Intervertebral disc characterisation by elastography: a preliminary study.

BiomecAM chai

Non-invasive biomechanical characterization of intervertebral discs by shear wave ultrasound elastography: a feasibility study.

PublishedJournal ArticleThe final publication is available at Springer via http://dx.doi.org/10.1007/s00330-014-3382-8OBJECTIVES: Although magnetic resonance is widely spread to assess qualitatively disc morphology, a simple method to determine reliably intervertebral disc status is still lacking. Shear wave elastography is a novel technique that allows quantitative evaluation of soft-tissues' mechanical properties. The aim of this study was to assess preliminary the feasibility and reliability of mechanical characterization of cervical intervertebral discs by elastography and to provide first reference values for asymptomatic subjects. METHODS: Elastographic measurements were performed to determine shear wave speed (SWS) in C6-C7 or C7-T1 disc of 47 subjects; repeatability and inter-operator reproducibility were assessed. RESULTS: Global average shear wave speed (SWS) was 3.0 ± 0.4 m/s; measurement repeatability and inter-user reproducibility were 7 and 10%, respectively. SWS was correlated with both subject's age (p = 1.3 × 10(-5)) and body mass index (p = 0.008). CONCLUSIONS: Shear wave elastography in intervertebral discs proved reliable and allowed stratification of subjects according to age and BMI. Applications could be relevant, for instance, in early detection of disc degeneration or in follow-up after trauma; these results open the way to larger cohort studies to define the place of this technique in routine intervertebral disc assessment. KEY POINTS: A simple method to obtain objectively intervertebral disc status is still lacking. Shear wave elastography was applied in vivo to assess intervertebral discs. Elastography showed promising results in biomechanical disc evaluation. Elastography could be relevant in clinical routine for intervertebral disc assessment.ParisTech BiomecAM chair programParisTechYves Cotrel FoundationsSociété GénéraleProteorCove

Intervertebral disc characterization by shear wave elastography: An in vitro preliminary study.

Published onlineJOURNAL ARTICLEAuthor's accepted (post-print) manuscriptThe final version of record is available at http://dx.doi.org/10.1177/0954411914540279Patient-specific numerical simulation of the spine is a useful tool both in clinic and research. While geometrical personalization of the spine is no more an issue, thanks to recent technological advances, non-invasive personalization of soft tissue's mechanical properties remains a challenge. Ultrasound elastography is a relatively recent measurement technique allowing the evaluation of soft tissue's elastic modulus through the measurement of shear wave speed. The aim of this study was to determine the feasibility of elastographic measurements in intervertebral disc. An in vitro approach was chosen to test the hypothesis that shear wave speed can be used to evaluate intervertebral disc mechanical properties and to assess measurement repeatability. In total, 11 oxtail intervertebral discs were tested in compression to determine their stiffness and apparent elastic modulus at rest and at 400 N. Elastographic measurements were performed in these two conditions and compared to these mechanical parameters. The protocol was repeated six times to determine elastographic measurement repeatability. Average shear wave speed over all samples was 5.3 ± 1.0 m/s, with a repeatability of 7% at rest and 4.6% at 400 N; stiffness and apparent elastic modulus were 266.3 ± 70.5 N/mm and 5.4 ± 1.1 MPa at rest, respectively, while at 400 N they were 781.0 ± 153.8 N/mm and 13.2 ± 2.4 MPa, respectively. Correlations were found between elastographic measurements and intervertebral disc mechanical properties; these preliminary results are promising for further in vivo application.ParisTech BiomecAM chair programProteorParisTechYves Cotrel Foundation

In vivo cervical intervertebral disc characterisation by elastography.

PublishedJournal ArticleThis is an Accepted Manuscript of an article published by Taylor & Francis in Computer Methods in Biomechanics and Biomedical Engineering on 30/07/2014, available online: http://www.tandfonline.com/10.1080/10255842.2014.931515Not availableParisTech BiomecAM chair programProteorSociété GénéraleCoveaParisTechYves Cotrel Foundation

Automatic Frame Selection Using MLP Neural Network in Ultrasound Elastography

Ultrasound elastography estimates the mechanical properties of the tissue from two Radio-Frequency (RF) frames collected before and after tissue deformation due to an external or internal force. This work focuses on strain imaging in quasi-static elastography, where the tissue undergoes slow deformations and strain images are estimated as a surrogate for elasticity modulus. The quality of the strain image depends heavily on the underlying deformation, and even the best strain estimation algorithms cannot estimate a good strain image if the underlying deformation is not suitable. Herein, we introduce a new method for tracking the RF frames and selecting automatically the best possible pair. We achieve this by decomposing the axial displacement image into a linear combination of principal components (which are calculated offline) multiplied by their corresponding weights. We then use the calculated weights as the input feature vector to a multi-layer perceptron (MLP) classifier. The output is a binary decision, either 1 which refers to good frames, or 0 which refers to bad frames. Our MLP model is trained on in-vivo dataset and tested on different datasets of both in-vivo and phantom data. Results show that by using our technique, we would be able to achieve higher quality strain images compared to the traditional methods of picking up pairs that are 1, 2 or 3 frames apart. The training phase of our algorithm is computationally expensive and takes few hours, but it is only done once. The testing phase chooses the optimal pair of frames in only 1.9 ms

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

Published onlineJOURNAL ARTICLEThe final publication is available at Springer via http://dx.doi.org/10.1007/s00330-015-3911-0OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. KEY POINTS: • 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.ParisTech BiomecAM chair programParisTechParisTechSociété GénéraleProteorCoveaInvestissements d'Aveni