Smart ultrasound device for real-time myocardial stiffness quantification of the human heart

Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): ERC Introduction Myocardial stiffness (MS) is crucial to understand cardiac biomechanics and evaluate cardiac function. We recently demonstrated that shear wave imaging using acoustic radiation force can provide quantitative end-diastolic MS in human patients [1] . However, the dependence of shear wave velocity with myofiber orientation remained a limitation and required to perform Shear Wave Velocity (SWV) estimations from different probe orientations which is challenging in clinical practice. We propose a new approach to provide real-time quantitative assessment of MS without dependence of the probe orientation based on a dedicated smart ultrasound (US) device. Methods A new US probe was designed and manufactured to generate acoustic radiation force along the central axis and track the SWV simultaneously along three different orientations to obtain an elliptic profile of SWS. The probe was connected to dedicated electronics and software to provide real-time end-diastolic MS with ECG gating. Validation was performed on 4 in-vitro calibrated phantoms (0.92 – 1.49 – 2.58 – 3.49 m/s) and on ex vivo porcine hearts. MS along and across the fibers were compared to the values measured by conventional shear wave imaging with a linear probe mounted on a rotation motor (angular step of 10°) (Aixplorer, Supersonic imaging). Finally, the in vivo feasibility and reproducibility of measuring MS of the antero-septal wall and of the right ventricular (RV) wall was assessed transthoracically on four human volunteer . Results In vitro results on phantoms showed a good agreement with calibrated value (r2 = 0.98, std = 4.8%). Elliptic profiles on ex-vivo porcine heart showed good agreement with Aixplorer measurements acquired at different angles, with a relative difference along the long axis (LA) of: Δ=7.0%, Δ=7.1%, Δ=9% respectively for left ventricle (LV), right ventricle (RV) and septum. Finally, myocardial SWV assessment in human volunteers was obtained successfully on the RV and on the septum in late diastole. The mean MS was 1.79+/- 0.15 m/s along the fiber direction, the fractional anisotropy (FA) was 0.25 +/- 0.06 on septal wall in good agreement with previous results [1] and 1.06 +/- 0.11 m/s along fibers orientation and a FA of 0.27 +/- 0.08 on RV. Finally the beat to beat reproducibility of MS measurement was estimated to be 8.22%. Conclusion The new smart US device allowed non-invasive quantification of anisotropic myocardial tissues in real time. Results showed the accuracy of the methods. This approach could offer a new clinical tool for the evaluation of the myocardium in cardiomyopathies and in heart failure patients. Abstract Figure. SWV on myocardium human volonteer

Characterizing the borehole response for single-well shear-wave reflection imaging

Single-well shear-wave imaging using a dipole source-receiver system is an important application for detecting geological structures away from the borehole. This development allows for determining the azimuth information of the structures. Existing analyses, however, focus on the data received at the borehole axis and use the elastic reciprocity theorem to model the borehole radiation and recording. We extend the existing analyses to model the radiation, reflection, and the recording response of the borehole for azimuthally spaced receivers off the borehole axis. By treating the mirror image of the borehole source with respect to the reflector plane as a virtual source, the borehole reception problem is shown to be equivalent to the response of the borehole to the spherical wave incidence from the virtual source, which can be solved using the cylindrical-wave expansion method. An asymptotic solution using the steepest decent method is obtained if the virtual source is far from the borehole. The analytical solution allows us to analyze the borehole response for azimuthally spaced off-axis receivers. The analysis results agree well with those from 3D finite-difference simulations. With this analysis, one can further model the multi-component shear-wave reflection data from the cross-dipole acoustic tool and study the azimuthal variation characteristics of the data. The results show that, while the data characteristics are dominated by those of a dipole, non-dipole responses due to the off-axis reception can be observed, the magnitude of the responses depending on the off-axis distance and frequency and on the formation elasticity. The non-dipole response characteristics have the potential to resolve the 180°-ambiguity problem in the azimuth determination for the dipole shear-wave imaging. The findings, therefore, provide new information to the shear-wave reflection imaging analysis and development.