Acoustic Radiation Force-Driven Assessment of Myocardial Elasticity Using the Displacement Ratio Rate (DRR) Method

TLDR: A novel ARF-based imaging technique, the displacement ratio rate (DRR) method, was developed to rank the relative stiffnesses of dynamically varying tissue, and results predicted a similar cyclic stiffness variation to that offered by velocimetry while being insensitive to variations in applied radiation force.

Abstract: A noninvasive method of characterizing myocardial stiffness could have significant implications in diagnosing cardiac disease. Acoustic radiation force (ARF)–driven techniques have demonstrated their ability to discern elastic properties of soft tissue. For the purpose of myocardial elasticity imaging, a novel ARF-based imaging technique, the displacement ratio rate (DRR) method, was developed to rank the relative stiffnesses of dynamically varying tissue. The basis and performance of this technique was demonstrated through numerical and phantom imaging results. This new method requires a relatively small temporal (<1 ms) and spatial (tenths of mm2) sampling window and appears to be independent of applied ARF magnitude. The DRR method was implemented in two in vivo canine studies, during which data were acquired through the full cardiac cycle by imaging directly on the exposed epicardium. These data were then compared with results obtained by acoustic radiation force impulse (ARFI) imaging and shear wave velocimetry, with the latter being used as the gold standard. Through the cardiac cycle, velocimetry results portray a range of shear wave velocities from 0.76–1.97 m/s, with the highest velocities observed during systole and the lowest observed during diastole. If a basic shear wave elasticity model is assumed, such a velocity result would suggest a period of increased stiffness during systole (when compared with diastole). Despite drawbacks of the DRR method (i.e., sensitivity to noise and limited stiffness range), its results predicted a similar cyclic stiffness variation to that offered by velocimetry while being insensitive to variations in applied radiation force.