These results establish the preliminary normal range of LV diastolic stiffness under different scan views and provide important guidance for future clinical studies using cardiac SWE.

Objective To investigate the correlation between 2-D ultrasound shear wave elastography (SWE) and magnetic resonance elastography (MRE) in liver stiffness measurement and the diagnostic performance of 2-D SWE for liver fibrosis when imaging from different intercostal spaces and using MRE as the reference standard. Methods 2-D SWE was performed on 47 patients (22 females and 25 males, age 19–77) using the GE LOGIQ E9 scanner. Each of the 47 patients had same day MRE obtained for clinical purposes. The study was HIPAA-compliant and approved by the institutional review board. Informed consent was obtained from each subject. 2-D SWE measurements were acquired from the 9th, 8th, and 7th intercostal spaces. Correlation with MRE was calculated at each intercostal space and multiple intercostal spaces combined. The performance of 2-D SWE in diagnosing liver fibrosis was evaluated with receiver operating characteristic (ROC) curve analysis using MRE as the standard. Results The highest correlation between 2-D SWE and MRE was from the 8th and 7th intercostal spaces (r = 0.68 – 0.76). The range of the areas under the ROC curve for separating normal or inflamed livers from fibrotic livers using MRE as the clinical reference were 0.84 – 0.92 when using 8th and 7th intercostal spaces individually, and 0.89 –0.9 when combined. Conclusion The results suggest that 2-D SWE and MRE are well correlated when SWE is performed at the 8th and 7th intercostal spaces. The 9th intercostal space is less reliable for diagnosing fibrosis using 2-D SWE. Combining measurements from multiple intercostal spaces does not significantly improve 2-D SWE performance for the detection of fibrosis.

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.

The long-term goal of this study is to assess chemotherapy-induced cardiotoxicity for pediatric cancer patients using cardiac ultrasound shear wave (SW) elastography. This pilot study aimed to systematically investigate the feasibility of using cardiac SW elastography in children and provide myocardial stiffness control data for cancer patients. Twenty healthy volunteers (ages 5-18) were recruited. A novel cardiac SW elastography sequence with pulse-inversion harmonic imaging and time-aligned sequential tracking was developed for this study. Cardiac SW elastography produces and detects transient SWs propagating in the myocardium in late-diastole, which can be used to quantify myocardial stiffness. The parasternal long-axis (L-A) and short-axis (S-A) views of the interventricular septum (IVS) were feasible for pediatric cardiac SW elastography. The L-A and S-A views of the basal and mid IVS provided better success rates than those of the apical IVS. Success rates decreased with increased body mass index (BMI), but did not differ with age or gender. Two-dimensional SW speed measurements were 1.26, 1.22, 1.71 and 1.67 m/s for L-A base, L-A mid, S-A base and S-A mid IVS, respectively. All S-A SW speed values were significantly higher (p < 0.01) than L-A values due to myocardial anisotropy. No SW speed difference was observed for different ages and genders. This pilot study demonstrated, for the first time, the feasibility of using cardiac SW elastography to measure quantitative myocardial stiffness in children, and established control SW speed values for using SW elastography to assess chemo-induced cardiotoxicity for pediatric cancer patients. The results showed that the myocardial anisotropy needs to be accounted for when comparing SW speed from different imaging axes.

We demonstrate the use of focused ultrasound waves to excite eigenmodes of microfabricated structures such as atomic force microscopy microcantilevers and coupled microcantilever arrays, among the smallest objects that have been excited in air using ultrasound radiation force. The method is based on the radiation force produced by a double-sideband suppressed carrier ultrasound waveform, centered at 500 kHz. The difference frequency between the sidebands, ranging from 10 to 200 kHz, excited resonances of these structures. Frequency response curves and deflection shapes were consistent with conventional base excitation, demonstrating the feasibility of noncontact excitation for a variety of microscale devices.