title: The role of the acoustic radiation force in color Doppler twinkling artifacts.
abstract: OBJECTIVE
  The aim of this experimental study was to evaluate whether the acoustic radiation force (ARF) is a potential source of twinkling artifacts in color Doppler images.
  
  
  METHODS
  Color Doppler images were obtained using a clinical ultrasonic scanner (Voluson e, GE Healthcare) for a high contrast (+15 dB) circular scattering phantom at pulse repetition frequencies (PRFs) ranging from 0.1 to 13 kHz. Ultrasound transmissions resulting in ARF were measured using a hydrophone at the various PRFs considered. The influence of ARF on the appearance of twinkling colors was examined via the common parameter PRF. This methodology is based on the fact that alternating positive and negative Doppler shifts induced by the ARF are centered at a PRF twice the maximum Doppler frequency on the color scale bar, whereas the twinkling color aliasing is expected to remain similar regardless of PRF.
  
  
  RESULTS
  Color twinkling artifacts were observed to be most conspicuous at the lowest PRF of 0.1 kHz. The extent of twinkling rapidly decreased as the PRF increased, eventually disappearing when the PRF ≥0.6 kHz. The measured ultrasound transmissions, however, were found to be insensitive to the PRF, and therefore it can be inferred that the PRF was insensitive to the ARF.
  
  
  CONCLUSIONS
  Based on our experimental observations, the ARF may not be a source of color Doppler twinkling artifacts.
authors.affiliation: Department of Radiotechnology, Cheju Halla University, Jeju, Korea.
authors.forename: Jeong-Hwa
authors.identifier: 0000-0001-8155-2787
authors.initials: JH
authors.lastname: Yang
authors.affiliation: Interdisciplinary Postgraduate Program in Biomedical Engineering, Jeju National University, Jeju, Korea.
authors.forename: Gwansuk
authors.identifier: 0000-0003-1855-2738
authors.initials: G
authors.lastname: Kang
authors.affiliation: Interdisciplinary Postgraduate Program in Biomedical Engineering, Jeju National University, Jeju, Korea ; Department of Medicine, Jeju National University School of Medicine, Jeju, Korea.
authors.forename: Min Joo
authors.identifier: 0000-0003-4626-3706
authors.initials: MJ
authors.lastname: Choi
keywords: Acoustic radiation force; Artifacts; Pulse repetition frequency; Ultrasonography, Doppler, color