In this study, an algorithm previously developed for estimating the total ultrasonic attenuation along the propagation path from the surface of the transducer to a region of interest (ROI) in tissue, was modified to make it more practical for use in clinical settings. Specifically, the algorithm was re-derived for when a tissue mimicking phantom rather than a planar reflector is used to obtain the reference power spectrum. The reference power spectrum is needed to compensate for the transfer function of the transmitted pulse, the transfer function of transducer, and the diffraction effects that result from focusing/beam forming. The modified algorithm was tested on simulated radio frequency (RF) echo lines obtained from two samples that have different scatterer sizes and different attenuation coefficient slopes, one of which was used as a reference. The mean and standard deviation of the percent errors in the attenuation coefficient estimates (ACEs) were less than 5% and 10%, respectively, for ROIs that contain more than 10 pulse lengths and more than 25 independent echo lines. The proposed algorithm was also tested on two tissue mimicking phantoms that have attenuation coefficient slopes of 0.7 dB/cm-MHz and 0.5 dB/cm-MHz respectively, the latter being the reference phantom. When a single element spherically focused source was used, the mean and standard deviation of the percent errors in the ACEs were less than 5% and 10% respectively for windows that contain more than 10 pulse lengths and more than 17 independent echo lines. When a clinical array transducer was used, the mean and standard deviation of the percent errors in the ACEs were less than 5% and 25%, respectively, for windows that contain more than 12 pulse lengths and more than 45 independent echo lines.

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