Elasticity Imaging: Principles Stanislav (Stas) Emelianov emelian@mail.utexas.edu Department of Biomedical Engineering The University of Texas at Austin Department of Imaging Physics The University of Texas M.D. Anderson Cancer Center Elasticity Imaging – Goal Remote non-invasive (or adjunct to invasive) imaging (or sensing) of mechanical properties of tissue for clinical applications Elasticity Changes in tissue elasticity are related to pathological changes … Such swellings as are soft, free from pain, and yield to the finger, ... and are less dangerous than the others. ... then, as are painful, hard, and large, indicate danger of speedy death; but such as are soft, free of pain, and yield when pressed with the finger, are more chronic than these. THE BOOK OF PROGNOSTICS, Hippocrates, 400 B.C. Hippocrates It is the business of the physician to know, in the first place, things similar and things dissimilar; … which are to be seen, touched, and heard; which are to be perceived in the sight, and the touch, and the hearing, … which are to be known by all the means we know other things. ON THE SURGERY, Hippocrates, 400 B.C. Hippocrates, 400 B.C. 1 Elasticity Imaging – Glance at History Hippocrates, circa 460-377 B.C. Tissue Elasticity Ultrasound MRI Oestreicher, 1951 Mechanical Properties of Tissue Mechanical Properties of Tissue Elasticity (e.g., bulk and shear moduli) Elasticity (e.g., bulk and shear moduli) Viscosity (e.g., bulk and shear viscosities) Viscosity (e.g., bulk and shear viscosities) Nonlinearity (e.g., strain hardening) Nonlinearity (e.g., strain hardening) Other (e.g., anisotropy, pseudoelasticity) Other (e.g., anisotropy, pseudoelasticity) Other methods Frank et al, 1948 Biomechanics (muscle, skin, ...) Sarvazyan et al, 1975 Frizzell et al, 1976 Fung, 1981 Thompson et al, 1981 Wilson and Robinson, 1982 Dickinson and Hill, 1982 Eisensher et al, 1983 Tristam et al, 1986 Sarvazyan et al, 1984 Krouskop, (Le)vinson, 1987 Lerner and Parker, 1988 Yamakoshi et al, 1988 Adler et al, 1989 Meunier and Bertrand, 1989 Duck, 1990 Parker et al, 1990 Ophir et al, 1991 Sarvazyan and Skovoroda, 1991 Avalanche of papers Krouskop et al, 1998 Erkamp et al, 1998 Pereira et al, 1990 DeJong et al, 1990 Fowlkes et al, 1992 Sarvazyan et al, 1995 Fowlkes et al, 1995 Muthupillai et al, 1995 Plewes et al, 1995 Chenevert et al, 1998 Many papers 2 Which Elastic Moduli? Elasticity Human sense of touch – what do we feel? R Relations between various elastic constants Constant l m E n K G Common Pair E, n l, m m nE (1 n )(1 2n ) E 2(1 n ) m (3l 2m ) (l m ) E l l 2(l m ) 0.5 l 23 m m m 2l m n E 3(1 2n ) E 2(1 n ) K, G K 23 G • G 9 KG 3K G 3K 2G 6 K 2G K G • x2 = = Poisson’s ratio (n) Bulk modulus (K) Shear modulus (mG) Young’s modulus (E) F1 Rigid circular die G cl K 32 G G K G 0 K x1 x3 F F1 3m 0 Most soft tissues are incompressible, i.e., deformation produces no volume change ct Incompressible material W n In addition, due to tissue incompressibility, Young’s modulus = 3 · shear modulus 1 2 E 3m Semi-infinite elastic medium K – bulk modulus m – shear modulus G F 8RWG 1 K 1 G 3K E 3m 1 G 8 RWm 0 K Static deformation of (nearly) incompressible material is primarily determined by shear or Young’s modulus Sarvazyan et al, 1995 3 Breast Tissue Elasticity and Pathology Breast Tissue Elasticity and Pathology Skovoroda et al., 1995, Wellman et al., 1999, Biophysics, 40(6):1359-1364. Breast Tissue Type Normal gland Infiltrative ductal cancer with alveolar tissue predominating. Fibroadenomas of glandular origin Infiltrative ductal cancer with fibrous tissue predominating. Ductal fibroadenoma Young’s Modulus (kPa) 0.5-1.5 1.0-1.5 1.5-2.5 2.0-3.0 8.0-12.0 Elastic Properties of Prostate Gland Aglyamov S.R. and Skovoroda A.R., 2000, Biophysics, 2000, 45(6). Harvard BioRobotics Laboratory Technical Report. Krouskop et al., 1998, Ultrasonic Imaging, 20:260-274. Samani et al., 2003, Physics in Medicine and Biology, 48:2183-2198 . 4 Elastic Properties of Arteries Sarvazyan A.P., 2001,” In: Handbook of Elastic Properties of Solids, Liquids and Gases. Type of soft tissue E, kPa Comments Contrast in Elasticity Imaging Reference Artery human, in vitro Thoracic aorta Abdominal aorta Iliac artery Femoral artery Liquids 300-940 980-1,420 1,100-3,500 1,230-5,500 For normal physiological conditions of longitudinal tension and distending blood pressure, below 200 mm Hg. Ascending aorta 183-582 M-mode echocardiography in different age groups. Alessandri et al., 1995 Coronary artery 1,060-4,110 Represents values for various ages (0-80 y.o.) and atherosclerosis conditions in right and left arteries. Ozolanta et al., 1998 Equilibrated at intraluminal pressure of 45 mmHg, media thickness and lumen diameter were measured in the applied 3 -140 mmHg intraluminal pressure range. Intengan et al., 1998 rat, in vitro mesenteric small arteries aortic wall porcine, in vitro thoracic aorta intima-medial layer adventitia layer ascending aorta intima-medial layer adventitia layer descending aorta intima-medial layer adventitia layer Contrast Mechanism in Other Imaging Modalities 100-1,500 700-1,600 All Soft Tissues Range includes measurements for normal vs spontaneously hypertensive animals. 248 69 Bending experiments were used to impose various strains on different layers of tested blood vessels. spatial distribution of the absorption (density) Bone 102 103 104 105 106 107 108 109 1010 Bulk Modulus (Pa) MRI: proton spin density and relaxation time constants Marque et al., 1999 43 4.7 447 112 Computerized Tomography: McDonald, 1974 Fung, 1993 Shear Modulus (Pa) Blood Vitreous Humor Dermis Connective Tissue Contracted Muscle Palpable Nodules Glandular Tissue of Breast Liver Relaxed Muscle Fat Bone Ultrasound Imaging: variation in acoustical impedance (bulk modulus and density) Epidermis Cartilage Cornea Optical Imaging: refraction index, absorption/scattering Sarvazyan et al, 1995 5 Strain Theory of Elasticity Stress 1-D deformation L0 • • • • • • Strain Stress Constitutive relationships Equations of equilibrium Equations of motion (wave equation) References L=L0+DL Strain Tensor 1-D example 11 12 13 21 22 23 31 32 33 L0 General: Lagrangian strain: 1 u 1 L2 L20 2 L20 u u u ij i j k k 2 x j xi xi x j Symmetry: Other strains: L L0 L L0 1 L L ; ; L0 L 2 L2 2 2 0 Small deformations: DL 1 L2 L20 L L0 1 L2 L20 1 L0 2 L20 L0 2 L2 ij ji Normal strain components: 11; 22; 33 Shear strain components: 12 21; 23 32; 31 13 F Stress Tensor F 11 12 13 21 22 23 31 32 33 S0 S L=L0+DL Symmetry: ij ji Cauchy stress: F S Other stresses: F F L0 ; S0 S0 L Small deformations: DL F F F L0 1 L0 S S0 S0 L Normal and Shear Stresses Normal stress components: 11; 22; 33 Shear stress components: 12 21; 23 32; 31 13 6 Constitutive Relations General Concept Uniaxial Deformation L0 F F ij S0 ij n n – Poisson’s ratio This is not a definition of a Poisson’s ratio Stress 22 11 1 0 Cijmn ij mn 2 81 constants Cijmn C jimn Cijmn Cijnm Cijmn Cmnij Examples: Rubber – Mooney-Rivlin function Foam – Blatz-K(a)o potential Tissue – ??? (Fung 1981) l 2 1-D example F one plane (monoclinic) – 13 two orthogonal planes (orthotropic) – 9 one axis (transversely isotropic) – 5 (cubic) – 3 11( x) const 11 0 x1 Remarks: Nonlinearity ( I1 , I 2 , I 3 ) Stress-strain relations: Nonlinear x i fi 0 j fi – body (volumetric) forces, e.g., gravity Constitutive (stress-strain) relations: Two elastic constants (l and m, for example) are needed to describe linear isotropic material Strain energy: Equilibrium (Newton’s 2nd law) ij ij l ii ij 2m ij 21 constants General F ii2 m ij2 Stress-strain relations: Symmetry: Strain Equations of Equilibrium Hooke’s Law Strain energy (linear, isotropic material): 0 Stress-strain relations: ij Cijmn mn L=L0+DL 11 E11 E – Young’s modulus Generalized Hooke’s Law Strain energy (linear, anisotropic material): – strain energy function or potential S Constitutive Relations • Generally, both elastic moduli are functions of coordinate: l=l(x1,x2,x3) and m=m(x1,x2,x3) • In forward problem formulation, there are 15 equations and 15 unknowns (ij, ij, ui) • The existence and uniqueness of the solution can be demonstrated ij e.g., ij l ii ij 2m ij ij Strain-displacement relations: 1 u ij i 2 x j u j xi uk uk xi x j Derive 1-D equation of equilibrium for E=const 7 Equations of Equilibrium Small deformations of linear, isotropic (i.e., Hookean) material u u u u u u u u (l ( 1 2 3 )) (2m 1 ) ( m ( 1 2 )) ( m ( 1 3 )) f1 0 x1 x1 x2 x3 x1 x1 x2 x2 x1 x3 x3 x1 u u u u u u u u (l ( 1 2 3 )) ( m ( 2 1 )) (2m 2 ) ( m ( 2 3 )) f 2 0 x2 x1 x2 x3 x1 x1 x2 x2 x2 x3 x3 x2 u u u u u u u u (l ( 1 2 3 )) ( m ( 3 1 )) ( m ( 3 2 )) (2m 3 ) f 3 0 x3 x1 x2 x3 x1 x1 x3 x2 x2 x3 x3 x3 Boundary (force and/or displacement) conditions ij n j Fi (ui ui0 ) 0 j 11n1 12n2 13n3 0 n=(n1,n2,n3) – unit normal vector at the surface ui0 – surface displacement components Free surface (i.e., Fi=0): ij n j 0 21n1 22n2 23n3 0 j 31n1 32n2 33n3 0 u1 u Displaced surface: 0 1 0 2 0 3 (ui ui0 ) 0 u2 u Mixed boundary conditions: 11n1 12n2 13n3 F1 u2 0 u3 0 To describe elastic properties of linear isotropic material, how many moduli of elasticity are required: To describe elastic properties of linear isotropic material, how many moduli of elasticity are required: Generalized Hooke’s Law Strain energy (linear, anisotropic material): 1 0 Cijmn ij mn 2 21% 7% 29% 21% 21% 1. 2. 3. 4. 5. One modulus Two moduli Three moduli Four moduli Five moduli 0 Stress-strain relations: Cijmn C jimn Cijmn Cijnm Cijmn Cmnij l 2 ii2 m ij2 Stress-strain relations: ij l ii ij 2m ij ij Cijmn mn 81 constants Hooke’s Law Strain energy (linear, isotropic material): 21 constants Symmetry: one plane (monoclinic) – 13 two orthogonal planes (orthotropic) – 9 one axis (transversely isotropic) – 5 (cubic) – 3 Two elastic constants (l and m, for example) are needed to describe linear isotropic material Nonlinearity Strain energy: ( I1 , I 2 , I 3 ) Stress-strain relations: Nonlinear u3 u 8 Viscosity Mechanical Properties of Tissue Deformation Creep Time Equilibrium (Newton’s 2nd law) ij x i j fi 2 ui t 2 Loading Cycles Constitutive (stress-strain) relations: Stress ij l ii ij 2m ij Stress Relaxation Stress Load Deformation Other (e.g., anisotropy, pseudoelasticity) Creep Constant Load Hysteresis loops: independent of the rate of loading (most soft tissues) ii ij 2 ij t t 12 • Bulk and shear viscosities are introduced Strain Constant Deformation 8 1st cycle Cornea Stress Relaxation Time • Is there a characteristic time? 0 • Four (4) parameters are needed to describe mechanical properties of the viscoelastic material 5th 4 30 60 90 >10th Load Viscosity (e.g., bulk and shear viscosities) • – shear viscosity – bulk viscosity Force (N) Elasticity (e.g., bulk and shear moduli) Nonlinearity (e.g., strain hardening) Viscosity Equations of Motion • Shear viscosity: shear waves • Bulk viscosity: longitudinal ultrasound waves • Viscoelastic models: Maxwell, Voigt, Kelvin, KVFD, etc. cycle • There are various models to describe constitutive relations, e.g., Voight model, Maxwell model, Kelvin model, etc. Time (min) Elongation 9 To describe viscoelastic properties of linear isotropic material, how many parameters are required: To describe viscoelastic properties of linear isotropic material, how many parameters are required: ij x i 0% 23% 18% 0% 18% 1. 2. 3. 4. 5. One parameter Two parameters Three parameters Four parameters Five parameters Mechanical Properties of Tissue Equilibrium (Newton’s 2nd law) j fi 2 ui t 2 Elasticity (e.g., bulk and shear moduli) Constitutive (stress-strain) relations: ij l ii ij 2m ij ii ij 2 ij t t – shear viscosity – bulk viscosity Viscosity (e.g., bulk and shear viscosities) • Bulk and shear viscosities are introduced • Four (4) parameters are needed to describe mechanical properties of the viscoelastic material • There are various models to describe constitutive relations, e.g., Voight model, Maxwell model, Kelvin model, etc. Nonlinearity (e.g., strain hardening) Other (e.g., anisotropy, pseudoelasticity) 10 Nonlinearity Constitutive Relations General Concept Uniaxial Deformation L0 F F ij ij S0 – strain energy function or potential S • • Most soft tissues exhibit strain hardening Tissues of organs with primary “mechanical” functions (muscle, skin, tendon, etc.) Other tissues (kidney, brain, blood clot, etc.) Strain hardening is more common although strain softening is possible • • L=L0+DL 22 11 n – Poisson’s ratio This is not a definition of a Poisson’s ratio Strain Examples: Rubber – Mooney-Rivlin function Foam – Blatz-K(a)o potential Tissue – ??? (Fung 1981) Vessel Composition (Fung, 1988): muscle (soft), elastin (soft), collagen (hard) Strain hardening in kidney samples (Erkamp et al, 1998) 80 40 Stress (kPa) E – Young’s modulus n Stress 11 E11 Strain hardening Strain hardening 30 Collagen 40 20 10 Elastin 0 1.0 1.1 1.2 Stretch ratio (L/L0) 1.3 0 5 10 15 Strain [%] Wellman et al., 1999 11 Strain hardening Mechanical Properties of Tissue This and other graphs as well as other literature data suggest that tissue strain hardening (or nonlinearity in stress-strain relations) can be used for tissue analysis including composition, differentiation, etc. Anisotropy Constitutive Relations Generalized Hooke’s Law Strain energy (linear, anisotropic material): Elasticity (e.g., bulk and shear moduli) 1 0 Cijmn ij mn 2 0 Stress-strain relations: Viscosity (e.g., bulk and shear viscosities) Nonlinearity (e.g., strain hardening) Other (e.g., anisotropy, pseudoelasticity) Cijmn C jimn Cijmn Cijnm Cijmn Cmnij l 2 ii2 m ij2 Stress-strain relations: ij l ii ij 2m ij ij Cijmn mn 81 constants Hooke’s Law Strain energy (linear, isotropic material): 21 constants Symmetry: one plane (monoclinic) – 13 two orthogonal planes (orthotropic) – 9 one axis (transversely isotropic) – 5 (cubic) – 3 Two elastic constants (l and m, for example) are needed to describe linear isotropic material Nonlinearity Strain energy: ( I1 , I 2 , I 3 ) Stress-strain relations: Nonlinear Krouskop et al, 1998 Ophir et al., 2001 12 To describe elastic properties of linear anisotropic material, how many parameters are required: Anisotropy • • Arterial wall: orthotropic material – 9 constants two orthogonal planes of symmetry Muscle: transversely isotropic – 5 constants axis of symmetry Isotropic – 2 constants 16 Stress (kPa) • Along fibers 12 Across fibers 8 4 0 0 5 10 Strain (%) 15 20 To describe elastic properties of linear anisotropic material, how many parameters are required Generalized Hooke’s Law Strain energy (linear, anisotropic material): 8% 4% 4% 8% 21% 1. 2. 3. 4. 5. One parameter Two parameters Nine parameters Twenty one parameters Infinite set of parameters 1 0 Cijmn ij mn 2 0 Stress-strain relations: Cijmn C jimn Cijmn Cijnm Cijmn Cmnij l 2 ii2 m ij2 Stress-strain relations: ij l ii ij 2m ij ij Cijmn mn 81 constants Hooke’s Law Strain energy (linear, isotropic material): 21 constants Symmetry: one plane (monoclinic) – 13 two orthogonal planes (orthotropic) – 9 one axis (transversely isotropic) – 5 (cubic) – 3 Two elastic constants (l and m, for example) are needed to describe linear isotropic material Nonlinearity Strain energy: ( I1 , I 2 , I 3 ) Stress-strain relations: Nonlinear 13 Mechanical Properties of Tissue: References Theory of Elasticity: References • Landau LD and Lifshitz EM. Theory of elasticity. Pergamon Press; New York, 1986 • Saada AS. Elasticity Theory and Applications. Krieger Publishing Company; Malabar, Florida, 1993 • Nowazki W. Dynamics of elastic systems. Wiley; New York, 1963 • Nowazki W. Thermoelasticity. Pergamon Press; New York, 1983 • Duck, F.A. Physical properties of tissues. Academic press; New York, 1990 • Fung YC. Biomechanics – mechanical properties of living tissues. SpringerVerlag; New York, 1981 • Krouskop TA, Wheeler TM, Kallel F, Garra BS, Hall TJ, “The elastic moduli of breast and prostate tissues under compression,” Ultrasonic Imaging vol. 20 pp. 260-274, 1998 • Aglyamov SR, Skovoroda AR, “Mechanical properties of soft biological tissues,” Biophysics, Pergamon, 45(6):1103-1111, 2000. • Sarvazyan AP, “Elastic properties of soft tissues,” In: Handbook of Elastic Properties of Solids, Liquids and Gases, Volume III, Chapter 5, 107-127, eds. Levy, Bass and Stern, Academic Press, 2001 • Other text books and archival publications • There are many other textbooks and archival publications Elasticity Imaging – Approaches Static (strain-based, or reconstructive) imaging internal motion under static deformation Dynamic (wave-based) imaging shear wave propagation Mechanical (stress-based, also reconstructive) measuring tissue response at the surface 14 Elasticity Imaging – Approaches How … Static Elasticity Imaging? How … Static Elasticity Imaging? Displacement Displacement Strain Amplitude Strain Static (strain-based, or reconstructive) Soft imaging internal motion under static deformation Dynamic (wave-based) Hard imaging shear wave propagation Mechanical (stress-based, also reconstructive) Range Range measuring tissue response at the surface 15 How … Static Elasticity Imaging? Static or Reconstructive Ultrasound Elasticity Imaging Elasticity Reconstruction: back to Equations of Equilibrium Small deformations of linear, isotropic (i.e., Hookean) material B-Scan Displacements Strains Elasticity • Capture data during deformation u u u u u u u u (l ( 1 2 3 )) (2m 1 ) ( m ( 1 2 )) ( m ( 1 3 )) f1 0 x1 x1 x2 x3 x1 x1 x2 x2 x1 x3 x3 x1 u u u u u u u u (l ( 1 2 3 )) ( m ( 2 1 )) (2m 2 ) ( m ( 2 3 )) f 2 0 x2 x1 x2 x3 x1 x1 x2 x2 x2 x3 x3 x2 • Estimate displacement vector (3-D) u u u u u u u u (l ( 1 2 3 )) ( m ( 3 1 )) ( m ( 3 2 )) (2m 3 ) f 3 0 x3 x1 x2 x3 x1 x1 x3 x2 x2 x3 x3 x3 • Compute strain tensor (3-D) Eliminating “non-measurable” parameters and assuming “2-D” case: u1 u u u2 u1 u ) ( m ( 1 2 )) )) (2m 2 ) 0 (2m (m ( x2 x1 x1 x2 x2 x1 x1 x1 x1 x2 x2 x2 • Reconstruct mechanical properties Deform and image Track internal motion Evaluate deformations Reconstruct Young’s or shear elastic modulus Second-order hyperbolic partial differential equation: mechanical boundary conditions are required along two intersecting characteristics no assumptions are made regarding either l(x1,x2) or Poisson’s ratio 16 L0 Elasticity Imaging – Approaches F F S0 S Theory of Elasticity (Dynamic Approach) Example: plane waves • Infinite homogeneous (l,m=const) elastic medium (i.e., ignore bulk and shear viscosities), no body forces (fi=0) L=L0+DL Static (strain-based, or reconstructive) imaging internal motion under static deformation Dynamic (wave-based) imaging shear wave propagation General (3-D) case • Strain 11 1 u L L0 L0 • Stress 11 u F S 11 E11 E – Young’s modulus ij l ii ij 2m ij measuring tissue response at the surface • Equations of motion 11 2u 21 x1 t u u u u u u u u 2u (l ( 1 2 3 )) (2m 1 ) ( m ( 1 2 )) ( m ( 1 3 )) 21 x1 x1 x2 x3 x1 x1 x2 x2 x1 x3 x3 x1 t ij x i j fi u u u u u u u u 2u (l ( 1 2 3 )) ( m ( 2 1 )) (2m 2 ) ( m ( 2 3 )) 22 x2 x1 x2 x3 x1 x1 x2 x2 x2 x3 x3 x2 t 11 12 13 21 22 23 31 32 33 11 12 13 21 22 23 31 32 33 • Constitutive relationships Mechanical (stress-based, also reconstructive) • Assume that u1=u1(x1,t), u2=u2(x1,t), and u3=u3(x1,t) u u ij i j k k 2 x j xi xi x j 2ui t 2 ii ij 2 ij t t u u u u u 2u u u u (l ( 1 2 3 )) ( m ( 3 1 )) ( m ( 3 2 )) (2m 3 ) 23 x3 x1 x2 x3 x1 x1 x3 x2 x2 x3 x3 x3 t l 2m u21 u21 0 m 2 2 x1 t 2 u 2 ( 3) x12 2 u 2 ( 3) t 2 2u1 1 2u1 l 2m 0 where cl x12 cl2 t 2 0 2 u 2 ( 3) x12 Longitudinal wave (ultrasound) 2 1 u 2 ( 3) m 0 where c t ct2 t 2 Shear waves ! 17 Speed of shear waves is most closely related to: Speed of shear waves is most closely related to • Infinite homogeneous (l,m=const) elastic medium (i.e., ignore bulk and shear viscosities), no body forces (fi=0) Shear Wave Imaging • Assume that u1=u1(x1,t), u2=u2(x1,t), and u3=u3(x1,t) 18% 11% 7% 11% 11% 1. 2. 3. 4. 5. Poisson’s ratio Bulk modulus Young’s modulus Compressibility Shear viscosity u u u u u u u u 2u (l ( 1 2 3 )) (2m 1 ) ( m ( 1 2 )) ( m ( 1 3 )) 21 x1 x1 x2 x3 x1 x1 x2 x2 x1 x3 x3 x1 t u u u u u u u u 2u (l ( 1 2 3 )) ( m ( 2 1 )) (2m 2 ) ( m ( 2 3 )) 22 x2 x1 x2 x3 x1 x1 x2 x2 x2 x3 x3 x2 t u u u u u 2u u u u (l ( 1 2 3 )) ( m ( 3 1 )) ( m ( 3 2 )) (2m 3 ) 23 x3 x1 x2 x3 x1 x1 x3 x2 x2 x3 x3 x3 t l 2m u21 u21 0 m 2 2 x1 t 2 u 2 ( 3) x12 2 u 2 ( 3) t 2 2u1 1 2u1 l 2m 0 where cl x12 cl2 t 2 0 2 u 2 ( 3) x12 Longitudinal wave (ultrasound) 2 1 u 2 ( 3) m 0 where c t ct2 t 2 Shear waves ! E 3m Bercoff et al. 2004 18 Supersonic Shear Wave Imaging Elasticity Imaging: Principles Stanislav (Stas) Emelianov emelian@mail.utexas.edu Department of Biomedical Engineering The University of Texas at Austin Bercoff et al. 2004 Department of Imaging Physics The University of Texas M.D. Anderson Cancer Center 19