Reverberant Shear Wave Elastography: A Multi-Modal and Multi-Scale Approach to Measure the Viscoelasticity Properties of Soft Tissues

There are a variety of approaches used to create elastography images. Techniques based on shear wave propagation have received significant attention. However, there remain some limitations and problems due to shear wave reflections, limited penetration in highly viscous media, requirements for prior knowledge of wave propagation direction, and complicated propagation in layers where surface acoustic waves and guided waves are dominant. To overcome these issues, reverberant shear wave elastography (RSWE) was proposed as an alternative method which applies the concept of a narrow-band diffuse field of shear waves within the tissue. Since 2017, the RSWE approach has been implemented in ultrasound (US) and optical coherence tomography (OCT). Specifically, this approach has been implemented in these imaging modalities because they are similar in image formation principles and both share several approaches to estimate the biomechanical properties in tissues. Moreover, they cover different spatial-scale and penetration depth characteristics. RSWE has shown promising results in the elastic and viscoelastic characterization of multiple tissues including liver, cornea, and breast. This review summarizes the 4-year progress of the RSWE method in US and OCT. Theoretical derivations, numerical simulations, and applications in ex vivo and in vivo tissues are shown. Finally, we emphasize the current challenges of RSWE in terms of excitation methods and estimation of biomechanical parameters for tissue-specific cases and discuss future pathways for the in vivo and in situ clinical implementations.