Effects of motion on high frame rate contrast enhanced echocardiography and its correction

Contrast echocardiography (CE) ultrasound with microbubble contrast agents have significantly advanced our capability in assessing cardiac function, including myocardium perfusion imaging and quantification. However in conventional CE techniques with line by line scanning, the frame rate is limited to tens of frames per second and image quality is low. Recent research works in high frame-rate (HFR) ultrasound have shown significant improvement of the frame rate in non-contrast cardiac imaging. But with a higher frame rate, the coherent compounding of HFR CE images shows some artifacts due to the motion of the microbubbles. In this work we demonstrate the impact of this motion on compounded HFR CE in simulation and then apply a motion correction algorithm on in-vivo data acquired from the left ventricle (LV) chamber of a sheep. It shows that even if with the fast flow found inside the LV, the contrast is improved at least 100%

Plane wave versus focused transmissions for contrast enhanced ultrasound imaging: the role of parameter settings and the effects of flow rate on contrast measurements.

Contrast enhanced ultrasound (CEUS) and dynamic contrast enhanced ultrasound (DCE-US) can be used to provide information about the vasculature aiding diagnosis and monitoring of a number of pathologies including cancer. In the development of a CEUS imaging system, there are many choices to be made, such as whether to use plane wave (PW) or focused imaging (FI), and the values for parameters such as transmit frequency, F-number, mechanical index, and number of compounding angles (for PW imaging). CEUS image contrast may also be dependent on subject characteristics, e.g. flow speed and vessel orientation. We evaluated the effect of such choices on vessel contrast for PW and FI in vitro, using 2D ultrasound imaging. CEUS images were obtained using a VantageTM (Verasonics Inc.) and a pulse-inversion (PI) algorithm on a flow phantom. Contrast (C) and contrast reduction (CR) were calculated, where C was the initial ratio of signal in vessel to signal in background and CR was its reduction after 200 frames (acquired in 20 s). Two transducer orientations were used: parallel and perpendicular to the vessel direction. Similar C and CR was achievable for PW and FI by choosing optimal parameter values. PW imaging suffered from high frequency grating lobe artefacts, which may lead to degraded image quality and misinterpretation of data. Flow rate influenced the contrast based on: (1) false contrast increase due to the bubble motion between the PI positive and negative pulses (for both PW and FI), and (2) contrast reduction due to the incoherency caused by bubble motion between the compounding angles (for PW only). The effects were less pronounced for perpendicular transducer orientation compared to a parallel one. Although both effects are undesirable, it may be more straight forward to account for artefacts in FI as it only suffers from the former effect. In conclusion, if higher frame rate imaging is not required (a benefit of PW), FI appears to be a better choice of imaging mode for CEUS, providing greater image quality over PW for similar rates of contrast reduction

Ultrafast Echocardiography

Grâce à son accessibilité, sa polyvalence et sa sécurité, l'échocardiographie est devenue la technique d'imagerie la plus utilisée pour évaluer la fonction cardiaque. Au vu du succès de l'échographie ultrarapide par ondes planes des techniques similaires pour augmenter la résolution temporelle en échocardiographie ont été mise en oeuvre. L’augmentation de la résolution temporelle de l’échographie cardiaque au-delà des valeurs actuellement atteignables (~ 60 à 80 images par secondes), pourrait être utilisé pour améliorer d’autres caractéristiques de l'échocardiographie, comme par exemple élargir la plage de vitesses détectables en imagerie Doppler couleur limitées par la valeur de Nyquist. Nous avons étudié l'échocardiographie ultrarapide en utilisant des fronts d’ondes ultrasonores divergentes. La résolution temporelle atteinte par la méthode d'ondes divergentes a permis d’améliorer les capacités des modes d’échocardiographie en mode B et en Doppler couleur. La résolution temporelle de la méthode mode B a été augmentée jusqu'à 633 images par secondes, tout en gardant une qualité d'image comparable à celle de la méthode d’échocardiographie conventionnelle. La vitesse de Nyquist de la méthode Doppler couleur a été multipliée jusqu'à 6 fois au delà de la limite conventionnelle en utilisant une technique inspirée de l’imagerie radar; l’implémentation de cette méthode n’aurait pas été possible sans l’utilisation de fronts d’ondes divergentes. Les performances avantageuses de la méthode d'échocardiographie ultrarapide sont supportées par plusieurs résultats in vitro et in vivo inclus dans ce manuscrit.Because of its low cost, versatility and safety, echocardiography has become the most common imaging technique to assess the cardiac function. The recent success of ultrafast ultrasound plane wave imaging has prompted the implementation of similar approaches to enhance the echocardiography temporal resolution. The ability to enhance the echocardiography frame rate beyond conventional values (~60 to 80 fps) would positively impact other echocardiography features, e.g. broaden the color Doppler unambiguous velocity range. We investigated the ultrafast echocardiography imaging approach using ultrasound diverging waves. The high frame rate offered by the diverging wave method was used to enhance the capabilities of both B-mode and color Doppler echocardiography. The B-mode temporal resolution was increased to 633 fps whilst the image quality was kept almost unchanged with reference to the conventional echocardiography technique. The color Doppler Nyquist velocity range was extended to up to 6 times the conventional limit using a weather radar imaging approach; such an approach could not have been implemented without using the ultrafast diverging wave imaging technique. The advantageous performance of the ultrafast diverging wave echocardiography approach is supported by multiple in vitro and in vivo results included in this manuscript

Ultrafast Ultrasound Imaging

Among medical imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), ultrasound imaging stands out due to its temporal resolution. Owing to the nature of medical ultrasound imaging, it has been used for not only observation of the morphology of living organs but also functional imaging, such as blood flow imaging and evaluation of the cardiac function. Ultrafast ultrasound imaging, which has recently become widely available, significantly increases the opportunities for medical functional imaging. Ultrafast ultrasound imaging typically enables imaging frame-rates of up to ten thousand frames per second (fps). Due to the extremely high temporal resolution, this enables visualization of rapid dynamic responses of biological tissues, which cannot be observed and analyzed by conventional ultrasound imaging. This Special Issue includes various studies of improvements to the performance of ultrafast ultrasoun

Coherent Multi-Transducer Ultrasound Imaging

An extended aperture has the potential to greatly improve ultrasound imaging performance. This work extends the effective aperture size by coherently compounding the received radio frequency data from multiple transducers. A framework is developed in which an ultrasound imaging system consisting of $N$ synchronized matrix arrays, each with partly shared field of view, take turns to transmit plane waves. Only one individual transducer transmits at each time while all $N$ transducers simultaneously receive. The subwavelength localization accuracy required to combine information from multiple transducers is achieved without the use of any external tracking device. The method developed in this study is based on the study of the backscattered echoes received by the same transducer and resulting from a targeted scatterer point in the medium insonated by the multiple ultrasound probes of the system. The current transducer locations along with the speed of sound in the medium are deduced by optimizing the cross-correlation between these echoes. The method is demonstrated experimentally in 2-D using ultrasound point and anechoic lesion phantoms and a first demonstration of a free-hand experiment is also shown. Results demonstrate that the coherent multi-transducer imaging has the potential to improve ultrasound image quality, improving resolution and target detectability. Lateral resolution, contrast and contrast-to-noise ratio improved from 0.67 mm, -6.708 dB and 0.702, respectively, when using a single probe, to 0.18 mm, -7.251 dB and 0.721 in the coherent multi-transducer imaging case

Advanced signal processing methods for plane-wave color Doppler ultrasound imaging

Conventional medical ultrasound imaging uses focused beams to scan the imaging scene line-by-line, but recently however, plane-wave imaging, in which plane-waves are used to illuminate the entire imaging scene, has been gaining popularity due its ability to achieve high frame rates, thus allowing the capture of fast dynamic events and producing continuous Doppler data. In most implementations, multiple low-resolution images from different plane wave tilt angles are coherently averaged (compounded) to form a single high-resolution image, albeit with the undesirable side effect of reducing the frame rate, and attenuating signals with high Doppler shifts. This thesis introduces a spread-spectrum color Doppler imaging method that produces high-resolution images without the use of frame compounding, thereby eliminating the tradeoff between beam quality, frame rate and the unaliased Doppler frequency limit. The method uses a Doppler ensemble formed of a long random sequence of transmit tilt angles that randomize the phase of out-of-cell (clutter) echoes, thereby spreading the clutter power in the Doppler spectrum without compounding, while keeping the spectrum of in-cell echoes intact. The spread-spectrum method adequately suppresses out-of-cell blood echoes to achieve high spatial resolution, but spread-spectrum suppression is not adequate for wall clutter which may be 60 dB above blood echoes. We thus implemented a clutter filter that re-arranges the ensemble samples such that they follow a linear tilt angle order, thereby compacting the clutter spectrum and spreading that of the blood Doppler signal, and allowing clutter suppression with frequency domain filters. We later improved this filter with a redesign of the random sweep plan such that each tilt angle is repeated multiple times, allowing, after ensemble re-arrangement, the use of comb filters for improved clutter suppression. Experiments performed using a carotid artery phantom with constant flow demonstrate that the spread-spectrum method more accurately measures the parabolic flow profile of the vessel and outperforms conventional plane-wave Doppler in both contrast resolution and estimation of high flow velocities. To improve velocity estimation in pulsatile flow, we developed a method that uses the chirped Fourier transform to reduce stationarity broadening during the high acceleration phase of pulsatile flow waveforms. Experimental results showed lower standard deviations compared to conventional intensity-weighted-moving-average methods. The methods in this thesis are expected to be valuable for Doppler applications that require measurement of high velocities at high frame rates, with high spatial resolution

Ultrafast radial modulation imaging

International audienceRadial modulation imaging improves the detection of microbubbles at high frequency by using a dual ultrasonic excitation. However, the synchronization between the imaging pulses is non-trivial because microbubbles need to be interrogated in the compression and the rarefaction phase and the time-delay difference from dispersion has to be corrected. To address these issues, we propose the use of ultrafast radial modulation imaging (uRMI). In this technique, a beat frequency between the modulation pulse (around 1 MHz) and the ultrafast pulse-repetition frequency was exploited to separate microbubbles from tissue phantom in-vitro. This led to a modulated images set in the spectral domain of the slow-time that may then be demodulated through a digital lock-in amplifier to retrieve the contrast image. Ultrafast RMI, applied on a flow phantom with microbubbles, provided a contrast-to-tissue ratio from 7.2 to 14.8 dB at 15 MHz. For flow speed lower than 0.05 mL/min, uRMI (16 dB) provided a better contrast-to-tissue ratio than other techniques: SVD spatiotemporal filter (11 dB), amplitude modulation (9 dB) or microbubbles disruption (6 dB) or. This technique may then be suitable to improve the detection of targeted microbubbles, in ultrasound molecular imaging applications, and the detection of extremely slow microbubbles moving in the finest vessels in ultrasound localization microscopy

High frame rate contrast enhanced ultrasound imaging for slow flow: influence of ultrasound pressure and flow rate on bubble disruption and image persistence

Contrast-enhanced ultrasound (CEUS) utilising microbubbles shows great potential for visualising lymphatic vessels and identifying sentinel lymph nodes (SLNs) which are valuable for axillary staging in breast cancer patients. However, current CEUS imaging techniques have limitations that affect the accurate visualisation and tracking of lymphatic vessels and SLN. (i) Tissue artefacts and bubble disruption can reduce the image contrast. (ii) Limited spatial and temporal resolution diminishes the amount of information that can be captured by CEUS. (iii) The slow lymph flow makes Doppler-based approaches less effective. This work evaluates on a lymphatic vessel phantom the use of high frame rate (HFR) CEUS for the detection of lymphatic vessels where flow is slow. Specifically, the work particularly investigates the impact of key factors in lymphatic imaging, including ultrasound pressure and flow velocity as well as probe motion during vessel tracking, on bubble disruption and image contrast. Experiments were also conducted to apply HFR CEUS imaging on vasculature in a rabbit popliteal lymph node (LN). Our results show that (i) HFR imaging and singular value decomposition (SVD) filtering can significantly reduce tissue artefacts in the phantom at high clinical frequencies; (ii) the slow flow rate within the phantom makes image contrast and signal persistence more susceptible to changes in ultrasound amplitude or mechanical index (MI), and an MI value can be chosen to reach a compromise between images contrast and bubble disruption under slow flow condition; (iii) probe motion significantly decreases image contrast of the vessel, which can be improved by applying motion correction before SVD filtering; (iv) the optical observation of the impact of ultrasound pressure on HFR CEUS further confirms the importance of optimising ultrasound amplitude and (v) vessels inside rabbit LN with blood flow less than 3 mm/s are clearly visualised

2-D and 3-D high frame-rate Pulse Wave Imaging for the characterization of focal vascular disease

Cardiovascular diseases are major causes of morbidity and mortality in Western-style populations. Atherosclerosis and Abdominal Aortic Aneurysms (AAAs) are two prevalent vascular diseases that may progress without symptoms and contribute to acute cardiovascular events such as stroke and AAA rupture, which are consistently among the leading causes of death worldwide. The imaging methods used in the diagnosis of these diseases, have been reported to present several limitations. Given that both are associated with mechanical changes in the arterial wall, imaging of the arterial mechanical properties may improve early disease detection and patient care. Pulse wave velocity (PWV) refers to the velocity at which arterial waves generated by ventricular ejection travel along the arterial tree. PWV is a surrogate marker of arterial stiffness linked to cardiovascular mortality. The foot-to-foot method that is typically used to calculate PWV suffers from errors of distance measurements and time-delay measurements. Additionally, a single PWV estimate is provided over a relatively long distance, thus inherently lacking the capability to provide regional arterial stiffness measurements. Pulse Wave Imaging (PWI) is a noninvasive, ultrasound-based technique for imaging the propagation of pulse waves along the wall of major arteries and providing a regional PWV value for the imaged artery. The aim of this work was to enable PWI to provide more localized PWV and stiffness measurements within the imaged arterial segment and to further extend it into a 2-D and 3-D technique for the detection and monitoring of focal vascular disease at high temporal and spatial resolution. The improved modality was integrated with blood flow imaging modalities aiming to render PWI a comprehensive methodology for the study of arterial biomechanics in vivo. Spatial information was increased with the introduction of piecewise PWI. This novel technique was used to measure PWV within small sub-regions of the imaged vessel in murine aneurysmal (n = 8) and atherosclerotic aortas (n = 11) in vivo. It provided PWV and stiffness maps while capturing the progressive arterial stiffening caused by atherosclerosis. PWI was further augmented with a sophisticated adaptive algorithm, enabling it to optimally partition the imaged artery into relatively homogeneous segments, automatically isolating arterial stiffness inhomogeneities. Adaptive PWI was validated in silicone phantoms consisting of segments of varying stiffness and then tested in murine aortas in vivo. Subsequently, the conventional tradeoff between spatial and temporal resolution was addressed with a plane wave compounding implementation of PWI, allowing the acquisition of full field of view frames at over 2000 Hz. A GPU-accelerated PWI post-processing framework was developed for the processing of the big bulk of generated data. The parameters of coherent compounding were optimized in vivo. The optimized sequences were then used in the clinic to assess the mechanical properties of atherosclerotic carotids (n=10) and carotids of patients after endarterectomy (n=7), a procedure to remove the plaque and restore blood flow to the brain. In the case of atherosclerotic patients undergoing carotid endarterectomy, the results were compared against the histology of the excised plaques. Investigation of the mechanical properties of plaques was also conducted for the first time with a high-frequency transducer (18.5 MHz). Additionally, 4-D PWI was introduced, utilizing high frame rate 3-D plane wave acquisitions with a 2-D matrix array transducer (16x16 elements, 2.5 MHz). A novel methodology for PWV estimation along the direction of pulse wave propagation was implemented and validated in silicone phantoms. 4-D PWI provided comprehensive views of the pulse wave propagation in a plaque phantom and the results were compared against conventional PWI. Finally, its feasibility was tested in the carotid arteries of healthy human subjects (n=6). PWVs derived in 3-D were within the physiological range and showed good agreement with the results of conventional PWI. Finally, PWI was integrated with flow imaging modalities (Color and Vector Doppler). Thus, full field-of-view, high frame-rate, simultaneous and co-localized imaging of the arterial wall dynamics and color flow as well as 2-D vector flow was implemented. The feasibility of both techniques was tested in healthy subjects (n=6) in vivo. The relationship between the timings of the flow and wall velocities was investigated at multiple locations of the imaged artery. Vector flow velocities were found to be aligned with the vessel’s centerline during peak systole in the common carotid artery and interesting flow patterns were revealed in the case of the carotid bifurcation Consequently, with the aforementioned improvements and the inclusion of 3-D imaging, PWI is expected to provide comprehensive information on the mechanical properties of pathological arteries, providing clinicians with a powerful tool for the early detection of vascular abnormalities undetectable on the B-mode, while also enabling the monitoring of fully developed vascular pathology and of the recovery of post-operated vessels