Speed of sound and shear wave speed for calf soft tissue composition and nonlinearity assessment

Naiara Korta Martiartu; Dominik Nakhostin; Lisa Ruby; Thomas Frauenfelder; Marga B Rominger; Sergio J Sanabria

doi:10.21037/qims-20-1321

Speed of sound and shear wave speed for calf soft tissue composition and nonlinearity assessment

Quant Imaging Med Surg. 2021 Sep;11(9):4149-4161. doi: 10.21037/qims-20-1321.

Authors

Naiara Korta Martiartu¹, Dominik Nakhostin¹, Lisa Ruby¹, Thomas Frauenfelder¹, Marga B Rominger¹, Sergio J Sanabria^{1

2}

Affiliations

¹ Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland.
² Deusto Institute of Technology, University of Deusto/IKERBASQUE, Basque Foundation for Science, Bilbao, Basque Country, Spain.

Abstract

Background: The purpose of this study was threefold: (I) to study the correlation of speed-of-sound (SoS) and shear-wave-speed (SWS) ultrasound (US) in the gastrocnemius muscle, (II) to use reproducible tissue compression to characterize tissue nonlinearity effects, and (III) to compare the potential of SoS and SWS for tissue composition assessment.

Methods: Twenty gastrocnemius muscles of 10 healthy young subjects (age range, 23-34 years, two females and eight males) were prospectively examined with both clinical SWS (GE Logiq E9, in m/s) and a prototype system that measures SoS (in m/s). A reflector was positioned opposite the US probe as a timing reference for SoS, with the muscle in between. Reproducible tissue compression was applied by reducing probe-reflector distance in 5 mm steps. The Ogden hyperelastic model and the acoustoelastic theory were used to characterize SoS and SWS variations with tissue compression and extract novel metrics related to tissue nonlinearity. The body fat percentage (BF%) of the subjects was estimated using bioelectrical impedance analysis.

Results: A weak negative correlation was observed between SWS and SoS (r=-0.28, P=0.002). SWS showed an increasing trend with increasing tissue compression (P=0.10) while SoS values decayed nonlinearly (P<0.001). The acoustoelastic modeling showed a weak correlation for SWS (r=-0.36, P<0.001) but a very strong correlation for SoS (r=0.86, P<0.001), which was used to extract the SoS acoustoelastic parameter. SWS showed higher variability between both calves [intraclass correlation coefficient (ICC) =0.62, P=0.08] than SoS (ICC =0.91, P<0.001). Correlations with BF% were strong and positive for SWS (r=0.60, P<0.001), moderate and negative for SoS (r=-0.43, P=0.05), and moderate positive for SoS acoustoelastic parameter (r=0.48, P=0.03).

Conclusions: SWS and SoS provide independent information about tissue elastic properties. SWS correlated stronger with BF% than SoS, but measurements were less reliable. SoS enabled the extraction of novel metrics related to tissue nonlinearity with potential complementary information.

Keywords: Ultrasound (US); gastrocnemius; shear wave speed; skeletal muscle; speed of sound; tissue nonlinearity.