Elastography: modality-specific approaches, clinical applications, and research horizons

Manual palpation has been used for centuries to provide a relative indication of tissue health and disease. Engineers have sought to make these assessments increasingly quantitative and accessible within daily clinical practice. Since many of the developed techniques involve image-based quantification of tissue deformation in response to an applied force (i.e., "elastography”), such approaches fall squarely within the domain of the radiologist. While commercial elastography analysis software is becoming increasingly available for clinical use, the internal workings of these packages often remain a "black box,” with limited guidance on how to usefully apply the methods toward a meaningful diagnosis. The purpose of the present review article is to introduce some important approaches to elastography that have been developed for the most widely used clinical imaging modalities (e.g., ultrasound, MRI), to provide a basic sense of the underlying physical principles, and to discuss both current and potential (musculoskeletal) applications. The article also seeks to provide a perspective on emerging approaches that are rapidly developing in the research laboratory (e.g., optical coherence tomography, fibered confocal microscopy), and which may eventually gain a clinical foothol

3D Ultrafast Shear Wave Absolute Vibro-Elastography using a Matrix Array Transducer

3D ultrasound imaging provides more spatial information compared to conventional 2D frames by considering the volumes of data. One of the main bottlenecks of 3D imaging is the long data acquisition time which reduces practicality and can introduce artifacts from unwanted patient or sonographer motion. This paper introduces the first shear wave absolute vibro-elastography (S-WAVE) method with real-time volumetric acquisition using a matrix array transducer. In SWAVE, an external vibration source generates mechanical vibrations inside the tissue. The tissue motion is then estimated and used in solving a wave equation inverse problem to provide the tissue elasticity. A matrix array transducer is used with a Verasonics ultrasound machine and frame rate of 2000 volumes/s to acquire 100 radio frequency (RF) volumes in 0.05 s. Using plane wave (PW) and compounded diverging wave (CDW) imaging methods, we estimate axial, lateral and elevational displacements over 3D volumes. The curl of the displacements is used with local frequency estimation to estimate elasticity in the acquired volumes. Ultrafast acquisition extends substantially the possible S-WAVE excitation frequency range, now up to 800 Hz, enabling new tissue modeling and characterization. The method was validated on three homogeneous liver fibrosis phantoms and on four different inclusions within a heterogeneous phantom. The homogeneous phantom results show less than 8% (PW) and 5% (CDW) difference between the manufacturer values and the corresponding estimated values over a frequency range of 80 Hz to 800 Hz. The estimated elasticity values for the heterogeneous phantom at 400 Hz excitation frequency show average errors of 9% (PW) and 6% (CDW) compared to the provided average values by MRE. Furthermore, both imaging methods were able to detect the inclusions within the elasticity volumes

Magnetic resonance elastography (MRE) of the human brain: technique, findings and clinical applications

Neurological disorders are one of the most important public health concerns in developed countries. Established brain imaging techniques such as magnetic resonance imaging (MRI) and x-ray computerised tomography (CT) have been essential in the identification and diagnosis of a wide range of disorders, although usually are insufficient in sensitivity for detecting subtle pathological alterations to the brain prior to the onset of clinical symptoms—at a time when prognosis for treatment is more favourable. The mechanical properties of biological tissue provide information related to the strength and integrity of the cellular microstructure. In recent years, mechanical properties of the brain have been visualised and measured non-invasively with magnetic resonance elastography (MRE), a particularly sensitive medical imaging technique that may increase the potential for early diagnosis. This review begins with an introduction to the various methods used for the acquisition and analysis of MRE data. A systematic literature search is then conducted to identify studies that have specifically utilised MRE to investigate the human brain. Through the conversion of MRE-derived measurements to shear stiffness (kPa) and, where possible, the loss tangent (rad), a summary of results for global brain tissue and grey and white matter across studies is provided for healthy participants, as potential baseline values to be used in future clinical investigations. In addition, the extent to which MRE has revealed significant alterations to the brain in patients with neurological disorders is assessed and discussed in terms of known pathophysiology. The review concludes by predicting the trends for future MRE research and applications in neuroscience

Modes of shear wave in magnetic resonance elastography

Cataloged from PDF version of article.Manual palpation is used for diagnosing change in stiffness of tissues, due to a pathological state. Unfortunately, this diagnosis tool is limited with organs close to the surface of the body. Magnetic resonance elastography (MRE), also known as palpation by magnetic resonance imaging (MRI), can be used in detecting changes in material properties of the heart, liver, muscle, breast and brain. Alteration in stiffness of tissues can be detected by MRE, by simply measuring the wavelength of the induced shear wave by the actuator, from the phase difference images obtained by MR scanner. In addition to wavelength information, dependence of shear wave displacement amplitude to the frequency and excitation direction carry important information about material properties of the tissue. Modes of shear waves in MRE have not been studied previously. Change in material properties of the tissue, may affect modes of shear waves in MRE. Hence, a shift in natural frequencies may indicate a pathological state in the tissue. We propose a novel method to detect change in stiffness of tissues, by analyzing modes of shear waves and detecting frequency shift in peak displacement of shear waves in MRE. Eigenfrequency simulations are computed for a simple geometric object whose eigenfrequencies are known analytically. Validating simulation results with theoretical values, we are encouraged to continue with eigenfrequency analysis of the brain model. For different directions of motions of head, it is demonstrated by eigenfrequency analysis that brain has modes at certain frequencies. Results of frequency domain analysis indicates that modes of shear waves can be observed in brain by exciting head at its eigenfrequencies with correct excitation in that frequency. Results of frequency domain analysis repeated for neurodegenerative brain model are compared with the findings in healthy brain model. Comparing frequencies of peak displacements in neurodegenerative and healthy model, a constant frequency shift is observed in all frequencies of peak displacements. Preliminary results of modes of shear waves in brain MRE are presented, by sweeping mechanical excitation frequency. This method can be used in detecting change in stiffness of tissues for diagnosing diseases by observing shift in frequency of peak displacement and be beneficial for patient follow-up.Arıyürek, CemreM.S

A 64-channel personal computer based image reconstruction system and applications in single echo acquisition magnetic resonance elastography and ultra-fast magnetic resonance imaging.

Emerging technologies in parallel magnetic resonance imaging (MRI) with massive receiver arrays have paved the way for ultra-fast imaging at increasingly high frame rates. With the increase in the number of receiver channels used to implement parallel imaging techniques, there is a corresponding increase in the amount of data that needs to be processed, slowing down the process of image reconstruction. To develop a complete reconstruction system which is easy to assemble in a single computer for a real-time rendition of images is a relevant challenge demanding dedicated resources for high speed digital data transfer and computation. We have enhanced a 64 channel parallel receiver system designed for single echo acquisition (SEA) MRI into a real-time imaging system by interfacing it with two commercially available digital signal processor (DSP) boards which are capable of transferring large amounts of digital data via a dedicated bus from two high performance digitizer boards. The resulting system has been used to demodulate raw image data in real-time data and store them at rates of 200 frames per second (fps) and subsequently display the processed data at rates of 26 fps. A further interest in realtime reconstruction techniques is to reduce the data handling issues. Novel ways to minimize the digitized data are presented using reduced sampling rate techniques. The proposed techniques reduce the amount of data generated by a factor of 5 without compromising the SNR and with no additional hardware. Finally, the usability of this tool is demonstrated by investigating fast imaging applications. Of particular interest among them are MR elastography applications. An exploratory study of SEA MRE was done to study the temperature dependency of shear stiffness in an agarose gel and the results correlate well with existing literature. With the ability to make MRE images in a single echo, the SEA MRE technique has an advantage over the conventional MRE techniques

Evaluierung von Rekonstruktionsalgorithmen für die Magnetresonanz-Elastographie (MRE)

Magnetresonanzelastographie (MRE) ist eine neue Methode, mit der Magnetresonanztomographie nicht invasiv die Elastizität menschlichen Gewebes zu messen. Die Palpation zeigt, wie wichtig eine Abschätzung von Elastizitätsunterschieden für die Diagnostik sein kann. Ziel der MRE ist es, Elastogramme zur Diagnose bereitzustellen. Elastogramme sind Bilder, die in jedem Bildpunkt die Elastizität des Gewebes zeigen, in dem die ursprünglichen Bilddaten mit dem Magnetresonanztomographen akquiriert wurden. Dazu wird eine Bildakquisitionsmethode benutzt, die Bewegungen im Gewebe misst. Mechanische Wellen werden mit einem Schwingungsgenerator von außen über die Haut in das darunter liegende Gewebe induziert, was eine Schwingung der Wasserstoffprotonen verursacht, die durch Wechselwirkung mit den Magnetfeldern des Tomographen die zu messenden Signale generieren. Diese Schwingungen und dadurch bedingte Wellenausbreitungen können den Bilddaten durch Nachverarbeitung entnommen werden. Aus diesen Daten wiederum können dann Elastizitätsverteilungen bzw. Elastogramme rekonstruiert werden. Der Aufbau einer solchen Untersuchung bedarf der Steuerung einer mechanischen Anregung, welche mit dem Bildgebungsvorgang synchronisiert ist. Die Ergebnisse von MRE-Untersuchungen in Phantomen, der Skelettmuskulatur, des Hirns und der Haut mit dem beschriebenen System zeigen, dass MRE in den entsprechenden Regionen des Körpers Elastizitätsmessungen ermöglicht. Weiterhin werden Rekonstruktionsalgorithmen für die Berechnung von Elastogrammen vorgestellt, auf die Bilddaten der genannten Untersuchungen angewendet und evaluiert. Es zeigt sich, dass zur Rekonstruktion der Daten physikalische Eigenschaften angenommen werden müssen, die das menschliche Gewebe nicht realistisch beschreiben. Anhand der Evaluierung der Rekonstruktionsmethoden der MRE-Daten zeigt sich, dass aber gerade für die Rekonstruktion noch Forschungsbedarf besteht, um auch die Zuverlässigkeit des Verfahrens garantieren zu können, die für eine diagnostische Beurteilung notwendig ist. Dennoch lassen sich Elastizitätsverteilungen visualisieren, so dass die Aussagekraft der Elastograme mit statistischen Auswertungen von MRE-Untersuchungen mit einer großen Anzahl Patienten überprüft werden muss. Die MRE verspricht, eine Möglichkeit zu bieten, Krankheiten, die Elastizitätsänderungen verursachen, zu identifizieren und deren Verlauf zu verfolgen

QUANTITATIVE ELASTICITY IMAGING AND SOFT TISSUE CHARACTERIZATION USING TAGGED MAGNETIC RESONANCE IMAGING

Ph.DDOCTOR OF PHILOSOPH

Level Set Methods for MRE Image Processing and Analysis

Ph.DDOCTOR OF PHILOSOPH

Développement et évaluation des paramètres quantitatifs de l’IRM de la prostate

The purpose of this thesis is to develop and evaluate the quantitative methods of multiparametric MRI of prostate in discriminating Gleason score (GS) ≥7 cancers. We suppose that the quantitative parameter of MRI could help standardizer the diagnostic, reduce the inter-lecture and/ or inter-institution variation in diagnostic of prostate cancer. This thesis is divided into three chapters. The firs chapter, entilted « Quantitative T2 MRI of prostate » is a retrospective study on a database of prostate cancer patients before radical prostatectomy. The second chapter, entilted « Multi-parametric Quantitative MRI of prostate » is also a retrospective study before radical prostatectomy. The third chapter, entitled « MR elastography of prostate by transperineal approach », is an experimental study. Our first study shows that T2 value is robust between machines of different constructors. T2 value is significant predictor, but of weak performance, of aggressively cancer of prostate at 3T. Our second study shows that the combination of ADC_10th percentile with Time-to-peak (TTP) improved the diagnosis performance, and this model is also robust between two machines of different constructors. Our third study shows the initial results on elasticity of the prostate. These results show that MRI elastography of prostate at high excitation frequency (>100 Hz) by trans-perineale approach was feasible. The elastography may, in the future, be integrated in quantitative multi-parametric MRI to improve the diagnosis performanceL'objectif de cette thèse est de développer et d'évaluer des paramètres quantitatifs de l'IRM de la prostate en discriminant les cancers de score de Gleason (GS) ≥7. Nous supposons que les paramètres quantitatifs de l'IRM pourraient aider à standardiser le diagnostic, et à diminuer la variation inter-lecteur et/ou inter-institution du diagnostic du cancer de la prostate. Cette thèse est divisée en trois chapitres. Le premier chapitre, intitulé « IRM T2 quantitatif de la prostate », est une étude rétrospective sur une base de données des patients avant prostatectomie radicale. Le deuxième chapitre, intitulé « IRM multiparamétrique quantitative de la prostate », est aussi une étude rétrospective avant prostatectomie radicale. Le troisième chapitre, intitulé « Élastographie IRM de la prostate par voie trans-périnéale» est une étude expérimentale. Notre première étude montre que le T2 est robuste sur les machines de constructeurs différents. Le T2 est un prédicteur significatif, mais de faible performance, d'agressivité du cancer de la prostate à 3T. Notre deuxième étude montre que la combinaison du 10ème centile de l'ADC avec le Time-topeak (TTP) améliore la performance du diagnostic, et ce modèle est lui aussi robuste entre des machines de constructeurs différents. Notre troisième étude montre les résultats préliminaires sur l'élasticité de la prostate. Ces résultats montrent que l'élastographie IRM de la prostate en haute fréquence d'excitation (>100 Hz) par voie trans-périnéale est faisable. L'élastographie pourrait à l'avenir être intégrée à l'IRM multiparamétrique quantitative pour améliorer la performance de diagnosti

Development and Application of New Methods for Magnetic Resonance Elastography of the Brain

Accurate mechanical properties of the intact, living brain are essential for modeling traumatic brain injury (TBI). However, the properties of brain tissue in vivo have traditionally been measured in ex vivo samples. Magnetic resonance elastography (MRE) can be used to measure motion and estimate material properties of soft tissues in vivo, but MRE typically assumes tissue isotropy and homogeneity. The objective of this thesis is to improve MRE of soft tissue, like the brain, by developing and evaluating methods for in vivo estimation of heterogeneous, anisotropic properties. This was achieved through pursuit of the following aims: (1) quantifying the differences between in vivo and ex vivo brain tissue, thereby clarifying the need for in vivo measurements; (2) introducing and applying a new approach to anisotropic MRE, using data obtained during external actuation of the porcine brain in vivo, which highlighted the need for new actuation methods; and (3) developing and evaluating a method for anisotropic property estimation using MRE with actuation by harmonic focused ultrasound (FUS). This research has led to new methods for anisotropic MRE, and improved material property estimates of the brain and other soft tissues