Quantitative 3-d diagnostic ultrasound imaging using a modified transducer array and an automated image tracking technique

A Methodology for Non-Invasive 3-D Surveillance of Arteriovenous Fistulae Using Freehand Ultrasound

OBJECTIVE

Surveillance techniques for arteriovenous fistulae are required to maintain functional vascular access, with two-dimensional duplex ultrasound the most widely used imaging modality. This paper presents a surveillance method for an arteriovenous fistula using a freehand three-dimensional (3-D) ultrasound system. A patient-case study highlights the applicability in a clinical environment.

METHODS

The freehand ultrasound system uses optical tracking to determine the vascular probe location, and as the probe is swept down a patient's arm, each B-mode slice is spatially arranged to be post-processed as a volume. The volume is segmented to obtain the 3-D vasculature for high detail analysis.

RESULTS

The results follow a patient with stenosis, undergoing surgery to have a stent placement. A surveillance scan was taken pre-surgery, postsurgery, and at a two-month follow-up. Vasculature changes are quantified using detailed analysis, and the benefits of using 3-D imaging are shown through 3-D printing and visualization.

CONCLUSION AND SIGNIFICANCE

Non-invasive 3-D surveillance of arteriovenous fistulae is possible, and a patient-specific geometry was created using ultrasound and optical tracking. Access to this non-invasive 3-D surveillance technique will enable future studies to determine patient-specific remodeling behavior, in terms of geometry and hemodynamics over time.

3D freehand ultrasound without external tracking using deep learning

This work aims at creating 3D freehand ultrasound reconstructions from 2D probes with image-based tracking, therefore not requiring expensive or cumbersome external tracking hardware. Existing model-based approaches such as speckle decorrelation only partially capture the underlying complexity of ultrasound image formation, thus producing reconstruction accuracies incompatible with current clinical requirements. Here, we introduce an alternative approach that relies on a statistical analysis rather than physical models, and use a convolutional neural network (CNN) to directly estimate the motion of successive ultrasound frames in an end-to-end fashion. We demonstrate how this technique is related to prior approaches, and derive how to further improve its predictive capabilities by incorporating additional information such as data from inertial measurement units (IMU). This novel method is thoroughly evaluated and analyzed on a dataset of 800 in vivo ultrasound sweeps, yielding unprecedentedly accurate reconstructions with a median normalized drift of 5.2%. Even on long sweeps exceeding 20 cm with complex trajectories, this allows to obtain length measurements with median errors of 3.4%, hence paving the way toward translation into clinical routine.

Handheld real-time volumetric imaging of the spine: technology development

Technical difficulties, poor image quality and reliance on pattern identifications represent some of the drawbacks of two-dimensional ultrasound imaging of spinal bone anatomy. To overcome these limitations, this study sought to develop real-time volumetric imaging of the spine using a portable handheld device. The device measured 19.2 cm × 9.2 cm × 9.0 cm and imaged at 5 MHz centre frequency. 2D imaging under conventional ultrasound and volumetric (3D) imaging in real time was achieved and verified by inspection using a custom spine phantom. Further device performance was assessed and revealed a 75-min battery life and an average frame rate of 17.7 Hz in volumetric imaging mode. The results suggest that real-time volumetric imaging of the spine is a feasible technique for more intuitive visualization of the spine. These results may have important ramifications for a large array of neuraxial procedures.

Denoising 3D ultrasound volumes using sparse representation

In this paper, a new 3D ultrasound (US) denoising technique that adopts the sparse representation has been proposed for an effective noise reduction in 3D US volumes. The purpose of the proposed method is to reduce image noise while preserving 3D objects edges, hence improving the human interpretation for clinical diagnosis and the 3D segmentation accuracy for further automatic malignancy detection. For denoising 3D US volumes, sparse representation was employed, which has showed an excellent performance in reducing Gaussian noise. It has been well known that US images contain severe multiplicative speckle noise, which has different characteristics compared to the additive Gaussian noise. In this paper, we propose a denoising framework for effectively reducing both Gaussian noise and speckle noise on 3D US volumes. The proposed method removes Gaussian noise using sparse representation. Then, a logarithmic transform is performed to transform the speckle noise into Gaussian noise for applying the sparse representation. To demonstrate the effectiveness of the proposed denoising method, comparative and quantitative experiments had been conducted on a synthesized 3D US phantom data. Experimental results showed that the proposed denoising could improve image quality in terms of denoising measurements.

Improved elevational and azimuthal motion tracking using sector scans

Ultrasound data motion tracking is widely used to estimate relative tissue/transducer motion, for example in freehand 3-D imaging, in which successive 2-D ultrasound scan planes are registered in a 3-D volume. Speckle-tracking and decorrelation-based methods are used to estimate motion in the azimuthal and elevational planes. However, the performance of speckle-tracking is significantly degraded in sectorscan systems because of point-spread function rotation with lateral motion. In this paper, we develop a new method for joint azimuthal¿elevational motion estimation based on the complex correlation of individual IQ-demodulated sector-scan A-lines arising from tissue motion in 3-D space. We show that our method has performance benefits over both speckle-tracking and decorrelation-based tracking for motion estimation in sector-scan systems, particularly when there is both elevational and azimuthal motion. Motion-tracking efficacy is further demonstrated by improved freehand imaging of a known target (anatomically accurate 3-D-printed lumbar spine model) in a tissue-mimicking phantom, with an rms surface distance error of 1.2 mm, compared with 2.43 mm for conventional methods. These data indicate that the new algorithm is capable of improved tracking performance for sector scan systems, enabling effective freehand 3-D scanning.

Experimental evaluation of an ultrasound technique for the biometric recognition of human hand anatomic elements

In this work the moving ultrasound linear array technique has been used to perform 3D echographic images of different human hands, in order to evaluate this technique to biometric recognition purposes. An automated set up, based on a commercial echographic machine provided with a high frequency (12 MHz) linear array, has been built up. The probe is moved in the direction orthogonal to the array and at each step a B-scan is performed and stored to form a 3D matrix representing the under skin hand volume. B-scan and C-scan images of the hand of different users were analysed and compared. The results have shown that, in the analysed region (about 10mm under the palm skin), there are several anatomic elements (including hand bones, bending tendons, muscle tissue, blood vessels) that can be exploited for measurements of biometric parameters. The characteristics of the proposed technique are compared with those of the 2D optical hand geometry, which is a well established biometric technique, and its possible advantages are underlined and discussed.

Quantification of carotid vessel wall and plaque thickness change using 3D ultrasound images

Quantitative measurements of carotid plaque burden progression or regression are important in monitoring patients and in evaluation of new treatment options. 3D ultrasound (US) has been used to monitor the progression or regression of carotid artery plaques. This paper reports on the development and application of a method used to analyze changes in carotid plaque morphology from 3D US. The technique used is evaluated using manual segmentations of the arterial wall and lumen from 3D US images acquired in two imaging sessions. To reduce the effect of segmentation variability, segmentation was performed five times each for the wall and lumen. The mean wall and lumen surfaces, computed from this set of five segmentations, were matched on a point-by-point basis, and the distance between each pair of corresponding points served as an estimate of the combined thickness of the plaque, intima, and media (vessel-wall-plus-plaque thickness or VWT). The VWT maps associated with the first and the second US images were compared and the differences of VWT were obtained at each vertex. The 3D VWT and VWT-Change maps may provide important information for evaluating the location of plaque progression in relation to the localized disturbances of flow pattern, such as oscillatory shear, and regression in response to medical treatments.

3D prostate elastography: algorithm, simulations and experiments

A multi-resolution hybrid strain estimator is presented. The estimator is locally initialized by the B-mode tracking stage. Nonlinear and linear stretching regimes are applied in successive RF tracking stages for refining the estimated axial and lateral displacements. A staggering operator is used to derive the strain images from the reconstructed axial displacements. Simulations and experiments, conducted at a center frequency of 12 MHz, 40% fractional bandwidth, on a 128 element transducer with 0.2 mm pitch, with elastographic window length of 2 mm and overlap of 90%, demonstrate a 3-6 dB improvement in the elastographic contrast-to-noise ratio over the results obtained using conventional multi-stage stretching based strain estimators. The average image cross-correlation coefficient obtained using the proposed algorithm was improved by 6-8%. 3D elastographic simulations conducted to study the performance of a 3D elastographic imaging framework predict achievable axial and lateral resolutions of approximately five and ten wavelengths, respectively. A close correspondence between inclusions reconstructed from experimental elastograms and the known physical shape of actual 3D inclusions demonstrates the potential application of 3D elastography for identifying and classifying the detected lesions (invisible in sonograms) on the basis of their shape.

Free-hand ultrasound scanning approaches for volume quantification of the mouse heart Left ventricle

Two approaches for free-hand motion tracking that enable volumetric quantification of the murine heart were investigated. One approach used an instrumented, multijointed articulated arm attached to a 14 MHz ultrasound transducer array. A second approach used an E-beam transducer--a modified linear transducer array containing a main imaging array adjacent to three perpendicular tracking arrays. Motion between successive B-mode image frames was computed by tracking image speckle in each tracking array. Both tracking systems produced accurate results in a phantom validation study (4.50% error and 3.75% error for estimates derived using the articulated arm and E-beam tracking techniques, respectively). The tracking approaches also were tested in vivo on three mice. Results were compared to values obtained by mounting each mouse on a micromanipulator, adjusting its position by 0.5-mm increments, and acquiring B-mode images using a high-resolution ultrasound scanner. Left ventricular end diastolic volume (LVEDV) estimates differed from values obtained using the high-resolution scanner by a mean error of 18.2% and 2.60% for eight scans conducted on each of two mice using the articulated arm, and a mean error of 13.6%, 6.53%, and 12.58% for eight scans conducted on each of three mice using the E-beam.

Sensorless freehand 3D ultrasound in real tissue: Speckle decorrelation without fully developed speckle

It has previously been demonstrated that freehand 3D ultrasound can be acquired without a position sensor by measuring the elevational speckle decorrelation from frame to frame. However, this requires that the B-scans contain significant amounts of fully developed speckle. In this paper, we show that this condition is rarely satisfied in scans of real tissue, which instead exhibit fairly ubiquitous coherent scattering. By examining the axial and lateral correlation functions, we propose an heuristic technique to quantify the amount of coherency at each point in the B-scans. This leads to an adapted elevational decorrelation scheme which allows for the coherent scattering. Using the adapted scheme, we demonstrate markedly improved reconstructions of animal tissue in vitro.

Determination of an optimal image frame interval for frame-to-frame ultrasound image motion tracking

Several important clinical applications depend on accurate ultrasound image frame-to-frame motion estimation. Assuming that there is a degree of finite noise in the image frames and that speckle partially decorrelates between successive frames during freehand scanning, we hypothesize that an optimal inter-frame interval (step size) must exist that provides the smallest relative dimensional error over a set of accumulated motion estimates. Smaller frame increments suffer from less decorrelation-related inaccuracy but present greater potential for cumulative error because more estimates are used over any specific dimensional interval. We studied these effects using a combination of theoretical modeling, numerical simulation, and experiments. Components of diagonal motion due to the limitations of manual transducer movement were considered as the cause of decorrelation. The results were examined for four different angles of the diagonal motion and two different signal-to-noise ratio (SNR) values. These indicate that an optimal step size does exist and that this is dependent on many variables including SNR, angle of the diagonal motion, transducer geometry, lens focusing parameters, transducer operating frequency, and beamforming parameters. In practical experiments, we found that the optimal step size generally required using every available image frame rather than 'skipping' any intermediate frames.

Speckle reducing anisotropic diffusion for 3D ultrasound images

This paper presents an approach for reducing speckle in three dimensional (3D) ultrasound images. A 2D speckle reduction technique, speckle reducing anisotropic diffusion (SRAD), is explored and extended to 3D. 3D SRAD is advantageous in that, like 2D SRAD, it keeps the advantages of the conventional anisotropic diffusion and the traditional speckle reducing filter, the Lee filter, by exploiting the instantaneous coefficient of variation (ICOV). Besides, 3D SRAD uses 3D information; thus it overcomes the shortcoming of the 2D technique that only uses 2D information. The algorithm of 3D SRAD is presented in the continuous domain as well as in the discrete domain. Experiments have been performed on both synthetic and real 3D ultrasound images and the experimental results were compared with those obtained by 3D anisotropic diffusion and the 3D Lee filter. The experimental results show that the quality of the 3D SRAD for speckle reduction in 3D ultrasound images improves upon that of 3D anisotropic diffusion and 3D Lee filter in terms of edge preservation and the smoothness of homogenous regions.

3-D real-time motion correction in high-intensity focused ultrasound therapy

A method for tracking the 3-D motion of tissues in real-time is combined with a 2-D high-intensity focused ultrasound (US), or HIFU, multichannel system to correct for respiratory motion during HIFU therapy. Motion estimation is based on an accurate ultrasonic speckle-tracking method. A pulse-echo sequence is performed for a subset of the transducers of the phased array. For each of these subapertures, the displacement is estimated by computing the 1-D cross-correlation of the backscattered signals acquired at two different times. The 3-D motion vector is then computed by a triangulation algorithm. This technique is experimentally validated in phantoms moving as fast as 40 mm s(-1), and combined with HIFU sequences. A real-time feedback correction of the HIFU beam is achieved by adjusting the delays of each channel. The sonications "locked on target" are interleaved with very short motion-estimation sequences. Finally, in vitro experiments of "locked on target" HIFU therapy are performed in fresh moving tissues.

Reconstruction and quantification of the carotid artery bifurcation from 3-D ultrasound images

Three-dimensional (3-D) ultrasound is a relatively new technique, which is well suited to imaging superficial blood vessels, and potentially provides a useful, noninvasive method for generating anatomically realistic 3-D models of the peripheral vasculature. Such models are essential for accurate simulation of blood flow using computational fluid dynamics (CFD), but may also be used to quantify atherosclerotic plaque more comprehensively than routine clinical methods. In this paper, we present a spline-based method for reconstructing the normal and diseased carotid artery bifurcation from images acquired using a freehand 3-D ultrasound system. The vessel wall (intima-media interface) and lumen surfaces are represented by a geometric model defined using smoothing splines. Using this coupled wall-lumen model, we demonstrate how plaque may be analyzed automatically to provide a comprehensive set of quantitative measures of size and shape, including established clinical measures, such as degree of (diameter) stenosis. The geometric accuracy of 3-D ultrasound reconstruction is assessed using pulsatile phantoms of the carotid bifurcation, and we conclude by demonstrating the in vivo application of the algorithms outlined to 3-D ultrasound scans from a series of patient carotid arteries.

Volumetric ultrasound imaging using 2-D CMUT arrays

Recently, capacitive micromachined ultrasonic transducers (CMUTs) have emerged as a candidate to overcome the difficulties in the realization of 2-D arrays for real-time 3-D imaging. In this paper, we present the first volumetric images obtained using a 2-D CMUT array. We have fabricated a 128 x 128-element 2-D CMUT array with through-wafer via interconnects and a 420-microm element pitch. As an experimental prototype, a 32 x 64-element portion of the 128 x 128-element array was diced and flip-chip bonded onto a glass fanout chip. This chip provides individual leads from a central 16 x 16-element portion of the array to surrounding bondpads. An 8 x 16-element portion of the array was used in the experiments along with a 128-channel data acquisition system. For imaging phantoms, we used a 2.37-mm diameter steel sphere located 10 mm from the array center and two 12-mm-thick Plexiglas plates located 20 mm and 60 mm from the array. A 4 x 4 group of elements in the middle of the 8 x 16-element array was used in transmit, and the remaining elements were used to receive the echo signals. The echo signal obtained from the spherical target presented a frequency spectrum centered at 4.37 MHz with a 100% fractional bandwidth, whereas the frequency spectrum for the echo signal from the parallel plate phantom was centered at 3.44 MHz with a 91% fractional bandwidth. The images were reconstructed by using RF beamforming and synthetic phased array approaches and visualized by surface rendering and multiplanar slicing techniques. The image of the spherical target has been used to approximate the point spread function of the system and is compared with theoretical expectations. This study experimentally demonstrates that 2-D CMUT arrays can be fabricated with high yield using silicon IC-fabrication processes, individual electrical connections can be provided using through-wafer vias, and flip-chip bonding can be used to integrate these dense 2-D arrays with electronic circuits for practical 3-D imaging applications.