Toward Standardized Acoustic Radiation Force (ARF)-Based Ultrasound Elasticity Measurements With Robotic Force Control.

Abstract

Acoustic radiation force (ARF)-based approaches to measure tissue elasticity require transmission of a focused high-energy acoustic pulse from a stationary ultrasound probe and ultrasound-based tracking of the resulting tissue displacements to obtain stiffness images or shear wave speed estimates. The method has established benefits in biomedical applications such as tumor detection and tissue fibrosis staging. One limitation, however, is the dependence on applied probe pressure, which is difficult to control manually and prohibits standardization of quantitative measurements. To overcome this limitation, we built a robot prototype that controls probe contact forces for shear wave speed quantification. The robot was evaluated with controlled force increments applied to a tissue-mimicking phantom and in vivo abdominal tissue from three human volunteers. The root-mean-square error between the desired and measured forces was 0.07 N in the phantom and higher for the fatty layer of in vivo abdominal tissue. The mean shear wave speeds increased from 3.7 to 4.5 m/s in the phantom and 1.0 to 3.0 m/s in the in vivo fat for compressive forces ranging from 2.5 to 30 N. The standard deviation of shear wave speeds obtained with the robotic approach were low in most cases ( 0.2 m/s) and comparable to that obtained with a semiquantitative landmark-based method. Results are promising for the introduction of robotic systems to control the applied probe pressure for ARF-based measurements of tissue elasticity. This approach has potential benefits in longitudinal studies of disease progression, comparative studies between patients, and large-scale multidimensional elasticity imaging.