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1 Elastografie Jan Kybic, J.Ophir 1,... January 9, mainslideshow/main_slide_show.pps

2 Elastography: Imaging of Tissue Elastic Properties In-Vitro and In-Vivo J. Ophir, B. Garra*, F. Kallel, E.E. Konofagou, R. Righetti** and T. Varghese The University of Texas Medical School, Houston, TX *The University of Vermont Medical Center, Burlington, VT **The University of Florence, Italy Supported by National Cancer Institute (NCI) Program Project Grant P01-CA 64597

3 Elastography Definition Motivation Basic principles Early experiments and images Contemporary results Future directions

4 JO 6/97 Definition Elastography: An imaging technique whereby local axial tissue strains are estimated from differential ultrasonic speckle displacements. These displacements are generated by a weak, quasi-static stress field. The resultant strain image is called an Elastogram.

5 Elastography Definition Motivation Basic principles Early experiments and images Contemporary results Future directions

6 Motivation *Most pathological changes are associated with changes in tissue stiffness. *Palpation is an effective method for lesion detection and evaluation. *Many cancers (breast, prostate) are iso-echoic, and hence difficult to detect by ultrasound.

7 Elastography Definition Motivation Basic data and principles Early experiments and images Contemporary results Future directions

8 Tissue Type Basic data on breast tissues Tissue Stiffness (kpa) 5% precompression 20% precompression Strain rate Strain rate 1%/sec 10%/sec 40%/sec 2%/sec 20%/sec 80%/sec Normal fat (n=40) 18 ± 7 19 ± 7 22 ± 9 20 ± 8 20 ± 6 23 ± 5 Normal glandular (n=31) 28 ± ± ± ± ± ± 17 Fibrous (n=21) 97 ± ± ± ± ± ± 83 Ductal tumor (n=23) 22 ± 8 25 ± 4 26 ± ± ± ± 78 Infilt.ductal tumor (n=32) 106 ± ± ± ± ± ± 178 JO 1/98 data courtesy of Dr. T. Krouskop, Baylor College of medicine

9 Basic Principles: Normal strain

10 One Dimensional Uniform Spring System

11 Strain Profile in Uniform Spring s t r a i n Depth

12 One Dimensional Non-Uniform Spring System

13 Strain Profile in Non-uniform Spring s t r a i n Depth

14 Basic Principles: Tissue Compression Model Two-dimensional representation/ perfect-slip conditions 5/98 Before compression After compression

15 Elastography data acquisition system

16 Basic Principles: The Elastography Process ESTIMATION OF STRAIN ESTIMATION OF STRESS Post-compression RF A-lines Pre-compression RF A-lines Applied Stress Theoretical Stress Distribution Local Cross Correlation Analysis Y local Stress Strain¹ Absolute Axial Stress Estimation local ELASTOGRAM

17 RF signal compression: 2% applied strain precomp postcomp Notice that a small compression (strain) of the tissue results in a small compression of the signal (similar to frequency modulation)

18 Basic Principles: Estimation of Strain Pre-compression RF line (T) del(t) Post-compression RF line Strain=del(t)/ (T)

19 Elastography Definition Motivation Basic principles Early experiments and images Contemporary results Future directions

20 Layered foam phantom (ca.1991) photograph sonogram elastogram

21 Sponge w/ diagonal cut (ca. 1991) photograph sonogram elastogram I elastogram II

22 Breast carcinoma in vitro (ca. 1992) sonogram elastogram

23 Breast Carcinoma in-vivo (ca. 1993)

24 Elastography Definition Motivation Basic principles Early experiments and images Contemporary results Future directions

25

26 Elastogram from an ovine kidney Sonogram Elastogram Photograph

27 4/98 Ovine Kidneys in-vitro (1997) Two longitudinal elastographic views at 5 MHz

28 IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL July 1998 Volume 45 Number 4 ITUCER (ISSN )

29 Canine prostate in-vitro (1998) Transverse slice Elastogram Photograph Sonogram 9/98

30 MRI, Elastogram, Sonogram and Pathology Images from a Canine Prostate at 5 MHz (1999)

31 Canine Prostate in 5 MHz 1 cm Trans. Long.

32 Infiltrating Ductal Carcinoma of the Breast sonogram (1996) elastogram

33 Invasive Ductal Carcinoma (1996) 1996 Sonogram Elastogram

34 Multifocal Breast Cancer in-vivo (1998) 2/98 Sonogram Elastogram

35 Infiltrating Ductal Carcinoma of the Breast In Vivo at 5 MHz (1999)

36 Breast tumors in-vivo (1999) Fibroadenoma Sonograms Elastograms Infil. Duct. Carcinoma

37 HIFU lesion in Canine Liver elastogram T2 MRI Sonogram Pathology

38 Elastography Definition Motivation Basic principles Early experiments and images Contemporary results Future directions

39 Conclusions and Future Directions Elastography conveys new and probably clinically important tissue information; The tradeoffs among engineering/elastographic image parameters are now reasonably well understood; Elastography can operate in hypoechoic areas (ex. shadows); Reliable small elastic contrast exists among normal soft-tissue components; good CNR allows its visualization; Pathology generally exhibits large elastic contrast; Promising areas include breast, prostate, vasculature, small parts and treatment monitoring.

40 Elastography: Block Diagram THEORY of ELASTICITY TISSUE MODULUS DISTRIBUTION modulus>>strain THEORY of ELASTICITY modulus>strain (dependence on boundary cond.) STRAIN FILTER STRAIN ELASTOGRAM ACOUSTIC, SIGNAL & PROCESSING PARAMETERS MODULUS ELASTOGRAM INVERSE PROBLEM SOLUTION strain>modulus JO 6/98 BOUNDARY CONDITIONS

41 Sonoelastogram Hitachi

42 Alternativní elastografické techniky

43 Buzení Excitace Kvazistatické (pomalé), tlakem sondy Impulsní Harmonické Mechanicky Interferencí ultrazvukových paprsků

44 Snímání Ultrazvuk Laserový vibrometr (interferometr) MRI + 3D data

45 Materiály s různou tuhostí. Fantom

46 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

47 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

48 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

49 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

50 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

51 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

52 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

53 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

54 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

55 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

56 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

57 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

58 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

59 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

60 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

61 Harmonické buzení MRI snímání Tužší hmota rychlejší vlnění

62 Sval při zatížení

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90 Vlnění v mozku

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138 Elastografie závěr Neinvazivní metody měření elastických parametrů in vivo Tuhost často koreluje s diagnózou; klinické využití v bĺızké budoucnosti Technicky náročná řešení, specializovaný hardware Jednodušší snímání složitý inverzní problém

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