Ultrasound Computed Tomography (USCT) has great potential for 3D quantitative imaging of acoustic breast tissue properties. Typical devices include high-frequency transducers, which makes tomography techniques based on numerical wave propagation simulations computationally challenging, especially in 3D. Therefore, despite the finite-frequency nature of ultrasonic waves, ray-theoretical approaches to transmission tomography are still widely used. This work introduces finite-frequency traveltime tomography to medical ultrasound. In addition to being computationally tractable for 3D imaging at high frequencies, the method has two main advantages: (1) It correctly accounts for the frequency dependence and volumetric sensitivity of traveltime measurements, which are related to off-ray-path scattering and diffraction. (2) It naturally enables out-of-plane imaging and the construction of 3D images from 2D slice-by-slice acquisition systems. Our method rests on the availability of calibration data in water, used to linearize the forward problem and to provide analytical expressions of cross-correlation traveltime sensitivity. As a consequence of the finite frequency content, sensitivity is distributed in multiple Fresnel volumes, thereby providing out-of-plane sensitivity. To improve computational efficiency, we develop a memory-efficient implementation by encoding the Jacobian operator with a 1D parameterization, which allows us to extend the method to large-scale domains. We validate our tomographic approach using lab measurements collected with a 2D setup of transducers and using a cylindrically symmetric phantom. We then demonstrate its applicability for 3D reconstructions by simulating a slice-by-slice acquisition system using the same dataset.

Computed ultrasound tomography in echo mode (CUTE) is a new ultrasound (US)-based medical imaging modality with promise for diagnosing various types of disease based on the tissue’s speed of sound (SoS). It is developed for conventional pulse-echo US using handheld probes and can thus be implemented in state-of-the-art medical US systems. One promising application is the quantification of the liver fat fraction in fatty liver disease. So far, CUTE was using linear array probes where the imaging depth is comparable to the aperture size. For liver imaging, however, convex probes are preferred since they provide a larger penetration depth and a wider view angle allowing to capture a large area of the liver. With the goal of liver imaging in mind, we adapt CUTE to convex probes, with a special focus on discussing strategies that make use of the convex geometry in order to make our implementation computationally efficient. We then demonstrate in an abdominal imaging phantom that accurate quantitative SoS using convex probes is feasible, in spite of the smaller aperture size in relation to the image area compared to linear arrays. A preliminary in vivo result of liver imaging confirms this outcome, but also indicates that deep quantitative imaging in the real liver can be more challenging, probably due to the increased complexity of the tissue compared to phantoms.

Background: Non-alcoholic fatty liver disease is rapidly emerging as the leading global cause of chronic liver disease. Efficient disease management requires low-cost, non-invasive techniques for diagnosing hepatic steatosis accurately. Here, we propose quantifying liver speed of sound (SoS) with computed ultrasound tomography in echo mode (CUTE), a recently developed ultrasound imaging modality adapted to clinical pulse-echo systems. CUTE reconstructs the spatial distribution of SoS by measuring local echo phase shifts when probing tissue at varying steering angles in transmission and reception. Methods: In this first-in-human phase II diagnostic study, we evaluated the liver of 22 healthy volunteers and 22 steatotic patients. We used conventional B-mode ultrasound images and controlled attenuation parameter (CAP) to diagnose the presence (CAP≥ 280 dB/m) or absence (CAP < 248 dB/m) of steatosis in the liver. A fully integrated convex-probe CUTE implementation was developed on the ultrasound system to estimate liver SoS. We investigated its diagnostic value via the receiver operating characteristic (ROC) analysis and correlation to CAP measurements. Results: We show that liver CUTE-SoS estimates correlate strongly (r = −0.84, p = 8.27 × 10⁻¹³) with CAP values and have 90.9% (95% confidence interval: 84–100%) sensitivity and 95.5% (81–100%) specificity for differentiating between normal and steatotic livers (area under the ROC curve: 0.93–1.0). Conclusions: Our results demonstrate that liver CUTE-SoS is a promising quantitative biomarker for diagnosing liver steatosis. This is a necessary first step towards establishing CUTE as a new quantitative add-on to diagnostic ultrasound that can potentially be as versatile as conventional ultrasound imaging.

Waveform inversion for ultrasound computed tomography (USCT) is a promising imaging technique for breast cancer screening. However, the improved spatial resolution and the ability to constrain multiple parameters simultaneously demand substantial computational resources for the recurring simulations of the wave equation. Hence, it is crucial to use fast and accurate methods for numerical wave propagation, on the one hand, and to keep the number of required simulations as small as possible, on the other hand. We present an efficient strategy for acoustic waveform inversion that combines (i) a spectral-element continuous Galerkin method for solving the wave equation, (ii) conforming hexahedral mesh generation to discretize the scanning device, (iii) a randomized descent method based on mini-batches to reduce the computational cost for misfit and gradient computations, and (iv) a trust-region method using a quasi-Newton approximation of the Hessian to iteratively solve the inverse problem. This approach combines ideas and state-of-the-art methods from global-scale seismology, large-scale nonlinear optimization, and machine learning. Numerical examples for a synthetic phantom demonstrate the efficiency of the discretization, the effectiveness of the mini-batch approximation and the robustness of the trust-region method to reconstruct the acoustic properties of breast tissue with partial information.

Objectives: Measurement location and patient state can impact noninvasive liver assessment and change clinical staging in ultrasound examinations. Research into differences exists for Shear Wave Speed (SWS) and Attenuation Imaging (ATI), but not for Shear Wave Dispersion (SWD). The aim of this study is to assess the effect of breathing phase, liver lobe, and prandial state on SWS, SWD, and ATI ultrasound measurements. Methods: Two experienced examiners performed SWS, SWD, and ATI measurements in 20 healthy volunteers using a Canon Aplio i800 system. Measurements were taken in the recommended condition (right lobe, following expiration, fasting state), as well as (a) following inspiration, (b) in the left lobe, and (c) in a nonfasting state. Results: SWS and SWD measurements were strongly correlated (r = 0.805, p < 0.001). Mean SWS was 1.34 ± 0.13 m/s in the recommended measurement position and did not change significantly under any condition. Mean SWD was 10.81 ± 2.05 m/s/kHz in the standard condition and significantly increased to 12.18 ± 1.41 m/s/kHz in the left lobe. Individual SWD measurements in the left lobe also had the highest average coefficient of variation (19.68%). No significant differences were found for ATI. Conclusion: Breathing and prandial state did not significantly affect SWS, SWD, and ATI values. SWS and SWD measurements were strongly correlated. SWD measurements in the left lobe showed a higher individual measurement variability. Interobserver agreement was moderate to good.