山口 匡

Abstract Analysis of the envelope statistics of ultrasound echo signals contributes to quantitative tissue characterization in medical ultrasound. Many probability distribution model functions have been studied, and the model function that should be used for tissue characterization depends on the type of disease, even in the same organ. Thus, an appropriate model selection is important for an accurate diagnosis. In this study, we aimed to select a model using threshold processing for modeling errors instead of a simple selection by minimizing the modeling error. For this purpose, we compared several indicators of modeling errors using random number simulations, ultrasonic simulation, and phantom experiment. The results validated that the Mahalanobis distance of moments is an appropriate indicator because it enables the use of a constant threshold value, regardless of the type of model function and data length.

OBJECTIVE: Hepatic fibrosis has recently been evaluated using ultrasonography or magnetic resonance elastography. Although the shear wave velocity (SWV) obtained using point shear wave elastography (pSWE) provides a valuable measure of fibrosis, underlying steatosis may affect its measurement. METHODS: Using hepatic fibrosis samples, this study evaluated the effect of steatosis on the shear wave velocity of pSWE (Vs) and viscoelastic properties (assessed by dynamic mechanical analysis) of rat liver. Fifty rats with various grades of steatosis and fibrosis underwent open abdominal in vivo Vs measurements using a commercial ultrasound scanner. The mechanical properties of hepatic tissue were also characterized under ex vivo conditions using dynamic mechanical analysis and the Zener model of viscoelasticity. RESULTS: Fibrosis and steatosis progression influenced Vs and elasticity. The SWV computed using the Zener model and Vs showed a substantial correlation (r > 0.8). Fibrosis progression increased SWV. Steatosis was also related to SWV. Steatosis progression obscured the SWV change associated with fibrosis progression. CONCLUSION: We conclude that steatosis progression affects the evaluation of fibrosis progression. This finding could aid discrimination of non-alcoholic steatohepatitis from non-alcoholic fatty liver disease using SWV.

Introduction: Assessing the stage of liver fibrosis during the diagnosis and follow-up of patients with diffuse liver disease is crucial. The tissue structure in the fibrotic liver is reflected in the texture and contrast of an ultrasound image, with the pixel brightness indicating the intensity of the echo envelope. Therefore, the progression of liver fibrosis can be evaluated non-invasively by analyzing ultrasound images. Methods: A convolutional-neural-network (CNN) classification of ultrasound images was applied to estimate liver fibrosis. In this study, the colorization of the ultrasound images using echo-envelope statistics that correspond to the features of the images is proposed to improve the accuracy of CNN classification. In the proposed method, the ultrasound image is modulated by the 3rd- and 4th-order moments of pixel brightness. The two modulated images and the original image were then synthesized into a color image of RGB representation. Results and Discussion: The colorized ultrasound images were classified via transfer learning of VGG-16 to evaluate the effect of colorization. Of the 80 ultrasound images with liver fibrosis stages F1–F4, 38 images were accurately classified by the CNN using the original ultrasound images, whereas 47 images were classified by the proposed method.

Abstract Previous studies have shown that shear wave elastography of liver tissue can be unstable due to factors such as uncertainties in the acoustic radiation force (ARF) irradiation due to the influence of tissues near the surface and the complexity of the liver’s structure and its physical properties. This study aims to verify the influence of near-surface tissues on ARF and the effect of tissue structure on shear wave propagation and shear wave velocity (SWV) evaluation using the wave propagation simulations by the elastic finite-difference time domain method. It is found that the ARF becomes weakly focused on multiple locations due to refraction of longitudinal waves by near-surface tissues, and multiple shear waves of small amplitude are propagated. However, a macroscopic SWV assessment, as in clinical practice, reduces the influence of near-surface tissues because the microscopic assessment results are averaged over the near-surface tissues.

Abstract We attempted to visualize a single microbubble driven by acoustic radiation force using a combination of pulse inversion Doppler and plane wave imaging. Commercial microbubbles, Sonazoid^® underwent ultrasound exposure with a center frequency of 5.2 MHz, a pulse repetition frequency of 4 kHz, and a negative peak sound pressure of 1.59 MPa. It succeeded in separately detecting individual microbubbles with high sensitivity. The disappearance of freely-translating microbubbles could be observed as a broadened spectrum of Doppler signal, i.e. a pseudo-Doppler effect. However, the trend was not apparent in the case of wall-colliding microbubbles.

Abstract We compared the evaluation accuracy of amplitude envelope statistics under the transmission and reception conditions of compounded plane wave imaging (CPWI) and focused beam imaging (FBI). In a basic study using a homogeneous phantom, we found that the amplitude gradient in the depth direction and the point spread function in the lateral direction spread in the FBI reduced the accuracy of evaluation in amplitude envelope statistics. On the other hand, CPWI showed a more stable evaluation than FBI because of the elimination of sound field characteristics. In CPWI, the multi-Rayleigh model discriminated signals from two types of scatterer with high accuracy in the evaluation using phantoms mimicking fatty liver. It was confirmed that the combination of CPWI and the multi-Rayleigh model is effective for detecting early fatty liver disease. The results show that CPWI is effective for improving the robustness of amplitude envelope statistics.

Percutaneous ablation under imaging guidance is a curative treatment that can induce complete tumor necrosis with advantages of minimal invasiveness and a low risk of complications. Thermal ablation, which includes radiofrequency ablation and microwave ablation, is a representative technique that has sufficient antitumor effects in cases of hepatocellular carcinoma with ≤3 lesions measuring ≤3 cm and preserved liver function. The short- and long-term outcomes of patients are comparable with those achieved with surgical resection. Despite their nonmalignant nature, some benign liver tumors require treatment for symptoms caused by the presence of the tumor and/or continuous enlargement. Ablation may be the treatment of choice because it has lower burden on patients than surgical treatment. This review describes the recent concepts, progress, and limitations of ablation-based treatment for benign liver tumors.

High-frame-rate imaging with a clutter filter can clearly visualize blood flow signals and provide more efficient discrimination with tissue signals. In vitro studies using clutter-less phantom and high-frequency ultrasound suggested a possibility of evaluating the red blood cell (RBC) aggregation by analyzing the frequency dependence of the backscatter coefficient (BSC). However, in in vivo applications, clutter filtering is required to visualize echoes from the RBC. This study initially evaluated the effect of the clutter filter for ultrasonic BSC analysis for in vitro and preliminary in vivo data to characterize hemorheology. Coherently compounded plane wave imaging at a frame rate of 2 kHz was carried out in high-frame-rate imaging. Two samples of RBCs suspended by saline and autologous plasma for in vitro data were circulated in two types of flow phantoms without or with clutter signals. The singular value decomposition was applied to suppress the clutter signal in the flow phantom. The BSC was calculated using the reference phantom method, and it was parametrized by spectral slope and mid-band fit (MBF) between 4-12 MHz. The velocity distribution was estimated by the block matching method, and the shear rate was estimated by the least squares approximation of the slope near the wall. Consequently, the spectral slope of the saline sample was always around four (Rayleigh scattering), independently of the shear rate, because the RBCs did not aggregate in the solution. Conversely, the spectral slope of the plasma sample was lower than four at low shear rates but approached four by increasing the shear rate, because the aggregations were presumably dissolved by the high shear rate. Moreover, the MBF of the plasma sample decreased from -36 to -49 dB in both flow phantoms with increasing shear rates, from approximately 10 to 100 s-1. The variation in the spectral slope and MBF in the saline sample was comparable to the results of in vivo cases in healthy human jugular veins when the tissue and blood flow signals could be separated.

PURPOSE: The aim of this study was to elucidate the frequency dependence of the speed of sound (SoS) and attenuation coefficients in phantoms with controlled attenuation properties (scatterer density, scatterer size, absorption control material) and rat livers. METHODS: The frequency dependence of SoS and attenuation coefficients were evaluated with ultrasound (1-15 MHz) by observing multiple phantoms with different scatterer sizes, densities, and presence or absence of evaporated milk as absorbing media. Normal and fatty model rat livers were examined with the same protocol. RESULTS: The phantom results revealed that the scatterer density and SoS of the base media were the dominant factors causing the changes in SoS. Frequency dependence was not observed in SoS. Assessment of the attenuation coefficient showed that the frequency dependence was mainly affected by absorption attenuation when the scatterer was as small as a hepatocyte (i.e. ≤ 10 µm). Scattering attenuation was also observed to affect frequency dependence when the scatterer was as large as lipid droplets (i.e. ≤ 40 µm). CONCLUSION: Assuming a consistent size of the main scatterers in the evaluation medium, the frequency dependence of the SoS and attenuation coefficients may provide insight into the scatterer density and the contribution of absorption and scattering attenuation. Further studies in the higher frequency band (up to about 50 MHz) are expected to advance the clinical application of high-frequency ultrasound.

Abstract This study investigates how the translational velocity of phospholipid-coated bubbles caused by acoustic radiation force depends on their size. The translations of bubbles with mean radii of 0.9–5 μm were experimentally evaluated at five ultrasound frequency conditions (3.5, 5, 7.5, 10, and 15 MHz). We compared experimental data with theoretical prediction using a viscoelastic interfacial rheological model and a model suitable for high amplitude oscillation. The results suggested that the translation of bubbles could be enhanced for a mean radius of 1–3 μm but echo intensity could not.

This study investigated the ability of in vivo quantitative ultrasound (QUS) assessment to evaluate lymphedema severity compared with the gold standard method, the International Society of Lymphology (ISL) stage. Ultrasonic measurements were made around the middle thigh (n = 150). Radiofrequency data were acquired using a clinical scanner and 8-MHz linear probe. Envelope statistical analysis was performed using constant false alarm rate processing and homodyned K (HK) distribution. The attenuation coefficient was calculated using the spectral log-difference technique. The backscatter coefficient (BSC) was obtained by the reference phantom method with attenuation compensation according to the attenuation coefficients in the dermis and hypodermis, and then effective scatterer diameter (ESD) and effective acoustic concentration (EAC) were estimated with a Gaussian model. Receiver operating characteristic curves of QUS parameters were obtained using a linear regression model. A single QUS parameter with high area under the curve (AUC) differed between the dermis (ESD and EAC) and hypodermis (HK) parameters. The combinations with ESD and EAC in the dermis, HK parameters in the hypodermis and typical features (dermal thickness and echogenic regions in the hypodermis) improved classification performance between ISL stages 0 and ≥I (AUC = 0.90 with sensitivity of 75% and specificity of 91%) in comparison with ESD and EAC in the dermis (AUC = 0.82) and HK parameters in the hypodermis (AUC = 0.82). In vivo QUS assessment by BSC and envelope statistical analyses can be valuable for non-invasively classifying an extremely early stage of lymphedema, such as ISL stage I, and following its progression.

PURPOSE: To quantify the bias of shear wave speed (SWS) measurements in a viscoelastic phantom across six different ultrasound (US) systems and to compare the SWS with those from transient elastography (TE) and magnetic resonance elastography (MRE). METHODS: A viscoelastic phantom of stiffness representing fibrotic liver or healthy thyroid was measured with nine (linear probe) and 10 (convex probe) modes of six different US-based shear wave elastography (SWE) systems using linear and convex probes. SWS measurements of three regions of interest were repeated thrice at two focal depths, coupling the probe to the phantom using a jig. An MRE system using three motion-encoding gradient frequencies of 60, 90, and 120 Hz and TE were also used to measure the stiffness of the phantom. RESULTS: The SWS from different SWE systems had mean coefficients of variation of 9.0-9.2% and 5.4-5.6% with linear and convex probes, respectively, in viscoelastic phantom measurement. The focal depth was a less significant source of SWS variability than the system. The total average SWS obtained with US-SWE systems was 19.9% higher than that obtained with MRE at 60 Hz, which is commonly used in clinical practice, and 31.5% higher than that obtained with TE using the M probe. CONCLUSIONS: Despite the measurement biases associated with the SWE systems, biases were not necessarily consistent, and they changed with the probes used and depth measured. The SWS of the viscoelastic phantom obtained using different modalities increased according to the shear wave frequency used.

Portal hypertension is a major pathophysiological condition in patients with cirrhosis. This accounts for the occurrence and severity of the various manifestations. The degree is determined by the portal pressure or hepatic venous pressure gradients, both of which are obtained by invasive interventional radiological procedures. Ultrasound (US) is a simple and minimally invasive imaging modality for the diagnosis of liver diseases. Owing to the availability of microbubble-based contrast agents and the development of imaging modes corresponding to contrast effects, contrast-enhanced US (CEUS) has become popular worldwide for the detailed evaluation of hepatic hemodynamics, diffuse liver disease, and focal hepatic lesions. Recent advancements in digital technology have enabled contrast-based demonstrations with improved resolution, leading to a wider range of applications. This review article describes the current role, benefits, and limitations of CEUS in the management of portal hypertension.

BACKGROUND: Increased skin and subcutaneous tissue stiffness in patients with early-stage lymphedema has been reported. The purpose of this study was to examine the use of shear wave elastography (SWE) for evaluating lower extremity lymphedema (LEL). METHODS: For 10 lower extremities of normal controls and 72 limbs of patients with gynecological cancer whose lymphatic function was categorized into six stages based on the range of dermal backflow (DBF) observed in indocyanine green (ICG) lymphography, SWE was performed and shear wave velocity (SWV) of the dermis and three layers of subcutaneous tissue at the thigh and calf were recorded. Twenty-five patients underwent thigh tissue histological and dermal thickness examinations. RESULTS: The strongest correlation between the ICG DBF stage and SWV during SWE was observed on the dermal layer of the thigh (p < 0.01, R = 0.67). There was a significant correlation between the dermal thickness of the thigh and the ICG DBF stage (p < 0.01, R = 0.87) and also between the dermal thickness of the thigh and SWV (p < 0.01, R = 0.73). CONCLUSION: Noninvasive, objective evaluation of LEL severity using SWE was well correlated with lymphatic function as determined by ICG lymphography. The DBF changes in the dermis of the thigh best reflected the changes in lymphatic function. Dermal thickness variations may partially account for differences in SWV.

高速超音波イメージングは血管や循環器系における血流速ベクトル評価に応用されている.流速推定値は,エイリアシングやグレーティングローブなどの超音波固有のアーチファクトによって推定誤差が表れる場合がある.粒子分布を可視化し速度計測を行える他のシステムの一つとして,光学的粒子画像追跡法(particle image velocimetry:PIV)が挙げられる.本報告では超音波・光学システムを併用した流れ場観察システムを構築し,複数種の血液模擬溶液の流速を評価した.また,超音波・光学システムでの安定した速度推定が可能な粒子径や濃度条件を整理するとともに,基礎的な音響特性(音速・減衰係数・後方散乱係数)を評価し,IEC規格が示す血液模擬溶液の推奨値と比較した.超音波および光学システムにおいて推定した流速は,直径20μmのポリアミド粒子が溶液中に0.2%存在している場合,同等(誤差4.0%)であるとともにIEC規格が示す音響特性の推奨値の範囲内かつ超音波像においてスペックルパタンが保持されていることを確認した.(著者抄録)

In the field of clinical ultrasound, the full digitalization of diagnostic equipment in the 2000s enabled the technological development of quantitative ultrasound (QUS), followed by multiple diagnostic technologies that have been put into practical use in recent years. In QUS, tissue characteristics are quantified and parameters are calculated by analyzing the radiofrequency (RF) echo signals returning to the transducer. However, the physical properties (and pathological level structure) of the biological tissues responsible for the imaging features and QUS parameters have not been sufficiently verified as there are various conditions for observing living tissue with ultrasound and inevitable discrepancies between theoretical and actual measurements. A major issue of QUS in clinical application is that the evaluation results depend on the acquisition conditions of the RF echo signal as the source of the image information, and also vary according to the model of the diagnostic device. In this paper, typical examples of QUS techniques for evaluating attenuation, speed of sound, amplitude envelope characteristics, and backscatter coefficient in living tissues are introduced. Exemplary basic research and clinical applications related to these technologies, and initiatives currently being undertaken to establish the QUS method as a true tissue characterization technology, are also discussed.

Lipid-coated microbubbles (MBs) with an indocyanine green (ICG) derivative were fabricated for ultrasound and near-infrared (NIR) fluorescence dual imaging. We characterized the NIR-fluorescence intensity, stability and viscoelastic properties of the encapsulating lipid shell, focusing on the influence of the ICG derivative and lipid compositions. In terms of the NIR fluorescence intensity, the fluorescence intensity of the MBs (with the ICG derivative) was significantly affected by the lipid composition of the MB shell. Regarding the contrast agent used for ultrasound imaging, the stability of the MBs and viscoelastic properties of shell also depended on the lipid compositions, while the incorporation of the ICG derivative into the MB shells had a negligible effect. The performance of this contrast agent for ultrasound and NIR fluorescence dual-imaging exhibited a significant trade-off relationship for the lipid composition.

We investigated the differences between the transmission (Tx)/reception (Rx) sound fields for target and reference signals using a reference phantom method (RPM) to assess the stability of backscattering coefficient (BSC) evaluation. A clinical ultrasound scanner and two types of phased linear array transducer with low and high frequencies were used to evaluate the BSCs for two types of homogenous phantom with different attenuation coefficients and BSCs. Different Tx/Rx sound fields were reproduced using different combinations of Tx focus depths and aperture sizes. Target signals with Tx conditions that were both the same as and different from those for the reference signals were used to produce signals with different Tx/Rx sound fields. The differences in the Tx/Rx sound fields affected the depth dependence of the evaluated BSC. It was concluded that this can be a factor creating variation in the BSC for homogenous targets.

Previous studies have shown that evaluation results of shear wave elastography were unstable due to factors such as liver structure and complexity of physical properties. The present study attempts to verify the influence of liver microstructure (fat droplets and fibrous tissue) on the shear wave and shear wave velocity (SWV) evaluation using a shear wave propagation simulation by the elastic finite-difference time-domain method. It was found that disruption of the shear wave causes variations in the SWV of the liver around fat droplets, and the SWV of the fibrous tissue depends on the shear wave propagation direction and the tissue shape. In a nonalcoholic steatohepatitis liver, which contains fat and fiber, the influences of these two tissues are synergistically reflected in the SWV evaluation.

In previous studies, the double-Nakagami (DN) model has been proposed for fatty liver assessment and applied to in vivo rat livers and clinical data sets. The healthy liver structure filter (HLSF) method, which extracts non-healthy areas using two DN parameters, has also been proposed. In this paper, we first verify the accuracy of the DN model and the HLSF method for acoustic fields at 15 and 5 MHz, which were reproduced using numerical simulation. We then apply the method to clinical data sets of livers observed using a frequency of 3 MHz and investigate the method's clinical usefulness. A positive correlation (r = 0.28) was found between the ratio of the non-healthy area and fat mass. Although the results were inferior to the results produced using 15 MHz ultrasound (r = 0.96), we found that it was possible to detect the difference between a normal liver and a fatty liver even at a lower frequency. (C) 2021 The Japan Society of Applied Physics

Hepatocellular carcinoma (HCC) is a common cancer worldwide. Recent international guidelines request an identification of the stage and patient background/condition for an appropriate decision for the management direction. Radiomics is a technology based on the quantitative extraction of image characteristics from radiological imaging modalities. Artificial intelligence (AI) algorithms are the principal axis of the radiomics procedure and may provide various results from large data sets beyond conventional techniques. This review article focused on the application of the radiomics-related diagnosis of HCC using radiological imaging (computed tomography, magnetic resonance imaging, and ultrasound (B-mode, contrast-enhanced ultrasound, and elastography)), and discussed the current role, limitation and future of ultrasound. Although the evidence has shown the positive effect of AI-based ultrasound in the prediction of tumor characteristics and malignant potential, posttreatment response and prognosis, there are still a number of issues in the practical management of patients with HCC. It is highly expected that the wide range of applications of AI for ultrasound will support the further improvement of the diagnostic ability of HCC and provide a great benefit to the patients.

Objective: Hepatic steatosis causes nonalcoholic fatty liver disease and may progress to fibrosis. Ultrasound is the first-line approach to examining hepatic steatosis. Fatty droplets in the liver parenchyma alter ultrasound radiofrequency (RF) signal statistical properties. This study proposes using sample entropy, a measure of irregularity in time-series data determined by the dimension [Formula: see text] and tolerance [Formula: see text], for ultrasound parametric imaging of hepatic steatosis and fibrosis. Methods: Liver donors and patients were enrolled, and their hepatic fat fraction (HFF) ([Formula: see text]), steatosis grade ([Formula: see text]), and fibrosis score ([Formula: see text]) were measured to verify the results of sample entropy imaging using sliding-window processing of ultrasound RF data. Results: The sample entropy calculated using [Formula: see text] 4 and [Formula: see text] was highly correlated with the HFF when a small window with a side length of one pulse was used. The areas under the receiver operating characteristic curve for detecting hepatic steatosis that was [Formula: see text]mild, [Formula: see text]moderate, and [Formula: see text]severe were 0.86, 0.90, and 0.88, respectively, and the area was 0.87 for detecting liver fibrosis in individuals with significant steatosis. Discussion/Conclusions: Ultrasound sample entropy imaging enables the identification of time-series patterns in RF signals received from the liver. The algorithmic scheme proposed in this study is compatible with general ultrasound pulse-echo systems, allowing clinical fibrosis risk evaluations of individuals with developing hepatic steatosis.

A better understanding of ultrasound scattering in a three-dimensional (3D) medium can provide more accurate methods for ultrasound tissue characterization. The possibility of using two-dimensional impedance maps (2DZMs) based on correlation coefficients has shown promise in the case of isotropic and sparse medium [Luchies and Oelze, J. Acoust. Soc. Am. 139, 1557-1564 (2016)]. The present study investigates the use of 2DZMs in order to quantify 3D scatterer properties of dense media from two-dimensional (2D) histological slices. Two 2DZM approaches were studied: one based on the correlation coefficient and the other based on the 2D Fourier transform of 2DZMs. Both 2DZM approaches consist in estimating the backscatter coefficient (BSC) from several 2DZMs, and then the resulting BSC was fit to the theoretical polydisperse structure factor model to yield 3D scatterer properties. Simulation studies were performed to evaluate the ability of both 2DZM approaches to quantify scattering of a 3D medium containing randomly distributed polydisperse spheres or monodisperse ellipsoids. Experimental studies were also performed using the histology photomicrographs obtained from HT29 cell pellet phantoms. Results demonstrate that the 2DZM Fourier transform-based approach was more suitable than the correlation coefficient-based approach for estimating scatterer properties when using a small number of 2DZMs.

Ultrasound imaging is a first-line assessment tool for hepatic steatosis. Properties of tissue microstructures correlate with the statistical distribution of ultrasound backscattered signals, which can be described by the Nakagami distribution (a widely adopted approximation of backscattered statistics). The double Nakagami distribution (DND) model, which combines two Nakagami distributions, was recently proposed for using high-frequency ultrasound to analyze backscattered statistics corresponding to lipid droplets in the fat-infiltrated liver. This study evaluated the clinical feasibility of the DND model in ultrasound parametric imaging of hepatic steatosis by conducting clinical experiments using low-frequency ultrasound dedicated to general abdominal examinations. A total of 204 patients were recruited, and ultrasound image raw data were acquired using a 3.5 MHz array transducer for DND parametric imaging using the sliding window technique. The DND parameters were compared with hepatic steatosis grades identified histologically. A receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance. The results indicated that DND parametric imaging constructed using a sliding window with the side length of five times the pulse length of the transducer provided stable and reliable DND parameter estimations and visualized changes in the backscattered statistics caused by hepatic steatosis. The DND parameter increased with the hepatic steatosis grade. The areas under the ROC curve for identifying hepatic steatosis were 0.76 (>= mild), 0.81 (>= moderate), and 0.82 (>= severe). When using low-frequency ultrasound, DND imaging allows the clinical detection of hepatic steatosis and reflects information associated with lipid droplets in the fat-infiltrated liver.

We studied the effect of acoustic and histopathological features on the ultrasound backscatter properties of lymphedema (LE) dermis. Experimental effective scatterer diameter (ESD) and effective acoustic concentration (EAC) were calculated from a backscatter coefficient using the reflector method for backscattered signals. Predicted parameters were also analyzed using two-dimensional Fourier transforms of the acoustic impedance and histopathological distributions. Backscattered signals were obtained from ex vivo human tissues negative (n = 5) and positive (n = 5) for LE using a laboratory-made scanner with a 14 MHz transducer. Acoustic impedance was analyzed using scanning acoustic microscopy with a 68 MHz transducer, and histopathological features, such as fiber number density and thickness, were assessed with digital histopathology. Both experimental and predicted EACs showed differences (in the range 25.7%-102%) between negative and positive LE. Although the mean and standard deviation of the acoustic impedance were related to the difference in EACs, the ESD and histopathological features were the same regardless of the presence of LE. (C) 2020 The Japan Society of Applied Physics

Clinical ultrasound is widely used for quantitative diagnosis. To clarify the relationship between anatomical and acoustic properties, high resolution imaging using high-frequency ultrasound (HFU) is required. However, when tissue properties are evaluated using HFU, the depth of field (DOF) is limited. To overcome this problem, an annular array transducer, which has a simple structure and produces high-quality images, is applied to HFU measurement. In previous phantom experiments, we demonstrated that the HFU annular array extends the DOF compared to that of a single-element transducer for quantitative ultrasound (QUS) analysis. Here, we extend that work by applying QUS methods to an ex vivo rat liver. The present study demonstrates that an annular array extends the region and improves the resolution for tissue characterization for an excised healthy rat liver. Amplitude envelope statistics and spectral-based analysis are used as QUS methods. (C) 2020 The Japan Society of Applied Physics

The dependence of the speed of sound (SoS) in sliced rat organs on the spatial resolution was investigated through ultrasound analysis at high frequencies (80 and 250 MHz). The radio-frequency echo signals from target were acquired by a scanning acoustic microscopy system developed by the authors that can observe a sample with a transducer. The SoS was evaluated by correcting for the time of flight difference obtained from the wide area measurement. The dependency of the SoS on the spatial resolution was evaluated by applying different filtering methods. Stable analysis was possible after time correction, and fine textures reflecting the microstructure could be observed. The application of different filters to the results obtained at 250 MHz resulted in average SoS values that were similar to those obtained at 80 MHz. These results suggest that the primary targets evaluated 80 and 250 MHz are connective tissue and single cells, respectively. (C) 2020 The Japan Society of Applied Physics

Contrast-enhanced ultrasound imaging using acoustic radiation force, called contrast-enhanced active Doppler ultrasound (CEADUS) imaging, has been proposed for visualizing lymph channels filled with stationary fluid. Based on optical observations and acoustical evaluation, the behaviour of bubbles in a simulated channel during ultrasound exposure was investigated under four conditions for negative peak sound pressure (P-np), at centre frequency of ultrasound and pulse repetition frequency of 15 MHz and 1 kHz, respectively. There was good correlation between the time changes of mean translational velocity for optical evaluation (V-OPT) and acoustical evaluation (V-US). In addition, the maxima of V-OPT and V-US were correlated (R = 0.665) and showed a similar trend proportional to the square of Pnp. These results strongly suggest that the acoustically-evaluated bubble translation has information equal to optically-evaluated one, meaning that the simultaneous observation system is useful to understand the bubble behaviours under CEADUS imaging. (C) 2020 The Japan Society of Applied Physics

Quantitative ultrasound (QUS) methods have been widely used for soft tissue characterization. Spatial resolution (i.e. ultrasound frequency) is an important factor for QUS methods. In a previous study, a double Nakagami (DN) distribution model to echo signals from fatty livers using a 15 MHz transducer was used to permit fine-resolution QUS. This study used a filtering approach to quantify steatosis progression using three QUS parameters obtained by fitting a DN distribution model to experimental envelope data. The filter was designed using QUS parameters obtained from three healthy liver. A strong correlation (r = 0.96, p < 0.001) was found between histologically quantified steatosis percentage and the percentage of the liver having non-healthy liver features. This approach was able to successfully diagnose fatty livers (>20% steatosis percentage) in a dataset of 12 livers ranging from 0% to 90% steatosis. (C) 2020 The Japan Society of Applied Physics

BACKGROUND: To examine in vitro acoustic property of nonalcoholic fatty disease in mouse and human liver to identify nonalcoholic steatohepatitis (NASH). METHODS: The acoustic impedance (× 106 kg/m2/s) was measured in 35 free fatty acids (FFAs, 500 mmol/L) and histologically-diagnosed liver samples of twelve mice (four control, four simple steatosis [SS], and four NASH) and eight humans (two control, three SS, and three NASH), using 80-MHz acoustic microscopy. The sum of percentage (SP) composition of FFAs (SP-FFAs) was also assessed. RESULTS: Median impedance of all FFAs was 0.7 (5 FFAs with impedance 0.7); 17 FFAs with impedance < 0.7 were classified as low-impedance group; and, 13 FFAs with impedance > 0.7 were classified as high-impedance group. The median impedance of the mouse liver decreased from control (1.715), to SS (1.68), to NASH (1.635) (control versus NASH, p = 0.039 without significant differences for the other comparisons, p ≥ 0.1). Similarly, the median impedance of human liver showed decreased from control (1.825), to SS (1.788), to NASH (1.76) (control versus SS, p = 0.023; control versus NASH, p = 0.003; SS versus NASH, p = 0.050). The ratio of SP-FFAs between the low-impedance and high-impedance groups showed an increase in both mice and humans, with significant differences in mice (control versus SS, p < 0.001; control versus NASH, p < 0.001; SS versus NASH, p = 0.003), without significant differences in humans (p ≥ 0.671). CONCLUSION: Lower acoustic impedance based on the intrahepatic composition of FFAs may be characteristic of NASH.

Purpose The backscatter coefficient (BSC) indicates the absolute scatterer property of a material, independently of clinicians and system settings. Our study verified that the BSC differed among the scanners, transducers, and beamforming methods used for quantitative ultrasound analyses of biological tissues. Methods Measurements were performed on four tissue-mimicking homogeneous phantoms containing spherical scatterers with mean diameters of 20 and 30 mu m prepared at concentrations of 0.5 and 2.0 wt%, respectively. The BSCs in the different systems were compared using ultrasound scanners with two single-element transducers and five linear high- or low-frequency probes. The beamforming methods were line-by-line formation using focused imaging (FI) and parallel beam formation using plane wave imaging (PWI). The BSC of each system was calculated by the reference phantom method. The mean deviation from the theoretical BSC computed by the Faran model was analyzed as the benchmark validation of the calculated BSC. Results The BSCs calculated in systems with different properties and beamforming methods well concurred with the theoretical BSC. The mean deviation was below +/- 2.8 dB on average, and within the approximate standard deviation (+/- 2.2 dB at most) in all cases. These variations agreed with a previous study in which the largest error among four different scanners with FI beamforming was 3.5 dB. Conclusion The BSC in PWI was equivalent to those in the other systems and to those of FI beamforming. This result indicates the possibility of ultra-high frame-rate BSC analysis using PWI.

High-frequency ultrasound (HFU, > 20 MHz) and quantitative ultrasound (QUS) methods permit a means to understand the relationship between anatomical and acoustic characteristics. In our previous research, we showed that analyzing the acoustic scattering with HFU was an effective method for noninvasive diagnosis. However, the depth of field (DOF) of HFU transducers was limited, which constrains the range of QUS analysis. In this study, we seek to improve the accuracy of HFU, QUS-based parameters on the envelope statistics and frequency-based analysis by using an annular array that allows for an extended DOF. A 20-MHz annular-array transducer with five elements was employed to obtain signals which were beamformed in post-processing. Two kinds of low concentration scattering phantoms were scanned with 30-mu m step size. Two QUS analysis techniques were employed: the Nakagami distribution and the reflector method. The results demonstrated that the annular array provides a stable analysis over an extended axial range. (C) 2019 The Japan Society of Applied Physics

© 2018, CARS. Purpose: Laparoscopic surgery requires complex surgical skills; hence, surgeons require regular training to improve their surgical techniques. The quantitative assessment of a surgeon’s skills and the provision of feedback are important processes for conducting effective training. The aim of this study was to develop an inexpensive training system that provides automatic technique evaluation and feedback. Methods: We detected the instrument using image processing of commercial web camera images and calculated the motion analysis parameters (MAPs) of the instrument to quantify performance features. Upon receiving the results, we developed a method of evaluating the surgeon’s skill level. The feedback system was developed using MAPs-based radar charts and scores for determining the skill level. These methods were evaluated using the videos of 38 surgeons performing a suturing task. Results: There were significant differences in MAPs among surgeons; therefore, MAPs can be effectively used to quantify a surgeon’s performance features. The results of skill evaluation and feedback differed greatly between skilled and unskilled surgeons, and it was possible to indicate points of improvement for the procedure performed in this study. Furthermore, the results obtained for certain novice surgeons were similar to those obtained for skilled surgeons. Conclusion: This system can be used to assess the skill level of surgeons, independent of the years of experience, and provide an understanding of the individual’s current surgical skill level effectively. We conclude that our system is useful as an inexpensive laparoscopic training system that might aid in skill improvement.

© 2018 The Japan Society of Applied Physics. Measurement of shear wave propagation speed in biological tissue is useful for evaluation of tissue stiffness. At present, there is a method using a shear wave generated by an ultrasonic push pulse, whose intensity is relatively higher than that used for B-mode imaging. However, this method poses a risk of tissue injury caused by cavitation. Therefore, a safer assessment method for shear wave propagation speed is required. In this paper, we propose a new method using shear waves generated by heartbeat pulses. Shear wave propagation speed is obtained by estimating wavenumbers in two dimensions using the phase of particle velocity. In basic experiments, different shear wave propagation speeds were obtained from two agar phantoms, whose stiffnesses were altered by changing the concentration of agar. In an in vivo experiment, the estimated shear wave propagation speed in a healthy liver was similar to those reported in the literature. These results show that the proposed method would be useful for safer estimation of shear wave propagation speed.

The development of a quantitative diagnostic method for liver fibrosis using an ultrasound B-mode image is highly required. In our previous study, a multi-Rayleigh model was proposed to express a probability distribution of echo envelope amplitude from a fibrotic liver. Using the multi-Rayleigh model, a structure of fibrotic tissue can be quantitatively estimated. In this study, a method of estimating the number of tissue components was proposed to improve the accuracy of estimating a fibrotic tissue structure. Using threshold processing for a squared Mahalanobis distance of moments, which is a statistical property of echo envelope amplitude, the number of tissue components could be quantitatively estimated. The results of evaluation of clinical ultrasound B-mode images using the multi-Rayleigh model with estimation of the number of tissue components well reflected the tissue structural changes caused by liver fibrosis. It was concluded that our proposed method of estimating the number of tissue components improves the accuracy of liver fibrosis evaluation based on the multi-Rayleigh model. (C) 2018 The Japan Society of Applied Physics

Many methods for the analysis of amplitude envelope statistics have been proposed in recent decades to enable echo signal characterization and realize quantitative diagnosis based on these statistics. In the statistical analysis of ultrasound signals, the spatial resolution of the signal is an important factor. An analysis method that offers higher sensitivity than the current analysis model is required to allow the effective use of recently developed high-resolution ultrasonic diagnostic equipment. In this study, we propose a multi-amplitude envelope statistical model called the double Nakagami probability density function (PDF) model that assumes the physical structure of fatty liver disease under high-frequency ultrasound excitation. Application of the proposed model to actual rat livers demonstrated that it was possible to evaluate fatty liver disease at an early stage with a lower scatterer density than that of a normal liver. However, it is difficult to detect the disease at this stage using existing technology. (C) 2018 The Japan Society of Applied Physics