Medical diagnostic applications and sources

Paving the way for bacteria-based drug delivery: biohybrid microrobots emerging from microrobotics and synthetic biology

Advances in microrobotics and synthetic biology are paving the way for innovative solutions to long-standing challenges in drug delivery. Both fields have independently worked on engineering bacteria as a therapeutic system, focusing on enhancing propulsion, cargo delivery, detection, and biocompatibility. Bacteria, with their inherent adaptability and functional versatility, serve as an ideal foundation for these efforts, enabling them to navigate complex biological environments such as the human body. This review explores the convergence of microrobotics and synthetic biology, which has catalysed the development of biohybrid bacterial microrobots that integrate the strengths of both disciplines. By incorporating external control modalities - such as light, ultrasound, and magnetic fields - these hybrid systems address the limitations of purely microrobotic or biological approaches, offering new opportunities to enhance precision and efficacy in targeted therapies. However, realising the full potential of biohybrid bacterial microrobots requires overcoming critical challenges, such as ensuring compatibility between biological and synthetic components, scaling manufacturing processes, and defining regulatory pathways tailored to living therapeutics. Addressing these hurdles through joint, interdisciplinary research efforts, can unlock the transformative possibilities of these systems in modern medicine.

Using torsional wave elastography to evaluate spring pot parameters in skin tumor mimicking phantoms

Estimating the tissue parameters of skin tumors is crucial for diagnosis and effective therapy in dermatology and related fields. However, identifying the most sensitive biomarkers require an optimal rheological model for simulating skin behavior this remains an ongoing research endeavor. Additionally, the multi-layered structure of the skin introduces further complexity to this task. In order to surmount these challenges, an inverse problem methodology, in conjunction with signal analysis techniques, is being employed. In this study, a fractional rheological model is presented to enhance the precision of skin tissue parameter estimation from the acquired signal from torsional wave elastography technique (TWE) on skin tumor-mimicking phantoms for lab validation and the estimation of the thickness of the cancerous layer. An exhaustive analysis of the spring-pot model (SP) solved by the finite difference time domain (FDTD) is conducted. The results of experiments performed using a TWE probe designed and prototyped in the laboratory were validated against ultrafast imaging carried out by the Verasonics Research System. Twelve tissue-mimicking phantoms, which precisely simulated the characteristics of skin tissue, were prepared for our experimental setting. The experimental data from these bi-layer phantoms were measured using a TWE probe, and the parameters of the skin tissue were estimated using inverse problem-solving. The agreement between the two datasets was evaluated by comparing the experimental data obtained from the TWE technique with simulated data from the SP- FDTD model using Pearson correlation, dynamic time warping (DTW), and time-frequency representation. Our findings show that the SP-FDTD model and TWE are capable of determining the mechanical properties of both layers in a bilayer phantom, using a single signal and an inverse problem approach. The ultrafast imaging and the validation of TWE results further demonstrate the robustness and reliability of our technology for a realistic range of phantoms. This fusion of the SP-FDTD model and TWE, as well as inverse problem-solving methods has the potential to have a considerable impact on diagnoses and treatments in dermatology and related fields.

A review of ultrasound contrast media

Efforts have been made over the last five decades to create effective ultrasonic contrast media (UCM) for cardiac and noncardiac applications. The initial UCM was established in the 1980s, following publications from the 1960s that detailed the discovery of ultrasonic contrast enhancement using small gaseous bubbles in echocardiographic examinations. An optimal contrast agent for echography should possess the following characteristics: non-toxicity, suitability for intravenous injection, ability to traverse pulmonary, cardiac, and capillary circulations, and stability for recirculation. Definity, Optison, Sonazoid, and SonoVue are examples of current commercial contrast media. These contrast media have shown potential for various clinical reasons, both on-label and off-label. Several possible UCMs have been developed or are in progress. Advancements in comprehending the physical, chemical, and biological characteristics of microbubbles have significantly improved the visualization of tumor blood vessels, the identification of areas with reduced blood supply, and the enhanced detection of narrowed blood vessels. Innovative advances are expected to enhance future applications such as ultrasonic molecular imaging and therapeutic utilization of microbubbles.

Real-Time Speed-of-Sound Estimation In Vivo via Steered Plane Wave Ultrasound

Speed-of-sound (SoS) is an intrinsic acoustic property of human tissues and has been regarded as a potential biomarker of tissue health. To foster the clinical use of this emerging biomarker in medical diagnostics, it is important for SoS estimates to be derived and displayed in real time. Here, we demonstrate that concurrent global SoS estimation and B-mode imaging can be achieved live on a portable ultrasound scanner. Our innovation is hinged upon the design of a novel pulse-echo SoS estimation framework that is based on steered plane wave imaging. It has accounted for the effects of refraction and imaging depth when the medium SoS differs from the nominal value of 1540 m/s that is conventionally used in medical imaging. The accuracy of our SoS estimation framework was comparatively analyzed with through-transmit time-of-flight measurements in vitro on 15 custom agar phantoms with different SoS values (1508-1682 m/s) and in vivo on human calf muscles ( N = 9 ; SoS range: 1560-1586 m/s). Our SoS estimation framework has a mean signed difference (MSD) of - 0.6 ± 2.3 m/s in vitro and - 2.2 ± 11.2 m/s in vivo relative to the reference measurements. In addition, our real-time system prototype has yielded simultaneous SoS estimates and B-mode imaging at an average frame rate of 18.1 fps. Overall, by realizing real-time tissue SoS estimation with B-mode imaging, our innovation can foster the use of tissue SoS as a biomarker in medical ultrasound diagnostics.

Symphonies of Growth: Unveiling the Impact of Sound Waves on Plant Physiology and Productivity

The application of sound wave technology to different plant species has revealed that variations in the Hz, sound pressure intensity, treatment duration, and type of setup of the sound source significantly impact the plant performance. A study conducted on cotton plants treated with Plant Acoustic Frequency Technology (PAFT) highlighted improvements across various growth metrics. In particular, the treated samples showed increases in the height, size of the fourth expanded leaf from the final one, count of branches carrying bolls, quantity of bolls, and weight of individual bolls. Another study showed how the impact of a 4 kHz sound stimulus positively promoted plant drought tolerance. In other cases, such as in transgenic rice plants, GUS expression was upregulated at 250 Hz but downregulated at 50 Hz. In the same way, sound frequencies have been found to enhance the osmotic potential, with the highest observed in samples treated with frequencies of 0.5 and 0.8 kHz compared to the control. Furthermore, a sound treatment with a frequency of 0.4 kHz and a sound pressure level (SPL) of 106 dB significantly increased the paddy rice germination index, as evidenced by an increase in the stem height and relative fresh weight. This paper presents a complete, rationalized and updated review of the literature on the effects of sound waves on the physiology and growth parameters of sound-treated plants.

Extended aperture image reconstruction for plane-wave imaging

B-mode images undergo degradation in the boundary region because of the limited number of elements in the ultrasound probe. Herein, a deep learning-based extended aperture image reconstruction method is proposed to reconstruct a B-mode image with an enhanced boundary region. The proposed network can reconstruct an image using pre-beamformed raw data received from the half-aperture of the probe. To generate a high-quality training target without degradation in the boundary region, the target data were acquired using the full-aperture. Training data were acquired from an experimental study using a tissue-mimicking phantom, vascular phantom, and simulation of random point scatterers. Compared with plane-wave images from delay and sum beamforming, the proposed extended aperture image reconstruction method achieves improvement at the boundary region in terms of the multi-scale structure of similarity and peak signal-to-noise ratio by 8% and 4.10 dB in resolution evaluation phantom, 7% and 3.15 dB in contrast speckle phantom, and 5% and 3 dB in in vivo study of carotid artery imaging. The findings in this study prove the feasibility of a deep learning-based extended aperture image reconstruction method for boundary region improvement.

Minimizing Image Quality Loss After Channel Count Reduction for Plane Wave Ultrasound via Deep Learning Inference

High-frame-rate ultrasound imaging uses unfocused transmissions to insonify an entire imaging view for each transmit event, thereby enabling frame rates over 1000 frames per second (fps). At these high frame rates, it is naturally challenging to realize real-time transfer of channel-domain raw data from the transducer to the system back end. Our work seeks to halve the total data transfer rate by uniformly decimating the receive channel count by 50% and, in turn, doubling the array pitch. We show that despite the reduced channel count and the inevitable use of a sparse array aperture, the resulting beamformed image quality can be maintained by designing a custom convolutional encoder-decoder neural network to infer the radio frequency (RF) data of the nullified channels. This deep learning framework was trained with in vivo human carotid data (5-MHz plane wave imaging, 128 channels, 31 steering angles over a 30° span, and 62 799 frames in total). After training, the network was tested on an in vitro point target scenario that was dissimilar to the training data, in addition to in vivo carotid validation datasets. In the point target phantom image beamformed from inferred channel data, spatial aliasing artifacts attributed to array pitch doubling were found to be reduced by up to 10 dB. For carotid imaging, our proposed approach yielded a lumen-to-tissue contrast that was on average within 3 dB compared to the full-aperture image, whereas without channel data inferencing, the carotid lumen was obscured. When implemented on an RTX-2080 GPU, the inference time to apply the trained network was 4 ms, which favors real-time imaging. Overall, our technique shows that with the help of deep learning, channel data transfer rates can be effectively halved with limited impact on the resulting image quality.

Design and Implementation of a Modular and Scalable Research Platform for Ultrasound Computed Tomography

Increasing attention has been attracted to the research of ultrasound computed tomography (USCT). This article reports the design considerations and implementation details of a novel USCT research system named UltraLucid, which aims to provide a user-friendly platform for researchers to develop new algorithms and conduct clinical trials. The modular design strategy is adopted to make the system highly scalable. A prototype has been assembled in our laboratory, which is equipped with a 2048-element ring transducer, 1024 transmit (TX) channels, 1024 receive (RX) channels, two servers, and a control unit. The prototype can acquire raw data from 1024 channels simultaneously using a modular data acquisition and a transfer system, consisting of 16 excitation and data acquisition (EDAQ) boards. Each EDAQ board has 64 independent TX and RX channels and 4-Gb Ethernet interfaces for raw data transmission. The raw data can be transferred to two servers at a theoretical rate of 64 Gb/s. Both servers are equipped with a 10.9-TB solid-state drive (SSD) array that can store raw data for offline processing. Alternatively, after processing by onboard field-programmable gate arrays (FPGAs), the raw data can be processed online using multicore central processing units (CPUs) and graphics processing units (GPUs) in each server. Through control software running on the host computer, the researchers can configure parameters for transmission, reception, and data acquisition. Novel TX-RX scheme and coded imaging can be implemented. The modular hardware structure and the software-based processing strategy make the system highly scalable and flexible. The system performance is evaluated with phantoms and in vivo experiments.

Ultrasound Open Platforms for Next-Generation Imaging Technique Development

Open platform (OP) ultrasound systems are aimed primarily at the research community. They have been at the forefront of the development of synthetic aperture, plane wave, shear wave elastography, and vector flow imaging. Such platforms are driven by a need for broad flexibility of parameters that are normally preset or fixed within clinical scanners. OP ultrasound scanners are defined to have three key features including customization of the transmit waveform, access to the prebeamformed receive data, and the ability to implement real-time imaging. In this paper, a formative discussion is given on the development of OPs from both the research community and the commercial sector. Both software- and hardware-based architectures are considered, and their specifications are compared in terms of resources and programmability. Software-based platforms capable of real-time beamforming generally make use of scalable graphics processing unit architectures, whereas a common feature of hardware-based platforms is the use of field-programmable gate array and digital signal processor devices to provide additional on-board processing capacity. OPs with extended number of channels (>256) are also discussed in relation to their role in supporting 3-D imaging technique development. With the increasing maturity of OP ultrasound scanners, the pace of advancement in ultrasound imaging algorithms is poised to be accelerated.

Effects of sound exposure on the growth and intracellular macromolecular synthesis of E. coli k-12

Microbes, as one of the primary producers of the biosphere, play an important role in ecosystems. Exploring the mechanism of adaptation and resistance of microbial population to various environmental factors has come into focus in the fields of modern microbial ecology and molecular ecology. However, facing the increasingly serious problem of acoustic pollution, very few efforts have been put forth into studying the relation of single cell organisms and sound field exposure. Herein, we studied the biological effects of sound exposure on the growth of E. coli K-12 with different acoustic parameters. The effects of sound exposure on the intracellular macromolecular synthesis and cellular morphology of E. coli K-12 were also analyzed and discussed. Experimental results indicated that E. coli K-12 exposed to sound waves owned a higher biomass and a faster specific growth rate compared to the control group. Also, the average length of E. coli K-12 cells increased more than 27.26%. The maximum biomass and maximum specific growth rate of the stimulation group by 8000 Hz, 80dB sound wave was about 1.7 times and 2.5 times that of the control group, respectively. Moreover, it was observed that E. coli K-12 can respond rapidly to sound stress at both the transcriptional and posttranscriptional levels by promoting the synthesis of intracellular RNA and total protein. Some potential mechanisms may be involved in the responses of bacterial cells to sound stress.

GPU-based minimum variance beamformer for synthetic aperture imaging of the eye

Minimum variance (MV) beamforming has emerged as an adaptive apodization approach to bolster the quality of images generated from synthetic aperture ultrasound imaging methods that are based on unfocused transmission principles. In this article, we describe a new high-speed, pixel-based MV beamforming framework for synthetic aperture imaging to form entire frames of adaptively apodized images at real-time throughputs and document its performance in swine eye imaging case examples. Our framework is based on parallel computing principles, and its real-time operational feasibility was realized on a six-GPU (graphics processing unit) platform with 3,072 computing cores. This framework was used to form images with synthetic aperture imaging data acquired from swine eyes (based on virtual point-source emissions). Results indicate that MV-apodized image formation with video-range processing throughput (>20 fps) can be realized for practical aperture sizes (128 channels) and frames with λ/2 pixel spacing. Also, in a corneal wound detection experiment, MV-apodized images generated using our framework revealed apparent contrast enhancement of the wound site (10.8 dB with respect to synthetic aperture images formed with fixed apodization). These findings indicate that GPU-based MV beamforming can, in real time, potentially enhance image quality when performing synthetic aperture imaging that uses unfocused firings.

Noninvasive detection of intimal xanthoma using combined ultrasound, strain rate and photoacoustic imaging

BACKGROUND AND MOTIVATION

The structure, composition and mechanics of carotid artery are good indicators of early progressive atherosclerotic lesions. The combination of three imaging modalities (ultrasound, strain rate and photoacoustic imaging) which could provide corroborative information about the named arterial properties could enhance the characterization of intimal xanthoma.

METHODS

The experiments were performed using a New Zealand white rabbit model of atherosclerosis. The aorta excised from an atherosclerotic rabbit was scanned ex vivo using the three imaging techniques: (1) ultrasound imaging of the longitudinal section: standard ultrasound B-mode (74Hz frame rate); (2) strain rate imaging: the artery was flushed with blood and a 1.5Hz physiologic pulsation was induced, while the ultrasound data were recorded at higher frame rate (296Hz); (3) photoacoustic imaging: the artery was irradiated with nanosecond pulsed laser light of low fluence in the 1210-1230nm wavelength range and the photoacoustic data was recorded at 10Hz frame rate. Post processing algorithms based on cross-correlation and optical absorption variation were implemented to derive strain rate and spectroscopic photoacoustic images, respectively.

RESULTS

Based on the spatio-temporal variation in displacement of different regions within the arterial wall, strain rate imaging reveals differences in tissue mechanical properties. Additionally, spectroscopic photoacoustic imaging can spatially resolve the optical absorption properties of arterial tissue and identify the location of lipid pools.

CONCLUSIONS

The study demonstrates that ultrasound, strain rate and photoacoustic imaging can be used to simultaneously evaluate the structure, the mechanics and the composition of atherosclerotic lesions to improve the assessment of plaque vulnerability.

Doppler imaging in the diagnosis of ovarian disease

INTRODUCTION

Pelvic ultrasonography remains the non-invasive imaging modality of choice for detecting and characterising adnexal masses. The use of Doppler ultrasound has improved the differential diagnosis of ovarian disease and helped to widen the understanding of the aetiology and possible pathophysiology of the various underlying conditions with an aim of improved diagnosis and management.

AREAS COVERED

This review describes the basis of different Doppler techniques and their application in ovarian disease. The present evidence is critically analysed in an attempt to define the current role of Doppler ultrasound of the ovaries. The technique holds promise in certain ovarian diseases but remains controversial in others.

EXPERT OPINION

Doppler ultrasound has a role in both the clinical and research settings. Clinically, it can be used to differentiate benign and malignant disease and help confirm diagnoses suggested on grey-scale imaging giving the user more confidence. Its use here, however, is generally restricted to a subjective impression of colour flow rather than a quantitative analysis of vascularity or blood flow velocity. These measures are more relevant in the research setting where quantitative Doppler is being used to clarify the possible underlying aetiology of various ovarian diseases such as polycystic ovarian syndrome and benign cysts. Doppler ultrasound has also been used in various models to evaluate the response to ovarian stimulation and the effect of surgery on the ovary.

Clinical ultrasound physics

Understanding the basic physics of ultrasound is essential for acute care physicians. Medical ultrasound machines generate and receive ultrasound waves. Brightness mode (B mode) is the basic mode that is usually used. Ultrasound waves are emitted from piezoelectric crystals of the ultrasound transducer. Depending on the acoustic impedance of different materials, which depends on their density, different grades of white and black images are produced. There are different methods that can control the quality of ultrasound waves including timing of ultrasound wave emission, frequency of waves, and size and curvature of the surface of the transducer. The received ultrasound signal can be amplified by increasing the gain. The operator should know sonographic artifacts which may distort the studied structures or even show unreal ones. The most common artifacts include shadow and enhancement artifacts, edge artifact, mirror artifact and reverberation artifact.

Ultrasonic colour Doppler imaging

Ultrasonic colour Doppler is an imaging technique that combines anatomical information derived using ultrasonic pulse-echo techniques with velocity information derived using ultrasonic Doppler techniques to generate colour-coded maps of tissue velocity superimposed on grey-scale images of tissue anatomy. The most common use of the technique is to image the movement of blood through the heart, arteries and veins, but it may also be used to image the motion of solid tissues such as the heart walls. Colour Doppler imaging is now provided on almost all commercial ultrasound machines, and has been found to be of great value in assessing blood flow in many clinical conditions. Although the method for obtaining the velocity information is in many ways similar to the method for obtaining the anatomical information, it is technically more demanding for a number of reasons. It also has a number of weaknesses, perhaps the greatest being that in conventional systems, the velocities measured and thus displayed are the components of the flow velocity directly towards or away from the transducer, while ideally the method would give information about the magnitude and direction of the three-dimensional flow vectors. This review briefly introduces the principles behind colour Doppler imaging and describes some clinical applications. It then describes the basic components of conventional colour Doppler systems and the methods used to derive velocity information from the ultrasound signal. Next, a number of new techniques that seek to overcome the vector problem mentioned above are described. Finally, some examples of vector velocity images are presented.

GPU-based beamformer: fast realization of plane wave compounding and synthetic aperture imaging

Although they show potential to improve ultrasound image quality, plane wave (PW) compounding and synthetic aperture (SA) imaging are computationally demanding and are known to be challenging to implement in real-time. In this work, we have developed a novel beamformer architecture with the real-time parallel processing capacity needed to enable fast realization of PW compounding and SA imaging. The beamformer hardware comprises an array of graphics processing units (GPUs) that are hosted within the same computer workstation. Their parallel computational resources are controlled by a pixel-based software processor that includes the operations of analytic signal conversion, delay-and-sum beamforming, and recursive compounding as required to generate images from the channel-domain data samples acquired using PW compounding and SA imaging principles. When using two GTX-480 GPUs for beamforming and one GTX-470 GPU for recursive compounding, the beamformer can compute compounded 512 x 255 pixel PW and SA images at throughputs of over 4700 fps and 3000 fps, respectively, for imaging depths of 5 cm and 15 cm (32 receive channels, 40 MHz sampling rate). Its processing capacity can be further increased if additional GPUs or more advanced models of GPU are used.

Imaging of parastomal hernia using three-dimensional intrastomal ultrasonography

BACKGROUND

Parastomal hernia is common in patients with a permanent stoma. At present there is no standard method for imaging a parastomal hernia. The aim of this study was to investigate the value of three-dimensional intrastomal ultrasonography in differentiating between a parastomal hernia and a bulge.

METHODS

Twenty patients were divided into four groups according to ultrasonography setting and probe cover. All patients were tested using three different ultrasound probe frequencies (9, 13 and 16 MHz). The intrastomal examination was performed during provocation in both the supine and upright positions, with a protector or water-containing balloon surrounding the probe.

RESULTS

The sharpest images were obtained using the rectal setting with a water-containing balloon surrounding the probe at 9 MHz in supine and erect positions, for evaluation of both fascia and muscle; in some instances even implanted mesh was detectable. When switched to render mode, the pictures improved in sharpness and it was easier to identify anatomical landmarks.

CONCLUSION

Intrastomal ultrasonography using the rectal setting and a frequency of 9 MHz is a feasible method for imaging a parastomal hernia and differentiating it from an abdominal bulge. The image quality improves when render mode is used.

Enhanced release of anticancer agents from nanoliposomes in response to diagnostic ultrasound energy levels

The efficacy of diagnostic ultrasound is explored for the release of anticancer agents loaded inside liposomes. Diagnostic ultrasound energy levels employed in the study were at a frequency of 7.5 MHz and the highest power intensity which is a function of the pulse repetition time. Design of Experiments was used to formulate the Ultrasound sensitive nanoliposome (USNL) by varying the lipid ratios and the intensity settings of ultrasound energy. Doxorubicin was loaded into the USNL and the release was compared to conventional Doxil liposomes. The USNLs released increasing amounts of drug in response to increasing irradiation times while the drug release was not significant when the Non-USNLs (Doxil liposomes) were exposed to ultrasound energy levels. In vitro studies to test the cytotoxicity of the formulations showed that the USNLs significantly inhibited cell survival of SCC9, squamous oral cancer cells, as compared to the Non-USNLs. We hypothesize that the drug is released due to increased membrane permeability during exposure to ultrasound energy levels, where the lipid composition and energy levels play a key role in determining the efficacy of diagnostic ultrasound energy as a tool for drug delivery.

Ultrasound physics and instrumentation for pathologists

CONTEXT

Interest in pathologist-performed ultrasound-guided fine-needle aspiration is increasing. Educational courses discuss clinical ultrasound and biopsy techniques but not ultrasound physics and instrumentation.

OBJECTIVE

To review modern ultrasound physics and instrumentation to help pathologists understand the basis of modern ultrasound.

DATA SOURCES

A review of recent literature and textbooks was performed.

CONCLUSIONS

Ultrasound physics and instrumentation are the foundations of clinical ultrasound. The key physical principle is the piezoelectric effect. When stimulated by an electric current, certain crystals vibrate and produce ultrasound. A hand-held transducer converts electricity into ultrasound, transmits it into tissue, and listens for reflected ultrasound to return. The returning echoes are converted into electrical signals and used to create a 2-dimensional gray-scale image. Scanning at a high frequency improves axial resolution but has low tissue penetration. Electronic focusing moves the long-axis focus to depth of the object of interest and improves lateral resolution. The short-axis focus in 1-dimensional transducers is fixed, which results in poor elevational resolution away from the focal zone. Using multiple foci improves lateral resolution but degrades temporal resolution. The sonographer can adjust the dynamic range to change contrast and bring out subtle masses. Contrast resolution is limited by processing speed, monitor resolution, and gray-scale perception of the human eye. Ultrasound is an evolving field. New technologies include miniaturization, spatial compound imaging, tissue harmonics, and multidimensional transducers. Clinical cytopathologists who understand ultrasound physics, instrumentation, and clinical ultrasound are ready for the challenges of cytopathologist-performed ultrasound-guided fine-needle aspiration and core-needle biopsy in the 21st century.

New sonographic techniques for harmonic imaging--underlying physical principles

In this paper, modern harmonic imaging techniques are reviewed and their physical principles are explained. The clinical advantages of these new techniques that are generally used in conjunction with ultrasound contrast agents are highlighted and compared to conventional flow imaging methods. Low/high mechanical index (MI) methods are discussed as well as emerging technologies for future transducer or beamformer generations. Finally the latest safety issues concerning applications of modern (harmonic) imaging techniques with contrast agents are given.