A method of imaging viscoelastic parameters with acoustic radiation force

Acoustic radiation force has been proposed as a method of interrogating the mechanical properties of tissue. One simple approach applies a series of focused ultrasonic pulses to generate an acoustic radiation force, then processes the echoes returned from these pulses to estimate the radiation-force-induced displacement as a function of time. This process can be repeated at a number of locations to acquire data for image formation. In previous work we have formed images of tissue stiffness by depicting the maximum displacement induced at each tissue location after a finite period of insonification. While these maximum displacement images are able to differentiate materials of disparate mechanical properties, they exploit only a fraction of the information available. In this paper we show that the time-displacement curves acquired from tissue mimicking phantoms exhibit a viscoelastic response which is accurately described by the Voigt model. We describe how the viscous and elastic parameters of this model may be determined from experimental data. Finally, we show phantom images that depict not only the maximum local displacement, but also the viscous and elastic model parameters. These images offer complementary information about the target.     

Liver ablation guidance with acoustic radiation force impulse imaging: challenges and opportunities

Previous studies have established the feasibility of monitoring radiofrequency (RF) ablation procedures with acoustic radiation force impulse (ARFI) imaging. However, questions remained regarding the utility of the technique in clinically realistic scenarios and at scanning depths associated with abdominal imaging in adults. We address several of these issues and detail recent progress towards the clinical relevance of the ARFI technique. Results from in vitro bovine tissues and an in vivo ovine model are presented. Additional experiments were conducted with a tissue-mimicking phantom and parallel receive tracking techniques in order to further support the clinical feasibility of the method. Thermal lesions created during RF ablation are visualized with high contrast in both in vitro and in vivo hepatic tissues, and radial lesion growth can be monitored throughout the duration of the procedure. ARFI imaging is implemented on a diagnostic ultrasonic scanner, and thus may be a convenient option to guide RF ablation procedures, particularly when electrode insertion is also performed with sonographic guidance.     

Magnetic resonance imaging of radiation dose distributions using a polymer-gel dosimeter

A new formulation of a tissue-equivalent polymer-gel dosimeter for the measurement of three-dimensional dose distributions of ionizing radiation has been developed. It is composed of aqueous gelatin infused with acrylamide and N, N'-methylene-bisacrylamide monomers, and made hypoxic by nitrogen saturation. Irradiation of the gel, referred to as BANG, causes localized polymerization of the monomers, which, in turn, reduces the transverse NMR relaxation times of water protons. The dose dependence of the NMR transverse relaxation rate, R2, is reproducible (less than 2% variation) and is linear up to about 8 Gy, with a slope of 0.25 s(-1)Gy(-1) at 1.5 T. Magnetic resonance imaging may be used to obtain accurate three-dimensional dose distributions with high spatial resolution. Since the radiation-induced polymers do not diffuse through the gelatin matrix, the dose distributions recorded by BANG gels are stable for long periods of time, and may be used to measure low-activity radioactive sources. Since the light-scattering properties of the polymerized regions are different from those of the clear, non-irradiated regions, the dose distributions are visible, and their optical densities are dependent on dose.     

压迫式弹性成像与声脉冲辐射力成像技术在乳腺肿瘤良恶性鉴别中的价值比较

目的:探讨分析压迫式弹性成像（CE）与声脉冲辐射力成像（ARFI）技术在乳腺肿瘤良恶性鉴别中的价值。方法:选择门诊或住院行超声检查发现的有乳腺肿块患者71例共89个病灶,经病理组织学确认良性病灶57个,恶性病灶32个。对各病灶进行彩色多普勒超声检查,并采取CE及ARFI技术,分别计算病灶弹性应变率比值（SR）及声触诊组织定量（VTQ）值,采用ROC曲线分析SR、VTQ对良恶性肿瘤的诊断效能。结果:恶性组病灶VTQ值与SR值均显著高于良性组（P<0.05）。采用ROC曲线分析VTQ、SR对乳腺良恶性肿瘤诊断效能,VTQ诊断曲线下面积（AUC）为0.918,95% CI为0.871~0.980（P<0.05）,最佳截断值为3.97,在此最佳截断值下,VTQ诊断敏感性94.64%、诊断特异性90.63%;SR诊断AUC为0.899,95% CI为0.854~0.956（P<0.05）,最佳截断值为4.12,在此最佳截断值下,SR诊断敏感性92.86%、诊断特异性84.38%。VTQ和SR诊断敏感性、特异性比较差异无统计学意义（P>0.05）。结论:两种超声诊断技术对乳腺良恶性肿瘤均具有较高的诊断价值,其诊断效能相似,临床上可联合使用,以实现优势互补,提高对乳腺癌的早期检出率。     

Magnetic resonance fast Fourier imaging

A new method for fast magnetic resonance imaging is presented. It provides a more rapid data acquisition than two-dimensional Fourier imaging (2DFI) by a factor which may be chosen depending on the required signal-to-noise ratio of the image. In addition to the readout gradient of 2DFI, the present method employs an oscillating modulation gradient. In this way, a curved alternating trajectory in k space is sampled after each spin excitation. For a p-times accelerated data acquisition, the trajectory consists of p periods, where p is of the order of 2 to 8 for low-frequency gradient modulation but can be chosen higher if certain hardware requirements are met. Adequate sampling density in k space is obtained by scanning shifted trajectories after subsequent spin excitations. The method can be combined with volume imaging (3DFI) and multiple slice 2DFI. It was implemented on a standard Philips Gyroscan system without any hardware modifications. Results obtained for an acceleration factor p = 4 are shown.     

Magnetic resonance metabolic imaging of glioma

2-Hydroxyglutarate (2-HG) is a potential oncometabolite involved in gliomagenesis that has been identified as an aberrant product of isocitrate dehydrogenase (IDH)-mutated glial tumors. Recent genomics studies have shown that heterozygous mutation of IDH genes 1 and 2, present in up to 86% of grade II gliomas, is associated with a favorable outcome. Two reports in this issue describe both ex vivo and in vivo methods that could noninvasively detect the presence of 2-HG in glioma patients. This approach could have valuable implications for diagnosis, prognosis, and stratification of brain tumors, as well as for monitoring of treatment in glioma patients.     

Magnetic resonance imaging in multiple sclerosis

The contribution of magnetic resonance imaging techniques to the clinical prognosis of multiple sclerosis. Magnetic resonance imaging (MRI) is a diagnostic technique with a high sensitivity for the detection of lesions, but with a poor pathological specificity. In the case of multiple sclerosis (MS), the improvement of diagnostic efficacy depends on a careful analysis of the clinical presentation and the use of increasingly stringent MRI criteria aimed at improving the specificity of the conventional MRI T2 sequences. New sequences such as fast spin-echo (also called turbo spin-echo) and FLAIR (fluid attenuated inversion recovery, a method derived from inversion recovery) have improved the visualization of lesions. MRI can under certain conditions be used to monitor the evolution of MS. Acute-phase monitoring is focused on observed changes in disease activity such as the appearance, recurrence or extension of lesions after i.v. injection of contrast medium, i.e., gadolinium (Gd)-enhanced MRI. In the chronic phase, the lesions is the aspect used as the monitoring criterion. However, MRI is still only a secondary criterion in phase III therapeutic trials due to its insufficient correlation with the disability. In neurological daily practice, conventional MRI is only of limited interest at the individual level in patient follow-up, as its prognostic value is poor. Moreover, the difficulty in determining the lesion load can only be excluded in the context of clinical trials, in which certain methodological precautions are taken. This is why techniques other than MRI are being investigated to obtain a better correlation with the clinical course of the disease, for instance the quantification of 'black holes' on T1 weighted images, and the measurement of cerebral and spinal atrophy. Adapted MRI techniques allow a weighted signal to be obtained via the movement (diffusion imaging), by the complexity of the molecular structure (magnetization transfer imaging), by chemical shift (spectroscopic imaging), or by local oxygenation (functional MRI). These new MRI techniques allow a more precise assessment of the pathological mechanisms involved in MS, such as edema, blood brain barrier break-down, demyelinisation, gliosis, cellular infiltration and axonal loss; they provide a better means of establishing the correlation between clinical impact and the destructive nature of the MS lesion. The importance of axonal loss has recently been confirmed in MS by analyzing MRI spectroscopic and neuropathological findings. In addition to magnetization transfer imaging, MR diffusion imaging and functional MRI are being intensively studied in order to assess their contribution to the study of reversibility of the degenerative process.     

Magnetic resonance imaging characteristics of deep endometriosis

The aim of this study was to describe magnetic resonance (MR) imaging findings in histopathologically proven deep endometriosis infiltrating the uterosacral ligaments, the pouch of Douglas, the rectum or the bladder. Twenty patients presenting with a clinical suspicion of deep endometriosis underwent preoperative MR imaging. Sagittal and axial fast T2- and axial T1-weighted spin echo MR sequences were performed. Four patients had post-contrast images. MR results, including morphology and signal intensity of each lesion, were compared to intraoperative gross appearance and histopathology. Histopathology diagnosed 24 lesions of deep endometriosis in the uterosacral ligaments (n = 12), the pouch of Douglas (n = 2), the rectum (n = 3), the bladder (n = 7). Uterosacral ligaments with deep endometriosis were statistically different from normal uterosacral ligaments for proximal nodularity (P = 0.001). There was no difference in signal intensity between normal and abnormal uterosacral ligaments. Contrast-enhanced SE images in four patients with detrusor invasion showed an interruption of the hypointense detrusor by the enhancing bladder endometriosis. Rectal endometriosis was missed in two of three patients and showed non-specific rectal wall thickening in one patient. It is concluded that MR imaging can diagnose deep endometriosis of uterosacral ligaments, the bladder and the pouch of Douglas, but lacks sensitivity in detecting rectal endometriosis without rectal distension.     

Magnetic resonance imaging of chest wall lesions

Magnetic resonance imaging (MRI) demonstrates surface anatomy, nerves, and soft tissue pathology. Selective placement of the cursor lines in MRI displays specific anatomy. The MR images can then be used as adjunct in teaching surface anatomy to medical students and to other health professionals. Because the normal surface anatomy could be imaged at UCLA's radiology department, it was decided to image soft tissue abnormalities with MR to assist in patient care. Patients imaged were scheduled for special procedures of the chest or staging lymphangiograms. Patients were placed into categories depending on known diagnosis or interesting clinical presentation. The diagnostic categories included Hodgkin's disease, melanoma, carcinomas (eg, lung or breast), lymphedema, sarcomas, dermatological disorders, and neurological disorders. All images were orchestrated by the radiologist. This article discusses both the teaching and clinical impact on patient care.     

Magnetic resonance imaging of the brain stem

Magnetic resonance imaging of 30 normal volonteers' posterior fossae was performed on a CGR Magniscan machine with a magnetic field strength of 0.5 Tesla. We chose the inversion recovery signal with a Tr of 2,000 ms, a TE of 21 ms and an inverse time of 500 ms. This sequence gives a better definition of the grey matter, the white matter and the CSF. To study the brain stem we suggest 8 horizontal and 3 sagittal sections.     

Magnetic resonance imaging of the shoulder anatomy

Magnetic Resonance represents the best method for shoulder study, since it enables us to emphasize all the parts making part of this area thanks to high anatomical details and a comprehensive view of it. Conventional radiographic techniques provide only limited evaluation of soft-tissue anatomy; ultrasonography, on the other hand, allows the visualization of tendons, synovial spaces and muscle fascicles but it is shown to be unfit above all for osseous structure evaluation: TC, finally, is not being employed at present in shoulder study.     

Magnetic resonance imaging of the coraco-acromial ligament

The coraco-acromial ligament is important first for the stability of the shoulder joint and second because it can impinge on the rotator cuff. In this study we demonstrate how the coraco-acromial ligament can be shown by magnetic resonance imaging (MRI) in the axial plane as well as in the more conventional coronal and sagittal planes. Clin. Anat. 10:88–91, 1997 © 1997 Wiley-Liss, Inc.     

Magnetic resonance imaging of prostate cancer.

Over the past 10 years, dramatic developments in hardware and software have made magnetic resonance imaging a very powerful diagnostic tool for imaging body organs. In this review, the technique as it applies to prostate imaging is discussed, and the literature is reviewed to provide an overview of the current status of prostate magnetic resonance imaging as a tool for diagnosis and staging of prostate cancer.     

In vivo visualization of abdominal malignancies with acoustic radiation force elastography

The utility of acoustic radiation force impulse (ARFI) imaging for real-time visualization of abdominal malignancies was investigated. Nine patients presenting with suspicious masses in the liver (n = 7) or kidney (n = 2) underwent combined sonography/ARFI imaging. Images were acquired of a total of 12 tumors in the nine patients. In all cases, boundary definition in ARFI images was improved or equivalent to boundary definition in B-mode images. Displacement contrast in ARFI images was superior to echo contrast in B-mode images for each tumor. The mean contrast for suspected hepatocellular carcinomas (HCCs) in B-mode images was 2.9 dB (range: 1.5-4.2) versus 7.5 dB (range: 3.1-11.9) in ARFI images, with all HCCs appearing more compliant than regional cirrhotic liver parenchyma. The mean contrast for metastases in B-mode images was 3.1 dB (range: 1.2-5.2) versus 9.3 dB (range: 5.7-13.9) in ARFI images, with all masses appearing less compliant than regional non-cirrhotic liver parenchyma. ARFI image contrast (10.4 dB) was superior to B-mode contrast (0.9 dB) for a renal mass. To our knowledge, we present the first in vivo images of abdominal malignancies in humans acquired with the ARFI method or any other technique of imaging tissue elasticity.     

Experimental validation of acoustic radiation force induced shear wave interference patterns

A novel elasticity imaging system founded on the use of acoustic radiation forces from a dual beam arrangement to generate shear wave interference patterns is described. Acquired pulse-echo data and correlation-based techniques were used to estimate the resultant deformation and to visualize tissue viscoelastic response. The use of normal versus axicon focal configurations was investigated for effects on shear wave generation. Theoretical models were introduced and shown in simulation to accurately predict shear wave propagation and interference pattern properties. In a tissue-mimicking phantom, experimental results are in congruence with theoretical predictions. Using dynamic acoustic radiation force excitation, results confirm that shear wave interference patterns can be produced remotely in a particular tissue region of interest (ROI). Overall, preliminary results are encouraging and the system described may prove feasible for interrogating the viscoelastic properties of normal and diseased tissue types.