Scatterer number density considerations in reference phantom-based attenuation estimation.

Attenuation estimation and imaging have the potential to be a valuable tool for tissue characterization, particularly for indicating the extent of thermal ablation therapy in the liver. Often the performance of attenuation estimation algorithms is characterized with numerical simulations or tissue-mimicking phantoms containing a high scatterer number density (SND). This ensures an ultrasound signal with a Rayleigh distributed envelope and a signal-to-noise ratio (SNR) approaching 1.91. However, biological tissue often fails to exhibit Rayleigh scattering statistics. For example, across 1647 regions of interest in five ex vivo bovine livers, we obtained an envelope SNR of 1.10 ± 0.12 when the tissue was imaged with the VFX 9L4 linear array transducer at a center frequency of 6.0 MHz on a Siemens S2000 scanner. In this article, we examine attenuation estimation in numerical phantoms, tissue-mimicking phantoms with variable SNDs and ex vivo bovine liver before and after thermal coagulation. We find that reference phantom-based attenuation estimation is robust to small deviations from Rayleigh statistics. However, in tissue with low SNDs, large deviations in envelope SNR from 1.91 lead to subsequently large increases in attenuation estimation variance. At the same time, low SND is not found to be a significant source of bias in the attenuation estimate. For example, we find that the standard deviation of attenuation slope estimates increases from 0.07 to 0.25 dB/cm-MHz as the envelope SNR decreases from 1.78 to 1.01 when estimating attenuation slope in tissue-mimicking phantoms with a large estimation kernel size (16 mm axially × 15 mm laterally). Meanwhile, the bias in the attenuation slope estimates is found to be negligible (<0.01 dB/cm-MHz). We also compare results obtained with reference phantom-based attenuation estimates in ex vivo bovine liver and thermally coagulated bovine liver.