Precise scatterer localization for ultrasound contrast imaging

This thesis is concerned with developing algorithms for the precise localization of ultrasound point scatterers with an eye to super-resolution ultrasound contrast imaging. In medical ultrasound, the conventional resolution is limited by diffraction and, in contrast to other sensing fields, point source imaging has not been extensively investigated. Here, two independent methods were proposed aiming to increase the lateral and the axial resolution respectively, by improving the localization accuracy of a single scatterer. The methods were examined with simulated and experimental data by using standard transmission protocols. Where a technique is applicable to imaging of more complicated structures than point sources, this was also examined. Further, a preliminary study was included with algorithm application to microbubbles that are currently used in contrast enhanced ultrasound. It was demonstrated that it is feasible to translate to ultrasonics, adaptive processes or techniques from optical imaging/astronomy. This way, it was possible to overcome the diffraction limit and achieve sub-wavelength localization. The accuracy gains are subject to many parameters but may reach up to two orders of magnitude, and are based exclusively on array signal processing. The latter is an important advantage since current attempts for super-resolution ultrasound are image-based which is generally undesired

Early or Delayed Intervention for Bile Duct Injuries following Laparoscopic Cholecystectomy? A Dilemma Looking for an Answer

Background. To evaluate the effect of timing of management and intervention on outcomes of bile duct injury. Materials and Methods. We retrospectively analyzed 92 patients between 1991 and 2011. Data concerned patient’s demographic characteristics, type of injury (according to Strasberg classification), time to referral, diagnostic procedures, timing of surgical management, and final outcome. The endpoint was the comparison of postoperative morbidity (stricture, recurrent cholangitis, required interventions/dilations, and redo reconstruction) and mortality between early (less than 2 weeks) and late (over 12 weeks) surgical reconstruction. Results. Three patients were treated conservatively, two patients were treated with percutaneous drainage, and 13 patients underwent PTC or ERCP. In total 74 patients were operated on in our unit. 58 of them underwent surgical reconstruction by end-to-side Roux-en-Y hepaticojejunostomy, 11 underwent primary bile duct repair, and the remaining 5 underwent more complex procedures. Of the 56 patients, 34 patients were submitted to early reconstruction, while 22 patients were submitted to late reconstruction. After a median follow-up of 93 months, there were two deaths associated with BDI after LC. Outcomes after early repairs were equal to outcomes after late repairs when performed by specialists. Conclusions. Early repair after BDI results in equal outcomes compared with late repair. BDI patients should be referred to centers of expertise and experience

Improved microbubble (MB) Localisation Using Particle Detecting algorithm:Evaluation of Algorithm Performance for Different Beamforming Methods

International audienceThe performance of image analysis techniques (particle detection) on contrast enhanced ultrasound (CEUS) images could be enhanced by using it in combination with the right beamformer (BF). The current study investigates the best performing combination of a particle detecting algorithm (Kanoulas et al. 2019) with four beamformers (BFs), classical and adaptive. In a series of in silico experiments, adjacent MBs are placed in distances comparable to the lateral resolution limit, the CEUS images of the MBs were simulated in FieldII, and finally beamformed with the four methods. The images were processed with the MB detection algorithm and the results were evaluated by the true detections (TD), missed MBs, spurious detections, and localisation uncertainty (LU). For the smallest distances all methods deteriorate but the MV methods provided 4-12% more TD. For the intermediate distances the TD were comparable for all BFs but the adaptive methods provided lower LU. When a set of evaluation metrics is used, the adaptive methods provide marginally but systematically improved results which suggests that, under the appropriate imaging conditions, they could be used to enhance vessel mapping

Super-Resolution Contrast Enhanced Ultrasound Methodology for the Identification of in-Vivo Vascular Dynamics in 2D

\u3cp\u3eObjectives The aim of this study was to provide an ultrasound-based super-resolution methodology that can be implemented using clinical 2-dimensional ultrasound equipment and standard contrast-enhanced ultrasound modes. In addition, the aim is to achieve this for true-to-life patient imaging conditions, including realistic examination times of a few minutes and adequate image penetration depths that can be used to scan entire organs without sacrificing current super-resolution ultrasound imaging performance. Methods Standard contrast-enhanced ultrasound was used along with bolus or infusion injections of SonoVue (Bracco, Geneva, Switzerland) microbubble (MB) suspensions. An image analysis methodology, translated from light microscopy algorithms, was developed for use with ultrasound contrast imaging video data. New features that are tailored for ultrasound contrast image data were developed for MB detection and segmentation, so that the algorithm can deal with single and overlapping MBs. The method was tested initially on synthetic data, then with a simple microvessel phantom, and then with in vivo ultrasound contrast video loops from sheep ovaries. Tracks detailing the vascular structure and corresponding velocity map of the sheep ovary were reconstructed. Images acquired from light microscopy, optical projection tomography, and optical coherence tomography were compared with the vasculature network that was revealed in the ultrasound contrast data. The final method was applied to clinical prostate data as a proof of principle. Results Features of the ovary identified in optical modalities mentioned previously were also identified in the ultrasound super-resolution density maps. Follicular areas, follicle wall, vessel diameter, and tissue dimensions were very similar. An approximately 8.5-fold resolution gain was demonstrated in vessel width, as vessels of width down to 60 μm were detected and verified (λ = 514 μm). Best agreement was found between ultrasound measurements and optical coherence tomography with 10% difference in the measured vessel widths, whereas ex vivo microscopy measurements were significantly lower by 43% on average. The results were mostly achieved using video loops of under 2-minute duration that included respiratory motion. A feasibility study on a human prostate showed good agreement between density and velocity ultrasound maps with the histological evaluation of the location of a tumor. Conclusions The feasibility of a 2-dimensional contrast-enhanced ultrasound-based super-resolution method was demonstrated using in vitro, synthetic and in vivo animal data. The method reduces the examination times to a few minutes using state-of-the-art ultrasound equipment and can provide super-resolution maps for an entire prostate with similar resolution to that achieved in other studies.\u3c/p\u3