2D Ultrasound Elasticity Imaging of Abdominal Aortic Aneurysms Using Deep Neural Networks

Abdominal aortic aneurysms (AAA) pose a significant clinical risk due to their potential for rupture, which is often asymptomatic but can be fatal. Although maximum diameter is commonly used for risk assessment, diameter alone is insufficient as it does not capture the properties of the underlying material of the vessel wall, which play a critical role in determining the risk of rupture. To overcome this limitation, we propose a deep learning-based framework for elasticity imaging of AAAs with 2D ultrasound. Leveraging finite element simulations, we generate a diverse dataset of displacement fields with their corresponding modulus distributions. We train a model with U-Net architecture and normalized mean squared error (NMSE) to infer the spatial modulus distribution from the axial and lateral components of the displacement fields. This model is evaluated across three experimental domains: digital phantom data from 3D COMSOL simulations, physical phantom experiments using biomechanically distinct vessel models, and clinical ultrasound exams from AAA patients. Our simulated results demonstrate that the proposed deep learning model is able to reconstruct modulus distributions, achieving an NMSE score of 1.6%. Similarly, in phantom data, the predicted modular ratio closely matches the expected values, affirming the model's ability to generalize to phantom data. We compare our approach with an iterative method which shows comparable performance but higher computation time per reconstruction. In contrast, once trained offline, the deep learning method can provide quick and accurate estimates of tissue stiffness from ultrasound images, so as to provide near real-time predictions of AAA growth.