Morphology-, Noise-, and Resolution-Robust Ultrasound Elasticity Imaging with Fourier Neural Operators

Abstract: Ultrasound-based elasticity imaging is a non-invasive technique for estimating tissue stiffness fields from displacement fields obtained by comparing ultrasound signals before and after compression. While recent deep learning approaches have enabled faster and more accurate elasticity estimation compared to traditional methods, several challenges remain for clinical translation. In this study, we employ finite element simulations of free-hand palpation to investigate the applicability of the Fourier neural operator (FNO). Four practical scenarios were investigated: (1) prediction across diverse lesion morphologies, (2) generalization to cases with lesion counts differing from those in the training data, (3) robustness to noise in measured displacement fields, and (4) resilience to variations in ultrasound device resolution. Across these tasks, FNO consistently outperformed baseline models such as U-Net and DeepONet in predictive accuracy and generalization, while maintaining robustness under noise and resolution changes. Validated through in silico simulations, these findings demonstrate the potential of FNO as a framework that could facilitate translation of elasticity imaging toward clinical practice.