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Register a new userLiquid-liver phantom: mimicking the viscoelastic dispersion of human liver for elastography in ultrasound and MRI
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Different clinical elastography devices show different liver-stiffness values in the same subject, hindering comparison of values and establishment of system-independent thresholds for disease detection. Therefore, authorities request standardized phantoms that address the viscosity-related dispersion of stiffness over frequency. A linear polymerized polyacrylamide phantom (PAAm) was calibrated to the viscoelastic properties of healthy human liver in vivo. Shear-wave speed as a surrogate of stiffness was quantified between 5 Hz and 3000 Hz frequency-range by shear rheometry, ultrasound-based time-harmonic elastography, clinical MR elastography (MRE), and tabletop MRE. Imaging parameters for ultrasound were close to those of liver in vivo. Reproducibility, aging behavior and temperature dependency were assessed and fulfilled requirements for quantitative elastography. In addition, the phantom was used to characterize the frequency bandwidth of shear-wave speed of several clinical elastography methods. The liquid-liver phantom has favorable properties for standardization and development of liver elastography: first, it can be used across clinical and experimental elastography devices in ultrasound and MRI. Second, being a liquid, it can easily be adapted in size and shape to specific technical requirements, and by adding inclusions and scatterers. Finally, since the phantom is based on non-crosslinked linear PAA constituents, it is easy to produce, indicating potential widespread use among researchers and vendors to standardize liver-stiffness measurements.
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In the framework of algebraic inversion, Magnetic Resonance Elastography (MRE) repeatability, reproducibility and robustness were evaluated on extracted shear velocities (or elastic moduli). The same excitation system was implemented at two sites equipped with clinical MR scanners of 1.5 T and 3 T. A set of four elastic, isotropic, homogeneous calibrated phantoms of distinct elasticity representing the spectrum of liver fibrosis severity was mechanically characterized. The repeatability of the measurements and the reproducibility between the two platforms were found to be excellent with mean coefficients of variations of 1.62% for the shear velocity mean values and 1.95% for the associated standard deviations. MRE velocities were robust to the amplitude and pattern variations of the displacement field with virtually no difference between outcomes from both magnets at identical excitation frequencies even when the displacement field amplitude was 6 times smaller. However, MRE outcomes were very sensitive to the number of voxels per wavelength, s, of the recorded displacement field, with relative biases reaching 62% and precision losing up to a factor 23.5. For both magnetic field strengths, MRE accuracy and precision were largely degraded outside of established conditions of validity ($6 lesssim s lesssim 9$) resulting in estimated shear velocity values not significantly different between phantoms of increasing elasticity. When fulfilling the spatial sampling conditions, either prospectively in the acquisition or retrospectively before the reconstruction, MRE produced quantitative measurements that allowed to unambiguously discriminate, with infinitesimal p-values, between the phantoms mimicking increasing severity of liver fibrosis.
Objective: Realistic tissue-mimicking phantoms are essential for the development, the investigation and the calibration of medical imaging techniques and protocols. Because it requires taking both mechanical and imaging properties into account, the development of robust, calibrated phantoms is a major challenge in elastography. Soft polyvinyl chloride gels in a liquid plasticizer (plastisol or PVCP) have been proposed as soft tissue-mimicking phantoms (TMP) for elasticity imaging. PVCP phantoms are relatively low-cost and can be easily stored over long time periods without any specific requirements. In this work, the preparation of a PVCP gel phantom for both MR and ultrasoundelastography is proposed and its acoustic, NMR and mechanical properties are studied.Material and methods: The acoustic and magnetic resonance imaging properties of PVCP are measured for different mass ratios between ultrasound speckle particles and PVCP solution, and between resin and plasticizer. The linear mechanical properties of plastisol samples are then investigated over time using not only indentation tests, but also MR and ultrasound-elastography clinical protocols. These properties are compared to typical values reported for biological soft tissues and to the values found in the literature for PVCP gels.Results and conclusions: After a period of two weeks, the mechanical properties of the plastisol samples measured with indentation testing are stable for at least the following 4 weeks (end of follow-up period 43 days after gelation-fusion). Neither the mechanical nor the NMR properties of plastisol gels were found to be affected by the addition of cellulose as acoustic speckle. Mechanical properties of the proposed gels were successfully characterized by clinical, commercially-available MR Elastography and sonoelastography protocols. PVCP with a mass ratio of ultrasound speckle particles of 0.6% to 0.8% and a mass ratio between resin and plasticizer between 50 and 70% appears as a good TMP candidate that can be used with both MR and ultrasound-based elastography methods.
Segmentation of medical images is a challenging task owing to their complexity. A standard segmentation problem within Magnetic Resonance Imaging (MRI) is the task of labeling voxels according to their tissue type. Image segmentation provides volumetric quantification of liver area and thus helps in the diagnosis of disorders, such as Hepatitis, Cirrhosis, Jaundice, Hemochromatosis etc.This work deals with comparison of segmentation by applying Level Set Method,Fuzzy Level Information C-Means Clustering Algorithm and Gradient Vector Flow Snake Algorithm.The results are compared using the parameters such as Number of pixels correctly classified, and percentage of area segmented.
The invasive measurement of the hepatic venous pressure gradient is still considered as the reference method to assess the severity of portal hypertension. Even though previous studies have shown that the liver stiffness measured by elastography could predict portal hypertension in patients with chronic liver disease, the mechanisms behind remain today poorly understood. The main reason is that the liver stiffness is not specific to portal hypertension and is also influenced by concomitant pathologies, such as cirrhosis. Portal hypertension is also source of a vascular incidence, with a substantial diversion of portal venous blood to the systemic circulation, bypassing the liver. This study focuses on this vascular effect of portal hypertension. We propose to generate and control the portal venous flow (to isolate the modifications in the portal venous flow as single effect of portal hypertension) in an anesthetized pig and then to quantify its implications on liver stiffness by an original combination of MRE and 4D-Flow Magnetic Resonance Imaging (MRI). A catheter balloon is progressively inflated in the portal vein and the peak flow, peak velocity magnitude and liver stiffness are quantified in a 1.5T MRI scanner (AREA, Siemens Healthcare, Erlangen, Germany). A strong correlation is observed between the portal peak velocity magnitude, the portal peak flow or the liver stiffness and the portal vein intraluminal obstruction. Moreover, the comparison of mechanical and flow parameters highlights a correlation with the possibility of identifying linear relationships. These results give preliminary indications about how liver stiffness can be affected by portal venous flow and, by extension, by hypertension.
The quantification of liver fat as a diagnostic assessment of steatosis remains an important priority for noninvasive imaging systems. We derive a framework in which the unknown fat volume percentage can be estimated from a pair of ultrasound measurements. The precise estimation of ultrasound speed of sound and attenuation within the liver are shown to be sufficient for estimating fat volume assuming a classical model of the properties of a composite elastic material. In this model, steatosis is represented as a random dispersion of spherical fat vacuoles with acoustic properties similar to those of edible oils. Using values of speed of sound and attenuation from the literature where normal and steatotic livers were studied near 3.5 MHz, we demonstrate agreement of the new estimation method with independent measures of fat. This framework holds the potential for translation to clinical scanners where the two ultrasound measurements can be made and utilized for improved quantitative assessment of steatosis.
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