Acoustic Radiation Force Impulse (ARFI) Variance of Acceleration (evaluated as its decadic log and denoted, ‘log(VoA)’) imaging is a noninvasive ultrasound elastography method that differentiates tissue according to both its mechanical and acoustic properties. In application to stroke risk prediction, ARFI log(VoA) imaging has been demonstrated in pilot in vivo clinical studies for delineating carotid atherosclerotic plaque features that convey vulnerability to rupture. This presentation will review the diagnostic performance of ARFI log(VoA) imaging and highlight recent advancements to ARFI log(VoA) imaging, including its high-framerate implementation for efficient integration with vector Doppler data acquisition throughout the cardiac cycle, its combination with wall shear stress (WSS) measurement for a more complete assessment of plaque rupture potential, and its execution using a swept aperture for volumetric interrogation of plaque composition, structure, and WSS. Finally, a new framework for ground truth validation of experimental WSS measurement in human stenosed carotid arteries will be presented.
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