Double-Profile Intersection (DoPIo) Ultrasound: Pointwise Shear Elasticity Estimation using Paired Confocal Displacement Profiles.

Current acoustic radiation force (ARF) based methods for quantifying tissue elasticity primarily rely on shear wave propagation. However, their spatial resolution is limited by the need for spatial averaging, and their accuracy is affected by shear wave guidance, out of plane reflections, and geometric dispersion, which reduce their applicability in mechanically complex tissues. This study introduces a novel technique called Double Profile Intersection (DoPIo) ultrasound, which enables pointwise estimation of shear elastic modulus within the region of ARF excitation by leveraging the scatterer shearing rate. This rate is inferred by tracking ARF induced displacement using two tracking beams with different lateral widths. The wider beam captures scatterers located outside the ARF excitation region that begin to displace as shearing propagates. The time at which the two resulting displacement profiles intersect is mapped to shear elastic modulus using an empirically derived model based on finite element simulations. <i>In silico</i>, DoPIo estimated shear elastic modulus with a median error of -0.02 kPa and a median absolute deviation of 1.98 kPa in elastic materials up to 35 kPa. Experimental validation <i>in vitro</i> and <i>ex vivo</i> demonstrated that DoPIo reliably distinguished softer regions from stiffer ones, and its modulus estimates remained consistent across varying ARF push amplitudes, provided sufficient displacement estimation signal to noise ratio. DoPIo offers a feasible approach for high resolution, on axis shear elasticity estimation and holds promise as a quantitative biomarker that is independent of ARF amplitude.