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Study of viscous and elastic properties of soft tissues using supersonic shear imaging

Supersonic shear imaging (SSI) is a new ultrasound based technique for real time visualization of soft tissue viscoelastic properties. Using ultrasound focused beams, it is possible to remotely generate inside the body mechanical sources radiating low frequency shear waves. SSI is based on the ultrasonic generation of a shear source moving at a supersonic speed inside the body. In a complete analogy with the "sonic boom" created by a supersonic aircraft, the resulting shear waves will constructively interfere along a Mach cone, creating two intense plane waves. These plane shear waves propagate through the medium and are progressively distorted by tissue mechanical inhomogeneities. The ultrafast scanner developed in our laboratory (5000 images/s) is able to generate this supersonic source and image, in real time, the propagation of the resulting shear waves. Using inversion algorithms, viscosity and elasticity maps of the medium can be deduced from this shear wave propagation movie. Creating such a supersonic regime enables quantitative tissue elasticity mapping in less than 20 ms, even in strongly viscous medium like breast or liver. Results validating SSI for quantitative shear elasticity mapping in heterogeneous tissue mimicking phantoms are presented. Detection of in vitro thermally-induced lesions on fresh tissue samples is shown. In vivo tests made on healthy volunteers show the potential clinical applicability of SSI for breast cancer detection. Finally, viscosity mapping using SSI has been studied theoretically and experimentally. Based on a Voigt model, simulations in different viscous and elastic media were compared and fitted to in vitro experiments. Using this theoretical background, viscosity maps using SSI were for the first time derived in viscoelastic phantoms.