Nonlinear Characterization of Tissue Viscoelasticity With Acoustoelastic Attenuation of Shear Waves.

Shear-wave elastography (SWE) measures shear-wave speed (SWS), which is related to the underlying shear modulus of soft tissue. SWS in soft tissue changes depending on the amount of external strain that soft tissue is subjected to due to the acoustoelastic (AE) phenomenon. In the literature, variations of SWS as a function of applied uniaxial strain were used for nonlinear characterization, assuming soft tissues to be elastic, although soft tissues are indeed viscoelastic in nature. Hence, nonlinear characterization using SWS alone is insufficient. In this work, we use SWS together with shear-wave attenuation (SWA) during incremental quasi-static compressions in order to derive biomechanical characterization based on the AE theory in terms of well-defined storage and loss moduli. As part of this study, we also quantify the effect of applied strain on measurements of SWS and SWA since such confounding effects need to be taken into account when using SWS and/or SWA, e.g., for staging a disease state, while such effects can also serve as an additional imaging biomarker. Our results from tissue-mimicking phantoms with varying oil percentages and ex vivo porcine liver experiments demonstrate the feasibility of our proposed methods. In both experiments, SWA was observed to decrease with applied strain. For 10% compression in ex vivo livers, shear-wave attenuation decreased, on average, by 28% (93 Np/m), while SWS increased, on average, by 20% (0.26 m/s).