Characterization of cardiovascular liver motion for the eventual application of elasticity imaging to the liver in vivo.

Elastography, which uses ultrasound to image the tissue strain that results from an applied displacement, can display tumours and heat-ablated tissue with high contrast. However, its application to liver in vivo may be problematic due to the presence of respiratory and cardiovascular sources of displacement. The aim of this study was to measure the cardiovascular-induced component of natural liver motion for the purpose of planning future work that will either use the motion to produce elasticity images or will compensate for it when employing an external source of displacement. A total of 36 sequences of 7 s real-time radio frequency (RF) echo images of the liver were acquired from six healthy volunteers during breath-hold using a stationary 3.5 MHz transducer. For each image sequence, the axial and lateral components of displacement were measured for each pair of consecutive RF images using 2D-echo tracking. The spatio-temporal character of these displacements was then analysed using a novel approach, employing proper orthogonal decomposition, whereby the dominant motion patterns are described by eigenvectors with the highest eigenvalues. The motion patterns of different liver segments were complex, but they were also found to be cyclic, highly repeatable and capable of producing measurable displacements in the liver. These observations provide good evidence to suggest that it may be possible to correct for natural liver motion when using an externally applied displacement for elasticity imaging. It was also found that about 65%-70% of all liver motion could be described using the first eigenvector. Use of only this component of the motion will greatly simplify the design of a mechanical system to be used in an objective study of elasticity imaging of phantoms and excised tissues in the presence of simulated cardiovascular-induced liver motion.