Nonlinearity parameter estimation method from fundamental band signal depletion in pulse-echo using a dual-energy model

The estimation of the nonlinearity parameter (B/A) has the potential to be used in the clinical diagnosis of conditions such as liver steatosis. Recently, a pulse-echo method to estimate B/A based on the theory of the fundamental band amplitude depletion of weak waves, namely, the depletion method, was proposed. In the present work, the depletion method is presented with more technical detail. Then, the robustness of the depletion method is assessed by using simulations that diverge from the model requirements: (1) monochromatic plane wave propagation and (2) quadratic power-law frequency dependence attenuation. Regarding requirement (1), the results led to a critical finding that when using wideband pulses (37%-113% bandwidth), the bias of the B/A estimates is larger than the bias obtained using narrowband pulses (11%-28% bandwidth), even if requirement (2) holds. Regarding requirement (2), power-law frequency dependence closer to those of soft tissues, i.e., 1.1 or 1.2, using narrowband pulses presented bias of less than 10%. The use of narrowband pulses also was shown to be robust when the reference phantom and sample had attenuation mismatches of around 60%. Finally, the experimental feasibility of the depletion method was evaluated, showing results with good accuracy (bias <17%), which are consistent with the observations in the simulations.