Influence of tissue heterogeneity on the quantitative accuracy of pulse-echo speed-of-sound imaging: a simulation study

Computed ultrasound tomography in echo-mode (CUTE) generates spatially resolved maps of speed of sound (cSoS) based on the shift of echoes detected under varying steering angles. While this approach led to quantitative results when used in simplistic phantoms, achieving the same has been challenging in vivo. In this study, we investigate the influence of tissue heterogeneity on the accuracy of cSoS in simulations mimicking liver imaging. Our results show that it is mainly the short-scale heterogeneities inside the abdominal wall tissues that explain the artifact level and SoS biases that limit the current quantitative accuracy of CUTE.