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UBC Theses and Dissertations

Ultrasound elastography for intra-operative use and renal tissue imaging Schneider, Caitlin Marie


The kidney is a vital organ within the human body and improvements in the ability to characterize the kidney tissue can create benefits for patients with kidney tumors and for kidney transplant recipients. Often, changes in tissue health or development of cancer are manifested in changes in tissue structure that affect tissue elastic properties. For example, the cancerous tissue of renal cell carcinoma is stiffer than healthy kidney tissue, and the development of fibrosis, which impairs kidney function, also causes the tissue to become stiffer over time. These changes can be imaged with ultrasound elastography, a technique for quantitatively assessing tissue elasticity. If proven effective, elastography tissue characterization can replace biopsy. The ultrasound elastography method used in this thesis, called Shear Wave Absolute Vibro-Elastography, or SWAVE, measures the wavelength of induced steady-state multi-frequency mechanical shear waves to calculate tissue elasticity. SWAVE can employ standard ultrasound transducers that image the kidney though the skin above the organ, or custom miniaturized transducers that are placed directly on the surface of the organ during surgery. The accuracy of SWAVE is vastly improved by the use of 3D ultrasound data. We propose and evaluate 3D SWAVE imaging based on the use of a tracked intra-operative ultrasound transducer designed for use with the da Vinci Robot. Different tracking methods are evaluated for future intra-operative use. Elasticity images of tissue phantoms are obtained using interpolated 3D tissue displacement data acquired with the da Vinci robot and the intra-operative transducer. The use of tracked ultrasound transducer opens the way for introducing registered preoperative imaging, including elastography, to improve surgical guidance. Different methods of characterizing kidney tissue using SWAVE imaging are examined. The elastic and viscous properties are estimated kidney tissue ex-vivo. The effect of arterial pressure on the measured kidney elasticity is characterized. It was found that increasing input pressure increases the measured elasticity. Finally, ultrasound and ultrasound elastography are applied to kidney transplant recipients in-vivo to assess the level of fibrosis development. A preliminary study indicates that it is possible to transmit shear waves into the transplanted kidney and measure the elastic properties of the kidney tissue.

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