating different elastographic methods are warranted. PMID:22685685

Multiplane wave imaging increases signal-to-noise ratio in ultrafast ultrasound imaging.

PubMed

Tiran, Elodie; Deffieux, Thomas; Correia, Mafalda; Maresca, David; Osmanski, Bruno-Felix; Sieu, Lim-Anna; Bergel, Antoine; Cohen, Ivan; Pernot, Mathieu; Tanter, Mickael

2015-11-07

Ultrafast imaging using plane or diverging waves has recently enabled new ultrasound imaging modes with improved sensitivity and very high frame rates. Some of these new imaging modalities include shear wave elastography, ultrafast Doppler, ultrafast contrast-enhanced imaging and functional ultrasound imaging. Even though ultrafast imaging already encounters clinical success, increasing even more its penetration depth and signal-to-noise ratio for dedicated applications would be valuable. Ultrafast imaging relies on the coherent compounding of backscattered echoes resulting from successive tilted plane waves emissions; this produces high-resolution ultrasound images with a trade-off between final frame rate, contrast and resolution. In this work, we introduce multiplane wave imaging, a new method that strongly improves ultrafast images signal-to-noise ratio by virtually increasing the emission signal amplitude without compromising the frame rate. This method relies on the successive transmissions of multiple plane waves with differently coded amplitudes and emission angles in a single transmit event. Data from each single plane wave of increased amplitude can then be obtained, by recombining the received data of successive events with the proper coefficients. The benefits of multiplane wave for B-mode, shear wave elastography and ultrafast Doppler imaging are experimentally demonstrated. Multiplane wave with 4 plane waves emissions yields a 5.8  ±  0.5 dB increase in signal-to-noise ratio and approximately 10 mm in penetration in a calibrated ultrasound phantom (0.7 d MHz(-1) cm(-1)). In shear wave elastography, the same multiplane wave configuration yields a 2.07  ±  0.05 fold reduction of the particle velocity standard deviation and a two-fold reduction of the shear wave velocity maps standard deviation. In functional ultrasound imaging, the mapping of cerebral blood volume results in a 3 to 6 dB increase of the contrast-to-noise ratio in deep structures of the rodent brain.

Liver elastography, comments on EFSUMB elastography guidelines 2013

PubMed Central

Cui, Xin-Wu; Friedrich-Rust, Mireen; Molo, Chiara De; Ignee, Andre; Schreiber-Dietrich, Dagmar; Dietrich, Christoph F

2013-01-01

Recently the European Federation of Societies for Ultrasound in Medicine and Biology Guidelines and Recommendations have been published assessing the clinical use of ultrasound elastography. The document is intended to form a reference and to guide clinical users in a practical way. They give practical advice for the use and interpretation. Liver disease forms the largest section, reflecting published experience to date including evidence from meta-analyses with shear wave and strain elastography. In this review comments and illustrations on the guidelines are given. PMID:24151351

Promoting oral cancer examinations to medical primary care providers: a cluster randomized trial.

PubMed

Wee, Alvin G; Zimmerman, Lani M; Anderson, James R; Nunn, Martha E; Loberiza, Fausto R; Sitorius, Michael A; Pullen, Carol H

2016-09-01

To compare the percentage of patients who had an oral cancer examination (OCE) by their primary care provider (PCP) in medical clinics participating in a web-based education with poster reminder intervention to that of patients in control clinics. To also determine the effects for PCPs in medical clinics participating in the web-based education with poster reminder intervention as compared with those in control clinics regarding: a) index of knowledge of oral cancer risk factors (RiskOC) and b) index of knowledge of oral cancer diagnostic procedures (DiagOC). Six medical clinics were recruited to participate in this study and randomly assigned to an intervention group or a control group. PCPs (physicians, physician assistants, and advanced practice registered nurses) took a pretest; 2 weeks later, they participated in the web-based educational program, including a posttest (intervention group) or took a posttest only (control group). In each clinic, 1 week following completion of the PCPs' posttests, 94 patients were recruited to complete a one-page survey. The intervention clinics were found to be a significant factor for the PCPs to perform patient OCEs, after controlling for significant covariates, that is, age, main reason for clinic visit, OCE for patient in the past year, clinic's mean DiagOC score, and clinic's mean RiskOC score. The intervention also resulted in the PCPs increasing their pretest to posttest RiskOC scores. The use of intervention has the potential to increase PCPs' short-term knowledge and to increase the frequency of PCPs' routine, nonsymptomatic opportunistic OCE on patients. © 2016 American Association of Public Health Dentistry.

An ultrasound transient elastography system with coded excitation.

PubMed

Diao, Xianfen; Zhu, Jing; He, Xiaonian; Chen, Xin; Zhang, Xinyu; Chen, Siping; Liu, Weixiang

2017-06-28

Ultrasound transient elastography technology has found its place in elastography because it is safe and easy to operate. However, it's application in deep tissue is limited. The aim of this study is to design an ultrasound transient elastography system with coded excitation to obtain greater detection depth. The ultrasound transient elastography system requires tissue vibration to be strictly synchronous with ultrasound detection. Therefore, an ultrasound transient elastography system with coded excitation was designed. A central component of this transient elastography system was an arbitrary waveform generator with multi-channel signals output function. This arbitrary waveform generator was used to produce the tissue vibration signal, the ultrasound detection signal and the synchronous triggering signal of the radio frequency data acquisition system. The arbitrary waveform generator can produce different forms of vibration waveform to induce different shear wave propagation in the tissue. Moreover, it can achieve either traditional pulse-echo detection or a phase-modulated or a frequency-modulated coded excitation. A 7-chip Barker code and traditional pulse-echo detection were programmed on the designed ultrasound transient elastography system to detect the shear wave in the phantom excited by the mechanical vibrator. Then an elasticity QA phantom and sixteen in vitro rat livers were used for performance evaluation of the two detection pulses. The elasticity QA phantom's results show that our system is effective, and the rat liver results show the detection depth can be increased more than 1 cm. In addition, the SNR (signal-to-noise ratio) is increased by 15 dB using the 7-chip Barker coded excitation. Applying 7-chip Barker coded excitation technique to the ultrasound transient elastography can increase the detection depth and SNR. Using coded excitation technology to assess the human liver, especially in obese patients, may be a good choice.

Longitudinal shear wave imaging for elasticity mapping using optical coherence elastography

NASA Astrophysics Data System (ADS)

Zhu, Jiang; Miao, Yusi; Qi, Li; Qu, Yueqiao; He, Youmin; Yang, Qiang; Chen, Zhongping

2017-05-01

Shear wave measurements for the determination of tissue elastic properties have been used in clinical diagnosis and soft tissue assessment. A shear wave propagates as a transverse wave where vibration is perpendicular to the wave propagation direction. Previous transverse shear wave measurements could detect the shear modulus in the lateral region of the force; however, they could not provide the elastic information in the axial region of the force. In this study, we report the imaging and quantification of longitudinal shear wave propagation using optical coherence tomography to measure the elastic properties along the force direction. The experimental validation and finite element simulations show that the longitudinal shear wave propagates along the vibration direction as a plane wave in the near field of a planar source. The wave velocity measurement can quantify the shear moduli in a homogeneous phantom and a side-by-side phantom. Combining the transverse shear wave and longitudinal shear wave measurements, this system has great potential to detect the directionally dependent elastic properties in tissues without a change in the force direction.

Resonant acoustic spectroscopy of soft tissues using embedded magnetomotive nanotransducers and optical coherence tomography

PubMed Central

Oldenburg, Amy L

2010-01-01

We present a new method for performing dynamic elastography of soft tissue samples. By sensing nanoscale displacements with optical coherence tomography, a chirped, modulated force is applied to acquire the mechanical spectrum of a tissue sample within a few seconds. This modulated force is applied via magnetic nanoparticles, named ‘nanotransducers’, which are diffused into the tissue, and which contribute negligible inertia to the soft tissue mechanical system. Using this novel system, we observed that excised tissues exhibit mechanical resonance modes which are well described by a linear damped harmonic oscillator. Results are validated by using cylindrical tissue phantoms of agarose in which resonant frequencies (30–400 Hz) are consistent with longitudinal modes and the sample boundary conditions. We furthermore show that the Young’s modulus can be computed from their measured resonance frequencies, analogous to resonant ultrasound spectroscopy for stiff material analysis. Using this new technique, named magnetomotive resonant acoustic spectroscopy (MRAS), we monitored the relative stiffening of an excised rat liver during a chemical fixation process. PMID:20124653

Optical measurement of arterial mechanical properties: from atherosclerotic plaque initiation to rupture

NASA Astrophysics Data System (ADS)

Nadkarni, Seemantini K.

2013-12-01

During the pathogenesis of coronary atherosclerosis, from lesion initiation to rupture, arterial mechanical properties are altered by a number of cellular, molecular, and hemodynamic processes. There is growing recognition that mechanical factors may actively drive vascular cell signaling and regulate atherosclerosis disease progression. In advanced plaques, the mechanical properties of the atheroma influence stress distributions in the fibrous cap and mediate plaque rupture resulting in acute coronary events. This review paper explores current optical technologies that provide information on the mechanical properties of arterial tissue to advance our understanding of the mechanical factors involved in atherosclerosis development leading to plaque rupture. The optical approaches discussed include optical microrheology and traction force microscopy that probe the mechanical behavior of single cell and extracellular matrix components, and intravascular imaging modalities including laser speckle rheology, optical coherence elastography, and polarization-sensitive optical coherence tomography to measure the mechanical properties of advanced coronary lesions. Given the wealth of information that these techniques can provide, optical imaging modalities are poised to play an increasingly significant role in elucidating the mechanical aspects of coronary atherosclerosis in the future.

Elastography methods applicable to the eye

NASA Astrophysics Data System (ADS)

Khan, Altaf A.; Cortina, Soledad M.; Chamon, Wallace; Royston, Thomas J.

2014-02-01

Elastography is the mapping of tissues and cells by their respective mechanical properties, such as elasticity and viscosity. Our interest primarily lies in the human eye. Combining Scanning Laser Doppler Vibrometry (SLDV) with geometrically focused mechanical vibratory excitations of the cornea, it is possible to reconstruct these mechanical properties of the cornea. Experiments were conducted on phantom corneas as well as excised donor human corneas to test feasibility and derive a method of modeling. Finite element analysis was used to recreate the phantom studies and corroborate with the experimental data. Results are in close agreement. To further expand the study, lamb eyes were used in MR Elastography studies. 3D wave reconstruction was created and elastography maps were obtained. With MR Elastography, it would be possible to noninvasively measure mechanical properties of anatomical features not visible to SLDV, such as the lens and retina. Future plans include creating a more robust finite element model, improving the SLDV method for in-vivo application, and continuing experiments with MR Elastography.

Ultrasound elastography of the lower uterine segment in women with a previous cesarean section: Comparison of in-/ex-vivo elastography versus tensile-stress-strain-rupture analysis.

PubMed

Seliger, Gregor; Chaoui, Katharina; Lautenschläger, Christine; Jenderka, Klaus-Vitold; Kunze, Christian; Hiller, Grit Gesine Ruth; Tchirikov, Michael

2018-06-01

The purpose of this study was to assess, if the biomechanical properties of the lower uterine segment (LUS) in women with a previous cesarean section (CS) can be determined by ultrasound (US) elastography. The first aim was to establish an ex-vivo LUS tensile-stress-strain-rupture(break point) analysis with the possibility of simultaneously using US elastography. The second aim was to investigate the relationship between measurement results of LUS stiffness using US elastography in-/ex-vivo with results of tensile-stress-strain-rupture analysis, and to compare different US elastography LUS-stiffness-measurement methods ex-vivo. An explorative experimental, in-/ex-vivo US study of women with previous CS was conducted. LUS elasticity was measured by point Shear Wave Elastography (pSWE) and bidimensional Shear-Wave-Elastography (2D-SWE) first in-vivo during preoperative examination within 24 h before repeat CS (including resection of the thinnest part of the LUS = uterine scar area during CS), second within 1 h after operation during the ex-vivo experiment, followed by tensile-stress-strain-rupture analysis. Pearson's correlation coefficient and scatter plots, Bland-Altman plots and paired T-tests, were used. Thirty three women were included in the study; elastography measurements n = 1412. The feasibility of ex-vivo assessment of LUS by quantitative US elastography using pSWE and 2D-SWE to detect stiffness of LUS was demonstrated. The strongest correlation with tensile-stress-strain analysis was found in the US elastography examination carried out with 2D-SWE (0.78, p < 0.001, 95%CI [0.48, 0.92]). The laboratory experiment illustrated that, the break point - as a surrogate marker for the risk of rupture of the LUS after CS - is linearly dependent on the thickness of the LUS in the scar area (Coefficient of correlation: 0.79, p < 0.001, 95%CI [0.55, 0.91]). Two extremely stiff LUS-specimens (outlier or extreme values) rupture even at less stroke/strain than would be expected by their thickness. This study confirms that US elastography can help in determining viscoelastic properties of the LUS in women with a previous CS. The data from our small series are promising. However whether individual extreme values of high stiffness and consecutive restricted biomechanical resilience can explain the phenomenon of rupture during TOLAC in cases of LUS with adequate thickness remains a question which prospective trials have to analyze before US elastography can be introduced into clinical practice. Copyright © 2018 Elsevier B.V. All rights reserved.

Reliability and validity of quantifying absolute muscle hardness using ultrasound elastography.

PubMed

Chino, Kentaro; Akagi, Ryota; Dohi, Michiko; Fukashiro, Senshi; Takahashi, Hideyuki

2012-01-01

Muscle hardness is a mechanical property that represents transverse muscle stiffness. A quantitative method that uses ultrasound elastography for quantifying absolute human muscle hardness has been previously devised; however, its reliability and validity have not been completely verified. This study aimed to verify the reliability and validity of this quantitative method. The Young's moduli of seven tissue-mimicking materials (in vitro; Young's modulus range, 20-80 kPa; increments of 10 kPa) and the human medial gastrocnemius muscle (in vivo) were quantified using ultrasound elastography. On the basis of the strain/Young's modulus ratio of two reference materials, one hard and one soft (Young's moduli of 7 and 30 kPa, respectively), the Young's moduli of the tissue-mimicking materials and medial gastrocnemius muscle were calculated. The intra- and inter-investigator reliability of the method was confirmed on the basis of acceptably low coefficient of variations (≤6.9%) and substantially high intraclass correlation coefficients (≥0.77) obtained from all measurements. The correlation coefficient between the Young's moduli of the tissue-mimicking materials obtained using a mechanical method and ultrasound elastography was 0.996, which was equivalent to values previously obtained using magnetic resonance elastography. The Young's moduli of the medial gastrocnemius muscle obtained using ultrasound elastography were within the range of values previously obtained using magnetic resonance elastography. The reliability and validity of the quantitative method for measuring absolute muscle hardness using ultrasound elastography were thus verified.

Elastography in the differential diagnosis of thyroid nodules in Hashimoto thyroiditis.

PubMed

Şahin, Mustafa; Çakal, Erman; Özbek, Mustafa; Güngünes, Aşkin; Arslan, Müyesser Sayki; Akkaymak, Esra Tutal; Uçan, Bekir; Ünsal, Ilknur Öztürk; Bozkurt, Nujen Çolak; Delibaşi, Tuncay

2014-08-01

Elastography is a method which assesses the risk of the malignancy and provides information about the degree of hardness in tissue. Hashimoto's thyroiditis, autoimmune lymphocytic infiltration and fibrosis, is considered to be a very common disease that is able to change the hardness of the tissue. The diagnostic value of elastography of this group of patients has not previously been reported. In our study, we aimed to determine the diagnostic value of elastography in 283 patients (255 female, 28 male) with Hashimoto's thyroiditis. Elastography score and index were measured with real-time ultrasound elastography (Hitachi(®) EUB 7000 HV machine with using 13 MHz linear transducer). The outcome of this measure shows that malignant nodules were with higher elastography scores (ES) and strain indexes (SI) values. ES ≥3 were observed in 16/20 malignant and 130/263 benign nodules, respectively. The area under the curve (AUC) for the elasto score (AUC) was 0.72 (p = 0.001), and AUC for the strain index was 0.77 (p < 0.0001). Accordingly, our study suggests that strain index reflects malignancy better than the elasto score. We conclude that elastography score is ≥3 providing 80 % sensitivity and 50 %, six specificity for diagnosing malignancy. For strain index, we found that 2.45 (72.2 % sensitivity and 70 % specificity) is a cut-off point. We have detected a lower cut-off point for SI in Hashimoto patients although sensitivity and specificity decreases in Hashimoto in this population.

Reliability and Validity of Quantifying Absolute Muscle Hardness Using Ultrasound Elastography

PubMed Central

Chino, Kentaro; Akagi, Ryota; Dohi, Michiko; Fukashiro, Senshi; Takahashi, Hideyuki

2012-01-01

Muscle hardness is a mechanical property that represents transverse muscle stiffness. A quantitative method that uses ultrasound elastography for quantifying absolute human muscle hardness has been previously devised; however, its reliability and validity have not been completely verified. This study aimed to verify the reliability and validity of this quantitative method. The Young’s moduli of seven tissue-mimicking materials (in vitro; Young’s modulus range, 20–80 kPa; increments of 10 kPa) and the human medial gastrocnemius muscle (in vivo) were quantified using ultrasound elastography. On the basis of the strain/Young’s modulus ratio of two reference materials, one hard and one soft (Young’s moduli of 7 and 30 kPa, respectively), the Young’s moduli of the tissue-mimicking materials and medial gastrocnemius muscle were calculated. The intra- and inter-investigator reliability of the method was confirmed on the basis of acceptably low coefficient of variations (≤6.9%) and substantially high intraclass correlation coefficients (≥0.77) obtained from all measurements. The correlation coefficient between the Young’s moduli of the tissue-mimicking materials obtained using a mechanical method and ultrasound elastography was 0.996, which was equivalent to values previously obtained using magnetic resonance elastography. The Young’s moduli of the medial gastrocnemius muscle obtained using ultrasound elastography were within the range of values previously obtained using magnetic resonance elastography. The reliability and validity of the quantitative method for measuring absolute muscle hardness using ultrasound elastography were thus verified. PMID:23029231

The diagnostic performance of shear wave elastography for malignant cervical lymph nodes: A systematic review and meta-analysis.

PubMed

Suh, Chong Hyun; Choi, Young Jun; Baek, Jung Hwan; Lee, Jeong Hyun

2017-01-01

To evaluate the diagnostic performance of shear wave elastography for malignant cervical lymph nodes. We searched the Ovid-MEDLINE and EMBASE databases for published studies regarding the use of shear wave elastography for diagnosing malignant cervical lymph nodes. The diagnostic performance of shear wave elastography was assessed using bivariate modelling and hierarchical summary receiver operating characteristic modelling. Meta-regression analysis and subgroup analysis according to acoustic radiation force impulse imaging (ARFI) and Supersonic shear imaging (SSI) were also performed. Eight eligible studies which included a total sample size of 481 patients with 647 cervical lymph nodes, were included. Shear wave elastography showed a summary sensitivity of 81 % (95 % CI: 72-88 %) and specificity of 85 % (95 % CI: 70-93 %). The results of meta-regression analysis revealed that the prevalence of malignant lymph nodes was a significant factor affecting study heterogeneity (p < .01). According to the subgroup analysis, the summary estimates of the sensitivity and specificity did not differ between ARFI and SSI (p = .93). Shear wave elastography is an acceptable imaging modality for diagnosing malignant cervical lymph nodes. We believe that both ARFI and SSI may have a complementary role for diagnosing malignant cervical lymph nodes. • Shear wave elastography is acceptable modality for diagnosing malignant cervical lymph nodes. • Shear wave elastography demonstrated summary sensitivity of 81 % and specificity of 85 %. • ARFI and SSI have complementary roles for diagnosing malignant cervical lymph nodes.

High Contrast Ultrafast Imaging of the Human Heart

PubMed Central

Papadacci, Clement; Pernot, Mathieu; Couade, Mathieu; Fink, Mathias; Tanter, Mickael

2014-01-01

Non-invasive ultrafast imaging for human cardiac applications is a big challenge to image intrinsic waves such as electromechanical waves or remotely induced shear waves in elastography imaging techniques. In this paper we propose to perform ultrafast imaging of the heart with adapted sector size by using diverging waves emitted from a classical transthoracic cardiac phased array probe. As in ultrafast imaging with plane wave coherent compounding, diverging waves can be summed coherently to obtain high-quality images of the entire heart at high frame rate in a full field-of-view. To image shear waves propagation at high SNR, the field-of-view can be adapted by changing the angular aperture of the transmitted wave. Backscattered echoes from successive circular wave acquisitions are coherently summed at every location in the image to improve the image quality while maintaining very high frame rates. The transmitted diverging waves, angular apertures and subapertures size are tested in simulation and ultrafast coherent compounding is implemented on a commercial scanner. The improvement of the imaging quality is quantified in phantom and in vivo on human heart. Imaging shear wave propagation at 2500 frame/s using 5 diverging waves provides a strong increase of the Signal to noise ratio of the tissue velocity estimates while maintaining a high frame rate. Finally, ultrafast imaging with a 1 to 5 diverging waves is used to image the human heart at a frame rate of 900 frames/s over an entire cardiac cycle. Thanks to spatial coherent compounding, a strong improvement of imaging quality is obtained with a small number of transmitted diverging waves and a high frame rate, which allows imaging the propagation of electromechanical and shear waves with good image quality. PMID:24474135

Ultrasound elastography: principles, techniques, and clinical applications.

PubMed

Dewall, Ryan J

2013-01-01

Ultrasound elastography is an emerging set of imaging modalities used to image tissue elasticity and are often referred to as virtual palpation. These techniques have proven effective in detecting and assessing many different pathologies, because tissue mechanical changes often correlate with tissue pathological changes. This article reviews the principles of ultrasound elastography, many of the ultrasound-based techniques, and popular clinical applications. Originally, elastography was a technique that imaged tissue strain by comparing pre- and postcompression ultrasound images. However, new techniques have been developed that use different excitation methods such as external vibration or acoustic radiation force. Some techniques track transient phenomena such as shear waves to quantitatively measure tissue elasticity. Clinical use of elastography is increasing, with applications including lesion detection and classification, fibrosis staging, treatment monitoring, vascular imaging, and musculoskeletal applications.

Pulmonary ultrasound elastography: a feasibility study with phantoms and ex-vivo tissue

NASA Astrophysics Data System (ADS)

Nguyen, Man Minh; Xie, Hua; Paluch, Kamila; Stanton, Douglas; Ramachandran, Bharat

2013-03-01

Elastography has become widely used for minimally invasive diagnosis in many tumors as seen with breast, liver and prostate. Among different modalities, ultrasound-based elastography stands out due to its advantages including being safe, real-time, and relatively low-cost. While lung cancer is the leading cause of cancer mortality among both men and women, the use of ultrasound elastography for lung cancer diagnosis has hardly been investigated due to the limitations of ultrasound in air. In this work, we investigate the use of static-compression based endobronchial ultrasound elastography by a 3D trans-oesophageal echocardiography (TEE) transducer for lung cancer diagnosis. A water-filled balloon was designed to 1) improve the visualization of endobronchial ultrasound and 2) to induce compression via pumping motion inside the trachea and bronchiole. In a phantom study, we have successfully generated strain images indicating the stiffness difference between the gelatin background and agar inclusion. A similar strain ratio was confirmed with Philips ultrasound strain-based elastography product. For ex-vivo porcine lung study, different tissue ablation methods including chemical injection, Radio Frequency (RF) ablation, and direct heating were implemented to achieve tumor-mimicking tissue. Stiff ablated lung tissues were obtained and detected with our proposed method. These results suggest the feasibility of pulmonary elastography to differentiate stiff tumor tissue from normal tissue.

Elastography for the differentiation of benign and malignant liver lesions: a meta-analysis.

PubMed

Ma, Xuelei; Zhan, Wenli; Zhang, Binglan; Wei, Benling; Wu, Xin; Zhou, Min; Liu, Lei; Li, Ping

2014-05-01

The objective of this paper was to evaluate the overall accuracy of elastography in the diagnosis of benign and malignant liver lesions by liver biopsy as the gold standard. Literature databases were searched. The studies which were related to evaluate the diagnostic value of elastography for differentiation in benign and malignant liver lesions in English or Chinese were included. The summary receiver operating characteristic (SROC) curve was performed, and the areas under the curve (AUC) were also calculated to present the accuracy of the elastography for the diagnosis of benign and malignant liver lesions. Six studies which included a total of 448 liver lesions in 384 patients were analyzed. The summary sensitivity and specificity of elastography for the differentiation of malignant liver lesions were 85% (95% CI, 80 to 89%) and 84% (95% CI, 80 to 88%), respectively. And the summary diagnostic odds ratio was 46.33 (95% CI, 15.22 to 141.02), and the SROC was 0.9328. Elastography has a high sensitivity and specificity differentiation for benign and malignant liver lesions. As a non-invasive method, it is promising to be applied to clinical practice. To estimate elastography objectively, a large, prospective, international, and multi-center study is still needed.

Shear wave elastography with a new reliability indicator.

PubMed

Dietrich, Christoph F; Dong, Yi

2016-09-01

Non-invasive methods for liver stiffness assessment have been introduced over recent years. Of these, two main methods for estimating liver fibrosis using ultrasound elastography have become established in clinical practice: shear wave elastography and quasi-static or strain elastography. Shear waves are waves with a motion perpendicular (lateral) to the direction of the generating force. Shear waves travel relatively slowly (between 1 and 10 m/s). The stiffness of the liver tissue can be assessed based on shear wave velocity (the stiffness increases with the speed). The European Federation of Societies for Ultrasound in Medicine and Biology has published Guidelines and Recommendations that describe these technologies and provide recommendations for their clinical use. Most of the data available to date has been published using the Fibroscan (Echosens, France), point shear wave speed measurement using an acoustic radiation force impulse (Siemens, Germany) and 2D shear wave elastography using the Aixplorer (SuperSonic Imagine, France). More recently, also other manufacturers have introduced shear wave elastography technology into the market. A comparison of data obtained using different techniques for shear wave propagation and velocity measurement is of key interest for future studies, recommendations and guidelines. Here, we present a recently introduced shear wave elastography technology from Hitachi and discuss its reproducibility and comparability to the already established technologies.

Shear wave elastography with a new reliability indicator

PubMed Central

Dong, Yi

2016-01-01

Non-invasive methods for liver stiffness assessment have been introduced over recent years. Of these, two main methods for estimating liver fibrosis using ultrasound elastography have become established in clinical practice: shear wave elastography and quasi-static or strain elastography. Shear waves are waves with a motion perpendicular (lateral) to the direction of the generating force. Shear waves travel relatively slowly (between 1 and 10 m/s). The stiffness of the liver tissue can be assessed based on shear wave velocity (the stiffness increases with the speed). The European Federation of Societies for Ultrasound in Medicine and Biology has published Guidelines and Recommendations that describe these technologies and provide recommendations for their clinical use. Most of the data available to date has been published using the Fibroscan (Echosens, France), point shear wave speed measurement using an acoustic radiation force impulse (Siemens, Germany) and 2D shear wave elastography using the Aixplorer (SuperSonic Imagine, France). More recently, also other manufacturers have introduced shear wave elastography technology into the market. A comparison of data obtained using different techniques for shear wave propagation and velocity measurement is of key interest for future studies, recommendations and guidelines. Here, we present a recently introduced shear wave elastography technology from Hitachi and discuss its reproducibility and comparability to the already established technologies. PMID:27679731

Comparison of strain and shear wave elastography for qualitative and quantitative assessment of breast masses in the same population.

PubMed

Kim, Hyo Jin; Kim, Sun Mi; Kim, Bohyoung; La Yun, Bo; Jang, Mijung; Ko, Yousun; Lee, Soo Hyun; Jeong, Heeyeong; Chang, Jung Min; Cho, Nariya

2018-04-18

We investigated addition of strain and shear wave elastography to conventional ultrasonography for the qualitative and quantitative assessment of breast masses; cut-off points were determined for strain ratio, elasticity ratio, and visual score for differentiating between benign and malignant masses. In all, 108 masses from 94 patients were evaluated with strain and shear wave elastography and scored for suspicion of malignancy, visual score, strain ratio, and elasticity ratio. The diagnostic performance between ultrasonography alone and ultrasonography combined with either type of elastography was compared; cut-off points were determined for strain ratio, elasticity ratio, and visual score. Of the 108 masses, 44 were malignant and 64 were benign. The areas under the curves were significantly higher for strain and shear wave elastography-supplemented ultrasonography (0.839 and 0.826, respectively; P = 0.656) than for ultrasonography alone (0.764; P = 0.018 and 0.035, respectively). The diagnostic performances of strain and elasticity ratios were similar when differentiating benign from malignant masses. Cut-off values for strain ratio, elasticity ratio, and visual scores for strain and shear wave elastography were 2.93, 4, 3, and 2, respectively. Both forms of elastography similarly improved the diagnostic performance of conventional ultrasonography in the qualitative and quantitative assessment of breast masses.

Spin-echo Echo-planar Imaging MR Elastography versus Gradient-echo MR Elastography for Assessment of Liver Stiffness in Children and Young Adults Suspected of Having Liver Disease.

PubMed

Serai, Suraj D; Dillman, Jonathan R; Trout, Andrew T

2017-03-01

Purpose To compare two-dimensional (2D) gradient-recalled echo (GRE) and 2D spin-echo (SE) echo-planar imaging (EPI) magnetic resonance (MR) elastography for measurement of hepatic stiffness in pediatric and young adult patients suspected of having liver disease. Materials and Methods In this institutional review board-approved, HIPAA-compliant study, 58 patients underwent both 2D GRE and 2D SE-EPI MR elastography at 1.5 T during separate breath holds. Liver stiffness (mean of means; in kilopascals) was measured by five blinded reviewers. Pooled mean liver stiffness and region-of-interest (ROI) size were compared by using paired t tests. Intraclass correlation coefficients (ICCs) were used to assess agreement between techniques. Respiratory motion artifacts were compared across sequences by using the Fisher exact test. Results Mean patient age was 14.7 years ± 5.2 (standard deviation; age range, 0.7-20.5 years), and 55.2% (32 of 58) of patients were male. Mean liver stiffness was 2.92 kPa ± 1.29 measured at GRE MR elastography and 2.76 kPa ± 1.39 at SE-EPI MR elastography (n = 290; P = .15). Mean ROI sizes were 8495 mm 2 ± 4482 for 2D GRE MR elastography and 15 176 mm 2 ± 7609 for 2D SE-EPI MR elastography (n = 290; P < .001). Agreement was excellent for measured stiffness between five reviewers for both 2D GRE (ICC, 0.97; 95% confidence interval: 0.95, 0.98) and 2D SE-EPI (ICC, 0.98; 95% confidence interval: 0.96, 0.99). Mean ICC (n = 5) for agreement between 2D GRE and 2D SE-EPI MR elastography was 0.93 (range, 0.91-0.95). Moderate or severe breathing artifacts were observed on 27.5% (16 of 58) of 2D GRE images versus 0% 2D SE-EPI images (P < .001). Conclusion There is excellent agreement on measured hepatic stiffness between 2D GRE and 2D SE-EPI MR elastography across multiple reviewers. SE-EPI MR elastography allowed for stiffness measurement across larger areas of the liver and can be performed in a single breath hold. © RSNA, 2016.

Quantitative shear wave ultrasound elastography: initial experience in solid breast masses

PubMed Central

2010-01-01

Introduction Shear wave elastography is a new method of obtaining quantitative tissue elasticity data during breast ultrasound examinations. The aims of this study were (1) to determine the reproducibility of shear wave elastography (2) to correlate the elasticity values of a series of solid breast masses with histological findings and (3) to compare shear wave elastography with greyscale ultrasound for benign/malignant classification. Methods Using the Aixplorer® ultrasound system (SuperSonic Imagine, Aix en Provence, France), 53 solid breast lesions were identified in 52 consecutive patients. Two orthogonal elastography images were obtained of each lesion. Observers noted the mean elasticity values in regions of interest (ROI) placed over the stiffest areas on the two elastography images and a mean value was calculated for each lesion. A sub-set of 15 patients had two elastography images obtained by an additional operator. Reproducibility of observations was assessed between (1) two observers analysing the same pair of images and (2) findings from two pairs of images of the same lesion taken by two different operators. All lesions were subjected to percutaneous biopsy. Elastography measurements were correlated with histology results. After preliminary experience with 10 patients a mean elasticity cut off value of 50 kilopascals (kPa) was selected for benign/malignant differentiation. Greyscale images were classified according to the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS). BI-RADS categories 1-3 were taken as benign while BI-RADS categories 4 and 5 were classified as malignant. Results Twenty-three benign lesions and 30 cancers were diagnosed on histology. Measurement of mean elasticity yielded an intraclass correlation coefficient of 0.99 for two observers assessing the same pairs of elastography images. Analysis of images taken by two independent operators gave an intraclass correlation coefficient of 0.80. Shear wave elastography versus greyscale BI-RADS performance figures were sensitivity: 97% vs 87%, specificity: 83% vs 78%, positive predictive value (PPV): 88% vs 84%, negative predictive value (NPV): 95% vs 82% and accuracy: 91% vs 83% respectively. These differences were not statistically significant. Conclusions Shear wave elastography gives quantitative and reproducible information on solid breast lesions with diagnostic accuracy at least as good as greyscale ultrasound with BI-RADS classification. PMID:21122101

Quantitative shear wave ultrasound elastography: initial experience in solid breast masses.

PubMed

Evans, Andrew; Whelehan, Patsy; Thomson, Kim; McLean, Denis; Brauer, Katrin; Purdie, Colin; Jordan, Lee; Baker, Lee; Thompson, Alastair

2010-01-01

Shear wave elastography is a new method of obtaining quantitative tissue elasticity data during breast ultrasound examinations. The aims of this study were (1) to determine the reproducibility of shear wave elastography (2) to correlate the elasticity values of a series of solid breast masses with histological findings and (3) to compare shear wave elastography with greyscale ultrasound for benign/malignant classification. Using the Aixplorer® ultrasound system (SuperSonic Imagine, Aix en Provence, France), 53 solid breast lesions were identified in 52 consecutive patients. Two orthogonal elastography images were obtained of each lesion. Observers noted the mean elasticity values in regions of interest (ROI) placed over the stiffest areas on the two elastography images and a mean value was calculated for each lesion. A sub-set of 15 patients had two elastography images obtained by an additional operator. Reproducibility of observations was assessed between (1) two observers analysing the same pair of images and (2) findings from two pairs of images of the same lesion taken by two different operators. All lesions were subjected to percutaneous biopsy. Elastography measurements were correlated with histology results. After preliminary experience with 10 patients a mean elasticity cut off value of 50 kilopascals (kPa) was selected for benign/malignant differentiation. Greyscale images were classified according to the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS). BI-RADS categories 1-3 were taken as benign while BI-RADS categories 4 and 5 were classified as malignant. Twenty-three benign lesions and 30 cancers were diagnosed on histology. Measurement of mean elasticity yielded an intraclass correlation coefficient of 0.99 for two observers assessing the same pairs of elastography images. Analysis of images taken by two independent operators gave an intraclass correlation coefficient of 0.80. Shear wave elastography versus greyscale BI-RADS performance figures were sensitivity: 97% vs 87%, specificity: 83% vs 78%, positive predictive value (PPV): 88% vs 84%, negative predictive value (NPV): 95% vs 82% and accuracy: 91% vs 83% respectively. These differences were not statistically significant. Shear wave elastography gives quantitative and reproducible information on solid breast lesions with diagnostic accuracy at least as good as greyscale ultrasound with BI-RADS classification.

Prediction of Esophageal Varices in Patients with Cirrhosis: Usefulness of Three-dimensional MR Elastography with Echo-planar Imaging Technique

PubMed Central

Shin, Sung Ui; Yu, Mi Hye; Yoon, Jeong Hee; Han, Joon Koo; Choi, Byung-Ihn; Glaser, Kevin J.; Ehman, Richard L.

2014-01-01

Purpose To determine the diagnostic performance of magnetic resonance (MR) elastography in comparison to spleen length and dynamic contrast material–enhanced (DCE) MR imaging in association with esophageal varices in patients with liver cirrhosis by using endoscopy as the reference standard. Materials and Methods This retrospective study received institutional review board approval, and informed consent was waived. One hundred thirty-nine patients with liver cirrhosis who underwent liver DCE MR imaging, including MR elastography, were included. Hepatic stiffness (HS) and spleen stiffness (SS) values assessed with MR elastography, as well as spleen length, were correlated with the presence of esophageal varices and high-risk varices by using Spearman correlation analysis. The diagnostic performance of MR elastography was compared with that of DCE MR imaging and combined assessment of MR elastography and DCE MR imaging by using receiver operating characteristic analysis. MR elastography reproducibility was assessed prospectively, with informed consent, in another 15 patients by using intraclass correlation coefficients. Results There were significant positive linear correlations between HS, SS, and spleen length and the grade of esophageal varices (r = 0.46, r = 0.48, and r = 0.36, respectively; all P < .0001). HS and SS values (>4.81 kPa and >7.60 kPa, respectively) showed better performance than did spleen length in the association with esophageal varices (P = .0306 and P = .0064, respectively). Diagnostic performance of HS and SS in predicting high-risk varices was comparable to that of DCE MR imaging (P = .1282 and P = .1371, respectively). When MR elastography and DCE MR imaging were combined, sensitivity improved significantly (P = .0004). MR elastography was highly reproducible (intraclass correlation coefficient > 0.9). Conclusion HS and SS are associated with esophageal varices and showed better performance than did spleen length in assessing the presence of esophageal varices. MR elastography is comparable to DCE MR imaging in predicting the presence of esophageal varices and high-risk varices, but, when assessed in combination, sensitivity is higher. © RSNA, 2014 Online supplemental material is available for this article. PMID:24620910

Transient elastography for the assessment of chronic liver disease: Ready for the clinic?

PubMed Central

Cobbold, JFL; Morin, S; Taylor-Robinson, SD

2007-01-01

Transient elastography is a recently developed non-invasive technique for the assessment of hepatic fibrosis. The technique has been subject to rigorous evaluation in a number of studies in patients with chronic liver disease of varying aetiology. Transient elastography has been compared with histological assessment of percutaneous liver biopsy, with high sensitivity and specificity for the diagnosis of cirrhosis, and has also been used to assess pre-cirrhotic disease. However, the cut-off values between different histological stages vary substantially in different studies, patient groups and aetiology of liver disease. More recent studies have examined the possible place of transient elastography in clinical practice, including risk stratification for the development of complications of cirrhosis. This review describes the technique of transient elastography and discusses the interpretation of recent studies, emphasizing its applicability in the clinical setting. PMID:17828808

Building an Open-source Simulation Platform of Acoustic Radiation Force-based Breast Elastography

PubMed Central

Wang, Yu; Peng, Bo; Jiang, Jingfeng

2017-01-01

Ultrasound-based elastography including strain elastography (SE), acoustic radiation force Impulse (ARFI) imaging, point shear wave elastography (pSWE) and supersonic shear imaging (SSI) have been used to differentiate breast tumors among other clinical applications. The objective of this study is to extend a previously published virtual simulation platform built for ultrasound quasi-static breast elastography toward acoustic radiation force-based breast elastography. Consequently, the extended virtual breast elastography simulation platform can be used to validate image pixels with known underlying soft tissue properties (i.e. “ground truth”) in complex, heterogeneous media, enhancing confidence in elastographic image interpretations. The proposed virtual breast elastography system inherited four key components from the previously published virtual simulation platform: an ultrasound simulator (Field II), a mesh generator (Tetgen), a finite element solver (FEBio) and a visualization and data processing package (VTK). Using a simple message passing mechanism, functionalities have now been extended to acoustic radiation force-based elastography simulations. Examples involving three different numerical breast models with increasing complexity – one uniform model, one simple inclusion model and one virtual complex breast model derived from magnetic resonance imaging data, were used to demonstrate capabilities of this extended virtual platform. Overall, simulation results were compared with the published results. In the uniform model, the estimated shear wave speed (SWS) values were within 4% compared to the predetermined SWS values. In the simple inclusion and the complex breast models, SWS values of all hard inclusions in soft backgrounds were slightly underestimated, similar to what has been reported. The elastic contrast values and visual observation show that ARFI images have higher spatial resolution, while SSI images can provide higher inclusion-to-background contrast. In summary, our initial results were consistent with our expectations and what have been reported in the literature. The proposed (open-source) simulation platform can serve as a single gateway to perform many elastographic simulations in a transparent manner, thereby promoting collaborative developments. PMID:28075330

Building an open-source simulation platform of acoustic radiation force-based breast elastography

NASA Astrophysics Data System (ADS)

Wang, Yu; Peng, Bo; Jiang, Jingfeng

2017-03-01

Ultrasound-based elastography including strain elastography, acoustic radiation force impulse (ARFI) imaging, point shear wave elastography and supersonic shear imaging (SSI) have been used to differentiate breast tumors among other clinical applications. The objective of this study is to extend a previously published virtual simulation platform built for ultrasound quasi-static breast elastography toward acoustic radiation force-based breast elastography. Consequently, the extended virtual breast elastography simulation platform can be used to validate image pixels with known underlying soft tissue properties (i.e. ‘ground truth’) in complex, heterogeneous media, enhancing confidence in elastographic image interpretations. The proposed virtual breast elastography system inherited four key components from the previously published virtual simulation platform: an ultrasound simulator (Field II), a mesh generator (Tetgen), a finite element solver (FEBio) and a visualization and data processing package (VTK). Using a simple message passing mechanism, functionalities have now been extended to acoustic radiation force-based elastography simulations. Examples involving three different numerical breast models with increasing complexity—one uniform model, one simple inclusion model and one virtual complex breast model derived from magnetic resonance imaging data, were used to demonstrate capabilities of this extended virtual platform. Overall, simulation results were compared with the published results. In the uniform model, the estimated shear wave speed (SWS) values were within 4% compared to the predetermined SWS values. In the simple inclusion and the complex breast models, SWS values of all hard inclusions in soft backgrounds were slightly underestimated, similar to what has been reported. The elastic contrast values and visual observation show that ARFI images have higher spatial resolution, while SSI images can provide higher inclusion-to-background contrast. In summary, our initial results were consistent with our expectations and what have been reported in the literature. The proposed (open-source) simulation platform can serve as a single gateway to perform many elastographic simulations in a transparent manner, thereby promoting collaborative developments.

Lumbar annulus fibrosus biomechanical characterization in healthy children by ultrasound shear wave elastography.

PubMed

Vergari, Claudio; Dubois, Guillaume; Vialle, Raphael; Gennisson, Jean-Luc; Tanter, Mickael; Dubousset, Jean; Rouch, Philippe; Skalli, Wafa

2016-04-01

Intervertebral disc (IVD) is key to spine biomechanics, and it is often involved in the cascade leading to spinal deformities such as idiopathic scoliosis, especially during the growth spurt. Recent progress in elastography techniques allows access to non-invasive measurement of cervical IVD in adults; the aim of this study was to determine the feasibility and reliability of shear wave elastography in healthy children lumbar IVD. Elastography measurements were performed in 31 healthy children (6-17 years old), in the annulus fibrosus and in the transverse plane of L5-S1 or L4-L5 IVD. Reliability was determined by three experienced operators repeating measurements. Average shear wave speed in IVD was 2.9 ± 0.5 m/s; no significant correlations were observed with sex, age or body morphology. Intra-operator repeatability was 5.0 % while inter-operator reproducibility was 6.2 %. Intraclass correlation coefficient was higher than 0.9 for each operator. Feasibility and reliability of IVD shear wave elastography were demonstrated. The measurement protocol is compatible with clinical routine and the results show the method's potential to give an insight into spine deformity progression and early detection. • Intervertebral disc mechanical properties are key to spine biomechanics • Feasibility of shear wave elastography in children lumbar disc was assessed • Measurement was fast and reliable • Elastography could represent a novel biomarker for spine pathologies.

Ultrasound elastography of the prostate: state of the art.

PubMed

Correas, J-M; Tissier, A-M; Khairoune, A; Khoury, G; Eiss, D; Hélénon, O

2013-05-01

Prostate cancer is the cancer exhibiting the highest incidence rate and it appears as the second cause of cancer death in men, after lung cancer. Prostate cancer is difficult to detect, and the treatment efficacy remains limited despite the increase use of biological tests (prostate-specific antigen [PSA] dosage), the development of new imaging modalities, and the use of invasive procedures such as biopsy. Ultrasound elastography is a novel imaging technique capable of mapping tissue stiffness of the prostate. It is known that prostatic cancer tissue is often harder than healthy tissue (information used by digital rectal examination [DRE]). Two elastography techniques have been developed based on different principles: first, quasi-static (or strain) technique, and second, shear wave technique. The tissue stiffness information provided by US elastography should improve the detection of prostate cancer and provide guidance for biopsy. Prostate elastography provides high sensitivity for detecting prostate cancer and shows high negative predictive values, ensuring that few cancers will be missed. US elastography should become an additional method of imaging the prostate, complementing the conventional transrectal ultrasound and MRI. This technique requires significant training (especially for quasi-static elastography) to become familiar with acquisition process, acquisition technique, characteristics and limitations, and to achieve correct diagnoses. Copyright © 2013 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Correlates of mammographic density in B-mode ultrasound and real time elastography.

PubMed

Jud, Sebastian Michael; Häberle, Lothar; Fasching, Peter A; Heusinger, Katharina; Hack, Carolin; Faschingbauer, Florian; Uder, Michael; Wittenberg, Thomas; Wagner, Florian; Meier-Meitinger, Martina; Schulz-Wendtland, Rüdiger; Beckmann, Matthias W; Adamietz, Boris R

2012-07-01

The aim of our study involved the assessment of B-mode imaging and elastography with regard to their ability to predict mammographic density (MD) without X-rays. Women, who underwent routine mammography, were prospectively examined with additional B-mode ultrasound and elastography. MD was assessed quantitatively with a computer-assisted method (Madena). The B-mode and elastography images were assessed by histograms with equally sized gray-level intervals. Regression models were built and cross validated to examine the ability to predict MD. The results of this study showed that B-mode imaging and elastography were able to predict MD. B-mode seemed to give a more accurate prediction. R for B-mode image and elastography were 0.67 and 0.44, respectively. Areas in the B-mode images that correlated with mammographic dense areas were either dark gray or of intermediate gray levels. Concerning elastography only the gray levels that represent extremely stiff tissue correlated positively with MD. In conclusion, ultrasound seems to be able to predict MD. Easy and cheap utilization of regular breast ultrasound machines encourages the use of ultrasound in larger case-control studies to validate this method as a breast cancer risk predictor. Furthermore, the application of ultrasound for breast tissue characterization could enable comprehensive research concerning breast cancer risk and breast density in young and pregnant women.

Shear-wave elastography of the breast: value of a quality measure and comparison with strain elastography.

PubMed

Barr, Richard G; Zhang, Zheng

2015-04-01

To determine whether addition of quality measure (QM) of shear-wave (SW) velocity (Vs) estimation can increase SW elastography sensitivity for breast cancer. With written informed consent, this institutional review board-approved, HIPAA-compliant study included 143 women (mean age, 48.5 years ± 8.7) scheduled for breast biopsy. Mean lesion size was 16.4 mm ± 11.8; 95 (66%) lesions were benign; 48 (34%), malignant. If more than one lesion was present, lesion with highest Breast Imaging Reporting and Data System (BI-RADS) category was chosen. If there were more than one with highest BI-RADS category, a lesion was randomly selected. Conventional ultrasonography (US), strain elastography, and SW elastography were performed with QM. QM assesses SW quality to provide accurate Vs. Lesions were evaluated for Vs and QM (high or low). Lesions with Vs of less than 4.5 m/sec were classified benign; lesions with Vs of 4.5 m/sec or greater, malignant. Results were correlated with pathologic findings. Vs data with or without incorporating QM were used to determine SW elastography diagnostic performance. Binomial proportions and exact 95% confidence intervals (CIs) were calculated. In 95 benign lesions, 13 (14%) had no SW elastography signal; 77 (81%), Vs of less than 4.5 m/sec; and five (5%), Vs of 4.5 m/sec or greater. In 48 malignant lesions, eight (17%) had no SW elastography signal; 20 (42%), Vs of less than 4.5 m/sec; and 20 (42%), V of 4.5 m/sec or greater. QM was low in 17 of 20 (85%) malignant lesions with Vs of less than 4.5 m/sec. Without QM, using Vs of 4.5 m/sec or greater as test positive, SW elastography had lesion-level sensitivity of 50% (95% CI: 34%, 66%); specificity, 94% (95% CI: 86%, 98%); positive predictive value (PPV), 80% (95% CI: 59%, 93%); and negative predictive value (NPV), 79% (95% CI: 70%, 87%). Using QM where additional lesions with both low Vs and low QM were treated as test positive, SW elastography had lesion-level sensitivity of 93% (95% CI: 80%, 98%); specificity, 89% (95% CI: 80%, 95%); PPV, 80% (95% CI: 66%, 91%); and NPV, 96% (95% CI: 89%, 99%). Addition of QM can improve SW elastography sensitivity, with no significant change in specificity. © RSNA, 2014 Online supplemental material is available for this article.

Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions.

PubMed

Okasha, Hussein; Elkholy, Shaimaa; El-Sayed, Ramy; Wifi, Mohamed-Naguib; El-Nady, Mohamed; El-Nabawi, Walid; El-Dayem, Waleed A; Radwan, Mohamed I; Farag, Ali; El-Sherif, Yahya; Al-Gemeie, Emad; Salman, Ahmed; El-Sherbiny, Mohamed; El-Mazny, Ahmed; Mahdy, Reem E

2017-08-28

To evaluate the accuracy of the elastography score combined to the strain ratio in the diagnosis of solid pancreatic lesions (SPL). A total of 172 patients with SPL identified by endoscopic ultrasound were enrolled in the study to evaluate the efficacy of elastography and strain ratio in differentiating malignant from benign lesions. The semi quantitative score of elastography was represented by the strain ratio method. Two areas were selected, area (A) representing the region of interest and area (B) representing the normal area. Area (B) was then divided by area (A). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated by comparing diagnoses made by elastography, strain ratio and final diagnoses. SPL were shown to be benign in 49 patients and malignant in 123 patients. Elastography alone had a sensitivity of 99%, a specificity of 63%, and an accuracy of 88%, a PPV of 87% and an NPV of 96%. The best cut-off level of strain ratio to obtain the maximal area under the curve was 7.8 with a sensitivity of 92%, specificity of 77%, PPV of 91%, NPV of 80% and an accuracy of 88%. Another estimated cut off strain ratio level of 3.8 had a higher sensitivity of 99% and NPV of 96%, but with less specificity, PPV and accuracy 53%, 84% and 86%, respectively. Adding both elastography to strain ratio resulted in a sensitivity of 98%, specificity of 77%, PPV of 91%, NPV of 95% and accuracy of 92% for the diagnosis of SPL. Combining elastography to strain ratio increases the accuracy of the differentiation of benign from malignant SPL.

Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions

PubMed Central

Okasha, Hussein; Elkholy, Shaimaa; El-Sayed, Ramy; Wifi, Mohamed-Naguib; El-Nady, Mohamed; El-Nabawi, Walid; El-Dayem, Waleed A; Radwan, Mohamed I; Farag, Ali; El-sherif, Yahya; Al-Gemeie, Emad; Salman, Ahmed; El-Sherbiny, Mohamed; El-Mazny, Ahmed; Mahdy, Reem E

2017-01-01

AIM To evaluate the accuracy of the elastography score combined to the strain ratio in the diagnosis of solid pancreatic lesions (SPL). METHODS A total of 172 patients with SPL identified by endoscopic ultrasound were enrolled in the study to evaluate the efficacy of elastography and strain ratio in differentiating malignant from benign lesions. The semi quantitative score of elastography was represented by the strain ratio method. Two areas were selected, area (A) representing the region of interest and area (B) representing the normal area. Area (B) was then divided by area (A). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated by comparing diagnoses made by elastography, strain ratio and final diagnoses. RESULTS SPL were shown to be benign in 49 patients and malignant in 123 patients. Elastography alone had a sensitivity of 99%, a specificity of 63%, and an accuracy of 88%, a PPV of 87% and an NPV of 96%. The best cut-off level of strain ratio to obtain the maximal area under the curve was 7.8 with a sensitivity of 92%, specificity of 77%, PPV of 91%, NPV of 80% and an accuracy of 88%. Another estimated cut off strain ratio level of 3.8 had a higher sensitivity of 99% and NPV of 96%, but with less specificity, PPV and accuracy 53%, 84% and 86%, respectively. Adding both elastography to strain ratio resulted in a sensitivity of 98%, specificity of 77%, PPV of 91%, NPV of 95% and accuracy of 92% for the diagnosis of SPL. CONCLUSION Combining elastography to strain ratio increases the accuracy of the differentiation of benign from malignant SPL. PMID:28932088

A soft patellar tendon on ultrasound elastography is associated with pain and functional deficit in volleyball players.

PubMed

Ooi, Chin Chin; Richards, Paula J; Maffulli, Nicola; Ede, David; Schneider, Michal E; Connell, David; Morrissey, Dylan; Malliaras, Peter

2016-05-01

To investigate the diagnostic performance of grey scale Ultrasound (US), power Doppler (PD) and US elastography for diagnosing painful patellar tendinopathy, and to establish their relationship with Victorian Institute of Sport Assessment-Patella (VISA-P) scores in a group of volleyball players with and without symptoms of patellar tendinopathy. Cross-sectional study. Thirty-five volleyball players (70 patellar tendons) were recruited during a national university volleyball competition. Players were imaged with conventional US followed by elastography. The clinical findings of painful patellar tendons were used as the reference standard for diagnosing patellar tendinopathy. In addition, all participants completed the VISA-P questionnaires. Of the 70 patellar tendons, 40 (57.1%) were clinically painful. The diagnostic accuracy of grey scale US, PD and elastography were 60%, 50%, 62.9%, respectively, with sensitivity/specificity of 72.5%/43.3%, 12.5%/100%, and 70%/53.3%, respectively. Combined US elastography and grey scale imaging achieved 82.5% sensitivity, 33.3% specificity and 61.4% accuracy while routine combination technique of PD and grey scale imaging revealed 72.5% sensitivity, 43.3% specificity and 60.0% accuracy. Tendons in players categorized as soft on elastography had statistically significantly greater AP thickness (p<0.001) and lower VISA-P scores (p=0.004) than those categorized as hard. There was no significant association between grey scale US abnormalities (hypoechogenicities and/or fusiform swelling) and VISA-P scores (p=0.098). Soft tendon properties depicted by US elastography may be more related to patellar tendon symptoms compared to grey scale US abnormalities. The supplementation of US elastography to conventional US may enhance the sensitivity for diagnosing patellar tendinopathy in routine clinical practice. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Comparison of non-invasive assessment of liver fibrosis in patients with alpha1-antitrypsin deficiency using magnetic resonance elastography (MRE), acoustic radiation force impulse (ARFI) Quantification, and 2D-shear wave elastography (2D-SWE).

PubMed

Reiter, Rolf; Wetzel, Martin; Hamesch, Karim; Strnad, Pavel; Asbach, Patrick; Haas, Matthias; Siegmund, Britta; Trautwein, Christian; Hamm, Bernd; Klatt, Dieter; Braun, Jürgen; Sack, Ingolf; Tzschätzsch, Heiko

2018-01-01

Although it has been known for decades that patients with alpha1-antitrypsin deficiency (AATD) have an increased risk of cirrhosis and hepatocellular carcinoma, limited data exist on non-invasive imaging-based methods for assessing liver fibrosis such as magnetic resonance elastography (MRE) and acoustic radiation force impulse (ARFI) quantification, and no data exist on 2D-shear wave elastography (2D-SWE). Therefore, the purpose of this study is to evaluate and compare the applicability of different elastography methods for the assessment of AATD-related liver fibrosis. Fifteen clinically asymptomatic AATD patients (11 homozygous PiZZ, 4 heterozygous PiMZ) and 16 matched healthy volunteers were examined using MRE and ARFI quantification. Additionally, patients were examined with 2D-SWE. A high correlation is evident for the shear wave speed (SWS) determined with different elastography methods in AATD patients: 2D-SWE/MRE, ARFI quantification/2D-SWE, and ARFI quantification/MRE (R = 0.8587, 0.7425, and 0.6914, respectively; P≤0.0089). Four AATD patients with pathologically increased SWS were consistently identified with all three methods-MRE, ARFI quantification, and 2D-SWE. The high correlation and consistent identification of patients with pathologically increased SWS using MRE, ARFI quantification, and 2D-SWE suggest that elastography has the potential to become a suitable imaging tool for the assessment of AATD-related liver fibrosis. These promising results provide motivation for further investigation of non-invasive assessment of AATD-related liver fibrosis using elastography.

In Pursuit of Internal Waves

NASA Astrophysics Data System (ADS)

Peacock, Thomas

2014-11-01

Orders of magnitude larger than surface waves, and so powerful that their generation impacts the lunar orbit, internal waves, propagating disturbances of a density-stratified fluid, are ubiquitous throughout the ocean and atmosphere. Following the discovery of the phenomenon of ``dead water'' by early Arctic explorers and the classic laboratory visualizations of the curious St. Andrew's Cross internal wave pattern, there has been a resurgence of interest in internal waves, inspired by their pivotal roles in local environmental and global climate processes, and their profound impact on ocean and aerospace engineering. We detail our widespread pursuit of internal waves through theoretical modeling, laboratory experiments and field studies, from the Pacific Ocean one thousand miles north and south of Hawaii, to the South China Sea, and on to the Arctic Ocean. We also describe our recent expedition to surf the most striking internal wave phenomenon of them all: the Morning Glory cloud in remote Northwest Australia. This work was supported by the National Science Foundation through a CAREER Grant OCE-064559 and through Grants OCE-1129757 and OCE-1357434, and by the Office of Naval Research through Grants N00014-09-1-0282, N00014-08-1-0390 and N00014-05-1-0575.

Light Stable Isotopic Compositions of Enriched Mantle Sources: Resolving the Dehydration Paradox

NASA Astrophysics Data System (ADS)

Dixon, J. E.; Bindeman, I. N.; Kingsley, R. H.

2017-12-01

An outstanding puzzle in mantle geochemistry has been the origin and evolution of Earth's volatile components. The "dehydration paradox" refers to the following conundrum. Mantle compositions for some enriched mid-ocean ridge (MORB) and ocean island (OIB) basalts basalts require involvement of a mostly dehydrated slab component to explain the trace element ratios and radiogenic isotopic compositions, but a fully hydrated slab component to explain the stable isotopic compositions. Volatile and stable isotopic data on enriched MORB show a diversity of enriched components. Pacific PREMA-type basalts (H2O/Ce = 215 ± 30, δDSMOW = -45 ± 5 ‰) are similar to those in the north Atlantic (H2O/Ce = 220 ± 30; δDSMOW = -30 to -40 ‰). Basalts with EM-type signatures have regionally variable volatile compositions. North Atlantic EM-type basalts are wetter (H2O/Ce = 330 ± 30) and have isotopically heavier hydrogen (δDSMOW = -57 ± 5 ‰) than north Atlantic MORB. South Atlantic EM-type basalts are damp (H2O/Ce = 120 ± 10) with intermediate δDSMOW (-68 ± 2 ‰), similar to dDSMOW for Pacific MORB. North EPR EM-type basalts are dry (H2O/Ce = 110 ± 20) and isotopically light (δDSMOW = -94 ± 3 ‰). Boron and lithium isotopic ratios parallel the trends observed for dDSMOW. A multi-stage metasomatic and melting model accounts for the origin of the enriched components by extending the subduction factory concept down through the mantle transition zone, with slab temperature a key variable. The dehydration paradox is resolved by decoupling of volatiles from lithophile elements, reflecting primary dehydration of the slab followed by secondary rehydration and re-equilibration by fluids derived from subcrustal hydrous phases (e.g., antigorite) in cooler, deeper parts of the slab. The "expanded subduction factory" model includes melting at several key depths, including 1) 180 to 280 km, where EM-type mantle compositions are generated above slabs with average to hot thermal profiles by addition of <1% carbonated sediment-derived supercritical fluids/melts to depleted asthenospheric or subcontinental lithospheric mantle, and 2) 410 to 660 km, where PREMA-type mantle sources are generated, above slabs with average to cool thermal profiles, by addition of <1% carbonated eclogite ± sediment-derived supercritical fluids to depleted mantle.

Evidence for shallow dehydration of the subducting plate beneath the Mariana forearc: New insights into the water cycle at subduction zones

NASA Astrophysics Data System (ADS)

Ribeiro, J.; Stern, R. J.; Kelley, K. A.; Shaw, A. M.; Martinez, F.; Ohara, Y.

2014-12-01

Water is efficiently recycled at subduction zones. It is fluxed from the surface into the mantle by the subducted plate and back to the surface or crust through explosive arc volcanism and degassing. Fluids released from dehydrating the subducting plate are transfer agents of water. Geophysical modeling [1] and the geochemistry of arc glasses [2] suggest that at cold-slab subduction zones, such as the Mariana convergent margin, the downgoing plate mostly dehydrates beneath the volcanic arc front (≥ ~ 80 -100 km depth to slab) to trigger volcanism. However, there is a gap in our understanding of the water fluxes released beneath forearcs, as examples of forearc magmatism are extremely rare. Here, we investigate the Southernmost Mariana Forearc Rift (SEMFR), where MORB-like spreading occurred unusually close to the trench, sampling slab-derived aqueous fluids released at ~ 30 to 100 km depth from the subducted plate. Examining the trace element and water contents of olivine-hosted melt inclusions and glassy rinds from the young (2 - 4 Ma) and fresh SEMFR pillowed basalts provide new insights into the global water cycle. SEMFR lavas contain ~2 wt % H2O, and the olivine-hosted melt inclusions have the highest subduction-related H2O/Ce ratios (H2O/Ce = 6000 - 19000) ever recorded in arc magmas (H2O/Ce < 10600 and global averaged H2O/Ce < 3000). Our findings show that (i) slab-derived fluids released beneath forearcs are water-rich compared to the deeper fluids released beneath the arc system; and (ii) cold downgoing plates lose most of their water at shallow depths (~ 70 - 80 km slab depth), suggesting that water is efficiently recycled beneath the forearc (≥ 90%). 1. Van Keken, P.E., et al., Subduction factory: 4. Depth-dependent flux of H2O from subducting slabs worldwide. Journal of Geophysical Research: Solid Earth, 2011. 116(B1): p. B01401, DOI: 10.1029/2010jb007922. 2. Ruscitto, D.M., et al., Global variations in H2O/Ce: 2. Relationships to arc magma geochemistry and volatile fluxes. Geochemistry Geophysics Geosystems, 2012. 13(3): p. Q03025, DOI: 10.1029/2011gc003887.

Elasticity mapping of tissue mimicking phantoms by remote palpation with a focused ultrasound beam and intensity autocorrelation measurements

NASA Astrophysics Data System (ADS)

Usha Devi, C.; Bharat Chandran, R. S.; Vasu, R. M.; Sood, A. K.

2007-05-01

We use a focused ultrasound beam to load a region of interest (ROI) in a tissue-mimicking phantom and read out the vibration amplitude of phantom particles from the modulation depth in the intensity autocorrelation of a coherent light beam that intercepted the ROI. The modulation depth, which is also affected by the local light absorption coefficient, which is employed in ultrasound assisted optical tomography, to read out absorption coefficient is greatly influenced by the vibration amplitude, depends to a great extend on local elasticity. We scan a plane in an elastography phantom with an inhomogeneous inclusion, in elasticity with the focused ultrasound and from the measured modulation depth variation create a qualitative map of the elasticity variation in the interrogated plane.

Ultrasound elastography in the early diagnosis of plantar fasciitis.

PubMed

Lee, So-Yeon; Park, Hee Jin; Kwag, Hyon Joo; Hong, Hyun-Pyo; Park, Hae-Won; Lee, Yong-Rae; Yoon, Kyung Jae; Lee, Yong-Taek

2014-01-01

The purpose of this study was to investigate whether ultrasound (US) elastography is useful for the early diagnosis of plantar fasciitis. We retrospectively reviewed US elastography findings of 18 feet with a clinical history and physical examination highly suggestive of plantar fasciitis but with normal findings on conventional US imaging as well as 18 asymptomatic feet. Softening of the plantar fascia was significantly greater in the patient than in the control group [Reviewers 1 and 2: 89% (16/18) vs. 50% (9/18), P=.027, respectively]. US elastography is useful for the early diagnosis of plantar fasciitis. Copyright © 2014 Elsevier Inc. All rights reserved.

Two-dimensional Shear Wave Elastography on Conventional Ultrasound Scanners with Time Aligned Sequential Tracking (TAST) and Comb-push Ultrasound Shear Elastography (CUSE)

PubMed Central

Song, Pengfei; Macdonald, Michael C.; Behler, Russell H.; Lanning, Justin D.; Wang, Michael H.; Urban, Matthew W.; Manduca, Armando; Zhao, Heng; Callstrom, Matthew R.; Alizad, Azra; Greenleaf, James F.; Chen, Shigao

2014-01-01

Two-dimensional (2D) shear wave elastography presents 2D quantitative shear elasticity maps of tissue, which are clinically useful for both focal lesion detection and diffuse disease diagnosis. Realization of 2D shear wave elastography on conventional ultrasound scanners, however, is challenging due to the low tracking pulse-repetition-frequency (PRF) of these systems. While some clinical and research platforms support software beamforming and plane wave imaging with high PRF, the majority of current clinical ultrasound systems do not have the software beamforming capability, which presents a critical challenge for translating the 2D shear wave elastography technique from laboratory to clinical scanners. To address this challenge, this paper presents a Time Aligned Sequential Tracking (TAST) method for shear wave tracking on conventional ultrasound scanners. TAST takes advantage of the parallel beamforming capability of conventional systems and realizes high PRF shear wave tracking by sequentially firing tracking vectors and aligning shear wave data in the temporal direction. The Comb-push Ultrasound Shear Elastography (CUSE) technique was used to simultaneously produce multiple shear wave sources within the field-of-view (FOV) to enhance shear wave signal-to-noise-ratio (SNR) and facilitate robust reconstructions of 2D elasticity maps. TAST and CUSE were realized on a conventional ultrasound scanner (the General Electric LOGIQ E9). A phantom study showed that the shear wave speed measurements from the LOGIQ E9 were in good agreement to the values measured from other 2D shear wave imaging technologies. An inclusion phantom study showed that the LOGIQ E9 had comparable performance to the Aixplorer (Supersonic Imagine) in terms of bias and precision in measuring different sized inclusions. Finally, in vivo case analysis of a breast with a malignant mass, and a liver from a healthy subject demonstrated the feasibility of using the LOGIQ E9 for in vivo 2D shear wave elastography. These promising results indicate that the proposed technique can enable the implementation of 2D shear wave elastography on conventional ultrasound scanners and potentially facilitate wider clinical applications with shear wave elastography. PMID:25643079

Transient and 2-Dimensional Shear-Wave Elastography Provide Comparable Assessment of Alcoholic Liver Fibrosis and Cirrhosis.

PubMed

Thiele, Maja; Detlefsen, Sönke; Sevelsted Møller, Linda; Madsen, Bjørn Stæhr; Fuglsang Hansen, Janne; Fialla, Annette Dam; Trebicka, Jonel; Krag, Aleksander

2016-01-01

Alcohol abuse causes half of all deaths from cirrhosis in the West, but few tools are available for noninvasive diagnosis of alcoholic liver disease. We evaluated 2 elastography techniques for diagnosis of alcoholic fibrosis and cirrhosis; liver biopsy with Ishak score and collagen-proportionate area were used as reference. We performed a prospective study of 199 consecutive patients with ongoing or prior alcohol abuse, but without known liver disease. One group of patients had a high pretest probability of cirrhosis because they were identified at hospital liver clinics (in Southern Denmark). The second, lower-risk group, was recruited from municipal alcohol rehabilitation centers and the Danish national public health portal. All subjects underwent same-day transient elastography (FibroScan), 2-dimensional shear wave elastography (Supersonic Aixplorer), and liver biopsy after an overnight fast. Transient elastography and 2-dimensional shear wave elastography identified subjects in each group with significant fibrosis (Ishak score ≥3) and cirrhosis (Ishak score ≥5) with high accuracy (area under the curve ≥0.92). There was no difference in diagnostic accuracy between techniques. The cutoff values for optimal identification of significant fibrosis by transient elastography and 2-dimensional shear wave elastography were 9.6 kPa and 10.2 kPa, and for cirrhosis 19.7 kPa and 16.4 kPa. Negative predictive values were high for both groups, but the positive predictive value for cirrhosis was >66% in the high-risk group vs approximately 50% in the low-risk group. Evidence of alcohol-induced damage to cholangiocytes, but not ongoing alcohol abuse, affected liver stiffness. The collagen-proportionate area correlated with Ishak grades and accurately identified individuals with significant fibrosis and cirrhosis. In a prospective study of individuals at risk for liver fibrosis due to alcohol consumption, we found elastography to be an excellent tool for diagnosing liver fibrosis and for excluding (ruling out rather than ruling in) cirrhosis. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Model-based optical coherence elastography using acoustic radiation force

NASA Astrophysics Data System (ADS)

Aglyamov, Salavat; Wang, Shang; Karpiouk, Andrei; Li, Jiasong; Emelianov, Stanislav; Larin, Kirill V.

2014-02-01

Acoustic Radiation Force (ARF) stimulation is actively used in ultrasound elastography to estimate mechanical properties of tissue. Compared with ultrasound imaging, OCT provides advantage in both spatial resolution and signal-to-noise ratio. Therefore, a combination of ARF and OCT technologies can provide a unique opportunity to measure viscoelastic properties of tissue, especially when the use of high intensity radiation pressure is limited for safety reasons. In this presentation we discuss a newly developed theoretical model of the deformation of a layered viscoelastic medium in response to an acoustic radiation force of short duration. An acoustic impulse was considered as an axisymmetric force generated on the upper surface of the medium. An analytical solution of this problem was obtained using the Hankel transform in frequency domain. It was demonstrated that layers at different depths introduce different frequency responses. To verify the developed model, experiments were performed using tissue-simulating, inhomogeneous phantoms of varying mechanical properties. The Young's modulus of the phantoms was varied from 5 to 50 kPa. A single-element focused ultrasound transducer (3.5 MHz) was used to apply the radiation force with various durations on the surface of phantoms. Displacements on the phantom surface were measured using a phase-sensitive OCT at 25 kHz repetition frequency. The experimental results were in good agreement with the modeling results. Therefore, the proposed theoretical model can be used to reconstruct the mechanical properties of tissue based on ARF/OCT measurements.

Simultaneous MR elastography and diffusion acquisitions: diffusion-MRE (dMRE).

PubMed

Yin, Ziying; Magin, Richard L; Klatt, Dieter

2014-05-01

To present a new technique for concurrent MR elastography (MRE) and diffusion MRI: diffusion-MRE (dMRE). In dMRE, shear wave motion and MR signal decay due to diffusion are encoded into the phase and magnitude components of the MR signal by using a pair of bipolar gradients for both motion-sensitization and diffusion encoding. The pulse sequence timing is adjusted so that the bipolar gradients are sensitive to both coherent and incoherent intravoxel motions. The shape, number, and duration of the gradient lobes can be adjusted to provide flexibility and encoding efficiency. In this proof-of-concept study, dMRE was validated using a tissue phantom composed of a gel bead embedded in a hydrated mixture of agarose and gelatin. The apparent diffusion coefficient (ADC) and shear stiffness measured using dMRE were compared with results obtained from separate, conventional spin-echo (SE) diffusion and SE-MRE acquisitions. The averaged ADC values (n = 3) for selected ROIs in the beads were (1.75 ± 0.16) μm(2) /ms and (1.74 ± 0.16) μm(2) /ms for SE-diffusion and dMRE methods, respectively. The corresponding shear stiffness values in the beads were (2.45 ± 0.23) kPa and (2.42 ± 0.20) kPa. Simultaneous MRE and diffusion acquisition is feasible and can be implemented with no observable interference between the two methods. Copyright © 2014 Wiley Periodicals, Inc.

Sonographic Elastography of Mastitis.

PubMed

Sousaris, Nicholas; Barr, Richard G

2016-08-01

Sonographic elastography has been shown to be a useful imaging modality in characterizing breast lesions as benign or malignant. However, in preliminary research, mastitis has given false-positive findings on both strain and shear wave elastography. In this article, we review the findings in mastitis with and without abscess formation on both strain and shear wave elastography. The elastographic findings in all cases were suggestive of a malignancy according to published thresholds. In cases of mastitis with abscess formation, there is a characteristic appearance, with a central very soft area (abscess cavity) and a very stiff outer rim (edema and inflammation). This appearance should raise the suspicion of mastitis with abscess formation, since these findings are rare in breast cancers.

Analisys of pectoralis major tendon in weightlifting athletes using ultrasonography and elastography.

PubMed

Pochini, Alberto de Castro; Ferretti, Mario; Kawakami, Eduardo Felipe Kin Ito; Fernandes, Artur da Rocha Corrêa; Yamada, Andre Fukunishi; Oliveira, Gabriela Clemente de; Cohen, Moisés; Andreoli, Carlos Vicente; Ejnisman, Benno

2015-01-01

To evaluate tendinopathy of the pectoralis major muscle in weightlifting athletes using ultrasound and elastography. This study included 20 patients, 10 with rupture of the pectoralis major muscle and 10 control patients. We evaluated pectoralis major muscle contralateral tendon with ultrasonographic and elastography examinations. The ultrasonographic examinations were performed using a high-resolution B mode ultrasound device. The elastography evaluation was classified into three patterns: (A), if stiff (more than 50% area with blue staining); (B), if intermediate (more than 50% green); and (C), if softened (more than 50% red). Patients' mean age was 33±5.3 years. The presence of tendinous injury measured by ultrasound had a significant different (p=0.0055), because 80% of cases had tendinous injury versus 10% in the Control Group. No significant differences were seen between groups related with change in elastography (p=0.1409). Long-term bodybuilders had ultrasound image with more tendinous injury than those in Control Group. There was no statistical significance regarding change in tendon elasticity compared with Control Group.

Ultrasound-based elastography for the diagnosis of portal hypertension in cirrhotics

PubMed Central

Şirli, Roxana; Sporea, Ioan; Popescu, Alina; Dănilă, Mirela

2015-01-01

Progressive fibrosis is encountered in almost all chronic liver diseases. Its clinical signs are diagnostic in advanced cirrhosis, but compensated liver cirrhosis is harder to diagnose. Liver biopsy is still considered the reference method for staging the severity of fibrosis, but due to its drawbacks (inter and intra-observer variability, sampling errors, unequal distribution of fibrosis in the liver, and risk of complications and even death), non-invasive methods were developed to assess fibrosis (serologic and elastographic). Elastographic methods can be ultrasound-based or magnetic resonance imaging-based. All ultrasound-based elastographic methods are valuable for the early diagnosis of cirrhosis, especially transient elastography (TE) and acoustic radiation force impulse (ARFI) elastography, which have similar sensitivities and specificities, although ARFI has better feasibility. TE is a promising method for predicting portal hypertension in cirrhotic patients, but it cannot replace upper digestive endoscopy. The diagnostic accuracy of using ARFI in the liver to predict portal hypertension in cirrhotic patients is debatable, with controversial results in published studies. The accuracy of ARFI elastography may be significantly increased if spleen stiffness is assessed, either alone or in combination with liver stiffness and other parameters. Two-dimensional shear-wave elastography, the ElastPQ technique and strain elastography all need to be evaluated as predictors of portal hypertension. PMID:26556985

Effect of bone-soft tissue friction on ultrasound axial shear strain elastography

NASA Astrophysics Data System (ADS)

Tang, Songyuan; Chaudhry, Anuj; Kim, Namhee; Reddy, J. N.; Righetti, Raffaella

2017-08-01

Bone-soft tissue friction is an important factor affecting several musculoskeletal disorders, frictional syndromes and the ability of a bone fracture to heal. However, this parameter is difficult to determine using non-invasive imaging modalities, especially in clinical settings. Ultrasound axial shear strain elastography is a non-invasive imaging modality that has been used in the recent past to estimate the bonding between different tissue layers. As most elastography methods, axial shear strain elastography is primarily used in soft tissues. More recently, this technique has been proposed to assess the bone-soft tissue interface. In this paper, we investigate the effect of a variation in bone-soft tissue friction coefficient in the resulting axial shear strain elastograms. Finite element poroelastic models of bone specimens exhibiting different bone-soft tissue friction coefficients were created and mechanically analyzed. These models were then imported to an ultrasound elastography simulation module to assess the presence of axial shear strain patterns. In vitro experiments were performed to corroborate selected simulation results. The results of this study show that the normalized axial shear strain estimated at the bone-soft tissue interface is statistically correlated to the bone-soft tissue coefficient of friction. This information may prove useful to better interpret ultrasound elastography results obtained in bone-related applications and, possibly, monitor bone healing.

Considering Angle Selection When Using Ultrasound Electrode Displacement Elastography to Evaluate Radiofrequency Ablation of Tissues

PubMed Central

Li, Qiang; Chen, Pin-Yu; Wang, Chiao-Yin; Liu, Hao-Li; Teng, Jianfu

2014-01-01

Percutaneous radiofrequency ablation (RFA) is a minimally invasive treatment to thermally destroy tumors. Ultrasound-based electrode-displacement elastography is an emerging technique for evaluating the region of RFA-induced lesions. The angle between the imaging probe and the RFA electrode can influence electrode-displacement elastography when visualizing the ablation zone. We explored the angle effect on electrode-displacement elastography to measure the ablation zone. Phantoms embedded with meatballs were fabricated and then ablated using an RFA system to simulate RFA-induced lesions. For each phantom, a commercial ultrasound scanner with a 7.5 MHz linear probe was used to acquire raw image data at different angles, ranging from 30° to 90° at increments of 10°, to construct electrode-displacement images and facilitate comparisons with tissue section images. The results revealed that the ablation regions detected using electrode-displacement elastography were highly correlated with those from tissue section images when the angle was between 30° and 60°. However, the boundaries of lesions were difficult to distinguish, when the angle was larger than 60°. The experimental findings suggest that angle selection should be considered to achieve reliable electrode-displacement elastography to describe ablation zones. PMID:24971347

Effect of bone-soft tissue friction on ultrasound axial shear strain elastography.

PubMed

Tang, Songyuan; Chaudhry, Anuj; Kim, Namhee; Reddy, J N; Righetti, Raffaella

2017-07-12

Bone-soft tissue friction is an important factor affecting several musculoskeletal disorders, frictional syndromes and the ability of a bone fracture to heal. However, this parameter is difficult to determine using non-invasive imaging modalities, especially in clinical settings. Ultrasound axial shear strain elastography is a non-invasive imaging modality that has been used in the recent past to estimate the bonding between different tissue layers. As most elastography methods, axial shear strain elastography is primarily used in soft tissues. More recently, this technique has been proposed to assess the bone-soft tissue interface. In this paper, we investigate the effect of a variation in bone-soft tissue friction coefficient in the resulting axial shear strain elastograms. Finite element poroelastic models of bone specimens exhibiting different bone-soft tissue friction coefficients were created and mechanically analyzed. These models were then imported to an ultrasound elastography simulation module to assess the presence of axial shear strain patterns. In vitro experiments were performed to corroborate selected simulation results. The results of this study show that the normalized axial shear strain estimated at the bone-soft tissue interface is statistically correlated to the bone-soft tissue coefficient of friction. This information may prove useful to better interpret ultrasound elastography results obtained in bone-related applications and, possibly, monitor bone healing.

Elastography: current status, future prospects, and making it work for you.

PubMed

Garra, Brian S

2011-09-01

Elastography has emerged as a useful adjunct tool for ultrasound diagnosis. Elastograms are images of tissue stiffness and may be in color, grayscale, or a combination of the two. The first and most common application of elastography is for the diagnosis of breast lesions where studies have shown an area under the receiver operating characteristic curve of 0.88 to 0.95 for distinguishing cancer from benign lesions. The technique is also useful for the diagnosis of complex cysts, although different scanners may vary in how they display such lesions. Recent advances in elastography include quantification using strain ratios, acoustic radiation force impulse imaging, and shear wave velocity estimation. These are useful not only for characterizing focal masses but also for diagnosing diffuse organ diseases such as liver cirrhosis. Other near term potential applications for elastography include characterization of thyroid nodules and lymph node evaluation for metastatic disease. Prostate cancer detection is also a potential application, but obtaining high-quality elastograms may be difficult. This area is evolving. Other promising applications include atheromatous plaque and arterial wall evaluation, venous thrombus evaluation, graft rejection, and monitoring of tumor ablation therapy. When contemplating the acquisition of a system with elastography in this rapidly evolving field, a clear picture of the manufacturer's plans for future upgrades (including quantification) should be obtained.

System for robot-assisted real-time laparoscopic ultrasound elastography

NASA Astrophysics Data System (ADS)

Billings, Seth; Deshmukh, Nishikant; Kang, Hyun Jae; Taylor, Russell; Boctor, Emad M.

2012-02-01

Surgical robots provide many advantages for surgery, including minimal invasiveness, precise motion, high dexterity, and crisp stereovision. One limitation of current robotic procedures, compared to open surgery, is the loss of haptic information for such purposes as palpation, which can be very important in minimally invasive tumor resection. Numerous studies have reported the use of real-time ultrasound elastography, in conjunction with conventional B-mode ultrasound, to differentiate malignant from benign lesions. Several groups (including our own) have reported integration of ultrasound with the da Vinci robot, and ultrasound elastography is a very promising image guidance method for robotassisted procedures that will further enable the role of robots in interventions where precise knowledge of sub-surface anatomical features is crucial. We present a novel robot-assisted real-time ultrasound elastography system for minimally invasive robot-assisted interventions. Our system combines a da Vinci surgical robot with a non-clinical experimental software interface, a robotically articulated laparoscopic ultrasound probe, and our GPU-based elastography system. Elasticity and B-mode ultrasound images are displayed as picture-in-picture overlays in the da Vinci console. Our system minimizes dependence on human performance factors by incorporating computer-assisted motion control that automatically generates the tissue palpation required for elastography imaging, while leaving high-level control in the hands of the user. In addition to ensuring consistent strain imaging, the elastography assistance mode avoids the cognitive burden of tedious manual palpation. Preliminary tests of the system with an elasticity phantom demonstrate the ability to differentiate simulated lesions of varied stiffness and to clearly delineate lesion boundaries.

Endoscopic ultrasound elastography: Current status and future perspectives

PubMed Central

Cui, Xin-Wu; Chang, Jian-Min; Kan, Quan-Cheng; Chiorean, Liliana; Ignee, Andre; Dietrich, Christoph F

2015-01-01

Elastography is a new ultrasound modality that provides images and measurements related to tissue stiffness. Endoscopic ultrasound (EUS) has played an important role in the diagnosis and management of numerous abdominal and mediastinal diseases. Elastography by means of EUS examination can assess the elasticity of tumors in the proximity of the digestive tract that are hard to reach with conventional transcutaneous ultrasound probes, such as pancreatic masses and mediastinal or abdominal lymph nodes, thus improving the diagnostic yield of the procedure. Results from previous studies have promised benefits for EUS elastography in the differential diagnosis of lymph nodes, as well as for assessing masses with pancreatic or gastrointestinal (GI) tract locations. It is important to mention that EUS elastography is not considered a modality that can replace biopsy. However, it may be a useful adjunct, improving the accuracy of EUS-fine needle aspiration biopsy (EUS-FNAB) by selecting the most suspicious area to be targeted. Even more, it may be useful for guiding further clinical management when EUS-FNAB is negative or inconclusive. In the present paper we will discuss the current knowledge of EUS elastography, including the technical aspects, along with its applications in the differential diagnosis between benign and malignant solid pancreatic masses and lymph nodes, as well as its aid in the differentiation between normal pancreatic tissues and chronic pancreatitis. Moreover, the emergent indication and future perspectives are summarized, such as the benefit of EUS elastography in EUS-guided fine needle aspiration biopsy, and its uses for characterization of lesions in liver, biliary tract, adrenal glands and GI tract. PMID:26715804

[Real-time elastography in the diagnosis of prostate cancer: personal experience].

PubMed

Romagnoli, Andrea; Autieri, Gaspare; Centrella, Danilo; Gastaldi, Christian; Pedaci, Giuseppe; Rivolta, Lorenzo; Pozzi, Emilio; Anghileri, Alessio; Cerabino, Maurizio; Bianchi, Carlo Maria; Roggia, Alberto

2010-01-01

Prostate cancer is the most common cancer in men. In the future, a significant further increase in the incidence of prostate cancer is expected. The indication to perform a prostate biopsy is digital rectal examination suspicious for prostate cancer, total prostate specific antigen (PSA) value, free PSA/total PSA ratio, PSA density and PSA velocity, and an evidence of hypoechoic area at transrectal ultrasound scan. Unfortunately the specificity and sensibility are still poor. The aim of this retrospective study is to evaluate the specificity and sensibility of real time elastography versus ultrasound transrectal B-mode scan. We retrospectively evaluated 108 pts. having undergone TRUS-guided transrectal prostate biopsy (10 samples). The indication for biopsy is: digital rectal examination, total prostate specific antigen (PSA) value, PSA ratio, PSA density and PSA velocity suspicious for prostate cancer, and/or an evidence of hypoechoic area at transrectal ultrasound scan, and/or hard area at real-time elastography. The mean age of patients is 66.8 years, mean PSA 6.5 ng/mL, and mean ratio 16.5%. We compared the histopathological findings of needle prostate biopsies with the results of transrectal ultrasound and transrectal real-time elastography. 32/108 (29.6%) pts. were positive for prostate cancer (mean Gleason score 7.08), mean PSA 14 ng/mL and mean ratio 9.5%. Transrectal ultrasound scan shows a sensibility of 69% and specificity of 68%. Transrectal ultrasound scan shows a VPP of 51.4%. Transrectal ultrasound scan shows a VPN of 80.9%. Real-time elastography shows a sensibility of 56% and specificity of 85.7%. Real-time elastography shows a VPP of 60.1%. Real-time elastography shows a VPN of 83%. Elastography has a significantly higher specificity for the detection of prostate cancer than the conventionally used examinations including DRE and TRUS. It is a useful real-time diagnostic method because it is not invasive, and simultaneous evaluation is possible while performing TRUS.

Diagnostic performance of quantitative shear wave elastography in the evaluation of solid breast masses: determination of the most discriminatory parameter.

PubMed

Au, Frederick Wing-Fai; Ghai, Sandeep; Moshonov, Hadas; Kahn, Harriette; Brennan, Cressida; Dua, Hemi; Crystal, Pavel

2014-09-01

The purpose of this article is to assess the diagnostic performance of quantitative shear wave elastography in the evaluation of solid breast masses and to determine the most discriminatory parameter. B-mode ultrasound and shear wave elastography were performed before core biopsy of 123 masses in 112 women. The diagnostic performance of ultrasound and quantitative shear wave elastography parameters (mean elasticity, maximum elasticity, and elasticity ratio) were compared. The added effect of shear wave elastography on the performance of ultrasound was determined. The mean elasticity, maximum elasticity, and elasticity ratio were 24.8 kPa, 30.3 kPa, and 1.90, respectively, for 79 benign masses and 130.7 kPa, 154.9 kPa, and 11.52, respectively, for 44 malignant masses (p < 0.001). The optimal cutoff value for each parameter was determined to be 42.5 kPa, 46.7 kPa, and 3.56, respectively. The AUC of each shear wave elastography parameter was higher than that of ultrasound (p < 0.001); the AUC value for the elasticity ratio (0.943) was the highest. By adding shear wave elastography parameters to the evaluation of BI-RADS category 4a masses, about 90% of masses could be downgraded to BI-RADS category 3. The numbers of downgraded masses were 40 of 44 (91%) for mean elasticity, 39 of 44 (89%) for maximum elasticity, and 42 of 44 (95%) for elasticity ratio. The numbers of correctly downgraded masses were 39 of 40 (98%) for mean elasticity, 38 of 39 (97%) for maximum elasticity, and 41 of 42 (98%) for elasticity ratio. There was improvement in the diagnostic performance of ultrasound of mass assessment with shear wave elastography parameters added to BI-RADS category 4a masses compared with ultrasound alone. Combined ultrasound and elasticity ratio had the highest improvement, from 35.44% to 87.34% for specificity, from 45.74% to 80.77% for positive predictive value, and from 57.72% to 90.24% for accuracy (p < 0.0001). The AUC of combined ultrasound and elasticity ratio (0.914) was the highest compared with the other combined parameters. There was a statistically significant difference in the values of the quantitative shear wave elastography parameters of benign and malignant solid breast masses. By adding shear wave elastography parameters to BI-RADS category 4a masses, we found that about 90% of them could be correctly downgraded to BI-RADS category 3, thereby avoiding biopsy. Elasticity ratio (cutoff, 3.56) appeared to be the most discriminatory parameter.

Towards the Early Detection of Breast Cancer in Young Women

DTIC Science & Technology

2005-10-01

T. Shiina, and F. Tranquart. Progress in Freehand Elastography of the Breast . IEICE Transactions on Information and Systems, E85D (1):5–14, 2002. [3...Meaney, Naomi R. Miller, Tsuyoshi Shiina, and Francois Tranquart. Progress in freehand elastography of the breast . IEICE Transactions on Information...solution of the non-linear inverse elasticity problem 28 [26] Liew HL and Pinsky PM. Recovery of shear modulus in elastography using an adjoint method

[Clinical Application of Non-invasive Diagnostic Tests for Liver Fibrosis].

PubMed

Shin, Jung Woo; Park, Neung Hwa

2016-07-25

The diagnostic assessment of liver fibrosis is an important step in the management of patients with chronic liver diseases. Liver biopsy is considered the gold standard to assess necroinflammation and fibrosis. However, recent technical advances have introduced numerous serum biomarkers and imaging tools using elastography as noninvasive alternatives to biopsy. Serum markers can be direct or indirect markers of the fibrosis process. The elastography-based studies include transient elastography, acoustic radiation force imaging, supersonic shear wave imaging and magnetic resonance elastography. As accumulation of clinical data shows that noninvasive tests provide prognostic information of clinical relevance, non-invasive diagnostic tools have been incorporated into clinical guidelines and practice. Here, the authors review noninvasive tests for the diagnosis of liver fibrosis.

Carbon Cycle in South China Sea: Flux, Controls and Global Implications

NASA Astrophysics Data System (ADS)

Dai, M.; Cao, Z.; Yang, W.; Guo, X.; Yin, Z.; Gan, J.

2016-12-01

The contemporary coastal ocean is generally seen as a significant CO2 sink of 0.2-0.4 Pg C/yr at the global scale. However, mechanistic understanding of the coastal ocean carbon cycle remains limited, leading to the unanswered question of why some coastal systems are sources while others are sinks of atmospheric CO2. As the largest marginal sea of Northern Pacific, the South China Sea (SCS) is a mini-ocean with wide shelves in both its southern and northern parts. Its northern shelf, which receives significant land inputs from the Pearl River, a world major river, can be categorized as a River-Dominated Margin (RioMar) during peak discharges, and is characterized as a CO2 sink to the atmosphere. The SCS basin is identified as an Ocean-Dominated Margin (OceMar) and a CO2 source. OceMar is characterized by exchange with the open ocean via a two-dimensional (at least) process, i.e., the horizontal intrusion of open ocean water and subsequent vertical mixing and upwelling. Depending on the different ratios of dissolved inorganic carbon (DIC) and nutrients from the source waters into the continental margins, the relative consumption or removal bwtween DIC and nutrients, when being transported into the euphotic zones where biogeochemical processes take over, determines the CO2 fluxes. Thus, excess DIC relative to nutrients existing in the upper layer will lead to CO2 degassing. The CO2 fluxes in both RioMars and OceMars can be quantified using a semi-analytical diagnostic approach by coupling the physical dynamics and biogeochemical processes. We extended our mechanistic studies in the SCS to other OceMars including the Caribbean Sea, the Arabian Sea, and the upwelling system off the Oregon-California coast, and RioMars including the East China Sea and Amazon River plume to demonstrate the global implications of our SCS carbon studies.

Effects of oral versus transdermal menopausal hormone treatments on self-reported sleep domains and their association with vasomotor symptoms in recently menopausal women enrolled in the Kronos Early Estrogen Prevention Study (KEEPS).

PubMed

Cintron, Dahima; Lahr, Brian D; Bailey, Kent R; Santoro, Nanette; Lloyd, Robin; Manson, JoAnn E; Neal-Perry, Genevieve; Pal, Lubna; Taylor, Hugh S; Wharton, Whitney; Naftolin, Fredrick; Harman, S Mitchell; Miller, Virginia M

2018-02-01

This study determined whether two different formulations of hormone therapy (HT): oral conjugated equine estrogens (o-CEE; 0.45 mg/d, n = 209), transdermal 17β-estradiol (t-E2; 50 μg/d, n = 201) plus cyclic progesterone (Prometrium, 200 mg) or placebo (PBO, n = 243) affected sleep domains in participants of the Kronos Early Estrogen Prevention Study. Participants completed the Pittsburgh Sleep Quality Index at baseline and during the intervention at 6, 18, 36, and 48 months. Global sleep quality and individual sleep domain scores were compared between treatments using analysis of covariance, and correlated with vasomotor symptom (VMS) scores using Spearman correlation coefficients. Global Pittsburgh Sleep Quality Index scores (mean 6.3; 24% with score >8) were similar across groups at baseline and were reduced (improved sleep quality) by both HT (average change -1.27 [o-CEE] and -1.32 [t-E2]) when compared with PBO (-0.60; P = 0.001 [o-CEE vs PBO] and P = 0.002 [t-E2 vs PBO]). Domain scores for sleep satisfaction and latency improved with both HT. The domain score for sleep disturbances improved more with t-E2 than o-CEE or PBO. Global sleep scores significantly correlated with VMS severity (rs = 0.170, P < 0.001 for hot flashes; rs = 0.177, P < 0.001 for night sweats). Change in scores for all domains except sleep latency and sleep efficiency correlated with change in severity of VMS. Poor sleep quality is common in recently menopausal women. Sleep quality improved with both HT formulations. The relationship of VMS with domains of sleep suggests that assessing severity of symptoms and domains of sleep may help direct therapy to improve sleep for postmenopausal women.

Effects of oral versus transdermal menopausal hormone treatments on self-reported sleep domains and their association with vasomotor symptoms in recently menopausal women enrolled in the Kronos Early Estrogen Prevention Study (KEEPS)

PubMed Central

Cintron, Dahima; Lahr, Brian D.; Bailey, Kent R.; Santoro, Nanette; Lloyd, Robin; Manson, JoAnn E.; Neal-Perry, Genevieve; Pal, Lubna; Taylor, Hugh S.; Wharton, Whitney; Naftolin, Fredrick; Harman, S. Mitchell; Miller, Virginia M.

2018-01-01

Abstract Objective: This study determined whether two different formulations of hormone therapy (HT): oral conjugated equine estrogens (o-CEE; 0.45 mg/d, n = 209), transdermal 17β-estradiol (t-E2; 50 μg/d, n = 201) plus cyclic progesterone (Prometrium, 200 mg) or placebo (PBO, n = 243) affected sleep domains in participants of the Kronos Early Estrogen Prevention Study. Methods: Participants completed the Pittsburgh Sleep Quality Index at baseline and during the intervention at 6, 18, 36, and 48 months. Global sleep quality and individual sleep domain scores were compared between treatments using analysis of covariance, and correlated with vasomotor symptom (VMS) scores using Spearman correlation coefficients. Results: Global Pittsburgh Sleep Quality Index scores (mean 6.3; 24% with score >8) were similar across groups at baseline and were reduced (improved sleep quality) by both HT (average change −1.27 [o-CEE] and −1.32 [t-E2]) when compared with PBO (−0.60; P = 0.001 [o-CEE vs PBO] and P = 0.002 [t-E2 vs PBO]). Domain scores for sleep satisfaction and latency improved with both HT. The domain score for sleep disturbances improved more with t-E2 than o-CEE or PBO. Global sleep scores significantly correlated with VMS severity (rs = 0.170, P < 0.001 for hot flashes; rs = 0.177, P < 0.001 for night sweats). Change in scores for all domains except sleep latency and sleep efficiency correlated with change in severity of VMS. Conclusions: Poor sleep quality is common in recently menopausal women. Sleep quality improved with both HT formulations. The relationship of VMS with domains of sleep suggests that assessing severity of symptoms and domains of sleep may help direct therapy to improve sleep for postmenopausal women. PMID:28832429

Imaging of optically diffusive media by use of opto-elastography

NASA Astrophysics Data System (ADS)

Bossy, Emmanuel; Funke, Arik R.; Daoudi, Khalid; Tanter, Mickael; Fink, Mathias; Boccara, Claude

2007-02-01

We present a camera-based optical detection scheme designed to detect the transient motion created by the acoustic radiation force in elastic media. An optically diffusive tissue mimicking phantom was illuminated with coherent laser light, and a high speed camera (2 kHz frame rate) was used to acquire and cross-correlate consecutive speckle patterns. Time-resolved transient decorrelations of the optical speckle were measured as the results of localised motion induced in the medium by the radiation force and subsequent propagating shear waves. As opposed to classical acousto-optic techniques which are sensitive to vibrations induced by compressional waves at ultrasonic frequencies, the proposed technique is sensitive only to the low frequency transient motion induced in the medium by the radiation force. It therefore provides a way to assess both optical and shear mechanical properties.

Breast elastography: Identification of benign and malignant cancer based on absolute elastic modulus measurement using vibro-elastography

NASA Astrophysics Data System (ADS)

Arroyo, Junior; Saavedra, Ana Cecilia; Guerrero, Jorge; Montenegro, Pilar; Aguilar, Jorge; Pinto, Joseph A.; Lobo, Julio; Salcudean, Tim; Lavarello, Roberto; Castañeda, Benjamín.

2018-03-01

Breast cancer is a public health problem with 1.7 million new cases per year worldwide and with several limitations in the state-of-art screening techniques. Ultrasound elastography involves a set of techniques intended to facilitate the noninvasive diagnosis of cancer. Among these, Vibro-elastography is an ultrasound-based technique that employs external mechanical excitation to infer the elastic properties of soft tissue. In this paper, we evaluate the Vibro-elastography performance in the differentiation of benign and malignant breast lesions. For this study, a group of 18 women with clinically confirmed tumors or suspected malignant breast lesions were invited to participate. For each volunteer, an elastogram was obtained, and the mean elasticity of the lesion and the adjacent healthy tissue were calculated. After the acquisition, the volunteers underwent core-needle biopsy. The histopathological results allowed to validate the Vibro-elastography diagnosis, which ranged from benign to malignant lesions. Results indicate that the mean elasticity value of the benign lesions, malignant lesions and healthy breast tissue were 39.4 +/- 12 KPa, 55.4 +/- 7.02 KPa and 23.91 +/- 4.57 kPa, respectively. The classification between benign and malignant breast cancer was performed using Support Vector Machine based on the measured lesion stiffness. A ROC curve permitted to quantify the accuracy of the differentiation and to define a suitable cutoff value of stiffness, obtaining an AUC of 0.90 and a cutoff value of 44.75 KPa. The results obtained suggest that Vibro-elastography allows differentiating between benign and malignant lesions. Furthermore, the elasticity values obtained for benign, malignant and healthy tissue are consistent with previous reports.

The influence of aminotransferase levels on liver stiffness assessed by Acoustic Radiation Force Impulse Elastography: a retrospective multicentre study.

PubMed

Bota, Simona; Sporea, Ioan; Peck-Radosavljevic, Markus; Sirli, Roxana; Tanaka, Hironori; Iijima, Hiroko; Saito, Hidetsugu; Ebinuma, Hirotoshi; Lupsor, Monica; Badea, Radu; Fierbinteanu-Braticevici, Carmen; Petrisor, Ana; Friedrich-Rust, Mireen; Sarrazin, Christoph; Takahashi, Hirokazu; Ono, Naofumi; Piscaglia, Fabio; Marinelli, Sara; D'Onofrio, Mirko; Gallotti, Anna; Salzl, Petra; Popescu, Alina; Danila, Mirela

2013-09-01

Acoustic Radiation Force Impulse Elastography is a new method for non-invasive evaluation of liver fibrosis. To evaluate the impact of elevated alanine aminotransferase levels on liver stiffness assessment by Acoustic Radiation Force Impulse Elastography. A multicentre retrospective study including 1242 patients with chronic liver disease, who underwent liver biopsy and Acoustic Radiation Force Impulse. Transient Elastography was also performed in 512 patients. The best Acoustic Radiation Force Impulse cut-off for predicting significant fibrosis was 1.29 m/s in cases with normal alanine aminotransferase levels and 1.44 m/s in patients with alanine aminotransferase levels>5 × the upper limit of normal. The best cut-off for predicting liver cirrhosis were 1.59 and 1.75 m/s, respectively. Acoustic Radiation Force Impulse cut-off for predicting significant fibrosis and cirrhosis were relatively similar in patients with normal alanine aminotransferase and in those with alanine aminotransferase levels between 1.1 and 5 × the upper limit of normal: 1.29 m/s vs. 1.36 m/s and 1.59 m/s vs. 1.57 m/s, respectively. For predicting cirrhosis, the Transient Elastography cut-offs were significantly higher in patients with alanine aminotransferase levels between 1.1 and 5 × the upper limit of normal compared to those with normal alanine aminotransferase: 12.3 kPa vs. 9.1 kPa. Liver stiffness values assessed by Acoustic Radiation Force Impulse and Transient Elastography are influenced by high aminotransferase levels. Transient Elastography was also influenced by moderately elevated aminotransferase levels. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Establishing ultrasound based transient elastography cutoffs for different stages of hepatic fibrosis and cirrhosis in Egyptian chronic hepatitis C patients.

PubMed

Elsharkawy, Aisha; Alboraie, Mohamed; Fouad, Rabab; Asem, Noha; Abdo, Mahmoud; Elmakhzangy, Hesham; Mehrez, Mai; Khattab, Hany; Esmat, Gamal

2017-12-01

Transient elastography is widely used to assess fibrosis stage in chronic hepatitis C (CHC). We aimed to establish and validate different transient elastography cut-off values for significant fibrosis and cirrhosis in CHC genotype 4 patients. The data of 100 treatment-naive CHC patients (training set) and 652 patients (validation set) were analysed. The patients were subjected to routine pretreatment laboratory investigations, liver biopsy and histopathological staging of hepatic fibrosis according to the METAVIR scoring system. Transient elastography was performed before and in the same week as liver biopsy using FibroScan (Echosens, Paris, France). Transient elastography results were correlated to different stages of hepatic fibrosis in both the training and validation sets. ROC curves were constructed. In the training set, the best transient elastography cut-off values for significant hepatic fibrosis (≥F2 METAVIR), advanced hepatic fibrosis (≥F3 METAVIR) and cirrhosis (F4 METAVIR) were 7.1, 9 and 12.2 kPa, with sensitivities of 87%, 87.5% and 90.9% and specificities of 100%, 99.9% and 99.9%, respectively. The application of these cut-offs in the validation set showed sensitivities of 85.5%, 82.8% and 92% and specificities of 86%, 89.4% and 99.01% for significant hepatic fibrosis, advanced hepatic fibrosis and cirrhosis, respectively. Transient elastography performs well for significant hepatic fibrosis, advanced hepatic fibrosis and cirrhosis, with validated cut-offs of 7.1, 9 and 12.2 kPa, respectively, in genotype 4 CHC patients. Copyright © 2017 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.

Efficacy of an artificial neural network-based approach to endoscopic ultrasound elastography in diagnosis of focal pancreatic masses.

PubMed

Săftoiu, Adrian; Vilmann, Peter; Gorunescu, Florin; Janssen, Jan; Hocke, Michael; Larsen, Michael; Iglesias-Garcia, Julio; Arcidiacono, Paolo; Will, Uwe; Giovannini, Marc; Dietrich, Cristoph F; Havre, Roald; Gheorghe, Cristian; McKay, Colin; Gheonea, Dan Ionuţ; Ciurea, Tudorel

2012-01-01

By using strain assessment, real-time endoscopic ultrasound (EUS) elastography provides additional information about a lesion's characteristics in the pancreas. We assessed the accuracy of real-time EUS elastography in focal pancreatic lesions using computer-aided diagnosis by artificial neural network analysis. We performed a prospective, blinded, multicentric study at of 258 patients (774 recordings from EUS elastography) who were diagnosed with chronic pancreatitis (n = 47) or pancreatic adenocarcinoma (n = 211) from 13 tertiary academic medical centers in Europe (the European EUS Elastography Multicentric Study Group). We used postprocessing software analysis to compute individual frames of elastography movies recorded by retrieving hue histogram data from a dynamic sequence of EUS elastography into a numeric matrix. The data then were analyzed in an extended neural network analysis, to automatically differentiate benign from malignant patterns. The neural computing approach had 91.14% training accuracy (95% confidence interval [CI], 89.87%-92.42%) and 84.27% testing accuracy (95% CI, 83.09%-85.44%). These results were obtained using the 10-fold cross-validation technique. The statistical analysis of the classification process showed a sensitivity of 87.59%, a specificity of 82.94%, a positive predictive value of 96.25%, and a negative predictive value of 57.22%. Moreover, the corresponding area under the receiver operating characteristic curve was 0.94 (95% CI, 0.91%-0.97%), which was significantly higher than the values obtained by simple mean hue histogram analysis, for which the area under the receiver operating characteristic was 0.85. Use of the artificial intelligence methodology via artificial neural networks supports the medical decision process, providing fast and accurate diagnoses. Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.

The potential role of elastography in differentiating between endometrial polyps and submucosal fibroids: a preliminary study

PubMed Central

2015-01-01

Endometrial polyps and submucosal fibroids are common causes of abnormal uterine bleeding (AUB) and less commonly infertility. The prevalence of such intrauterine lesions increases with age during the reproductive years, and usually decreases after menopause. The first-line imaging examination in the diagnosis of endometrial polyps as well as submucosal fibroidsis ultrasound, but its accuracy is not obvious. Elastography is an ultrasound-based imaging modality that is used to assess the stiffness of examined tissues. Considering the fact that endometrial polyps derive from soft endometrial tissue and submucosal fibroids are made of hard muscle tissue, elastography seems a perfect tool to differentiate between such lesions. I present two groups of patients with AUB and intrauterine lesions suspected on ultrasound. In the first group of patients, elastography showed that the stiffness of the lesion was similar to the endometrium and softer than the myometrium. During hysteroscopies endometrial polyps were removed. In the second group of patients, elastography showed that the stiffness of the lesion was similar to the myometrium and harder than the endometrium. During hysteroscopies submucosal fibroids were removed. In both groups, the diagnosis was confirmed by the pathological examination in all cases. It was demonstrated that with the use of elastography it is possible to assess the stiffness of intrauterine lesions, which may be useful in differentiating between endometrial polyps and submucosal fibroids. PMID:26327901

The potential role of elastography in differentiating between endometrial polyps and submucosal fibroids: a preliminary study.

PubMed

Woźniak, Sławomir

2015-06-01

Endometrial polyps and submucosal fibroids are common causes of abnormal uterine bleeding (AUB) and less commonly infertility. The prevalence of such intrauterine lesions increases with age during the reproductive years, and usually decreases after menopause. The first-line imaging examination in the diagnosis of endometrial polyps as well as submucosal fibroidsis ultrasound, but its accuracy is not obvious. Elastography is an ultrasound-based imaging modality that is used to assess the stiffness of examined tissues. Considering the fact that endometrial polyps derive from soft endometrial tissue and submucosal fibroids are made of hard muscle tissue, elastography seems a perfect tool to differentiate between such lesions. I present two groups of patients with AUB and intrauterine lesions suspected on ultrasound. In the first group of patients, elastography showed that the stiffness of the lesion was similar to the endometrium and softer than the myometrium. During hysteroscopies endometrial polyps were removed. In the second group of patients, elastography showed that the stiffness of the lesion was similar to the myometrium and harder than the endometrium. During hysteroscopies submucosal fibroids were removed. In both groups, the diagnosis was confirmed by the pathological examination in all cases. It was demonstrated that with the use of elastography it is possible to assess the stiffness of intrauterine lesions, which may be useful in differentiating between endometrial polyps and submucosal fibroids.

Repeatability of shear wave elastography in liver fibrosis phantoms—Evaluation of five different systems

PubMed Central

2018-01-01

This study aimed to assess and validate the repeatability and agreement of quantitative elastography of novel shear wave methods on four individual tissue-mimicking liver fibrosis phantoms with different known Young’s modulus. We used GE Logiq E9 2D-SWE, Philips iU22 ARFI (pSWE), Samsung TS80A SWE (pSWE), Hitachi Ascendus (SWM) and Transient Elastography (TE). Two individual investigators performed all measurements non-continued and in parallel. The methods were evaluated for inter- and intraobserver variability by intraclass correlation, coefficient of variation and limits of agreement using the median elastography value. All systems used in this study provided high repeatability in quantitative measurements in a liver fibrosis phantom and excellent inter- and intraclass correlations. All four elastography platforms showed excellent intra-and interobserver agreement (interclass correlation 0.981–1.000 and intraclass correlation 0.987–1.000) and no significant difference in mean elasticity measurements for all systems, except for TE on phantom 4. All four liver fibrosis phantoms could be differentiated by quantitative elastography, by all platforms (p<0.001). In the Bland-Altman analysis the differences in measurements were larger for the phantoms with higher Young’s modulus. All platforms had a coefficient of variation in the range 0.00–0.21 for all four phantoms, equivalent to low variance and high repeatability. PMID:29293527

[Differential diagnostic value of real-time tissue elastography and three dimensional ultrasound imaging in breast lumps].

PubMed

Li, M H; Liu, Y; Liu, L S; Li, P X; Chen, Q

2016-05-24

To investigate the real-time tissue elastography and 3D contrast-enhanced ultrasonography(CEUS) in breast lumps differential diagnostic value. A total of 126 patients (180 lumps) with breast mass were retrospectively analyzed from December 2012 to December 2014 in Tumor Hospital Affiliated To Xinjiang Medical University.All patients were divided into three groups by using stratified random method.Each group was detected by real-time tissue elastography, 3D CEUS and two joint inspection.Each group of 42 cases (60 lumps) was confirmed by the pathological results as gold standard.Diagnostic sensitivity, specificity and coincidence rate of different methods were compared. The benign masses of ultrasound contrast showed the punctate, linear and nodular enhancement, and the border of enhancement was smooth.The malignant tumors were mainly dominated by uneven and high enhancement. There was no statistical difference in sensitivity, specificity and coincidence rate between elastography group and 3D CEUS group (64.7% vs 73.5%, 69.2% vs 76.9%, 66.7% vs 75.0%, all P>0.05). The sensitivity, specificity and coincidence rate of two joint inspection group were higher than those of elastography group and 3D CEUS group, the differences were statistically significant (97.1%, 92.3% and 98.3% , all P<0.05). 3D CEUS combined with real-time tissue elastography is of high value in the diagnosis of breast masses.

Tissue elasticity of in vivo skeletal muscles measured in the transverse and longitudinal planes using shear wave elastography.

PubMed

Chino, Kentaro; Kawakami, Yasuo; Takahashi, Hideyuki

2017-07-01

The aim of the present study was to measure in vivo skeletal muscle elasticity in the transverse and longitudinal planes using shear wave elastography and then to compare the image stability, measurement values and measurement repeatability between these imaging planes. Thirty-one healthy males participated in this study. Tissue elasticity (shear wave velocity) of the medial gastrocnemius, rectus femoris, biceps brachii and rectus abdominis was measured in both the transverse and longitudinal planes using shear wave elastography. Image stability was evaluated by the standard deviation of the colour distribution in the shear wave elastography image. Measurement repeatability was assessed by the coefficient of variance obtained from three measurement values. Image stability of all tested muscles was significantly higher in the longitudinal plane (P<0·001), but measurement repeatability did not differ significantly between the imaging planes (P>0·05), except in the biceps brachii (P = 0·001). Measurement values of the medial gastrocnemius, rectus femoris and biceps brachii were significantly different between the imaging planes (P<0·001). Image stability and measurement values of shear wave elastography images varied with imaging plane, which indicates that imaging plane should be considered when measuring skeletal muscle tissue elasticity by shear wave elastography. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Ultrasound Elastography: The New Frontier in Direct Measurement of Muscle Stiffness

PubMed Central

Brandenburg, Joline E.; Eby, Sarah F.; Song, Pengfei; Zhao, Heng; Brault, Jeffrey S.; Chen, Shigao; An, Kai-Nan

2014-01-01

The use of brightness-mode ultrasound and Doppler ultrasound in physical medicine and rehabilitation has increased dramatically. The continuing evolution of ultrasound technology has also produced ultrasound elastography, a cutting-edge technology that can directly measure the mechanical properties of tissue, including muscle stiffness. Its real-time and direct measurements of muscle stiffness can aid the diagnosis and rehabilitation of acute musculoskeletal injuries and chronic myofascial pain. It can also help monitor outcomes of interventions affecting muscle in neuromuscular and musculoskeletal diseases, and it can better inform the functional prognosis. This technology has implications for even broader use of ultrasound in physical medicine and rehabilitation practice, but more knowledge about its uses and limitations is essential to its appropriate clinical implementation. In this review, we describe different ultrasound elastography techniques for studying muscle stiffness, including strain elastography, acoustic radiation force impulse imaging, and shear-wave elastography. We discuss the basic principles of these techniques, including the strengths and limitations of their measurement capabilities. We review the current muscle research, discuss physiatric clinical applications of these techniques, and note directions for future research. PMID:25064780

Analisys of pectoralis major tendon in weightlifting athletes using ultrasonography and elastography

PubMed Central

Pochini, Alberto de Castro; Ferretti, Mario; Kawakami, Eduardo Felipe Kin Ito; Fernandes, Artur da Rocha Corrêa; Yamada, Andre Fukunishi; de Oliveira, Gabriela Clemente; Cohen, Moisés; Andreoli, Carlos Vicente; Ejnisman, Benno

2015-01-01

ABSTRACT Objective To evaluate tendinopathy of the pectoralis major muscle in weightlifting athletes using ultrasound and elastography. Methods This study included 20 patients, 10 with rupture of the pectoralis major muscle and 10 control patients. We evaluated pectoralis major muscle contralateral tendon with ultrasonographic and elastography examinations. The ultrasonographic examinations were performed using a high-resolution B mode ultrasound device. The elastography evaluation was classified into three patterns: (A), if stiff (more than 50% area with blue staining); (B), if intermediate (more than 50% green); and (C), if softened (more than 50% red). Results Patients’ mean age was 33±5.3 years. The presence of tendinous injury measured by ultrasound had a significant different (p=0.0055), because 80% of cases had tendinous injury versus 10% in the Control Group. No significant differences were seen between groups related with change in elastography (p=0.1409). Conclusion Long-term bodybuilders had ultrasound image with more tendinous injury than those in Control Group. There was no statistical significance regarding change in tendon elasticity compared with Control Group. PMID:26761551

Ultrasound Elastography: Review of Techniques and Clinical Applications

PubMed Central

Sigrist, Rosa M.S.; Liau, Joy; Kaffas, Ahmed El; Chammas, Maria Cristina; Willmann, Juergen K.

2017-01-01

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. PMID:28435467

The role of ultrasound elastographic techniques in chronic liver disease: current status and future perspectives.

PubMed

Piscaglia, Fabio; Marinelli, Sara; Bota, Simona; Serra, Carla; Venerandi, Laura; Leoni, Simona; Salvatore, Veronica

2014-03-01

This review illustrates the state of the art clinical applications and the future perspectives of ultrasound elastographic methods for the evaluation of chronic liver diseases, including the most widely used and validated technique, transient elastography, followed by shear wave elastography and strain imaging elastography. Liver ultrasound elastography allows the non-invasive evaluation of liver stiffness, providing information regarding the stage of fibrosis, comparable to liver biopsy which is still considered the gold standard; in this way, it can help physicians in managing patients, including the decision as to when to start antiviral treatment. The characterization of focal liver lesions and the prognostic role of the elastographic technique in the prediction of complications of cirrhosis are still under investigation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

33 CFR 236.2 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... WATER RESOURCE POLICIES AND AUTHORITIES: CORPS OF ENGINEERS PARTICIPATION IN IMPROVEMENTS FOR ENVIRONMENTAL QUALITY § 236.2 Applicability. This regulation is applicable to all OCE elements and field...

Reproducibility of shear wave elastography (SWE) in patients with chronic liver disease

PubMed Central

Salomone Megna, Angelo; Ragucci, Monica; De Luca, Massimo; Marino Marsilia, Giuseppina; Nardone, Gerardo; Coccoli, Pietro; Prinster, Anna; Mannelli, Lorenzo; Vergara, Emilia; Monti, Serena; Liuzzi, Raffaele; Incoronato, Mariarosaria

2017-01-01

The presence of significant fibrosis is an indicator for liver disease staging and prognosis. The aim of the study was to determine reproducibility of real-time shear wave elastography using a hepatic biopsy as the reference standard to identify patients with chronic liver disease. Forty patients with chronic liver disease and 12 normal subjects received shear wave elastography performed by skilled operators. Interoperator reproducibility was studied in 29 patients. Fibrosis was evaluated using the Metavir score. The median and range shear wave elastography values in chronic liver disease subjects were 6.15 kPa and 3.14–16.7 kPa and were 4.49 kPa and 2.92–7.32 kPa in normal subjects, respectively. With respect to fibrosis detected by liver biopsy, shear wave elastography did not change significantly between F0 and F1 (p = 0.334), F1 and F2 (p = 0.611), or F3 and F4 (0.327); a significant difference was observed between the F0-F2 and F3-F4 groups (p = 0.002). SWE also correlated with inflammatory activity (Rs = 0.443, p = 0.0023) and ALT levels (Rs = 0.287, p = 0.0804). Age, sex and body mass index did not affect shear wave elastography measurements. Using receiver operator characteristic curves, two threshold values for shear wave elastography were identified: 5.62 kPa for patients with fibrosis (≥F2; sensitivity 80%, specificity 69.4%, and accuracy 77%) and 7.04 kPa for patients with severe fibrosis (≥F3; sensitivity 88.9%, specificity 81%, and accuracy 89%). Overall interobserver agreement was excellent and was analysed using an interclass correlation coefficient (0.94; CI 0.87–0.97).This study shows that shear wave elastography executed by skilled operators can be performed on almost all chronic liver disease patients with high reproducibility. It is not influenced by age, sex or body mass index, identifies severely fibrotic patients and is also related to inflammatory activity. PMID:29023554

[Shear waves elastography of the placenta in pregnant baboon].

PubMed

Quarello, E; Lacoste, R; Mancini, J; Melot-Dusseau, S; Gorincour, G

2015-03-01

To evaluate tissue characteristics of the placenta by transabdominal ShearWave Elastography in pregnant baboon. For 9 months (03/2013-12/2013) two operators (EQ, GG) performed ultrasound of the placenta during pregnancy pregnant baboons station partner primatology project. The identification of the placenta was performed previously in 2D ultrasound. The elastography method was then activated. Three measurements were carried out by operator for each placenta. The intraclass correlation coefficients within and between observers were calculated for the objective assessment (elastography) of placental maturity. During the study period, 21 pregnant baboons were included and ultrasounds were performed between 1 and 3 times each. The measurements have been carried out by two operators in 100% of cases. The intra- and inter-observer ICC for single values are respectively 0.657 - 95% CI (0.548 to 0.752) and 0.458 - 95% CI (0.167 to 0.675). The intra- and inter-observer ICC for average values are respectively 0.852 - 95% CI (0.784 to 0.901) and 0.628 - 95% CI (0.286 to 0.806). The study by transabdominal ShearWave Elastography of placenta's pregnant baboons is possible. The intra- and inter-operator reproducibility of this method is good using the average of three measurements. The objective study via elastography ShearWave of the degree of placental maturity seems not yet be used in clinical practice. Studies of larger cohorts are needed. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Evaluating a Web-Based Educational Module on Oral Cancer Examination Based on a Behavioral Framework.

PubMed

Wee, Alvin G; Zimmerman, Lani M; Pullen, Carol H; Allen, Carl M; Lambert, Paul M; Paskett, Electra D

2016-03-01

Patients at risk of developing oral and/or oropharyngeal cancer (OPC) are more likely to see primary care providers (PCPs) than a dentist. Many PCPs do not regularly perform oral cancer examination (OCE). The purpose of this study was to design a web-based educational program based on a behavioral framework to encourage PCPs to conduct OCE. PCPs were solicited to provide feedback on the program and to evaluate their short-term knowledge. The integrated behavioral model was used to design the program. Fifteen PCPs (five in each group: physicians, physician assistants, and nurse practitioners) reviewed the program and took a posttest: (1) index of knowledge of risk factors for oral cancer (RiskOC) and (2) index of knowledge of diagnostic procedures for oral cancer (DiagOC). Findings from the process evaluation were mainly positive, with comments on the length of the program comprising the ten negative comments. No significant difference among groups of PCPs (physicians, physician assistants, and nurse practitioners) was detected for DiagOC (p = 0.43) or RiskOC (p = 0.201). A program on OPC for PCPs should be less than 40 min. Postviewing knowledge outcomes were similar for all PCPs. The web-based program on OPC based on a behavioral framework could have similar short-term knowledge outcomes for all PCPs and may increase the number of PCPs performing OCEs.

Ultrasound elastography: the new frontier in direct measurement of muscle stiffness.

PubMed

Brandenburg, Joline E; Eby, Sarah F; Song, Pengfei; Zhao, Heng; Brault, Jeffrey S; Chen, Shigao; An, Kai-Nan

2014-11-01

The use of brightness-mode ultrasound and Doppler ultrasound in physical medicine and rehabilitation has increased dramatically. The continuing evolution of ultrasound technology has also produced ultrasound elastography, a cutting-edge technology that can directly measure the mechanical properties of tissue, including muscle stiffness. Its real-time and direct measurements of muscle stiffness can aid the diagnosis and rehabilitation of acute musculoskeletal injuries and chronic myofascial pain. It can also help monitor outcomes of interventions affecting muscle in neuromuscular and musculoskeletal diseases, and it can better inform the functional prognosis. This technology has implications for even broader use of ultrasound in physical medicine and rehabilitation practice, but more knowledge about its uses and limitations is essential to its appropriate clinical implementation. In this review, we describe different ultrasound elastography techniques for studying muscle stiffness, including strain elastography, acoustic radiation force impulse imaging, and shear-wave elastography. We discuss the basic principles of these techniques, including the strengths and limitations of their measurement capabilities. We review the current muscle research, discuss physiatric clinical applications of these techniques, and note directions for future research. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A Freehand Ultrasound Elastography System with Tracking for In-vivo Applications

PubMed Central

Foroughi, Pezhman; Kang, Hyun-Jae; Carnegie, Daniel A.; van Vledder, Mark G.; Choti, Michael A.; Hager, Gregory D.; Boctor, Emad M.

2012-01-01

Ultrasound transducers are commonly tracked in modern ultrasound navigation/guidance systems. In this paper, we demonstrate the advantages of incorporating tracking information into ultrasound elastography for clinical applications. First, we address a common limitation of freehand palpation: speckle decorrelation due to out-of-plane probe motion. We show that by automatically selecting pairs of radio frequency (RF) frames with minimal lateral and out-of-plane motions combined with a fast and robust displacement estimation technique greatly improves in-vivo elastography results. We also use tracking information and image quality measure to fuse multiple images with similar strain that are taken roughly from the same location to obtain a high quality elastography image. Finally, we show that tracking information can be used to give the user partial control over the rate of compression. Our methods are tested on tissue mimicking phantom and experiments have been conducted on intra-operative data acquired during animal and human experiments involving liver ablation. Our results suggest that in challenging clinical conditions, our proposed method produces reliable strain images and eliminates the need for a manual search through the ultrasound data in order to find RF pairs suitable for elastography. PMID:23257351

Shear wave velocity imaging using transient electrode perturbation: phantom and ex vivo validation.

PubMed

DeWall, Ryan J; Varghese, Tomy; Madsen, Ernest L

2011-03-01

This paper presents a new shear wave velocity imaging technique to monitor radio-frequency and microwave ablation procedures, coined electrode vibration elastography. A piezoelectric actuator attached to an ablation needle is transiently vibrated to generate shear waves that are tracked at high frame rates. The time-to-peak algorithm is used to reconstruct the shear wave velocity and thereby the shear modulus variations. The feasibility of electrode vibration elastography is demonstrated using finite element models and ultrasound simulations, tissue-mimicking phantoms simulating fully (phantom 1) and partially ablated (phantom 2) regions, and an ex vivo bovine liver ablation experiment. In phantom experiments, good boundary delineation was observed. Shear wave velocity estimates were within 7% of mechanical measurements in phantom 1 and within 17% in phantom 2. Good boundary delineation was also demonstrated in the ex vivo experiment. The shear wave velocity estimates inside the ablated region were higher than mechanical testing estimates, but estimates in the untreated tissue were within 20% of mechanical measurements. A comparison of electrode vibration elastography and electrode displacement elastography showed the complementary information that they can provide. Electrode vibration elastography shows promise as an imaging modality that provides ablation boundary delineation and quantitative information during ablation procedures.

Optical assessment of tissue mechanics: acousto-optical elastography of skin

NASA Astrophysics Data System (ADS)

Kirkpatrick, Sean J.

2003-10-01

A multiphysics approach, combining acoustics, optics, and mechanics can be used to detect regions of skin with distinct mechanical behavior that may indicate a pathology, such as a cancerous skin lesion. Herein, an acousto - optical approach to evaluating the viscoelastic behavior of superficial skin layers will be presented. The method relies upon inducing low frequency guided surface waves in the skin and detecting these waves by monitoring the shift in the backscattered laser speckle pattern created by illuminating a small region of the skin with coherent light. Artificial lesions in the form of chemical cross-linking and chemical softening were induced in superficial porcine skin layers and detected based upon variations in local mechanical behavior. The lesions affect not only the time-of-flight of the guided surface waves, but also change the relative phase of the acoustic waves as determined optically. The method may be applicable in the study and diagnosis of superficial skin lesions.

Noninvasive assessment of hepatic sinusoidal obstructive syndrome using acoustic radiation force impulse elastography imaging: A proof-of-concept study in rat models.

PubMed

Park, So Hyun; Lee, Seung Soo; Sung, Ji-Youn; Na, Kiyong; Kim, Hyoung Jung; Kim, So Yeon; Park, Beom Jin; Byun, Jae Ho

2018-05-01

To determine the feasibility of acoustic radiation force impulse (ARFI) elastography in the evaluation of hepatic sinusoidal obstruction syndrome (SOS) in rat models. Rat SOS models of various severities were created by monocrotaline gavage (n = 40) or by intraperitoneal injection of 5-fluorouracil, leucovorin and oxaliplatin (FOLFOX) (n = 16). Liver shear-wave velocity (SWV) was measured using ARFI elastography. Liver samples were analysed for the SOS score, steatosis, lobular inflammation and fibrosis. The liver SWV was significantly elevated in the SOS models (1.29-2.24 m/s) compared with that of the matched control rats (1.01-1.09; p≤.09; veFor seven FOLFOX-treated rats which were longitudinally followed-up, the liver SWV significantly increased at 7 weeks (1.32±0.13 m/s) compared with the baseline (1.08±0.1 m/s, p=.015) and then significantly declined after a 2-week, treatment-free period (1.15±0.13 m/s; p=.048). Multivariate analysis revealed that the SOS score (p<.001) and lobular inflammation (p=.044) were independently correlated with the liver SWV. Liver SWV is elevated in SOS in proportion to the degree of sinusoidal injury and lobular inflammation in rat SOS models. ARFI elastography has potential as an examination for diagnosis, severity assessment and follow-up of SOS. • Liver SWV using ARFI elastography was significantly elevated in SOS rat. • Sinusoidal injury and lobular inflammation grades had correlation with liver SWV. • ARFI elastography has potential for diagnosis, severity assessment, and follow-up of SOS.

Usefulness of elastography in predicting the outcome of Foley catheter labour induction.

PubMed

Wozniak, Slawomir; Czuczwar, Piotr; Szkodziak, Piotr; Paszkowski, Tomasz

2015-06-01

Incorrect selection of women for labour induction may increase the risk of caesarean section and other postpartum and neonatal complications. It has been recently shown that elastography of the uterine cervix holds the potential to predict the outcome of pharmacological labour induction. There are no data on the usefulness of elastography in predicting the outcome of mechanical induction of labour. To assess the usefulness of elastographic cervical assessment in predicting the success of Foley catheter labour induction. This prospective observational study included 39 pregnant women at term with an unfavourable cervix (Bishop score ≤ 6) suitable for Foley catheter labour induction. Before labour induction the following data were recorded: Bishop score, cervical length (measured by ultrasound) and the stiffness of cervical internal os, canal and external os assessed by elastography (elastography index - EI). Statistical relationships between pre-interventional assessment of the cervix and outcome of Foley catheter labour induction (successful induction, time to delivery and route of delivery) were analysed. EI's of internal cervical os and cervical canal were significantly lower (softer) in women with successful labour induction and vaginal delivery, while EI's of the external cervical os, Bishop score and cervix length were not significantly different. Time to vaginal delivery was significantly correlated with the EI's of internal cervical os, cervical canal and Bishop score, but not with EI's of the external cervical os and cervix length. Elastography has the potential to predict the outcome of Foley catheter labour induction. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

33 CFR 263.18 - Program completion-time objectives.

Code of Federal Regulations, 2010 CFR

2010-07-01

... submission of funding request or negative report to OCE 2 1 2 (b) Completion of feasibility study by... these objectives is encouraged for specific studies and projects when appropriate. However, high...

33 CFR 263.18 - Program completion-time objectives.

Code of Federal Regulations, 2011 CFR

2011-07-01

... submission of funding request or negative report to OCE 2 1 2 (b) Completion of feasibility study by... these objectives is encouraged for specific studies and projects when appropriate. However, high...

Shear wave induced resonance elastography of spherical masses with polarized torsional waves

NASA Astrophysics Data System (ADS)

Hadj Henni, Anis; Schmitt, Cédric; Trop, Isabelle; Cloutier, Guy

2012-03-01

Shear wave induced resonance (SWIR) is a technique for dynamic ultrasound elastography of confined mechanical inclusions. It was developed for breast tumor imaging and tissue characterization. This method relies on the polarization of torsional shear waves modeled with the Helmholtz equation in spherical coordinates. To validate modeling, an invitro set-up was used to measure and image the first three eigenfrequencies and eigenmodes of a soft sphere. A preliminary invivo SWIR measurement on a breast fibroadenoma is also reported. Results revealed the potential of SWIR elastography to detect and mechanically characterize breast lesions for early cancer detection.

Shear wave induced resonance elastography of spherical masses with polarized torsional waves.

PubMed

Henni, Anis Hadj; Schmitt, Cédric; Trop, Isabelle; Cloutier, Guy

2012-03-26

Shear Wave Induced Resonance (SWIR) is a technique for dynamic ultrasound elastography of confined mechanical inclusions. It was developed for breast tumor imaging and tissue characterization. This method relies on the polarization of torsional shear waves modeled with the Helmholtz equation in spherical coordinates. To validate modeling, an in vitro set-up was used to measure and image the first three eigenfrequencies and eigenmodes of a soft sphere. A preliminary in vivo SWIR measurement on a breast fibroadenoma is also reported. Results revealed the potential of SWIR elastography to detect and mechanically characterize breast lesions for early cancer detection.

Elastographic techniques of thyroid gland: current status.

PubMed

Andrioli, Massimiliano; Persani, Luca

2014-08-01

Thyroid nodules are very common with malignancies accounting for about 5 %. Fine-needle biopsy is the most accurate test for thyroid cancer diagnosis. Elastography, a new technology directly evaluating the elastic property of the tissue, has been recently added to the diagnostic armamentarium of the endocrinologists as noninvasive predictor of thyroid malignancy. In this paper, we critically reviewed characteristics and applications of elastographic methods in thyroid gland. Elastographic techniques can be classified on the basis of the following: source-of-tissue compression (free-hand, carotid vibration, ultrasound pulses), processing time (real-time, off-line), stiffness expression (qualitative, semi-quantitative, or quantitative). Acoustic radiation force impulse and aixplorer shear wave are the newest and most promising quantitative elastographic methods. Primary application of elastography is the detection of nodular lesions suspicious for malignancy. Published data show a high sensitivity and negative predictive value of the technique. Insufficient data are available on the possible application of elastography in the differential diagnosis of indeterminate lesions and in thyroiditis. Elastography represents a noninvasive tool able to increase the performance of ultrasound in the selection of thyroid nodules at higher risk of malignancy. Some technical improvements and definition of more robust quantitative diagnostic criteria are required for assigning a definite role in the management of thyroid nodules and thyroiditis to elastography.

Shear Wave Velocity Imaging Using Transient Electrode Perturbation: Phantom and ex vivo Validation

PubMed Central

Varghese, Tomy; Madsen, Ernest L.

2011-01-01

This paper presents a new shear wave velocity imaging technique to monitor radio-frequency and microwave ablation procedures, coined electrode vibration elastography. A piezoelectric actuator attached to an ablation needle is transiently vibrated to generate shear waves that are tracked at high frame rates. The time-to-peak algorithm is used to reconstruct the shear wave velocity and thereby the shear modulus variations. The feasibility of electrode vibration elastography is demonstrated using finite element models and ultrasound simulations, tissue-mimicking phantoms simulating fully (phantom 1) and partially ablated (phantom 2) regions, and an ex vivo bovine liver ablation experiment. In phantom experiments, good boundary delineation was observed. Shear wave velocity estimates were within 7% of mechanical measurements in phantom 1 and within 17% in phantom 2. Good boundary delineation was also demonstrated in the ex vivo experiment. The shear wave velocity estimates inside the ablated region were higher than mechanical testing estimates, but estimates in the untreated tissue were within 20% of mechanical measurements. A comparison of electrode vibration elastography and electrode displacement elastography showed the complementary information that they can provide. Electrode vibration elastography shows promise as an imaging modality that provides ablation boundary delineation and quantitative information during ablation procedures. PMID:21075719

A novel shape similarity based elastography system for prostate cancer assessment

NASA Astrophysics Data System (ADS)

Wang, Haisu; Mousavi, Seyed Reza; Samani, Abbas

2012-03-01

Prostate cancer is the second common cancer among men worldwide and remains the second leading cancer-related cause of death in mature men. The disease can be cured if it is detected at early stage. This implies that prostate cancer detection at early stage is very critical for desirable treatment outcome. Conventional techniques of prostate cancer screening and detection, such as Digital Rectal Examination (DRE), Prostate-Specific Antigen (PSA) and Trans Rectal Ultra-Sonography (TRUS), are known to have low sensitivity and specificity. Elastography is an imaging technique that uses tissue stiffness as contrast mechanism. As the association between the degree of prostate tissue stiffness alteration and its pathology is well established, elastography can potentially detect prostate cancer with a high degree of sensitivity and specificity. In this paper, we present a novel elastography technique which, unlike other elastography techniques, does not require displacement data acquisition system. This technique requires the prostate's pre-compression and postcompression transrectal ultrasound images. The conceptual foundation of reconstructing the prostate's normal and pathological tissues elastic moduli is to determine these moduli such that the similarity between calculated and observed shape features of the post compression prostate image is maximized. Results indicate that this technique is highly accurate and robust.

Copolymer-in-oil phantom materials for elastography.

PubMed

Oudry, J; Bastard, C; Miette, V; Willinger, R; Sandrin, L

2009-07-01

Phantoms that mimic mechanical and acoustic properties of soft biological tissues are essential to elasticity imaging investigation and to elastography device characterization. Several materials including agar/gelatin, polyvinyl alcohol and polyacrylamide gels have been used successfully in the past to produce tissue phantoms, as reported in the literature. However, it is difficult to find a phantom material with a wide range of stiffness, good stability over time and high resistance to rupture. We aim at developing and testing a new copolymer-in-oil phantom material for elastography. The phantom is composed of a mixture of copolymer, mineral oil and additives for acoustic scattering. The mechanical properties of phantoms were evaluated with a mechanical test instrument and an ultrasound-based elastography technique. The acoustic properties were investigated using a through-transmission water-substituting method. We showed that copolymer-in-oil phantoms are stable over time. Their mechanical and acoustic properties mimic those of most soft tissues: the Young's modulus ranges from 2.2-150 kPa, the attenuation coefficient from 0.4-4.0 dB.cm(-1) and the ultrasound speed from 1420-1464 m/s. Their density is equal to 0.90 +/- 0.04 g/cm3. The results suggest that copolymer-in-oil phantoms are attractive materials for elastography.

Icebergs Melting in Uniform and Vertically Sheared Flows

NASA Astrophysics Data System (ADS)

Cenedese, Claudia; Fitzmaurice, Anna; Straneo, Fiammetta

2017-11-01

Icebergs calving into Greenlandic Fjords frequently experience strongly sheared flows over their draft, but the impact of this flow past the iceberg on the melt plumes generated along the iceberg sides is not fully captured by existing melt parameterizations. A series of novel laboratory experiments showed that side melting of icebergs subject to relative velocities is controlled by two distinct regimes, which depend on the melt plume behavior (side-attached or side-detached). These two regimes produce a nonlinear dependence of melt rate on velocity, and different distributions of meltwater in the water column. Iceberg meltwater may either be confined to a thin surface layer, when the melt plumes are side-attached, or mixed down to the iceberg draft, when the melt plumes are side-detached. In a two-layer vertically sheared flow, the average flow speed in existing melt parameterizations gives an underestimate of the submarine melt rate, in part due to the nonlinearity of the dependence of melt rate on flow speed, but also because vertical shear in the velocity profile fundamentally changes the flow splitting around the ice block and consequently the velocity felt by the ice surface. Including this nonlinear velocity dependence in melting parameterizations applied to observed icebergs increases iceberg side melt in the side-attached regime, improving agreement with observations of iceberg submarine melt rates. AF was supported by NA14OAR4320106, CC by NSF OCE-1434041 and OCE-1658079, and FS by NSF PLR-1332911 and OCE-1434041.

A novel breast software phantom for biomechanical modeling of elastography.

PubMed

Bhatti, Syeda Naema; Sridhar-Keralapura, Mallika

2012-04-01

In developing breast imaging technologies, testing is done with phantoms. Physical phantoms are normally used but their size, shape, composition, and detail cannot be modified readily. These difficulties can be avoided by creating a software breast phantom. Researchers have created software breast phantoms using geometric and/or mathematical methods for applications like image fusion. The authors report a 3D software breast phantom that was built using a mechanical design tool, to investigate the biomechanics of elastography using finite element modeling (FEM). The authors propose this phantom as an intermediate assessment tool for elastography simulation; for use after testing with commonly used phantoms and before clinical testing. The authors design the phantom to be flexible in both, the breast geometry and biomechanical parameters, to make it a useful tool for elastography simulation. The authors develop the 3D software phantom using a mechanical design tool based on illustrations of normal breast anatomy. The software phantom does not use geometric primitives or imaging data. The authors discuss how to create this phantom and how to modify it. The authors demonstrate a typical elastography experiment of applying a static stress to the top surface of the breast just above a simulated tumor and calculate normal strains in 3D and in 2D with plane strain approximations with linear solvers. In particular, they investigate contrast transfer efficiency (CTE) by designing a parametric study based on location, shape, and stiffness of simulated tumors. The authors also compare their findings to a commonly used elastography phantom. The 3D breast software phantom is flexible in shape, size, and location of tumors, glandular to fatty content, and the ductal structure. Residual modulus, maps, and profiles, served as a guide to optimize meshing of this geometrically nonlinear phantom for biomechanical modeling of elastography. At best, low residues (around 1-5 KPa) were found within the phantom while errors were elevated (around 10-30 KPa) at tumor and lobule boundaries. From our FEM analysis, the breast phantom generated a superior CTE in both 2D and in 3D over the block phantom. It also showed differences in CTE values and strain contrast for deep and shallow tumors and showed significant change in CTE when 3D modeling was used. These changes were not significant in the block phantom. Both phantoms, however, showed worsened CTE values for increased input tumor-background modulus contrast. Block phantoms serve as a starting tool but a next level phantom, like the proposed breast phantom, will serve as a valuable intermediate for elastography simulation before clinical testing. Further, given the CTE metrics for the breast phantom are superior to the block phantom, and vary for tumor shape, location, and stiffness, these phantoms would enhance the study of elastography contrast. Further, the use of 2D phantoms with plane strain approximations overestimates the CTE value when compared to the true CTE achieved with 3D models. Thus, the use of 3D phantoms, like the breast phantom, with no approximations, will assist in more accurate estimation of modulus, especially valuable for 3D elastography systems.

An elastography method based on the scanning contact resonance of a piezoelectric cantilever

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fu, Ji; Li, Faxin, E-mail: lifaxin@pku.edu.cn

2013-12-15

Purpose: Most tissues may become significantly stiffer than their normal states when there are lesions inside. The tissue's modulus can then act as an identification parameter for clinic diagnosis of tumors or fibrosis, which leads to elastography. This study introduces a novel elastography method that can be used for modulus imaging of superficial organs. Methods: This method is based on the scanning contact-resonance of a unimorph piezoelectric cantilever. The cantilever vibrates in its bending mode with the tip pressed tightly on the sample. The contact resonance frequency of the cantilever-sample system is tracked at each scanning point, from which themore » sample's modulus can be derived based on a beam dynamic model and a contact mechanics model. Scanning is performed by a three-dimensional motorized stage and the whole system is controlled by a homemade software program based on LabVIEW. Results: Testing onin vitro beef tissues indicates that the fat and the muscle can be easily distinguished using this system, and the accuracy of the modulus measurement can be comparable with that of nanoindentation. Imaging on homemade gelatin phantoms shows that the depth information of the abnormalities can be qualitatively obtained by varying the pressing force. The detection limit of this elastography method is specially examined both experimentally and numerically. Results show that it can detect the typical lesions in superficial organs with the depth of several centimeters. The lateral resolution of this elastography method/system is better than 0.5 mm, and could be further enhanced by using more scanning points. Conclusions: The proposed elastography system can be regarded as a sensitive palpation robot, which may be very promising in early diagnosis of tumors in superficial organs such as breast and thyroid.« less

Acoustic radiation force impulse elastography for differentiation of benign and malignant thyroid nodules with concurrent Hashimoto's thyroiditis.

PubMed

Liu, Bo-Ji; Xu, Hui-Xiong; Zhang, Yi-Feng; Xu, Jun-Mei; Li, Dan-Dan; Bo, Xiao-Wan; Li, Xiao-Long; Guo, Le-Hang; Xu, Xiao-Hong; Qu, Shen

2015-03-01

The purpose of the study was to explore the diagnostic performance of acoustic radiation force impulse (ARFI) elastography in differential diagnosis between benign and malignant thyroid nodules in patients with coexistent Hashimoto's thyroiditis (HT). A total of 141 pathological proven nodules in 141 HT patients (7 males and 134 females, mean age 50.1 years, range 23-75 years) received conventional ultrasound (US), elasticity imaging (EI) and ARFI elastography, including virtual touch tissue imaging (VTI) and virtual touch tissue quantification (VTQ), before surgery. Shear wave velocity (SWV) and SWV ratio were measured for each nodule on VTQ. The US, EI and ARFI elastography features were compared between benign and malignant nodules in HT patients. Receiver operating characteristic curve (ROC) analyses and area under curve (AUC) were performed to assess the diagnostic performance. Pathologically, 70 nodules were benign and 71 nodules were malignant. Significant differences were found between benign and malignant nodules in HT patients for EI (EI score) and ARFI (VTI grade and SWV) (all P value <0.05). The AUCs for EI, VTI, SWV and SWV ratio were 0.68 [95% confidence interval (CI): 0.59-0.77], 0.90 (95% CI: 0.84-0.95), 0.77 (95%CI: 0.70-0.85) and 0.74 (95%CI: 0.66-0.82), respectively. The cut-off points were EI score ≥3, VTI grade ≥4, SWV ≥2.58 m/s and SWV ratio ≥1.03, respectively. In conclusion, ARFI elastography is useful for differentiation between benign and malignant thyroid nodules in HT patients. The diagnostic performance of ARFI elastography is better than EI.

Quantitative photoacoustic elastography of Young's modulus in humans

NASA Astrophysics Data System (ADS)

Hai, Pengfei; Zhou, Yong; Gong, Lei; Wang, Lihong V.

2017-03-01

Elastography can noninvasively map the elasticity distribution of biological tissue, which is often altered in pathological states. In this work, we report quantitative photoacoustic elastography (QPAE), capable of measuring Young's modulus of human tissue in vivo. By combining photoacoustic elastography with a stress sensor having known stress-strain behavior, QPAE can simultaneously measure strain and stress, from which Young's modulus is calculated. We first applied QPAE to quantify the Young's modulus of tissue-mimicking agar phantoms with different concentrations. The measured values fitted well with both the empirical expectations based on the agar concentrations and those measured in independent standard compression tests. We then demonstrated the feasibility of QPAE by measuring the Young's modulus of human skeletal muscle in vivo. The data showed a linear relationship between muscle stiffness and loading. The results proved that QPAE can noninvasively quantify the absolute elasticity of biological tissue, thus enabling longitudinal imaging of tissue elasticity. QPAE can be exploited for both preclinical biomechanics studies and clinical applications.

Comparison Between Neck and Shoulder Stiffness Determined by Shear Wave Ultrasound Elastography and a Muscle Hardness Meter.

PubMed

Akagi, Ryota; Kusama, Saki

2015-08-01

The goals of this study were to compare neck and shoulder stiffness values determined by shear wave ultrasound elastography with those obtained with a muscle hardness meter and to verify the correspondence between objective and subjective stiffness in the neck and shoulder. Twenty-four young men and women participated in the study. Their neck and shoulder stiffness was determined at six sites. Before the start of the measurements, patients rated their present subjective symptoms of neck and shoulder stiffness on a 6-point verbal scale. At all measurement sites, the correlation coefficients between the values of muscle hardness indices determined by the muscle hardness meter and shear wave ultrasound elastography were not significant. Furthermore, individuals' subjective neck and shoulder stiffness did not correspond to their objective symptoms. These results suggest that the use of shear wave ultrasound elastography is essential to more precisely assess neck and shoulder stiffness. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Ultrasound elastographic techniques in focal liver lesions

PubMed Central

Conti, Clara Benedetta; Cavalcoli, Federica; Fraquelli, Mirella; Conte, Dario; Massironi, Sara

2016-01-01

Elastographic techniques are new ultrasound-based imaging techniques developed to estimate tissue deformability/stiffness. Several ultrasound elastographic approaches have been developed, such as static elastography, transient elastography and acoustic radiation force imaging methods, which include point shear wave and shear wave imaging elastography. The application of these methods in clinical practice aims at estimating the mechanical tissues properties. One of the main settings for the application of these tools has been liver stiffness assessment in chronic liver disease, which has been studied mainly using transient elastography. Another field of application for these techniques is the assessment of focal lesions, detected by ultrasound in organs such as pancreas, prostate, breast, thyroid, lymph nodes. Considering the frequency and importance of the detection of focal liver lesions through routine ultrasound, some studies have also aimed to assess the role that elestography can play in studying the stiffness of different types of liver lesions, in order to predict their nature and thus offer valuable non-invasive methods for the diagnosis of liver masses. PMID:26973405

Ultrasound elastographic techniques in focal liver lesions.

PubMed

Conti, Clara Benedetta; Cavalcoli, Federica; Fraquelli, Mirella; Conte, Dario; Massironi, Sara

2016-03-07

Elastographic techniques are new ultrasound-based imaging techniques developed to estimate tissue deformability/stiffness. Several ultrasound elastographic approaches have been developed, such as static elastography, transient elastography and acoustic radiation force imaging methods, which include point shear wave and shear wave imaging elastography. The application of these methods in clinical practice aims at estimating the mechanical tissues properties. One of the main settings for the application of these tools has been liver stiffness assessment in chronic liver disease, which has been studied mainly using transient elastography. Another field of application for these techniques is the assessment of focal lesions, detected by ultrasound in organs such as pancreas, prostate, breast, thyroid, lymph nodes. Considering the frequency and importance of the detection of focal liver lesions through routine ultrasound, some studies have also aimed to assess the role that elestography can play in studying the stiffness of different types of liver lesions, in order to predict their nature and thus offer valuable non-invasive methods for the diagnosis of liver masses.

Endoscopic ultrasound: Elastographic lymph node evaluation.

PubMed

Dietrich, Christoph F; Jenssen, Christian; Arcidiacono, Paolo G; Cui, Xin-Wu; Giovannini, Marc; Hocke, Michael; Iglesias-Garcia, Julio; Saftoiu, Adrian; Sun, Siyu; Chiorean, Liliana

2015-01-01

Different imaging techniques can bring different information which will contribute to the final diagnosis and further management of the patients. Even from the time of Hippocrates, palpation has been used in order to detect and characterize a body mass. The so-called virtual palpation has now become a reality due to elastography, which is a recently developed technique. Elastography has already been proving its added value as a complementary imaging method, helpful to better characterize and differentiate between benign and malignant masses. The current applications of elastography in lymph nodes (LNs) assessment by endoscopic ultrasonography will be further discussed in this paper, with a review of the literature and future perspectives.

Muscle ultrasound elastography and MRI in preschool children with Duchenne muscular dystrophy.

PubMed

Pichiecchio, Anna; Alessandrino, Francesco; Bortolotto, Chandra; Cerica, Alessandra; Rosti, Cristina; Raciti, Maria Vittoria; Rossi, Marta; Berardinelli, Angela; Baranello, Giovanni; Bastianello, Stefano; Calliada, Fabrizio

2018-06-01

The aim of this study was to determine muscle tissue elasticity, measured with shear-wave elastography, in selected lower limb muscles of patients affected by Duchenne muscular dystrophy (DMD) and to correlate the values obtained with those recorded in healthy children and with muscle magnetic resonance imaging (MRI) data from the same DMD children, specifically the pattern on T1-weighted (w) and short-tau inversion recovery (STIR) sequences. Five preschool DMD children and five age-matched healthy children were studied with shear-wave elastography. In the DMD children, muscle stiffness was moderately higher compared with the muscle stiffness in HC, in the rectus femoris, vastus lateralis, adductor magnus and gluteus maximus muscles. On muscle MRI T1-w images showed fatty replacement in 3/5 patients at the level of the GM, while thigh and leg muscles were affected in 2/5; hyperintensity on STIR images was identified in 4/5 patients. No significant correlation was observed between stiffness values and MRI scoring. Our study demonstrated that lower limb muscles of preschool DMD patients show fatty replacement and patchy edema on muscle MRI and increased stiffness on shear-wave elastography. In conclusion, although further studies in larger cohorts are needed, shear-wave elastography could be considered a useful non-invasive tool to easily monitor muscle changes in early stages of the disease. Copyright © 2018 Elsevier B.V. All rights reserved.

[Renal elastography].

PubMed

Correas, Jean-Michel; Anglicheau, Dany; Gennisson, Jean-Luc; Tanter, Mickael

2016-04-01

Renal elastography has become available with the development of noninvasive quantitative techniques (including shear-wave elastography), following the rapidly growing field of diagnosis and quantification of liver fibrosis, which has a demonstrated major clinical impact. Ultrasound or even magnetic resonance techniques are leaving the pure research area to reach the routine clinical use. With the increased incidence of chronic kidney disease and its specific morbidity and mortality, the noninvasive diagnosis of renal fibrosis can be of critical value. However, it is difficult to simply extend the application from one organ to the other due to a large number of anatomical and technical issues. Indeed, the kidney exhibits various features that make stiffness assessment more complex, such as the presence of various tissue types (cortex, medulla), high spatial orientation (anisotropy), local blood flow, fatty sinus with variable volume and echotexture, perirenal space with variable fatty content, and the variable depth of the organ. Furthermore, the stiffness changes of the renal parenchyma are not exclusively related to fibrosis, as renal perfusion or hydronephrosis will impact the local elasticity. Renal elastography might be able to diagnose acute or chronic obstruction, or to renal tumor or pseudotumor characterization. Today, renal elastography appears as a promising application that still requires optimization and validation, which is the contrary for liver stiffness assessment. Copyright © 2016 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

Differences in liver stiffness values obtained with new ultrasound elastography machines and Fibroscan: A comparative study.

PubMed

Piscaglia, Fabio; Salvatore, Veronica; Mulazzani, Lorenzo; Cantisani, Vito; Colecchia, Antonio; Di Donato, Roberto; Felicani, Cristina; Ferrarini, Alessia; Gamal, Nesrine; Grasso, Valentina; Marasco, Giovanni; Mazzotta, Elena; Ravaioli, Federico; Ruggieri, Giacomo; Serio, Ilaria; Sitouok Nkamgho, Joules Fabrice; Serra, Carla; Festi, Davide; Schiavone, Cosima; Bolondi, Luigi

2017-07-01

Whether Fibroscan thresholds can be immediately adopted for none, some or all other shear wave elastography techniques has not been tested. The aim of the present study was to test the concordance of the findings obtained from 7 of the most recent ultrasound elastography machines with respect to Fibroscan. Sixteen hepatitis C virus-related patients with fibrosis ≥2 and having reliable results at Fibroscan were investigated in two intercostal spaces using 7 different elastography machines. Coefficients of both precision (an index of data dispersion) and accuracy (an index of bias correction factors expressing different magnitudes of changes in comparison to the reference) were calculated. Median stiffness values differed among the different machines as did coefficients of both precision (range 0.54-0.72) and accuracy (range 0.28-0.87). When the average of the measurements of two intercostal spaces was considered, coefficients of precision significantly increased with all machines (range 0.72-0.90) whereas of accuracy improved more scatteredly and by a smaller degree (range 0.40-0.99). The present results showed only moderate concordance of the majority of elastography machines with the Fibroscan results, preventing the possibility of the immediate universal adoption of Fibroscan thresholds for defining liver fibrosis staging for all new machines. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Investigation of the acute plantar fasciitis with contrast-enhanced ultrasound and shear wave elastography - first results.

PubMed

Putz, Franz Josef; Hautmann, Matthias G; Banas, Miriam C; Jung, Ernst Michael

2017-01-01

The plantar fasciitis is a common disease with a high prevalence in public and a frequent cause of heel pain. In our pilot study, we wanted to characterise the feasibility of shear-wave elastography and contrast-enhanced ultrasound (CEUS) in the assessment of the plantar fasciitis. 23 cases of painful heels were examined by B-Mode ultrasound, Power Doppler (PD), shear wave elastography and contrast-enhanced ultrasound before anti-inflammatory radiation. Time-intensity-curves were analysed by the integrated software. The results for area-under-the-curve (AUC), peak, time-to-peak (TTP) and mean-transit-time (MTT) were compared between the plantar fascia and the surrounding tissue. All cases showed thickening of the plantar fascia, in most cases with interstitial oedema (87.0%). Shear wave elastography showed inhomogeneous stiffness of the plantar fascia. 83.3% of cases showed a visible hyperperfusion in CEUS at the proximal plantar fascia in comparison to the surrounding tissue. This hyperperfusion could also be found in 75.0% of cases with no signs of vascularisation in PD. AUC (p = 0.0005) and peak (p = 0.037) were significantely higher in the plantar fascia than in the surrounding tissue. CEUS and shear wave elastography are new diagnostic tools in the assessment of plantar fasciitis and can provide quantitative parameters for monitoring therapy.

Accuracy of localization of prostate lesions using manual palpation and ultrasound elastography

NASA Astrophysics Data System (ADS)

Kut, Carmen; Schneider, Caitlin; Carter-Monroe, Naima; Su, Li-Ming; Boctor, Emad; Taylor, Russell

2009-02-01

Purpose: To compare the accuracy of detecting tumor location and size in the prostate using both manual palpation and ultrasound elastography (UE). Methods: Tumors in the prostate were simulated using both synthetic and ex vivo tissue phantoms. 25 participants were asked to provide the presence, size and depth of these simulated lesions using manual palpation and UE. Ultrasound images were captured using a laparoscopic ultrasound probe, fitted with a Gore-Tetrad transducer with frequency of 7.5 MHz and a RF capture depth of 4-5 cm. A MATLAB GUI application was employed to process the RF data for ex vivo phantoms, and to generate UE images using a cross-correlation algorithm. Ultrasonix software was used to provide real time elastography during laparoscopic palpation of the synthetic phantoms. Statistical analyses were performed based on a two-tailed, student t-test with α = 0.05. Results: UE displays both a higher accuracy and specificity in tumor detection (sensitivity = 84%, specificity = 74%). Tumor diameters and depths are better estimated using ultrasound elastography when compared with manual palpation. Conclusions: Our results indicate that UE has strong potential in assisting surgeons to intra-operatively evaluate the tumor depth and size. We have also demonstrated that ultrasound elastography can be implemented in a laparoscopic environment, in which manual palpation would not be feasible. With further work, this application can provide accurate and clinically relevant information for surgeons during prostate resection.

78 FR 20329 - Submission for OMB review; 30-day Comment Request: A Generic Submission for Formative Research...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-04

... NCI through its Office of Communications and Education (OCE), to pretest NCI communications strategies... also responsible for the design, implementation, and evaluation of education programs over the entire...

An Attosecond Transient Absorption Spectroscopy Setup with a Water Window Attosecond source

NASA Astrophysics Data System (ADS)

Chew, Andrew; Yin, Yanchun; Li, Jie; Ren, Xiaoming; Wang, Yang; Wu, Yi; Chang, Zenghu

2017-04-01

Attosecond transient absorption, or time-resolved pump-probe spectroscopy, are excellent tools that can be used to investigate fast electron dynamics for a given atomic or molecular system. Recent push for high energy long wavelength few cycle laser sources has resulted in the production of x-ray spectra that would allow the probing of electron dynamics at the carbon k-edge in molecules such as CH4 and CO2. The motion of charges can be caused by photo-dissociation and charge migration. We present here the first results from our experimental setup where we produce a broadband attosecond pulse with spectra that stretches into the water window. National Science Foundation (1068604), Army Research Oce (W911NF-14-1-0383), Air Force Oce of Scientic Research (FA9550-15-1-0037, FA9550-16-1-0013) and the DARPA PULSE program by a Grant from AMRDEC (W31P4Q1310017).

Quantitative elasticity measurement of urinary bladder wall using laser-induced surface acoustic waves.

PubMed

Li, Chunhui; Guan, Guangying; Zhang, Fan; Song, Shaozhen; Wang, Ruikang K; Huang, Zhihong; Nabi, Ghulam

2014-12-01

The maintenance of urinary bladder elasticity is essential to its functions, including the storage and voiding phases of the micturition cycle. The bladder stiffness can be changed by various pathophysiological conditions. Quantitative measurement of bladder elasticity is an essential step toward understanding various urinary bladder disease processes and improving patient care. As a nondestructive, and noncontact method, laser-induced surface acoustic waves (SAWs) can accurately characterize the elastic properties of different layers of organs such as the urinary bladder. This initial investigation evaluates the feasibility of a noncontact, all-optical method of generating and measuring the elasticity of the urinary bladder. Quantitative elasticity measurements of ex vivo porcine urinary bladder were made using the laser-induced SAW technique. A pulsed laser was used to excite SAWs that propagated on the bladder wall surface. A dedicated phase-sensitive optical coherence tomography (PhS-OCT) system remotely recorded the SAWs, from which the elasticity properties of different layers of the bladder were estimated. During the experiments, series of measurements were performed under five precisely controlled bladder volumes using water to estimate changes in the elasticity in relation to various urinary bladder contents. The results, validated by optical coherence elastography, show that the laser-induced SAW technique combined with PhS-OCT can be a feasible method of quantitative estimation of biomechanical properties.

33 CFR 239.9 - Effective date.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Effective date. 239.9 Section 239....9 Effective date. These regulations are applicable to all projects not approved by OCE prior to the date of this regulation. ...

Longitudinal changes in menopausal symptoms comparing women randomized to low-dose oral conjugated estrogens or transdermal estradiol plus micronized progesterone versus placebo: the Kronos Early Estrogen Prevention Study.

PubMed

Santoro, Nanette; Allshouse, Amanda; Neal-Perry, Genevieve; Pal, Lubna; Lobo, Rogerio A; Naftolin, Frederick; Black, Dennis M; Brinton, Eliot A; Budoff, Matthew J; Cedars, Marcelle I; Dowling, N Maritza; Dunn, Mary; Gleason, Carey E; Hodis, Howard N; Isaac, Barbara; Magnani, Maureen; Manson, JoAnn E; Miller, Virginia M; Taylor, Hugh S; Wharton, Whitney; Wolff, Erin; Zepeda, Viola; Harman, S Mitchell

2017-03-01

The objective of the present study was to compare the efficacy of two forms of menopausal hormone therapy in alleviating vasomotor symptoms, insomnia, and irritability in early postmenopausal women during 4 years. A total of 727 women, aged 42 to 58, within 3 years of their final menstrual period, were randomized to receive oral conjugated estrogens (o-CEE) 0.45 mg (n = 230) or transdermal estradiol (t-E2) 50 μg (n = 225; both with micronized progesterone 200 mg for 12 d each mo), or placebos (PBOs; n = 275). Menopausal symptoms were recorded at screening and at 6, 12, 24, 36, and 48 months postrandomization. Differences in proportions of women with symptoms at baseline and at each follow-up time point were compared by treatment arm using exact χ tests in an intent-to-treat analysis. Differences in treatment effect by race/ethnicity and body mass index were tested using generalized linear mixed effects modeling. Moderate to severe hot flashes (from 44% at baseline to 28.3% for PBO, 7.4% for t-E2, and 4.2% for o-CEE) and night sweats (from 35% at baseline to 19% for PBO, 5.3% for t-E2, and 4.7% for o-CEE) were reduced significantly by 6 months in women randomized to either active hormone compared with PBO (P < 0.001 for both symptoms), with no significant differences between the active treatment arms. Insomnia and irritability decreased from baseline to 6 months postrandomization in all groups. There was an intermittent reduction in insomnia in both active treatment arms versus PBO, with o-CEE being more effective than PBO at 36 and 48 months (P = 0.002 and 0.05) and t-E2 being more effective than PBO at 48 months (P = 0.004). Neither hormone treatment significantly affected irritability compared with PBO. Symptom relief for active treatment versus PBO was not significantly modified by body mass index or race/ethnicity. Recently postmenopausal women had similar and substantial reductions in hot flashes and night sweats with lower-than-conventional doses of oral or transdermal estrogen. These reductions were sustained during 4 years. Insomnia was intermittently reduced compared with PBO for both hormone regimens.

Longitudinal Changes in Menopausal Symptoms Comparing Women Randomized to Low-Dose Oral Conjugated Estrogens or Transdermal Estradiol Plus Micronized Progesterone Versus Placebo: the Kronos Early Estrogen Prevention Study (KEEPS)

PubMed Central

Santoro, Nanette; Allshouse, Amanda; Neal-Perry, Genevieve; Pal, Lubna; Lobo, Rogerio A.; Naftolin, Frederick; Black, Dennis M.; Brinton, Eliot A.; Budoff, Matthew J.; Cedars, Marcelle I.; Dowling, N. Maritza; Dunn, Mary; Gleason, Carey E.; Hodis, Howard N.; Isaac, Barbara; Magnani, Maureen; Manson, JoAnn E.; Miller, Virginia M.; Taylor, Hugh S.; Wharton, Whitney; Wolff, Erin; Zepeda, Viola; Harman, S. Mitchell

2016-01-01

Objective To compare the efficacy of two forms of menopausal hormone therapy in alleviating vasomotor symptoms, insomnia, and irritability in early menopausal women over four years. Methods 727 women, aged 42–58, within three years of their final menstrual period were randomized to receive oral conjugated estrogens (o-CEE) 0.45 mg (n=230) or transdermal estradiol (t-E2) 50mcg (n=225; both with micronized progesterone 200mg for 12 days each month), or placebos (PBO; n=275). Menopausal symptoms were recorded at screening and at 6, 12, 24, 36 and 48 months post-randomization. Differences in proportions of women with symptoms at baseline and at each followup timepoint were compared by treatment arm using exact chi-square tests in an intent-to-treat (ITT) analysis. Differences in treatment effect by race/ethnicity and body mass index (BMI) were tested using generalized linear mixed effects modeling. Results Moderate-to-severe hot flashes (from 44% at baseline to 28.3% for PBO, 7.4% for t-E2 and 4.2% for o-CEE) and night sweats (from 35% at baseline to 19% for PBO, 5.3% for t-E2 and 4.7% for o-CEE) were reduced significantly by 6 months in women randomized to either active hormone compared to PBO (P<0.001 for both symptoms), with no significant differences between the active treatment arms. Insomnia and irritability decreased from baseline to 6 months post randomization in all groups. There was an intermittent reduction in insomnia in both active treatment arms vs PBO, with o-CEE more effective than PBO at 36 and 48 months (p=0.002mad 0.05) and t-E2 more effective than PBO at 48 months (p=0.004). Neither hormone treatment significantly affected irritability compared to PBO. Symptom relief for active treatment vs PBO was not significantly modified by BMI or race/ethnicity. Conclusions Recently-menopausal women had similar and substantial reductions in hot flashes and night sweats with lower than conventional doses of oral or transdermal estrogen. These reductions were sustained over 4 years. Insomnia was intermittently reduced compared to placebo for both hormone regimens. PMID:27779568

Transient Elastography vs. Aspartate Aminotransferase to Platelet Ratio Index in Hepatitis C: A Meta-Analysis.

PubMed

Mattos, A Z; Mattos, A A

Many different non-invasive methods have been studied with the purpose of staging liver fibrosis. The objective of this study was verifying if transient elastography is superior to aspartate aminotransferase to platelet ratio index for staging fibrosis in patients with chronic hepatitis C. A systematic review with meta-analysis of studies which evaluated both non-invasive tests and used biopsy as the reference standard was performed. A random-effects model was used, anticipating heterogeneity among studies. Diagnostic odds ratio was the main effect measure, and summary receiver operating characteristic curves were created. A sensitivity analysis was planned, in which the meta-analysis would be repeated excluding each study at a time. Eight studies were included in the meta-analysis. Regarding the prediction of significant fibrosis, transient elastography and aspartate aminotransferase to platelet ratio index had diagnostic odds ratios of 11.70 (95% confidence interval = 7.13-19.21) and 8.56 (95% confidence interval = 4.90-14.94) respectively. Concerning the prediction of cirrhosis, transient elastography and aspartate aminotransferase to platelet ratio index had diagnostic odds ratios of 66.49 (95% confidence interval = 23.71-186.48) and 7.47 (95% confidence interval = 4.88-11.43) respectively. In conclusion, there was no evidence of significant superiority of transient elastography over aspartate aminotransferase to platelet ratio index regarding the prediction of significant fibrosis, but the former proved to be better than the latter concerning prediction of cirrhosis.

Validity of measurement of shear modulus by ultrasound shear wave elastography in human pennate muscle.

PubMed

Miyamoto, Naokazu; Hirata, Kosuke; Kanehisa, Hiroaki; Yoshitake, Yasuhide

2015-01-01

Ultrasound shear wave elastography is becoming a valuable tool for measuring mechanical properties of individual muscles. Since ultrasound shear wave elastography measures shear modulus along the principal axis of the probe (i.e., along the transverse axis of the imaging plane), the measured shear modulus most accurately represents the mechanical property of the muscle along the fascicle direction when the probe's principal axis is parallel to the fascicle direction in the plane of the ultrasound image. However, it is unclear how the measured shear modulus is affected by the probe angle relative to the fascicle direction in the same plane. The purpose of the present study was therefore to examine whether the angle between the principal axis of the probe and the fascicle direction in the same plane affects the measured shear modulus. Shear modulus in seven specially-designed tissue-mimicking phantoms, and in eleven human in-vivo biceps brachii and medial gastrocnemius were determined by using ultrasound shear wave elastography. The probe was positioned parallel or 20° obliquely to the fascicle across the B-mode images. The reproducibility of shear modulus measurements was high for both parallel and oblique conditions. Although there was a significant effect of the probe angle relative to the fascicle on the shear modulus in human experiment, the magnitude was negligibly small. These findings indicate that the ultrasound shear wave elastography is a valid tool for evaluating the mechanical property of pennate muscles along the fascicle direction.

Transient elastography with the XL probe rapidly identifies patients with nonhepatic ascites.

PubMed

Kohlhaas, Anna; Durango, Esteban; Millonig, Gunda; Bastard, Cecile; Sandrin, Laurent; Golriz, Mohammad; Mehrabi, Arianeb; Büchler, Markus W; Seitz, Helmut Karl; Mueller, Sebastian

2012-01-01

In contrast with other elastographic techniques, ascites is considered an exclusion criterion for assessment of fibrosis stage by transient elastography. However, a normal liver stiffness could rule out hepatic causes of ascites at an early stage. The aim of the present study was to determine whether liver stiffness can be generally determined by transient elastography through an ascites layer, to determine whether the ascites-mediated increase in intra-abdominal pressure affects liver stiffness, and to provide initial data from a pilot cohort of patients with various causes of ascites. Using the XL probe in an artificial ascites model, we demonstrated (copolymer phantoms surrounded by water) that a transient elastography-generated shear wave allows accurate determination of phantom stiffness up to a water lamella of 20 mm. We next showed in an animal ascites model that increased intra-abdominal pressure does not affect liver stiffness. Liver stiffness was then determined in 24 consecutive patients with ascites due to hepatic (n = 18) or nonhepatic (n = 6) causes. The cause of ascites was eventually clarified using routine clinical, imaging, laboratory, and other tools. Valid (75%) or acceptable (25%) liver stiffness data could be obtained in 23 patients (95.8%) with ascites up to an ascites lamella of 39 mm. The six patients (25%) with nonhepatic causes of ascites (eg, pancreatitis, peritoneal carcinomatosis) had a significantly lower liver stiffness (<8 kPa) as compared with the remaining patients with hepatic ascites (>30 kPa). Mean liver stiffness was 5.4 kPa ± 1.3 versus 66.2 ± 13.3 kPa. In conclusion, the presence of ascites and increased intra-abdominal pressure does not alter underlying liver stiffness as determined by transient elastography. We suggest that, using the XL probe, transient elastography can be used first-line to identify patients with nonhepatic ascites at an early stage.

Transient elastography with the XL probe rapidly identifies patients with nonhepatic ascites

PubMed Central

Kohlhaas, Anna; Durango, Esteban; Millonig, Gunda; Bastard, Cecile; Sandrin, Laurent; Golriz, Mohammad; Mehrabi, Arianeb; Büchler, Markus W; Seitz, Helmut Karl; Mueller, Sebastian

2012-01-01

Background In contrast with other elastographic techniques, ascites is considered an exclusion criterion for assessment of fibrosis stage by transient elastography. However, a normal liver stiffness could rule out hepatic causes of ascites at an early stage. The aim of the present study was to determine whether liver stiffness can be generally determined by transient elastography through an ascites layer, to determine whether the ascites-mediated increase in intra-abdominal pressure affects liver stiffness, and to provide initial data from a pilot cohort of patients with various causes of ascites. Methods and results Using the XL probe in an artificial ascites model, we demonstrated (copolymer phantoms surrounded by water) that a transient elastography-generated shear wave allows accurate determination of phantom stiffness up to a water lamella of 20 mm. We next showed in an animal ascites model that increased intra-abdominal pressure does not affect liver stiffness. Liver stiffness was then determined in 24 consecutive patients with ascites due to hepatic (n = 18) or nonhepatic (n = 6) causes. The cause of ascites was eventually clarified using routine clinical, imaging, laboratory, and other tools. Valid (75%) or acceptable (25%) liver stiffness data could be obtained in 23 patients (95.8%) with ascites up to an ascites lamella of 39 mm. The six patients (25%) with nonhepatic causes of ascites (eg, pancreatitis, peritoneal carcinomatosis) had a significantly lower liver stiffness (<8 kPa) as compared with the remaining patients with hepatic ascites (>30 kPa). Mean liver stiffness was 5.4 kPa ± 1.3 versus 66.2 ± 13.3 kPa. Conclusion In conclusion, the presence of ascites and increased intra-abdominal pressure does not alter underlying liver stiffness as determined by transient elastography. We suggest that, using the XL probe, transient elastography can be used first-line to identify patients with nonhepatic ascites at an early stage. PMID:24367229

Imaging of idle breast implants with ultrasound-strain elastography- A first experimental study to establish criteria for accurate imaging of idle implants via ultrasound-strain elastography.

PubMed

Kuehlmann, Britta; Prantl, Lukas; Michael Jung, Ernst

2016-01-01

To investigate whether there are fundamental sonographic and elastographic criteria to precisely assess different surfaces and fillings of idle breast implants and to determine their most distinctive parameters. This was a comparative study of different unused breast implant materials, neighter in animals nor in humans. This knowledge should be transferred in vivo to develop an objective measurement tool. Nine idle breast implants-silicone and polyurethane (PU)-were examined in an experimental study by using ultrasound B-mode with tissue harmonic imaging (THI), speckle reduction imaging (SRI, level 0-4), cross-beam (CB, low, medium, high), photopic and the colour coded ultrasound-strain elastography with a multifrequency probe (9-15 MHz).Using a standardised protocol the implants' centre as well as the edge were analysed by one experienced examiner. Two independent readers performed analysis and evaluation. For image interpretation a score was created (score 0:inadequate image, score 5:best image quality). The highest score result for the centre was achieved by using ultrasound with B-mode in addition with CB level medium, SRI level 2, THI and photopic (mean:3.22±SD:1.56), but without any statistic significant difference (t-value = 0.71). With elastography the implants' edge in general was represented without disruptive artefacts (3.89±0.60) with statistic significant difference (t-value = 5.29). Implants filled with inner cohesive silicone gel II° showed best imaging conditions for their centre via ultrasound (5±0) as well as for their edge via elastography (4.50±0.71). Ultrasound-strain elastography and high resolution ultrasound represent a valuable measurement tool to evaluate different properties of idle breast implants. These modified ultrasound examinations could be an additional help for clinical investigations and be correlated with Baker's Classification.

Acoustic radiation force impulse elastography: comparison and combination with other noninvasive tests for the diagnosis of compensated liver cirrhosis.

PubMed

Pfeifer, Lukas; Adler, Werner; Zopf, Steffen; Siebler, Jürgen; Wildner, Dane; Goertz, Ruediger S; Schellhaas, Barbara; Neurath, Markus F; Strobel, Deike

2017-05-01

The aim of this study was to compare acoustic radiation force impulse (ARFI) elastography with other noninvasive tests and to develop a new score for the assessment of liver fibrosis/cirrhosis. B-mode ultrasound (including high-frequency liver surface evaluation), routine blood tests, ARFI quantification, and mini-laparoscopic liver evaluation were obtained in compensated patients scheduled for mini-laparoscopic biopsy. Our new cirrhosis score (CS) for the assessment of liver cirrhosis, based on a linear combination of ARFI, platelet (PLT), liver surface, and prothrombin index (PI), was calculated by linear discriminant analysis. Its performance was compared with ARFI-elastography, APRI, FIB-4, alanine aminotransferase (ALT)/aspartate aminotransferase (AST)-ratio, PLT, and PI. For the diagnosis of cirrhosis, a combined gold standard (cirrhosis at histology and/or at macroscopic liver evaluation) was used. In total, 171 patients, of whom 38 had compensated cirrhosis, were included. The CS was significantly better for the diagnosis of cirrhosis compared with ARFI (P=0.028), APRI (P=0.012), PLTs (P=0.013), PI (P=0.025), and ALT/AST ratio (P=0.001), but not the FIB-4 score (P=0.207), with an area under the receiver operating characteristic curve of 0.92 [95% confidence interval (CI): 0.87-0.97], 0.86 (95% CI:0.79-0.93), 0.80 (95% CI: 0.72-0.87), 0.79 (95% CI: 0.7-0.87), 0.81 (95% CI: 0.73-0.89), 0.72 (95% CI:0.64-0.81), and 0.86 (95% CI: 0.8-0.93), respectively. Sensitivity, specificity, positive predictive value, and negative predictive value for CS were 87%, 86%, 63%, and 96%, respectively. The FIB-4 score was significantly superior to the APRI score (P=0.041) and the ALT/AST ratio (P=0.011), with no significant difference from ARFI elastography (P=0.88) for the diagnosis of cirrhosis. Combining ARFI elastography with other noninvasive tests that are used routinely in the workup of patients with suspected liver disease can improve diagnostic accuracy for compensated liver cirrhosis as compared with ARFI elastography alone. The FIB-4 score showed an overall comparable diagnostic accuracy to ARFI-elastography for compensated cirrhosis.

Feasibility of a transient elastography technique for in vitro arterial elasticity assessment.

PubMed

Brum, J; Balay, G; Bia, D; Armentano, R L; Negreira, C

2010-01-01

The early detection of biomechanical modifications in the arterial wall could be used as a predictor factor for various diseases, for example hypertension or atherosclerosis. In this work a transient elastography technique is used for the in vitro evaluation of the arterial wall elasticity. The obtained Young modulus is compared with the one obtained by a more classical approach: pressure-diameter relationships. As a sample an arterial phantom made of PolyVinyl Alcohol (PVA) gel was used. Diameter variation due to pressure variation inside the phantom was recorded by means of ultrasound. Through both techniques similar Young modulus estimations are obtained showing in this way the feasibility of applying transient elastography for the arterial wall elasticity assessment.

77 FR 68209 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-15

...-through devices, brachytherapy sources, intraoperative radiation therapy (IORT), brachytherapy composite... Modulated Radiation Therapy I/OCE Integrated Outpatient Code Editor IOL Intraocular lens IOM Institute of Medicine IORT Intraoperative radiation treatment IPF Inpatient Psychiatric Facility IPPS [Hospital...

Categorizing Biomarkers of the Human Exposome and Developing Metrics for Assessing Environmental Sustainability

EPA Science Inventory

The concept of maintaining environmental sustainability broadly encompasses all human activities that impact the global environment, including the production of energy, use and management of finite resources such as petrochemicals, metals, food production (farmland, fresh and oce...

Comparison of two ways of altering carpal tunnel pressure with ultrasound surface wave elastography.

PubMed

Cheng, Yu-Shiuan; Zhou, Boran; Kubo, Kazutoshi; An, Kai-Nan; Moran, Steven L; Amadio, Peter C; Zhang, Xiaoming; Zhao, Chunfeng

2018-06-06

Higher carpal tunnel pressure is related to the development of carpal tunnel syndrome. Currently, the measurement of carpal tunnel pressure is invasive and therefore, a noninvasive technique is needed. We previously demonstrated that speed of wave propagation through a tendon in the carpal tunnel measured by ultrasound elastography could be used as an indicator of carpal tunnel pressure in a cadaveric model, in which a balloon had to be inserted into the carpal tunnel to adjust the carpal tunnel pressure. However, the method for adjusting the carpal tunnel pressure in the cadaveric model is not applicable for the in vivo model. The objective of this study was to utilize a different technique to adjust carpal tunnel pressure via pressing the palm and to validate it with ultrasound surface wave elastography in a human cadaveric model. The outcome was also compared with a previous balloon insertion technique. Results showed that wave speed of intra-carpal tunnel tendon and the ratio of wave speed of intra-and outer-carpal tunnel tendons increased linearly with carpal tunnel pressure. Moreover, wave speed of intra carpal tunnel tendon via both ways of altering carpal tunnel pressure showed similar results with high correlation. Therefore, it was concluded that the technique of pressing the palm can be used to adjust carpal tunnel pressure, and pressure changes can be detected via ultrasound surface wave elastography in an ex vivo model. Future studies will utilize this technique in vivo to validate the usefulness of ultrasound surface wave elastography for measuring carpal tunnel pressure. Copyright © 2018 Elsevier Ltd. All rights reserved.

Diagnostic potential of real-time elastography (RTE) and shear wave elastography (SWE) to differentiate benign and malignant thyroid nodules: A systematic review and meta-analysis.

PubMed

Hu, Xiangdong; Liu, Yujiang; Qian, Linxue

2017-10-01

Real-time elastography (RTE) and shear wave elastography (SWE) are noninvasive and easily available imaging techniques that measure the tissue strain, and it has been reported that the sensitivity and the specificity of elastography were better in differentiating between benign and malignant thyroid nodules than conventional technologies. Relevant articles were searched in multiple databases; the comparison of elasticity index (EI) was conducted with the Review Manager 5.0. Forest plots of the sensitivity and specificity and SROC curve of RTE and SWE were performed with STATA 10.0 software. In addition, sensitivity analysis and bias analysis of the studies were conducted to examine the quality of articles; and to estimate possible publication bias, funnel plot was used and the Egger test was conducted. Finally 22 articles which eventually satisfied the inclusion criteria were included in this study. After eliminating the inefficient, benign and malignant nodules were 2106 and 613, respectively. The meta-analysis suggested that the difference of EI between benign and malignant nodules was statistically significant (SMD = 2.11, 95% CI [1.67, 2.55], P < .00001). The overall sensitivities of RTE and SWE were roughly comparable, whereas the difference of specificities between these 2 methods was statistically significant. In addition, statistically significant difference of AUC between RTE and SWE was observed between RTE and SWE (P < .01). The specificity of RTE was statistically higher than that of SWE; which suggests that compared with SWE, RTE may be more accurate on differentiating benign and malignant thyroid nodules.

Value of the Strain Ratio on Ultrasonic Elastography for Differentiation of Benign and Malignant Soft Tissue Tumors.

PubMed

Hahn, Seok; Lee, Young Han; Lee, Seung Hyun; Suh, Jin-Suck

2017-01-01

The purpose of this study was to evaluate whether the strain ratio provides additional value to conventional visual elasticity scores in the differentiation of benign and malignant soft tissue tumors by ultrasonic elastography. The Institutional Review Board approved the protocol of this retrospective review. Seventy-three patients who underwent elastography and had a soft tissue mass pathologically confirmed by ultrasound-guided core biopsy or surgical excision were enrolled from April 2012 through October 2014. On elastography, elasticity scores were determined with a 5-point visual scale, and the strain ratio to adjacent soft tissue at the same depth was calculated. Tumors were divided into benign and malignant groups according to the pathologic diagnoses. Elasticity scores and strain ratios were compared between benign and malignant groups, and diagnostic performance was evaluated by receiver operating characteristic curves. Of the 73 patients, 40 had benign tumors, and 33 had malignant tumors. Strain ratios (P = .003) and elasticity scores (P = .048) were significantly different between pathologic results. The areas under the receiver operating characteristic curves were 0.700 (95% confidence interval, 0.581-0.802) for the strain ratio and 0.623 (95% confidence interval, 0.515-0.746) for elastography. The strain ratios of malignant soft tissue tumors were lower than those of benign tumors and showed better diagnostic performance than did elasticity scores. The strain ratio can be used as a diagnostic indicator to predict the malignant potential of soft tissue tumors. © 2016 by the American Institute of Ultrasound in Medicine.

Diagnostic potential of real-time elastography (RTE) and shear wave elastography (SWE) to differentiate benign and malignant thyroid nodules

PubMed Central

Hu, Xiangdong; Liu, Yujiang; Qian, Linxue

2017-01-01

Abstract Background: Real-time elastography (RTE) and shear wave elastography (SWE) are noninvasive and easily available imaging techniques that measure the tissue strain, and it has been reported that the sensitivity and the specificity of elastography were better in differentiating between benign and malignant thyroid nodules than conventional technologies. Methods: Relevant articles were searched in multiple databases; the comparison of elasticity index (EI) was conducted with the Review Manager 5.0. Forest plots of the sensitivity and specificity and SROC curve of RTE and SWE were performed with STATA 10.0 software. In addition, sensitivity analysis and bias analysis of the studies were conducted to examine the quality of articles; and to estimate possible publication bias, funnel plot was used and the Egger test was conducted. Results: Finally 22 articles which eventually satisfied the inclusion criteria were included in this study. After eliminating the inefficient, benign and malignant nodules were 2106 and 613, respectively. The meta-analysis suggested that the difference of EI between benign and malignant nodules was statistically significant (SMD = 2.11, 95% CI [1.67, 2.55], P < .00001). The overall sensitivities of RTE and SWE were roughly comparable, whereas the difference of specificities between these 2 methods was statistically significant. In addition, statistically significant difference of AUC between RTE and SWE was observed between RTE and SWE (P < .01). Conclusion: The specificity of RTE was statistically higher than that of SWE; which suggests that compared with SWE, RTE may be more accurate on differentiating benign and malignant thyroid nodules. PMID:29068996

In vivo time-harmonic multifrequency elastography of the human liver

NASA Astrophysics Data System (ADS)

Tzschätzsch, Heiko; Ipek-Ugay, Selcan; Guo, Jing; Streitberger, Kaspar-Josche; Gentz, Enno; Fischer, Thomas; Klaua, Robert; Schultz, Michael; Braun, Jürgen; Sack, Ingolf

2014-04-01

Elastography is capable of noninvasively detecting hepatic fibrosis by imposing mechanical stress and measuring the viscoelastic response in the liver. Magnetic resonance elastography (MRE) relies on time-harmonic vibrations, while most dynamic ultrasound elastography methods employ transient stimulation methods. This study attempts to benefit from the advantages of time-harmonic tissue stimulation, i.e. relative insensitivity to obesity and ascites and mechanical approachability of the entire liver, and the advantages of ultrasound, i.e. time efficiency, low costs, and wide availability, by introducing in vivo time-harmonic elastography (THE) of the human liver using ultrasound and a broad range of harmonic stimulation frequencies. THE employs continuous harmonic shear vibrations at 7 frequencies from 30 to 60 Hz in a single examination and determines the elasticity and the viscosity of the liver from the dispersion of the shear wave speed within the applied frequency range. The feasibility of the method is demonstrated in the livers of eight healthy volunteers and a patient with cirrhosis. Multifrequency MRE at the same drive frequencies was used as elastographic reference method. Similar values of shear modulus and shear viscosity according the Kelvin-Voigt model were obtained by MRE and THE, indicating that the new method is suitable for in vivo quantification of the shear viscoelastic properties of the liver, however, in real-time and at a fraction of the costs of MRE. In conclusion, THE may provide a useful tool for fast assessment of the viscoelastic properties of the liver at low costs and without limitations in obesity, ascites or hemochromatosis.

Feasibility of transient elastography versus real-time two-dimensional shear wave elastography in difficult-to-scan patients.

PubMed

Staugaard, Benjamin; Christensen, Peer Brehm; Mössner, Belinda; Hansen, Janne Fuglsang; Madsen, Bjørn Stæhr; Søholm, Jacob; Krag, Aleksander; Thiele, Maja

2016-11-01

Transient elastography (TE) is hampered in some patients by failures and unreliable results. We hypothesized that real time two-dimensional shear wave elastography (2D-SWE), the FibroScan XL probe, and repeated TE exams, could be used to obtain reliable liver stiffness measurements in patients with an invalid TE examination. We reviewed 1975 patients with 5764 TE exams performed between 2007 and 2014, to identify failures and unreliable exams. Fifty-four patients with an invalid TE at their latest appointment entered a comparative feasibility study of TE vs. 2D-SWE. The initial TE exam was successful in 93% (1835/1975) of patients. Success rate increased from 89% to 96% when the XL probe became available (OR: 1.07, 95% CI 1.06-1.09). Likewise, re-examining those with a failed or unreliable TE led to a reliable TE in 96% of patients. Combining availability of the XL probe with TE re-examination resulted in a 99.5% success rate on a per-patient level. When comparing the feasibility of TE vs. 2D-SWE, 96% (52/54) of patients obtained a reliable TE, while 2D-SWE was reliable in 63% (34/54, p < 0.001). The odds of a successful 2D-SWE exam decreased with higher skin-capsule distance (OR = 0.77, 95% CI 0.67-0.98). Transient elastography can be accomplished in nearly all patients by use of the FibroScan XL probe and repeated examinations. In difficult-to-scan patients, the feasibility of TE is superior to 2D-SWE.

Comparison of shear wave velocities on ultrasound elastography between different machines, transducers, and acquisition depths: a phantom study.

PubMed

Shin, Hyun Joo; Kim, Myung-Joon; Kim, Ha Yan; Roh, Yun Ho; Lee, Mi-Jung

2016-10-01

To investigate consistency in shear wave velocities (SWVs) on ultrasound elastography using different machines, transducers and acquisition depths. The SWVs were measured using an elasticity phantom with a Young's modulus of 16.9 kPa, with three recently introduced ultrasound elastography machines (A, B and C from different vendors) and two transducers (low and high frequencies) at four depths (2, 3, 4 and 5 cm). Mean SWVs from 15 measurements and coefficient of variations (CVs) were compared between three machines, two transducers and four acquisition depths. The SWVs using the high frequency transducer were not acquired at 5 cm depth in machine B, and a high frequency transducer was not available in machine C. The mean SWVs in the three machines were different (p ≤ 0.002). The CVs were 0-0.09 in three machines. The mean SWVs between the two transducers were different (p < 0.001) except at 4 and 5 cm depths in machine A. The SWVs were affected by the acquisition depths in all conditions (p < 0.001). There is considerable difference in SWVs on ultrasound elastography depending on different machines, transducers and acquisition depths. Caution is needed when using the cutoff values of SWVs in different conditions. • The shear wave velocities (SWVs) are different between different ultrasound elastography machines • The SWVs are also different between different transducers and acquisition depths • Caution is needed when using the cutoff SWVs measured under different conditions.

Plasma orexin A levels in recently menopausal women during and 3 years following use of hormone therapy.

PubMed

Cintron, Dahima; Beckman, John P; Bailey, Kent R; Lahr, Brian D; Jayachandran, Muthuvel; Miller, Virginia M

2017-05-01

Alterations in sleep quality and metabolism during menopause are improved by menopausal hormone therapy (MHT). The mechanisms mediating these effects remain unclear. Orexin A (OxA) is a neuro-peptide that regulates sleep/wakefulness, food intake and metabolism. This study examined changes in plasma OxA levels during and after treatment in women from the Kronos Early Estrogen Prevention Study (KEEPS). KEEPS randomized women within three years of menopause to: oral conjugated equine estrogen (o-CEE, 0.45mg/day), transdermal 17β estradiol (t-E2, 50μg/day), or placebo pills and patches for four years. Plasma OxA levels were measured by enzyme immunoassays in fasting blood samples collected annually from KEEPS participants at Mayo Clinic during and three years after MHT. Changes in menopausal symptoms and plasma OxA levels were assessed for treatment differences. During treatment, OxA levels increased more in women randomized to o-CEE compared with the other groups. Women randomized to either form of MHT demonstrated smaller increases in BMI than those on placebo. Insomnia severity decreased similarly among treatment groups. However, neither changes in sleep nor changes in BMI correlated with changes in plasma OxA levels. Changes in waist circumference correlated positively with changes in plasma OxA levels three years after discontinuation of study treatments. Although OxA levels increased only in women randomized to o-CEE, these changes did not correlate with changes in sleep quality or BMI. The modest correlation of OxA levels with waist circumference once study treatments were discontinued suggests that OxA may be modulated through multiple intermediary pathways affected by metabolites of 17β-estradiol. Clinical Trial Registration for KEEPS: NCT00154180. Copyright © 2017. Published by Elsevier B.V.

Detection of Early-Stage Oral Cancer Lesions: A Survey of California Dental Hygienists.

PubMed

Barao, Dayna M Hashimoto; Essex, Gwen; Lazar, Ann A; Rowe, Dorothy J

2016-12-01

Purpose: To assess dental hygienists' knowledge of early-stage oral cancer lesions and their practices, attitudes, barriers, and facilitators related to early detection. Methods: A 20-item survey containing images of oral lesions and related multiple-choice questions was distributed electronically by the California Dental Hygienists' Association to all dental hygienists whose email addresses were in their database. Response frequencies were calculated per survey item. Logistic regression analysis was used to explore associations. Results: Seven hundred fifty-one dental hygienists responded, yielding a 12% response rate. Respondents' correct identification of the six images of oral lesions varied from 40%-97%. Most respondents reported conducting oral cancer examinations (OCE) at every dental hygiene appointment and performing palpation during OCE. Regions of the mouth varied regarding the frequency of palpation. Lymph node palpation was considered the most commonly omitted step. Those who conducted palpations were 3.3 (95% CI: 1.4 to 7.9, p=0.006) times more likely to report that they knew someone with oral cancer and had detected oral cancer lesions than those who did not. Knowing a person with a history of oral cancer and previously detecting a cancerous lesion were also reported as factors encouraging respondents to bring suspicious lesions to the attention of the dentist. Discouraging factors were mostly related to the dentist' behavior, such as not referring a suspicious lesion for biopsy that the respondent identified. Conclusion: Detection of early-stage oral cancer lesions by dental hygienists may be enhanced through more extensive education of visual appearances of lesions and the importance of palpation in a comprehensive OCE. Copyright © 2016 The American Dental Hygienists’ Association.

Effects of compression force on elasticity index and elasticity ratio in ultrasound elastography

PubMed Central

Sasaki, Y; Sakamoto, J; Kamio, T; Nishikawa, K; Otonari-Yamamoto, M; Wako, M

2014-01-01

Objectives: The purpose of this study was to investigate the relationship between compression force and hardness values in ultrasound elastography. Methods: Ultrasound elastography was performed using an elastography phantom, comprising inclusions with different elasticities and echogenicities. The compression force was set to approximately 100 gw (light force) and approximately 500 gw (heavy force). The elasticity index (EI) of the inclusion was measured. The EI was a relative hardness value of a structure within an elastographic image. Similarly, the EI of the background was measured as a reference. The elasticity ratio (ER) was calculated as the EI of the inclusion divided by the EI of the reference. Results: The hardness of the phantom could be discerned with both the EI and ER, regardless of the compression force. The EI and ER with heavy force tended to be higher than those with light force, but the difference was not significant. A strong correlation was observed between the EI and ER of soft structures, whereas the correlation between the EI and ER of hard structures was weak, and the ER values varied widely. Conclusions: The EI offers potential as a good indicator for assessing the hardness. PMID:24592929

Comparison of Two Different Ultrasound Devices Using Strain Elastography Technology in the Diagnosis of Breast Lesions Related to the Histologic Results.

PubMed

Farrokh, André; Schaefer, Fritz; Degenhardt, Friedrich; Maass, Nicolai

2018-05-01

This study was conducted to provide evidence that elastograms of two different devices and different manufacturers using the same technical approach provide the same diagnoses. A total of 110 breast lesions were prospectively analysed by two experts in ultrasound, using the strain elastography function from two different manufacturers (Hitachi HI-RTE, Hitachi Medical Systems, Wiesbaden, Germany; and Siemens eSie Touch, Siemens Medical Systems, Erlangen, Germany). Results were compared with the histopathologic results. Applying the Bowker test of symmetry, no statistically significant difference between the two elastography functions of these two devices was found (p = 0.120). The Cohen's kappa of k = 0.591 showed moderate strength of agreement between the two elastograms. The two examiners yielded moderate strength of agreement analysing the elastograms (Hitachi HI-RTE, k = 0.478; Siemens eSie Touch, k = 0.441). In conclusion, evidence is provided that elastograms of the same lesion generated by two different ultrasound devices equipped with a strain elastography function do not significantly differ. Copyright © 2018 World Federation for Ultrasound in Medicine and Biology. Published by Elsevier Inc. All rights reserved.

Accuracy of real-time shear wave elastography in the assessment of normal liver tissue in the guinea pig (cavia porcellus).

PubMed

Glińska-Suchocka, K; Kubiak, K; Spużak, J; Jankowski, M; Borusewicz, P

2017-03-28

Shear wave elastography is a novel technique enabling real-time measurement of the elasticity of liver tissue. The color map is superimposed on the classic ultrasound image of the assessed tissue, which enables a precise evaluation of the stiffness of the liver tissue. The aim of the study was to assess the stiffness of normal liver tissue in the guinea pig using shear wave elastography. The study was carried out on 36 guinea pigs using the SuperSonic Imagine Aixplorer scanner, and a 1 to 6 MH convex SC6-1 transducer. An ultrasound guided Try-Cut liver core needle biopsy was carried out in all the studied animals and the collected samples were examined to exclude pathological lesions. The mean liver tissue stiffness ranged from 0.89 to 5.40 kPa. We found that shear wave elastography is an easy, non-invasive technique that can be used to assess the stiffness of liver tissue. The obtained results can be used in future studies to assess the types and changes of liver tissue in the course of various types of liver disease.

Combination of elastography and tissue quantification using the acoustic radiation force impulse (ARFI) technology for differential diagnosis of breast masses.

PubMed

Tozaki, Mitsuhiro; Isobe, Sachiko; Sakamoto, Masaaki

2012-10-01

We evaluated the diagnostic performance of elastography and tissue quantification using acoustic radiation force impulse (ARFI) technology for differential diagnosis of breast masses. There were 161 mass lesions. First, lesion correspondence on ARFI elastographic images to those on the B-mode images was evaluated: no findings on ARFI images (pattern 1), lesions that were bright inside (pattern 2), lesions that were dark inside (pattern 4), lesions that contained both bright and dark areas (pattern 3). In addition, pattern 4 was subdivided into 4a (dark area same as B-mode lesion) and 4b (dark area larger than lesion). Next, shear wave velocity (SWV) was measured using virtual touch tissue quantification. There were 13 pattern 1 lesions and five pattern 2 lesions; all of these lesions were benign, whereas all pattern 4b lesions (n = 43) were malignant. When the value of 3.59 m/s was chosen as the cutoff value, the combination of elastography and tissue quantification showed 91 % (83-91) sensitivity, 93 % (65-70) specificity, and 92 % (148-161) accuracy. The combination of elastography and tissue quantification is thought to be a promising ultrasound technique for differential diagnosis of breast-mass lesions.

Effectiveness of the Benign and Malignant Diagnosis of Mediastinal and Hilar Lymph Nodes by Endobronchial Ultrasound Elastography.

PubMed

Huang, Haidong; Huang, Zhiang; Wang, Qin; Wang, Xinan; Dong, Yuchao; Zhang, Wei; Zarogoulidis, Paul; Man, Yan-Gao; Schmidt, Wolfgang Hohenforst; Bai, Chong

2017-01-01

Background and Objectives: Endobronchial ultrasound elastography is a new technique for describing the stiffness of tissue during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). The aims of this study were to investigate the diagnostic value of Endobronchial ultrasound (EBUS) elastography for distinguishing the difference between benign and malignant lymph nodes among mediastinal and hilar lymph node. Materials and Methods: From June 2015 to August 2015, 47 patients confirmed of mediastinal and hilar lymph node enlargement through examination of Computed tomography (CT) were enrolled, and a total of 78 lymph nodes were evaluated by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). EBUS-guided elastography of lymph nodes was performed prior to EBUS-TBNA. A convex probe EBUS was used with a new EBUS processor to assess elastographic patterns that were classified based on color distribution as follows: Type 1, predominantly non-blue (green, yellow and red); Type 2, part blue, part non-blue (green, yellow and red); Type 3, predominantly blue. Pathological determination of malignant or benign lymph nodes was used as the gold standard for this study. The elastographic patterns were compared with the final pathologic results from EBUS-TBNA. Results: On pathological evaluation of the lymph nodes, 45 were benign and 33 were malignant. The lymph nodes that were classified as Type 1 on endobronchial ultrasound elastography were benign in 26/27 (96.3%) and malignant in 1/27 (3.7%); for Type 2 lymph nodes, 15/20 (75.0%) were benign and 5/20 (25.0%) were malignant; Type 3 lymph nodes were benign in 4/31 (12.9%) and malignant in 27/31 (87.1%). In classifying Type 1 as 'benign' and Type 3 as 'malignant,' the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy rates were 96.43%, 86.67%, 87.10%, 96.30%, 91.38%, respectively. Conclusion: EBUS elastography of mediastinal and hilar lymph nodes is a noninvasive technique that can be performed reliably and may be helpful in the prediction of benign and malignant lymph nodes among mediastinal and hilar lymph node during EBUS-TBNA.

SU-E-J-76: Incorporation of Ultrasound Elastography in Target Volume Delineation for Partial Breast Radiotherapy Planning: A Comparative Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Juneja, P; Harris, E; Bamber, J

2014-06-01

Purpose: There is substantial observer variability in the delineation of target volumes for post-surgical partial breast radiotherapy because the tumour bed has poor x-ray contrast. This variability may result in substantial variations in planned dose distribution. Ultrasound elastography (USE) has an ability to detect mechanical discontinuities and therefore, the potential to image the scar and distortion in breast tissue architecture. The goal of this study was to compare USE techniques: strain elastography (SE), shear wave elastography (SWE) and acoustic radiation force impulse (ARFI) imaging using phantoms that simulate features of the tumour bed, for the purpose of incorporating USE inmore » breast radiotherapy planning. Methods: Three gelatine-based phantoms (10% w/v) containing: a stiff inclusion (gelatine 16% w/v) with adhered boundaries, a stiff inclusion (gelatine 16% w/v) with mobile boundaries and fluid cavity inclusion (to mimic seroma), were constructed and used to investigate the USE techniques. The accuracy of the elastography techniques was quantified by comparing the imaged inclusion with the modelled ground-truth using the Dice similarity coefficient (DSC). For two regions of interest (ROI), the DSC measures their spatial overlap. Ground-truth ROIs were modelled using geometrical measurements from B-mode images. Results: The phantoms simulating stiff scar tissue with adhered and mobile boundaries and seroma were successfully developed and imaged using SE and SWE. The edges of the stiff inclusions were more clearly visible in SE than in SWE. Subsequently, for all these phantoms the measured DSCs were found to be higher for SE (DSCs: 0.91–0.97) than SWE (DSCs: 0.68–0.79) with an average relative difference of 23%. In the case of seroma phantom, DSC values for SE and SWE were similar. Conclusion: This study presents a first attempt to identify the most suitable elastography technique for use in breast radiotherapy planning. Further analysis will include comparison of ARFI with SE and SWE. This work is supported by the EPSRC Platform Grant, reference number EP/H046526/1.« less

What’s Upstream? GIS’s critical role in developing nutrient reference conditions for estuaries

EPA Science Inventory

Eutrophication due to excess levels of nitrogen and phosphorus can seriously impair ecological function in estuaries. Protective criteria for nutrients are difficult to establish because the source can vary spatially and seasonally, originate either from the watershed or the oce...

EXPLORING PROOF OF CONCEPT IN OCEAN CURRENT ENERGY EXTRACTION

EPA Science Inventory

The small-scale OCEE is expected to yield a power density similar to that of an average wind turbine of comparable size. The project will result in specifications for materials, turbine geometries and turbine location/orientation that will extract the most energy from ocean curre...

33 CFR 273.11 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Applicability. 273.11 Section 273.11 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE AQUATIC PLANT CONTROL § 273.11 Applicability. This regulation is applicable to all OCE elements and all...

33 CFR 273.11 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Applicability. 273.11 Section 273.11 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE AQUATIC PLANT CONTROL § 273.11 Applicability. This regulation is applicable to all OCE elements and all...

High H2O/Ce of K-rich MORB from Lena Trough and Gakkel Ridge, Arctic Ocean

NASA Astrophysics Data System (ADS)

Snow, J. E.; Feig, S. T.

2014-12-01

Lena Trough in the Arctic ocean is the oblique spreading continuation of Gakkel Ridge through the Fram Strait (eg Snow et al. 2011). Extreme trace element and isotopic compositions seen in Lena Trough basalt appear to be the enriched end member dominating the geochemistry of the Western Volcanic Zone of the Western Gakkel Ridge as traced by Pb isotopes, K2O/TiO2, Ba/Nb and other isotopic, major and trace element indicators of mixing (Nauret et al., 2011). This is in contrast to neighboring Gakkel Ridge which has been spreading for 50-60 million years. Basalts from Lena Trough also show a pure MORB noble gas signature (Nauret et al., 2010) and peridotites show no evidence of ancient components in their Os isotopes (Lassiter, et al., in press). The major and trace element compositions of the basalts, however are very distinct from MORB, being far more potassic than all but a single locality on the SW Indian Ridge. We determined H2O and trace element composiitions of a suite of 17 basalt glasses from the Central Lena Trough (CLT) and the Gakkel Western Volcanic Zone, including many of those previously analyzed by Nauret et al. (2012). The Western Gakkel glasses have high H2O/Ce for MORB (>300) suggesting a water rich source consistent with the idea that the northernmost Atlantic mantle is enriched in water (Michael et al., 1995). They are within the range of Eastern Gakkel host glasses determined by Wanless et al, 2013. The Lena Trough (CLT) glasses are very rich in water for MORB (>1% H2O) and are among the highest H2O/Ce (>400) ever measured in MORB aside from melt inclusions in olivine. Mantle melting dynamics and melt evolution cannot account for the H2O/Ce variations in MORB, as these elements have similar behavior during melting and crustal evolution. Interestingly, the H2O/K2O ratios in the basalts are only around 1. This is because the K2O levels in the CLT glasses are very high as well relative to REE. The absolutely linear relationship between H2O and K2O/TiO2 in Lena and Gakkel basalts shows that water systematics in these rocks are completely governed by source composition, with little or no modification by mantle melting dynamics or crystal fractionation. The geochemical influence of the WVZ enriched mantle source declines with distance from Lena Trough along Gakkel Ridge.

Age-related changes in pancreatic elasticity: When should we be concerned about their effect on strain elastography?

PubMed

Chantarojanasiri, Tanyaporn; Hirooka, Yoshiki; Kawashima, Hiroki; Ohno, Eizaburo; Sugimoto, Hiroyuki; Hayashi, Daijuro; Kuwahara, Takamichi; Yamamura, Takeshi; Funasaka, Kohei; Nakamura, Masanao; Miyahara, Ryoji; Ishigami, Masatoshi; Watanabe, Osamu; Hashimoto, Senju; Goto, Hidemi

2016-07-01

Ultrasound strain elastography is one of the useful methods for evaluating pancreatic lesions. During aging, several pancreatic parenchymal changes occur that may interfere with the interpretation of the ultrasound images. We studied age-related changes in pancreatic elasticity using transabdominal ultrasound strain elastography in subjects without known pancreatic disease. This study was conducted at Nagoya University Hospital, which is an academic medical center, and included 102 subjects (66 women and 39 men) aged 20-85years (mean 58.6±17.5) who underwent transabdominal ultrasonography for screening and follow-up for non-pancreatic diseases. Strain elastography of the pancreas was performed, and the results were subjected to quantitative strain histogram analysis. The correlations of age with four elastographic parameters (Mean, Standard deviation, Skewness, and Kurtosis) and other findings, including hyperechoic pancreas, hyperechoic liver, and diabetes, were evaluated. There was a significant correlation between increasing age and elastographic parameters such as the Mean (P=0.004), Skewness (P=0.007), and Kurtosis (P=0.03), and these differences became significant after the age of 40. The prevalence of hyperechoic pancreas increased with age (P<0.001), and the Means were lower in those with hyperechoic pancreas (P=0.004) and a higher body mass index (BMI, P=0.008). No significant correlations with diabetes, hyperechoic liver, or elastographic parameters were demonstrated. Strain elastography demonstrated elastographic changes in the pancreas with aging that included a decreasing Mean and increasing Skewness and Kurtosis after the age of 40. The prevalence of pancreatic hyperechogenicity increased, and the pancreatic hyperechogenicity was significantly negatively correlated with the Mean. Copyright © 2016 Elsevier B.V. All rights reserved.

Investigation into the visual perceptive ability of anaesthetists during ultrasound-guided interscalene and femoral blocks conducted on soft embalmed cadavers: a randomised single-blind study.

PubMed

Mustafa, A; Seeley, J; Munirama, S; Columb, M; McKendrick, M; Schwab, A; Corner, G; Eisma, R; Mcleod, G

2018-04-01

Errors may occur during regional anaesthesia whilst searching for nerves, needle tips, and test doses. Poor visual search impacts on decision making, clinical intervention, and patient safety. We conducted a randomised single-blind study in a single university hospital. Twenty trainees and two consultants examined the paired B-mode and fused B-mode and elastography video recordings of 24 interscalene and 24 femoral blocks conducted on two soft embalmed cadavers. Perineural injection was randomised equally to 0.25, 0.5, and 1.0 ml volumes. Tissue displacement perceived on both imaging modalities was defined as 'target' or 'distractor'. Our primary objective was to test the anaesthetists' perception of the number and proportion of targets and distractors on B-mode and fused elastography videos collected during femoral and sciatic nerve block on soft embalmed cadavers. Our secondary objectives were to determine the differences between novices and experts, and between test-dose volumes, and to measure the area and brightness of spread and strain patterns. All anaesthetists recognised perineural spread using 0.25 ml volumes. Distractor patterns were recognised in 133 (12%) of B-mode and in 403 (38%) of fused B-mode and elastography patterns; P<0.001. With elastography, novice recognition improved from 12 to 37% (P<0.001), and consultant recognition increased from 24 to 53%; P<0.001. Distractor recognition improved from 8 to 31% using 0.25 ml volumes (P<0.001), and from 15 to 45% using 1 ml volumes (P<0.001). Visual search improved with fusion elastography, increased volume, and consultants. A need exists to investigate image search strategies. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Interobserver variability of ultrasound elastography and the ultrasound BI-RADS lexicon of breast lesions.

PubMed

Park, Chang Suk; Kim, Sung Hun; Jung, Na Young; Choi, Jae Jung; Kang, Bong Joo; Jung, Hyun Seouk

2015-03-01

Elastographpy is a newly developed noninvasive imaging technique that uses ultrasound (US) to evaluate tissue stiffness. The interpretation of the same elastographic images may be variable according to reviewers. Because breast lesions are usually reported according to American College of Radiology Breast Imaging and Data System (ACR BI-RADS) lexicons and final category, we tried to compare observer variability between lexicons and final categorization of US BI-RADS and the elasticity score of US elastography. From April 2009 to February 2010, 1356 breast lesions in 1330 patients underwent ultrasound-guided core biopsy. Among them, 63 breast lesions in 55 patients (mean age, 45.7 years; range, 21-79 years) underwent both conventional ultrasound and elastography and were included in this study. Two radiologists independently performed conventional ultrasound and elastography, and another three observers reviewed conventional ultrasound images and elastography videos. Observers independently recorded the elasticity score for a 5-point scoring system proposed by Itoh et al., BI-RADS lexicons and final category using ultrasound BI-RADS. The histopathologic results were obtained and used as the reference standard. Interobserver variability was evaluated. Of the 63 lesions, 42 (66.7 %) were benign, and 21 (33.3 %) were malignant. The highest value of concordance among all variables was achieved for the elasticity score (k = 0.59), followed by shape (k = 0.54), final category (k = 0.48), posterior acoustic features (k = 0.44), echogenecity and orientation (k = 0.43). The least concordances were margin (k = 0.26), lesion boundary (k = 0.29) and calcification (k = 0.3). Elasticity score showed a higher level of interobserver agreement for the diagnosis of breast lesions than BI-RADS lexicons and final category.

Prospective comparison of magnetic resonance imaging to transient elastography and serum markers for liver fibrosis detection.

PubMed

Dyvorne, Hadrien A; Jajamovich, Guido H; Bane, Octavia; Fiel, M Isabel; Chou, Hsin; Schiano, Thomas D; Dieterich, Douglas; Babb, James S; Friedman, Scott L; Taouli, Bachir

2016-05-01

Establishing accurate non-invasive methods of liver fibrosis quantification remains a major unmet need. Here, we assessed the diagnostic value of a multiparametric magnetic resonance imaging (MRI) protocol including diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE)-MRI and magnetic resonance elastography (MRE) in comparison with transient elastography (TE) and blood tests [including ELF (Enhanced Liver Fibrosis) and APRI] for liver fibrosis detection. In this single centre cross-sectional study, we prospectively enrolled 60 subjects with liver disease who underwent multiparametric MRI (DWI, DCE-MRI and MRE), TE and blood tests. Correlation was assessed between non-invasive modalities and histopathologic findings including stage, grade and collagen content, while accounting for covariates such as age, sex, BMI, HCV status and MRI-derived fat and iron content. ROC curve analysis evaluated the performance of each technique for detection of moderate-to-advanced liver fibrosis (F2-F4) and advanced fibrosis (F3-F4). Magnetic resonance elastography provided the strongest correlation with fibrosis stage (r = 0.66, P < 0.001), inflammation grade (r = 0.52, P < 0.001) and collagen content (r = 0.53, P = 0.036). For detection of moderate-to-advanced fibrosis (F2-F4), AUCs were 0.78, 0.82, 0.72, 0.79, 0.71 for MRE, TE, DCE-MRI, DWI and APRI, respectively. For detection of advanced fibrosis (F3-F4), AUCs were 0.94, 0.77, 0.79, 0.79 and 0.70, respectively. Magnetic resonance elastography provides the highest correlation with histopathologic markers and yields high diagnostic performance for detection of advanced liver fibrosis and cirrhosis, compared to DWI, DCE-MRI, TE and serum markers. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Doppler ultrasonography combined with transient elastography improves the non-invasive assessment of fibrosis in patients with chronic liver diseases.

PubMed

Alempijevic, Tamara; Zec, Simon; Nikolic, Vladimir; Veljkovic, Aleksandar; Stojanovic, Zoran; Matovic, Vera; Milosavljevic, Tomica

2017-01-31

Accurate clinical assessment of liver fibrosis is essential and the aim of our study was to compare and combine hemodynamic Doppler ultrasonography, liver stiffness by transient elastography, and non-invasive serum biomarkers with the degree of fibrosis confirmed by liver biopsy, and thereby to determine the value of combining non-invasive method in the prediction significant liver fibrosis. We included 102 patients with chronic liver disease of various etiology. Each patient was evaluated using Doppler ultrasonography measurements of the velocity and flow pattern at portal trunk, hepatic and splenic artery, serum fibrosis biomarkers, and transient elastography. These parameters were then input into a multilayer perceptron artificial neural network with two hidden layers, and used to create models for predicting significant fibrosis. According to METAVIR score, clinically significant fibrosis (≥F2) was detected in 57.8% of patients. A model based only on Doppler parameters (hepatic artery diameter, hepatic artery systolic and diastolic velocity, splenic artery systolic velocity and splenic artery Resistance Index), predicted significant liver fibrosis with a sensitivity and specificity of75.0% and 60.0%. The addition of unrelated non-invasive tests improved the diagnostic accuracy of Doppler examination. The best model for prediction of significant fibrosis was obtained by combining Doppler parameters, non-invasive markers (APRI, ASPRI, and FIB-4) and transient elastography, with a sensitivity and specificity of 88.9% and 100%. Doppler parameters alone predict the presence of ≥F2 fibrosis with fair accuracy. Better prediction rates are achieved by combining Doppler variables with non-invasive markers and liver stiffness by transient elastography.

Fontan Circulation in Adult Patients: Acoustic Radiation Force Impulse Elastography as a Useful Tool for Liver Assessment.

PubMed

Melero-Ferrer, Josep Lluís; Osa-Sáez, Ana; Buendía-Fuentes, Francisco; Ballesta-Cuñat, Antonio; Flors, Lucía; Rodríguez-Serrano, María; Calvillo-Batllés, Pilar; Arnau-Vives, Miguel-Ángel; Palencia-Pérez, Miguel A; Rueda-Soriano, Joaquín

2014-07-01

The development of liver fibrosis and cirrhosis due to long-standing liver congestion is known to occur in adult patients with Fontan circulation. Hepatic elastography has shown to be a useful tool for the noninvasive assessment and staging of liver fibrosis in chronic liver diseases, although the utility of this technique in Fontan patients remains to be adequately studied. Twenty-one patients with Fontan circulation underwent an abdominal ultrasound and an acoustic radiation force impulse (ARFI) elastography. In order to compare the results from this group, a cohort of 14 healthy controls and another group containing 17 patients with cirrhosis were included. The association between the velocity values measured with elastography and clinical and analytical parameters were also studied. Mean shear waves propagation velocity in liver tissue in the Fontan group was 1.86 ± 0.5 m/s, with 76% of patients over the cirrhosis threshold (1.55 m/s). The control group had a mean velocity of 1.09 ± 0.06 m/s, while the cirrhotic group obtained 2.71 ± 0.51 m/s. Seven patients with Fontan circulation had increased liver enzymes. Liver ultrasound showed evidence of chronic liver disease in six patients. Velocity values obtained in the presence or absence of analytical or liver ultrasound abnormalities showed significant differences in the univariate analysis (P = .04 and P = .03 respectively). In conclusion, ARFI elastography showed increased wave propagation velocity values in the Fontan population suggesting increased liver stiffness which could be related to advanced fibrosis. A statistically significant association between ARFI values and the presence of analytical and ultrasound abnormalities has been demonstrated. © The Author(s) 2014.

Quantitative Shear Wave Velocity Measurement on Acoustic Radiation Force Impulse Elastography for Differential Diagnosis between Benign and Malignant Thyroid Nodules: A Meta-analysis.

PubMed

Liu, Bo-Ji; Li, Dan-Dan; Xu, Hui-Xiong; Guo, Le-Hang; Zhang, Yi-Feng; Xu, Jun-Mei; Liu, Chang; Liu, Lin-Na; Li, Xiao-Long; Xu, Xiao-Hong; Qu, Shen; Xing, Mingzhao

2015-12-01

The aim of this study was to evaluate the diagnostic performance of quantitative shear wave velocity (SWV) measurement on acoustic radiation force impulse (ARFI) elastography for differentiation between benign and malignant thyroid nodules using meta-analysis. The databases of PubMed and the Web of Science were searched. Studies published in English on assessment of the sensitivity and specificity of ARFI elastography for the differentiation of thyroid nodules were collected. The quantitative measurement of ARFI elastography was evaluated by SWV (m/s). Meta-Disc Version 1.4 software was used to describe and calculate the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and summary receiver operating characteristic curves. We analyzed a total of 13 studies, which included 1,854 thyroid nodules (including 1,339 benign nodules and 515 malignant nodules) from 1,641 patients. The summary sensitivity and specificity for differential diagnosis between benign and malignant thyroid nodules by SWV were 0.81 (95% confidence interval [CI]: 0.77-0.84) and 0.84 (95% CI: 0.81-0.86), respectively. The pooled positive and negative likelihood ratios were 5.21 (95% CI: 3.56-7.62) and 0.23 (95% CI: 0.17-0.32), respectively. The pooled diagnostic odds ratio was 27.53 (95% CI: 14.58-52.01), and the area under the summary receiver operating characteristic curve was 0.91 (Q* = 0.84). In conclusion, SWV measurement on ARFI elastography has high sensitivity and specificity for differential diagnosis between benign and malignant thyroid nodules and can be used in combination with conventional ultrasound. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Five-dimensional ultrasound system for soft tissue visualization.

PubMed

Deshmukh, Nishikant P; Caban, Jesus J; Taylor, Russell H; Hager, Gregory D; Boctor, Emad M

2015-12-01

A five-dimensional ultrasound (US) system is proposed as a real-time pipeline involving fusion of 3D B-mode data with the 3D ultrasound elastography (USE) data as well as visualization of these fused data and a real-time update capability over time for each consecutive scan. 3D B-mode data assist in visualizing the anatomy of the target organ, and 3D elastography data adds strain information. We investigate the feasibility of such a system and show that an end-to-end real-time system, from acquisition to visualization, can be developed. We present a system that consists of (a) a real-time 3D elastography algorithm based on a normalized cross-correlation (NCC) computation on a GPU; (b) real-time 3D B-mode acquisition and network transfer; (c) scan conversion of 3D elastography and B-mode volumes (if acquired by 4D wobbler probe); and (d) visualization software that fuses, visualizes, and updates 3D B-mode and 3D elastography data in real time. We achieved a speed improvement of 4.45-fold for the threaded version of the NCC-based 3D USE versus the non-threaded version. The maximum speed was 79 volumes/s for 3D scan conversion. In a phantom, we validated the dimensions of a 2.2-cm-diameter sphere scan-converted to B-mode volume. Also, we validated the 5D US system visualization transfer function and detected 1- and 2-cm spherical objects (phantom lesion). Finally, we applied the system to a phantom consisting of three lesions to delineate the lesions from the surrounding background regions of the phantom. A 5D US system is achievable with real-time performance. We can distinguish between hard and soft areas in a phantom using the transfer functions.

Value of ultrasound shear wave elastography in the diagnosis of adenomyosis.

PubMed

Acar, S; Millar, E; Mitkova, M; Mitkov, V

2016-11-01

The aim of the study was to assess the accuracy of ultrasound shear wave elastography in the diagnosis of adenomyosis. One hundred and fifty three patients were examined. Ninety-seven patients were with suspected adenomyosis and 56 patients were with unremarkable myometrium. Adenomyosis was confirmed in 39 cases (A subgroup) and excluded in 14 cases (B subgroup) in the main group based on morphological examination. All patients underwent ultrasound examination using an Aixplorer (Supersonic Imagine, France) scanner with application of shear wave elastography during transvaginal scanning. Retrospective analysis of the elastography criteria against the findings from morphological/histological examination was performed. The following values of Young's modulus were found in subgroup A (adenomyosis): Emean - 72.7 (22.6-274.2) kPa (median, 5-95th percentiles), Emax - 94.8 (29.3-300.0) kPa, SD - 9.9 (2.6-26.3) kPa; in subgroup B (non adenomyosis) - 28.3 (12.7-59.5) kPa, 33.6 (16.0-80.8) kPa, 3.0 (1.4-15.6) kPa; in the control group - 24.4 (17.9-32.4) kPa, 29.8 (21.6-40.8) kPa, 2.3 (1.3-6.1) kPa, respectively (P < 0.05 for all comparison with subgroup В and the control group). The Emean cut-off value for adenomyosis diagnosis was 34.6 kPa. The sensitivity, specificity, positive predictive value, negative predictive value and area under curve (AUC) were 89.7%, 92.9%, 97.2%, 76.5% and 0.908. The Emax cut-off value was 45.4 kPa (89.7%, 92.9%, 97.2%, 76.5% and 0.907, respectively). This study showed a significant increase of the myometrial stiffness estimated with shear wave elastography use in patients with adenomyosis.

Shear-wave elastography of the testis in the healthy man - determination of standard values.

PubMed

Trottmann, M; Marcon, J; D'Anastasi, M; Bruce, M F; Stief, C G; Reiser, M F; Buchner, A; Clevert, D A

2016-01-01

Real-time shear-wave elastography (SWE) is a newly developed technique for the sonographic quantification of tissue elasticity, which already is used in the assessment of breast and thyroid lesions. Due to limited overlying tissue, the testes are ideally suited for assessment using shear wave elastography. To our knowledge, no published data exist on real-time SWE of the testes. Sixty six male volunteers (mean age 51.86±18.82, range 20-86) with no known testicular pathology underwent normal B-mode sonography and multi-frame shear-wave elastography of both testes using the Aixplorer ® ultrasound system (SuperSonic Imagine, Aix en Provence, France). Three measurements were performed for each testis; one in the upper pole, in the middle portion and in the lower pole respectively. The results were statistically evaluated using multivariate analysis. Mean shear-wave velocity values were similar in the inferior and superior part of the testicle (1.15 m/s) and were significantly lower in the centre (0.90 m/s). These values were age-independent. Testicular stiffness was significantly lower in the upper pole than in the rest of the testis with increasing volume (p = 0.007). Real-time shear-wave elastography proved to be feasible in the assessment of testicular stiffness. It is important to consider the measurement region as standard values differ between the centre and the testicular periphery. Further studies with more subjects may be required to define the normal range of values for each age group. Useful clinical applications could include the diagnostic work-up of patients with scrotal masses or male infertility.

[The diagnostic value of ultrasonic elastography and ultrasonography comprehensive score in cervical lesions].

PubMed

Lu, R; Xiao, Y

2017-07-18

Objective: To evaluate the clinical value of ultrasonic elastography and ultrasonography comprehensive scoring method in the diagnosis of cervical lesions. Methods: A total of 116 patients were selected from the Department of Gynecology of the first hospital affiliated with Central South University from March 2014 to September 2015.All of the lesions were preoperatively examined by Doppler Ultrasound and elastography.The elasticity score was determined by a 5-point scoring method. Calculation of the strain ratio was based on a comparison of the average strain measured in the lesion with the adjacent tissue of the same depth, size, and shape.All these ultrasonic parameters were quantified, added, and arrived at ultrasonography comprehensive scores.To use surgical pathology as the gold standard, the sensitivity, specificity, accuracy of Doppler Ultrasound, elasticity score and strain ratio methods and ultrasonography comprehensive scoring method were comparatively analyzed. Results: (1) The sensitivity, specificity, and accuracy of Doppler Ultrasound in diagnosing cervical lesions were 82.89% (63/76), 85.0% (34/40), and 83.62% (97/116), respectively.(2) The sensitivity, specificity, and accuracy of the elasticity score method were 77.63% (59/76), 82.5% (33/40), and 79.31% (92/116), respectively; the sensitivity, specificity, and accuracy of the strain ratio measure method were 84.21% (64/76), 87.5% (35/40), and 85.34% (99/116), respectively.(3) The sensitivity, specificity, and accuracy of ultrasonography comprehensive scoring method were 90.79% (69/76), 92.5% (37/40), and 91.38% (106/116), respectively. Conclusion: (1) It was obvious that ultrasonic elastography had certain diagnostic value in cervical lesions. Strain ratio measurement can be more objective than elasticity score method.(2) The combined application of ultrasonography comprehensive scoring method, ultrasonic elastography and conventional sonography was more accurate than single parameter.

Time Harmonic Elastography Reveals Sensitivity of Liver Stiffness to Water Ingestion.

PubMed

Ipek-Ugay, Selcan; Tzschätzsch, Heiko; Hudert, Christian; Marticorena Garcia, Stephan Rodrigo; Fischer, Thomas; Braun, Jürgen; Althoff, Christian; Sack, Ingolf

2016-06-01

The aim of the study was to test the sensitivity of liver stiffness (LS) measured by time harmonic elastography in large tissue windows to water uptake and post-prandial effects. Each subject gave written informed consent to participate in this institutional review board-approved prospective study. LS was measured by time harmonic elastography in 10 healthy volunteers pre- and post-prandially, as well as before, directly after and 2 h after drinking water. The LS-time function during water intake was measured in 14 scans over 3 h in five volunteers. LS increased by 10% (p = 0.0015) post-prandially and by 11% (p = 0.0024) after pure water ingestion, and decreased to normal values after 2 h. LS was lower after overnight fasting than after 2-h fasting (3%, p = 0.04). Over the time course, LS increased to post-water peak values 15 min after drinking 0.25 L water and remained unaffected by further ingestion of water. In conclusion, our study indicates that LS measured by time harmonic elastography represents an effective-medium property sensitive to physiologic changes in vascular load of the liver. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Transurethral prostate magnetic resonance elastography: prospective imaging requirements.

PubMed

Arani, Arvin; Plewes, Donald; Chopra, Rajiv

2011-02-01

Tissue stiffness is known to undergo alterations when affected by prostate cancer and may serve as an indicator of the disease. Stiffness measurements can be made with magnetic resonance elastography performed using a transurethral actuator to generate shear waves in the prostate gland. The goal of this study was to help determine the imaging requirements of transurethral magnetic resonance elastography and to evaluate whether the spatial and stiffness resolution of this technique overlapped with the requirements for prostate cancer detection. Through the use of prostate-mimicking gelatin phantoms, frequencies of at least 400 Hz were necessary to obtain accurate stiffness measurements of 10 mm diameter inclusions, but the detection of inclusions with diameters as small as 4.75 mm was possible at 200 Hz. The shear wave attenuation coefficient was measured in vivo in the canine prostate gland, and was used to predict the detectable penetration depth of shear waves in prostate tissue. These results suggested that frequencies below 200 Hz could propagate to the prostate boundary with a signal to noise ratio (SNR) of 60 and an actuator capable of producing 60 μm displacements. These requirements are achievable with current imaging and actuator technologies, and motivate further investigation of magnetic resonance elastography for the targeting of prostate cancer. Copyright © 2010 Wiley-Liss, Inc.

Ultrasound Elastography for Estimation of Regional Strain of Multilayered Hydrogels and Tissue-Engineered Cartilage

PubMed Central

Chung, Chen-Yuan; Heebner, Joseph; Baskaran, Harihara; Welter, Jean F.; Mansour, Joseph M.

2015-01-01

Tissue-engineered (TE) cartilage constructs tend to develop inhomogeneously, thus, to predict the mechanical performance of the tissue, conventional biomechanical testing, which yields average material properties, is of limited value. Rather, techniques for evaluating regional and depth-dependent properties of TE cartilage, preferably non-destructively, are required. The purpose of this study was to build upon our previous results and to investigate the feasibility of using ultrasound elastography to non-destructively assess the depth-dependent biomechanical characteristics of TE cartilage while in a sterile bioreactor. As a proof-of-concept, and to standardize an assessment protocol, a well-characterized three-layered hydrogel construct was used as a surrogate for TE cartilage, and was studied under controlled incremental compressions. The strain field of the construct predicted by elastography was then validated by comparison with a poroelastic finite-element analysis (FEA). On average, the differences between the strains predicted by elastography and the FEA were within 10%. Subsequently engineered cartilage tissue was evaluated in the same test fixture. Results from these examinations showed internal regions where the local strain was 1–2 orders of magnitude greater than that near the surface. These studies document the feasibility of using ultrasound to evaluate the mechanical behaviors of maturing TE constructs in a sterile environment. PMID:26077987

Elastography methods for the non-invasive assessment of portal hypertension.

PubMed

Roccarina, Davide; Rosselli, Matteo; Genesca, Joan; Tsochatzis, Emmanuel A

2018-02-01

The gold standard to assess the presence and severity of portal hypertension remains the hepatic vein pressure gradient, however the recent development of non-invasive assessment using elastography techniques offers valuable alternatives. In this review, we discuss the diagnostic accuracy and utility of such techniques in patients with portal hypertension due to cirrhosis. Areas covered: A literature search focused on liver and spleen stiffness measurement with different elastographic techniques for the assessment of the presence and severity of portal hypertension and oesophageal varices in people with chronic liver disease. The combination of elastography with parameters such as platelet count and spleen size is also discussed. Expert commentary: Non-invasive assessment of liver fibrosis and portal hypertension is a validated tool for the diagnosis and follow-up of patients. Baveno VI recommended the combination of transient elastography and platelet count for ruling out varices needing treatment in patients with compensated advanced chronic liver disease. Assessment of aetiology specific cut-offs for ruling in and ruling out clinically significant portal hypertension is an unmet clinical need. The incorporation of spleen stiffness measurements in non-invasive algorithms using validated software and improved measuring scales might enhance the non-invasive diagnosis of portal hypertension in the next 5 years.

High-resolution optical polarimetric elastography for measuring the mechanical properties of tissue

NASA Astrophysics Data System (ADS)

Hudnut, Alexa W.; Armani, Andrea M.

2018-02-01

Traditionally, chemical and molecular markers have been the predominate method in diagnostics. Recently, alternate methods of determining tissue and disease characteristics have been proposed based on testing the mechanical behavior of biomaterials. Existing methods for performing elastography measurements, such as atomic force microscopy, compression testing, and ultrasound elastography, require either extensive sample processing or have poor resolution. In the present work, we demonstrate an optical polarimetric elastography device to characterize the mechanical properties of salmon skeletal muscle. A fiber-coupled 1550nm laser paired with an optical polarizer is used to create a fiber optic sensing region. By measuring the change in polarization from the initial state to the final state within the fiber sensing region with a polarimeter, the loading-unloading curves can be determined for the biomaterial. The device is used to characterize the difference between samples with a range of collagen membranes. The loading-unloading curves are used to determine the change in polarization phase and energy loss of the samples at 10%, 20% and 30% strain. As expected, the energy loss is a better metric for measuring the mechanical properties of the tissues because it incorporates the entire loading-unloading curve rather than a single point. Using this metric, it is demonstrated the device can repeatedly differentiate between the different membrane configurations.

TECHNIQUES FOR DETERMINING UV EXPOSURE IN COASTAL WATERS: CASE STUDY IN SOUTH FLORIDA

EPA Science Inventory

The photosynthesis of coral reefs is inhibited by solar ultraviolet (UV) radiation and UV in combination with unusually high sea surface temperatures is believed to play an important role in coral bleaching. In this presentation we use a new technique based on remotely sensed oce...

What’s Upstream? GIS’s critical role in developing nutrient reference conditions for estuaries - April 2, 2015

EPA Science Inventory

Eutrophication due to excess levels of nitrogen and phosphorus can seriously impair ecological function in estuaries. Protective criteria for nutrients are difficult to establish because the source can vary spatially and seasonally, originate either from the watershed or the oce...

7 CFR 2902.6 - Providing product information to Federal agencies.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Web site. An informational USDA Web site implementing section 9002 can be found at: http://www.biobased.oce.usda.gov. USDA will maintain a voluntary Web-based information site for manufacturers and... information. This Web site will provide information as to the availability, relative price, biobased content...

33 CFR 263.20 - Program funding.

Code of Federal Regulations, 2010 CFR

2010-07-01

... authorities of this Program will be utilized by the Corps of Engineers in conducting studies approved by... grants of Program funds will be made to local interests for conducting studies or constructing projects... Engineer to proceed with a feasibility study, after submission of a DPR to OCE and approval of the Division...

33 CFR 263.20 - Program funding.

Code of Federal Regulations, 2011 CFR

2011-07-01

... authorities of this Program will be utilized by the Corps of Engineers in conducting studies approved by... grants of Program funds will be made to local interests for conducting studies or constructing projects... Engineer to proceed with a feasibility study, after submission of a DPR to OCE and approval of the Division...

The Future of Migration.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France).

This book comprises papers delivered at a conference of National Experts on Migration. The principle objective of the conference was twofold: to examine significant trends that will affect the future of migration in countries in the Organization for Economic Co-operation and Development (OCED), and to identify the relevant issues that will have to…

Space transportation system flight 2 OSTA-1 scientific payload data management plan

NASA Technical Reports Server (NTRS)

1981-01-01

The Shuttle Imaging Radar-A (SIR-A), Shuttle Multispectral Infrared Radiometer (SMIRR), Future Identification and Location Experiment (FILE), Measurement of Air Pollution from Satellites (MAPS), Ocean Color Experiment (OCE), the Night/Day Optical Survey of Lightning (NOSL), and the Heflex Bioengineering Test (HBT) experiments are described.

H2O Paradox and its Implications on H2O in Moon

NASA Astrophysics Data System (ADS)

Zhang, Youxue

2017-04-01

The concentration of H2O in the mantle of a planetary body plays a significant role in the viscosity and partial melting and hence the convection and evolution of the planetary body. Even though the composition of the primitive terrestrial mantle (PTM) is thought to be well known [1-2], the concentration of H2O in PTM remains paradoxial because different methods of estimation give different results [3]: Using H2O/Ce ratio in MORB and OIB and Ce concentration in PTM, the H2O concentration in PTM would be (300÷×1.5) ppm; using mass balance by adding surface water to the mantle [3-4], H2O concentration in PTM would be (900÷×1.3) ppm [2-3]. The inconsistency based on these two seemingly reliable methods is referred to as the H2O paradox [3]. For Moon, H2O contents in the primitive lunar mantle (PLM) estimated from H2O in plagioclase in lunar anorthosite and that from H2O/Ce ratio in melt inclusions are roughly consistent at ˜110 ppm [5-6] even though there is still debate about the volatile depletion trend [7]. One possible solution to the H2O paradox in PTM is to assume that early Earth experienced whole mantle degassing, which lowered the H2O/Ce ratio in the whole mantle but without depleting Ce in the mantle. The second possible solution is that some deep Earth reservoirs with high H2O/Ce ratios have not been sampled by MORB and OIB. Candidates include the transition zone [8] and the D" layer. The third possible solution is that ocean water only partially originated from mantle degassing, but partially from extraterrestrial sources such as comets [9-10]. At present, there is not enough information to determine which scenario is the answer to the H2O paradox. On the other hand, each scenario would have its own implications to H2O in PLM. If the first scenario applies to Moon, because degassed H2O or H2 would have escaped from the lunar surface, the very early lunar mantle could have much higher H2O [11] than that obtained using the H2O/Ce ratio method. The second scenario is unlikely on Moon because there was unlikely plate tectonics, and because there is no similar H2O-rich transition zone or D" layer due to the much lower maximum pressure in Moon. In the third scenario, volatiles from an extralunar source would likely be lost from the high vacuum environment of the lunar surface, meaning that it would not impact on the H2O content estimation. [1] McDonough & Sun (1995) Chem. Geol. 120, 223. [2] Palme & O'Neill (2014) Treatise on Geochemistry 3, 1. [3] Zhang (2014) Treatise on Geochemistry 6, 37. [4] Zhang & Zindler (1989) JGR 94, 13719. [5] Hui et al. (2013) Nature Geosci. 6, 177. [6] Chen et al. (2015) EPSL 427, 37. [7] Albarede et al. (2015) MPS 50, 568. [8] Sobolev et al. (2016) Nature 531, 628. [9] Chyba (1987) Nature 330, 632. [10] Hartogh et al. (2011) Nature 478, 218. [11] Hui et al. (2016) Goldschmidt Conf. Abstr.

Practical Challenges of Current Video Rate OCT Elastography: Accounting for Dynamic and Static Tissue Properties

PubMed Central

Brezinski, Mark E

2017-01-01

Optical coherence tomography (OCT) elastography (OCTE) has the potential to be an important diagnostic tool for pathologies including coronary artery disease, osteoarthritis, malignancies, and even dental caries. Many groups have performed OCTE, including our own, using a wide range of approaches. However, we will demonstrate current OCTE approaches are not scalable to real-time, in vivo imaging. As will be discussed, among the most important reasons is current designs focus on the system and not the target. Specifically, tissue dynamic responses are not accounted, with examples being the tissue strain response time, preload variability, and conditioning variability. Tissue dynamic responses, and to a lesser degree static tissue properties, prevent accurate video rate modulus assessments for current embodiments. Accounting for them is the focus of this paper. A top-down approach will be presented to overcome these challenges to real time in vivo tissue characterization. Discussed first is an example clinical scenario where OTCE would be of substantial relevance, the prevention of acute myocardial infarction or heart attacks. Then the principles behind OCTE are examined. Next, constrains on in vivo application of current OCTE are evaluated, focusing on dynamic tissue responses. An example is the tissue strain response, where it takes about 20 msec after a stress is applied to reach plateau. This response delay is not an issue at slow acquisition rates, as most current OCTE approaches are preformed, but it is for video rate OCTE. Since at video rate each frame is only 30 msec, for essentially all current approaches this means the strain for a given stress is changing constantly during the B-scan. Therefore the modulus can’t be accurately assessed. This serious issue is an even greater problem for pulsed techniques as it means the strain/modulus for a given stress (at a location) is unpredictably changing over a B-scan. The paper concludes by introducing a novel video rate approach to overcome these challenges. PMID:29286052

Practical Challenges of Current Video Rate OCT Elastography: Accounting for Dynamic and Static Tissue Properties.

PubMed

Brezinski, Mark E

2014-12-01

Optical coherence tomography (OCT) elastography (OCTE) has the potential to be an important diagnostic tool for pathologies including coronary artery disease, osteoarthritis, malignancies, and even dental caries. Many groups have performed OCTE, including our own, using a wide range of approaches. However, we will demonstrate current OCTE approaches are not scalable to real-time, in vivo imaging. As will be discussed, among the most important reasons is current designs focus on the system and not the target. Specifically, tissue dynamic responses are not accounted, with examples being the tissue strain response time, preload variability, and conditioning variability. Tissue dynamic responses, and to a lesser degree static tissue properties, prevent accurate video rate modulus assessments for current embodiments. Accounting for them is the focus of this paper. A top-down approach will be presented to overcome these challenges to real time in vivo tissue characterization. Discussed first is an example clinical scenario where OTCE would be of substantial relevance, the prevention of acute myocardial infarction or heart attacks. Then the principles behind OCTE are examined. Next, constrains on in vivo application of current OCTE are evaluated, focusing on dynamic tissue responses. An example is the tissue strain response, where it takes about 20 msec after a stress is applied to reach plateau. This response delay is not an issue at slow acquisition rates, as most current OCTE approaches are preformed, but it is for video rate OCTE. Since at video rate each frame is only 30 msec, for essentially all current approaches this means the strain for a given stress is changing constantly during the B-scan. Therefore the modulus can't be accurately assessed. This serious issue is an even greater problem for pulsed techniques as it means the strain/modulus for a given stress (at a location) is unpredictably changing over a B-scan. The paper concludes by introducing a novel video rate approach to overcome these challenges.

Magnetic Resonance Elastography Demonstrating Low Brain Stiffness in a Patient with Low-Pressure Hydrocephalus: Case Report.

PubMed

Olivero, William C; Wszalek, Tracey; Wang, Huan; Farahvar, Arash; Rieth, Sandra M; Johnson, Curtis L

2016-01-01

The authors describe the case of a 19-year-old female with shunted aqueductal stenosis who presented with low-pressure hydrocephalus that responded to negative pressure drainage. A magnetic resonance elastography scan performed 3 weeks later demonstrated very low brain tissue stiffness (high brain tissue compliance). An analysis of the importance of this finding in understanding this rare condition is discussed. © 2016 S. Karger AG, Basel.

Development of an Automated Modality-Independent Elastographic Image Analysis System for Tumor Screening

DTIC Science & Technology

2006-02-01

further develop modality-independent elastography as a system that is able to reproducibly detect regions of increased stiffness within the breast based...tested on a tissue-like polymer phantom. elastography , breast cancer screening, image processing 16. SECURITY CLASSIFICATION OF: 17. LIMITATION...is a map of the breast (or other tissue of interest) that reflects material inhomogeneity, such as in the case of a tumor mass that disrupts the

Magnetic resonance elastography (MRE) in cancer: Technique, analysis, and applications

PubMed Central

Pepin, Kay M.; Ehman, Richard L.; McGee, Kiaran P.

2015-01-01

Tissue mechanical properties are significantly altered with the development of cancer. Magnetic resonance elastography (MRE) is a noninvasive technique capable of quantifying tissue mechanical properties in vivo. This review describes the basic principles of MRE and introduces some of the many promising MRE methods that have been developed for the detection and characterization of cancer, evaluation of response to therapy, and investigation of the underlying mechanical mechanisms associated with malignancy. PMID:26592944

77 FR 25366 - Underground Storage Tank Program: Approved State Program for the State of Oregon

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-30

... the online instructions for submitting comments. Email: griffith[email protected] . Mail: Katherine Griffith, U. S. Environmental Protection Agency, Region 10, 1200 Sixth Avenue, Suite 900, Mail Stop: OCE... electronically in http://www.regulations.gov or in hard copy. FOR FURTHER INFORMATION CONTACT: Katherine Griffith...

Relationship of liver stiffness and controlled attenuation parameter measured by transient elastography with diabetes mellitus in patients with chronic liver disease.

PubMed

Ahn, Jem Ma; Paik, Yong-Han; Kim, So Hyun; Lee, Jun Hee; Cho, Ju Yeon; Sohn, Won; Gwak, Geum-Youn; Choi, Moon Seok; Lee, Joon Hyeok; Koh, Kwang Cheol; Paik, Seung Woon; Yoo, Byung Chul

2014-08-01

High prevalence of diabetes mellitus in patients with liver cirrhosis has been reported in many studies. The aim of our study was to evaluate the relationship of hepatic fibrosis and steatosis assessed by transient elastography with diabetes in patients with chronic liver disease. The study population consisted of 979 chronic liver disease patients. Liver fibrosis and steatosis were assessed by liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) on transient elastography. Diabetes was diagnosed in 165 (16.9%) of 979 patients. The prevalence of diabetes had significant difference among the etiologies of chronic liver disease. Higher degrees of liver fibrosis and steatosis, assessed by LSM and CAP score, showed higher prevalence of diabetes (F0/1 [14%], F2/3 [18%], F4 [31%], P<0.001; S0/1 [15%], S2 [17%], S3 [26%], P=0.021). Multivariate analysis showed that the independent predictive risk factors for diabetes were hypertension (OR, 1.98; P=0.001), LSM F4 (OR, 1.86; P=0.010), male gender (OR, 1.60; P=0.027), and age>50 yr (OR, 1.52; P=0.046). The degree of hepatic fibrosis but not steatosis assessed by transient elastography has significant relationship with the prevalence of diabetes in patients with chronic liver disease.

Attenuation measuring ultrasound shearwave elastography and in vivo application in post-transplant liver patients

NASA Astrophysics Data System (ADS)

Nenadic, Ivan Z.; Qiang, Bo; Urban, Matthew W.; Zhao, Heng; Sanchez, William; Greenleaf, James F.; Chen, Shigao

2017-01-01

Ultrasound and magnetic resonance elastography techniques are used to assess mechanical properties of soft tissues. Tissue stiffness is related to various pathologies such as fibrosis, loss of compliance, and cancer. One way to perform elastography is measuring shear wave velocity of propagating waves in tissue induced by intrinsic motion or an external source of vibration, and relating the shear wave velocity to tissue elasticity. All tissues are inherently viscoelastic and ignoring viscosity biases the velocity-based estimates of elasticity and ignores a potentially important parameter of tissue health. We present attenuation measuring ultrasound shearwave elastography (AMUSE), a technique that independently measures both shear wave velocity and attenuation in tissue and therefore allows characterization of viscoelasticity without using a rheological model. The theoretical basis for AMUSE is first derived and validated in finite element simulations. AMUSE is validated against the traditional methods for assessing shear wave velocity (phase gradient) and attenuation (amplitude decay) in tissue mimicking phantoms and excised tissue. The results agreed within one standard deviation. AMUSE was used to measure shear wave velocity and attenuation in 15 transplanted livers in patients with potential acute rejection, and the results were compared with the biopsy findings in a preliminary study. The comparison showed excellent agreement and suggests that AMUSE can be used to separate transplanted livers with acute rejection from livers with no rejection.

The use of real-time elastography in the assessment of gallbladder polyps: preliminary observations.

PubMed

Teber, Mehmet Akif; Tan, Sinan; Dönmez, Uğur; İpek, Ali; Uçar, Ali Erkan; Yıldırım, Halil; Aslan, Ahmet; Arslan, Halil

2014-12-01

Gallbladder polyps often have a benign nature. Current guidelines suggest surgical removal of polyps greater than 10 mm. However, the accuracy of the size criteria is limited because neoplasia can be found in gallbladder polyps less than 10 mm. The aim of this study was to evaluate the feasibility of real time elastography for gallbladder polyps and to demonstrate the elasticity properties of the polyps. Fifty-three polypoid lesions of the gallbladder were prospectively examined with real-time elastography. Of these patients, 52 had a diagnosis of benign gallbladder polyps and one patient was accepted as a gallbladder carcinoma due to its clinical and radiological findings. B-mode and real-time elastographic images were simultaneously presented as a two-panel image, and the elastogram was displayed in a color scale that ranged from red (greatest strain, softest component), to green (average strain, intermediate component), to blue (no strain, hardest component). The mean size for benign gallbladder polyps was 7.2 +/- 3 mm (range, 5-21 mm). All benign gallbladder polyps on consecutive real-time elastographic images appeared as having a high-strain elastographic pattern. Only one patient who was accepted with gallbladder carcinoma had a gallbladder polyp with low elasticity properties. Our study showed that real time elastography of gallbladder polyps is feasible. This novel approach may be useful for the characterization of polypoid lesions of the gallbladder.

An Investigation of the Immediate Effect of Static Stretching on the Morphology and Stiffness of Achilles Tendon in Dominant and Non-Dominant Legs

PubMed Central

Chiu, Tsz-chun Roxy; Ngo, Hiu-ching; Lau, Lai-wa; Leung, King-wah; Lo, Man-him; Yu, Ho-fai; Ying, Michael

2016-01-01

Aims This study was undertaken to investigate the immediate effect of static stretching on normal Achilles tendon morphology and stiffness, and the different effect on dominant and non-dominant legs; and to evaluate inter-operator and intra-operator reliability of using shear-wave elastography in measuring Achilles tendon stiffness. Methods 20 healthy subjects (13 males, 7 females) were included in the study. Thickness, cross-sectional area and stiffness of Achilles tendons in both legs were measured before and after 5-min static stretching using grey-scale ultrasound and shear-wave elastography. Inter-operator and intra-operator reliability of tendon stiffness measurements of six operators were evaluated. Results Result showed that there was no significant change in the thickness and cross-sectional area of Achilles tendon after static stretching in both dominant and non-dominant legs (p > 0.05). Tendon stiffness showed a significant increase in non-dominant leg (p < 0.05) but not in dominant leg (p > 0.05). The inter-operator reliability of shear-wave elastography measurements was 0.749 and the intra-operator reliability ranged from 0.751 to 0.941. Conclusion Shear-wave elastography is a useful and non-invasive imaging tool to assess the immediate stiffness change of Achilles tendon in response to static stretching with high intra-operator and inter-operator reliability. PMID:27120097

External vibration multi-directional ultrasound shearwave elastography (EVMUSE): application in liver fibrosis staging.

PubMed

Zhao, Heng; Song, Pengfei; Meixner, Duane D; Kinnick, Randall R; Callstrom, Matthew R; Sanchez, William; Urban, Matthew W; Manduca, Armando; Greenleaf, James F; Chen, Shigao

2014-11-01

Shear wave speed can be used to assess tissue elasticity, which is associated with tissue health. Ultrasound shear wave elastography techniques based on measuring the propagation speed of the shear waves induced by acoustic radiation force are becoming promising alternatives to biopsy in liver fibrosis staging. However, shear waves generated by such methods are typically very weak. Therefore, the penetration may become problematic, especially for overweight or obese patients. In this study, we developed a new method called external vibration multi-directional ultrasound shearwave elastography (EVMUSE), in which external vibration from a loudspeaker was used to generate a multi-directional shear wave field. A directional filter was then applied to separate the complex shear wave field into several shear wave fields propagating in different directions. A 2-D shear wave speed map was reconstructed from each individual shear wave field, and a final 2-D shear wave speed map was constructed by compounding these individual wave speed maps. The method was validated using two homogeneous phantoms and one multi-purpose tissue-mimicking phantom. Ten patients undergoing liver magnetic resonance elastography (MRE) were also studied with EVMUSE to compare results between the two methods. Phantom results showed EVMUSE was able to quantify tissue elasticity accurately with good penetration. In vivo EVMUSE results were well correlated with MRE results, indicating the promise of using EVMUSE for liver fibrosis staging.

Differentiating benign from malignant solid breast masses: value of shear wave elastography according to lesion stiffness combined with greyscale ultrasound according to BI-RADS classification.

PubMed

Evans, A; Whelehan, P; Thomson, K; Brauer, K; Jordan, L; Purdie, C; McLean, D; Baker, L; Vinnicombe, S; Thompson, A

2012-07-10

The aim of this study was to assess the performance of shear wave elastography combined with BI-RADS classification of greyscale ultrasound images for benign/malignant differentiation in a large group of patients. One hundred and seventy-five consecutive patients with solid breast masses on routine ultrasonography undergoing percutaneous biopsy had the greyscale findings classified according to the American College of Radiology BI-RADS. The mean elasticity values from four shear wave images were obtained. For mean elasticity vs greyscale BI-RADS, the performance results against histology were sensitivity: 95% vs 95%, specificity: 77% vs 69%, Positive Predictive Value (PPV): 88% vs 84%, Negative Predictive Value (NPV): 90% vs 91%, and accuracy: 89% vs 86% (all P>0.05). The results for the combination (positive result from either modality counted as malignant) were sensitivity 100%, specificity 61%, PPV 82%, NPV 100%, and accuracy 86%. The combination of BI-RADS greyscale and shear wave elastography yielded superior sensitivity to BI-RADS alone (P=0.03) or shear wave alone (P=0.03). The NPV was superior in combination compared with either alone (BI-RADS P=0.01 and shear wave P=0.02). Together, BI-RADS assessment of greyscale ultrasound images and shear wave ultrasound elastography are extremely sensitive for detection of malignancy.

Differentiating benign from malignant solid breast masses: value of shear wave elastography according to lesion stiffness combined with greyscale ultrasound according to BI-RADS classification

PubMed Central

Evans, A; Whelehan, P; Thomson, K; Brauer, K; Jordan, L; Purdie, C; McLean, D; Baker, L; Vinnicombe, S; Thompson, A

2012-01-01

Background: The aim of this study was to assess the performance of shear wave elastography combined with BI-RADS classification of greyscale ultrasound images for benign/malignant differentiation in a large group of patients. Methods: One hundred and seventy-five consecutive patients with solid breast masses on routine ultrasonography undergoing percutaneous biopsy had the greyscale findings classified according to the American College of Radiology BI-RADS. The mean elasticity values from four shear wave images were obtained. Results: For mean elasticity vs greyscale BI-RADS, the performance results against histology were sensitivity: 95% vs 95%, specificity: 77% vs 69%, Positive Predictive Value (PPV): 88% vs 84%, Negative Predictive Value (NPV): 90% vs 91%, and accuracy: 89% vs 86% (all P>0.05). The results for the combination (positive result from either modality counted as malignant) were sensitivity 100%, specificity 61%, PPV 82%, NPV 100%, and accuracy 86%. The combination of BI-RADS greyscale and shear wave elastography yielded superior sensitivity to BI-RADS alone (P=0.03) or shear wave alone (P=0.03). The NPV was superior in combination compared with either alone (BI-RADS P=0.01 and shear wave P=0.02). Conclusion: Together, BI-RADS assessment of greyscale ultrasound images and shear wave ultrasound elastography are extremely sensitive for detection of malignancy. PMID:22691969

External Vibration Multi-directional Ultrasound Shearwave Elastography (EVMUSE): Application in Liver Fibrosis Staging

PubMed Central

Zhao, Heng; Song, Pengfei; Meixner, Duane D.; Kinnick, Randall R.; Callstrom, Matthew R.; Sanchez, William; Urban, Matthew W.; Manduca, Armando; Greenleaf, James F.

2014-01-01

Shear wave speed can be used to assess tissue elasticity, which is associated with tissue health. Ultrasound shear wave elastography techniques based on measuring the propagation speed of the shear waves induced by acoustic radiation force are becoming promising alternatives to biopsy in liver fibrosis staging. However, shear waves generated by such methods are typically very weak. Therefore, the penetration may become problematic, especially for overweight or obese patients. In this study, we developed a new method called External Vibration Multi-directional Ultrasound Shearwave Elastography (EVMUSE), in which external vibration from a loudspeaker was used to generate a multi-directional shear wave field. A directional filter was then applied to separate the complex shear wave field into several shear wave fields propagating in different directions. A two-dimensional (2D) shear wave speed map was reconstructed from each individual shear wave field, and a final 2D shear wave speed map was constructed by compounding these individual wave speed maps. The method was validated using two homogeneous phantoms and one multi-purpose tissue-mimicking phantom. Ten patients undergoing liver Magnetic Resonance Elastography (MRE) were also studied with EVMUSE to compare results between the two methods. Phantom results showed EVMUSE was able to quantify tissue elasticity accurately with good penetration. In vivo EVMUSE results were well correlated with MRE results, indicating the promise of using EVMUSE for liver fibrosis staging. PMID:25020066

The Biological and Chemical Oceanography Data Management Office

NASA Astrophysics Data System (ADS)

Allison, M. D.; Chandler, C. L.; Groman, R. C.; Wiebe, P. H.; Glover, D. M.; Gegg, S. R.

2011-12-01

Oceanography and marine ecosystem research are inherently interdisciplinary fields of study that generate and require access to a wide variety of measurements. In late 2006 the Biological and Chemical Oceanography Sections of the National Science Foundation (NSF) Geosciences Directorate Division of Ocean Sciences (OCE) funded the Biological and Chemical Oceanography Data Management Office (BCO-DMO). In late 2010 additional funding was contributed to support management of research data from the NSF Office of Polar Programs Antarctic Organisms & Ecosystems Program. The BCO-DMO is recognized in the 2011 Division of Ocean Sciences Sample and Data Policy as one of several program specific data offices that support NSF OCE funded researchers. BCO-DMO staff members offer data management support throughout the project life cycle to investigators from large national programs and medium-sized collaborative research projects, as well as researchers from single investigator awards. The office manages and serves all types of oceanographic data and information generated during the research process and contributed by the originating investigators. BCO-DMO has built a data system that includes the legacy data from several large ocean research programs (e.g. United States Joint Global Ocean Flux Study and United States GLOBal Ocean ECosystems Dynamics), to which data have been contributed from recently granted NSF OCE and OPP awards. The BCO-DMO data system can accommodate many different types of data including: in situ and experimental biological, chemical, and physical measurements; modeling results and synthesis data products. The system enables reuse of oceanographic data for new research endeavors, supports synthesis and modeling activities, provides availability of "real data" for K-12 and college level use, and provides decision-support field data for policy-relevant investigations. We will present an overview of the data management system capabilities including: map-based and text-based data discovery and access systems; recent enhancements to data search tools; data export and download utilities; and strategic use of controlled vocabularies to facilitate data integration and to improve data system interoperability.

The effect of statistical noise on IMRT plan quality and convergence for MC-based and MC-correction-based optimized treatment plans.

PubMed

Siebers, Jeffrey V

2008-04-04

Monte Carlo (MC) is rarely used for IMRT plan optimization outside of research centres due to the extensive computational resources or long computation times required to complete the process. Time can be reduced by degrading the statistical precision of the MC dose calculation used within the optimization loop. However, this eventually introduces optimization convergence errors (OCEs). This study determines the statistical noise levels tolerated during MC-IMRT optimization under the condition that the optimized plan has OCEs <100 cGy (1.5% of the prescription dose) for MC-optimized IMRT treatment plans.Seven-field prostate IMRT treatment plans for 10 prostate patients are used in this study. Pre-optimization is performed for deliverable beams with a pencil-beam (PB) dose algorithm. Further deliverable-based optimization proceeds using: (1) MC-based optimization, where dose is recomputed with MC after each intensity update or (2) a once-corrected (OC) MC-hybrid optimization, where a MC dose computation defines beam-by-beam dose correction matrices that are used during a PB-based optimization. Optimizations are performed with nominal per beam MC statistical precisions of 2, 5, 8, 10, 15, and 20%. Following optimizer convergence, beams are re-computed with MC using 2% per beam nominal statistical precision and the 2 PTV and 10 OAR dose indices used in the optimization objective function are tallied. For both the MC-optimization and OC-optimization methods, statistical equivalence tests found that OCEs are less than 1.5% of the prescription dose for plans optimized with nominal statistical uncertainties of up to 10% per beam. The achieved statistical uncertainty in the patient for the 10% per beam simulations from the combination of the 7 beams is ~3% with respect to maximum dose for voxels with D>0.5D(max). The MC dose computation time for the OC-optimization is only 6.2 minutes on a single 3 Ghz processor with results clinically equivalent to high precision MC computations.

Liver fibrosis diagnosis by blood test and elastography in chronic hepatitis C: agreement or combination?

PubMed

Calès, P; Boursier, J; Lebigot, J; de Ledinghen, V; Aubé, C; Hubert, I; Oberti, F

2017-04-01

In chronic hepatitis C, the European Association for the Study of the Liver and the Asociacion Latinoamericana para el Estudio del Higado recommend performing transient elastography plus a blood test to diagnose significant fibrosis; test concordance confirms the diagnosis. To validate this rule and improve it by combining a blood test, FibroMeter (virus second generation, Echosens, Paris, France) and transient elastography (constitutive tests) into a single combined test, as suggested by the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America. A total of 1199 patients were included in an exploratory set (HCV, n = 679) or in two validation sets (HCV ± HIV, HBV, n = 520). Accuracy was mainly evaluated by correct diagnosis rate for severe fibrosis (pathological Metavir F ≥ 3, primary outcome) by classical test scores or a fibrosis classification, reflecting Metavir staging, as a function of test concordance. Score accuracy: there were no significant differences between the blood test (75.7%), elastography (79.1%) and the combined test (79.4%) (P = 0.066); the score accuracy of each test was significantly (P < 0.001) decreased in discordant vs. concordant tests. Classification accuracy: combined test accuracy (91.7%) was significantly (P < 0.001) increased vs. the blood test (84.1%) and elastography (88.2%); accuracy of each constitutive test was significantly (P < 0.001) decreased in discordant vs. concordant tests but not with combined test: 89.0 vs. 92.7% (P = 0.118). Multivariate analysis for accuracy showed an interaction between concordance and fibrosis level: in the 1% of patients with full classification discordance and severe fibrosis, non-invasive tests were unreliable. The advantage of combined test classification was confirmed in the validation sets. The concordance recommendation is validated. A combined test, expressed in classification instead of score, improves this rule and validates the recommendation of a combined test, avoiding 99% of biopsies, and offering precise staging. © 2017 John Wiley & Sons Ltd.

Application of Modified Spin-Echo–based Sequences for Hepatic MR Elastography: Evaluation, Comparison with the Conventional Gradient-Echo Sequence, and Preliminary Clinical Experience

PubMed Central

Mariappan, Yogesh K.; Dzyubak, Bogdan; Glaser, Kevin J.; Venkatesh, Sudhakar K.; Sirlin, Claude B.; Hooker, Jonathan; McGee, Kiaran P.

2017-01-01

Purpose To (a) evaluate modified spin-echo (SE) magnetic resonance (MR) elastographic sequences for acquiring MR images with improved signal-to-noise ratio (SNR) in patients in whom the standard gradient-echo (GRE) MR elastographic sequence yields low hepatic signal intensity and (b) compare the stiffness values obtained with these sequences with those obtained with the conventional GRE sequence. Materials and Methods This HIPAA-compliant retrospective study was approved by the institutional review board; the requirement to obtain informed consent was waived. Data obtained with modified SE and SE echo-planar imaging (EPI) MR elastographic pulse sequences with short echo times were compared with those obtained with the conventional GRE MR elastographic sequence in two patient cohorts, one that exhibited adequate liver signal intensity and one that exhibited low liver signal intensity. Shear stiffness values obtained with the three sequences in 130 patients with successful GRE-based examinations were retrospectively tested for statistical equivalence by using a 5% margin. In 47 patients in whom GRE examinations were considered to have failed because of low SNR, the SNR and confidence level with the SE-based sequences were compared with those with the GRE sequence. Results The results of this study helped confirm the equivalence of SE MR elastography and SE-EPI MR elastography to GRE MR elastography (P = .0212 and P = .0001, respectively). The SE and SE-EPI MR elastographic sequences provided substantially improved SNR and stiffness inversion confidence level in 47 patients in whom GRE MR elastography had failed. Conclusion Modified SE-based MR elastographic sequences provide higher SNR MR elastographic data and reliable stiffness measurements; thus, they enable quantification of stiffness in patients in whom the conventional GRE MR elastographic sequence failed owing to low signal intensity. The equivalence of the three sequences indicates that the current diagnostic thresholds are applicable to SE MR elastographic sequences for assessing liver fibrosis. © RSNA, 2016 PMID:27509543

Real-Time Shear Wave versus Transient Elastography for Predicting Fibrosis: Applicability, and Impact of Inflammation and Steatosis. A Non-Invasive Comparison.

PubMed

Poynard, Thierry; Pham, Tam; Perazzo, Hugo; Munteanu, Mona; Luckina, Elena; Elaribi, Djamel; Ngo, Yen; Bonyhay, Luminita; Seurat, Noemie; Legroux, Muriel; Ngo, An; Deckmyn, Olivier; Thabut, Dominique; Ratziu, Vlad; Lucidarme, Olivier

2016-01-01

Real-time shear wave elastography (2D-SWE) is a two-dimensional transient elastography and a competitor as a biomarker of liver fibrosis in comparison with the standard reference transient elastography by M probe (TE-M). The aims were to compare several criteria of applicability, and to assess inflammation and steatosis impact on elasticity values, two unmet needs. We took FibroTest as the fibrosis reference and ActiTest and SteatoTest as quantitative estimates of inflammation and steatosis. After standardization of estimates, analyses used curve fitting, quantitative Lin concordance coefficient [LCC], and multivariate logistic regression. A total of 2,251 consecutive patients were included. We validated the predetermined 0.2 kPa cut-off as a too low minimal elasticity value identifying not-reliable 2D-SWE results (LCC with FibroTest = 0.0281[-0.119;0.175]. Other criteria, elasticity CV, body mass index and depth of measures were not sufficiently discriminant. The applicability of 2D-SWE (95%CI) 89.6%(88.2-90.8), was significantly higher than that of TE, 85.6%(84.0-87.0; P<0.0001). In patients with non-advanced fibrosis (METAVIR F0F1F2), elasticity values estimated by 2D-SWE was less impacted by inflammation and steatosis than elasticity value estimated by TE-M: LCC (95%CI) 0.039 (0.021;0.058) vs 0.090 (0.068;0.112;P<0.01) and 0.105 (0.068;0.141) vs 0.192 (0.153;0.230; P<0.01) respectively. The three analyses methods gave similar results. Elasticity results including very low minimal signal in the region of interest should be considered not reliable. 2D-SWE had a higher applicability than TE, the reference elastography, with less impact of inflammation and steatosis especially in patients with non-advanced fibrosis, as presumed by blood tests. ClinicalTrials.gov NCT01927133.

Dynamic Elastography in Diagnostics of Liver Fibrosis in Patients After Liver Transplantation Due to Cirrhosis in the Course of Hepatitis C.

PubMed

Mikołajczyk-Korniak, N; Tronina, O; Ślubowska, K; Perkowska-Ptasińska, A; Pacholczyk, M; Bączkowska, T; Durlik, M

2016-06-01

Assessment of the dynamics and degree of liver fibrosis in patients after liver transplantation is a basic element in the process of determining transplant survival prognosis. It allows planning and early initiation of prophylaxis or treatment, which translates into increased chances of preventing cirrhosis and of long-term optimal function of the graft. The aim of this study was to compare the results of biopsy and dynamic elastography in diagnostics of transplanted liver fibrosis, as well as determination of the stiffness cut-off point for assessment of significant fibrosis. The study included 36 patients who had undergone liver transplantation due to cirrhosis in the course of hepatitis C virus (HVC) infection. Fibrosis was assessed in bioptates according to the METAVIR score (F0-F4). Elastography was performed using FibroScan; receiver operating characteristic curve analysis was used to identify the cut-off point for significant fibrosis (≥F2). The median stiffness in kPa for the whole group F0-F4 was 6.3 (range 3.4-29.9); for ≥F2 it was 6.9 (3.4-29.9), whereas for F0-F1 it was 4.4 (3.5-8.0). It was demonstrated that the value of 4.7 kPa in elastography is a statistically significant cut-off point for differentiation between the groups F0-F1 and F2-F4 (sensitivity: 93%, specificity: 57%, positive predictive value: 90%, negative predictive value: 66%), area under the receiver operating characteristic curve: 0.746 (95% confidence interval: 0.53-0.95, P < .05). Elastography is a promising tool for noninvasive assessment of significant liver fibrosis in patients after transplantation due to cirrhosis in the course of hepatitis C; it allows reduction in the number of biopsies performed. Copyright © 2016 Elsevier Inc. All rights reserved.

Value of ultrasound shear wave elastography in the diagnosis of adenomyosis

PubMed Central

Millar, E; Mitkova, M; Mitkov, V

2016-01-01

Background The aim of the study was to assess the accuracy of ultrasound shear wave elastography in the diagnosis of adenomyosis. Methods One hundred and fifty three patients were examined. Ninety-seven patients were with suspected adenomyosis and 56 patients were with unremarkable myometrium. Adenomyosis was confirmed in 39 cases (A subgroup) and excluded in 14 cases (B subgroup) in the main group based on morphological examination. All patients underwent ultrasound examination using an Aixplorer (Supersonic Imagine, France) scanner with application of shear wave elastography during transvaginal scanning. Retrospective analysis of the elastography criteria against the findings from morphological/histological examination was performed. Results The following values of Young’s modulus were found in subgroup A (adenomyosis): Emean – 72.7 (22.6–274.2) kPa (median, 5–95th percentiles), Emax – 94.8 (29.3–300.0) kPa, SD – 9.9 (2.6–26.3) kPa; in subgroup B (non adenomyosis) – 28.3 (12.7–59.5) kPa, 33.6 (16.0–80.8) kPa, 3.0 (1.4–15.6) kPa; in the control group – 24.4 (17.9–32.4) kPa, 29.8 (21.6–40.8) kPa, 2.3 (1.3–6.1) kPa, respectively (P < 0.05 for all comparison with subgroup В and the control group). The Emean cut-off value for adenomyosis diagnosis was 34.6 kPa. The sensitivity, specificity, positive predictive value, negative predictive value and area under curve (AUC) were 89.7%, 92.9%, 97.2%, 76.5% and 0.908. The Emax cut-off value was 45.4 kPa (89.7%, 92.9%, 97.2%, 76.5% and 0.907, respectively). Conclusion This study showed a significant increase of the myometrial stiffness estimated with shear wave elastography use in patients with adenomyosis. PMID:27847535

EUS elastography (strain ratio) and fractal-based quantitative analysis for the diagnosis of solid pancreatic lesions.

PubMed

Carrara, Silvia; Di Leo, Milena; Grizzi, Fabio; Correale, Loredana; Rahal, Daoud; Anderloni, Andrea; Auriemma, Francesco; Fugazza, Alessandro; Preatoni, Paoletta; Maselli, Roberta; Hassan, Cesare; Finati, Elena; Mangiavillano, Benedetto; Repici, Alessandro

2018-06-01

EUS elastography is useful in characterizing solid pancreatic lesions (SPLs), and fractal analysis-based technology has been used to evaluate geometric complexity in oncology. The aim of this study was to evaluate EUS elastography (strain ratio) and fractal analysis for the characterization of SPLs. Consecutive patients with SPLs were prospectively enrolled between December 2015 and February 2017. Elastographic evaluation included parenchymal strain ratio (pSR) and wall strain ratio (wSR) and was performed with a new compact US processor. Elastographic images were analyzed using a computer program to determine the 3-dimensional histogram fractal dimension. A composite cytology/histology/clinical reference standard was used to assess sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating curve. Overall, 102 SPLs from 100 patients were studied. At final diagnosis, 69 (68%) were malignant and 33 benign. At elastography, both pSR and wSR appeared to be significantly higher in malignant as compared with benign SPLs (pSR, 24.5 vs 6.4 [P < .001]; wSR, 56.6 vs 15.3 [P < .001]). When the best cut-off levels of pSR and wSR at 9.10 and 16.2, respectively, were used, sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating curve were 88.4%, 78.8%, 89.7%, 76.9%, and 86.7% and 91.3%, 69.7%, 86.5%, 80%, and 85.7%, respectively. Fractal analysis showed a significant statistical difference (P = .0087) between the mean surface fractal dimension of malignant lesions (D = 2.66 ± .01) versus neuroendocrine tumor (D = 2.73 ± .03) and a statistical difference for all 3 channels red, green, and blue (P < .0001). EUS elastography with pSR and fractal-based analysis are useful in characterizing SPLs. (Clinical trial registration number: NCT02855151.). Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

The Paradox of a Wet (High H2O) and Dry (Low H2O/Ce) Mantle: High Water Concentrations in Mantle Garnet Pyroxenites from Hawaii

NASA Technical Reports Server (NTRS)

Peslier, Anne H.; Bizimis, Michael

2013-01-01

Water dissolved as trace amounts in anhydrous minerals has a large influence on the melting behavior and physical properties of the mantle. The water concentration of the oceanic mantle is inferred from the analyses of Mid-Ocean Ridge Basalt (MORB) and Oceanic Island Basalt (OIB). but there is little data from actual mantle samples. Moreover, enriched mineralogies (pyroxenites, eclogites) are thought as important sources of heterogeneity in the mantle, but their water concentrations and their effect on the water budget and cycling in the mantle are virtually unknown. Here, we analyzed by FTIR water in garnet clinopyroxenite xenoliths from Salt Lake Crater, Oahu, Hawaii. These pyroxenites are high-pressure (>20kb) crystal fractionates from alkalic melts. The clinopyroxenes (cpx) have 260 to 576 ppm wt H2O, with the least differentiated samples (Mg#>0.8) in the 400-500 ppm range. Orthopyroxene (opx) contain 117-265 ppm H2O, about half of that of cpx, consistent with other natural sample studies, but lower than cpx/opx equilibrium from experimental data. The pyroxenite cpx and opx H2O concentrations are at the high-end of on-and off-craton peridotite xenolith concentrations and those of Hawaiian spinel peridotites. In contrast, garnet has extremely low water contents (<5ppm H2O). There is no correlation between H2O in cpx and lithophile element concentrations. Phlogopite is present in some samples, and its modal abundance shows a positive correlation in Mg# with cpx, implying equilibrium. However, there is no correlation between H2O concentrations and or the presence of phlogopite. These data imply that cpx and opx may be at water saturation, far lower than experimental data suggest. Reconstructed bulk rock pyroxenite H2O ranges from 200-460 ppm (average 331 +/- 75 ppm), 2 to 8 times higher than H2O estimates for the MORB source (50-200 ppm), but in the range of E-MORB, OIB and the source of rejuvenated Hawaiian magmas. The average bulk rock pyroxenite H2O/Ce is 69 +/-35, lower than estimates of the MORB source (approx 150) or FOZO, C (200-250) mantle component, but consistent with "dry" EM sources (<100). These data suggest that a metasomatized, refertilized oceanic lithosphere that contains pyroxenitic veins (e.g. the lower part of an oceanic plate, where ascending melts can become trapped and crystallize), will have both higher water concentrations and low H2O/Ce, and may contribute to EM-type OIB sources, like that of Samoa basalts. Therefore, a low H2O/Ce mantle source may not necessarily be "dry".

Parametric approaches to micro-scale characterization of tissue volumes in vivo and ex vivo: Imaging microvasculature, attenuation, birefringence, and stiffness (Conference Presentation)

NASA Astrophysics Data System (ADS)

Sampson, David D.; Chin, Lixin; Gong, Peijun; Wijesinghe, Philip; Es'haghian, Shaghayegh; Allen, Wesley M.; Klyen, Blake R.; Kirk, Rodney W.; Kennedy, Brendan F.; McLaughlin, Robert A.

2016-03-01

INVITED TALK Advances in imaging tissue microstructure in living subjects, or in freshly excised tissue with minimum preparation and processing, are important for future diagnosis and surgical guidance in the clinical setting, particularly for application to cancer. Whilst microscopy methods continue to advance on the cellular scale and medical imaging is well established on the scale of the whole tumor or organ, it is attractive to consider imaging the tumor environment on the micro-scale, between that of cells and whole tissues. Such a scenario is ideally suited to optical coherence tomography (OCT), with the twin attractions of requiring little or no tissue preparation, and in vivo capability. OCT's intrinsic scattering contrast reveals many morphological features of tumors, but is frequently ineffective in revealing other important aspects, such as microvasculature, or in reliably distinguishing tumor from uninvolved stroma. To address these shortcomings, we are developing several advances on the basic OCT approach. We are exploring speckle fluctuations to image tissue microvasculature and we have been developing several parametric approaches to tissue micro-scale characterization. Our approaches extract, from a three-dimensional OCT data set, a two-dimensional image of an optical parameter, such as attenuation or birefringence, or a mechanical parameter, such as stiffness, that aids in characterizing the tissue. This latter method, termed optical coherence elastography, parallels developments in ultrasound and magnetic resonance imaging. Parametric imaging of birefringence and of stiffness both show promise in addressing the important issue of differentiating cancer from uninvolved stroma in breast tissue.

Real-Time Palpation Imaging for Improved Detection and Discrimination of Breast Abnormalities

DTIC Science & Technology

2005-07-01

contrasts are also in the range of elastic contrasts in terms of shear storage moduli for 85 Hz shear waves in in vivo MR breast elastography (Sinkus et al... elastography ) may aid the differentiation of benign and malignant solid breast masses .(4-19) This research is based on the fact that benign and malignant...on 445 breast masses of which 42 were discarded based on our exclusion criteria leaving 403 (157 malignant-39.0%; 246 benign-61.0%) lesions as

Changing Patterns of Finance in Higher Education. Country Study: Denmark. OECD Educational Monographs.

ERIC Educational Resources Information Center

Enslev, Lisbeth; And Others

A country study on Denmark is presented as part of a series prepared by the Organisation for Economic Cooperation and Development (OCED) Education Committee activity on changing patterns of finance in higher education. In Denmark, postsecondary institutions are the direct responsibility of the state. Some central problems are to strike a balance…

Technical Assistance in Evaluating Career Education Projects. Final Report. Volume I: Summary Volume.

ERIC Educational Resources Information Center

Stenner, A. Jackson; And Others

This document contains the first of five volumes reporting the activities and results of a career education evaluation project conducted to accomplish the following two objectives: (1) to improve the quality of evaluations by career education projects funded by the United States Office of Career Education (OCE) through the provision of technical…

Using level set based inversion of arrival times to recover shear wave speed in transient elastography and supersonic imaging

NASA Astrophysics Data System (ADS)

McLaughlin, Joyce; Renzi, Daniel

2006-04-01

Transient elastography and supersonic imaging are promising new techniques for characterizing the elasticity of soft tissues. Using this method, an 'ultrafast imaging' system (up to 10 000 frames s-1) follows in real time the propagation of a low-frequency shear wave. The displacement of the propagating shear wave is measured as a function of time and space. Here we develop a fast level set based algorithm for finding the shear wave speed from the interior positions of the propagating front. We compare the performance of level curve methods developed here and our previously developed (McLaughlin J and Renzi D 2006 Shear wave speed recovery in transient elastography and supersonic imaging using propagating fronts Inverse Problems 22 681-706) distance methods. We give reconstruction examples from synthetic data and from data obtained from a phantom experiment accomplished by Mathias Fink's group (the Laboratoire Ondes et Acoustique, ESPCI, Université Paris VII).

Non-invasive assessment of liver fibrosis by transient elastography in post transfusional iron overload.

PubMed

Mirault, Tristan; Lucidarme, Damien; Turlin, Bruno; Vandevenne, Philippe; Gosset, Pierre; Ernst, Olivier; Rose, Christian

2008-04-01

Liver fibrosis, assessed by biopsy, is the main complication of post transfusional liver iron overload. Transient elastography (TE) is a new, non invasive method able to measure liver stiffness (LS) caused by fibrosis. We prospectively evaluated the predictive value of LS measurement for liver fibrosis evaluation in 15 chronically transfused patients and compared these results with the METAVIR histological fibrosis stage from liver biopsies. Mean TE values significantly differed in patients with severe fibrosis (METAVIR F3, F4): 9.1 (+/-3.7 SD) kPa from those with mild or no fibrosis (METAVIR F0, F1, F2): 5.9 (+/-1.8 SD) kPa (P = 0.046). TE value above 6.25 kPa (Se = 80%; Sp = 70%; AUROC = 0.820) identified patients at risk for severe fibrosis (Negative Predictive Value 88%; Positive Predictive Value 57%). Transient elastography appears to be a reliable tool to evaluate liver fibrosis in post-transfusional iron overload.

Cardiac elastography: detecting pathological changes in myocardium tissues

NASA Astrophysics Data System (ADS)

Konofagou, Elisa E.; Harrigan, Timothy; Solomon, Scott

2003-05-01

Estimation of the mechanical properties of the cardiac muscle has been shown to play a crucial role in the detection of cardiovascular disease. Elastography was recently shown feasible on RF cardiac data in vivo. In this paper, the role of elastography in the detection of ischemia/infarct is explored with simulations and in vivo experiments. In finite-element simulations of a portion of the cardiac muscle containing an infarcted region, the cardiac cycle was simulated with successive compressive and tensile strains ranging between -30% and 20%. The incremental elastic modulus was also mapped uisng adaptive methods. We then demonstrated this technique utilizing envelope-detected sonographic data (Hewlett-Packard Sonos 5500) in a patient with a known myocardial infarction. In cine-loop and M-Mode elastograms from both normal and infarcted regions in simulations and experiments, the infarcted region was identifed by the up to one order of magnitude lower incremental axial displacements and strains, and higher modulus. Information on motion, deformation and mechanical property should constitute a unique tool for noninvasive cardiac diagnosis.

Vibration-synchronized magnetic resonance imaging for the detection of myocardial elasticity changes.

PubMed

Elgeti, Thomas; Tzschätzsch, Heiko; Hirsch, Sebastian; Krefting, Dagmar; Klatt, Dieter; Niendorf, Thoralf; Braun, Jürgen; Sack, Ingolf

2012-04-01

Vibration synchronized magnetic resonance imaging of harmonically oscillating tissue interfaces is proposed for cardiac magnetic resonance elastography. The new approach exploits cardiac triggered cine imaging synchronized with extrinsic harmonic stimulation (f = 22.83 Hz) to display oscillatory tissue deformations in magnitude images. Oscillations are analyzed by intensity threshold-based image processing to track wave amplitude variations over the cardiac cycle. In agreement to literature data, results in 10 volunteers showed that endocardial wave amplitudes during systole (0.13 ± 0.07 mm) were significantly lower than during diastole (0.34 ± 0.14 mm, P < 0.001). Wave amplitudes were found to decrease 117 ± 40 ms before myocardial contraction and to increase 75 ± 31 ms before myocardial relaxation. Vibration synchronized magnetic resonance imaging improves the temporal resolution of magnetic resonance elastography as it overcomes the use of extra motion encoding gradients, is less sensitive to susceptibility artifacts, and does not suffer from dynamic range constraints frequently encountered in phase-based magnetic resonance elastography. Copyright © 2012 Wiley Periodicals, Inc.

Ultrasound Shear Wave Elastography for Liver Disease. A Critical Appraisal of the Many Actors on the Stage.

PubMed

Piscaglia, F; Salvatore, V; Mulazzani, L; Cantisani, V; Schiavone, C

2016-02-01

In the last 12 - 18 months nearly all ultrasound manufacturers have arrived to implement ultrasound shear wave elastography modality in their equipment for the assessment of chronic liver disease; the few remaining players are expected to follow in 2016.When all manufacturers rush to a new technology at the same time, it is evident that the clinical demand for this information is of utmost value. Around 1990, there was similar demand for color Doppler ultrasound; high demand for contrast-enhanced ultrasonography was evident at the beginning of this century, and around 2010 demand increased for strain elastography. However, some issues regarding the new shear wave ultrasound technologies must be noted to avoid misuse of the resulting information for clinical decisions. As new articles are expected to appear in 2016 reporting the findings of the new technologies from various companies, we felt that the beginning of this year was the right time to present an appraisal of these issues. We likewise expect that in the meantime EFSUMB will release a new update of the existing guidelines 1 2.The first ultrasound elastography method became available 13 years ago in the form of transient elastography with Fibroscan(®) 3. It was the first technique providing non-invasive quantitive information about the stiffness of the liver and hence regarding the amount of fibrosis in chronic liver disease 3. The innovation was enormous, since a non-invasive modality was finally available to provide findings otherwise achievable only by liver biopsy. In fact, prior to ultrasound elastography, a combination of conventional and Doppler ultrasound parameters were utilized to inform the physician about the presence of cirrhosis and portal hypertension 4. However, skilled operators were required, reproducibility and diagnostic accuracy were suboptimal, and it was not possible to differentiate the pre-cirrhotic stages of fibrosis. All these limitations were substantially improved by transient elastography, performed with Fibroscan(®), a technology dedicated exclusively to liver elastography. Since then, more than 1300 articles dealing with transient elastography have been listed in PubMed, some describing results with more than 10,000 patients 5. The technique has been tested in nearly all liver disease etiologies, with histology as the reference standard. Meta-analysis of data, available in many etiologies 6, showed good performance and reproducibility as well as some situations limiting reliability 5. Thresholds for the different fibrosis stages (F0 to F4) have been provided by many large-scale studies utilizing histology as the reference standard 7. Transient elastography tracks the velocity of shear waves generated by the gentle hit of a piston on the skin, with the resulting compression wave traveling in the liver along its longitudinal axis. The measurement is made in a 4 cm long section of the liver, thus able to average slightly inhomogeneous fibrotic deposition.In 2008 a new modality became available, Acoustic Radiation Force Impulse (ARFI) quantification, and classified by EFSUMB 1 as point shear wave elastography (pSWE), since the speed of the shear wave (perpendicular to the longitudinal axis) is measured in a small region (a "point", few millimeters) at a freely-choosen depth within 8 cm from the skin. This technology was the first to be implemented in a conventional ultrasound scanner by Siemens(®) 8. Several articles have been published regarding this technology, most with the best reference standards 9, some including findings on more than 1000 hepatitis C patients 10 or reporting meta-analysis of data 11. Although the correlation between Siemens pSWE and transient elastography appeared high 12 13, the calculated thresholds for the different fibrosis stages and the stiffness ranges between the two techniques are not superimposable.Interestingly, pSWE appears to provide greater applicability than transient elastography for measuring both liver 13 and spleen stiffness, which is a new application of elastography 14, of interest for the prediction of the degree of portal hypertension 15 16.Nowadays other companies have started producing equipment with pSWE technology, but only very few articles have been published so far, for instance describing the use of Philips(®) equipment, which was the second to provide pSWE. These articles show preliminary good results also in comparison with TE 17 18. Not enough evidence is currently available in the literature about the elastographic performance of the products most recently introduced to the market. Furthermore, with some products the shear wave velocities generated by a single ultrasound acoustic push pulse can be measured in a bidimensional area (a box in the range of 2 - 3 cm per side) rather than in a single small point, producing a so-called bidimensional 2D-SWE 1. The stiffness is depicted in color within the area and refreshing of the measurement occurs every 1 - 2 seconds. Once the best image is acquired, the operator chooses a Region Of Interest (ROI) within the color box, where the mean stiffness is then calculated. 2D-SWE can be performed as a "one shot" technique or as a semi-"real-time" technique for a few seconds (at about 1 frame per second) in order to obtain a stable elastogram. With either technique, there should be no motion/breathing during image acquisition. A bidimensional averaged area should overcome the limitation of pSWE to inadvertently investigate small regions of greater or lesser stiffness than average. A shear wave quality indicator could be useful to provide real-time feedback and optimize placement of the sampling ROIs, a technology recently presented by Toshiba(®), but which is still awaiting validation in the literature.Supersonic Imagine by Aixplorer(®) which works with a different modality of insonation and video analysis compared to the the previously-mentioned three techniques (i. e., transient elastography, pSWE and 2D-SWE), leading to a bidimensional assessment of liver stiffness in real time up to 5 Hz and in larger regions; thus this technique is also termed real-time 2 D SWE. It has been available on the market for a few years 19 20, and many articles have been published showing stiffness values quite similar to those of Fibroscan(®) 21; likewise, defined thresholds based on histological findings have appeared in several articles 19 20 21.After this brief summary of the technological state of the art we would like to mention the following critical issues that we believe every user should note prior to providing liver stiffness reports. · The thresholds obtained from the "oldest" techniques for the various fibrosis stages based on hundreds of patients with histology as reference standard cannot be straightforwardly applied to the new ultrasound elastography techniques, even if based on the same principle (e. g. pSWE). In fact, the different manufacturers apply proprietary patented calculation modes, which might result in slightly to moderately different values. It should be kept in mind that the range for intermediate fibrosis stages (F1 to F3) is quite narrow, in the order of 2 - 3 kilopascal (over a total range spanning 2 to 75 kPa with Fibroscan), so that slightly different differences in outputs could shift the assessment of patients from one stage to another. Comparative studies using phantoms and healthy volunteers, as well as patients, are eagerly awaited. In fact, the equipment might not produce linear correlations of measurements at different degrees of severity of fibrosis. As a theoretical example, some equipment might well correlate in their values with an older technique, such as transient elastography, at low levels of liver fibrosis, but not as well in cases of more advanced fibrosis or vice versa. Consequentely, when elastography data are included in a report, the equipment utilized for the measurement should be clearly specified, and conclusions about the fibrosis stage should be withheld if an insufficient number of comparative studies with solid reference standards are available for that specific equipment.. · Future studies using histology as a reference might be biased in comparison to previous studies, since nowadays fewer patients with chronic hepatitis C or hepatitis B undergo biopsy. In fact, due to wide availability of effective drugs as well as the use of established elastography methods for patients with viral hepatitis, most cases submitted to biopsy today have uncertain etiology or inconsistent and inconclusive clinical data. Therefore, extrapolated thresholds from such inhomogeneous populations applied to more ordinary patients with viral hepatitis might become problematic in the future, although no better solution is currently anticipated. This situation might lead to the adoption of a standard validated elastographic method as reference, but this has to be agreed-upon at an international level.. · Ultrasound elastography embedded in conventional scanners usually allows the choice of where to place the ROI within the color stiffness box and whether to confirm or exclude each single measurement when determining the final value. Thus, the operator has a greater potential to influence the final findings than with Fibroscan®, where these choices are not available. This has to be kept in mind to avoid the possibility that an operator could, even inadvertently, tend to confirm an assumption about that specific patient or to confirm the patient's expectations.. · Quality criteria for the new technologies following transient elastography are absent (depending on the manufacturer) or have not been satisfactorily defined, so that the information potentially inserted in a report cannot currently be judged for its reliability by the clinician.. (ABSTRACT TRUNCATED) © Georg Thieme Verlag KG Stuttgart · New York.

Performance of 2-D shear wave elastography in liver fibrosis assessment compared with serologic tests and transient elastography in clinical routine.

PubMed

Bota, Simona; Paternostro, Rafael; Etschmaier, Alexandra; Schwarzer, Remy; Salzl, Petra; Mandorfer, Mattias; Kienbacher, Christian; Ferlitsch, Monika; Reiberger, Thomas; Trauner, Michael; Peck-Radosavljevic, Markus; Ferlitsch, Arnulf

2015-09-01

Liver stiffness values assessed with 2-D shear wave elastography (SWE), transient elastography (TE) and simple serologic tests were compared with respect to non-invasive assessment in a cohort of 127 consecutive patients with chronic liver diseases. The rate of reliable liver stiffness measurements was significantly higher with 2-D SWE than with TE: 99.2% versus 74.8%, p < 0.0001 (different reliability criteria used, according to current recommendations). In univariate analysis, liver stiffness measured with 2-D SWE correlated best with fibrosis stage estimated with TE (r = 0.699, p < 0.0001), followed by Forns score (r = 0.534, p < 0.0001) and King's score (r = 0.512, p < 0.0001). However, in multivariate analysis, only 2-D SWE-measured values remained correlated with fibrosis stage (p < 0.0001). The optimal 2-D SWE cutoff values for predicting significant fibrosis were 8.03 kPa for fibrosis stage ≥2 (area under the receiver operating characteristic curve = 0.832) and 13.1 kPa for fibrosis stage 4 (area under the receiver operating characteristic curve = 0.915), respectively. In conclusion, 2-D SWE can be used to obtain reliable liver stiffness measurements in almost all patients and performs very well in predicting the presence of liver cirrhosis. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Acoustic radiation force impulse shear wave elastography (ARFI) of acute and chronic pancreatitis and pancreatic tumor.

PubMed

Goertz, Ruediger S; Schuderer, Johanna; Strobel, Deike; Pfeifer, Lukas; Neurath, Markus F; Wildner, Dane

2016-12-01

Acoustic Radiation Force Impulse (ARFI) elastography evaluates tissue stiffness non-invasively and has rarely been applied to pancreas examinations so far. In a prospective and retrospective analysis, ARFI shear wave velocities of healthy parenchyma, pancreatic lipomatosis, acute and chronic pancreatitis, adenocarcinoma and neuroendocrine tumor (NET) of the pancreas were evaluated and compared. In 95 patients ARFI elastography of the pancreatic head, and also of the tail for a specific group, was analysed retrospectively. Additionally, prospectively in 100 patients ARFI was performed in the head and tail of the pancreas. A total of 195 patients were included in the study. Healthy parenchyma (n=21) and lipomatosis (n=30) showed similar shear wave velocities of about 1.3m/s. Acute pancreatitis (n=35), chronic pancreatitis (n=53) and adenocarcinoma (n=52) showed consecutively increasing ARFI values, respectively. NET (n=4) revealed the highest shear wave velocities amounting to 3.62m/s. ARFI elastography showed relevant differences between acute pancreatitis and chronic pancreatitis or adenocarcinoma. With a cut-off value of 1.74m/s for the diagnosis of a malignant disease the sensitivity was 91.1% whereas the specificity amounted to 60.4%. ARFI shear wave velocities present differences in various pathologies of the pancreas. Acute and chronic pancreatitis as well as neoplastic lesions show high ARFI values. Very high elasticity values may indicate malignant disease of the pancreas. However, there is a considerable overlap between the entities. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Extensor indicis proprius tendon transfer using shear wave elastography.

PubMed

Lamouille, J; Müller, C; Aubry, S; Bensamoun, S; Raffoul, W; Durand, S

2017-06-01

The means for judging optimal tension during tendon transfers are approximate and not very quantifiable. The purpose of this study was to demonstrate the feasibility of quantitatively assessing muscular mechanical properties intraoperatively using ultrasound elastography (shear wave elastography [SWE]) during extensor indicis proprius (EIP) transfer. We report two cases of EIP transfer for post-traumatic rupture of the extensor pollicis longus muscle. Ultrasound acquisitions measured the elasticity modulus of the EIP muscle at different stages: rest, active extension, active extension against resistance, EIP section, distal passive traction of the tendon, after tendon transfer at rest and then during active extension. A preliminary analysis was conducted of the distribution of values for this modulus at the various transfer steps. Different shear wave velocity and elasticity modulus values were observed at the various transfer steps. The tension applied during the transfer seemed close to the resting tension if a traditional protocol were followed. The elasticity modulus varied by a factor of 37 between the active extension against resistance step (565.1 kPa) and after the tendon section (15.3 kPa). The elasticity modulus values were distributed in the same way for each patient. The therapeutic benefit of SWE elastography was studied for the first time in tendon transfers. Quantitative data on the elasticity modulus during this test may make it an effective means of improving intraoperative adjustments. Copyright © 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.

3D Myocardial Elastography In Vivo.

PubMed

Papadacci, Clement; Bunting, Ethan A; Wan, Elaine Y; Nauleau, Pierre; Konofagou, Elisa E

2017-02-01

Strain evaluation is of major interest in clinical cardiology as it can quantify the cardiac function. Myocardial elastography, a radio-frequency (RF)-based cross-correlation method, has been developed to evaluate the local strain distribution in the heart in vivo. However, inhomogeneities such as RF ablation lesions or infarction require a three-dimensional approach to be measured accurately. In addition, acquisitions at high volume rate are essential to evaluate the cardiac strain in three dimensions. Conventional focused transmit schemes using 2D matrix arrays, trade off sufficient volume rate for beam density or sector size to image rapid moving structure such as the heart, which lowers accuracy and precision in the strain estimation. In this study, we developed 3D myocardial elastography at high volume rates using diverging wave transmits to evaluate the local axial strain distribution in three dimensions in three open-chest canines before and after radio-frequency ablation. Acquisitions were performed with a 2.5 MHz 2D matrix array fully programmable used to emit 2000 diverging waves at 2000 volumes/s. Incremental displacements and strains enabled the visualization of rapid events during the QRS complex along with the different phases of the cardiac cycle in entire volumes. Cumulative displacement and strain volumes depict high contrast between non-ablated and ablated myocardium at the lesion location, mapping the tissue coagulation. 3D myocardial strain elastography could thus become an important technique to measure the regional strain distribution in three dimensions in humans.

Surveying Requirements Meeting Management Sessions, 1-5 February 1982,

DTIC Science & Technology

1983-02-01

organized and conducted by the Engineering Division, Directorate of Civil Works, Office of the Chief of Engineers, to improve management and...Development) 1. Technical User Groups Overview - M. K. Miles, OCE 2. Organizing a Successful Computer Aided Applications Program - Dr. N. Radhakrishnan...2. Organization Structure 3. In-House Capabilities 4. Expertise Requirements 5. Professionalism TUESDAY-2 FEBRUARY No Management Activities WEDNESDAY

Una introducción a la acidificación oceánica y costera

EPA Pesticide Factsheets

El dióxido de carbono que los seres humanos emiten en la atmósfera a través de la combustión de combustibles fósiles (petróleo, carbón y gas natural) está modificando las características químicas del océano al aumentar su acidez.

Technical Assistance in Evaluating Career Education Projects. Final Report. Volume II: Final Career Education Evaluation Report.

ERIC Educational Resources Information Center

Stenner, A. Jackson; And Others

This document contains the second of five volumes reporting the activities and results of a career education evaluation project conducted to accomplish the following two objectives: (1) to improve the quality of evaluations by career education projects funded by the United States Office of Career Education (OCE) through the provision of technical…

A generalized four-fifth law for compressible turbulence

NASA Astrophysics Data System (ADS)

Aluie, Hussein

2016-11-01

Kolmogorov's 4/5-th law is a celebrated exact result of incompressible turbulence, and is key to the formulation of his 1941 phenomenology. We will present its generalization to compressible turbulence. Partial support was provided by NSF Grant OCE-1259794, US Department of Energy (US DOE) Grant DE-SC0014318, and the LANL LDRD program through Project Number 20150568ER.

Making Improvements to The Army Distributed Learning Program

DTIC Science & Technology

2012-01-01

Learning (pre/post comparisons). e Army could develop an IT platform to administer course pretests and posttests . Automatic scoring/reporting... groups with proponent schools, DL contractors, and TRADOC head- quarters sta; reviews of Army processes for developing courseware; and an analysis...Lessons ORD Operational Requirements Document PB President’s Budget PCO Procuring Contract Oce PEG Program Evaluation Group PEO EIS U.S. Army

Diagnosis of CO2 Fluxes in the Coastal Ocean

NASA Astrophysics Data System (ADS)

Dai, M.; Cao, Z.; Yang, W.; Guo, X.; Yin, Z.; Zhao, Y.

2017-12-01

Coastal ocean carbon is an important component of the global carbon cycle. However, its mechanistic-based conceptualization, a prerequisite of coastal carbon modeling and its inclusion in the Earth System Model, remains difficult due to the highest variability in both time and space. Here we show that the inter-seasonal change of the global coastal pCO2 is more determined by non-temperature factors such as biological drawdown and water mass mixing, the latter of which features the dynamic boundary processes of the coastal ocean at both land-margin and margin-open ocean interfaces. Considering these unique features, we resolve the coastal CO2 fluxes using a semi-analytical approach coupling physics-biogeochemistry and carbon-nutrients and conceptualize the coastal carbon cycle into Ocean-dominated Margins (OceMar) and River-dominated Ocean Margins (RiOMar). The diagnostic result of CO2 fluxes in the South China Sea basin and the Arabian Sea as OceMars and in the Pearl River Plume as a RioMar is consistent with field observations. Our mechanistic-based diagnostic approach therefore helps better understand and model coastal carbon cycle yet the stoichiometry of carbon-nutrients coupling needs scrutiny when applying our approach.

Influence of culture conditions and medium composition on the production of antibacterial compounds by marine Serratia sp. WPRA3.

PubMed

Jafarzade, Mahtab; Yahya, Nur Ain; Shayesteh, Fatemeh; Usup, Gires; Ahmad, Asmat

2013-06-01

This study was undertaken to investigate the influence of culture conditions and medium components on production of antibacterial compounds by Serratia sp. WPRA3 (JX020764) which was isolated from marine water of Port Dickson, Malaysia. Biochemical, morphological, and molecular characteristics suggested that the isolate is a new candidate of the Serratia sp. The isolate showed strong antimicrobial activity against fungi, Gram-negative and Gram-positive bacteria. This bacterium exhibited optimum antibacterial compounds production at 28°C, pH 7 and 200 rev/min aeration during 72 h of incubation period. Highest antibacterial activity was obtained when sodium chloride (2%), yeast extract (0.5%), and glucose concentration (0.75%) were used as salt, nitrogen, and carbon sources respectively. Different active fractions were obtained by Thin-Layer Chromatography (TLC) and Flash Column Chromatography (FCC) from ethyl acetate crude extracts namely OCE and RCE in different culture conditions, OCE (pH 5, 200 rev/min) and RCE (pH 7/without aeration). In conclusion, the results suggested different culture conditions have a significant impact on the types of secondary metabolites produced by the bacterium.

WE-AB-202-09: Feasibility and Quantitative Analysis of 4DCT-Based High Precision Lung Elastography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hasse, K; Neylon, J; Low, D

2016-06-15

Purpose: The purpose of this project is to derive high precision elastography measurements from 4DCT lung scans to facilitate the implementation of elastography in a radiotherapy context. Methods: 4DCT scans of the lungs were acquired, and breathing stages were subsequently registered to each other using an optical flow DIR algorithm. The displacement of each voxel gleaned from the registration was taken to be the ground-truth deformation. These vectors, along with the 4DCT source datasets, were used to generate a GPU-based biomechanical simulation that acted as a forward model to solve the inverse elasticity problem. The lung surface displacements were appliedmore » as boundary constraints for the model-guided lung tissue elastography, while the inner voxels were allowed to deform according to the linear elastic forces within the model. A biomechanically-based anisotropic convergence magnification technique was applied to the inner voxels in order to amplify the subtleties of the interior deformation. Solving the inverse elasticity problem was accomplished by modifying the tissue elasticity and iteratively deforming the biomechanical model. Convergence occurred when each voxel was within 0.5 mm of the ground-truth deformation and 1 kPa of the ground-truth elasticity distribution. To analyze the feasibility of the model-guided approach, we present the results for regions of low ventilation, specifically, the apex. Results: The maximum apical boundary expansion was observed to be between 2 and 6 mm. Simulating this expansion within an apical lung model, it was observed that 100% of voxels converged within 0.5 mm of ground-truth deformation, while 91.8% converged within 1 kPa of the ground-truth elasticity distribution. A mean elasticity error of 0.6 kPa illustrates the high precision of our technique. Conclusion: By utilizing 4DCT lung data coupled with a biomechanical model, high precision lung elastography can be accurately performed, even in low ventilation regions of the lungs. This material is based upon work supported by the National Science Foundation Graduate Research Fellowship under Grant No. DGE-1144087.« less

Magnetic resonance elastography of the brain: A comparison between pigs and humans.

PubMed

Weickenmeier, Johannes; Kurt, Mehmet; Ozkaya, Efe; Wintermark, Max; Pauly, Kim Butts; Kuhl, Ellen

2018-01-01

Magnetic resonance elastography holds promise as a non-invasive, easy-to-use, in vivo biomarker for neurodegenerative diseases. Throughout the past decade, pigs have gained increased popularity as large animal models for human neurodegeneration. However, the volume of a pig brain is an order of magnitude smaller than the human brain, its skull is 40% thicker, and its head is about twice as big. This raises the question to which extent established vibration devices, actuation frequencies, and analysis tools for humans translate to large animal studies in pigs. Here we explored the feasibility of using human brain magnetic resonance elastography to characterize the dynamic properties of the porcine brain. In contrast to humans, where vibration devices induce an anterior-posterior displacement recorded in transverse sections, the porcine anatomy requires a dorsal-ventral displacement recorded in coronal sections. Within these settings, we applied a wide range of actuation frequencies, from 40Hz to 90Hz, and recorded the storage and loss moduli for human and porcine brains. Strikingly, we found that optimal actuation frequencies for humans translate one-to-one to pigs and reliably generate shear waves for elastographic post-processing. In a direct comparison, human and porcine storage and loss moduli followed similar trends and increased with increasing frequency. When translating these frequency-dependent storage and loss moduli into the frequency-independent stiffnesses and viscosities of a standard linear solid model, we found human values of μ 1 =1.3kPa, μ 2 =2.1kPa, and η=0.025kPas and porcine values of μ 1 =2.0kPa, μ 2 =4.9kPa, and η=0.046kPas. These results suggest that living human brain is softer and less viscous than dead porcine brain. Our study compares, for the first time, magnetic resonance elastography in human and porcine brains, and paves the way towards systematic interspecies comparison studies and ex vivo validation of magnetic resonance elastography as a whole. Copyright © 2017 Elsevier Ltd. All rights reserved.

Improvement of liver stiffness measurement, acoustic radiation force impulse measurements, and noninvasive fibrosis markers after direct-acting antivirals for hepatitis C virus G4 recurrence post living donor liver transplantation: Egyptian cohort.

PubMed

Alem, Shereen Abdel; Said, Mohamed; Anwar, Ismail; Abdellatif, Zeinab; Elbaz, Tamer; Eletreby, Rasha; AbouElKhair, Mahmoud; El-Serafy, Magdy; Mogawer, Sherif; El-Amir, Mona; El-Shazly, Mostafa; Hosny, Adel; Yosry, Ayman

2018-05-02

Progression of recurrent hepatitis C is accelerated in liver transplant (LT) recipients. Direct-acting antivirals (DAAs) have recently emerged as a promising therapeutic regimen for the treatment of hepatitis C virus infection. Rates of sustained virological response (SVR) have drastically improved since the introduction of DAAs. The aim is to elucidate the changes in liver stiffness measurement (LSM) by transient elastography (TE) as well as acoustic radiation force impulse (ARFI) elastography and fibrosis scores after DAA treatment in LT recipients with hepatitis C virus recurrence. A single-center, prospective study including 58 LT recipients with hepatitis C recurrence who received different sofosbuvir-based treatment regimens. Transient elastography and ARFI elastography values were recorded as well as fibrosis 4 score (FIB-4) and aspartate aminotransferase-to-platelet ratio index were calculated at baseline and SVR at week 24 (SVR24). The outcome was improvement in LSM and at least a 20% decrease in LSM at SVR24 compared with baseline. The sustained virological response was 98.1%. There was improvement of platelet counts, alanine aminotransferase, and aspartate aminotransferase, which in turn caused improvement in fibrosis scores at SVR24. LSM by TE and ARFI elastography decreased from the baseline median value of 6.3 kPa (interquartile range [IQR]; 4.6 to 8.8 kPa) and 1.28 m/s (IQR; 1.07 to 1.53 m/s) to an SVR24 median value of 6.2 kPa (IQR; 4.85 to 8.9 kPa) and 1.12 (IQR; 0.97 to 1.30 m/s), respectively. Logistic regression analysis showed that baseline viral load was the only significant predictor of improvement in LS after DAA therapy at SVR24. Sofosbuvir-based treatment resulted in an early improvement in parameters of liver fibrosis in post-LT patients with hepatitis C recurrence. © 2018 Wiley Periodicals, Inc.

Real-Time Shear Wave versus Transient Elastography for Predicting Fibrosis: Applicability, and Impact of Inflammation and Steatosis. A Non-Invasive Comparison

PubMed Central

Poynard, Thierry; Pham, Tam; Perazzo, Hugo; Munteanu, Mona; Luckina, Elena; Elaribi, Djamel; Ngo, Yen; Bonyhay, Luminita; Seurat, Noemie; Legroux, Muriel; Ngo, An; Deckmyn, Olivier; Thabut, Dominique; Ratziu, Vlad; Lucidarme, Olivier

2016-01-01

Background and Aims Real-time shear wave elastography (2D-SWE) is a two-dimensional transient elastography and a competitor as a biomarker of liver fibrosis in comparison with the standard reference transient elastography by M probe (TE-M). The aims were to compare several criteria of applicability, and to assess inflammation and steatosis impact on elasticity values, two unmet needs. Methods We took FibroTest as the fibrosis reference and ActiTest and SteatoTest as quantitative estimates of inflammation and steatosis. After standardization of estimates, analyses used curve fitting, quantitative Lin concordance coefficient [LCC], and multivariate logistic regression. Results A total of 2,251 consecutive patients were included. We validated the predetermined 0.2 kPa cut-off as a too low minimal elasticity value identifying not-reliable 2D-SWE results (LCC with FibroTest = 0.0281[-0.119;0.175]. Other criteria, elasticity CV, body mass index and depth of measures were not sufficiently discriminant. The applicability of 2D-SWE (95%CI) 89.6%(88.2–90.8), was significantly higher than that of TE, 85.6%(84.0–87.0; P<0.0001). In patients with non-advanced fibrosis (METAVIR F0F1F2), elasticity values estimated by 2D-SWE was less impacted by inflammation and steatosis than elasticity value estimated by TE-M: LCC (95%CI) 0.039 (0.021;0.058) vs 0.090 (0.068;0.112;P<0.01) and 0.105 (0.068;0.141) vs 0.192 (0.153;0.230; P<0.01) respectively. The three analyses methods gave similar results. Conclusions Elasticity results including very low minimal signal in the region of interest should be considered not reliable. 2D-SWE had a higher applicability than TE, the reference elastography, with less impact of inflammation and steatosis especially in patients with non-advanced fibrosis, as presumed by blood tests. Trial Registration ClinicalTrials.gov NCT01927133 PMID:27706177

Shear-wave elastography of the liver and spleen identifies clinically significant portal hypertension: A prospective multicentre study.

PubMed

Jansen, Christian; Bogs, Christopher; Verlinden, Wim; Thiele, Maja; Möller, Philipp; Görtzen, Jan; Lehmann, Jennifer; Vanwolleghem, Thomas; Vonghia, Luisa; Praktiknjo, Michael; Chang, Johannes; Krag, Aleksander; Strassburg, Christian P; Francque, Sven; Trebicka, Jonel

2017-03-01

Clinically significant portal hypertension (CSPH) is associated with severe complications and decompensation of cirrhosis. Liver stiffness measured either by transient elastography (TE) or Shear-wave elastography (SWE) and spleen stiffness by TE might be helpful in the diagnosis of CSPH. We recently showed the algorithm to rule-out CSPH using sequential liver- (L-SWE) and spleen-Shear-wave elastography (S-SWE). This study investigated the diagnostic value of S-SWE for diagnosis of CSPH. One hundred and fifty-eight cirrhotic patients with pressure gradient measurements were included into this prospective multicentre study. L-SWE was measured in 155 patients, S-SWE in 112 patients, and both in 109 patients. Liver-shear-wave elastography and S-SWE correlated with clinical events and decompensation. SWE of liver and spleen revealed strong correlations with the pressure gradient and to differentiate between patients with and without CSPH. The best cut-off values were 24.6 kPa:L-SWE and 26.3 kPa:S-SWE. L-SWE ≤16.0 kPa and S-SWE ≤21.7 kPa were able to rule-out CSPH. Cut-off values of L-SWE >29.5 kPa and S-SWE >35.6 kPa were able to rule-in CSPH (specificity >92%). Patients with a L-SWE >38.0 kPa had likely CSPH. In patients with L-SWE ≤38.0 kPa, a S-SWE >27.9 kPa ruled in CSPH. This algorithm has a sensitivity of 89.2% and a specificity of 91.4% to rule-in CSPH. Patients not fulfilling these criteria may undergo HVPG measurement. Liver and spleen SWE correlate with portal pressure and can both be used as a non-invasive method to investigate CSPH. Even though external validation is still missing, these algorithms to rule-out and rule-in CSPH using sequential SWE of liver and spleen might change the clinical practice. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Real-Time Elastography Visualization and Histopathological Characterization of Rabbit Atherosclerotic Carotid Arteries.

PubMed

Wang, ZhenZhen; Liu, NaNa; Zhang, LiFeng; Li, XiaoYing; Han, XueSong; Peng, YanQing; Dang, MeiZheng; Sun, LiTao; Tian, JiaWei

2016-01-01

To evaluate the feasibility of non-invasive vascular real-time elastography imaging (RTE) in visualizing the composition of rabbit carotid atherosclerotic plaque as determined by histopathology, a rabbit model of accelerated carotid atherosclerosis was used. Thirty rabbits were randomly divided into two groups of 15 rabbits each. The first group was fed a cholesterol-rich diet and received balloon-induced injury the left common carotid artery endothelium, whereas the second group only received a cholesterol-rich diet. The rabbits were all examined in vivo with HITACHI non-invasive vascular real-time elastography (Hi-RTE) at baseline and 12 wk, and results from the elastography were compared with American Heart Association histologic classifications. Hi-RTE and the American Heart Association histologic classifications had good agreement, with weighted Cohen's kappa (95% confidence internal) of 0.785 (0.649-0.920). Strains of segmented plaques that were stained in different colors were statistically different (p < 0.0001). The sensitivity and specificity of elastograms for detecting a lipid core were 95.5% and 61.5%, respectively, and the area under the receiver operating characteristic curve was 0.789, with a 95% confidence interval of 0.679 to 0.876. This study is the first to indicate the feasibility of utilizing Hi-RTE in visualizing normal and atherosclerotic rabbit carotid arteries non-invasively. This affordable and reliable method can be widely applied in research of both animal and human peripheral artery atherosclerosis. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Ultrasound Elastography of the Neonatal Brain: Preliminary Study.

PubMed

Kim, Hyun Gi; Park, Moon Sung; Lee, Jung-Dong; Park, Seon Young

2017-07-01

To determine the ultrasound elasticity of the brain in neonates METHODS: Strain elastography was performed in 21 healthy neonates (mean gestational age [GA], 34 weeks; range, 28-40 weeks). Elastographic scores were assigned to the following structures on a 5-point color scale (1-5): ventricle, periventricular white matter, caudate, subcortical, cortical gray matter, and subdural space. Three elastographic images were evaluated in each patient, and median elastographic scores were calculated. The scores were compared between regions and were correlated with the corrected GA. Interobserver agreements for assignment of elastographic scores were analyzed. The ventricle and subdural space showed an elasticity score of 1 in all patients. The cortical gray matter (median, 3.0; first-third quartiles, 2.33-3.33) showed higher elasticity compared to the periventricular white mater (4.0; 3.00-4.00; P < .001), caudate (4.3; 3.67-4.67; P < .001), and subcortical white matter (4.0; 4.00-4.00; P < .001). The caudate showed lower elasticity compared to periventricular white matter (P = .004). The periventricular white matter showed higher elasticity compared to subcortical white matter (P = .009). There was a positive trend between the corrected GA and cortical gray matter elastographic score (γ = 0.376; P = .093). Interobserver agreement was moderate to almost perfect (κ = 0.53-0.89). Neonatal intracranial regions showed different elasticity, which could be accessed by strain elastography. These normal findings should prompt future studies investigating the use of ultrasound elastography in the neonatal brain. © 2017 by the American Institute of Ultrasound in Medicine.

Quantitative US Elastography Can Be Used to Quantify Mechanical and Histologic Tendon Healing in a Rabbit Model of Achilles Tendon Transection.

PubMed

Yamamoto, Yohei; Yamaguchi, Satoshi; Sasho, Takahisa; Fukawa, Taisuke; Akatsu, Yorikazu; Akagi, Ryuichiro; Yamaguchi, Tadashi; Takahashi, Kenji; Nagashima, Kengo; Takahashi, Kazuhisa

2017-05-01

Purpose To determine the time-dependent change in strain ratios (SRs) at the healing site of an Achilles tendon rupture in a rabbit model of tendon transection and to assess the correlation between SRs and the mechanical and histologic properties of the healing tissue. Materials and Methods Experimental methods were approved by the institutional animal care and use committee. The Achilles tendons of 24 New Zealand white rabbits (48 limbs) were surgically transected. The SRs of Achilles tendons were calculated by using compression-based quantitative ultrasonographic elastography measurements obtained 2, 4, 8, and 12 weeks after transection. After in vivo elastography, the left Achilles tendon was harvested for mechanical testing of ultimate load, ultimate stress, elastic modulus, and linear stiffness, and the right tendons were harvested for tissue histologic analysis with the Bonar scale. Time-dependent changes in SRs, mechanical parameters, and Bonar scale scores were evaluated by using repeated-measures analysis of variance. The correlation between SRs and each measured variable was evaluated by using the Spearman rank correlation coefficient. Results Mean SRs and Bonar scale values decreased as a function of time after transection, whereas mechanical parameters increased (P < .001). SR correlated with ultimate stress (ρ = 0.68, P <.001,) elastic modulus (ρ = 0.74, P <.001), and the Bonar scale (ρ = 0.87, P <.001). Conclusion Quantitative elastography could be a useful method with which to evaluate mechanical and histologic properties of the healing tendon. © RSNA, 2017 Online supplemental material is available for this article.

Visualizing ex vivo radiofrequency and microwave ablation zones using electrode vibration elastography

PubMed Central

DeWall, Ryan J.; Varghese, Tomy; Brace, Chris L.

2012-01-01

Purpose: Electrode vibration elastography is a new shear wave imaging technique that can be used to visualize thermal ablation zones. Prior work has shown the ability of electrode vibration elastography to delineate radiofrequency ablations; however, there has been no previous study of delineation of microwave ablations or radiological–pathological correlations using multiple observers. Methods: Radiofrequency and microwave ablations were formed in ex vivo bovine liver tissue. Their visualization was compared on shear wave velocity and maximum displacement images. Ablation dimensions were compared to gross pathology. Elastographic imaging and gross pathology overlap and interobserver variability were quantified using similarity measures. Results: Elastographic imaging correlated with gross pathology. Correlation of area estimates was better in radiofrequency than in microwave ablations, with Pearson coefficients of 0.79 and 0.54 on shear wave velocity images and 0.90 and 0.70 on maximum displacement images for radiofrequency and microwave ablations, respectively. The absolute relative difference in area between elastographic imaging and gross pathology was 18.9% and 22.9% on shear wave velocity images and 16.0% and 23.1% on maximum displacement images for radiofrequency and microwave ablations, respectively. Conclusions: Statistically significant radiological–pathological correlation was observed in this study, but correlation coefficients were lower than other modulus imaging techniques, most notably in microwave ablations. Observers provided similar delineations for most thermal ablations. These results suggest that electrode vibration elastography is capable of imaging thermal ablations, but refinement of the technique may be necessary before it can be used to monitor thermal ablation procedures clinically. PMID:23127063

Non-invasive assessment of liver fibrosis: Between prediction/prevention of outcomes and cost-effectiveness.

PubMed

Stasi, Cristina; Milani, Stefano

2016-01-28

The assessment of the fibrotic evolution of chronic hepatitis has always been a challenge for the clinical hepatologist. Over the past decade, various non-invasive methods have been proposed to detect the presence of fibrosis, including the elastometric measure of stiffness, panels of clinical and biochemical parameters, and combinations of both methods. The aim of this review is to analyse the most recent data on non-invasive techniques for the evaluation of hepatic fibrosis with particular attention to cost-effectiveness. We searched for relevant studies published in English using the PubMed database from 2009 to the present. A large number of studies have suggested that elastography and serum markers are useful techniques for diagnosing severe fibrosis and cirrhosis and for excluding significant fibrosis in hepatitis C virus patients. In addition, hepatic stiffness may also help to prognosticate treatment response to antiviral therapy. It has also been shown that magnetic resonance elastography has a high accuracy for staging and differentiating liver fibrosis. Finally, studies have shown that non-invasive methods are becoming increasingly precise in either positively identifying or excluding liver fibrosis, thus reducing the need for liver biopsy. However, both serum markers and transient elastography still have "grey area" values of lower accuracy. In this case, liver biopsy is still required to properly assess liver fibrosis. Recently, the guidelines produced by the World Health Organization have suggested that the AST-to-platelet ratio index or FIB-4 test could be utilised for the evaluation of liver fibrosis rather than other, more expensive non-invasive tests, such as elastography or FibroTest.

Non-invasive assessment of liver fibrosis: Between prediction/prevention of outcomes and cost-effectiveness

PubMed Central

Stasi, Cristina; Milani, Stefano

2016-01-01

The assessment of the fibrotic evolution of chronic hepatitis has always been a challenge for the clinical hepatologist. Over the past decade, various non-invasive methods have been proposed to detect the presence of fibrosis, including the elastometric measure of stiffness, panels of clinical and biochemical parameters, and combinations of both methods. The aim of this review is to analyse the most recent data on non-invasive techniques for the evaluation of hepatic fibrosis with particular attention to cost-effectiveness. We searched for relevant studies published in English using the PubMed database from 2009 to the present. A large number of studies have suggested that elastography and serum markers are useful techniques for diagnosing severe fibrosis and cirrhosis and for excluding significant fibrosis in hepatitis C virus patients. In addition, hepatic stiffness may also help to prognosticate treatment response to antiviral therapy. It has also been shown that magnetic resonance elastography has a high accuracy for staging and differentiating liver fibrosis. Finally, studies have shown that non-invasive methods are becoming increasingly precise in either positively identifying or excluding liver fibrosis, thus reducing the need for liver biopsy. However, both serum markers and transient elastography still have “grey area” values of lower accuracy. In this case, liver biopsy is still required to properly assess liver fibrosis. Recently, the guidelines produced by the World Health Organization have suggested that the AST-to-platelet ratio index or FIB-4 test could be utilised for the evaluation of liver fibrosis rather than other, more expensive non-invasive tests, such as elastography or FibroTest. PMID:26819535

Non-Invasive Evaluation of Cystic Fibrosis Related Liver Disease in Adults with ARFI, Transient Elastography and Different Fibrosis Scores

PubMed Central

Oltmanns, Annett; Güttler, Andrea; Petroff, David; Wirtz, Hubert; Mainz, Jochen G.; Mössner, Joachim; Berg, Thomas; Tröltzsch, Michael; Keim, Volker; Wiegand, Johannes

2012-01-01

Background Cystic fibrosis-related liver disease (CFLD) is present in up to 30% of cystic fibrosis patients and can result in progressive liver failure. Diagnosis of CFLD is challenging. Non-invasive methods for staging of liver fibrosis display an interesting diagnostic approach for CFLD detection. Aim We evaluated transient elastography (TE), acoustic radiation force impulse imaging (ARFI), and fibrosis indices for CFLD detection. Methods TE and ARFI were performed in 55 adult CF patients. In addition, AST/Platelets-Ratio-Index (APRI), and Forns' score were calculated. Healthy probands and patients with alcoholic liver cirrhosis served as controls. Results Fourteen CF patients met CFLD criteria, six had liver cirrhosis. Elastography acquisition was successful in >89% of cases. Non-cirrhotic CFLD individuals showed elastography values similar to CF patients without liver involvement. Cases with liver cirrhosis differed significantly from other CFLD patients (ARFI: 1.49 vs. 1.13 m/s; p = 0.031; TE: 7.95 vs. 4.16 kPa; p = 0.020) and had significantly lower results than individuals with alcoholic liver cirrhosis (ARFI: 1.49 vs. 2.99 m/s; p = 0.002). APRI showed the best diagnostic performance for CFLD detection (AUROC 0.815; sensitivity 85.7%, specificity 70.7%). Conclusions ARFI, TE, and laboratory based fibrosis indices correlate with each other and reliably detect CFLD related liver cirrhosis in adult CF patients. CF specific cut-off values for cirrhosis in adults are lower than in alcoholic cirrhosis. PMID:22848732

[Proposal for the systematization of the elastographic study of mammary lesions through ultrasound scan].

PubMed

Fleury, Eduardo de Faria Castro; Fleury, Jose Carlos Vendramini; Oliveira, Vilmar Marques de; Rinaldi, Jose Francisco; Piato, Sebastiao; Roveda Junior, Decio

2009-01-01

Proposal of systematization for the elastographic study in the ultrasound routine. Evaluation was made of 308 patients forwarded to the breast intervention service in the CTC-Genesis from May 1, 2007 to March 1, 2008 to perform percutaneous breast biopsy. Prior to the percutaneous biopsy, an ultrasound study and an elastography were performed. Lesions were primarily analyzed and classified according to the Bi-Rads lexicon criteria by the conventional ultrasound scan (B mode). The elastography was then performed and analyzed in accordance with the systematization proposed by the authors, using images obtained during compression and after decompression of the area of interest. Lesions were classified following the system developed by the authors using a four-point scale, where scores (1) and (2) were considered benign, score (3) probably benign and score (4) suspicion of malignancy. Results obtained by the two methods were compared with the histological results using the areas within the ROC (receiver operator curves) curves. The area within the curve for elastography was of 0.952 with a confidence interval between 0.910 and 0.966, error of 0.023, and of 0.867 with a confidence interval between 0.823 and 0.903, error of 0.0333 for the ultrasound. When the areas were compared, a difference between the curves of 0.026 was observed, which was statistically significant. This work shows the systematization of the elastographic study using information obtained during compression and after decompression of the ultrasound scan sample, thus showing that elastography might enhance the assessment of risk of malignancy for lesions characterized by the ultrasound.

Measuring shear-wave speed with point shear-wave elastography and MR elastography: a phantom study

PubMed Central

Kishimoto, Riwa; Suga, Mikio; Koyama, Atsuhisa; Omatsu, Tokuhiko; Tachibana, Yasuhiko; Ebner, Daniel K; Obata, Takayuki

2017-01-01

Objectives To compare shear-wave speed (SWS) measured by ultrasound-based point shear-wave elastography (pSWE) and MR elastography (MRE) on phantoms with a known shear modulus, and to assess method validity and variability. Methods 5 homogeneous phantoms of different stiffnesses were made. Shear modulus was measured by a rheometer, and this value was used as the standard. 10 SWS measurements were obtained at 4 different depths with 1.0–4.5 MHz convex (4C1) and 4.0–9.0 MHz linear (9L4) transducers using pSWE. MRE was carried out once per phantom, and SWSs at 5 different depths were obtained. These SWSs were then compared with those from a rheometer using linear regression analyses. Results SWSs obtained with both pSWE as well as MRE had a strong correlation with those obtained by a rheometer (R2>0.97). The relative difference in SWS between the procedures was from −25.2% to 25.6% for all phantoms, and from −8.1% to 6.9% when the softest and hardest phantoms were excluded. Depth dependency was noted in the 9L4 transducer of pSWE and MRE. Conclusions SWSs from pSWE and MRE showed a good correlation with a rheometer-determined SWS. Although based on phantom studies, SWSs obtained with these methods are not always equivalent, the measurement can be thought of as reliable and these SWSs were reasonably close to each other for the middle range of stiffness within the measurable range. PMID:28057657

Comparison of strain and acoustic radiation force impulse elastography of breast lesions by qualitative evaluation.

PubMed

Zhao, Qing; Wang, Xiao-Lei; Sun, Jia-Wei; Jiang, Zhao-Peng; Tao, Lin; Zhou, Xian-Li

2018-04-13

To compare the diagnostic performance of conventional strain elastography (CSE) and acoustic radiation force impulse (ARFI) induced SE for qualitative assessment of breast lesions and evaluate the additional value of the two techniques combined with Breast Imaging Reporting and Data System (BI-RADS) respectively for the differentiation of benign and malignant breast lesions. In a cohort of 110 women, the conventional ultrasound (US) features and the elasticity scores of CSE and ARFI induced SE were recorded. The diagnostic performances of BI-RADS, elastography and BI-RADS plus elastography were evaluated, including the area under the receiver operating characteristic curve (AUROC), sensitivity, specificity and accuracy. Pathologically, there were forty-eight malignant and sixty-two benign breast lesions in the final analysis. The AUCs for CSE and ARFI induced SE are similar (CSE, 0.807; ARFI induced SE, 0.846; p > 0.05), however, the specificity of the latter method was significantly higher than that of CSE (83.9% vs. 58.1%, p = 0.004) in differentiating breast lesions. The accuracy and specificity of BI-RADS plus ARFI induced SE (84.5%, 80.6%, respectively) were significantly higher than BI-RADS alone (73.6%, 54.8%, respectively) and BI-RADS plus conventional SE (72.7%, 56.5%, respectively), respectively (p < 0.05) without loss of sensitivity. Our study showed that BI-RADS plus ARFI induced SE had a better diagnostic performance in the diagnosis of breast lesions in comparison with BI-RADS alone or BI-RADS plus CSE.

The paradox of a wet (high H2O) and dry (low H2O/Ce) mantle: High water concentrations in mantle garnet pyroxenites from Hawaii

NASA Astrophysics Data System (ADS)

Bizimis, M.; Peslier, A. H.

2013-12-01

Water dissolved as trace amounts in anhydrous minerals has a large influence on the melting behavior and physical properties of the mantle. The water concentration of the oceanic mantle is inferred from the analyses of MORB and OIB [1], but there is little data from actual mantle samples. Moreover, enriched mineralogies (pyroxenites, eclogites) are thought as important sources of heterogeneity in the mantle, but their water concentrations and their effect on the water budget and cycling in the mantle are virtually unknown. We analyzed by FTIR water concentrations in garnet clinopyroxenite xenoliths from Salt Lake Crater, Oahu, Hawaii. These pyroxenites are high-pressure (>20kb) crystal fractionates from alkalic melts. The clinopyroxenes (cpx) have 260 to 576 ppm wt. H2O, with the least differentiated samples (Mg#>0.8) in the 400-500 ppm range. Orthopyroxene (opx) contain 117-265 ppm H2O, about half of that of cpx, consistent with other natural sample studies, but lower than experimental cpx/opx equilibrium data. These pyroxenite cpx and opx water concentrations are at the high-end of on-and off-craton peridotite xenolith concentrations and megacrysts from kimberites [2] and those of Hawaiian spinel peridotites. In contrast, garnet has extremely low water contents (<5ppm H2O). There is no correlation between water in cpx and lithophile element concentrations. Phlogopite is present in some samples, and its modal abundance shows a positive correlation in Mg# with cpx, implying equilibrium. However, there is no correlation between water concentrations and the presence of phlogopite. These data imply that cpx and opx water concentrations may be buffered by phlogopite crystallization. Reconstructed bulk rock pyroxenite water concentrations (not including phlogopite, i.e. minimum) range from 200-460 ppm (average 331× 75 ppm), significantly higher than water estimates for the MORB source (50-200 ppm), but in the range of E-MORB, OIB and the source of rejuvenated Hawaiian magmas [1,3]. The average bulk rock pyroxenite H2O/Ce is 69 × 35, lower than estimates of the MORB source (~150) or FOZO, C (200-250) mantle component, but consistent with 'dry' EM sources (<100) [1]. These data suggest that a metasomatized, refertilized oceanic lithosphere that contains a pyroxenite component (e.g. in the lower part of an oceanic plate, where ascending melts can become trapped and crystallize), will have both higher water concentrations and low H2O/Ce, and may contribute to EM-type OIB sources, like that of Samoan basalts [5]. Therefore, a low H2O/Ce mantle source may not necessarily be 'dry'. [1] Dixon et al., 2002, Nature 420, 385-389. [2] Peslier, 2010 JVGR 197, 239-258. [3] Dixon et al., 1997 JP 38, 911-939. [4] O'Leary et al. 2010 EPSL 297, 111-120. [5] Workman et al., 2006 EPSL 241, 932 - 951.

Arterial waveguide model for shear wave elastography: implementation and in vitro validation

NASA Astrophysics Data System (ADS)

Vaziri Astaneh, Ali; Urban, Matthew W.; Aquino, Wilkins; Greenleaf, James F.; Guddati, Murthy N.

2017-07-01

Arterial stiffness is found to be an early indicator of many cardiovascular diseases. Among various techniques, shear wave elastography has emerged as a promising tool for estimating local arterial stiffness through the observed dispersion of guided waves. In this paper, we develop efficient models for the computational simulation of guided wave dispersion in arterial walls. The models are capable of considering fluid-loaded tubes, immersed in fluid or embedded in a solid, which are encountered in in vitro/ex vivo, and in vivo experiments. The proposed methods are based on judiciously combining Fourier transformation and finite element discretization, leading to a significant reduction in computational cost while fully capturing complex 3D wave propagation. The developed methods are implemented in open-source code, and verified by comparing them with significantly more expensive, fully 3D finite element models. We also validate the models using the shear wave elastography of tissue-mimicking phantoms. The computational efficiency of the developed methods indicates the possibility of being able to estimate arterial stiffness in real time, which would be beneficial in clinical settings.

Reliable protocol for shear wave elastography of lower limb muscles at rest and during passive stretching.

PubMed

Dubois, Guillaume; Kheireddine, Walid; Vergari, Claudio; Bonneau, Dominique; Thoreux, Patricia; Rouch, Philippe; Tanter, Mickael; Gennisson, Jean-Luc; Skalli, Wafa

2015-09-01

Development of shear wave elastography gave access to non-invasive muscle stiffness assessment in vivo. The aim of the present study was to define a measurement protocol to be used in clinical routine for quantifying the shear modulus of lower limb muscles. Four positions were defined to evaluate shear modulus in 10 healthy subjects: parallel to the fibers, in the anterior and posterior aspects of the lower limb, at rest and during passive stretching. Reliability was first evaluated on two muscles by three operators; these measurements were repeated six times. Then, measurement reliability was compared in 11 muscles by two operators; these measurements were repeated three times. Reproducibility of shear modulus was 0.48 kPa and repeatability was 0.41 kPa, with all muscles pooled. Position did not significantly influence reliability. Shear wave elastography appeared to be an appropriate and reliable tool to evaluate the shear modulus of lower limb muscles with the proposed protocol. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Ultrasound elastography to determine the layered mechanical properties of articular cartilage and the importance of such structural characteristics under load.

PubMed

McCredie, Alexandra J; Stride, Eleanor; Saffari, Nader

2009-01-01

Articular cartilage is an important load bearing surface in joints. Prone to damage and with limited self-repair ability, it is of interest to tissue engineers. Tissue implant design requires full mechanical characterisation of healthy native tissue. A layered organisation of reinforcing collagen fibrils exists in healthy articular cartilage and is believed to be important for correct tissue function. However, the effect of this on the local depth-dependent elasticity is poorly characterised. In this study, quasi-static ultrasound elastography is used both to compare the depth-dependent elastic properties of cartilage structures with two different fibril arrangements and to monitor changes in the elastic properties of engineered samples during development. Results show global and local elastic properties of the native tissues and highlight the differences caused by fibril architecture. At increasing culture periods, results from the engineered tissue demonstrate an increase in elastic stiffness and the time taken to reach equilibrium under a quasi-static displacement. The study suggests suitability of ultrasound elastography for design and monitoring engineered articular cartilage.

Real-time 1-D/2-D transient elastography on a standard ultrasound scanner using mechanically induced vibration.

PubMed

Azar, Reza Zahiri; Dickie, Kris; Pelissier, Laurent

2012-10-01

Transient elastography has been well established in the literature as a means of assessing the elasticity of soft tissue. In this technique, tissue elasticity is estimated from the study of the propagation of the transient shear waves induced by an external or internal source of vibration. Previous studies have focused mainly on custom single-element transducers and ultrafast scanners which are not available in a typical clinical setup. In this work, we report the design and implementation of a transient elastography system on a standard ultrasound scanner that enables quantitative assessment of tissue elasticity in real-time. Two new custom imaging modes are introduced that enable the system to image the axial component of the transient shear wave, in response to an externally induced vibration, in both 1-D and 2-D. Elasticity reconstruction algorithms that estimate the tissue elasticity from these transient waves are also presented. Simulation results are provided to show the advantages and limitations of the proposed system. The performance of the system is also validated experimentally using a commercial elasticity phantom.

NOAA Weather Radio

Science.gov Websites

Search For Go NWS All NOAA Radio NOAA emite avisos, vigilancias, pronósticos y otra información de Nacional de Administración Oceánica y Atmosférica y el Departamento de Comercio Federal. SEGUNDOS SALVAN Alarmas Las Radios NOAA equipadas con un rasgo de tono de alarma especial pueden sonar una alarma y pueden

Compendium of Administrators of Land Use and Related Programs. Revision

DTIC Science & Technology

1982-09-01

construction engineering research laboratory Army Nation Unitad Stoic«» Army ^ n * Technical Report N-40 (Revised) September 19 82...CONTRACT OR GRANT NUMBER’«) \\ 9. PERFORMING ORGANIZATION NAME AND ADDRESS U.S. ARMY CONSTRUCTION ENGINEERING RESEARCH LABORATORY...Chief of Engineers (OCE), under Project 4A762720A896, "Environmental Quality for Construction and Operation of Military Facilities" Task 04. "Land Use

Appendixes L-P. Vol. II, A Plan for Managing the Development, Implementation and Operation of a Model Elementary Teacher Education Program.

ERIC Educational Resources Information Center

Oregon Coll. of Education, Monmouth.

Five appendixes make up this part of the final report on the elementary teacher education program. Appendix L is a summary chart of the orientation meetings, giving dates, locations, and participants. Appendix M is a listing of the seven school districts actively participating in the OCE coalition, with a brief description of their essential…

Accuracy of the Enhanced Liver Fibrosis Test vs FibroTest, Elastography, and Indirect Markers in Detection of Advanced Fibrosis in Patients With Alcoholic Liver Disease.

PubMed

Thiele, Maja; Madsen, Bjørn Stæhr; Hansen, Janne Fuglsang; Detlefsen, Sönke; Antonsen, Steen; Krag, Aleksander

2018-04-01

Alcohol is the leading cause of cirrhosis and liver-related mortality, but we lack serum markers to detect compensated disease. We compared the accuracy of the Enhanced Liver Fibrosis test (ELF), the FibroTest, liver stiffness measurements (made by transient elastography and 2-dimensional shear-wave elastography), and 6 indirect marker tests in detection of advanced liver fibrosis (Kleiner stage ≥F3). We performed a prospective study of 10 liver fibrosis markers (patented and not), all performed on the same day. Patients were recruited from primary centers (municipal alcohol rehabilitation, n = 128; 6% with advanced fibrosis) and secondary health care centers (hospital outpatient clinics, n = 161; 36% with advanced fibrosis) in the Region of Southern Denmark from 2013 through 2016. Biopsy-verified fibrosis stage was used as the reference standard. The primary aim was to validate ELF in detection of advanced fibrosis in patients with alcoholic liver disease recruited from primary and secondary health care centers, using the literature-based cutoff value of 10.5. Secondary aims were to assess the diagnostic accuracy of ELF for significant fibrosis and cirrhosis and to determine whether combinations of fibrosis markers increase diagnostic yield. The ELF identified patients with advanced liver fibrosis with an area under the receiver operating characteristic curve (AUROC) of 0.92 (95% confidence interval 0.89-0.96); findings did not differ significantly between patients from primary vs secondary care (P = .917). ELF more accurately identified patients with advanced liver fibrosis than indirect marker tests, but ELF and FibroTest had comparable diagnostic accuracies (AUROC of FibroTest, 0.90) (P = .209 for comparison with ELF). Results from the ELF and FibroTest did not differ significantly from those of liver stiffness measurement in intention-to-diagnose analyses (AUROC for transient elastography, 0.90), but did differ in the per-protocol analysis (AUROC for transient elastography, 0.97) (P = .521 and .004 for comparison with ELF). Adding a serum marker to transient elastography analysis did not increase accuracy. For patients in primary care, ELF values below 10.5 and FibroTest values below 0.58 had negative predictive values for advanced liver fibrosis of 98% and 94%, respectively. In a prospective, direct comparison of tests, ELF and FibroTest identified advanced liver fibrosis in alcoholic patients from primary and secondary care with high diagnostic accuracy (AUROC values of 0.90 or higher using biopsy as reference). Advanced fibrosis can be ruled out in primary health care patients based on an ELF value below 10.5 or a FibroTest value below 0.58. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

MR elastography of the liver at 3.0 T in diagnosing liver fibrosis grades; preliminary clinical experience.

PubMed

Yoshimitsu, Kengo; Mitsufuji, Toshimichi; Shinagawa, Yoshinobu; Fujimitsu, Ritsuko; Morita, Ayako; Urakawa, Hiroshi; Hayashi, Hiroyuki; Takano, Koichi

2016-03-01

To clarify the usefulness of 3.0-T MR elastography (MRE) in diagnosing the histological grades of liver fibrosis using preliminary clinical data. Between November 2012 and March 2014, MRE was applied to all patients who underwent liver MR study at a 3.0-T clinical unit. Among them, those who had pathological evaluation of liver tissue within 3 months from MR examinations were retrospectively recruited, and the liver stiffness measured by MRE was correlated with histological results. Institutional review board approved this study, waiving informed consent. There were 70 patients who met the inclusion criteria. Liver stiffness showed significant correlation with the pathological grades of liver fibrosis (rho = 0.89, p < 0.0001, Spearman's rank correlation). Areas under the receiver operating characteristic curve were 0.93, 0.95, 0.99 and 0.95 for fibrosis score greater than or equal to F1, F2, F3 and F4, with cut-off values of 3.13, 3.85, 4.28 and 5.38 kPa, respectively. Multivariate analysis suggested that grades of necroinflammation also affected liver stiffness, but to a significantly lesser degree as compared to fibrosis. 3.0-T clinical MRE was suggested to be sufficiently useful in assessing the grades of liver fibrosis. MR elastography may help clinicians assess patients with chronic liver diseases. Usefulness of 3.0-T MR elastography has rarely been reported. Measured liver stiffness correlated well with the histological grades of liver fibrosis. Measured liver stiffness was also affected by necroinflammation, but to a lesser degree. 3.0-T MRE could be a non-invasive alternative to liver biopsy.

Placental elastography in a murine intrauterine growth restriction model.

PubMed

Quibel, T; Deloison, B; Chammings, F; Chalouhi, G E; Siauve, N; Alison, M; Bessières, B; Gennisson, J L; Clément, O; Salomon, L J

2015-11-01

To compare placental elasticity in normal versus intrauterine growth restriction (IUGR) murine pregnancies using shear wave elastography (SWE). Intrauterine growth restriction was created by ligation of the left uterine artery of Sprague-Dawley rats on E17. Ultrasonography (US) and elastography were performed 2 days later on exteriorized horns after laparotomy. Biparietal diameter (BPD) and abdominal diameter (AD) were measured and compared in each horn. Placental elasticity of each placenta was compared in the right and left horns, respectively, using the Young's modulus, which increases with increasing stiffness of the tissue. Two hundred seventeen feto-placental units from 18 rats were included. Fetuses in the left ligated horn had smaller biometric measurements than those in the right horn (6.7 vs 7.2 mm, p < 0.001, and 9.2 vs 11.2 mm, p < 0.001 for BPD and AD, respectively). Mean fetal weight was lower in the pups from the left than the right horn (1.65 vs 2.11 g; p < 0.001). Mean (SD) Young's modulus was higher for placentas from the left than the right horn (11.7 ± 1.5 kPa vs 8.01 ± 3.8 kPa, respectively; p < 0.001), indicating increased stiffness in placentas from the left than the right horn. There was an inverse relationship between fetal weight and placental elasticity (r = 0.42; p < 0.001). Shear wave elastography may be used to provide quantitative elasticity measurements of the placenta. In our model, placentas from IUGR fetuses demonstrated greater stiffness, which correlated with the degree of fetal growth restriction. © 2015 John Wiley & Sons, Ltd.

Multiresolution MR elastography using nonlinear inversion

PubMed Central

McGarry, M. D. J.; Van Houten, E. E. W.; Johnson, C. L.; Georgiadis, J. G.; Sutton, B. P.; Weaver, J. B.; Paulsen, K. D.

2012-01-01

Purpose: Nonlinear inversion (NLI) in MR elastography requires discretization of the displacement field for a finite element (FE) solution of the “forward problem”, and discretization of the unknown mechanical property field for the iterative solution of the “inverse problem”. The resolution requirements for these two discretizations are different: the forward problem requires sufficient resolution of the displacement FE mesh to ensure convergence, whereas lowering the mechanical property resolution in the inverse problem stabilizes the mechanical property estimates in the presence of measurement noise. Previous NLI implementations use the same FE mesh to support the displacement and property fields, requiring a trade-off between the competing resolution requirements. Methods: This work implements and evaluates multiresolution FE meshes for NLI elastography, allowing independent discretizations of the displacements and each mechanical property parameter to be estimated. The displacement resolution can then be selected to ensure mesh convergence, and the resolution of the property meshes can be independently manipulated to control the stability of the inversion. Results: Phantom experiments indicate that eight nodes per wavelength (NPW) are sufficient for accurate mechanical property recovery, whereas mechanical property estimation from 50 Hz in vivo brain data stabilizes once the displacement resolution reaches 1.7 mm (approximately 19 NPW). Viscoelastic mechanical property estimates of in vivo brain tissue show that subsampling the loss modulus while holding the storage modulus resolution constant does not substantially alter the storage modulus images. Controlling the ratio of the number of measurements to unknown mechanical properties by subsampling the mechanical property distributions (relative to the data resolution) improves the repeatability of the property estimates, at a cost of modestly decreased spatial resolution. Conclusions: Multiresolution NLI elastography provides a more flexible framework for mechanical property estimation compared to previous single mesh implementations. PMID:23039674

The importance of acoustic radiation force impulse (ARFI) elastography in the diagnosis and clinical course of acute pancreatitis.

PubMed

Kaya, Muhsin; Değirmenci, Serdar; Göya, Cemil; Tuncel, Elif Tuba; Uçmak, Feyzullah; Kaplan, Mehmet Ali

2018-05-01

Acute pancreatitis (AP) is characterized by acute inflammation of the pancreas and it has a highly variable clinical course. The aim of our study was to evaluate the value of acoustic radiation force impulse (ARFI) elastography in the diagnosis and clinical course of AP. Consecutive patients with a diagnosis of AP (patients group) and healthy subject (control group) were prospectively enrolled to the study. Demographic features and clinical, laboratory, and radiological data were recorded. Virtual Touch Tissue Quantification (VTQ) was used to implement ARFI elastography. The tissue elasticity is proportional to the square of the wave velocity (SWV). A total of 108 patients (age, 57±1.8 y) and 79 healthy subjects (age, 53.6±1.81 y) were included in the study. There were 100 (92.5%) edematous and 8 (7.4%) necrotizing AP. The mean SWV was significantly higher in the patient group than in the control group (2.43±0.08 vs. 1.27±0.025 m/s, p < 0.001). There was not significant difference between patient and control group regarding age and gender. SWV cutoff value of 1.63 m/s was associated with 100% sensitivity and 98% specificity for the diagnosis of AP. There was not significant difference between patients with and without complications and patients with edematous and necrotizing AP regarding mean SWV value. There was also not significant correlation between mean SWV value and age, mean length of hospital stay, and mean amylase level. ARFI elastography may be a feasible method for the diagnosis of AP, but it has no value for the prediction of clinical course of AP.

Thyroid nodule classification using ultrasound elastography via linear discriminant analysis.

PubMed

Luo, Si; Kim, Eung-Hun; Dighe, Manjiri; Kim, Yongmin

2011-05-01

The non-surgical diagnosis of thyroid nodules is currently made via a fine needle aspiration (FNA) biopsy. It is estimated that somewhere between 250,000 and 300,000 thyroid FNA biopsies are performed in the United States annually. However, a large percentage (approximately 70%) of these biopsies turn out to be benign. Since the aggressive FNA management of thyroid nodules is costly, quantitative risk assessment and stratification of a nodule's malignancy is of value in triage and more appropriate healthcare resources utilization. In this paper, we introduce a new method for classifying the thyroid nodules based on the ultrasound (US) elastography features. Unlike approaches to assess the stiffness of a thyroid nodule by visually inspecting the pseudo-color pattern in the strain image, we use a classification algorithm to stratify the nodule by using the power spectrum of strain rate waveform extracted from the US elastography image sequence. Pulsation from the carotid artery was used to compress the thyroid nodules. Ultrasound data previously acquired from 98 thyroid nodules were used in this retrospective study to evaluate our classification algorithm. A classifier was developed based on the linear discriminant analysis (LDA) and used to differentiate the thyroid nodules into two types: (I) no FNA (observation-only) and (II) FNA. Using our method, 62 nodules were classified as type I, all of which were benign, while 36 nodules were classified as Type-II, 16 malignant and 20 benign, resulting in a sensitivity of 100% and specificity of 75.6% in detecting malignant thyroid nodules. This indicates that our triage method based on US elastography has the potential to substantially reduce the number of FNA biopsies (63.3%) by detecting benign nodules and managing them via follow-up observations rather than an FNA biopsy. Published by Elsevier B.V.

Assessment of the accuracy of an ultrasound elastography liver scanning system using a PVA-cryogel phantom with optimal acoustic and mechanical properties

NASA Astrophysics Data System (ADS)

Cournane, S.; Cannon, L.; Browne, J. E.; Fagan, A. J.

2010-10-01

The accuracy of a transient elastography liver-scanning ultrasound system was assessed using a novel application of PVA-cryogel as a tissue-mimicking material with acoustic and shear elasticity properties optimized to best represent those of liver tissue. Although the liver-scanning system has been shown to offer a safer alternative for diagnosing liver cirrhosis through stiffness measurement, as compared to the liver needle biopsy exam, the scanner's accuracy has not been fully established. Young's elastic modulus values of 5-6 wt% PVA-cryogel phantoms, also containing glycerol and 0.3 µm Al2O3 and 3 µm Al2O3, were measured using a 'gold standard' mechanical testing technique and transient elastography. The mechanically measured values and acoustic velocities of the phantoms ranged between 1.6 and 16.1 kPa and 1540 and 1570 m s-1, respectively, mimicking those observed in liver tissue. The values reported by the transient elastography system overestimated Young's elastic modulus values representative of the progressive stages of liver fibrosis by up to 32%. These results were attributed to the relative rather than absolute nature of the measurement arising from the single-point acoustic velocity calibration of the system, rendering the measurements critically dependent on the speed of sound of the sample under investigation. Given the wide range of acoustic velocities which exist in the liver, spanning healthy tissue to cirrhotic pathology, coupled with the system's assumption that the liver is approximately elastic when it is rather highly viscoelastic, care should be exercised when interpreting the results from this system in patient groups.

Magnetic resonance elastography of the lung parenchyma in an in situ porcine model with a noninvasive mechanical driver: correlation of shear stiffness with trans-respiratory system pressures.

PubMed

Mariappan, Yogesh K; Kolipaka, Arunark; Manduca, Armando; Hubmayr, Rolf D; Ehman, Richard L; Araoz, Philip; McGee, Kiaran P

2012-01-01

Quantification of the mechanical properties of lung parenchyma is an active field of research due to the association of this metric with normal function, disease initiation and progression. A phase contrast MRI-based elasticity imaging technique known as magnetic resonance elastography is being investigated as a method for measuring the shear stiffness of lung parenchyma. Previous experiments performed with small animals using invasive drivers in direct contact with the lungs have indicated that the quantification of lung shear modulus with (1) H based magnetic resonance elastography is feasible. This technique has been extended to an in situ porcine model with a noninvasive mechanical driver placed on the chest wall. This approach was tested to measure the change in parenchymal stiffness as a function of airway opening pressure (P(ao) ) in 10 adult pigs. In all animals, shear stiffness was successfully quantified at four different P(ao) values. Mean (±STD error of mean) pulmonary parenchyma density corrected stiffness values were calculated to be 1.48 (±0.09), 1.68 (±0.10), 2.05 (±0.13), and 2.23 (±0.17) kPa for P(ao) values of 5, 10, 15, and 20 cm H2O, respectively. Shear stiffness increased with increasing P(ao) , in agreement with the literature. It is concluded that in an in situ porcine lung shear stiffness can be quantitated with (1) H magnetic resonance elastography using a noninvasive mechanical driver and that it is feasible to measure the change in shear stiffness due to change in P(ao) . Copyright © 2011 Wiley-Liss, Inc.

Measurement of real-time tissue elastography in a phantom model and comparison with transient elastography in pediatric patients with liver diseases.

PubMed

Schenk, Jens-Peter; Alzen, Gerhard; Klingmüller, Volker; Teufel, Ulrike; El Sakka, Saroa; Engelmann, Guido; Selmi, Buket

2014-01-01

We aimed to determine the comparability of real-time tissue elastography (RTE) and transient elastography (TE) in pediatric patients with liver diseases. RTE was performed on the Elasticity QA Phantom Model 049 (Computerized Imaging Reference Systems Company Inc., Norfolk, Virginia, USA), which has five areas with different levels of stiffness. RTE measurements of relative stiffness (MEAN [mean value of tissue elasticity], AREA [% of blue color-coded stiffer tissue]) in the phantom were compared with the phantom stiffness specified in kPa (measurement unit of TE). RTE and TE were performed on 147 pediatric patients with various liver diseases. A total of 109 measurements were valid. The participants had following diseases: metabolic liver disease (n=25), cystic fibrosis (n=20), hepatopathy of unknown origin (n=11), autoimmune hepatitis (n=12), Wilson's disease (n=11), and various liver parenchyma alterations (n=30). Correlations between RTE and TE measurements in the patients were calculated. In addition, RTE was performed on a control group (n=30), and the RTE values between the patient and control groups were compared. The RTE parameters showed good correlation in the phantom model with phantom stiffness (MEAN/kPa, r=-0.97; AREA/kPa, r=0.98). However, the correlation of RTE and TE was weak in the patient group (MEAN/kPa, r=-0.23; AREA/kPa, r=0.24). A significant difference was observed between the patient and control groups (MEAN, P = 5.32 e-7; AREA, P = 1.62 e-6). In the phantom model, RTE was correlated with kPa, confirming the presumed comparability of the methods. However, there was no direct correlation between RTE and TE in patients with defined liver diseases under real clinical conditions.

Reference Values for Shear Wave Elastography of Neck and Shoulder Muscles in Healthy Individuals.

PubMed

Ewertsen, Caroline; Carlsen, Jonathan; Perveez, Mohammed Aftab; Schytz, Henrik

2018-01-01

to establish reference values for ultrasound shear-wave elastography for pericranial muscles in healthy individuals (m. trapezius, m. splenius capitis, m. semispinalis capitis, m. sternocleidomastoideus and m. masseter). Also to evaluate day-to-day variations in the shear-wave speeds and evaluate the effect of the pennation of the muscle fibers, ie scanning parallel or perpendicularly to the fibers. 10 healthy individuals (5 males and 5 females) had their pericranial muscles examined with shear-wave elastography in two orthogonal planes on two different days for their dominant and non-dominant side. Mean shear wave speeds from 5 ROI's in each muscle, for each scan plane for the dominant and non-dominant side for the two days were calculated. The effect of the different parameters - muscle pennation, gender, dominant vs non-dominant side and day was evaluated. The effect of scan plane in relation to muscle pennation was statistically significant (p<0.0001). The mean shear-wave speed when scanning parallel to the muscle fibers was significantly higher than the mean shear-wave speed when scanning perpendicularly to the fibers. The day-to-day variation was statistically significant (p=0.0258), but not clinically relevant. Shear-wave speeds differed significantly between muscles. Mean shear wave speeds (m/s) for the muscles in the parallel plane were: for masseter 2.45 (SD:+/-0.25), semispinal 3.36 (SD:+/-0.75), splenius 3.04 (SD:+/-0.65), sternocleidomastoid 2.75 (SD:+/-0.23), trapezius 3.20 (SD:+/-0.27) and trapezius lateral 3.87 (SD:+/-3.87). The shear wave speed variation depended on the direction of scanning. Shear wave elastography may be a method to evaluate muscle stiffness in patients suffering from chronic neck pain.

Evaluation of Acoustic Radiation Force Impulse (ARFI) for Fibrosis Staging in Chronic Liver Diseases.

PubMed

Gani, Rino Alvani; Hasan, Irsan; Sanityoso, Andri; Lesmana, Cosmas Rinaldi A; Kurniawan, Juferdy; Jasirwan, Chyntia Olivia Maurine; Kalista, Kemal Fariz; Lutfie, Lutfie

2017-04-01

acoustic radiation force impulse (ARFI) is a new proposed noninvasive method for liver fibrosis staging. Integrated with B-mode ultrasonography, ARFI can be used to assess liver tissue condition. However its diagnostic accuracy is still being continuously evaluated. Also, there is lack of data regarding the utilization of ARFI in our population. This study aimed to evaluate the diagnostic value of ARFI as an alternative noninvasive modality for fibrosis staging in chronic hepatitis B and hepatitis C patients in our population. we conducted cross-sectional comparison of ARFI imaging and transient elastography on patients who underwent liver biopsy at Cipto Mangunkusumo Hospital. Fibrosis staging using METAVIR scoring system presented as standard reference. A total of 43 patients underwent liver biopsy was evaluated by ARFI imaging and transient elastography. Cut-off values were determined using receiver-operating characteristic (ROC). both liver stiffness determined by ARFI and transient elastography (TE) were moderately correlated with METAVIR score with value of 0.581 and 0.613, respectively (both P<0.01). Diagnostic accuracy of ARFI predicted significant fibrosis (F≥2) with area under receiver operating characteristic curve (AUROC) of 0.773 (95% CI 0.616-0.930) and even better for cirrhosis (F4 fibrosis), expressed as AUROC of 0.856 (95% CI 0.736-0.975). Transient elastography was better for significant fibrosis with AUROC of 0.761 (95% CI 0.601-0.920) and was best for prediction of cirrhosis, expressed as AUROC of 0.845 (95% CI 0.722-0.968). ARFI is provided with more convenient evaluation of liver tissue condition, and its diagnostic accuracy is not significantly different from TE for staging liver fibrosis.

Real-time shear wave elastography may predict autoimmune thyroid disease.

PubMed

Vlad, Mihaela; Golu, Ioana; Bota, Simona; Vlad, Adrian; Timar, Bogdan; Timar, Romulus; Sporea, Ioan

2015-05-01

To evaluate and compare the values of the elasticity index as measured by shear wave elastography in healthy subjects and in patients with autoimmune thyroid disease, in order to establish if this investigation can predict the occurrence of autoimmune thyroid disease. A total of 104 cases were included in the study group: 91 women (87.5%), out of which 52 (50%) with autoimmune thyroid disease diagnosed by specific tests and 52 (50%) healthy volunteers, matched for age and gender. For all the subjects, three measurements were performed on each thyroid lobe and a mean value was calculated. The data were expressed in kPa. The investigation was performed with an Aixplorer system (SuperSonic Imagine, France), using a linear high-resolution 15-4 MHz transducer. The mean value for the elasticity index was similar in the right and the left thyroid lobes, both in normal subjects and in patients with autoimmune thyroid disease: 19.6 ± 6.6 vs. 19.5 ± 6.8 kPa, p = 0.92, and 26.6 ± 10.0 vs. 25.8 ± 11.7 kPa, p = 0.71, respectively. This parameter was significantly higher in patients with autoimmune thyroid disease than in controls (p < 0.001). For a cut-off value of 22.3 kPa, which resulted in the highest sum of sensitivity and specificity, the elasticity index assessed by shear wave elastography had a sensitivity of 59.6% and a specificity of 76.9% (AUROC = 0.71; p < 0.001) for predicting the presence of autoimmune thyroid disease. Quantitative elasticity index measured by shear wave elastography was significantly higher in autoimmune thyroid disease than in normal thyroid parenchyma and may predict the presence of autoimmune thyroid disease.

Assessment of biopsy‐proven liver fibrosis by two‐dimensional shear wave elastography: An individual patient data‐based meta‐analysis

PubMed Central

de Lédinghen, Victor; Cassinotto, Christophe; Chu, Winnie C.‐W.; Leung, Vivian Y.‐F.; Ferraioli, Giovanna; Filice, Carlo; Castera, Laurent; Vilgrain, Valérie; Ronot, Maxime; Dumortier, Jérôme; Guibal, Aymeric; Pol, Stanislas; Trebicka, Jonel; Jansen, Christian; Strassburg, Christian; Zheng, Rongqin; Zheng, Jian; Francque, Sven; Vanwolleghem, Thomas; Vonghia, Luisa; Manesis, Emanuel K.; Zoumpoulis, Pavlos; Sporea, Ioan; Thiele, Maja; Krag, Aleksander; Cohen‐Bacrie, Claude; Criton, Aline; Gay, Joel; Deffieux, Thomas; Friedrich‐Rust, Mireen

2017-01-01

Two‐dimensional shear wave elastography (2D‐SWE) has proven to be efficient for the evaluation of liver fibrosis in small to moderate‐sized clinical trials. We aimed at running a larger‐scale meta‐analysis of individual data. Centers which have worked with Aixplorer ultrasound equipment were contacted to share their data. Retrospective statistical analysis used direct and paired receiver operating characteristic and area under the receiver operating characteristic curve (AUROC) analyses, accounting for random effects. Data on both 2D‐SWE and liver biopsy were available for 1,134 patients from 13 sites, as well as on successful transient elastography in 665 patients. Most patients had chronic hepatitis C (n = 379), hepatitis B (n = 400), or nonalcoholic fatty liver disease (n = 156). AUROCs of 2D‐SWE in patients with hepatitis C, hepatitis B, and nonalcoholic fatty liver disease were 86.3%, 90.6%, and 85.5% for diagnosing significant fibrosis and 92.9%, 95.5%, and 91.7% for diagnosing cirrhosis, respectively. The AUROC of 2D‐SWE was 0.022‐0.084 (95% confidence interval) larger than the AUROC of transient elastography for diagnosing significant fibrosis (P = 0.001) and 0.003‐0.034 for diagnosing cirrhosis (P = 0.022) in all patients. This difference was strongest in hepatitis B patients. Conclusion: 2D‐SWE has good to excellent performance for the noninvasive staging of liver fibrosis in patients with hepatitis B; further prospective studies are needed for head‐to‐head comparison between 2D‐SWE and other imaging modalities to establish disease‐specific appropriate cutoff points for assessment of fibrosis stage. (Hepatology 2018;67:260‐272). PMID:28370257

Revisiting the Cramér Rao Lower Bound for Elastography: Predicting the Performance of Axial, Lateral and Polar Strain Elastograms.

PubMed

Verma, Prashant; Doyley, Marvin M

2017-09-01

We derived the Cramér Rao lower bound for 2-D estimators employed in quasi-static elastography. To illustrate the theory, we modeled the 2-D point spread function as a sinc-modulated sine pulse in the axial direction and as a sinc function in the lateral direction. We compared theoretical predictions of the variance incurred in displacements and strains when quasi-static elastography was performed under varying conditions (different scanning methods, different configuration of conventional linear array imaging and different-size kernels) with those measured from simulated or experimentally acquired data. We performed studies to illustrate the application of the derived expressions when performing vascular elastography with plane wave and compounded plane wave imaging. Standard deviations in lateral displacements were an order higher than those in axial. Additionally, the derived expressions predicted that peak performance should occur when 2% strain is applied, the same order of magnitude as observed in simulations (1%) and experiments (1%-2%). We assessed how different configurations of conventional linear array imaging (number of active reception and transmission elements) influenced the quality of axial and lateral strain elastograms. The theoretical expressions predicted that 2-D echo tracking should be performed with wide kernels, but the length of the kernels should be selected using knowledge of the magnitude of the applied strain: specifically, longer kernels for small strains (<5%) and shorter kernels for larger strains. Although the general trends of theoretical predictions and experimental observations were similar, biases incurred during beamforming and subsample displacement estimation produced noticeable differences. Copyright © 2017 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Combination of two-dimensional shear wave elastography with ultrasound breast imaging reporting and data system in the diagnosis of breast lesions: a new method to increase the diagnostic performance.

PubMed

Li, Dan-Dan; Xu, Hui-Xiong; Guo, Le-Hang; Bo, Xiao-Wan; Li, Xiao-Long; Wu, Rong; Xu, Jun-Mei; Zhang, Yi-Feng; Zhang, Kun

2016-09-01

To evaluate the diagnostic performance of a new method of combined two-dimensional shear wave elastography (i.e. virtual touch imaging quantification, VTIQ) and ultrasound (US) Breast Imaging Reporting and Data System (BI-RADS) in the differential diagnosis of breast lesions. From September 2014 to December 2014, 276 patients with 296 pathologically proven breast lesions were enrolled in this study. The conventional US images were interpreted by two independent readers. The diagnosis performances of BI-RADS and combined BI-RADS and VTIQ were evaluated, including the area under the receiver operating characteristic curve (AUROC), sensitivity and specificity. Observer consistency was also evaluated. Pathologically, 212 breast lesions were benign and 84 were malignant. Compared with BI-RADS alone, the AUROCs and specificities of the combined method for both readers increased significantly (AUROC: 0.862 vs. 0.693 in reader 1, 0.861 vs. 0.730 in reader 2; specificity: 91.5 % vs. 38.7 % in reader 1, 94.8 % vs. 47.2 % in reader 2; all P < .05). The Kappa value between the two readers for BI-RADS assessment was 0.614, and 0.796 for the combined method. The combined VTIQ and BI-RADS had a better diagnostic performance in the diagnosis of breast lesions in comparison with BI-RADS alone. • Combination of conventional ultrasound and elastography distinguishes breast cancers more effectively. • Combination of conventional ultrasound and elastography increases observer consistency. • BI-RADS weights more than the 2D-SWE with an increase in malignancy probability.

Added value of Virtual Touch IQ shear wave elastography in the ultrasound assessment of breast lesions.

PubMed

Ianculescu, Victor; Ciolovan, Laura Maria; Dunant, Ariane; Vielh, Philippe; Mazouni, Chafika; Delaloge, Suzette; Dromain, Clarisse; Blidaru, Alexandru; Balleyguier, Corinne

2014-05-01

To determine the diagnostic performance of Acoustic Radiation Force Impulse (ARFI) Virtual Touch IQ shear wave elastography in the discrimination of benign and malignant breast lesions. Conventional B-mode and elasticity imaging were used to evaluate 110 breast lesions. Elastographic assessment of breast tissue abnormalities was done using a shear wave based technique, Virtual Touch IQ (VTIQ), implemented on a Siemens Acuson S3000 ultrasound machine. Tissue mechanical properties were interpreted as two-dimensional qualitative and quantitative colour maps displaying relative shear wave velocity. Wave speed measurements in m/s were possible at operator defined regions of interest. The pathologic diagnosis was established on samples obtained by ultrasound guided core biopsy or fine needle aspiration. BIRADS based B-mode evaluation of the 48 benign and 62 malignant lesions achieved 92% sensitivity and 62.5% specificity. Subsequently performed VTIQ elastography relying on visual interpretation of the colour overlay displaying relative shear wave velocities managed similar standalone diagnostic performance with 92% sensitivity and 64.6% specificity. Lesion and surrounding tissue shear wave speed values were calculated and a significant difference was found between the benign and malignant populations (Mann-Whitney U test, p<0.0001). By selecting a lesion cut-off value of 3.31m/s we achieved 80.4% sensitivity and 73% specificity. Applying this threshold only to BIRADS 4a masses, we reached overall levels of 92% sensitivity and 72.9% specificity. VTIQ qualitative and quantitative elastography has the potential to further characterise B-mode detected breast lesions, increasing specificity and reducing the number of unnecessary biopsies. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Diagnostic value of commercially available shear-wave elastography for breast cancers: integration into BI-RADS classification with subcategories of category 4.

PubMed

Youk, Ji Hyun; Gweon, Hye Mi; Son, Eun Ju; Han, Kyung Hwa; Kim, Jeong-Ah

2013-10-01

To evaluate the diagnostic performance of shear-wave elastography (SWE) for breast cancer and to determine whether the integration of SWE into BI-RADS with subcategories of category 4 improves the diagnostic performance. A total of 389 breast masses (malignant 120, benign 269) in 324 women who underwent SWE before ultrasound-guided core biopsy or surgery were included. The qualitative SWE feature was assessed using a four-colour overlay pattern. Quantitative elasticity values including the lesion-to-fat elasticity ratio (Eratio) were measured. Diagnostic performance of B-mode ultrasound, SWE, or their combined studies was compared using the area under the ROC curve (AUC). AUC of Eratio (0.952) was the highest among elasticity values (mean, maximum, and minimum elasticity, 0.949, 0.939, and 0.928; P = 0.04) and AUC of colour pattern was 0.947. AUC of combined studies was significantly higher than for a single study (P < 0.0001). When adding SWE to category 4 lesions, lesions were dichotomised according to % of malignancy: 2.1 % vs. 43.2 % (category 4a) and 0 % vs. 100 % (category 4b) for Eratio and 2.4 % vs. 25.8 % (category 4a) for colour pattern (P < 0.05). Shear-wave elastography showed a good diagnostic performance. Adding SWE features to BI-RADS improved the diagnostic performance and may be helpful to stratify category 4 lesions. • Quantitative and qualitative shear-wave elastography provides further diagnostic information during breast ultrasound. • The elasticity ratio (E ratio ) showed the best diagnostic performance in SWE. • E ratio and four-colour overlay pattern significantly differed between benign and malignant lesions. • SWE features allowed further stratification of BI-RADS category 4 lesions.

Real time elastography - a non-invasive diagnostic method of small hepatocellular carcinoma in cirrhosis.

PubMed

Gheorghe, Liana; Iacob, Speranta; Iacob, Razvan; Dumbrava, Mona; Becheanu, Gabriel; Herlea, Vlad; Gheorghe, Cristian; Lupescu, Ioana; Popescu, Irinel

2009-12-01

Small nodules (under 3 cm) detected on ultrasound (US) in cirrhotics represent the most challenging category for noninvasive diagnosis of hepatocellular carcinoma (HCC). To evaluate real-time sonoelastography as a noninvasive tool for the diagnosis of small HCC nodules in cirrhotic patients. 42 cirrhotic patients with 58 nodules (1-3 cm) were evaluated with real-time elastography (Hitachi EUB-6500); the mean intensity of colors red, blue, green were measured using a semi-quantitative method. Analysis of histograms for each color of the sonoelastography images was performed for quantifying the elasticity of nodule tissue in comparison with the cirrhotic liver tissue. AUROC curves were constructed to define the best cut-off points to distinguish malignant features of the nodules. Univariate and multivariate logistic regression analysis was performed. 595 sonoelastography images from 42 patients (25 men; 17 women) were analyzed. The mean age was 56.4 +/- 0.7 years and 69% patients were in Child-Pugh class A, 19% class B, 11% class C. For the mean intensity of green color AUROC=0.81, a cut-off value under 108.7 being diagnostic for HCC with a Sp=91.1%, Se=50%, PPV=92.1%, NPV=47.1%. Mean intensity of blue color proved to be an excellent diagnostic tool for HCC (AUROC=0.94); for a cut-off value greater than 128.9, Sp=92.2%, Se=78.9%, PPV=95.4%, NPV=68%. Independent predictive factors of HCC for a small nodule in cirrhotic patients were: blue color over 128.9 at sonoelastography and hypervascular appearance at Doppler US. US elastography is a promising method for the non-invasive diagnosis of early HCC. Blue color at elastography and hypervascular aspects are independent predictors of HCC.

R&D Plan for Army Applications of AI/Robotics.

DTIC Science & Technology

1982-05-01

Research, Development, and Acquisition (Army) OCE--Office, Chief of Engineers HTTG--High Technology Test Group DNA--Defense Nuclear Agency Contractors...comparison, include both trailer and van-mounted tools and * testing equipment that are generally of sufficient weight and bulk to be mounted and used on a...interactive diagnosis and corrective maintenance information for surface-to-surface missile launching systems beyond the capability of automet’. test equipment

Development of Probabilistic Rigid Pavement Design Methodologies for Military Airfields.

DTIC Science & Technology

1983-12-01

4A161102AT22, Task AO, Work Unit 009, "Methodology for Considering Material Variability in Pavement Design." OCE Project Monitor was Mr. S. S. Gillespie. The...PREFACE. .. ............................. VOLUME 1: STATE OF THE ART VARIABILITY OF AIRFIELD PAVEMENT MATERIALS VOLUME 11: MATHEMATICAL FORMULATION OF...VOLUME IV: PROBABILISTIC ANALYSIS OF RIGID AIRFIELD DESIGN BY ELASTIC LAYERED THEORY VOLUME I STATE OF THE ART VARIABILITY OF AIRFIELD PAVEMENT MATERIALS

Defense Acquisition Research Journal. Volume 20, Number 3, Issue 67, October 2013

DTIC Science & Technology

2013-10-01

Contracting Operations (PZCO) FIGURE 4. CONTRACTING PHASE ZERO: PLAN, EXERCISE, REHEARSE, AND SYNCHRONIZE Note. BPA = Blanket Purchase Agreement; COCO...Construction Supplies; Oce Equipment; Quality of Life; and Morale, Welfare, and Recreation PO/TO/DO/ BPA Small Purchase Standard Vehicles PO/TO/DO/ BPA Small...Purchase Standard Vehicles PO/TO/DO/ BPA Small Purchase Standard Vehicles PO/TO/DO/ BPA Small Purchase Food, Water, Billeting, Hygiene; Transportation

Breast magnetic resonance elastography: a review of clinical work and future perspectives.

PubMed

Bohte, A E; Nelissen, J L; Runge, J H; Holub, O; Lambert, S A; de Graaf, L; Kolkman, S; van der Meij, S; Stoker, J; Strijkers, G J; Nederveen, A J; Sinkus, R

2018-05-30

This review on magnetic resonance elastography (MRE) of the breast provides an overview of available literature and describes current developments in the field of breast MRE, including new transducer technology for data acquisition and multi-frequency-derived power-law behaviour of tissue. Moreover, we discuss the future potential of breast MRE, which goes beyond its original application as an additional tool in differentiating benign from malignant breast lesions. These areas of ongoing and future research include MRE for pre-operative tumour delineation, staging, monitoring and predicting response to treatment, as well as prediction of the metastatic potential of primary tumours. Copyright © 2018 John Wiley & Sons, Ltd.

Brain palpation from physiological vibrations using MRI.

PubMed

Zorgani, Ali; Souchon, Rémi; Dinh, Au-Hoang; Chapelon, Jean-Yves; Ménager, Jean-Michel; Lounis, Samir; Rouvière, Olivier; Catheline, Stefan

2015-10-20

We present a magnetic resonance elastography approach for tissue characterization that is inspired by seismic noise correlation and time reversal. The idea consists of extracting the elasticity from the natural shear waves in living tissues that are caused by cardiac motion, blood pulsatility, and any muscle activity. In contrast to other magnetic resonance elastography techniques, this noise-based approach is, thus, passive and broadband and does not need any synchronization with sources. The experimental demonstration is conducted in a calibrated phantom and in vivo in the brain of two healthy volunteers. Potential applications of this "brain palpation" approach for characterizing brain anomalies and diseases are foreseen.

Shear-wave elastography in breast ultrasonography: the state of the art

PubMed Central

2017-01-01

Shear-wave elastography (SWE) is a recently developed ultrasound technique that can visualize and measure tissue elasticity. In breast ultrasonography, SWE has been shown to be useful for differentiating benign breast lesions from malignant breast lesions, and it has been suggested that SWE enhances the diagnostic performance of ultrasonography, potentially improving the specificity of conventional ultrasonography using the Breast Imaging Reporting and Data System criteria. More recently, not only has SWE been proven useful for the diagnosis of breast cancer, but has also been shown to provide valuable information that can be used as a preoperative predictor of the prognosis or response to chemotherapy. PMID:28513127

Review of MR Elastography Applications and Recent Developments

PubMed Central

Glaser, Kevin J.; Manduca, Armando; Ehman, Richard L.

2012-01-01

The technique of MR elastography (MRE) has emerged as a useful modality for quantitatively imaging the mechanical properties of soft tissues in vivo. Recently, MRE has been introduced as a clinical tool for evaluating chronic liver disease, but many other potential applications are being explored. These applications include measuring tissue changes associated with diseases of the liver, breast, brain, heart, and skeletal muscle including both focal lesions (e.g., hepatic, breast, and brain tumors) and diffuse diseases (e.g., fibrosis and multiple sclerosis). The purpose of this review article is to summarize some of the recent developments of MRE and to highlight some emerging applications. PMID:22987755

Maximizing the endosonography: The role of contrast harmonics, elastography and confocal endomicroscopy.

PubMed

Seicean, Andrada; Mosteanu, Ofelia; Seicean, Radu

2017-01-07

New technologies in endoscopic ultrasound (EUS) evaluation have been developed because of the need to improve the EUS and EUS-fine needle aspiration (EUS-FNA) diagnostic rate. This paper reviews the principle, indications, main literature results, limitations and future expectations for each of the methods presented. Contrast-enhanced harmonic EUS uses a low mechanical index and highlights slow-flow vascularization. This technique is useful for differentiating solid and cystic pancreatic lesions and assessing biliary neoplasms, submucosal neoplasms and lymph nodes. It is also useful for the discrimination of pancreatic masses based on their qualitative patterns; however, the quantitative assessment needs to be improved. The detection of small solid lesions is better, and the EUS-FNA guidance needs further research. The differentiation of cystic lesions of the pancreas and the identification of the associated malignancy features represent the main indications. Elastography is used to assess tissue hardness based on the measurement of elasticity. Despite its low negative predictive value, elastography might rule out the diagnosis of malignancy for pancreatic masses. Needle confocal laser endomicroscopy offers useful information about cystic lesions of the pancreas and is still under evaluation for use with solid pancreatic lesions of lymph nodes.

Automatic Generation of Boundary Conditions Using Demons Nonrigid Image Registration for Use in 3-D Modality-Independent Elastography

PubMed Central

Ou, Jao J.; Ong, Rowena E.; Miga, Michael I.

2013-01-01

Modality-independent elastography (MIE) is a method of elastography that reconstructs the elastic properties of tissue using images acquired under different loading conditions and a biomechanical model. Boundary conditions are a critical input to the algorithm and are often determined by time-consuming point correspondence methods requiring manual user input. This study presents a novel method of automatically generating boundary conditions by nonrigidly registering two image sets with a demons diffusion-based registration algorithm. The use of this method was successfully performed in silico using magnetic resonance and X-ray-computed tomography image data with known boundary conditions. These preliminary results produced boundary conditions with an accuracy of up to 80% compared to the known conditions. Demons-based boundary conditions were utilized within a 3-D MIE reconstruction to determine an elasticity contrast ratio between tumor and normal tissue. Two phantom experiments were then conducted to further test the accuracy of the demons boundary conditions and the MIE reconstruction arising from the use of these conditions. Preliminary results show a reasonable characterization of the material properties on this first attempt and a significant improvement in the automation level and viability of the method. PMID:21690002

Automatic generation of boundary conditions using demons nonrigid image registration for use in 3-D modality-independent elastography.

PubMed

Pheiffer, Thomas S; Ou, Jao J; Ong, Rowena E; Miga, Michael I

2011-09-01

Modality-independent elastography (MIE) is a method of elastography that reconstructs the elastic properties of tissue using images acquired under different loading conditions and a biomechanical model. Boundary conditions are a critical input to the algorithm and are often determined by time-consuming point correspondence methods requiring manual user input. This study presents a novel method of automatically generating boundary conditions by nonrigidly registering two image sets with a demons diffusion-based registration algorithm. The use of this method was successfully performed in silico using magnetic resonance and X-ray-computed tomography image data with known boundary conditions. These preliminary results produced boundary conditions with an accuracy of up to 80% compared to the known conditions. Demons-based boundary conditions were utilized within a 3-D MIE reconstruction to determine an elasticity contrast ratio between tumor and normal tissue. Two phantom experiments were then conducted to further test the accuracy of the demons boundary conditions and the MIE reconstruction arising from the use of these conditions. Preliminary results show a reasonable characterization of the material properties on this first attempt and a significant improvement in the automation level and viability of the method.

Real-time elastography in the evaluation of diffuse thyroid disease: a study based on elastography histogram parameters.

PubMed

Yoon, Jung Hyun; Yoo, Jaeheung; Kim, Eun-Kyung; Moon, Hee Jung; Lee, Hye Sun; Seo, Jae Young; Park, Hye Young; Park, Woon-Ju; Kwak, Jin Young

2014-09-01

The purpose of this study was to evaluate the diagnostic performance of quantitative histogram parameters using real-time tissue elastography (RTE) in the diagnosis of patients with diffuse thyroid disease. One hundred and sixteen patients (mean age, 43.7 ± 10.97 y) who had undergone pre-operative staging ultrasonography and RTE were included. For each patient, 11 parameters were obtained from RTE images, from which the "elastic index" was calculated. Diagnostic performance of the elastic index and that of the 11 parameters on RTE were calculated and compared. Of the 116 patients, 31 had diffuse thyroid disease and 85 had normal thyroid parenchyma. Area under the receiver operating characteristic curve (A(z)) of MEAN (average relative value) elasticity was high (0.737), without significant differences from other elasticity values. Diagnostic performance of the elastic index was higher than the MEAN, A(z) = 0.753, without significance (p = 0.802). In conclusion, RTE using the elastic index was found to have good diagnostic performance and may be useful in the diagnosis and management of patients with diffuse thyroid disease. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Noninvasive assessment of liver fibrosis in patients with chronic hepatitis B.

PubMed

Enomoto, Masaru; Morikawa, Hiroyasu; Tamori, Akihiro; Kawada, Norifumi

2014-09-14

Infection with hepatitis B virus is an important health problem worldwide: it affects more than 350 million people and is a leading cause of liver-related morbidity, accounting for 1 million deaths annually. Hepatic fibrosis is a consequence of the accumulation of extracellular matrix components in the liver. An accurate diagnosis of liver fibrosis is essential for the management of chronic liver disease. Liver biopsy has been considered the gold standard for diagnosing disease, grading necroinflammatory activity, and staging fibrosis. However, liver biopsy is unsuitable for repeated evaluations because it is invasive and can cause major complications, including death. Several noninvasive evaluations have been introduced for the assessment of liver fibrosis: serum biomarkers, combined indices or scores, and imaging techniques including transient elastography, acoustic radiation force impulse, real-time tissue elastography, and magnetic resonance elastography. Here, we review the recent progress of noninvasive assessment of liver fibrosis in patients with chronic hepatitis B. Most noninvasive evaluations for liver fibrosis have been validated first in patients with chronic hepatitis C, and later in those with chronic hepatitis B. The establishment of a noninvasive assessment of liver fibrosis is urgently needed to aid in the management of this leading cause of chronic liver disease.

Application of Eshelby's Solution to Elastography for Diagnosis of Breast Cancer.

PubMed

Shin, Bonghun; Gopaul, Darindra; Fienberg, Samantha; Kwon, Hyock Ju

2016-03-01

Eshelby's solution is the analytical method that can derive the elastic field within and around an ellipsoidal inclusion embedded in a matrix. Since breast tumor can be regarded as an elastic inclusion with different elastic properties from those of surrounding matrix when the deformation is small, we applied Eshelby's solution to predict the stress and strain fields in the breast containing a suspicious lesion. The results were used to investigate the effectiveness of strain ratio (SR) from elastography in representing modulus ratio (MR) that may be the meaningful indicator of the malignancy of the lesion. This study showed that SR significantly underestimates MR and is varied with the shape and the modulus of the lesion. Based on the results from Eshelby's solution and finite element analysis (FEA), we proposed a surface regression model as a polynomial function that can predict the MR of the lesion to the matrix. The model has been applied to gelatin-based phantoms and clinical ultrasound images of human breasts containing different types of lesions. The results suggest the potential of the proposed method to improve the diagnostic performance of breast cancer using elastography. © The Author(s) 2015.

Preliminary Comparison of Multi-scale and Multi-model Direct Inversion Algorithms for 3T MR Elastography.

PubMed

Yoshimitsu, Kengo; Shinagawa, Yoshinobu; Mitsufuji, Toshimichi; Mutoh, Emi; Urakawa, Hiroshi; Sakamoto, Keiko; Fujimitsu, Ritsuko; Takano, Koichi

2017-01-10

To elucidate whether any differences are present in the stiffness map obtained with a multiscale direct inversion algorithm (MSDI) vs that with a multimodel direct inversion algorithm (MMDI), both qualitatively and quantitatively. The MR elastography (MRE) data of 37 consecutive patients who underwent liver MR elastography between September and October 2014 were retrospectively analyzed by using both MSDI and MMDI. Two radiologists qualitatively assessed the stiffness maps for the image quality in consensus, and the measured liver stiffness and measurable areas were quantitatively compared between MSDI and MMDI. MMDI provided a stiffness map of better image quality, with comparable or slightly less artifacts. Measurable areas by MMDI (43.7 ± 17.8 cm 2 ) was larger than that by MSDI (37.5 ± 14.7 cm 2 ) (P < 0.05). Liver stiffness measured by MMDI (4.51 ± 2.32 kPa) was slightly (7%), but significantly less than that by MSDI (4.86 ± 2.44 kPa) (P < 0.05). MMDI can provide stiffness map of better image quality, and slightly lower stiffness values as compared to MSDI at 3T MRE, which radiologists should be aware of.

Improving arrival time identification in transient elastography

NASA Astrophysics Data System (ADS)

Klein, Jens; McLaughlin, Joyce; Renzi, Daniel

2012-04-01

In this paper, we improve the first step in the arrival time algorithm used for shear wave speed recovery in transient elastography. In transient elastography, a shear wave is initiated at the boundary and the interior displacement of the propagating shear wave is imaged with an ultrasound ultra-fast imaging system. The first step in the arrival time algorithm finds the arrival times of the shear wave by cross correlating displacement time traces (the time history of the displacement at a single point) with a reference time trace located near the shear wave source. The second step finds the shear wave speed from the arrival times. In performing the first step, we observe that the wave pulse decorrelates as it travels through the medium, which leads to inaccurate estimates of the arrival times and ultimately to blurring and artifacts in the shear wave speed image. In particular, wave ‘spreading’ accounts for much of this decorrelation. Here we remove most of the decorrelation by allowing the reference wave pulse to spread during the cross correlation. This dramatically improves the images obtained from arrival time identification. We illustrate the improvement of this method on phantom and in vivo data obtained from the laboratory of Mathias Fink at ESPCI, Paris.

Is real-time elastography helpful to differentiate acute from subacute deep venous thrombosis? A preliminary study.

PubMed

Aslan, Ahmet; Barutca, Hakan; Ayaz, Ercan; Aslan, Mine; Kocaaslan, Cemal; Inan, Ibrahim; Sahin, Sinan; Yıkılmaz, Ali

2018-02-01

To detect and characterize changes in stiffness of thrombus in patients with acute and subacute deep venous thrombosis (DVT) by using real-time elastography (RTE). Fifty-eight patients with acute or subacute DVT were prospectively evaluated by B-mode sonography (US), color Doppler US (CDUS), and RTE. Two radiologists evaluated the thrombus echogenicity, compressibility, and recanalization of the affected vein, and thrombus stiffness in consensus. The thrombi were classified into 3 groups as soft, intermediate, and hard on RTE images. The final study group consisted of 30 patients with acute DVT, among whom 10 were women (33%), and 19 patients with subacute DVT, among whom 6 were women (32%). The presence of hypoechoic thrombus, incompressible vein, and absence of recanalization on US and CDUS were significantly associated with acute DVT (P < .001 for all variables). The differences in elasticity pattern of the thrombi between acute and subacute DVT were not significant (P = .202). Venous thrombus hardens with age; however, elastography pattern on RTE, in its present form, may not be able to differentiate acute DVT from subacute DVT. © 2017 Wiley Periodicals, Inc.

Modeling of Soft Poroelastic Tissue in Time-Harmonic MR Elastography

PubMed Central

Perriñez, Phillip R.; Kennedy, Francis E.; Van Houten, Elijah E. W.; Weaver, John B.; Paulsen, Keith D.

2010-01-01

Elastography is an emerging imaging technique that focuses on assessing the resistance to deformation of soft biological tissues in vivo. Magnetic resonance elastography (MRE) uses measured displacement fields resulting from low-amplitude, low-frequency (10 Hz–1 kHz) time-harmonic vibration to recover images of the elastic property distribution of tissues including breast, liver, muscle, prostate, and brain. While many soft tissues display complex time-dependent behavior not described by linear elasticity, the models most commonly employed in MRE parameter reconstructions are based on elastic assumptions. Further, elasticity models fail to include the interstitial fluid phase present in vivo. Alternative continuum models, such as consolidation theory, are able to represent tissue and other materials comprising two distinct phases, generally consisting of a porous elastic solid and penetrating fluid. MRE reconstructions of simulated elastic and poroelastic phantoms were performed to investigate the limitations of current-elasticity-based methods in producing accurate elastic parameter estimates in poroelastic media. The results indicate that linearly elastic reconstructions of fluid-saturated porous media at amplitudes and frequencies relevant to steady-state MRE can yield misleading effective property distributions resulting from the complex interaction between their solid and fluid phases. PMID:19272864

Noninvasive scoring system for significant inflammation related to chronic hepatitis B

NASA Astrophysics Data System (ADS)

Hong, Mei-Zhu; Ye, Linglong; Jin, Li-Xin; Ren, Yan-Dan; Yu, Xiao-Fang; Liu, Xiao-Bin; Zhang, Ru-Mian; Fang, Kuangnan; Pan, Jin-Shui

2017-03-01

Although a liver stiffness measurement-based model can precisely predict significant intrahepatic inflammation, transient elastography is not commonly available in a primary care center. Additionally, high body mass index and bilirubinemia have notable effects on the accuracy of transient elastography. The present study aimed to create a noninvasive scoring system for the prediction of intrahepatic inflammatory activity related to chronic hepatitis B, without the aid of transient elastography. A total of 396 patients with chronic hepatitis B were enrolled in the present study. Liver biopsies were performed, liver histology was scored using the Scheuer scoring system, and serum markers and liver function were investigated. Inflammatory activity scoring models were constructed for both hepatitis B envelope antigen (+) and hepatitis B envelope antigen (-) patients. The sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve were 86.00%, 84.80%, 62.32%, 95.39%, and 0.9219, respectively, in the hepatitis B envelope antigen (+) group and 91.89%, 89.86%, 70.83%, 97.64%, and 0.9691, respectively, in the hepatitis B envelope antigen (-) group. Significant inflammation related to chronic hepatitis B can be predicted with satisfactory accuracy by using our logistic regression-based scoring system.

Toric focusing for radiation force applications using a toric lens coupled to a spherically focused transducer.

PubMed

Arnal, Bastien; Nguyen, Thu-Mai; O'Donnell, Matthew

2014-12-01

Dynamic elastography using radiation force requires that an ultrasound field be focused during hundreds of microseconds at a pressure of several megapascals. Here, we address the importance of the focal geometry. Although there is usually no control of the elevational focal width in generating a tissue mechanical response, we propose a tunable approach to adapt the focus geometry that can significantly improve radiation force efficiency. Several thin, in-house-made polydimethylsiloxane lenses were designed to modify the focal spot of a spherical transducer. They exhibited low absorption and the focal spot widths were extended up to 8-fold in the elevation direction. Radiation force experiments demonstrated an 8-fold increase in tissue displacements using the same pressure level in a tissue-mimicking phantom with a similar shear wave spectrum, meaning it does not affect elastography resolution. Our results demonstrate that larger tissue responses can be obtained for a given pressure level, or that similar response can be reached at a much lower mechanical index (MI). We envision that this work will impact 3-D elastography using 2-D phased arrays, where such shaping can be achieved electronically with the potential for adaptive optimization.

High-resolution analysis of the mechanical behavior of tissue

NASA Astrophysics Data System (ADS)

Hudnut, Alexa W.; Armani, Andrea M.

2017-06-01

The mechanical behavior and properties of biomaterials, such as tissue, have been directly and indirectly connected to numerous malignant physiological states. For example, an increase in the Young's Modulus of tissue can be indicative of cancer. Due to the heterogeneity of biomaterials, it is extremely important to perform these measurements using whole or unprocessed tissue because the tissue matrix contains important information about the intercellular interactions and the structure. Thus, developing high-resolution approaches that can accurately measure the elasticity of unprocessed tissue samples is of great interest. Unfortunately, conventional elastography methods such as atomic force microscopy, compression testing, and ultrasound elastography either require sample processing or have poor resolution. In the present work, we demonstrate the characterization of unprocessed salmon muscle using an optical polarimetric elastography system. We compare the results of compression testing within different samples of salmon skeletal muscle with different numbers of collagen membranes to characterize differences in heterogeneity. Using the intrinsic collagen membranes as markers, we determine the resolution of the system when testing biomaterials. The device reproducibly measures the stiffness of the tissues at variable strains. By analyzing the amount of energy lost by the sample during compression, collagen membranes that are 500 μm in size are detected.

Diagnosis of hyperfunctional thyroid nodules: impact of US-elastography.

PubMed

Ruhlmann, M; Stebner, V; Görges, R; Farahati, J; Simon, D; Bockisch, A; Rosenbaum-Krumme, S; Nagarajah, J

2014-01-01

Several studies described the ultrasound based real-time elastography (USE) having a high sensitivity, specificity and negative predictive value in the diagnosis of suspicious thyroid nodules. Recently published studies called these results into question. Until now the usefulness of USE in the diagnosis of scintigraphically hyperfunctional thyroid nodules is not examined. This study included 135 hyperfunctional thyroid nodules of 102 consecutive patients. The following attributes of the nodules were analyzed: stiffness with the USE using scores of Rago or Asteria and ultrasound criteria using TIRADS. 94 of the examined thyroid nodules (70%) were rated as hard (suspicious for malignancy) and 41 nodules (30%) as soft (not suspicious) with a specificity of 30%. The scoring systems of Rago and Asteria showed no significant difference. Applying the TIRADS criteria 44 nodules (33%) have a higher risk for malignancy (33 nodules TIRADS 4a, 11 nodules TIRADS 4b). Combining USE and TIRADS 32 nodules (24%) are categorized as suspicious (intersection of hard nodules that are categorized as TIRADS 4a or 4b). Ultrasound based real-time elastography cannot identify scintigraphically hyperfunctional thyroid nodules as benign nodules reliably. Its accuracy in the assessment of at least "hot" thyroid nodules is to be questioned.

[IMPORTANCE OF SHEAR WAVE ELASTOGRAPHY OF LIVERS IN PRACTICALLY HEALTHY PREGNANT WOMEN].

PubMed

Sariyeva, E; Salahova, S; Bayramov, N

2017-01-01

Pulse-wave elastography (SWE) that is one of the mostly used methods in the recent years holds important place in assessment of liver fibrosis. However there is no exact information on the results of liver elastography in healthy pregnant women in the world literature. The aim of the study was to investigate theSWE parameters of liver elastography in practically healthy pregnant women. The subject of the research was 50 practically healthy pregnant women within 18-45 years old (mean age 27.7±0.7). The pregnant women with genital and extragenital diseases were not included to the research. The research work was executed in the II Department of Obstetrics and Gynecology of Azerbaijan Medical University. SWE of liver in pregnant women was conducted in the I Department of Surgical Diseases of Azerbaijan Medical University through Supersonic Aixplorer Multi Wave device presented by the Scientific Development Foundation under the President of the Azerbaijan Republic. The obtained tissue hardness indicators are assessed under METAVIR scale. The results of the research showed that the measures of liver in practically healthy pregnant women are normal, edges flat, its echogenicity mainly normal, echostructure of its parenchyma homogenous, hardness was F0-F1 (normal) under METAVIR scale, fibrosis not observed. The obtained results were processed by variational (power average, percentile distribution) and correlation (ρ-Spearman) analyzes using the statistical package SPSS-20. A statistical study of the distribution of liver density in healthy women showed that the average density was 4,43±0,01 with 95% confidence interval (4,23 - 4,63). The histogram of distribution of liver density in practically healthy women belongs to the family of normal distributions with coefficients of variation coefficient (16.3%), asymmetry (-0.861±0.337) and excess (-0.068±0.662). Correlation analysis in healthy women did not reveal a reliable relationship between age and liver density (ρ=0.082, p=0.571), but a significant inverse correlation was found between the body mass index (BMI) and liver density (ρ=-0.317; p=0.025). Easy application, non-invasiveness, maximum exactness within the real time, repeatedly application of procedure and no risk to fetus by Shear Wave elastography of liver allow applying this method in pregnant women. Study of liver elasticity in pregnant women allows assessing the grades of hepatic fibrosis and differentiating liver disease.

Ames Mutagenicity Test of the RDX Replacement, Triaminoguanidinium-1-methyl-5-nitriminotetrazolate (TAG-MNT)

DTIC Science & Technology

2010-03-01

5-nitriminotetrazolate (TAG-MNT) using the Xenometrix Microplate Format Mutagenicity Assay with five strains of bacteria in compliance with the...798.5265.), The U.S. Food and Drug Administration (USFDA) and OCED (OECD, 1997). f. Xenometrix has developed a proprietary microplate format (MPFTM...8217-Azotetrazolate Salts. Chem. Mater. 17(14): 3784-3793. Kasuske, L., J. M. Schofer and K. Hasegawa. 2009. Two marines with generalized seizure activity. J Emerg

Phase Zero Contracting Operations-Strategic and Integrative Planning for Contingency and Expeditionary Operations

DTIC Science & Technology

2013-10-01

349–372 Phase Zero Contracting Operations (PZCO) FIGURE 4. CONTRACTING PHASE ZERO: PLAN, EXERCISE, REHEARSE, AND SYNCHRONIZE Note. BPA = Blanket...More Robust Construction Supplies; Oce Equipment; Quality of Life; and Morale, Welfare, and Recreation PO/TO/DO/ BPA Small Purchase Standard Vehicles PO...TO/DO/ BPA Small Purchase Standard Vehicles PO/TO/DO/ BPA Small Purchase Standard Vehicles PO/TO/DO/ BPA Small Purchase Food, Water, Billeting, Hygiene

An Autonomous Indicator-based pH Sensor for Oceanographic Research and Monitoring

DTIC Science & Technology

2010-01-01

E-mail: michael.degrandpre@umontana.edu Co-PI: Jim Beck , MSME Sunburst Sensors, LLC, 1121 E. Broadway, Suite 114, Missoula, MT 59802 Phone...NOPP Award Number: ONR- BAA -07-040 NSF Award Number: OCE-0836807 LONG-TERM GOALS This project, funded under NOPP Topic 3A Sensors for...Spaulding continued work on establishing long- term stability of mCP. Jim Beck coordinated improvements to the design of the software and hardware

Specialization of Perceptual Processes.

DTIC Science & Technology

1994-09-01

population rose and fell, furniture was rearranged, a small mountain range was built in part of the lab (really), carpets were shampooed , and oce lighting...common task is the tracking of moving objects. Coombs [22] implemented a system 44 for xating and tracking objects using a stereo eye/ head system...be a person (person?). Finally, a motion unit is used to detect foot gestures. A pair of nod-of-the- head detectors were implemented and tested, but

Computer vision elastography: speckle adaptive motion estimation for elastography using ultrasound sequences.

PubMed

Revell, James; Mirmehdi, Majid; McNally, Donal

2005-06-01

We present the development and validation of an image based speckle tracking methodology, for determining temporal two-dimensional (2-D) axial and lateral displacement and strain fields from ultrasound video streams. We refine a multiple scale region matching approach incorporating novel solutions to known speckle tracking problems. Key contributions include automatic similarity measure selection to adapt to varying speckle density, quantifying trajectory fields, and spatiotemporal elastograms. Results are validated using tissue mimicking phantoms and in vitro data, before applying them to in vivo musculoskeletal ultrasound sequences. The method presented has the potential to improve clinical knowledge of tendon pathology from carpel tunnel syndrome, inflammation from implants, sport injuries, and many others.

[The role of ultrasonography in the investigation of male infertility].

PubMed

Fejes, Zsuzsanna; Pásztor, Norbert; Karczagi, Lilla; Brzózka, Ádám; Király, István; Morvay, Zita; Palkó, András

2018-05-01

Unintended childlessness affects approximately 9-15% of couples in the reproductive age. It is known that a remarkable proportion of infertility is caused by the disorders of the male reproductive functions. Diagnostic imaging methods and especially ultrasonography play a crucial role in the infertility work-up, the ultrasound examination has become the method of choice for imaging in diseases affecting the testis. With the development of high resolution transducers and technology using colour Doppler, pulsed Doppler, share wave elastography and strain elastography, it is now possible to make accurate diagnoses. However, the place of the new imaging methods in the algorithm of infertility check-up should be clearly defined. Orv Hetil. 2018; 159(21): 815-822.

In Vivo Estimation of Perineal Body Properties Using Ultrasound Quasistatic Elastography in Nulliparous Women

PubMed Central

Chen, Luyun; Low, Lisa Kane; DeLancey, John OL; Ashton-Miller, James A

2015-01-01

Objective The perineal body must undergo a remarkable transformation during pregnancy to accommodate an estimated stretch ratio of over 3.3 in order to permit vaginal delivery of the fetal head. Yet measurements of perineal body elastic properties are lacking in vivo, whether in the pregnant or non-pregnant state. The objective of this study, therefore, was to develop a method for measuring perineal body elastic modulus and to test its feasibility in young nulliparous women. Methods An UltraSONIX RP500 ultrasound system was equipped with elastography software. Approximately 1 Hz free-hand sinusoidal compression loading of the perineum was used to measure the relative stiffness of the perineal body compared to that of a custom reference standoff pad with a modulus of 36.7 kPa. Measurements were made in 20 healthy nulliparous women. Four subjects were invited back for second and third visits to evaluate within- and between-visit repeatability using the coefficient of variation. Results The mean± SD elastic compression modulus of the perineal body was 28.9 ± 4.7 kPa. Within- and between-visit repeatability averaged 3.4% and 8.3%, respectively. Conclusion Ultrasound elastography using a standoff pad reference provides a valid method for evaluating the elastic modulus of the perineal body in living women. PMID:25801422

Probe Oscillation Shear Wave Elastography: Initial In Vivo Results in Liver.

PubMed

Mellema, Daniel C; Song, Pengfei; Kinnick, Randall R; Trzasko, Joshua D; Urban, Matthew W; Greenleaf, James F; Manduca, Armando; Chen, Shigao

2018-05-01

Shear wave elastography methods are able to accurately measure tissue stiffness, allowing these techniques to monitor the progression of hepatic fibrosis. While many methods rely on acoustic radiation force to generate shear waves for 2-D imaging, probe oscillation shear wave elastography (PROSE) provides an alternative approach by generating shear waves through continuous vibration of the ultrasound probe while simultaneously detecting the resulting motion. The generated shear wave field in in vivo liver is complicated, and the amplitude and quality of these shear waves can be influenced by the placement of the vibrating probe. To address these challenges, a real-time shear wave visualization tool was implemented to provide instantaneous visual feedback to optimize probe placement. Even with the real-time display, it was not possible to fully suppress residual motion with established filtering methods. To solve this problem, the shear wave signal in each frame was decoupled from motion and other sources through the use of a parameter-free empirical mode decomposition before calculating shear wave speeds. This method was evaluated in a phantom as well as in in vivo livers from five volunteers. PROSE results in the phantom as well as in vivo liver correlated well with independent measurements using the commercial General Electric Logiq E9 scanner.

Effects of an acute bout of dynamic stretching on biomechanical properties of the gastrocnemius muscle determined by shear wave elastography

PubMed Central

Noorkoiv, Marika; Baltzopoulos, Vasilios; Gokalp, Hulya; Marzilger, Robert; Mohagheghi, Amir A.

2018-01-01

Aims The aim of this study was to examine the acute effects of dynamic stretching (DS) exercise on passive ankle range of motion (RoM), resting localized muscle stiffness, as measured by shear wave speed (SWS) of medial gastrocnemius muscle, fascicle strain, and thickness. Methods/Results Twenty-three participants performed a DS protocol. Before and after stretching, SWS was measured in the belly of the resting medial gastrocnemius muscle (MGM) using shear wave elastography. DS produced small improvements in maximum dorsiflexion (+1.5° ±1.5; mean difference ±90% confidence limits) and maximum plantarflexion (+2.3° ±1.8), a small decrease in fascicle strain (-2.6% ±4.4) and a small increase in SWS at neutral resting angle (+11.4% ±1.5). There was also a small increase in muscle thickness (+4.1mm ±2.0). Conclusions Through the use of elastography, this is the first study to suggest that DS increases muscle stiffness, decreases fascicle strain and increases muscle thickness as a result of improved RoM. These results can be beneficial to coaches, exercise and clinical scientists when choosing DS as a muscle conditioning or rehabilitation intervention. PMID:29723229

The influence of hepatic steatosis on the evaluation of fibrosis with non-alcoholic fatty liver disease by acoustic radiation force impulse.

PubMed

Yanrong Guo; Haoming Lin; Xinyu Zhang; Huiying Wen; Siping Chen; Xin Chen

2017-07-01

Acoustic radiation force impulse (ARFI) elastography is a non-invasive method for the assessment of liver by measuring liver stiffness. The aim of this study is to evaluate the accuracy of ARFI for the diagnosis of liver fibrosis and to assess impact of steatosis on liver fibrosis stiffness measurement, in rats model of non-alcoholic fatty liver disease (NAFLD). The rat models were conducted in 59 rats. The right liver lobe was processed and embedded in a fabricated gelatin solution. Liver mechanics were measured using shear wave velocity (SWV) induced by acoustic radiation force. In rats with NAFLD, the diagnostic performance of ARFI elastography in predicting severe fibrosis (F ≥ 3) and cirrhosis (F ≥ 4) had the areas under the receiver operating characteristic curves (AUROC) of 0.993 and 0.985. Among rats mean SWV values were significantly higher in rats with severe steatosis by histology compared to those mild or without steatosis for F0-F2 fibrosis stages (3.07 versus 2.51 m/s, P = 0.01). ARFI elastography is a promising method for staging hepatic fibrosis with NAFLD in rat models. The presence of severe steatosis is a significant factor for assessing the lower stage of fibrosis.

Efficiency of B-mode Ultrasound and Strain Elastography in Differentiating Between Benign and Malignant Cervical Lymph Nodes.

PubMed

Turgut, Eser; Celenk, Cetin; Tanrivermis Sayit, Asli; Bekci, Tumay; Gunbey, Hediye Pinar; Aslan, Kerim

2017-09-01

The purpose of this study was to evaluate the diagnostic accuracy and efficiency of ultrasonography (US), especially when combined with strain elastography (SE), in differentiating between benign and malignant cervical lymph nodes (LNs). Forty-one LNs were examined by B-mode US, power Doppler US, and SE. The following imaging features were analyzed: shape, echogenicity, echogenic hilum, calcification, intranodal vascular pattern, elasticity scores (5 categories), and strain ratio. The average strain ratio was calculated as the mean strain of the adjacent sternocleidomastoid muscle divided by the mean strain of the target LN. The results of the US and SE features were compared with the histopathologic findings. The imaging features that were significantly associated with malignant LNs were an increased short-to-long axis diameter ratio, abnormal or absence of hilum, microcalcification, type 2-3-4 vascularity, 3-4-5 elasticity scores, and a high level of strain ratio (P < 0.05). The cutoff value of the strain index was detected as 1.18. According to this, there was a significant difference (P = 0.004) in the strain index between benign and malignant LNs. Strain elastography is useful in differentiating between benign and malignant cervical LNs, thereby informing decisions to perform a biopsy and/or surgery, and facilitating follow-up.

The value of shear wave elastography in the quantification of corpus cavernosum penis rigidity and its alteration with age.

PubMed

Inci, Ercan; Turkay, Rustu; Nalbant, Mustafa Orhan; Yenice, Mustafa Gurkan; Tugcu, Volkan

2017-04-01

The goal of this study was to measure corpus cavernosum (CC) penis rigidity with shear wave elastography (SWE) in healthy volunteers and to evaluate the change of rigidity with age. SWE was performed in 60 healthy volunteers (age range 20-71, mean 47±12,83 years). Volunteers were divided into 2 groups by age (Group 1 age <50, group 2 age ≥50). We assessed SWE in 3 parts of penis (proximal, middle and glans penis) on both sides of CC. All values of SWE (in kilo Pascal) were noted along with volunteers' ages. The measurements were done both with transverse (T) and longitudinal (L) sections. We compared all SW values of penis parts and their alterations with age. The shear wave elastography values of CC penis increased with increasing age (p<0,01). There was no significant difference between both sides of CC penis (p<0,05). We calculated no significant difference between T and L sections of all parts of penis (p<0,05). SWE can provide noninvasive quantitative data of CC penis rigidity and its alteration with age. These data may create a new approach in the evaluation process and treatment options for penile pathologies. Copyright © 2017 Elsevier B.V. All rights reserved.

In Vivo, High-Frequency Three-Dimensional Cardiac MR Elastography: Feasibility in Normal Volunteers

PubMed Central

Arani, Arvin; Glaser, Kevin L.; Arunachalam, Shivaram P.; Rossman, Phillip J.; Lake, David S.; Trzasko, Joshua D.; Manduca, Armando; McGee, Kiaran P.; Ehman, Richard L.; Araoz, Philip A.

2016-01-01

Purpose Noninvasive stiffness imaging techniques (elastography) can image myocardial tissue biomechanics in vivo. For cardiac MR elastography (MRE) techniques, the optimal vibration frequency for in vivo experiments is unknown. Furthermore, the accuracy of cardiac MRE has never been evaluated in a geometrically accurate phantom. Therefore, the purpose of this study was to determine the necessary driving frequency to obtain accurate three-dimensional (3D) cardiac MRE stiffness estimates in a geometrically accurate diastolic cardiac phantom and to determine the optimal vibration frequency that can be introduced in healthy volunteers. Methods The 3D cardiac MRE was performed on eight healthy volunteers using 80 Hz, 100 Hz, 140 Hz, 180 Hz, and 220 Hz vibration frequencies. These frequencies were tested in a geometrically accurate diastolic heart phantom and compared with dynamic mechanical analysis (DMA). Results The 3D Cardiac MRE was shown to be feasible in volunteers at frequencies as high as 180 Hz. MRE and DMA agreed within 5% at frequencies greater than 180 Hz in the cardiac phantom. However, octahedral shear strain signal to noise ratios and myocardial coverage was shown to be highest at a frequency of 140 Hz across all subjects. Conclusion This study motivates future evaluation of high-frequency 3D MRE in patient populations. PMID:26778442

Differences of standard values of Supersonic shear imaging and ARFI technique - in vivo study of testicular tissue.

PubMed

Trottmann, M; Rübenthaler, J; Marcon, J; Stief, C G; Reiser, M F; Clevert, D A

2016-01-01

To investigate the difference of standard values of Supersonic shear imaging (SSI) and Acoustic Radiation Force Impulse (ARFI) technique in the evaluation of testicular tissue stiffness in vivo. 58 healthy male testes were examined using B-mode sonography and ARFI and SSI. B-mode sonography was performed in order to scan the testis for pathologies followed by performance of real-time elastography in three predefined areas (upper pole, central portion and lower pole) using the SuperSonic® Aixplorer ultrasound device (SuperSonic Imagine, Aix-en-Provence, France). Afterwards a second assessment of the same testicular regions by elastography followed using the ARFI technique of the Siemens Acuson 2000™ ultrasound device (Siemens Health Care, Germany). Values of shear wave velocity were described in m/s. Parameters of elastography techniques were compared using paired sample t-test. The values of SSI were all significantly higher in all measured areas compared to ARFI (p < 0.001 to p = 0.015). Quantitatively there was a higher mean SSI wave velocity value of 1,1 compared to 0.8 m/s measured by ARFI. SSI values are significantly higher than ARFI values when measuring the stiffness of testicular tissue and should only be compared with caution.

Effect of depth on shear-wave elastography estimated in the internal and external cervical os during pregnancy

PubMed Central

Hernandez-Andrade, Edgar; Aurioles-Garibay, Alma; Garcia, Maynor; Korzeniewski, Steven J.; Schwartz, Alyse G.; Ahn, Hyunyoung; Martinez-Varea, Alicia; Yeo, Lami; Chaiworapongsa, Tinnakorn; Hassan, Sonia S.; Romero, Roberto

2014-01-01

Aim To investigate the effect of depth on cervical shear-wave elastography. Methods Shear-wave elastography was applied to estimate the velocity of propagation of the acoustic force impulse (shear-wave) in the cervix of 154 pregnant women at 11-36 weeks of gestation. Shear-wave speed (SWS) was evaluated in cross-sectional views of the internal and external cervical os in five regions of interest: anterior, posterior, lateral right, lateral left, and endocervix. Distance from the center of the US transducer to the center of the each region of interest was registered. Results In all regions, SWS decreased significantly with gestational age (p=0.006). In the internal os SWS was similar among the anterior, posterior and lateral regions, and lower in the endocervix. In the external os, the endocervix and anterior regions showed similar SWS values, lower than those from the posterior and lateral regions. In the endocervix, these differences remained significant after adjustment for depth, gestational age and cervical length. SWS estimations in all regions of the internal os were higher than those of the external os, suggesting denser tissue. Conclusion Depth from the ultrasound probe to different regions in the cervix did not significantly affect the SWS estimations. PMID:25029081

Diagnosing cysts with correlation coefficient images from 2-dimensional freehand elastography.

PubMed

Booi, Rebecca C; Carson, Paul L; O'Donnell, Matthew; Richards, Michael S; Rubin, Jonathan M

2007-09-01

We compared the diagnostic potential of using correlation coefficient images versus elastograms from 2-dimensional (2D) freehand elastography to characterize breast cysts. In this preliminary study, which was approved by the Institutional Review Board and compliant with the Health Insurance Portability and Accountability Act, we imaged 4 consecutive human subjects (4 cysts, 1 biopsy-verified benign breast parenchyma) with freehand 2D elastography. Data were processed offline with conventional 2D phase-sensitive speckle-tracking algorithms. The correlation coefficient in the cyst and surrounding tissue was calculated, and appearances of the cysts in the correlation coefficient images and elastograms were compared. The correlation coefficient in the cysts was considerably lower (14%-37%) than in the surrounding tissue because of the lack of sufficient speckle in the cysts, as well as the prominence of random noise, reverberations, and clutter, which decorrelated quickly. Thus, the cysts were visible in all correlation coefficient images. In contrast, the elastograms associated with these cysts each had different elastographic patterns. The solid mass in this study did not have the same high decorrelation rate as the cysts, having a correlation coefficient only 2.1% lower than that of surrounding tissue. Correlation coefficient images may produce a more direct, reliable, and consistent method for characterizing cysts than elastograms.

Magnetic resonance imaging and transient elastography in the management of Nonalcoholic Fatty Liver Disease (NAFLD).

PubMed

Han, Ma Ai Thanda; Saouaf, Rola; Ayoub, Walid; Todo, Tsuyoshi; Mena, Edward; Noureddin, Mazen

2017-04-01

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease and cirrhosis worldwide and the second most common cause of liver transplantation in major medical centers. Because liver steatosis and fibrosis severity are related to disease morbidity and mortality, the extent of disease, and disease progression, they need to be assessed and monitored. In addition, innovation with new drug developments requires disease staging and monitoring in both phase 2 and 3 clinical trials. Currently, disease assessment in both clinical practice and research is mostly performed by liver biopsy, an invasive, procedure with risks. Noninvasive, highly accurate tests are needed that could be used in clinical trials as surrogate endpoints and in clinical practice for monitoring patients. Area Covered: We discuss noninvasive tests, transient elastography (TE) with controlled attenuation parameter (CAP), magnetic resonance imaging (MRI), and MR elastography (MRE), summarize the available evidence of their usefulness for assessing steatosis and fibrosis. Therefore they could be used as clinical trials outcomes and in disease monitoring in clinical practice. Expert Commentary: TE with CAP, MRI and MRE are highly accurate noninvasive diagnostic tools for quantifying hepatic steatosis and fibrosis. Therefore they could be used as clinical trials outcomes and in disease monitoring in clinical practice.

Hepatic and Splenic Acoustic Radiation Force Impulse Shear Wave Velocity Elastography in Children with Liver Disease Associated with Cystic Fibrosis

PubMed Central

Cañas, Teresa; Maciá, Araceli; Muñoz-Codoceo, Rosa Ana; Fontanilla, Teresa; González-Rios, Patricia; Miralles, María; Gómez-Mardones, Gloria

2015-01-01

Background. Liver disease associated with cystic fibrosis (CFLD) is the second cause of mortality in these patients. The diagnosis is difficult because none of the available tests are specific enough. Noninvasive elastographic techniques have been proven to be useful to diagnose hepatic fibrosis. Acoustic radiation force impulse (ARFI) imaging is an elastography imaging system. The purpose of the work was to study the utility of liver and spleen ARFI Imaging in the detection of CFLD. Method. 72 patients with cystic fibrosis (CF) were studied and received ARFI imaging in the liver and in the spleen. SWV values were compared with the values of 60 healthy controls. Results. Comparing the SWV values of CFLD with the control healthy group, values in the right lobe were higher in patients with CFLD. We found a SWV RHL cut-off value to detect CFLD of 1.27 m/s with a sensitivity of 56.5% and a specificity of 90.5%. CF patients were found to have higher SWC spleen values than the control group. Conclusions. ARFI shear wave elastography in the right hepatic lobe is a noninvasive technique useful to detect CFLD in our sample of patients. Splenic SWV values are higher in CF patients, without any clinical consequence. PMID:26609528

Hepatic and Splenic Acoustic Radiation Force Impulse Shear Wave Velocity Elastography in Children with Liver Disease Associated with Cystic Fibrosis.

PubMed

Cañas, Teresa; Maciá, Araceli; Muñoz-Codoceo, Rosa Ana; Fontanilla, Teresa; González-Rios, Patricia; Miralles, María; Gómez-Mardones, Gloria

2015-01-01

Liver disease associated with cystic fibrosis (CFLD) is the second cause of mortality in these patients. The diagnosis is difficult because none of the available tests are specific enough. Noninvasive elastographic techniques have been proven to be useful to diagnose hepatic fibrosis. Acoustic radiation force impulse (ARFI) imaging is an elastography imaging system. The purpose of the work was to study the utility of liver and spleen ARFI Imaging in the detection of CFLD. Method. 72 patients with cystic fibrosis (CF) were studied and received ARFI imaging in the liver and in the spleen. SWV values were compared with the values of 60 healthy controls. Results. Comparing the SWV values of CFLD with the control healthy group, values in the right lobe were higher in patients with CFLD. We found a SWV RHL cut-off value to detect CFLD of 1.27 m/s with a sensitivity of 56.5% and a specificity of 90.5%. CF patients were found to have higher SWC spleen values than the control group. Conclusions. ARFI shear wave elastography in the right hepatic lobe is a noninvasive technique useful to detect CFLD in our sample of patients. Splenic SWV values are higher in CF patients, without any clinical consequence.

Tissue mimicking materials for the detection of prostate cancer using shear wave elastography: a validation study.

PubMed

Cao, Rui; Huang, Zhihong; Varghese, Tomy; Nabi, Ghulam

2013-02-01

Quantification of stiffness changes may provide important diagnostic information and aid in the early detection of cancers. Shear wave elastography is an imaging technique that assesses tissue stiffness using acoustic radiation force as an alternate to manual palpation reported previously with quasistatic elastography. In this study, the elastic properties of tissue mimicking materials, including agar, polyacrylamide (PAA), and silicone, are evaluated with an objective to determine material characteristics which resemble normal and cancerous prostate tissue. Acoustic properties and stiffness of tissue mimicking phantoms were measured using compressional mechanical testing and shear wave elastography using supersonic shear imaging. The latter is based on the principles of shear waves generated using acoustic radiation force. The evaluation included tissue mimicking materials (TMMs) within the prostate at different positions and sizes that could mimic cancerous and normal prostate tissue. Patient data on normal and prostate cancer tissues quantified using biopsy histopathology were used to validate the findings. Pathologist reports on histopathology were blinded to mechanical testing and elastographic findings. Young's modulus values of 86.2 ± 4.5 and 271.5 ± 25.7 kPa were obtained for PAA mixed with 2% Al(2)O(3) particles and silicone, respectively. Young's modulus of TMMs from mechanical compression testing showed a clear trend of increasing stiffness with an increasing percentage of agar. The silicone material had higher stiffness values when compared with PAA with Al(2)O(3). The mean Young's modulus value in cancerous tissue was 90.5 ± 4.5 kPa as compared to 93.8 ± 4.4 and 86.2 ± 4.5 kPa obtained with PAA with 2% Al(2)O(3) phantom at a depth of 52.4 and 36.6 mm, respectively. PAA mixed with Al(2)O(3) provides the most suitable tissue mimicking material for prostate cancer tumor material, while agar could form the surrounding background to simulate normal prostate tissue.

Probe Oscillation Shear Elastography (PROSE): A High Frame-Rate Method for Two-Dimensional Ultrasound Shear Wave Elastography.

PubMed

Mellema, Daniel C; Song, Pengfei; Kinnick, Randall R; Urban, Matthew W; Greenleaf, James F; Manduca, Armando; Chen, Shigao

2016-09-01

Ultrasound shear wave elastography (SWE) utilizes the propagation of induced shear waves to characterize the shear modulus of soft tissue. Many methods rely on an acoustic radiation force (ARF) "push beam" to generate shear waves. However, specialized hardware is required to generate the push beams, and the thermal stress that is placed upon the ultrasound system, transducer, and tissue by the push beams currently limits the frame-rate to about 1 Hz. These constraints have limited the implementation of ARF to high-end clinical systems. This paper presents Probe Oscillation Shear Elastography (PROSE) as an alternative method to measure tissue elasticity. PROSE generates shear waves using a harmonic mechanical vibration of an ultrasound transducer, while simultaneously detecting motion with the same transducer under pulse-echo mode. Motion of the transducer during detection produces a "strain-like" compression artifact that is coupled with the observed shear waves. A novel symmetric sampling scheme is proposed such that pulse-echo detection events are acquired when the ultrasound transducer returns to the same physical position, allowing the shear waves to be decoupled from the compression artifact. Full field-of-view (FOV) two-dimensional (2D) shear wave speed images were obtained by applying a local frequency estimation (LFE) technique, capable of generating a 2D map from a single frame of shear wave motion. The shear wave imaging frame rate of PROSE is comparable to the vibration frequency, which can be an order of magnitude higher than ARF based techniques. PROSE was able to produce smooth and accurate shear wave images from three homogeneous phantoms with different moduli, with an effective frame rate of 300 Hz. An inclusion phantom study showed that increased vibration frequencies improved the accuracy of inclusion imaging, and allowed targets as small as 6.5 mm to be resolved with good contrast (contrast-to-noise ratio ≥ 19 dB) between the target and background.

Probe Oscillation Shear Elastography (PROSE): A High Frame-Rate Method for Two-Dimensional Ultrasound Shear Wave Elastography

PubMed Central

Mellema, Daniel C.; Song, Pengfei; Kinnick, Randall R.; Urban, Matthew W.; Greenleaf, James F.; Manduca, Armando; Chen, Shigao

2017-01-01

Ultrasound shear wave elastography (SWE) utilizes the propagation of induced shear waves to characterize the shear modulus of soft tissue. Many methods rely on an acoustic radiation force (ARF) “push beam” to generate shear waves. However, specialized hardware is required to generate the push beams, and the thermal stress that is placed upon the ultrasound system, transducer, and tissue by the push beams currently limits the frame-rate to about 1 Hz. These constraints have limited the implementation of ARF to high-end clinical systems. This paper presents Probe Oscillation Shear Elastography (PROSE) as an alternative method to measure tissue elasticity. PROSE generates shear waves using a harmonic mechanical vibration of an ultrasound transducer, while simultaneously detecting motion with the same transducer under pulse-echo mode. Motion of the transducer during detection produces a “strain-like” compression artifact that is coupled with the observed shear waves. A novel symmetric sampling scheme is proposed such that pulse-echo detection events are acquired when the ultrasound transducer returns to the same physical position, allowing the shear waves to be decoupled from the compression artifact. Full field-of-view (FOV) two-dimensional (2D) shear wave speed images were obtained by applying a local frequency estimation (LFE) technique, capable of generating a 2D map from a single frame of shear wave motion. The shear wave imaging frame rate of PROSE is comparable to the vibration frequency, which can be an order of magnitude higher than ARF based techniques. PROSE was able to produce smooth and accurate shear wave images from three homogeneous phantoms with different moduli, with an effective frame rate of 300Hz. An inclusion phantom study showed that increased vibration frequencies improved the accuracy of inclusion imaging, and allowed targets as small as 6.5 mm to be resolved with good contrast (contrast-to-noise ratio ≥19 dB) between the target and background. PMID:27076352

Viscoelastic Parameters for Quantifying Liver Fibrosis: Three-Dimensional Multifrequency MR Elastography Study on Thin Liver Rat Slices

PubMed Central

Ronot, Maxime; Lambert, Simon A.; Wagner, Mathilde; Garteiser, Philippe; Doblas, Sabrina; Albuquerque, Miguel; Paradis, Valérie; Vilgrain, Valérie; Sinkus, Ralph; Van Beers, Bernard E.

2014-01-01

Objective To assess in a high-resolution model of thin liver rat slices which viscoelastic parameter at three-dimensional multifrequency MR elastography has the best diagnostic performance for quantifying liver fibrosis. Materials and Methods The study was approved by the ethics committee for animal care of our institution. Eight normal rats and 42 rats with carbon tetrachloride induced liver fibrosis were used in the study. The rats were sacrificed, their livers were resected and three-dimensional MR elastography of 5±2 mm liver slices was performed at 7T with mechanical frequencies of 500, 600 and 700 Hz. The complex shear, storage and loss moduli, and the coefficient of the frequency power law were calculated. At histopathology, fibrosis and inflammation were assessed with METAVIR score, fibrosis was further quantified with morphometry. The diagnostic value of the viscoelastic parameters for assessing fibrosis severity was evaluated with simple and multiple linear regressions, receiver operating characteristic analysis and Obuchowski measures. Results At simple regression, the shear, storage and loss moduli were associated with the severity of fibrosis. At multiple regression, the storage modulus at 600 Hz was the only parameter associated with fibrosis severity (r = 0.86, p<0.0001). This parameter had an Obuchowski measure of 0.89+/−0.03. This measure was significantly larger than that of the loss modulus (0.78+/−0.04, p = 0.028), but not than that of the complex shear modulus (0.88+/−0.03, p = 0.84). Conclusion Our high resolution, three-dimensional multifrequency MR elastography study of thin liver slices shows that the storage modulus is the viscoelastic parameter that has the best association with the severity of liver fibrosis. However, its diagnostic performance does not differ significantly from that of the complex shear modulus. PMID:24722733

The efficiency of acoustic radiation force impulse (ARFI) elastography in the diagnosis and staging of carpal tunnel syndrome.

PubMed

Arslan, Harun; Yavuz, Alpaslan; İlgen, Ferda; Aycan, Abdurrahman; Ozgokce, Mesut; Akdeniz, Hüseyin; Batur, Abdussamet

2018-01-12

The aim of the present study was to quantify the stiffness of the median nerve (MN) at the carpal tunnel inlet by acoustic radiation force impulse (ARFI) elastography and to evaluate whether ARFI can be used in diagnosis and staging of carpal tunnel syndrome (CTS). Sonographic examinations of 96 wrists in 50 patients were included in the study. The cross-sectional area and stiffness of the MN were quantitatively measured by B-mode ultrasonography (USG) and ARFI. The findings of CTS were assigned to four groups: (I) normal (n = 21), (II) mild (n = 39), (III) moderate (n = 38), and (IV) severe (n = 19). The differences between CTS patients and controls and the differences in electrodiagnostic tests among subgroups were statistically compared. ROC analysis was performed to determine the cut-off values between subgroups. Bilateral CTS was present in 46 patients (92 wrists) and unilateral CTS in four patients. Of the 96 nerves in the 50 symptomatic "idiopathic CTS" patients (48 women, 2 men; mean age 45.9 years, range 23-73 years), 39 (40.4%) were mild, 38 (39.8%) were moderate, and 19 (19.8%) were severely affected. When compared to controls, MN stiffness was significantly higher in the CTS group (P < 0.001); furthermore, it was higher in the severe or extreme severity group than the mild or moderate severity group (P < 0.001). A 3.250 m/s cut-off value on ARFI revealed sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 81, 82, 95.1, 50, and 82%, respectively. The MN stiffness measured by ARFI elastography is significantly higher in patients with CTS then in controls. ARFI elastography appears to be a highly efficient imaging modality for the diagnosis and staging of these patients.

Measurement of Liver Stiffness Using Shear Wave Elastography in a Rat Model: Factors Impacting Stiffness Measurement with Multiple- and Single-Tracking-Location Techniques.

PubMed

Langdon, Jonathan H; Elegbe, Etana; Gonzalez, Raul S; Osapoetra, Laurentius; Ford, Tristan; McAleavey, Stephen A

2017-11-01

The clinical use of elastography for monitoring fibrosis progression is challenged by the subtle changes in liver stiffness associated with early-stage fibrosis and the comparatively large variance in stiffness estimates provided by elastography. Single-tracking-location (STL) shear wave elasticity imaging (SWEI) is an ultrasound elastography technique previously found to provide improved estimate precision compared with multiple-tracking-location (MTL) SWEI. Because of the improved precision, it is reasonable to expect that STL-SWEI would provide improved ability to differentiate liver fibrosis stage compared with MTL-SWEI. However, this expectation has not been previously challenged rigorously. In this work, the performance of STL- and MTL-SWEI in the setting of a rat model of liver fibrosis is characterized, and the advantages of STL-SWEI in staging fibrosis are explored. The purpose of this study was to determine what advantages, if any, arise from using STL-SWEI instead of MTL-SWEI in the characterization of fibrotic liver. Thus, the ability of STL-SWEI to differentiate livers at various METAVIR fibrosis scores, for ex vivo postmortem measurements, is explored. In addition, we examined the effect of the common confounding factor of fluid versus solid boundary conditions in SWEI experiments. Sprague-Dawley rats were treated with carbon tetrachloride over several weeks to produce liver disease of varying severity. STL and MTL stiffness measurements were performed ex vivo and compared with the METAVIR scores from histological analysis and the duration of treatment. A strong association was observed between liver stiffness and weeks of treatment with the liver toxin carbon tetrachloride. Direct comparison of STL- and MTL-SWEI measurements revealed no significant difference in ability to differentiate fibrosis stages based on SWEI mean values. However, image interquartile range was greatly improved in the case of STL-SWEI, compared with MTL-SWEI, at small beam spacing. Copyright © 2017 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Assessment of liver fibrosis in chronic hepatitis: comparison of shear wave elastography and transient elastography.

PubMed

Paul, Shashi B; Das, Prasenjit; Mahanta, Mousumi; Sreenivas, Vishnubhatla; Kedia, Saurabh; Kalra, Nancy; Kaur, Harpreet; Vijayvargiya, Maneesh; Ghosh, Shouriyo; Gamanagatti, Shivanand R; Shalimar; Gupta, Siddhartha Dutta; Acharya, Subrat K

2017-12-01

To evaluate the diagnostic accuracy of shear wave elastography (SWE) and transient elastography (TE) in the evaluation of liver fibrosis in chronic hepatitis B (CHB) and C (CHC) patients taking liver biopsy as gold standard. Ethics committee approved this prospective cross-sectional study. Between October 2012 and December 2014, consecutive CHB/CHC patients fulfilling the inclusion criteria were included-age more than 18 years, informed written consent, willing and suitable for liver biopsy. SWE, TE, and biopsy were performed the same day. Liver stiffness measurement (LSM) cut-offs for various stages of fibrosis were generated for SWE and TE. AUC, sensitivity, specificity, and positive/negative predictive values were estimated individually or in combination. CH patients (n = 240, CHB 172, CHC 68), 176 males, 64 females, mean age 32.6 ± 11.6 years were enrolled. Mean LSM of patients with no histological fibrosis (F0) was 5.0 ± 0.7 and 5.1+1.4 kPa on SWE and TE, respectively. For differentiating F2 and F3-4 fibrosis on SWE, at 7.0 kPa cut-off, the sensitivity was 81.3% and specificity 77.6%. For TE, at 8.3 kPa cut-off, sensitivity was 81.8% and specificity 83.1%. For F3 vs. F4, SWE sensitivity was 83.3% and specificity 90.7%. At 14.8 kPa cut-off, TE showed similar sensitivity (83.3%) but specificity increased to 96.5%. Significant correlation between SWE and TE was observed (r = 0.33, p < 0.001). On combining SWE and TE, a drop in sensitivity with increased specificity for all stages of liver fibrosis occured. SWE is an accurate technique for evaluating liver fibrosis. SWE compares favorably with TE especially for predicting advanced fibrosis/cirrhosis. Combining SWE and TE further improves specificity.

Tissue mimicking materials for the detection of prostate cancer using shear wave elastography: A validation study

PubMed Central

Cao, Rui; Huang, Zhihong; Varghese, Tomy; Nabi, Ghulam

2013-01-01

Purpose: Quantification of stiffness changes may provide important diagnostic information and aid in the early detection of cancers. Shear wave elastography is an imaging technique that assesses tissue stiffness using acoustic radiation force as an alternate to manual palpation reported previously with quasistatic elastography. In this study, the elastic properties of tissue mimicking materials, including agar, polyacrylamide (PAA), and silicone, are evaluated with an objective to determine material characteristics which resemble normal and cancerous prostate tissue. Methods: Acoustic properties and stiffness of tissue mimicking phantoms were measured using compressional mechanical testing and shear wave elastography using supersonic shear imaging. The latter is based on the principles of shear waves generated using acoustic radiation force. The evaluation included tissue mimicking materials (TMMs) within the prostate at different positions and sizes that could mimic cancerous and normal prostate tissue. Patient data on normal and prostate cancer tissues quantified using biopsy histopathology were used to validate the findings. Pathologist reports on histopathology were blinded to mechanical testing and elastographic findings. Results: Young's modulus values of 86.2 ± 4.5 and 271.5 ± 25.7 kPa were obtained for PAA mixed with 2% Al2O3 particles and silicone, respectively. Young's modulus of TMMs from mechanical compression testing showed a clear trend of increasing stiffness with an increasing percentage of agar. The silicone material had higher stiffness values when compared with PAA with Al2O3. The mean Young's modulus value in cancerous tissue was 90.5 ± 4.5 kPa as compared to 93.8 ± 4.4 and 86.2 ± 4.5 kPa obtained with PAA with 2% Al2O3 phantom at a depth of 52.4 and 36.6 mm, respectively. Conclusions: PAA mixed with Al2O3 provides the most suitable tissue mimicking material for prostate cancer tumor material, while agar could form the surrounding background to simulate normal prostate tissue. PMID:23387774

[Comparison of the M and XL FibroScan(®) probes to estimate liver stiffness by transient elastography].

PubMed

Herrero, José Ignacio; Iñarrairaegui, Mercedes; D'Avola, Delia; Sangro, Bruno; Prieto, Jesús; Quiroga, Jorge

2014-04-01

The FibroScan(®) XL probe has been specifically designed for obese patients to measure liver stiffness by transient elastography, but it has not been well tested in non-obese patients. The aim of this study was to compare the M and XL FibroScan(®) probes in a series of unselected obese (body mass index above 30 kg/m(2)) and non-obese patients with chronic liver disease. Two hundred and fifty-four patients underwent a transient elastography examination with both the M and XL probes. The results obtained with the two probes were compared in the whole series and in obese (n=82) and non-obese (n=167) patients separately. The reliability of the examinations was assessed using the criteria defined by Castéra et al. The proportion of reliable exams was significantly higher when the XL probe was used (83% versus 73%; P=.001). This significance was maintained in the group of obese patients (82% versus 55%; P<.001), but not in the non-obese patients (84% versus 83%). Despite a high correlation between the stiffness values obtained with the two probes (R=.897; P<.001), and a high concordance in the estimation of fibrosis obtained with the two probes (Cronbach's alpha value: 0.932), the liver stiffness values obtained with the XL probe were significantly lower than those obtained with the M probe, both in the whole series (9.5 ± 9.1 kPa versus 11.3 ± 12.6 kPa; P<0.001) and in the obese and non-obese groups. In conclusion, transient elastography with the XL probe allows a higher proportion of reliable examinations in obese patients but not in non-obese patients. Stiffness values were lower with the XL probe than with the M probe. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography: An individual patient data-based meta-analysis.

PubMed

Herrmann, Eva; de Lédinghen, Victor; Cassinotto, Christophe; Chu, Winnie C-W; Leung, Vivian Y-F; Ferraioli, Giovanna; Filice, Carlo; Castera, Laurent; Vilgrain, Valérie; Ronot, Maxime; Dumortier, Jérôme; Guibal, Aymeric; Pol, Stanislas; Trebicka, Jonel; Jansen, Christian; Strassburg, Christian; Zheng, Rongqin; Zheng, Jian; Francque, Sven; Vanwolleghem, Thomas; Vonghia, Luisa; Manesis, Emanuel K; Zoumpoulis, Pavlos; Sporea, Ioan; Thiele, Maja; Krag, Aleksander; Cohen-Bacrie, Claude; Criton, Aline; Gay, Joel; Deffieux, Thomas; Friedrich-Rust, Mireen

2018-01-01

Two-dimensional shear wave elastography (2D-SWE) has proven to be efficient for the evaluation of liver fibrosis in small to moderate-sized clinical trials. We aimed at running a larger-scale meta-analysis of individual data. Centers which have worked with Aixplorer ultrasound equipment were contacted to share their data. Retrospective statistical analysis used direct and paired receiver operating characteristic and area under the receiver operating characteristic curve (AUROC) analyses, accounting for random effects. Data on both 2D-SWE and liver biopsy were available for 1,134 patients from 13 sites, as well as on successful transient elastography in 665 patients. Most patients had chronic hepatitis C (n = 379), hepatitis B (n = 400), or nonalcoholic fatty liver disease (n = 156). AUROCs of 2D-SWE in patients with hepatitis C, hepatitis B, and nonalcoholic fatty liver disease were 86.3%, 90.6%, and 85.5% for diagnosing significant fibrosis and 92.9%, 95.5%, and 91.7% for diagnosing cirrhosis, respectively. The AUROC of 2D-SWE was 0.022-0.084 (95% confidence interval) larger than the AUROC of transient elastography for diagnosing significant fibrosis (P = 0.001) and 0.003-0.034 for diagnosing cirrhosis (P = 0.022) in all patients. This difference was strongest in hepatitis B patients. 2D-SWE has good to excellent performance for the noninvasive staging of liver fibrosis in patients with hepatitis B; further prospective studies are needed for head-to-head comparison between 2D-SWE and other imaging modalities to establish disease-specific appropriate cutoff points for assessment of fibrosis stage. (Hepatology 2018;67:260-272). © 2017 The Authors. Hepatology published by Wiley Periodicals, Inc., on behalf of the American Association for the Study of Liver Diseases.

Standard value of ultrasound elastography using acoustic radiation force impulse imaging (ARFI) in healthy liver tissue of children and adolescents.

PubMed

Eiler, J; Kleinholdermann, U; Albers, D; Dahms, J; Hermann, F; Behrens, C; Luedemann, M; Klingmueller, V; Alzen, G F P

2012-10-01

Ultrasound elastography by acoustic radiation force impulse imaging (ARFI) is used in adults for non invasive measurement of liver stiffness, indicating liver diseases like fibrosis. To establish ARFI in children and adolescents we determined standard values of healthy liver tissue and analysed potentially influencing factors. 132 patients between 0 and 17 years old were measured using ARFI. None of them had any liver disease or any other disease that could affect the liver secondarily. All patients had a normal ultrasound scan, a normal BMI and normal liver function tests. The mean value of all ARFI measurements was calculated and potentially influencing factors were analysed. The mean value of all ARFI elastography measurements was 1.16 m/sec (SD ± 0.14 m/sec). Neither age (p = 0.533) nor depth of measurement (p = 0.066) had no significant influence on ARFI values, whereas a significant effect of gender was found with lower ARFI values in females (p = 0.025), however, there was no significant interaction between age groups (before or after puberty) and gender (p = 0.276). There was an interlobar difference with lower values in the right liver lobe compared to the left (p = 0.036) and with a significantly lower variance (p < 0.001). Consistend values were measured by different examiners (p = 0.108), however, the inter examiner variance deviated significantly (p < 0.001). ARFI elastography is a reliable method to measure liver stiffness in children and adolescents. In relation to studies which analyse liver diseases, the standard value of 1.16 m/sec (± 0.14 m/sec) allows a differentiation of healthy versus pathological liver tissue. © Georg Thieme Verlag KG Stuttgart · New York.

Ezetimibe for the Treatment of Nonalcoholic Steatohepatitis: Assessment by Novel Magnetic Resonance Imaging and Magnetic Resonance Elastography in a Randomized Trial (MOZART Trial)

PubMed Central

Loomba, Rohit; Sirlin, Claude B; Ang, Brandon; Bettencourt, Ricki; Jain, Rashmi; Salotti, Joanie; Soaft, Linda; Hooker, Jonathan; Kono, Yuko; Bhatt, Archana; Hernandez, Laura; Nguyen, Phirum; Noureddin, Mazen; Haufe, William; Hooker, Catherine; Yin, Meng; Ehman, Richard; Lin, Grace Y; Valasek, Mark A; Brenner, David A; Richards, Lisa

2015-01-01

Ezetimibe inhibits intestinal cholesterol absorption and lowers low-density lipoprotein cholesterol. Uncontrolled studies have suggested that it reduces liver fat as estimated by ultrasound in nonalcoholic steatohepatitis (NASH). Therefore, we aimed to examine the efficacy of ezetimibe versus placebo in reducing liver fat by the magnetic resonance imaging-derived proton density-fat fraction (MRI-PDFF) and liver histology in patients with biopsy-proven NASH. In this randomized, double-blind, placebo-controlled trial, 50 patients with biopsy-proven NASH were randomized to either ezetimibe 10 mg orally daily or placebo for 24 weeks. The primary outcome was a change in liver fat as measured by MRI-PDFF in colocalized regions of interest within each of the nine liver segments. Novel assessment by two-dimensional and three-dimensional magnetic resonance elastography was also performed. Ezetimibe was not significantly better than placebo at reducing liver fat as measured by MRI-PDFF (mean difference between the ezetimibe and placebo arms -1.3%, P = 0.4). Compared to baseline, however, end-of-treatment MRI-PDFF was significantly lower in the ezetimibe arm (15%-11.6%, P < 0.016) but not in the placebo arm (18.5%-16.4%, P = 0.15). There were no significant differences in histologic response rates, serum alanine aminotransferase and aspartate aminotransferase levels, or longitudinal changes in two-dimensional and three-dimensional magnetic resonance elastography-derived liver stiffness between the ezetimibe and placebo arms. Compared to histologic nonresponders (25/35), histologic responders (10/35) had a significantly greater reduction in MRI-PDFF (-4.35 ± 4.9% versus -0.30 ± 4.1%, P < 0.019). Conclusions: Ezetimibe did not significantly reduce liver fat in NASH. This trial demonstrates the application of colocalization of MRI-PDFF-derived fat maps and magnetic resonance elastography-derived stiffness maps of the liver before and after treatment to noninvasively assess treatment response in NASH. (Hepatology 2015;61:1239–1250) PMID:25482832

Dollar Summary of Federal Supply Classification and Service Category by Company, FY83, Part 5 (N065-W059).

DTIC Science & Technology

1983-01-01

BLDGS 1,269 PHILLIPS SWAGER ASSOCIATES ILLINOIS ARMY A/E CONSTRUCTION /ADMIN 9 SVC BLDGS 174 QUINLIVIAN PIERIK KRAUSE ROBSON JV NEW YORK NAVY A/E...CONSTRUCTION /AIRFIELD & MSL FAC RANCORN WILDMAN & KRAUSE VIRGINIA NAVY A/E CONSTRUCTION /AIRFIELD & MSL FAC REED ALONZO B MASS ARMY A/E CONSTRUCTION...ARCHITECT/ENGINEER - GENERAL CONTRACTOR TOTAL OUADRA ENGINEERING INC ALASKA OCE ARCHITECT/ENGINEER - GENERAL QUINLIVAN PIERIK & KRAUSE MASS ARMY ARCHITECT

Functional Genomics of a Non-Toxic Alexandrium Lusitanicum Culture

DTIC Science & Technology

2007-02-01

OCE-0402707. This work was also supported by a graduate fellowship from the Fundacao para a Ciencia e Tecnologia , Portugal. Reproduction in whole or...that lead to this point. This work was supported by a graduate fellowship from the Fundaqa-o para a Ciencia e Tecnologia , Portugal. 3 4 TABLE OF...from the Fundaqo para a Ci~ncia e cultures (data not shown). It is therefore possible that the Tecnologia (FCT), Portugal. Funding provided in part

The Effect of Extremely Low Frequency Radiation on Human Performance: A Preliminary Study.

DTIC Science & Technology

1974-08-01

Medical Research Laboratory Prepared for: Bu,’eau of Medicine and Surgery August 1974 DISTRIBUTED BY: HIM National Technical Information Service U. S... NATIONAL TECHNICAL INFORMATION SERVICE US Nptdrslmr,iI .1 C.-In~oce SSpiiISIiold, VA. 72151 PRICES SUBJECI" TO CHARGE FORM IA7 (P’AGE I Unclassified701 DD...anecdotal evidence which attributes a rather ambiguously defined neurasthenic syndrome (general weakness, f,9tigue, laziness, sleepiness in daytime, etc

Environmental Impact Research Program: Visual Resources Assessment Procedure for US Army Corps of Engineers

DTIC Science & Technology

1988-03-01

32264. Technical Monitors were Dr. John Bushman and Mr. David P. Buelow, OCE, and Mr. Dave Mathis, Water Resources Support Center, Fort Belvoir, Va. The...Manager for EIRP was Dr. Roger T. Saucier. Dr. John Harrison was Chief, EL. The report was written by Dr. Smardon, Dr. Palmer, Mr. Knopf, Ms. Grinde...Riverfront area will continue. Historic Mill District projects and establishment of the Riverside Parkway System will further unify S the Riverfront

Reliability-Based Performance Assessment of Damaged Ships

DTIC Science & Technology

2006-10-01

37OR.A 2 AceI 2 oce 3 3C7R Main Deck Plan View at 9.906 metre STAA T~SIc ACCa IC 111 tI RO MAO ’ 2 0004 M 3O m 3 STORES) me 3 1 002~s STOR1 PfIS PlnVIS...Vol. 15, pp.7 4 -9 3 . Kaplan , M. Benatar, M., Bentson, J., Achtarides, T.A. (1984). "Analysis and assessment of major uncertainties associated with

Optimal Collision Avoidance Trajectories for Unmanned/Remotely Piloted Aircraft

DTIC Science & Technology

2014-12-26

projected operational tempos (OPTEMPOs)” [15]. The Oce of the Secretary of Defense (OSD) Unmanned Systems Roadmap [15] goes on to say that the airspace...methods [63]. In an indirect method, the researcher derives the first- order necessary conditions for optimality “via the calculus of variations and...region around the ownship using a variation of a superquadric. From [116], the standard equation for a superellipsoid appears as: ✓ x a1 ◆ 2 ✏ 2

An Evaluation of Selected Instruments used to Measure the Moisture Content of Hardened Concrete

DTIC Science & Technology

1976-02-01

Civil Works Investigation Engineering Studies Item ES 625 (now WU 31138 ). The study was authorized in October 1967 by OCE first indorsement of a WES...OF MEASUREMENT U PART I: INTRODUCTION 5 Background 5 Objective 6 Scope 6 PART II: MATERIALS, MIXTURE, TEST EQUIPMENT, AND...square inch Fahrenheit degrees M. 25.1+ 0.301+8 0.02831685 28.3H952 0.1+535921+ 0.006891+T5T 5 /9 To obtain millimetres metres cubic metres

The Defense Logistics Agency: Providing Logistics Support throughout the Department of Defense

DTIC Science & Technology

1993-10-01

agencies, as well as its engineer, ordnance, and transportation corps. 6 As the Navy and Army recovered from these losses, the dust seemed to settle, yet... transportation and packaging assis- tance, and surveillance of contractor progress to assure timely delivery of material. To streamline contract management in DOD...Ar Foce ktem Ironsr o Ohr.cloru•e. Aki F-oce Nmw Ciamfe. 1901), 11: and ds eracbd froro Headqueree De .. L ta iercy, Weapon Sys- •mppo f Pr•gwn tohy

2. Photographic copy of architectural elevations for Building 4505, Taylor ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. Photographic copy of architectural elevations for Building 4505, Taylor & Barnes, Architects & Engineers, 803 W. Third Street, Los Angeles California, O.C.E. Office of Civil Engineer Job No. A(9-10), Military Construction: Materiel Command Flight Test Base, Muroc, California, Hangar and Auxiliary Buildings: Hangar Type P-A, Exterior Elevations, Sheet No. 18, March 1944. Reproduced from the holdings of the National Archives, Pacific Southwest Region - Edwards Air Force Base, North Base, Hangar, End of North Base Road, Boron, Kern County, CA

Aquatic Plant Control Research Program. Feasibility of Relating Phenology and Carbohydrate Partitioning to Improve Aquatic Plant Control

DTIC Science & Technology

1988-07-01

Station (WES), Vicksburg, Miss. Technical Monitor for OCE was Mr. E. Carl Brown. The Principal Investigator for this study was Dr. Howard E. Westerdahl ...Brinson (1980) and Barko, Adams, and Clesceri (1986). Also, Westerdahl and Hall (1987) observed a dif- ferential response of hydrilla and watermilfoil to...treatment effect on carbohydrate levels of alligatorweed. Weed Science 16:66-69. Westerdahl , H. E., and J. F. Hall. 1987. Fluridone effects on stressed sub

1. Photographic copy of architectural plan for Building 4505, Taylor ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. Photographic copy of architectural plan for Building 4505, Taylor & Barnes, Architects & Engineers, 803 W. Third Street, Los Angeles California, O.C.E. Office of Civil Engineer Job No. A(9-10), Military Construction: Materiel Command Flight Test Base, Muroc, California, Hangar and Auxiliary Buildings: Hangar Type P-A, Floor Plan & Roof Plan, Sheet No. 16, March 1944. Reproduced from the holdings of the National Archives, Pacific Southwest Region - Edwards Air Force Base, North Base, Hangar, End of North Base Road, Boron, Kern County, CA

Development of an Adaptive Kalman Target Tracking Filter and Predictor for Fire Control Applications

DTIC Science & Technology

1977-03-01

future work in lite area of prefiltering. the author believcs that an even greater amount of data compression can be achieced by using simple data...TT~ KII~ OT’ WHE~ -TCAPNS1 7 TCKt4 ATQIx - lP.TKKI C F(N) - rTE-1jIl-rIC CO-OCING Vrf ’-Or - 1.FUT(K-1* C P(494E) - ERROP C0VT,’-C~ "ATTX - I’JPU1t-z/K

Elasticity imaging of speckle-free tissue regions with moving acoustic radiation force and phase-sensitive optical coherence tomography

NASA Astrophysics Data System (ADS)

Hsieh, Bao-Yu; Song, Shaozhen; Nguyen, Thu-Mai; Yoon, Soon Joon; Shen, Tueng; Wang, Ruikang; O'Donnell, Matthew

2016-03-01

Phase-sensitive optical coherence tomography (PhS-OCT) can be utilized for quantitative shear-wave elastography using speckle tracking. However, current approaches cannot directly reconstruct elastic properties in speckle-less or speckle-free regions, for example within the crystalline lens in ophthalmology. Investigating the elasticity of the crystalline lens could improve understanding and help manage presbyopia-related pathologies that change biomechanical properties. We propose to reconstruct the elastic properties in speckle-less regions by sequentially launching shear waves with moving acoustic radiation force (mARF), and then detecting the displacement at a specific speckle-generating position, or limited set of positions, with PhS-OCT. A linear ultrasound array (with a center frequency of 5 MHz) interfaced with a programmable imaging system was designed to launch shear waves by mARF. Acoustic sources were electronically translated to launch shear waves at laterally shifted positions, where displacements were detected by speckle tracking images produced by PhS-OCT operating in M-B mode with a 125-kHz A-line rate. Local displacements were calculated and stitched together sequentially based on the distance between the acoustic source and the detection beam. Shear wave speed, and the associated elasticity map, were then reconstructed based on a time-of-flight algorithm. In this study, moving-source shear wave elasticity imaging (SWEI) can highlight a stiff inclusion within an otherwise homogeneous phantom but with a CNR increased by 3.15 dB compared to a similar image reconstructed with moving-detector SWEI. Partial speckle-free phantoms were also investigated to demonstrate that the moving-source sequence could reconstruct the elastic properties of speckle-free regions. Results show that harder inclusions within the speckle-free region can be detected, suggesting that this imaging method may be able to detect the elastic properties of the crystalline lens.

Shear wave speed recovery in transient elastography and supersonic imaging using propagating fronts

NASA Astrophysics Data System (ADS)

McLaughlin, Joyce; Renzi, Daniel

2006-04-01

Transient elastography and supersonic imaging are promising new techniques for characterizing the elasticity of soft tissues. Using this method, an 'ultrafast imaging' system (up to 10 000 frames s-1) follows in real time the propagation of a low frequency shear wave. The displacement of the propagating shear wave is measured as a function of time and space. The objective of this paper is to develop and test algorithms whose ultimate product is images of the shear wave speed of tissue mimicking phantoms. The data used in the algorithms are the front of the propagating shear wave. Here, we first develop techniques to find the arrival time surface given the displacement data from a transient elastography experiment. The arrival time surface satisfies the Eikonal equation. We then propose a family of methods, called distance methods, to solve the inverse Eikonal equation: given the arrival times of a propagating wave, find the wave speed. Lastly, we explain why simple inversion schemes for the inverse Eikonal equation lead to large outliers in the wave speed and numerically demonstrate that the new scheme presented here does not have any large outliers. We exhibit two recoveries using these methods: one is with synthetic data; the other is with laboratory data obtained by Mathias Fink's group (the Laboratoire Ondes et Acoustique, ESPCI, Université Paris VII).

Monitoring Cartilage Tissue Engineering Using Magnetic Resonance Spectroscopy, Imaging, and Elastography

PubMed Central

Klatt, Dieter; Magin, Richard L.

2013-01-01

A key technical challenge in cartilage tissue engineering is the development of a noninvasive method for monitoring the composition, structure, and function of the tissue at different growth stages. Due to its noninvasive, three-dimensional imaging capabilities and the breadth of available contrast mechanisms, magnetic resonance imaging (MRI) techniques can be expected to play a leading role in assessing engineered cartilage. In this review, we describe the new MR-based tools (spectroscopy, imaging, and elastography) that can provide quantitative biomarkers for cartilage tissue development both in vitro and in vivo. Magnetic resonance spectroscopy can identify the changing molecular structure and alternations in the conformation of major macromolecules (collagen and proteoglycans) using parameters such as chemical shift, relaxation rates, and magnetic spin couplings. MRI provides high-resolution images whose contrast reflects developing tissue microstructure and porosity through changes in local relaxation times and the apparent diffusion coefficient. Magnetic resonance elastography uses low-frequency mechanical vibrations in conjunction with MRI to measure soft tissue mechanical properties (shear modulus and viscosity). When combined, these three techniques provide a noninvasive, multiscale window for characterizing cartilage tissue growth at all stages of tissue development, from the initial cell seeding of scaffolds to the development of the extracellular matrix during construct incubation, and finally, to the postimplantation assessment of tissue integration in animals and patients. PMID:23574498

Ability of Magnetic Resonance Elastography to Assess Taut Bands

PubMed Central

Chen, Qingshan; Basford, Jeffery; An, Kai-Nan

2008-01-01

Background Myofascial taut bands are central to diagnosis of myofascial pain. Despite their importance, we still lack either a laboratory test or imaging technique capable of objectively confirming either their nature or location. This study explores the ability of magnetic resonance elastography to localize and investigate the mechanical properties of myofascial taut bands on the basis of their effects on shear wave propagation. Methods This study was conducted in three phases. The first involved the imaging of taut bands in gel phantoms, the second a finite element modeling of the phantom experiment, and the third a preliminary evaluation involving eight human subjects-four of whom had, and four of whom did not have myofascial pain. Experiments were performed with a 1.5 Tesla magnetic resonance imaging scanner. Shear wave propagation was imaged and shear stiffness was reconstructed using matched filtering stiffness inversion algorithms. Findings The gel phantom imaging and finite element calculation experiments supported our hypothesis that taut bands can be imaged based on its outstanding shear stiffness. The preliminary human study showed a statistically significant 50-100% (p=0.01) increase of shear stiffness in the taut band regions of the involved subjects relative to that of the controls or in nearby uninvolved muscle. Interpretation This study suggests that magnetic resonance elastography may have a potential for objectively characterizing myofascial taut bands that have been up to now detectable only by the clinician's fingers. PMID:18206282

Noninvasive biomarkers in non-alcoholic fatty liver disease: Current status and a glimpse of the future

PubMed Central

Fitzpatrick, Emer; Dhawan, Anil

2014-01-01

The development of non invasive biomarkers of disease has become a major focus of interest in nonalcoholic fatty liver disease (NAFLD). The large prevalence of the disease and the invasive nature of the investigation means that screening with liver biopsy is impractical. In addition to screening, the differentiation of those with simple steatosis vs steatohepatitis and fibrosis is clinically important as the prognosis of each differs. Serum biomarkers may be a combination of simple markers derived from large data sets or direct markers of disease activity. Serum markers of inflammation, apoptosis and oxidative stress in addition to fibrosis have been extensively studied in patients with NAFLD. Other techniques such as transient elastography, magnetic resonance elastography and acoustic radiation force imaging are becoming more established as noninvasive methods of detecting fibrosis in a variety of chronic liver conditions in addition to NAFLD. Newer high throughput methods such as proteomics and glycomics allow the nonhypothesis-driven identification of novel markers and may also potentially contribute to our understanding of the pathogenesis of the condition. This review addresses some of the methodological issues which need to be considered in the search for the ideal biomarker. It is likely that a combination of serum biomarkers and techniques such as transient elastography may provide the optimal diagnostic discrimination however this remains to be proven in large studies. PMID:25152587

Characterization of benign thyroid nodules with HyperSPACE (Hyper Spectral Analysis for Characterization in Echography) before and after percutaneous laser ablation: a pilot study.

PubMed

Granchi, Simona; Vannacci, Enrico; Biagi, Elena

2017-04-22

To evaluate the capability of the HyperSPACE (Hyper SPectral Analysis for Characterization in Echography) method in tissue characterization, in order to provide information for the laser treatment of benign thyroid nodules in respect of conventional B-mode images and elastography. The method, based on the spectral analysis of the raw radiofrequency ultrasonic signal, was applied to characterize the nodule before and after laser treatment. Thirty patients (25 females and 5 males, age between 37 and 81 years) with thyroid benign nodule at cytology (Thyr 2) were evaluated by conventional ultrasonography, elastography, and HyperSPACE, before and after laser ablation. The images processed by HyperSPACE exhibit different color distributions that are referred to different tissue features. By calculating the percentages of the color coverages, the analysed nodules were subdivided into 3 groups. Each nodule belonging to the same group experienced, on average, similar necrosis extension. The nodules exhibit different Configurations (colors) distributions that could be indicative of the response of nodular tissue to the laser treatmentConclusions: HyperSPACEcan characterize benign nodules by providing additional information in respect of conventional ultrasound and elastography which is useful for support in the laser treatment of nodules in order to increase the probability of success.

Diagnosis and quantification of fibrosis, steatosis, and hepatic siderosis through multiparametric magnetic resonance imaging.

PubMed

Stoopen-Rometti, M; Encinas-Escobar, E R; Ramirez-Carmona, C R; Wolpert-Barraza, E; Kimura-Hayama, E; Sosa-Lozano, L A; Favila, R; Kimura-Fujikami, Y; Saavedra-Abril, J A; Loaeza-Del Castillo, A

The presence of liver fibrosis is the common denominator in numerous chronic liver diseases that can progress to fibrosis and hepatocellular carcinoma. Most important, with respect to frequency, are viral hepatitis and non-alcoholic fatty liver disease, the prevalence of which is increasing in epidemic proportions. Liver biopsy, albeit imperfect, continues to be the criterion standard, but in many clinical situations tends to be replaced with noninvasive imaging methods. The aim of the present article was to describe our imaging department experience with magnetic resonance elastography and to analyze and discuss recently published results in gastroenterology, hepatology, and radiology from other authors in the literature, complemented with a PubMed search covering the last 10 years. Magnetic resonance elastography is an efficacious, noninvasive method with results that are concordant with liver biopsy. It is superior to ultrasound elastography because it evaluates a much greater volume of hepatic tissue and shows the often heterogeneous lesion distribution. The greatest advantage of the magnetic resonance protocol described is the fact that it quantifies fibrosis, fat content, and iron content in the same 25min examination specifically directed for that purpose, resulting in a favorable cost-benefit ratio for the patient and/or institution. Copyright © 2016 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

Non-invasive measurement of liver and pancreas fibrosis in patients with cystic fibrosis.

PubMed

Friedrich-Rust, Mireen; Schlueter, Nina; Smaczny, Christina; Eickmeier, Olaf; Rosewich, Martin; Feifel, Kirstin; Herrmann, Eva; Poynard, Thierry; Gleiber, Wolfgang; Lais, Christoph; Zielen, Stefan; Wagner, Thomas O F; Zeuzem, Stefan; Bojunga, Joerg

2013-09-01

Patients with cystic fibrosis (CF) have a relevant morbidity and mortality caused by CF-related liver-disease. While transient elastography (TE) is an established elastography method in hepatology centers, Acoustic-Radiation-Force-Impulse (ARFI)-Imaging is a novel ultrasound-based elastography method which is integrated in a conventional ultrasound-system. The aim of the present study was to evaluate the prevalence of liver-fibrosis in patients with CF using TE, ARFI-imaging and fibrosis blood tests. 106 patients with CF were prospectively included in the present study and received ARFI-imaging of the left and right liver-lobe, ARFI of the pancreas TE of the liver and laboratory evaluation. The prevalence of liver-fibrosis according to recently published best practice guidelines for CFLD was 22.6%. Prevalence of significant liver-fibrosis assessed by TE, ARFI-right-liver-lobe, ARFI-left-liver-lobe, Fibrotest, Fibrotest-corrected-by-haptoglobin was 17%, 24%, 40%, 7%, and 16%, respectively. The best agreement was found for TE, ARFI-right-liver-lobe and Fibrotest-corrected-by-haptoglobin. Patients with pancreatic-insufficiency had significantly lower pancreas-ARFI-values as compared to patients without. ARFI-imaging and TE seem to be promising non-invasive methods for detection of liver-fibrosis in patients with CF. Copyright © 2013 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Sono-elastography for Differentiating Benign and Malignant Cervical Lymph Nodes: A Systematic Review and Meta-Analysis

PubMed Central

Ghajarzadeh, Mahsa; Mohammadifar, Mehdi; Azarkhish, Kamran; Emami-Razavi, Seyed Hassan

2014-01-01

We did this systematic review to determine diagnostic accuracy of sono-elastography in evaluating cervical lymph nodes (LNs). A highly sensitive search for sono-elastography and LNs was performed in MEDLINE, Cochrane Library, ACP Journal Club, EMBASE, Health Technology assessment, and ISI web of knowledge for studies published prior to December 2012. SPSS version 18 (SPSS Inc., Chicago, IL, USA) used for descriptive analysis and meta-disk version 1.4 applied for meta-analysis. Forest plots for pooled estimates and summery of receiver operating characteristic plots for different cut-offs were produced. The literature and manual search yielded 69 articles, of which 10 were eligible to include. A total of 578 individuals with a total number of 936 cervical LNs was evaluated (502 malignant and 434 benign). The summary sensitivity of the scoring and strain ratio (SR) measurements for the differentiation of benign and malignant LNs were 0.76 (95% CI: 0.71–0.8) and 0.83 (95% CI: 0.78–0.87). The summary specificities were 0.8 (95% confidence interval [CI]: 0.75–0.84) and 0.84 (95% CI: 0.79–0.88), respectively. Area under the curve for scoring system was 0.86 (standard error [SE] = 0.03) and 0.95 (SE = 0.02) for SR measurement. Sono-elastograohy has high accuracy in differentiating benign and malignant cervical LNs. PMID:25709787

In vivo, high-frequency three-dimensional cardiac MR elastography: Feasibility in normal volunteers.

PubMed

Arani, Arvin; Glaser, Kevin L; Arunachalam, Shivaram P; Rossman, Phillip J; Lake, David S; Trzasko, Joshua D; Manduca, Armando; McGee, Kiaran P; Ehman, Richard L; Araoz, Philip A

2017-01-01

Noninvasive stiffness imaging techniques (elastography) can image myocardial tissue biomechanics in vivo. For cardiac MR elastography (MRE) techniques, the optimal vibration frequency for in vivo experiments is unknown. Furthermore, the accuracy of cardiac MRE has never been evaluated in a geometrically accurate phantom. Therefore, the purpose of this study was to determine the necessary driving frequency to obtain accurate three-dimensional (3D) cardiac MRE stiffness estimates in a geometrically accurate diastolic cardiac phantom and to determine the optimal vibration frequency that can be introduced in healthy volunteers. The 3D cardiac MRE was performed on eight healthy volunteers using 80 Hz, 100 Hz, 140 Hz, 180 Hz, and 220 Hz vibration frequencies. These frequencies were tested in a geometrically accurate diastolic heart phantom and compared with dynamic mechanical analysis (DMA). The 3D Cardiac MRE was shown to be feasible in volunteers at frequencies as high as 180 Hz. MRE and DMA agreed within 5% at frequencies greater than 180 Hz in the cardiac phantom. However, octahedral shear strain signal to noise ratios and myocardial coverage was shown to be highest at a frequency of 140 Hz across all subjects. This study motivates future evaluation of high-frequency 3D MRE in patient populations. Magn Reson Med 77:351-360, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Power strain imaging based on vibro-elastography techniques

NASA Astrophysics Data System (ADS)

Wen, Xu; Salcudean, S. E.

2007-03-01

This paper describes a new ultrasound elastography technique, power strain imaging, based on vibro-elastography (VE) techniques. With this method, tissue is compressed by a vibrating actuator driven by low-pass or band-pass filtered white noise, typically in the 0-20 Hz range. Tissue displacements at different spatial locations are estimated by correlation-based approaches on the raw ultrasound radio frequency signals and recorded in time sequences. The power spectra of these time sequences are computed by Fourier spectral analysis techniques. As the average of the power spectrum is proportional to the squared amplitude of the tissue motion, the square root of the average power over the range of excitation frequencies is used as a measure of the tissue displacement. Then tissue strain is determined by the least squares estimation of the gradient of the displacement field. The computation of the power spectra of the time sequences can be implemented efficiently by using Welch's periodogram method with moving windows or with accumulative windows with a forgetting factor. Compared to the transfer function estimation originally used in VE, the computation of cross spectral densities is not needed, which saves both the memory and computational times. Phantom experiments demonstrate that the proposed method produces stable and operator-independent strain images with high signal-to-noise ratio in real time. This approach has been also tested on a few patient data of the prostate region, and the results are encouraging.

Transient micro-elastography: A novel non-invasive approach to measure liver stiffness in mice

PubMed Central

Bastard, Cécile; Bosisio, Matteo R; Chabert, Michèle; Kalopissis, Athina D; Mahrouf-Yorgov, Meriem; Gilgenkrantz, Hélène; Mueller, Sebastian; Sandrin, Laurent

2011-01-01

AIM: To develop and validate a transient micro-elastography device to measure liver stiffness (LS) in mice. METHODS: A novel transient micro-elastography (TME) device, dedicated to LS measurements in mice with a range of measurement from 1-170 kPa, was developed using an optimized vibration frequency of 300 Hz and a 2 mm piston. The novel probe was validated in a classical fibrosis model (CCl4) and in a transgenic murine model of systemic amyloidosis. RESULTS: TME could be successfully performed in control mice below the xiphoid cartilage, with a mean LS of 4.4 ± 1.3 kPa, a mean success rate of 88%, and an excellent intra-observer agreement (0.98). Treatment with CCl4 over seven weeks drastically increased LS as compared to controls (18.2 ± 3.7 kPa vs 3.6 ± 1.2 kPa). Moreover, fibrosis stage was highly correlated with LS (Spearman coefficient = 0.88, P < 0.01). In the amyloidosis model, much higher LS values were obtained, reaching maximum values of > 150 kPa. LS significantly correlated with the amyloidosis index (0.93, P < 0.0001) and the plasma concentration of mutant hapoA-II (0.62, P < 0.005). CONCLUSION: Here, we have established the first non-invasive approach to measure LS in mice, and have successfully validated it in two murine models of high LS. PMID:21448348

Sono-elastography for Differentiating Benign and Malignant Cervical Lymph Nodes: A Systematic Review and Meta-Analysis.

PubMed

Ghajarzadeh, Mahsa; Mohammadifar, Mehdi; Azarkhish, Kamran; Emami-Razavi, Seyed Hassan

2014-12-01

We did this systematic review to determine diagnostic accuracy of sono-elastography in evaluating cervical lymph nodes (LNs). A highly sensitive search for sono-elastography and LNs was performed in MEDLINE, Cochrane Library, ACP Journal Club, EMBASE, Health Technology assessment, and ISI web of knowledge for studies published prior to December 2012. SPSS version 18 (SPSS Inc., Chicago, IL, USA) used for descriptive analysis and meta-disk version 1.4 applied for meta-analysis. Forest plots for pooled estimates and summery of receiver operating characteristic plots for different cut-offs were produced. The literature and manual search yielded 69 articles, of which 10 were eligible to include. A total of 578 individuals with a total number of 936 cervical LNs was evaluated (502 malignant and 434 benign). The summary sensitivity of the scoring and strain ratio (SR) measurements for the differentiation of benign and malignant LNs were 0.76 (95% CI: 0.71-0.8) and 0.83 (95% CI: 0.78-0.87). The summary specificities were 0.8 (95% confidence interval [CI]: 0.75-0.84) and 0.84 (95% CI: 0.79-0.88), respectively. Area under the curve for scoring system was 0.86 (standard error [SE] = 0.03) and 0.95 (SE = 0.02) for SR measurement. Sono-elastograohy has high accuracy in differentiating benign and malignant cervical LNs.

Effect of Calcifications on Breast Ultrasound Shear Wave Elastography: An Investigational Study.

PubMed

Gregory, Adriana; Mehrmohammadi, Mohammad; Denis, Max; Bayat, Mahdi; Stan, Daniela L; Fatemi, Mostafa; Alizad, Azra

2015-01-01

To investigate the effects of macrocalcifications and clustered microcalcifications associated with benign breast masses on shear wave elastography (SWE). SuperSonic Imagine (SSI) and comb-push ultrasound shear elastography (CUSE) were performed on three sets of phantoms to investigate how calcifications of different sizes and distributions influence measured elasticity. To demonstrate the effect in vivo, three female patients with benign breast masses associated with mammographically-identified calcifications were evaluated by CUSE. Apparent maximum elasticity (Emax) estimates resulting from individual macrocalcifications (with diameters of 2mm, 3mm, 5mm, 6mm, 9mm, 11mm, and 15mm) showed values over 50 kPa for all cases, which represents more than 100% increase over background (~21kPa). We considered a 2cm-diameter circular region of interest for all phantom experiments. Mean elasticity (Emean) values varied from 26 kPa to 73 kPa, depending on the macrocalcification size. Highly dense clusters of microcalcifications showed higher Emax values than clusters of microcalcification with low concentrations, but the difference in Emean values was not significant. Our results demonstrate that the presence of large isolated macrocalcifications and highly concentrated clusters of microcalcifications can introduce areas with apparent high elasticity in SWE. Considering that benign breast masses normally have significantly lower elasticity values than malignant tumors, such areas with high elasticity appearing due to presence of calcification in benign breast masses may lead to misdiagnosis.

Diagnostic Criteria and Accuracy of Categorizing Malignant Thyroid Nodules by Ultrasonography and Ultrasound Elastography with Pathologic Correlation.

PubMed

Elsayed, Naglaa Mostafa; Elkhatib, Yasser Atta

2016-03-01

Thyroid nodules are a common medical and surgical concern. Thyroid ultrasound (US) is the primary imaging modality used for initial evaluation and assortment of nodules for fine needle aspiration (FNA) cytology/biopsy. Ultrasound elastography (USE) is believed to improve the diagnostic accuracy of US in distinguishing benign from malignant nodules. The aim of the work described here is to evaluate the diagnostic criteria and accuracy of US and USE in the diagnosis of malignant thyroid nodules. A prospective study of 88 patients who have thyroid nodules was performed. US, color Doppler, and USE were evaluated using a Philips iU22 equipped with a 5 to 12 MHz, linear transducer, followed by FNA of the each scanned nodule. The most sensitive US criteria for malignant nodules were a height-to-width ratio greater than one and the absence of a halo sign (sensitivity 0.875% and 1.000%, respectively). The most specific criteria for malignancy were a spiculated/blurred margin and the presence of microcalcifications (specificity 0.968% and 0.888%, respectively). The receiver operating characteristic curve showed that the cutoff diagnostic criteria of malignancy are two US characteristics and an elastography score of 4. The diagnostic accuracy of US for malignant thyroid nodules increases by combining US and USE. © The Author(s) 2015.

Modulus reconstruction from prostate ultrasound images using finite element modeling

NASA Astrophysics Data System (ADS)

Yan, Zhennan; Zhang, Shaoting; Alam, S. Kaisar; Metaxas, Dimitris N.; Garra, Brian S.; Feleppa, Ernest J.

2012-03-01

In medical diagnosis, use of elastography is becoming increasingly more useful. However, treatments usually assume a planar compression applied to tissue surfaces and measure the deformation. The stress distribution is relatively uniform close to the surface when using a large, flat compressor but it diverges gradually along tissue depth. Generally in prostate elastography, the transrectal probes used for scanning and compression are cylindrical side-fire or rounded end-fire probes, and the force is applied through the rectal wall. These make it very difficult to detect cancer in prostate, since the rounded contact surfaces exaggerate the non-uniformity of the applied stress, especially for the distal, anterior prostate. We have developed a preliminary 2D Finite Element Model (FEM) to simulate prostate deformation in elastography. The model includes a homogeneous prostate with a stiffer tumor in the proximal, posterior region of the gland. A force is applied to the rectal wall to deform the prostate, strain and stress distributions can be computed from the resultant displacements. Then, we assume the displacements as boundary condition and reconstruct the modulus distribution (inverse problem) using linear perturbation method. FEM simulation shows that strain and strain contrast (of the lesion) decrease very rapidly with increasing depth and lateral distance. Therefore, lesions would not be clearly visible if located far away from the probe. However, the reconstructed modulus image can better depict relatively stiff lesion wherever the lesion is located.

Imaging mechanical properties of hepatic tissue by magnetic resonance elastography

NASA Astrophysics Data System (ADS)

Yin, Meng; Rouviere, Olivier; Burgart, Lawrence J.; Fidler, Jeff L.; Manduca, Armando; Ehman, Richard L.

2006-03-01

PURPOSE: To assess the feasibility of a modified phase-contrast MRI technique (MR Elastography) for quantitatively assessing the mechanical properties of hepatic tissues by imaging propagating acoustic shear waves. MATERIALS AND METHODS: Both phantom and human studies were performed to develop and optimize a practical imaging protocol by visualizing and investigating the diffraction field of shear waves generated from pneumatic longitudinal drivers. The effects of interposed ribs in a transcostal approach were also investigated. A gradient echo MRE pulse sequence was adapted for shear wave imaging in the liver during suspended respiration, and then tested to measure hepatic shear stiffness in 13 healthy volunteers and 1 patient with chronic liver disease to determine the potential of non-invasively detecting liver fibrosis. RESULTS: Phantom studies demonstrate that longitudinal waves generated by the driver are mode-converted to shear waves in a distribution governed by diffraction principles. The transcostal approach was determined to be the most effective method for generating shear waves in human studies. Hepatic stiffness measurements in the 13 normal volunteers demonstrated a mean value of 2.0+/-0.2kPa. The shear stiffness measurement in the patient was much higher at 8.5kPa. CONCLUSION: MR Elastography of the liver shows promise as a method to non-invasively detect and characterize diffuse liver disease, potentially reducing the need for biopsy to diagnose hepatic fibrosis.