Deep Learning for High Speed Optical Coherence Elastography

Mechanical properties of tissue provide valuable information for identifying lesions. One approach to obtain quantitative estimates of elastic properties is shear wave elastography with optical coherence elastography (OCE). However, given the shear wave velocity, it is still difficult to estimate elastic properties. Hence, we propose deep learning to directly predict elastic tissue properties from OCE data. We acquire 2D images with a frame rate of 30 kHz and use convolutional neural networks to predict gelatin concentration, which we use as a surrogate for tissue elasticity. We compare our deep learning approach to predictions from conventional regression models, using the shear wave velocity as a feature. Mean absolut prediction errors for the conventional approaches range from 1.32$\pm$0.98 p.p. to 1.57$\pm$1.30 p.p. whereas we report an error of 0.90$\pm$0.84 p.p for the convolutional neural network with 3D spatio-temporal input. Our results indicate that deep learning on spatio-temporal data outperforms elastography based on explicit shear wave velocity estimation.Comment: Accepted at IEEE International Symposium on Biomedical Imaging 202

Elastic waves in a soft electrically conducting solid in a strong magnetic field

Shear wave motion of a soft, electrically-conducting solid in the presence of a strong magnetic field excites eddy currents in the solid. These, in turn, give rise to Lorentz forces that resist the wave motion. We derive a mathematical model for linear elastic wave propagation in a soft electrically conducting solid in the presence of a strong magnetic field. The model reduces to an effective anisotropic dissipation term resembling an anisotropic viscous foundation. The application to magnetic resonance elastography, which uses strong magnetic fields to measure shear wave speed in soft tissues for diagnostic purposes, is considered

Ultrasound shear wave elastography for liver disease. A critical appraisal of the many actors on the stage

In the last 12\u200a-\u200a18 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(\uae) 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(\uae), 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\u200acm 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\u200acm from the skin. This technology was the first to be implemented in a conventional ultrasound scanner by Siemens(\uae) 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(\uae) 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\u200a-\u200a3\u200acm 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\u200a-\u200a2 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(\uae), but which is still awaiting validation in the literature.Supersonic Imagine by Aixplorer(\uae) which works with a different modality of insonation and video analysis compared to the the previously-mentioned three techniques (i.\u200ae., transient elastography, pSWE and 2D-SWE), leading to a bidimensional assessment of liver stiffness in real time up to 5\u200aHz and in larger regions; thus this technique is also termed real-time 2\u200aD 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(\uae) 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. \ub7 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.\u200ag. 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\u200a-\u200a3 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.. \ub7 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.. \ub7 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\uae, 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.. \ub7 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

Spring-damper equivalents of the fractional, poroelastic, and poroviscoelastic models for elastography

In MR elastography it is common to use an elastic model for the tissue's response in order to properly interpret the results. More complex models such as viscoelastic, fractional viscoelastic, poroelastic, or poroviscoelastic ones are also used. These models appear at first sight to be very different, but here it is shown that they all may be expressed in terms of elementary viscoelastic models. For a medium expressed with fractional models, many elementary spring-damper combinations are added, each of them weighted according to a long-tailed distribution, hinting at a fractional distribution of time constants or relaxation frequencies. This may open up for a more physical interpretation of the fractional models. The shear wave component of the poroelastic model is shown to be modeled exactly by a three-component Zener model. The extended poroviscoelastic model is found to be equivalent to what is called a non-standard four-parameter model. Accordingly, the large number of parameters in the porous models can be reduced to the same number as in their viscoelastic equivalents. As long as the individual displacements from the solid and fluid parts cannot be measured individually the main use of the poro(visco)elastic models is therefore as a physics based method for determining parameters in a viscoelastic model.Comment: 11 pages, 7 figures. Changed inconsistent notation in Eqs 1, 5, 8, 10 and corrected mistakes in Eqs 2, 4, 12, 3

Shear waves in prestrained poroelastic media

Shear wave elastography measures shear wave speed in soft tissues for diagnostic purposes. In [1], shear wave speed was shown to depend on prestrain, but not necessarily prestress, in a perfused canine liver. We model this phenomenon by examining incremental waves in a pressurized poroelastic medium with incompressible phases. The analysis suggests novel restrictions on the strain energy functions for soft tissues

Influence of wall thickness and diameter on arterial shear wave elastography: a phantom and finite element study

Quantitative, non-invasive and local measurements of arterial mechanical properties could be highly beneficial for early diagnosis of cardiovascular disease and follow up of treatment. Arterial shear wave elastography (SWE) and wave velocity dispersion analysis have previously been applied to measure arterial stiffness. Arterial wall thickness (h) and inner diameter (D) vary with age and pathology and may influence the shear wave propagation. Nevertheless, the effect of arterial geometry in SWE has not yet been systematically investigated. In this study the influence of geometry on the estimated mechanical properties of plates (h = 0.5–3 mm) and hollow cylinders (h = 1, 2 and 3 mm, D = 6 mm) was assessed by experiments in phantoms and by finite element method simulations. In addition, simulations in hollow cylinders with wall thickness difficult to achieve in phantoms were performed (h = 0.5–1.3 mm, D = 5–8 mm). The phase velocity curves obtained from experiments and simulations were compared in the frequency range 200–1000 Hz and showed good agreement (R2 = 0.80 ± 0.07 for plates and R2 = 0.82 ± 0.04 for hollow cylinders). Wall thickness had a larger effect than diameter on the dispersion curves, which did not have major effects above 400 Hz. An underestimation of 0.1–0.2 mm in wall thickness introduces an error 4–9 kPa in hollow cylinders with shear modulus of 21–26 kPa. Therefore, wall thickness should correctly be measured in arterial SWE applications for accurate mechanical properties estimation

Viscoelastic modulus reconstruction using time harmonic vibrations

This paper presents a new iterative reconstruction method to provide high-resolution images of shear modulus and viscosity via the internal measurement of displacement fields in tissues. To solve the inverse problem, we compute the Fr\'echet derivatives of the least-squares discrepancy functional with respect to the shear modulus and shear viscosity. The proposed iterative reconstruction method using this Fr\'echet derivative does not require any differentiation of the displacement data for the full isotropic linearly viscoelastic model, whereas the standard reconstruction methods require at least double differentiation. Because the minimization problem is ill-posed and highly nonlinear, this adjoint-based optimization method needs a very well-matched initial guess. We find a good initial guess. For a well-matched initial guess, numerical experiments show that the proposed method considerably improves the quality of the reconstructed viscoelastic images.Comment: 15 page