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★ A tissue stiffness dependent displacement estimation algorithm is proposed. ★ The algorithm parameter is optimized with simulation. ★ The performance is verified with simulation, phantom and in vitro experiments. ★ It is found about 10 times faster than the traditional algorithm. ★ This algorithm has the potential for HIFU treatment monitoring.To monitor HIFU-induced lesion with elastography in quasi-real time, a fast correlation based elastographic algorithm using tissue stiffness–dependent displacement estimation (SdDE) is developed in this paper. The high time efficiency of the proposed method contributes to the reduction on both the number of the displacement points and the computational time of most of the points by utilizing local uniformity of the tissue under HIFU treatment. To obtain admirable comprehensive performance, the key algorithm parameter, a threshold to densify the displacement points, is optimized with simulation over a wedge-inclusion tissue model by compromising the axial resolution (AR) and the computational cost. With the optimum parameter, results from both simulations and phantom experiments show that the SdDE is faster in about one order of magnitude than the traditional correlation based algorithm. At the same time, other performance parameters, such as the signal-to-noise ratio (SNRe), the contrast-to-noise ratio (CNRe) and the axial resolution (AR), are superior to or comparable with that obtained from the traditional algorithm. In vitro experiments on bovine livers validate the improvement on the time efficiency under the circumstances of real tissue and real radio frequency (RF) signal. This preliminary work implies potential of the SdDE in dynamic or close real time guidance and monitoring of HIFU treatment.