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. 2021 Jan 26;66(3):035013.
doi: 10.1088/1361-6560/abcb1e.

Characterizing blood clots using acoustic radiation force optical coherence elastography and ultrasound shear wave elastography

Hsiao-Chuan Liu  1   2 , Mehdi Abbasi  1 , Yong Hong Ding  1 , Tuhin Roy  3 , Margherita Capriotti  1 , Yang Liu  1 , Seán Fitzgerald  1   4 , Karen M Doyle  4 , Murthy Guddati  3 , Matthew W Urban  1   5 , Waleed Brinjikji  1
Affiliations

Characterizing blood clots using acoustic radiation force optical coherence elastography and ultrasound shear wave elastography

Hsiao-Chuan Liu et al. Phys Med Biol. .

Abstract

Thromboembolism in a cerebral blood vessel is associated with high morbidity and mortality. Mechanical thrombectomy (MT) is one of the emergenc proceduresperformed to remove emboli. However, the interventional approaches such as aspiration catheters or stent retriever are empirically selected. An inappropriate selection of surgical devices can influence the success rate during embolectomy, which can lead to an increase in brain damage. There has been growing interest in the study of clot composition and using a priori knowledge of clot composition to provide guidance for an appropriate treatment strategy for interventional physicians. Developing imaging tools which can allow interventionalists to understand clot composition could affect management and device strategy. In this study, we investigated how clots of different compositions can be characterized by using acoustic radiation force optical coherence elastography (ARF-OCE) and compared with ultrasound shear wave elastography (SWE). Five different clots compositions using human blood were fabricated into cylindrical forms from fibrin-rich (21% red blood cells, RBCs) to RBC-rich (95% RBCs). Using the ARF-OCE and SWE, we characterized the wave velocities measured in the time-domain. In addition, the semi-analytical finite element model was used to explore the relationship between the phase velocities with various frequency ranges and diameters of the clots. The study demonstrated that the wave group velocities generally decrease as RBC content increases in ARF-OCE and SWE. The correlation of the group velocities from the OCE and SWE methods represented a good agreement as RBC composition is larger than 39%. Using the phase velocity dispersion analysis applied to ARF-OCE data, we estimated the shear wave velocities decoupling the effects of the geometry and material properties of the clots. The study demonstrated that the composition of the clots can be characterized by elastographic methods using ARF-OCE and SWE, and OCE demonstrated better ability to discriminate between clots of different RBC compositions, compared to the ultrasound-based approach, especially in clots with low RBC compositions.

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Conflict of interest statement

Disclosures

The authors declare that there are no conflicts of interest related to this article.

Figures

FIG. 1
FIG. 1
Schematic of acoustic radiation forced optical coherence tomography (ARF-OCT). GM and RF represent galvanometer mirror and radio frequency, respectively. The three function generators are utilized to provide trigger and driving signals for synchronizing OCT scan, excitation and recording signals.
FIG. 2
FIG. 2
The normalized dispersion curves for solid cylinder with three-dimensional deformation situation by using semi-analytical finite element theoretical calculations.
FIG. 3
FIG. 3
Histological examination of the clots with representative examples for the following RBC compositions. (a) 21% RBC, (b) 39% RBC, (c) 68% RBC, (d) 84% RBC and (e) 95% RBC.
FIG. 4
FIG. 4
(a) and (b) An example shows the 39% and 95% RBC composition of an OCT image composed by using IQ data, respectively. (c) and (d) A 2D spatiotemporal wave map of wave motion in 39% and 95% RBC composition, respectively. (e) The mean group velocity with their SDs for each RBC composition. The Exc in (a) and (b) denotes the ultrasound excitation location.
FIG. 5
FIG. 5
The combination of three individual samples for each RBC compositions, measured by ARF-OCE. The symbols ***, ** and * indicate the p-value < 0.001, < 0.01 and < 0.05, respectively. The notation NS means non-significant (p > 0.05).
FIG. 6
FIG. 6
(a) and (b) An example shows the 39% and 95% RBC composition of ultrasound B-mode image, respectively. (c) and (d) A 2D a lateral time-peak wave map of wave motion in 39% and 95% RBC composition, respectively. (e) The mean group velocity with their SDs for each RBC composition. The Exc in (a) and (b) denotes the ultrasound excitation location.
FIG. 7
FIG. 7
The combination of three individual samples for each RBC compositions, measured by SWE. ***, ** and * indicate the p-value < 0.001, < 0.01 and < 0.05, respectively. The notation NS means non-significant (p > 0.05).
FIG. 8
FIG. 8
The Spearman correlation between OCE and SWE results that are shown in (a) for the compositions from 21% to 95%, (b) for the compositions from 39% to 95%.
FIG. 9
FIG. 9
OCE dispersion analysis results. The match with the measured and computed dispersion curves with the inverted shear wave velocities. (a) shows the match in the physical space and (b) shows the match in the normalized space. The mean with SD for five RBC compositions were presented in (c). The symbol ***, ** and * indicate the p-value < 0.001, < 0.01 and < 0.05, respectively. The notation NS means non-significant (p > 0.05).
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