Validation of Volumetric Multi-Frequency Shear Wave Vibro-Elastography with Matrix Array Transducer for the in vivo Liver

3D Shear Wave Absolute Vibro-Elastography (S-WAVE) is a steady-state, volumetric elastography imaging technique similar to magnetic resonance elastography (MRE), with the additional advantage of multi-frequency imaging and a significantly shorter exam time. We present a novel ultrasound matrix array implementation of S-WAVE for high-volume refresh rate acquisition. This new imaging setup is equipped with real-time shear wave monitoring for an improved data collection workflow and image quality. The image processing and elasticity reconstruction pipeline is tailored for high Body Mass Index subjects. We characterized this system with tissue phantoms and a human study cohort composed of seven healthy volunteers and twenty-five patients with non-alcoholic fatty liver disease. The validation results show that S-WAVE can maintain a high agreement with the liver tissue stiffness measurements obtained with both the 2D and 3D MRE techniques, with an average cross-correlation > 93% and an average R 2 = 0.87, which outperforms the conventional transient elasticity technique. Our findings show that the matrix array-based 3D S-WAVE is a suitable volumetric elastography imaging solution for delivering a similar assessment of liver fibrosis as MRE in a more accessible, flexible, and cost-effective way.