Longitudinal Quantitative Ultrasonic Analysis of Patellar Tendon in a Collegiate Athlete After Bilateral Debridement: A Case Report.

CONTEXT: A National Collegiate Athletic Association Division I female basketball athlete (age = 20 years, height = 190.5 cm, mass = 87 kg) had chronic patellar tendinopathy. INTERVENTION(S): After undergoing unsuccessful conservative treatments, the athlete underwent bilateral open patellar debridement surgery. Pain and dysfunction were assessed via the Victorian Institute of Sport-P (VISA-P) score with concurrently collected B-mode ultrasound images of the patellar tendon throughout a 12-month rehabilitation. RESULTS: Peak spatial frequency radius (PSFR), a quantitative ultrasound measure previously shown to be correlated with collagen organization, was compared with changes in VISA-P scores. Overall increases in PSFR values across 0°, 30°, 60°, and 90° of knee flexion were observed throughout recovery. Despite increased PSFR values and returning to sport, the athlete reported substantial pain. CONCLUSIONS: In this level 3 exploration case report, we provide novel insight into ultrasonically measured structural changes of the patellar tendon after surgery and during rehabilitation of an athlete with chronic tendinopathy. Perceived pain measurements were not necessarily related to structural adaptations.

Changes in tendon spatial frequency parameters with loading.

To examine and compare the loading related changes in micro-morphology of the patellar tendon. Fifteen healthy young males (age 19±3yrs, body mass 83±5kg) were utilised in a within subjects matched pairs design. B mode ultrasound images were taken in the sagittal plane of the patellar tendon at rest with the knee at 90° flexion. Repeat images were taken whilst the subjects were carrying out maximal voluntary isometric contractions. Spatial frequency parameters related to the tendon morphology were determined within regions of interest (ROI) from the B mode images at rest and during isometric contractions. A number of spatial parameters were observed to be significantly different between resting and contracted images (Peak spatial frequency radius (PSFR), axis ratio, spatial Q-factor, PSFR amplitude ratio, and the sum). These spatial frequency parameters were indicative of acute alterations in the tendon micro-morphology with loading. Acute loading modifies the micro-morphology of the tendon, as observed via spatial frequency analysis. Further research is warranted to explore its utility with regard to different loading induced micro-morphological alterations, as these could give valuable insight not only to aid strengthening of this tissue but also optimization of recovery from injury and treatment of conditions such as tendinopathies.

A new method for shear wave speed estimation in shear wave elastography.

Visualization of mechanical properties of tissue can aid in noninvasive pathology diagnosis. Shear wave elastography (SWE) measures the elastic properties of soft tissues by estimation of local shear wave propagation speed. In this paper, a new robust method for estimation of shear wave speed is introduced which has the potential for simplifying continuous filtering and real-time elasticity processing. Shear waves were generated by external mechanical excitation and imaged at a high frame rate. Three homogeneous phantoms of varying elastic moduli and one inclusion phantom were imaged. Waves propagating in separate directions were filtered and shear wave speed was estimated by inversion of the 1-D first-order wave equation. Final 2-D shear wave speed maps were constructed by weighted averaging of estimates from opposite traveling directions. Shear wave speed results for phantoms with gelatin concentrations of 5%, 7%, and 9% were 1.52 ± 0.10 m/s, 1.86 ± 0.10 m/s, and 2.37 ± 0.15 m/s, respectively, which were consistent with estimates computed from three other conventional methods, as well as compression tests done with a commercial texture analyzer. The method was shown to be able to reconstruct a 2-D speed map of an inclusion phantom with good image quality and variance comparable to conventional methods. Suggestions for further work are given.

Optimal control strategy for fed-batch enzymatic hydrolysis of lignocellulosic biomass based on epidemic modeling.

A mathematical optimal control strategy for feeding operation was developed for fed-batch enzymatic hydrolysis of dilute acid pretreated lignocellulosic biomass based on a modified epidemic model. Cellulose conversion was maximized and glucose concentration achieved highest possible value over a fixed hydrolysis time. Boundaries of feeding rate and lignin content were set for feasible controls. Using the optimal control feeding strategy, glucose concentration and accumulated cellulose conversion reached up to 77.31 g/L and 72.08% in 100 h, which are 108.76% and 37.50% higher than in batch hydrolysis with same amount of enzyme consumption. Solids content in feeding source has a significant interference on system mass transfer. Optimal control is a useful tool for guiding operations in fed-batch and continuous processes as it enables process optimization through clear objective functions and feasible controls.

Enabling real-time ultrasound imaging of soft tissue mechanical properties by simplification of the shear wave motion equation.

Ultrasound based shear wave elastography (SWE) is a technique used for non-invasive characterization and imaging of soft tissue mechanical properties. Robust estimation of shear wave propagation speed is essential for imaging of soft tissue mechanical properties. In this study we propose to estimate shear wave speed by inversion of the first-order wave equation following directional filtering. This approach relies on estimation of first-order derivatives which allows for accurate estimations using smaller smoothing filters than when estimating second-order derivatives. The performance was compared to three current methods used to estimate shear wave propagation speed: direct inversion of the wave equation (DIWE), time-to-peak (TTP) and cross-correlation (CC). The shear wave speed of three homogeneous phantoms of different elastic moduli (gelatin by weight of 5%, 7%, and 9%) were measured with each method. The proposed method was shown to produce shear speed estimates comparable to the conventional methods (standard deviation of measurements being 0.13 m/s, 0.05 m/s, and 0.12 m/s), but with simpler processing and usually less time (by a factor of 1, 13, and 20 for DIWE, CC, and TTP respectively). The proposed method was able to produce a 2-D speed estimate from a single direction of wave propagation in about four seconds using an off-the-shelf PC, showing the feasibility of performing real-time or near real-time elasticity imaging with dedicated hardware.