There is a need to expeditiously detect brain injury requiring treatment after head trauma such as intracranial hemorrhage (ICH). Such injuries often show no symptoms and remain undetected until emergency intervention is necessary. CT and MRI systems are highly sensitive and specific for ICH detection, but, may be impractical for field-forward patient examination. Medical ultrasound (US) is an ideal imaging modality that is portable, fast, inexpensive, safe, and produces images with excellent resolution. However, despite these advantages, noninvasive transcranial US is impractical due to the high acoustic impedance between the skull and brain. The skull can reflect US transmission into the brain and generates strong acoustic reverberation overwhelming signals of interest from the skull interior. If these limitations were overcome, US would revolutionize field forward neuroimaging for the warfighter and civilian populations.
Ultrasound is also viewed as having no known harmful biological effects, as long as exposures are kept within well-characterized safety limits. Although ultrasound use for body-scans of soft tissue has been widely successful, acquiring ultrasound images of the intracranial contents is extremely difficult using conventional ultrasound systems. These systems typically employ longitudinal or compressional waves that readily travel through body tissue, but do not easily traverse the calvarium. The large acoustic impedance that exists between the skull bone and fluid material surrounding the brain greatly in adults greatly suppresses subcranial acoustic signal transmission and return, reducing echo amplitude, and clarity when captured by a receiver at the skull outer surface.
Two fundamental forms of ultrasound signal interference are caused by this geometry that severely limit conventional ultrasound systems for brain imaging. First, the skull bone is relatively thin (only a few ultrasonic wavelengths) and, thus, ultrasonic waves tend to ring or reverberate over time as they bounce back and forth between the skull-brain and skull-exterior (air) interfaces-causing significant resonance-interference. Second, a variety of wave types are simultaneously induced by the ultrasonic source positioned at the skull exterior surface (longitudinal, shear, Rayleigh surface waves). These waves propagate away through very different travel paths (some travel along the skull surface, others travel inside the skull as guided waves, others transmit across the skull). When these signals return to the receiver, they mix and interfere with each other introducing numerous artefacts that prevent echolocation and appropriate assignment of echo amplitude to specific regions. The result is a set of challenges collectively termed “inline plane-interference.” These above-mentioned forms of interference (resonance and inline-plane) together greatly diminish the signal-to-noise ratio (SNR) of transcranial ultrasound overwhelming the signal of interest from ICH.
Thus, there remains a need for a non-invasive method for imaging a subject, such as through a skull, that provides the same or similar advantages to US, but with the ability to achieve meaningful, high-resolution images.
The present disclosure addresses the aforementioned drawbacks by providing systems and methods for non-contact imaging that utilizes wave conversion. In some non-limiting configurations, electromagnetic (EM) waves are used to transmit past a barrier, such as a skull of a subject, where the RF is absorbed and converted to US waves once past the barrier. This approach enables acoustic energy to be well-coupled to tissue on the opposing side of the barrier, such as brain tissue within a skull, while controlling against reverberation and clutter. The US waves propagate within the tissue and can be measured using coherent lidar, for example. The lidar wavelength may be selected to enable transmission through a portion of the barrier, such as through a calvarium into the cranial cavity. The US wave may modulate the optical wave, which can then be received noninvasively outside the skull upon return. In a non-limiting example, the skull layer is effectively eliminated by use of the methods in accordance with the present disclosure, permitting sonographic imaging of the brain. In some configurations, the system may be portable for use in field-forward settings as a means to detect and image ICH.
The systems and methods may facilitate measuring subtle acoustic contrasts from tumors and other diseases of brain tissue. The systems and methods may also provide for detecting treatable head injuries in civilian and military applications at locations away from the hospital setting. A noninvasive approach to US for brain imaging and diagnostics may provide medical staff a tool to detect dangerous hematomas in the field. In some configurations, a system may include low cost, low swap, and may be portable. In some configurations, tumors and other disease states may be monitored.
In one aspect, a method is provided for generating at least one of an image, or a tissue map of a subject, and/or providing diagnostic information characterizing interior tissue disease with the method comprising: transmitting EM waves to a subject without patient contact, external to the human body. The method includes generating thermoelastic acoustic propagating waves inside the subject using the EM waves as the source; detecting and measuring the acoustic propagating waves using an optical device or a contact transducer system to sense, temporally measure, and spatially map acoustic/mechanical vibrational waves. The method also includes construction of at least one image, tissue characterization or report of the subject based on the sensed and measured acoustic propagating waves.
In one aspect, a method is provided for generating an image or a map of a subject. The method includes delivering a first electromagnetic radiation to a first material in the subject and converting the first electromagnetic radiation to an acoustic radiation force to transmit within a second material in the subject. The method also includes detecting transmission of the acoustic radiation force within the second material in the subject to acquire data and generating an image or a map of the subject from the data.
In one aspect, a system is provided for generating at least one of an image or a map of a subject. The system includes a first electromagnetic radiation transmitter for delivering a first electromagnetic radiation to a first material in the subject. The first electromagnetic radiation is configured to convert to an acoustic radiation force to transmit within a second material in the subject. The system also includes a detector for detecting transmission of the acoustic radiation force within the second material in the subject to acquire data. The system also includes a computer system configured to generate an image or a map of the subject from the data.
The foregoing and other aspects and advantages of the present disclosure will appear from the following description. In the description, reference is made to the accompanying drawings that form a part hereof, and in which there is shown by way of illustration a preferred embodiment. This embodiment does not necessarily represent the full scope of the invention, however, and reference is therefore made to the claims and herein for interpreting the scope of the invention. Like reference numerals will be used to refer to like parts from Figure to Figure in the following description.
Systems and methods for non-contact, non-invasive imaging are provided. Electromagnetic (EM) waves may be used to transmit past a barrier, such as a skull of a subject, where the RF is absorbed and converted to ultrasound (US) waves or shear waves once past the barrier. This approach enables acoustic energy to be well-coupled to tissue on the opposing side of the barrier while minimizing reverberation and clutter. The US waves propagate within the tissue and may be measured using an optical detector, such as coherent lidar. The lidar wavelength may be selected to enable transmission through a portion of the barrier. The US wave may modulate the optical wave, which is then received noninvasively outside the tissue upon return. In some configurations, the system may be portable for use in field-forward settings as a means to detect and image ICH.
In some configurations, RF waves are used to transmit past the skull, absorb, and convert to US waves once inside the brain. This enables acoustic energy to be well-coupled to brain tissue, while, minimizing skull reverberation and clutter. The US waves propagate within brain tissue and are then measured using coherent lidar. The lidar wavelength may be selected to enable transmission through the calvarium into the cranial cavity. The US wave modulates the optical wave, which is then received noninvasively outside the skull upon return. The skull layer is effectively eliminated, permitting sonographic imaging of the brain. A portable system may be used in field-forward settings as a means to detect and image ICH. Subtle acoustic contrasts may be measured from tumors and other diseases of brain tissue.
The systems and methods may facilitate measuring subtle acoustic contrasts from tumors and other diseases of brain tissue. The systems and methods may also provide for detecting treatable head injuries in civilian and military applications at locations away from the hospital setting, such as TBI, ICH, and internal bleeding. A noninvasive approach to US for brain imaging and diagnostics may provide medical staff a tool to detect dangerous hematomas in the field. In some configurations, a system may include low cost, low swap, and may be portable. In some configurations, tumors and other disease states may be monitored that may be unobservable with conventional ultrasound due to the attenuation typically suffered by conventional ultrasound when passing through a barrier, such as a bone or skull. Elastography may also be used to determine tissue mechanical properties for tumor detection, progression, and classification.
Referring to
Ultrasound imaging or elastography may be performed in accordance with the present disclosure. Ultrasound imaging may include echo-pulse, tomographic, or any other ultrasound imaging form. Elastography may include shear wave conversion, hematoma detection, tumor detection or grading, disease state determination, and the like.
A transmitter may include a carrier frequency of 20 kHz-10 GHz. For example, audible frequencies can range from 20 Hz to 20 kHz, ultrasonic frequencies can rage form 20 kHz to 10 MHz, and the carrier can include these ranges and/or others. In a non-limiting example, the transmitter is configured to emit 2 GHz waves. In another non-limiting example, the transmitter is configured to emit 1.6 GHz waves. In some configurations, an array or a plurality of transmitters may be used. The transmitters or antenna may be spaced apart to deliver a desired wave configuration to the subject, such as a plane wave. In a non-limiting example, spacing may be 0.1-0.8 of the RF wavelength.
In some configurations, transmitters or applicators may be used to generate 1-5 mm spot size beams outside a skull that transmit across the skull and then convert to ultrasound once inside the brain. The ultrasound waves then travel and interact in tissue like standard ultrasound.
In some configurations, an optical detector such as a coherent laser vibrometer, or light detection and ranging (LIDAR) detector, may be used to measure the ultrasound waves just inside the skull at a prescribed datum. The optical carrier wavelength of the laser may be selected as a means to penetrate through the skull. In a non-limiting example, the selected wavelength may be 700-1064 nm, or may be selected to be in the range of 700-800 nm. The power of the optical wavelength may be selected to be skin safe, but sufficient to overcome the significant loss of two-way transmit through the skull. In some configurations, this may be accomplished through time and multipixel averaging. In some configurations, the optical detector or laser may include a swept sine or ramp to provide for range binning of the detected waves, which provides for determining a depth of a feature in the subject.
Referring to
Referring to
The RF to pressure conversion may be determined by:
P
0
=ΓμαF, where Γ=βνS2/Cp (1)
The pressure wave may be determined by:
Where p represents pressure, Γ represents a Gruneisen parameter of tissue, μa represents an RF absorption coefficient, F represents local RF fluence, β represents a volume expansion coefficient, vs represents an elastic wave speed, and Cp represents specific heat of the tissue.
Referring to
Where σ represents sample electrical conductivity, E represents RMS electric field, ρ represents sample density, c represents specific heat of tissue, dT represents change in temperature, dt represents change in time.
A safe SAR limit for a whole-body average may be a maximum permissible exposure of 0.4 W/kg, and a local SAR (per kg of tissue) limit may be a maximum permissible exposure of 8.0 W/kg. Other safety considerations include tissue heating, where cell temperature may increase due to RF absorption. The safety threshold for temperature increase may be <42° C. For genotoxicity, safety considerations may include consideration of micronucleus formation, DNA strand breaks, and chromosome damage.
Ultrasound safe limits may be determined by the Mechanical Index (MI), which is the maximum amplitude of the pressure pulse in the body, which may be given by:
Where Pr represents peak rarefaction pressure of an ultrasound wave, ƒc represents the ultrasound wave center frequency.
Ultrasound safe limits may include consideration of mechanical stress from acoustic radiation force, such as with a MI threshold of <1.9, above which tissue damage can occur, or cellular tear may take place. Thermal effects may also be considered, such as tissue temperature increase by mechanical friction. As noted above regarding SAR, a safety threshold may be determined as <42° C. Cavitation may also be considered, where vapor-filled bubbles can cause tissue damage. Auditory and vestibular effects may also be considered, such as taking into account anticipated perception of audible clicks detected in the cochlea and vertigo, or other cognitive impacts.
Optical safe parameters may also be considered. Tissue heating may be considered when considering a laser beam footprint on skin, which can burn with excessive optical power. As with the above considerations, a safe temperature limit for optical power considerations may be <42° C. Skin exposure may also be considered based on a risk of skin cancer development with prolonged exposure times. Eye exposure may create retina photoreceptor cell damage or cell death. A laser aperture may be adjusted in order to avoid unnecessary eye exposure, such as a 3 mm beam diameter or less permitted to enter a pupil. A safe optical intensity may be determined by:
Where P represents power; d represents spot size, f represents focal length, and λ represents optical wavelength.
Referring to
Non-limiting example brain tissue acoustic reflection imaging.
In a non-limiting example, RF energy may be directed to focus longitudinal ultrasound waves that propagate inside a brain cavity. The RF to US system may be operated without physical contact on the external side of the skull. Coherent-Lidar may be used to measure the converted acoustic/ultrasound wave. The lidar may use an optical wavelength of 810-1064 nm carrier which can propagate through the skull, such as at a depth of 0.5-2 cm, and measures the acoustic wave interference with brain tissues and anomalies. The lidar may also be operated without physical contact on the external side of the skull. In some configurations, the coherent lidar may use a linear chirp waveform which can range resolve the acoustic return. The range bins may be designed to provide an acoustic datum which then yields pertinent information that can be used to construct the ultrasound image of the brain tissue and cavity.
Non-limiting example RF to US shear wave elastography
In a non-limiting example, RF energy may be directed to focus longitudinal US wave, such as a 100 kHz wave, for performing elastography. A longitudinal wave creates force that launches low frequency shear waves. The shear waves may have a frequency of 10 -200 Hz. Short Wavelength Infrared (SWIR) Camera light may be used to detect the propagating shear waves. In a non-limiting example, the SWIR light may be used to penetrate a skull and measure a shear wave spatial and temporal speckle pattern during propagation. The SWIR camera may be selected to use 810-1064 nm wavelength Can penetrate skull and spatially images slow shear wave Speckle field as a function of time. SWIR Camera frame rate is set at 1 kHz and records speckle image of propagating shear wave. 2DFFT of time varying shear speckle field yields shear wave dispersion and characterizes hematoma and surrounding brain tissue
Referring to
In a non-limiting example, the detector 506 is contact transducer receive array positioned on the external surface of the phantom or subject's scalp. Further, the contact transducer may measure the acoustic propagating waves on the exterior surface. In one example the contract transducer may include a wearable device or a flexible ultrasound receiver surface device. An example multi-element contact transducer is shown in
In another non-limiting example, the detector 506 may be a diffuse correlation spectroscopy (DCS) system as shown in
Referring to
In a non-limiting example,
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In a non-limiting example, a FEKO multilevel-fast-multipole-method (MLFMM) surface equivalence principle simulation model at 2.45 GHz was used in which a single water-filled circular waveguide 902 with inner diameter 0.9525 cm [0.375 inches] was positioned adjacent to a deionized water bolus 904 that is next to the skull (bone) 906 followed by a volume of brain tissue 908 represented by the average dielectric parameters of gray and white matter. The water bolus thickness was 0.635 cm [0.25 inches], the skull (bone) thickness was 0.7 cm [0.275 inches], the brain thickness was 1.27 cm [0.5 inches]. The diameter was 2.54 cm [1 inch] each for the simulated water bolus, skull, and brain. The dielectric constant of the deionized water was assumed to be 80 and was lossless, such that the conductivity was zero. The dielectric constant of bone was assumed to be 11.7 with conductivity 0.41 Siemens/meter. The simulated transmit power was 5 Watts at the single frequency 2.45 GHz continuous wave (CW) in the Industrial Scientific Industrial (ISM) band. The wavelength in the dielectrically loaded circular waveguide was 1.37 cm [0.54 inches], and the calculated guide wavelength was 2.54 cm [1.0 inch]. The specific absorption rate (SAR) was proportional to the electrical conductivity times the electric field magnitude divided by the tissue density and was used to define the effective heating zone. The SAR was computed at a depth of 0.3175 cm [0.125 inches] in the brain.
In another non-limiting example, a FEKO simulation model was used in which the circular waveguide 910 had inner diameter 0.4 cm [0.158 inches] for operation in the ISM band at 5.8 GHz. The wavelength in the dielectrically loaded circular waveguide was 0.58 cm [0.23 inches], and the guide wavelength was 1.07 cm [0.42 inch]. For the 2.45 GHz simulation model of the single circular waveguide and phantom, the simulated SAR at 0.3175 cm depth was determined. For the 5.8 GHz simulation model, the simulated SAR at 0.3175 cm depth was determined. The simulated heated zone at 5.8 GHz was significantly smaller than the heated zone for the 2.45 GHz applicator.
Referring to
In a non-limiting example, a three-element water-filled circular waveguide array was simulated at 2.45 GHz. The simulated specific absorption rate (SAR) for a 3-element array of water-filled circular waveguide applicator operating at 2.45 GHz with focused beam steering produced by transmitting from two elements was determined. The center element and one element on the left were transmitting with equal power and equal phase. The microwave beamsteered peak SAR occurred at a position between the two transmitting elements.
Referring to
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Referring to
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The present disclosure has described one or more preferred embodiments, and it should be appreciated that many equivalents, alternatives, variations, and modifications, aside from those expressly stated, are possible and within the scope of the invention.
This application is based on, claims priority to, and incorporates herein by reference for all purposes, U.S. Provisional Application Ser. No. 63/324,833, filed Mar. 29, 2022.
This invention was made with government support under FA8702-15-D-0001 awarded by the U.S. Air Force. The government has certain rights in the invention.
Number | Date | Country | |
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63324833 | Mar 2022 | US |