Acoustic Radiation Force: A Review of Four Mechanisms for Biomedical Applications.

Radiation force is a universal phenomenon in any wave motion where the wave energy produces a static or transient force on the propagation medium. The theory of acoustic radiation force (ARF) dates back to the early 19th century. In recent years, there has been an increasing interest in the biomedical applications of ARF. Following a brief history of ARF, this article describes a concise theory of ARF under four physical mechanisms of radiation force generation in tissue-like media. These mechanisms are primarily based on the dissipation of acoustic energy of propagating waves, the reflection of the incident wave, gradients of the compressional wave speeds, and the spatial variations of energy density in standing acoustic waves. Examples describing some of the practical applications of ARF under each mechanism are presented. This article concludes with a discussion on selected ideas for potential future applications of ARF in biomedicine.

Acoustic waves in medical imaging and diagnostics.

Up until about two decades ago acoustic imaging and ultrasound imaging were synonymous. The term ultrasonography, or its abbreviated version sonography, meant an imaging modality based on the use of ultrasonic compressional bulk waves. Beginning in the 1990s, there started to emerge numerous acoustic imaging modalities based on the use of a different mode of acoustic wave: shear waves. Imaging with these waves was shown to provide very useful and very different information about the biological tissue being examined. We discuss the physical basis for the differences between these two basic modes of acoustic waves used in medical imaging and analyze the advantages associated with shear acoustic imaging. A comprehensive analysis of the range of acoustic wavelengths, velocities and frequencies that have been used in different imaging applications is presented. We discuss the potential for future shear wave imaging applications.

Biomedical applications of radiation force of ultrasound: historical roots and physical basis.

Radiation force is a universal phenomenon in any wave motion, electromagnetic or acoustic. Although acoustic and electromagnetic waves are both characterized by time variation of basic quantities, they are also both capable of exerting a steady force called radiation force. In 1902, Lord Rayleigh published his classic work on the radiation force of sound, introducing the concept of acoustic radiation pressure, and some years later, further fundamental contributions to the radiation force phenomenon were made by L. Brillouin and P. Langevin. Many of the studies discussing radiation force published before 1990 were related to techniques for measuring acoustic power of therapeutic devices; also, radiation force was one of the factors considered in the search for noncavitational, nonthermal mechanisms of ultrasonic bioeffects. A major surge in various biomedical applications of acoustic radiation force started in the 1990s and continues today. Numerous new applications emerged including manipulation of cells in suspension, increasing the sensitivity of biosensors and immunochemical tests, assessing viscoelastic properties of fluids and biological tissues, elasticity imaging, monitoring ablation of lesions during ablation therapy, targeted drug and gene delivery, molecular imaging and acoustical tweezers. We briefly present in this review the major milestones in the history of radiation force and its biomedical applications. In discussing the physical basis of radiation force and its applications, we present basic equations describing the relationship of radiation stress with parameters of acoustical fields and with the induced motion in the biological media. Momentum and force associated with a plane-traveling wave, equations for nonlinear and nonsteady-state acoustic streams, radiation stress tensor for solids and biological tissues and radiation force acting on particles and microbubbles are considered.

Vaginal tactile imaging.

Changes in the elasticity of the vaginal walls, connective support tissues, and muscles are thought to be significant factors in the development of pelvic organ prolapse, a highly prevalent condition affecting at least 50% of women in the United States during their lifetimes. It creates two predominant concerns specific to the biomechanical properties of pelvic support tissues: how does tissue elasticity affect the development of pelvic organ prolapse and how can functional elasticity be maintained through reconstructive surgery. We designed a prototype of vaginal tactile imager (VTI) for visualization and assessment of elastic properties of pelvic floor tissues. In this paper, we analyze applicability of tactile imaging for evaluation of reconstructive surgery results and characterization of normal and pelvic organ prolapse conditions. A pilot clinical study with 13 patients demonstrated that VTI allows imaging of vaginal walls with increased rigidity due to implanted mesh grafts following reconstructive pelvic surgery and VTI has the potential for prolapse characterization and detection.

Time reversal acoustic focusing with a catheter balloon.

The ability to deliver configurable myocardial lesions was noted as a critical factor to the success of atrial fibrillation (AF) treatment. This article considers the implementation of time reversal acoustics (TRA) principles for ultrasound focusing using an AF cardiac catheter developed for pulmonary vein isolation. Experiments conducted with a single transmitting channel demonstrated that a catheter balloon could be used as an acoustic reverberator to enable focusing and steering of ultrasound short pulses in the TRA mode. The spatial effectiveness of the TRA focusing was improved using a catheter balloon of irregular, asymmetric shape and using a binary mode of ultrasound radiation. The experiments demonstrated the ability of steering the focal point over several millimeters without degradation of the focusing quality. An ability of the TRA mode to produce suitable therapeutic application focusing of long continuous ultrasonic signals was characterized in a theoretical model. (E-mail: yegorasha@yahoo.com).

Mechanical imaging in medical applications.

Mechanical Imaging (MI), a.k.a. tactile imaging or stress imaging, is a branch of Elasticity Imaging, a medical diagnostic technique based on the visualization of tissue internal structures in terms of their elasticity modulus. During the last decade, numerous methods and devices have been developed implementing MI technology in various medical applications, such as the visualization and evaluation of prostate conditions, breast cancer screening, the differentiation of benign and malignant lesions, and the characterization of vaginal wall elasticity. This paper presents an overview of MI technology and its applications, strengths and limitations. Results of laboratory and clinical studies clearly indicate that Mechanical Imaging devices have the potential to be used as a cost effective means for cancer screening as well as diagnostics of various diseases accompanied by changes of mechanical properties of soft tissues.

Mechanical imaging of the breast.

In this paper, we analyze the physical basis for elasticity imaging of the breast by measuring breast skin stress patterns that result from a force sensor array pressed against the breast tissue. Temporal and spatial changes in the stress pattern allow detection of internal structures with different elastic properties and assessment of geometrical and mechanical parameters of these structures. The method entitled mechanical imaging is implemented in the breast mechanical imager (BMI), a compact device consisting of a hand held probe equipped with a pressure sensor array, a compact electronic unit, and a touchscreen laptop computer. Data acquired by the BMI allows calculation of size, shape, consistency/hardness, and mobility of detected lesions. The BMI prototype has been validated in laboratory experiments on tissue models and in an ongoing clinical study. The obtained results prove that the BMI has potential to become a screening and diagnostic tool that could largely supplant clinical breast examination through its higher sensitivity, quantitative record storage, ease-of-use, and inherent low cost.

Prostate mechanical imaging: 3-D image composition and feature calculations.

We have developed a method and a device entitled prostate mechanical imager (PMI) for the real-time imaging of prostate using a transrectal probe equipped with a pressure sensor array and position tracking sensor. PMI operation is based on measurement of the stress pattern on the rectal wall when the probe is pressed against the prostate. Temporal and spatial changes in the stress pattern provide information on the elastic structure of the gland and allow two-dimensional (2-D) and three-dimensional (3-D) reconstruction of prostate anatomy and assessment of prostate mechanical properties. The data acquired allow the calculation of prostate features such as size, shape, nodularity, consistency/hardness, and mobility. The PMI prototype has been validated in laboratory experiments on prostate phantoms and in a clinical study. The results obtained on model systems and in vivo images from patients prove that PMI has potential to become a diagnostic tool that could largely supplant DRE through its higher sensitivity, quantitative record storage, ease-of-use and inherent low cost.