Bayesian Approach for a Robust Speed-of-Sound Reconstruction Using Pulse-Echo Ultrasound

2-D Slicewise Waveform Inversion of Sound Speed and Acoustic Attenuation for Ring Array Ultrasound Tomography Based on a Block LU Solver

Ultrasound tomography is an emerging imaging modality that uses the transmission of ultrasound through tissue to reconstruct images of its mechanical properties. Initially, ray-based methods were used to reconstruct these images, but their inability to account for diffraction often resulted in poor resolution. Waveform inversion overcame this limitation, providing high-resolution images of the tissue. Most clinical implementations, often directed at breast cancer imaging, currently rely on a frequency-domain waveform inversion to reduce computation time. For ring arrays, ray tomography was long considered a necessary step prior to waveform inversion in order to avoid cycle skipping. However, in this paper, we demonstrate that frequency-domain waveform inversion can reliably reconstruct high-resolution images of sound speed and attenuation without relying on ray tomography to provide an initial model. We provide a detailed description of our frequency-domain waveform inversion algorithm with open-source code and data that we make publicly available.

Learning-based sound speed estimation and aberration correction for linear-array photoacoustic imaging

Photoacoustic (PA) image reconstruction involves acoustic inversion that necessitates the specification of the speed of sound (SoS) within the medium of propagation. Due to the lack of information on the spatial distribution of the SoS within heterogeneous soft tissue, a homogeneous SoS distribution (such as 1540 m/s) is typically assumed in PA image reconstruction, similar to that of ultrasound (US) imaging. Failure to compensate for the SoS variations leads to aberration artefacts, deteriorating the image quality. Various methods have been proposed to address this issue, but they usually involve complex hardware and/or time-consuming algorithms, hindering clinical translation. In this work, we introduce a deep learning framework for SoS estimation and subsequent aberration correction in a dual-modal PA/US imaging system exploiting a clinical US probe. As the acquired PA and US images were inherently co-registered, the estimated SoS distribution from US channel data using a deep neural network was incorporated for accurate PA image reconstruction. The framework comprised an initial pre-training stage based on digital phantoms, which was further enhanced through transfer learning using physical phantom data and associated SoS maps obtained from measurements. This framework achieved a root mean square error of 10.2 m/s and 15.2 m/s for SoS estimation on digital and physical phantoms, respectively and structural similarity index measures of up to 0.88 for PA reconstructions compared to the conventional approach of 0.69. A maximum of 1.2 times improvement in the signal-to-noise ratio of PA images was further demonstrated with a human volunteer study. Our results show that the proposed framework could be valuable in various clinical and preclinical applications to enhance PA image reconstruction.

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.

Improved Transcranial Plane-Wave Imaging With Learned Speed-of-Sound Maps

Although transcranial ultrasound plane-wave imaging (PWI) has promising clinical application prospects, studies have shown that variable speed-of-sound (SoS) would seriously damage the quality of ultrasound images. The mismatch between the conventional constant velocity assumption and the actual SoS distribution leads to the general blurring of ultrasound images. The optimization scheme for reconstructing transcranial ultrasound image is often solved using iterative methods like full-waveform inversion. These iterative methods are computationally expensive and based on prior magnetic resonance imaging (MRI) or computed tomography (CT) information. In contrast, the multi-stencils fast marching (MSFM) method can produce accurate time travel maps for the skull with heterogeneous acoustic speed. In this study, we first propose a convolutional neural network (CNN) to predict SoS maps of the skull from PWI channel data. Then, use these maps to correct the travel time to reduce transcranial aberration. To validate the performance of the proposed method, numerical, phantom and intact human skull studies were conducted using a linear array transducer (L11-5v, 128 elements, pitch = 0.3 mm). Numerical simulations demonstrate that for point targets, the lateral resolution of MSFM-restored images increased by 65%, and the center position shift decreased by 89%. For the cyst targets, the eccentricity of the fitting ellipse decreased by 75%, and the center position shift decreased by 58%. In the phantom study, the lateral resolution of MSFM-restored images was increased by 49%, and the position shift was reduced by 1.72 mm. This pipeline, termed AutoSoS, thus shows the potential to correct distortions in real-time transcranial ultrasound imaging, as demonstrated by experiments on the intact human skull.

Pulse-echo ultrasound attenuation tomography

Objective.We present the first fully two-dimensional attenuation imaging technique developed for pulse-echo ultrasound systems. Unlike state-of-the-art techniques, which use line-by-line acquisitions, our method uses steered emissions to constrain attenuation values at each location with multiple crossing wave paths, essential to resolve the spatial variations of this tissue property.Approach.At every location, we compute normalized cross-correlations between the beamformed images that are obtained from emissions at different steering angles. We demonstrate that their log-amplitudes provide the changes between attenuation-induced amplitude losses undergone by the different incident waves. This allows us to formulate a linear tomographic problem, which we efficiently solve via a Tikhonov-regularized least-squares approach.Main results.The performance of our tomography technique is first validated in numerical examples and then experimentally demonstrated in custom-made tissue-mimicking phantoms with inclusions of varying size, echogenicity, and attenuation. We show that this technique is particularly good at resolving lateral variations in tissue attenuation and remains accurate in media with varying echogenicity.Significance.Based on a similar principle, this method can be easily combined with computed ultrasound tomography in echo mode for speed-of-sound imaging, paving the way towards a multi-modal ultrasound tomography framework characterizing multiple acoustic tissue properties simultaneously.

Windowed Radon Transform for Robust Speed-of-Sound Imaging With Pulse-Echo Ultrasound

In recent years, methods estimating the spatial distribution of tissue speed of sound with pulse-echo ultrasound are gaining considerable traction. They can address limitations of B-mode imaging, for instance in diagnosing fatty liver diseases. Current state-of-the-art methods relate the tissue speed of sound to local echo shifts computed between images that are beamformed using restricted transmit and receive apertures. However, the aperture limitation affects the robustness of phase-shift estimations and, consequently, the accuracy of reconstructed speed-of-sound maps. Here, we propose a method based on the Radon transform of image patches able to estimate local phase shifts from full-aperture images. We validate our technique on simulated, phantom and in-vivo data acquired on a liver and compare it with a state-of-the-art method. We show that the proposed method enhances the stability to changes of beamforming speed of sound and to a reduction of the number of insonifications. In particular, the deployment of pulse-echo speed-of-sound estimation methods onto portable ultrasound devices can be eased by the reduction of the number of insonifications allowed by the proposed method.

Windowed Radon Transform and Tensor Rank-1 Decomposition for Adaptive Beamforming in Ultrafast Ultrasound

Ultrafast ultrasound has recently emerged as an alternative to traditional focused ultrasound. By virtue of the low number of insonifications it requires, ultrafast ultrasound enables the imaging of the human body at potentially very high frame rates. However, unaccounted for speed-of-sound variations in the insonified medium often result in phase aberrations in the reconstructed images. The diagnosis capability of ultrafast ultrasound is thus ultimately impeded. Therefore, there is a strong need for adaptive beamforming methods that are resilient to speed-of-sound aberrations. Several of such techniques have been proposed recently but they often lack parallelizability or the ability to directly correct both transmit and receive phase aberrations. In this article, we introduce an adaptive beamforming method designed to address these shortcomings. To do so, we compute the windowed Radon transform of several complex radio-frequency images reconstructed using delay-and-sum. Then, we apply to the obtained local sinograms weighted tensor rank-1 decompositions and their results are eventually used to reconstruct a corrected image. We demonstrate using simulated and in-vitro data that our method is able to successfully recover aberration-free images and that it outperforms both coherent compounding and the recently introduced SVD beamformer. Finally, we validate the proposed beamforming technique on in-vivo data, resulting in a significant improvement of image quality compared to the two reference methods.

First-in-human diagnostic study of hepatic steatosis with computed ultrasound tomography in echo mode

BACKGROUND

Non-alcoholic fatty liver disease is rapidly emerging as the leading global cause of chronic liver disease. Efficient disease management requires low-cost, non-invasive techniques for diagnosing hepatic steatosis accurately. Here, we propose quantifying liver speed of sound (SoS) with computed ultrasound tomography in echo mode (CUTE), a recently developed ultrasound imaging modality adapted to clinical pulse-echo systems. CUTE reconstructs the spatial distribution of SoS by measuring local echo phase shifts when probing tissue at varying steering angles in transmission and reception.

METHODS

In this first-in-human phase II diagnostic study, we evaluated the liver of 22 healthy volunteers and 22 steatotic patients. We used conventional B-mode ultrasound images and controlled attenuation parameter (CAP) to diagnose the presence (CAP≥ 280 dB/m) or absence (CAP < 248 dB/m) of steatosis in the liver. A fully integrated convex-probe CUTE implementation was developed on the ultrasound system to estimate liver SoS. We investigated its diagnostic value via the receiver operating characteristic (ROC) analysis and correlation to CAP measurements.

RESULTS

We show that liver CUTE-SoS estimates correlate strongly (r = -0.84, p = 8.27 × 10-13) with CAP values and have 90.9% (95% confidence interval: 84-100%) sensitivity and 95.5% (81-100%) specificity for differentiating between normal and steatotic livers (area under the ROC curve: 0.93-1.0).

CONCLUSIONS

Our results demonstrate that liver CUTE-SoS is a promising quantitative biomarker for diagnosing liver steatosis. This is a necessary first step towards establishing CUTE as a new quantitative add-on to diagnostic ultrasound that can potentially be as versatile as conventional ultrasound imaging.

Aberration correction in diagnostic ultrasound: A review of the prior field and current directions

Medical ultrasound images are reconstructed with simplifying assumptions on wave propagation, with one of the most prominent assumptions being that the imaging medium is composed of a constant sound speed. When the assumption of a constant sound speed are violated, which is true in most in vivoor clinical imaging scenarios, distortion of the transmitted and received ultrasound wavefronts appear and degrade the image quality. This distortion is known as aberration, and the techniques used to correct for the distortion are known as aberration correction techniques. Several models have been proposed to understand and correct for aberration. In this review paper, aberration and aberration correction are explored from the early models and correction techniques, including the near-field phase screen model and its associated correction techniques such as nearest-neighbor cross-correlation, to more recent models and correction techniques that incorporate spatially varying aberration and diffractive effects, such as models and techniques that rely on the estimation of the sound speed distribution in the imaging medium. In addition to historical models, future directions of ultrasound aberration correction are proposed.

Achieving descriptive accuracy in explanations via argumentation: The case of probabilistic classifiers

The pursuit of trust in and fairness of AI systems in order to enable human-centric goals has been gathering pace of late, often supported by the use of explanations for the outputs of these systems. Several properties of explanations have been highlighted as critical for achieving trustworthy and fair AI systems, but one that has thus far been overlooked is that of descriptive accuracy (DA), i.e., that the explanation contents are in correspondence with the internal working of the explained system. Indeed, the violation of this core property would lead to the paradoxical situation of systems producing explanations which are not suitably related to how the system actually works: clearly this may hinder user trust. Further, if explanations violate DA then they can be deceitful, resulting in an unfair behavior toward the users. Crucial as the DA property appears to be, it has been somehow overlooked in the XAI literature to date. To address this problem, we consider the questions of formalizing DA and of analyzing its satisfaction by explanation methods. We provide formal definitions of naive, structural and dialectical DA, using the family of probabilistic classifiers as the context for our analysis. We evaluate the satisfaction of our given notions of DA by several explanation methods, amounting to two popular feature-attribution methods from the literature, variants thereof and a novel form of explanation that we propose. We conduct experiments with a varied selection of concrete probabilistic classifiers and highlight the importance, with a user study, of our most demanding notion of dialectical DA, which our novel method satisfies by design and others may violate. We thus demonstrate how DA could be a critical component in achieving trustworthy and fair systems, in line with the principles of human-centric AI.

Ultrasound Matrix Imaging-Part II: The Distortion Matrix for Aberration Correction Over Multiple Isoplanatic Patches

This is the second article in a series of two which report on a matrix approach for ultrasound imaging in heterogeneous media. This article describes the quantification and correction of aberration, i.e. the distortion of an image caused by spatial variations in the medium speed-of-sound. Adaptive focusing can compensate for aberration, but is only effective over a restricted area called the isoplanatic patch. Here, we use an experimentally-recorded matrix of reflected acoustic signals to synthesize a set of virtual transducers. We then examine wave propagation between these virtual transducers and an arbitrary correction plane. Such wave-fronts consist of two components: (i) An ideal geometric wave-front linked to diffraction and the input focusing point, and; (ii) Phase distortions induced by the speed-of-sound variations. These distortions are stored in a so-called distortion matrix, the singular value decomposition of which gives access to an optimized focusing law at any point. We show that, by decoupling the aberrations undergone by the outgoing and incoming waves and applying an iterative strategy, compensation for even high-order and spatially-distributed aberrations can be achieved. After a numerical validation of the process, ultrasound matrix imaging (UMI) is applied to the in-vivo imaging of a gallbladder. A map of isoplanatic modes is retrieved and is shown to be strongly correlated with the arrangement of tissues constituting the medium. The corresponding focusing laws yield an ultrasound image with drastically improved contrast and transverse resolution. UMI thus provides a flexible and powerful route towards computational ultrasound.

Pulse-Echo Quantitative US Biomarkers for Liver Steatosis: Toward Technical Standardization

Excessive liver fat (steatosis) is now the most common cause of chronic liver disease worldwide and is an independent risk factor for cirrhosis and associated complications. Accurate and clinically useful diagnosis, risk stratification, prognostication, and therapy monitoring require accurate and reliable biomarker measurement at acceptable cost. This article describes a joint effort by the American Institute of Ultrasound in Medicine (AIUM) and the RSNA Quantitative Imaging Biomarkers Alliance (QIBA) to develop standards for clinical and technical validation of quantitative biomarkers for liver steatosis. The AIUM Liver Fat Quantification Task Force provides clinical guidance, while the RSNA QIBA Pulse-Echo Quantitative Ultrasound Biomarker Committee develops methods to measure biomarkers and reduce biomarker variability. In this article, the authors present the clinical need for quantitative imaging biomarkers of liver steatosis, review the current state of various imaging modalities, and describe the technical state of the art for three key liver steatosis pulse-echo quantitative US biomarkers: attenuation coefficient, backscatter coefficient, and speed of sound. Lastly, a perspective on current challenges and recommendations for clinical translation for each biomarker is offered.

Local Sound Speed Estimation for Pulse-Echo Ultrasound in Layered Media

Our previous methodology in local sound speed estimation utilized time delays measured by the cross correlation of delayed full-synthetic aperture channel data to estimate the average speed of sound. However, focal distortions in this methodology lead to biased estimates of the average speed of sound, which, in turn, leads to biased estimates of the local speed of sound. Here, we demonstrate the bias in the previous methodology and introduce a coherence-based average sound speed estimator that eliminates this bias and is computationally much cheaper in practice. Because this coherence-based approach estimates the average sound speed in the medium over an equally spaced grid in depth rather than time, we derive a refined model that relates the local and average speeds of sound as a function of depth in layered media. A fast, closed-form inversion of this model yields highly accurate local sound speed estimates. The root-mean-square (rms) error of local sound speed reconstruction in simulations of two-layer media is 4.6 and 2.5 m/s at 4 and 8 MHz, respectively. This work examines the impact of frequency, f -number, aberration, and reverberation on sound speed estimation. Phantom and in vivo experiments in rats further validate the coherence-based sound speed estimator.