The objective of this proposal is to develop a quantitative ultrasound technique (acoustic radiation force impulse) to noninvasively and objectively assess cervical stiffness/softness. A key benefit of our work is that development of a method to measure cervical stiffness/softness alone could have significant impact;cervical softness is a critical, yet subjective, measure made daily in an obstetrics clinic. Our goal is to use such a tool to build a comprehensive understanding of cervical microstructure and how it changes throughout normal and abnormal pregnancy. We anticipate that an enhanced understanding of cervical microstructural changes will lead to targeted investigation of specific remodeling processes in pregnancy that will promote understanding of cervical insufficiency. This in turn could guide the exploration of novel therapeutic strategies.

Public Health Relevance

This is a proposal to develop quantitative ultrasound technology using acoustic radiation force impulse (ARFI) tools in ex vivo hysterectomy specimens in order to ultimately image and objectively quantify in vivo cervical softening in pregnancy. Cervical softening occurs throughout normal pregnancy but morbidity may occur when the cervix is too soft too early (preterm delivery) or too firm too late (postterm delivery). Currently, we have only subjective assessment of this important parameter. That alone makes objective quantification of cervical softening clinically useful. Even more, cervical softening is related to cervical microstructural arrangement and thus strength. The proposed effort involves (a) determining the sensitivity of ultrasound to the changes in stiffness/softness of the human cervix, (b) testing ARFI in isotropic and anisotropic phantoms as well as ex vivo cervical tissue in order to establish parameters for transition to in vivo cervical scanning, and (c) confirming through second harmonic generation microscopy the cervical microstructural changes that are associated with our ultrasound measurements. Besides providing an objective measure of a clinically useful parameter, development of a tool to quantify cervical softening should also give insight into cervical structure and function, including the dysfunction that leads to preterm delivery.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21HD063031-01A1
Application #
7991724
Study Section
Special Emphasis Panel (ZRG1-SBIB-J (91))
Program Officer
Reddy, Uma M
Project Start
2010-07-25
Project End
2012-06-30
Budget Start
2010-07-25
Budget End
2011-06-30
Support Year
1
Fiscal Year
2010
Total Cost
$204,730
Indirect Cost
Name
University of Wisconsin Madison
Department
Physics
Type
Schools of Medicine
DUNS #
161202122
City
Madison
State
WI
Country
United States
Zip Code
53715
Vink, Joy; Feltovich, Helen (2016) Cervical etiology of spontaneous preterm birth. Semin Fetal Neonatal Med 21:106-12
Huang, Bin; Drehfal, Lindsey Carlson; Rosado-Mendez, Ivan M et al. (2016) Estimation of Shear Wave Speed in the Rhesus Macaques' Uterine Cervix. IEEE Trans Ultrason Ferroelectr Freq Control 63:1243-52
Rosado-Mendez, Ivan M; Drehfal, Lindsey C; Zagzebski, James A et al. (2016) Analysis of Coherent and Diffuse Scattering Using a Reference Phantom. IEEE Trans Ultrason Ferroelectr Freq Control 63:1306-20
Carlson, L C; Romero, S T; Palmeri, M L et al. (2015) Changes in shear wave speed pre- and post-induction of labor: a feasibility study. Ultrasound Obstet Gynecol 46:93-8
Myers, Kristin M; Feltovich, Helen; Mazza, Edoardo et al. (2015) The mechanical role of the cervix in pregnancy. J Biomech 48:1511-23
Carlson, L C; Feltovich, H; Palmeri, M L et al. (2014) Estimation of shear wave speed in the human uterine cervix. Ultrasound Obstet Gynecol 43:452-8
Carlson, Lindsey C; Feltovich, Helen; Palmeri, Mark L et al. (2014) Statistical analysis of shear wave speed in the uterine cervix. IEEE Trans Ultrason Ferroelectr Freq Control 61:1651-60
Feltovich, Helen; House, Michael (2014) Innovative methods of cervical assessment and potential for novel treatment. Clin Obstet Gynecol 57:531-6
Feltovich, H; Hall, T J (2013) Quantitative imaging of the cervix: setting the bar. Ultrasound Obstet Gynecol 41:121-8
Doherty, Joshua R; Trahey, Gregg E; Nightingale, Kathryn R et al. (2013) Acoustic radiation force elasticity imaging in diagnostic ultrasound. IEEE Trans Ultrason Ferroelectr Freq Control 60:685-701

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