Two-dimensional (2D) shear wave elastography presents 2D quantitative shear elasticity maps of tissue, which are clinically useful for both focal lesion detection and diffuse disease diagnosis. Realization of 2D shear wave elastography on conventional ultrasound scanners, however, is challenging due to the low tracking pulse-repetition-frequency (PRF) of these systems. While some clinical and research platforms support software beamforming and plane wave imaging with high PRF, the majority of current clinical ultrasound systems do not have the software beamforming capability, which presents a critical challenge for translating the 2D shear wave elastography technique from laboratory to clinical scanners. To address this challenge, this paper presents a Time Aligned Sequential Tracking (TAST) method for shear wave tracking on conventional ultrasound scanners. TAST takes advantage of the parallel beamforming capability of conventional systems and realizes high PRF shear wave tracking by sequentially firing tracking vectors and aligning shear wave data in the temporal direction. The Comb-push Ultrasound Shear Elastography (CUSE) technique was used to simultaneously produce multiple shear wave sources within the field-of-view (FOV) to enhance shear wave signal-to-noise-ratio (SNR) and facilitate robust reconstructions of 2D elasticity maps. TAST and CUSE were realized on a conventional ultrasound scanner (the General Electric LOGIQ E9). A phantom study showed that the shear wave speed measurements from the LOGIQ E9 were in good agreement to the values measured from other 2D shear wave imaging technologies. An inclusion phantom study showed that the LOGIQ E9 had comparable performance to the Aixplorer (Supersonic Imagine) in terms of bias and precision in measuring different sized inclusions. Finally, in vivo case analysis of a breast with a malignant mass, and a liver from a healthy subject demonstrated the feasibility of using the LOGIQ E9 for in vivo 2D shear wave elastography. These promising results indicate that the proposed technique can enable the implementation of 2D shear wave elastography on conventional ultrasound scanners and potentially facilitate wider clinical applications with shear wave elastography.

Acoustic radiation force imaging methods distinguish tissue structure and composition by monitoring tissue responses to applied radiation force excitations. Although these responses are a complex, multidimensional function of the geometric and viscoelastic nature of tissue, simplified discrete biomechanical models offer meaningful insight to the physical phenomena that govern induced tissue motion. Applying Voigt and standard linear viscoelastic tissue models, we present a new radiation force technique - monitored steady-state excitation and recovery (MSSER) imaging - that tracks both steady-state displacement during prolonged force application and transient response following force cessation to estimate tissue mechanical properties such as elasticity and viscosity. In concert with shear wave elasticity imaging (SWEI) estimates for Young's modulus, MSSER methods are useful for estimating tissue mechanical properties independent of the applied force magnitude. We test our methods in gelatin phantoms and excised pig muscle, with confirmation through mechanical property measurement. Our results measured 10.6 kPa, 14.7 kPa, and 17.1 kPa (gelatin) and 122.4 kPa (pig muscle) with less than 10% error. This work demonstrates the feasibility of MSSER imaging and merits further efforts to incorporate relevant mechanical tissue models into the development of novel radiation force imaging techniques.

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Seventy percent of cardiovascular disease (CVD) deaths are attributed to atherosclerosis. Despite their clinical significance, nonstenotic atherosclerotic plaques are not effectively detected by conventional atherosclerosis imaging methods. Moreover, conventional imaging methods are insufficient for describing plaque composition, which is relevant to cardiovascular risk assessment. Atherosclerosis imaging technologies capable of improving plaque detection and stratifying cardiovascular risk are needed. Acoustic Radiation Force Impulse (ARFI) ultrasound, a novel imaging method for noninvasively differentiating the mechanical properties of tissue, is demonstrated for in vivo detection of nonstenotic plaques and plaque material assessment in this pilot investigation. In vivo ARFI imaging was performed on four iliac arteries: 1) of a normocholesterolemic pig with no atherosclerosis as a control, 2) of a familial hypercholesterolemic pig with diffuse atherosclerosis, 3) of a normocholesterolemic pig fed a high-fat diet with early atherosclerotic plaques and 4) of a familial hypercholesterolemic pig with diffuse atherosclerosis and a small, minimally-occlusive plaque. ARFI results were compared to spatially matched immunohistochemistry, showing correlations between elastin and collagen content and ARFI-derived peak displacement and recovery time parameters. Faster recoveries from ARFI-induced peak displacements and smaller peak displacements were observed in areas of higher elastin and collagen content. Importantly, spatial correlations between tissue content and ARFI results were consistent and observable in both large and highly evolved as well as small plaques. ARFI imaging successfully distinguished nonstenotic plaques, while conventional B-Mode ultrasound did not. This work validates the potential relevance of ARFI imaging as a noninvasive imaging technology for in vivo detection and material assessment of atherosclerotic plaques.