Minimum Variance Approaches to Ultrasound Pixel-Based Beamforming.

We analyze the principles underlying minimum variance distortionless response (MVDR) beamforming in order to integrate it into a pixel-based algorithm. There is a challenge posed by the low echo signal-to-noise ratio (eSNR) when calculating beamformer contributions at pixels far away from the beam centreline. Together with the well-known scarcity of samples for covariance matrix estimation, this reduces the beamformer performance and degrades the image quality. To address this challenge, we implement the MVDR algorithm in two different ways. First, we develop the conventional minimum variance pixel-based (MVPB) beamformer that performs the MVDR after the pixel-based superposition step. This involves a combination of methods in the literature, extended over multiple transmits to increase the eSNR. Then we propose the coherent MVPB beamformer, where the MVDR is applied to data within individual transmits. Based on pressure field analysis, we develop new algorithms to improve the data alignment and matrix estimation, and hence overcome the low-eSNR issue. The methods are demonstrated on data acquired with an ultrasound open platform. The results show the coherent MVPB beamformer substantially outperforms the conventional MVPB in a series of experiments, including phantom and in vivo studies. Compared to the unified pixel-based beamformer, the newest delay-and-sum algorithm in [1], the coherent MVPB performs well on regions that conform to the diffuse scattering assumptions on which the minimum variance principles are based. It produces less good results for parts of the image that are dominated by specular reflections

A Spatial Coherence Approach to Minimum Variance Beamforming for Plane-Wave Compounding.

A new approach to implement minimum variance distortionless response (MVDR) beamforming is introduced for coherent plane-wave compounding (CPWC). MVDR requires the covariance matrix of the incoming signal to be estimated and a spatial smoothing approximation is usually adopted to prevent this calculation from being underconstrained. In the new approach, we analyze MVDR as a spatial filter that decorrelates signals received at individual channels before summation. Based on the analysis, we develop two MVDR beamformers without using any spatial smoothing. First, MVDR weights are applied to the received signals after accumulating the data over transmits at different angles, while the second involves weighting the data collected in individual transmits and compounding over the transducer elements. In both cases, the covariance matrix is estimated using a set of slightly different combinations of the echo data. We show the sufficient statistic for this estimation that can be described by approximating the correlation among the backscattered ultrasound signals to their spatial coherence. Using the van Cittert-Zernike theorem, their statistical similarity is assessed by relating the spatial coherence to the profile of the source intensity. Both spatial-coherence-based MVDR beamformers are evaluated on data sets acquired from simulation, phantom, and in vivo studies. Imaging results show that they offer improvements over simple coherent compounding in terms of spatial and contrast resolutions. They also outperform other existing MVDR-based methods in the literature that are applied to CPWC

A task-based analytical framework for ultrasonic beamformer comparison.

A task-based approach is employed to develop an analytical framework for ultrasound beamformer design and evaluation. In this approach, a Bayesian ideal-observer provides an idealized starting point and a way to measure information loss in practical beamformer designs. Different approximations of this ideal strategy are shown to lead to popular beamformers in the literature, including the matched filter, minimum variance (MV), and Wiener filter (WF) beamformers. Analysis of the approximations indicates that the WF beamformer should outperform the MV approach, especially in low echo signal-to-noise conditions. The beamformers are applied to five typical tasks from the BIRADS lexicon. Their performance is evaluated based on ability to discriminate idealized malignant and benign features. The numerical results show the advantages of the WF over the MV technique in general; although performance varies predictably in some contrast-limited tasks because of the model modifications required for the MV algorithm to avoid ill-conditioning.This is the final version of the article. It first appeared from American Institute of Physics Publishing via http://dx.doi.org/10.1121/1.496060

High-Resolution Ultrasound Imaging With Unified Pixel-Based Beamforming.

This paper describes the development and evaluation of a new beamforming strategy based on pixel-based focusing for ultrasound linear array systems. We first implement conventional pixel-based beamforming in which the transmitted wave is assumed as spherical and diverging from the centre of the transmit subaperture. This assumed wave-shape is only valid within a limited angle on each side of the beam and this restricts the number of different subaperture positions from which data can be combined to improve image quality. By analyzing the field patterns, we propose a new unified pixel-based beamforming algorithm that better adapts to the non-spherical wave-shape of the transmit beam. This approach enables us to select the best-possible signal from each transducer waveform for data superposition. In simulations and a phantom study, we show that the unified pixel-based beamformer offers significant improvements in image quality compared to other delay-and-sum methods but at a higher computational cost. The new algorithm also demonstrates robust performance in a limited in vivo study. Overall, the results show that it is potentially of value in clinical applications.This is the author accepted manuscript. The final version is available from IEEE via http://dx.doi.org/10.1109/TMI.2015.245698

Noninvasive evaluation of hand circulation before radial artery harvest for coronary artery bypass grafting

AbstractObjective: Radial artery harvesting for coronary artery bypass may lead to digit ischemia if collateral hand circulation is inadequate. The modified Allen's test is the most common preoperative screening test used. Unfortunately, this test has high false-positive and false-negative rates. The purpose of this study was to compare the results of a modified Allen's test with digit pressure change during radial artery compression for assessing collateral circulation before radial artery harvest. Methods: One hundred twenty-nine consecutive patients were studied before coronary artery bypass operations. A modified Allen's test was performed with Doppler ultrasound to assess blood flow in the superficial palmar arch before and during radial artery compression. A decreased audible Doppler signal after radial artery compression was considered a positive modified Allen's test. First and second digit pressures were measured before and during radial artery compression. A decrease in digit pressure of 40 mm Hg or more (digit ΔP) with radial artery compression was considered positive. Results: Seven of 14 dominant extremities (50%) and 8 of the 16 nondominant extremities (50%) with a positive modified Allen's test had a digit ΔP of less than 40 mm Hg (false positive). Sixteen of 115 dominant extremities (14%) and 5 of 112 nondominant extremities (4%) with a negative Allen's test had a digit ΔP of 40 mm Hg or more with radial artery compression (false negative). Conclusion: Use of the modified Allen's test for screening before radial artery harvest may unnecessarily exclude some patients from use of this conduit and may also place a number of patients at risk for digit ischemia from such harvest. Direct digit pressure measurement is a simple, objective method that may more precisely select patients for radial artery harvest. Additional studies are needed to define objective digital pressure criteria that will accurately predict patients at risk for hand ischemia after radial harvest. (J Thorac Cardiovasc Surg 1999;117:261-6

An Experimental Analysis Of the Demand For Payday Loans

The payday loan industry is one of the fastest growing segments of the consumer financial services market in the United States. We design an environment similar to the one that payday loan customers face and then conduct a laboratory experiment to examine what effect, if any, the existence of payday loans has on individuals\u27 abilities to manage and to survive financial setbacks. Our primary objective is to examine whether access to payday loans improves or worsens the likelihood of financial survival in our experiment. We also test the degree to which people\u27s use of payday loans affects their ability to survive financially. We find that payday loans help the subjects to absorb expenditure shocks and therefore survive financially. However, subjects whose demand for payday loans exceeds a certain threshold level are at a greater risk than a corresponding subject in the treatment in which payday loans do not exist

3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial

Background: Liraglutide 3·0 mg was shown to reduce bodyweight and improve glucose metabolism after the 56-week period of this trial, one of four trials in the SCALE programme. In the 3-year assessment of the SCALE Obesity and Prediabetes trial we aimed to evaluate the proportion of individuals with prediabetes who were diagnosed with type 2 diabetes. Methods: In this randomised, double-blind, placebo-controlled trial, adults with prediabetes and a body-mass index of at least 30 kg/m2, or at least 27 kg/m2 with comorbidities, were randomised 2:1, using a telephone or web-based system, to once-daily subcutaneous liraglutide 3·0 mg or matched placebo, as an adjunct to a reduced-calorie diet and increased physical activity. Time to diabetes onset by 160 weeks was the primary outcome, evaluated in all randomised treated individuals with at least one post-baseline assessment. The trial was conducted at 191 clinical research sites in 27 countries and is registered with ClinicalTrials.gov, number NCT01272219. Findings: The study ran between June 1, 2011, and March 2, 2015. We randomly assigned 2254 patients to receive liraglutide (n=1505) or placebo (n=749). 1128 (50%) participants completed the study up to week 160, after withdrawal of 714 (47%) participants in the liraglutide group and 412 (55%) participants in the placebo group. By week 160, 26 (2%) of 1472 individuals in the liraglutide group versus 46 (6%) of 738 in the placebo group were diagnosed with diabetes while on treatment. The mean time from randomisation to diagnosis was 99 (SD 47) weeks for the 26 individuals in the liraglutide group versus 87 (47) weeks for the 46 individuals in the placebo group. Taking the different diagnosis frequencies between the treatment groups into account, the time to onset of diabetes over 160 weeks among all randomised individuals was 2·7 times longer with liraglutide than with placebo (95% CI 1·9 to 3·9, p<0·0001), corresponding with a hazard ratio of 0·21 (95% CI 0·13–0·34). Liraglutide induced greater weight loss than placebo at week 160 (–6·1 [SD 7·3] vs −1·9% [6·3]; estimated treatment difference −4·3%, 95% CI −4·9 to −3·7, p<0·0001). Serious adverse events were reported by 227 (15%) of 1501 randomised treated individuals in the liraglutide group versus 96 (13%) of 747 individuals in the placebo group. Interpretation: In this trial, we provide results for 3 years of treatment, with the limitation that withdrawn individuals were not followed up after discontinuation. Liraglutide 3·0 mg might provide health benefits in terms of reduced risk of diabetes in individuals with obesity and prediabetes. Funding: Novo Nordisk, Denmark