Lag-One Coherence as a Metric for Ultrasonic Image Quality

In Vivo Demonstration of a Real-Time Temporal SNR Acoustic Output Adjustment Method

This work proposes a novel method of temporal signal-to-noise ratio (SNR)-guided adaptive acoustic output adjustment and demonstrates this approach during in vivo fetal imaging. Acoustic output adjustment is currently the responsibility of sonographers, but ultrasound safety studies show recommended as low as reasonably achievable (ALARA) practices are inconsistently followed. This study explores an automated ALARA method that adjusts the mechanical index (MI) output, targeting imaging conditions matching the temporal noise perception threshold. A 28-dB threshold SNR is used as the target SNR, following prior work showing relevant noise quantities are imperceptible once this image data quality level is reached. After implementing adaptive output adjustment on a clinical system, the average MI required to achieve 28-dB SNR in an 11-volunteer fetal abdomen imaging test ranged from 0.17 to 0.26. The higher MI levels were required when imaging at higher frequencies. During tests with 20-s MI adjustment imaging periods, the degree of motion impacted the adaptive performance. For stationary imaging views, target SNR levels were maintained in 90% of SNR evaluations. When scanning between targets the imaging conditions were more variable, but the target SNR was still maintained in 71% of the evaluations. Given the relatively low MI recommended when performing MI adjustment and the successful adjustment of MI in response to changing imaging conditions, these results encourage adoption of adaptive acoustic output approaches guided by temporal SNR.

Human Observer Sensitivity to Temporal Noise During B-Mode Ultrasound Scanning: Characterization and Imaging Implications

This work measures temporal signal-to-noise ratio (SNR) thresholds that indicate when random noise during ultrasound scanning becomes imperceptible to expert human observers. Visible noise compromises image quality and can potentially lead to non-diagnostic scans. Noise can arise from both stable acoustic sources (clutter) or randomly varying electronic sources (temporal noise). Extensive engineering effort has focused on decreasing noise in both of these categories. In this work, an observer study with five practicing sonographers was performed to assess sonographer sensitivity to temporal noise in ultrasound cine clips. Understanding the conditions where temporal noise is no longer visible during ultrasound imaging can inform engineering efforts seeking to minimize the impact this noise has on image quality. The sonographers were presented with paired temporal noise-free and noise-added simulated speckle cine clips and asked to select the noise-added clips. The degree of motion in the imaging target was found to have a significant effect on the SNR levels where noise was perceived, while changing imaging frequency had little impact. At realistic in vivo motion levels, temporal noise was not perceived in cine clips at and above 28 dB SNR. In a case study presented here, the potential of adaptive intensity adjustment based on this noise perception threshold is validated in a fetal imaging scenario. This study demonstrates how noise perception thresholds can be applied to help design or tune ultrasound systems for different imaging tasks and noise conditions.

Shape estimation of flexible ultrasound arrays using spatial coherence: A preliminary study

A flexible ultrasound array can potentially provide a larger field-of-view, enhanced imaging resolution, and less operator dependency compared to conventional rigid transducer arrays. However, such transducer arrays require information about relative element positions for beamforming and reconstructing geometrically accurate sonograms. In this study, we assess the potential utility of using spatial coherence of backscattered radiofrequency data to estimate transducer array shape (inverse problem). The methodology is evaluated through 1) simulation of flexible arrays and 2) blinded in vivo experiments using commercial rigid transducer arrays on various anatomical targets (shoulder, forearm, scapular, posterior calf muscles, and abdomen) and multi-purpose ultrasound phantoms. The average Euclidean error of shape estimation is below 0.1 wavelengths for simulated arrays and below 1.4 wavelengths (median: 0.58 wavelengths) for real arrays. The complex wavelet structural similarity index between the B-mode images reconstructed with estimated and ground truth array shapes is above 99 % and 96 %, for simulations and experiments, respectively. These findings suggest that optimizing for spatial coherence may be an effective way to estimate the unknown shape of conformal ultrasound arrays.

Far-focus compound ultrasound imaging with lag-one coherence-based zero-cross factor

BACKGROUND

Ultrasound imaging has been widely used in clinical examination because of portability, safety, and low cost. However, there are still some main challenges of imaging quality that remain in conventional ultrasound systems.

OBJECTIVE

Improving image quality of SA-based methods using an improved imaging mode named far-focus compound (FSC) imaging.

METHODS

A far-focus compound (FSC) imaging based on full-aperture transmission and full-aperture reception is proposed in this paper. In transmission, it uses the full aperture to transmit the focused beam to ensure image resolution and emission of sound field energy. In reception, the full aperture is used to receive the reflected beam to ensure the image quality. A lag-one coherence-based zero-cross factor (LOCZF) is then implemented in FSC for improvement of contrast ratio (CR). The LOCZF uses lag-one coherence as zero-cross factorâs adaptive coefficient. Comparisons were made with several other weighting techniques by performing simulations and experiments for performance evaluation.

RESULTS

Results confirm that LOCZF applied to FSC offers a good image contrast and simultaneously the speckle pattern. For simulated cysts, CR improvement of LOCZF reaches 194.1%. For experimental cysts, CR improvement of LOCZF reaches 220%. From the in-vivo result, compared with FSC, CR improvement of LOCZF reaches 112.7%.

CONCLUSION

Proved gCNR performance. In addition, the LOCZF method shows good performance in experiments. The proposed method can be used as an effective weighting technique for improvement of image quality in ultrasound imaging.

Spatial Coherence Approaches to Distinguish Suspicious Mass Contents in Fundamental and Harmonic Breast Ultrasound Images

When compared to fundamental B-mode imaging, coherence-based beamforming, and harmonic imaging are independently known to reduce acoustic clutter, distinguish solid from fluid content in indeterminate breast masses, and thereby reduce unnecessary biopsies during a breast cancer diagnosis. However, a systematic investigation of independent and combined coherence beamforming and harmonic imaging approaches is necessary for the clinical deployment of the most optimal approach. Therefore, we compare the performance of fundamental and harmonic images created with short-lag spatial coherence (SLSC), M-weighted SLSC (M-SLSC), SLSC combined with robust principal component analysis with no M-weighting (r-SLSC), and r-SLSC with M-weighting (R-SLSC), relative to traditional fundamental and harmonic B-mode images, when distinguishing solid from fluid breast masses. Raw channel data acquired from 40 total breast masses (28 solid, 7 fluid, 5 mixed) were beamformed and analyzed. The contrast of fluid masses was better with fundamental rather than harmonic coherence imaging, due to the lower spatial coherence within the fluid masses in the fundamental coherence images. Relative to SLSC imaging, M-SLSC, r-SLSC, and R-SLSC imaging provided similar contrast across multiple masses (with the exception of clinically challenging complicated cysts) and minimized the range of generalized contrast-to-noise ratios (gCNRs) of fluid masses, yet required additional computational resources. Among the eight coherence imaging modes compared, fundamental SLSC imaging best identified fluid versus solid breast mass contents, outperforming fundamental and harmonic B-mode imaging. With fundamental SLSC images, the specificity and sensitivity to identify fluid masses using the reader-independent metrics of contrast difference, mean lag one coherence (LOC), and gCNR were 0.86 and 1, 1 and 0.89, and 1 and 1, respectively. Results demonstrate that fundamental SLSC imaging and gCNR (or LOC if no coherence image or background region of interest is introduced) have the greatest potential to impact clinical decisions and improve the diagnostic certainty of breast mass contents. These observations are additionally anticipated to extend to masses in other organs.

A Very Large Cardiac Channel Data Database (VLCD) Used to Evaluate Global Image Coherence (GIC) as an In Vivo Image Quality Metric

Ultrasound image quality is of utmost importance for a clinician to reach a correct diagnosis. Conventionally, image quality is evaluated using metrics to determine the contrast and resolution. These metrics require localization of specific regions and targets in the image such as a region of interest (ROI), a background region, and/or a point scatterer. Such objects can all be difficult to identify in in-vivo images, especially for automatic evaluation of image quality in large amounts of data. Using a matrix array probe, we have recorded a Very Large cardiac Channel data Database (VLCD) to evaluate coherence as an in vivo image quality metric. The VLCD consists of 33280 individual image frames from 538 recordings of 106 patients. We also introduce a global image coherence (GIC), an in vivo image quality metric that does not require any identified ROI since it is defined as an average coherence value calculated from all the data pixels used to form the image, below a preselected range. The GIC is shown to be a quantitative metric for in vivo image quality when applied to the VLCD. We demonstrate, on a subset of the dataset, that the GIC correlates well with the conventional metrics contrast ratio (CR) and the generalized contrast-to-noise ratio (gCNR) with R = 0.74 ( ) and R = 0.62 ( ), respectively. There exist multiple methods to estimate the coherence of the received signal across the ultrasound array. We further show that all coherence measures investigated in this study are highly correlated ( 0.9 and ) when applied to the VLCD. Thus, even though there are differences in the implementation of coherence measures, all quantify the similarity of the signal across the array and can be averaged into a GIC to evaluate image quality automatically and quantitatively.

Improved Ultrafast Power Doppler Imaging Using United Spatial-Angular Adaptive Scaling Wiener Postfilter

Ultrafast power Doppler imaging (uPDI) using high-frame-rate plane-wave transmission is a new microvascular imaging modality that offers high Doppler sensitivity. However, due to the unfocused transmission of plane waves, the echo signal is subject to interference from noise and clutter, resulting in a low signal-to-noise ratio (SNR) and poor image quality. Adaptive beamforming techniques are effective in suppressing noise and clutter for improved image quality. In this study, an adaptive beamformer based on a united spatial-angular adaptive scaling Wiener (uSA-ASW) postfilter is proposed to improve the resolution and contrast of uPDI. In the proposed method, the signal power and noise power of the Wiener postfilter are estimated by uniting spatial and angular signals, and a united generalized coherence factor (uGCF) is introduced to dynamically adjust the noise power estimation and enhance the robustness of the method. Simulation and in vivo data were used to verify the effectiveness of the proposed method. The results show that the uSA-ASW can achieve higher resolution and significant improvements in image contrast and background noise suppression compared with conventional delay-and-sum (DAS), coherence factor (CF), spatial-angular CF (SACF), and adaptive scaling Wiener (ASW) postfilter methods. In the simulations, uSA-ASW improves contrast-to-noise ratio (CNR) by 34.7 dB (117.3%) compared with DAS, while reducing background noise power (BNP) by 52 dB (221.4%). The uSA-ASW method provides full-width at half-maximum (FWHM) reductions of [Formula: see text] (59.5%) and [Formula: see text] (56.9%), CNR improvements of 25.6 dB (199.9%) and 42 dB (253%), and BNP reductions of 46.1 dB (319.3%) and 12.9 dB (289.1%) over DAS in the experiments of contrast-free human neonatal brain and contrast-free human liver, respectively. In the contrast-free experiments, uSA-ASW effectively balances the performance of noise and clutter suppression and enhanced microvascular visualization. Overall, the proposed method has the potential to become a reliable microvascular imaging technique for aiding in more accurate diagnosis and detection of vascular-related diseases in clinical contexts.

Large-Array Deep Abdominal Imaging in Fundamental and Harmonic Mode

Deep abdominal images suffer from poor diffraction-limited lateral resolution. Extending the aperture size can improve resolution. However, phase distortion and clutter can limit the benefits of larger arrays. Previous studies have explored these effects using numerical simulations, multiple transducers, and mechanically swept arrays. In this work, we used an 8.8-cm linear array transducer to investigate the effects of aperture size when imaging through the abdominal wall. We acquired channel data in fundamental and harmonic modes using five aperture sizes. To avoid motion and increase the parameter sampling, we decoded the full-synthetic aperture data and retrospectively synthesized nine apertures (2.9-8.8 cm). We imaged a wire target and a phantom through ex vivo porcine abdominal samples and scanned the livers of 13 healthy subjects. We applied bulk sound speed correction to the wire target data. Although point resolution improved from 2.12 to 0.74 mm at 10.5 cm depth, contrast resolution often degraded with aperture size. In subjects, larger apertures resulted in an average maximum contrast degradation of 5.5 dB at 9-11 cm depth. However, larger apertures often led to visual detection of vascular targets unseen with conventional apertures. An average 3.7-dB contrast improvement over fundamental mode in subjects showed that the known benefits of tissue-harmonic imaging extend to larger arrays.

Quantifying the Impact of Imaging Through Body Walls on Shear Wave Elasticity Measurements

In the context of ultrasonic hepatic shear wave elasticity imaging (SWEI), measurement success has been determined to increase when using elevated acoustic output pressures. As SWEI sequences consist of two distinct operations (pushing and tracking), acquisition failures could be attributed to (i) insufficient acoustic radiation force generation resulting in inadequate shear wave amplitude and/or (ii) distorted ultrasonic tissue motion tracking. In the study described here, an opposing window experimental setup that isolated body wall effects separately between the push and track SWEI operations was implemented. A commonly employed commercial track configuration was used, harmonic multiple-track-location SWEI. The effects of imaging through body walls on the pushing and tracking operations of SWEI as a function of mechanical index (MI), spanning 5 different push beam MIs and 10 track beam MIs, were independently assessed using porcine body walls. Shear wave speed yield was found to increase with both increasing push and track MI. Although not consistent across all samples, measurements in a subset of body walls were found to be signal limited during tracking and to increase yield by up to 35% when increasing electronic signal-to-noise ratio by increasing harmonic track transmit pressure.

Comparison of Spatial Encodings for Ultrasound Imaging

Ultrasound pulse sequencing and receive signal focusing work hand-in-hand to determine image quality. These are commonly linked by geometry, for example, using focused beams or plane waves in transmission paired with appropriate time-of-flight calculations for focusing. Spatial encoding allows a broader class of array transmissions but requires decoding of the recorded echoes before geometric focusing can be applied. Recent work has expanded spatial encoding to include not only element apodizations, but also element time delays. This powerful technique allows for a unified beamforming strategy across different pulse sequences and increased flexibility in array signal processing giving access to estimates of individual transmit element signals, but tradeoffs in image quality between these encodings have not been previously studied. We evaluate in simulation several commonly used time delay and amplitude encodings and investigate the optimization of the parameter space for each. Using the signal-to-noise ratio (SNR), point resolution, and lesion detectability, we found tradeoffs between focused beams, plane waves, and Hadamard weight encodings. Beams with broader geometries maintained a wider field of view after decoding at the cost of the SNR and lesion detectability. Focused beams and plane waves showed slightly reduced resolution compared to Hadamard weights in some cases, especially close to the array. We also found overall degraded image quality using random weight or random delay encodings. We validate these findings with experimental phantom imaging for select cases. We believe that these findings provide a starting point for sequence optimization and improved image quality using the spatial encoding approach for imaging.

Coherence Metrics for Reader-Independent Differentiation of Cystic From Solid Breast Masses in Ultrasound Images

Traditional breast ultrasound imaging is a low-cost, real-time and portable method to assist with breast cancer screening and diagnosis, with particular benefits for patients with dense breast tissue. We previously demonstrated that incorporating coherence-based beamforming additionally improves the distinction of fluid-filled from solid breast masses, based on qualitative image interpretation by board-certified radiologists. However, variable sensitivity (range: 0.71-1.00 when detecting fluid-filled masses) was achieved by the individual radiologist readers. Therefore, we propose two objective coherence metrics, lag-one coherence (LOC) and coherence length (CL), to quantitatively determine the content of breast masses without requiring reader assessment. Data acquired from 31 breast masses were analyzed. Ideal separation (i.e., 1.00 sensitivity and specificity) was achieved between fluid-filled and solid breast masses based on the mean or median LOC value within each mass. When separated based on mean and median CL values, the sensitivity/specificity decreased to 1.00/0.95 and 0.92/0.89, respectively. The greatest sensitivity and specificity were achieved in dense, rather than non-dense, breast tissue. These results support the introduction of an objective, reader-independent method for automated diagnoses of cystic breast masses.

Combining ADMIRE and MV to Improve Image Quality

Aperture domain model image reconstruction (ADMIRE) is a frequency-domain, model-based beamformer, in part designed for removing reverberation and off-axis clutter. Minimum variance (MV) is alternatively designed to reduce off-axis interference and improve lateral resolution. MV is known to be less effective in high incoherent noise scenarios, and its performance in the presence of reverberation has not been evaluated. By implementing ADMIRE before MV, the benefits of both these beamformers can be achieved. In this article, the assumptions of MV are discussed, specifically their relationship to reverberation clutter. The use of ADMIRE as a preprocessing step to suppress noise from simulations with linear scanning and in vivo curvilinear kidney data is demonstrated, and both narrowband and broadband implementations of MV are applied. With optimal parameters, ADMIRE + MV demonstrated sizing improvements over MV alone by an average of 52.1% in 0-dB signal-to-clutter ratio reverberation cyst simulations and 14.5% in vivo while improving the contrast ratio compared to ADMIRE alone by an average of 15.1% in simulations and 14.0% in vivo. ADMIRE + MV demonstrated a consistent improvement compared to DAS, MV, and ADMIRE both in terms of sizing and contrast ratio.

An Automated Region-Selection Method for Adaptive ALARA Ultrasound Imaging

The objective of this work was to develop an automated region of the interest selection method to use for adaptive imaging. The as low as reasonably achievable (ALARA) principle is the recommended framework for setting the output level of diagnostic ultrasound devices, but studies suggest that it is not broadly observed. One way to address this would be to adjust output settings automatically based on image quality feedback, but a missing link is determining how and where to interrogate the image quality. This work provides a method of region of interest selection based on standard, envelope-detected image data that are readily available on ultrasound scanners. Image brightness, the standard deviation of the brightness values, the speckle signal-to-noise ratio, and frame-to-frame correlation were considered as image characteristics to serve as the basis for this selection method. Region selection with these filters was compared to results from image quality assessment at multiple acoustic output levels. After selecting the filter values based on data from 25 subjects, testing on ten reserved subjects' data produced a positive predictive value of 94% using image brightness, the speckle signal-to-noise ratio, and frame-to-frame correlation. The best case filter values for using only image brightness and speckle signal-to-noise ratio had a positive predictive value of 97%. These results suggest that these simple methods of filtering could select reliable regions of interest during live scanning to facilitate adaptive ALARA imaging.

Adaptive Models for Multi-Covariate Imaging of Sub-Resolution Targets (MIST)

Multi-covariate imaging of sub-resolution targets (MIST) is a statistical, model-based image formation technique that smooths speckles and reduces clutter. MIST decomposes the measured covariance of the element signals into modeled contributions from mainlobe, sidelobes, and noise. MIST covariance models are derived from the well-known autocorrelation relationship between transmit apodization and backscatter covariance. During in vivo imaging, the effective transmit aperture often deviates from the applied apodization due to nonlinear propagation and wavefront aberration. Previously, the backscatter correlation length provided a first-order measure of these patient-specific effects. In this work, we generalize and extend this approach by developing data-adaptive covariance estimation, parameterization, and model-formation techniques. We performed MIST imaging using these adaptive models and evaluated the performance gains using 152 tissue-harmonic scans of fetal targets acquired from 15 healthy pregnant subjects. Compared to standard MIST imaging, the contrast-to-noise ratio (CNR) is improved by a median of 8.3%, and the speckle signal-to-noise ratio (SNR) is improved by a median of 9.7%. The median CNR and SNR gains over B-mode are improved from 29.4% to 40.4% and 24.7% to 38.3%, respectively. We present a versatile empirical function that can parameterize an arbitrary speckle covariance and estimate the effective coherent aperture size and higher order coherence loss. We studied the performance of the proposed methods as a function of input parameters. The implications of system-independent MIST implementation are discussed.

Investigation on improving performance of adaptive beamformer by statistical analysis of ultrasonic echoes

Minimum variance (MV) beamformers have been introduced in medical ultrasound imaging to improve image quality. In most cases, the MV beamformers have been investigated in terms of resolution improvement. However, the contrast-to-noise ratio (CNR) is also a clinically important metrics and gathers attention recently. In this study, we examined the diagonal loading parameter σ in MV beamforming and determined its appropriate value by evaluating image quality evaluation metrics including CNR. In order to further improve the image quality, a method for determining the value of σ based on the difference in statistical properties of received ultrasonic echo signals was also investigated. The phantom experimental results showed that the proposed method achieved a better CNR than the conventional MV beamformer while keeping resolution significantly better than that in delay-and-sum beamforming.

Spatial Coherence Adaptive Clutter Filtering in Color Flow Imaging-Part II: Phantom and In Vivo Experiments

Conventional color flow processing is associated with a high degree of operator dependence, often requiring the careful tuning of clutter filters and priority encoding to optimize the display and accuracy of color flow images. In a companion paper, we introduced a novel framework to adapt color flow processing based on local measurements of backscatter spatial coherence. Through simulation studies, the adaptive selection of clutter filters using coherence image quality characterization was demonstrated as a means to dynamically suppress weakly-coherent clutter while preserving coherent flow signal in order to reduce velocity estimation bias. In this study, we extend previous work to evaluate the application of coherence-adaptive clutter filtering (CACF) on experimental data acquired from both phantom and in vivo liver and fetal vessels. In phantom experiments with clutter-generating tissue, CACF was shown to increase the dynamic range of velocity estimates and decrease bias and artifact from flash and thermal noise relative to conventional color flow processing. Under in vivo conditions, such properties allowed for the direct visualization of vessels that would have otherwise required fine-tuning of filter cutoff and priority thresholds with conventional processing. These advantages are presented alongside various failure modes identified in CACF as well as discussions of solutions to mitigate such limitations.

Spatial Coherence in Medical Ultrasound: A Review

Traditional pulse-echo ultrasound imaging heavily relies on the discernment of signals based on their relative magnitudes but is limited in its ability to mitigate sources of image degradation, the most prevalent of which is acoustic clutter. Advances in computing power and data storage have made it possible for echo data to be alternatively analyzed through the lens of spatial coherence, a measure of the similarity of these signals received across an array. Spatial coherence is not currently explicitly calculated on diagnostic ultrasound scanners but a large number of studies indicate that it can be employed to describe image quality, to adaptively select system parameters and to improve imaging and target detection. With the additional insights provided by spatial coherence, it is poised to play a significant role in the future of medical ultrasound. This review details the theory of spatial coherence in pulse-echo ultrasound and key advances made over the last few decades since its introduction in the 1980s.

Spatiotemporal Coherence to Quantify Sources of Image Degradation in Ultrasonic Imaging

Thermal noise and acoustic clutter signals degrade ultrasonic image quality and contribute to unreliable clinical assessment. When both noise and clutter are prevalent, it is difficult to determine which one is a more significant contributor to image degradation because there is no way to separately measure their contributions in vivo. Efforts to improve image quality often rely on an understanding of the type of image degradation at play. To address this, we derived and validated a method to quantify the individual contributions of thermal noise and acoustic clutter to image degradation by leveraging spatial and temporal coherence characteristics. Using Field II simulations, we validated the assumptions of our method, explored strategies for robust implementation, and investigated its accuracy and dynamic range. We further proposed a novel robust approach for estimating spatial lag-one coherence. Using this robust approach, we determined that our method can estimate the signal-to-thermal noise ratio (SNR) and signal-to-clutter ratio (SCR) with high accuracy between SNR levels of -30 to 40 dB and SCR levels of -20 to 15 dB. We further explored imaging parameter requirements with our Field II simulations and determined that SNR and SCR can be estimated accurately with as few as two frames and sixteen channels. Finally, we demonstrate in vivo feasibility in brain imaging and liver imaging, showing that it is possible to overcome the constraints of in vivo motion using high-frame rate M-Mode imaging.

Unsupervised learning of platform motion in synthetic aperture sonar

Synthetic aperture sonar (SAS) provides high-resolution acoustic imaging by processing coherently the backscattered signal recorded over consecutive pings as the bearing platform moves along a predefined path. Coherent processing requires accurate estimation and compensation of the platform's motion for high quality imaging. The motion of the platform carrying the SAS system can be estimated by cross-correlating redundant recordings at successive pings due to the spatiotemporal coherence of statistically homogeneous backscatter. This data-driven approach for estimating the motion of the SAS platform is essential when positioning information from navigational instruments is absent or inadequately accurate. Herein, the problem of platform motion estimation from coherence measurements of diffuse backscatter is formulated in a probabilistic framework. A variational autoencoder is designed to disentangle the ping-to-ping platform displacement from three-dimensional (3D) spatiotemporal coherence measurements. Unsupervised representation learning from unlabeled data offers robust 3D platform motion estimation. Including a small amount of labeled data during training improves further the platform motion estimation accuracy.

Spatial Coherence Adaptive Clutter Filtering in Color Flow Imaging-Part I: Simulation Studies

The appropriate selection of a clutter filter is critical for ensuring the accuracy of velocity estimates in ultrasound color flow imaging. Given the complex spatio-temporal dynamics of flow signal and clutter, however, the manual selection of filters can be a significant challenge, increasing the risk for bias and variance introduced by the removal of flow signal and/or poor clutter suppression. We propose a novel framework to adaptively select clutter filter settings based on color flow image quality feedback derived from the spatial coherence of ultrasonic backscatter. This framework seeks to relax assumptions of clutter magnitude and velocity that are traditionally required in existing adaptive filtering methods to generalize clutter filtering to a wider range of clinically-relevant color flow imaging conditions. In this study, the relationship between color flow velocity estimation error and the spatial coherence of clutter filtered channel signals was investigated in Field II simulations for a wide range of flow and clutter conditions. This relationship was leveraged in a basic implementation of coherence-adaptive clutter filtering (CACF) designed to dynamically adapt clutter filters at each imaging pixel and frame based on local measurements of spatial coherence. In simulation studies with known scatterer and clutter motion, CACF was demonstrated to reduce velocity estimation bias while maintaining variance on par with conventional filtering.

Occult Regions of Suppressed Coherence in Liver B-Mode Images

Ultrasound is an essential tool for diagnosing and monitoring diseases, but it can be limited by poor image quality. Lag-one coherence (LOC) is an image quality metric that can be related to signal-to-noise ratio and contrast-to-noise ratio. In this study, we examine matched LOC and B-mode images of the liver to discern patterns of low image quality, as indicated by lower LOC values, occurring beneath the abdominal wall, near out-of-plane vessels and adjacent to hyperechoic targets such the liver capsule. These regions of suppressed coherence are often occult; they present as temporally stable uniform speckle on B-mode images, but the LOC measurements in these regions suggest substantially degraded image quality. Quantitative characterization of the coherence suppression beneath the abdominal wall reveals a consistent pattern both in simulations and in vivo; sharp drops in coherence occurring beneath the abdominal wall asymptotically recover to a stable coherence at depth. Simulation studies suggest that abdominal wall reverberation clutter contributes to the initial drop in coherence but does not influence the asymptotic LOC value. Clinical implications are considered for contrast loss in B-mode imaging and estimation errors for elastography and Doppler imaging.

Reverberation Clutter Suppression Using 2-D Spatial Coherence Analysis

Diffuse reverberation clutter often significantly degrades the visibility of abdominal structures. Reverberation clutter acts as a temporally stationary haze that originates from the multiple scattering within the subcutaneous layers and has a narrow spatial correlation length. We recently presented an adaptive beamforming technique, Lag-one Spatial Coherence Adaptive Normalization (LoSCAN), which can recover the contrast suppressed by incoherent noise. LoSCAN successfully suppressed reverberation clutter in numerous clinical examples. However, reverberation clutter is a 3-D phenomenon and can often exhibit a finite partial correlation between receive channels. Due to a strict noise-incoherence assumption, LoSCAN does not eliminate correlated reverberation clutter. This work presents a 2-D matrix array-based LoSCAN method and evaluates matrix-LoSCAN-based strategies to suppress partially correlated reverberation clutter. We validated the proposed matrix LoSCAN method using Field II simulations of a 64×64 symmetric 2-D array. We show that a subaperture beamforming (SAB) method tuned to the direction of noise correlation is an effective method to enhance LoSCAN's performance. We evaluated the efficacy of the proposed methods using fundamental and harmonic channel data acquired from the liver of two healthy volunteers using a 64×16 custom 2-D array. Compared to azimuthal LoSCAN, the proposed approach increased the contrast by up to 5.5 dB and the generalized contrast-to-noise ratio (gCNR) by up to 0.07. We also present analytic models to understand the impact of partially correlated reverberation clutter on LoSCAN images and explain the proposed methods' mechanism of image quality improvement.

Quantifying the Effect of Abdominal Body Wall on In Situ Peak Rarefaction Pressure During Diagnostic Ultrasound Imaging

In this study, 3-D non-linear ultrasound simulations and experimental measurements were used to estimate the range of in situ pressures that can occur during transcutaneous abdominal imaging and to identify the sources of error when estimating in situ peak rarefaction pressures (PRPs) using linear derating, as specified by the mechanical index (MI) guideline. Using simulations, it was found that, for a large transmit aperture (F/1.5), MI consistently over-estimated in situ PRP by 20%-48% primarily owing to phase aberration. For a medium transmit aperture (F/3), the MI accurately estimated the in situ PRP to within 8%. For a small transmit aperture (F/5), MI consistently underestimated the in situ PRP by 32%-50%, with peak locations occurring 1-2 cm before the focal depth, often within the body wall itself. The large variability across body wall samples and focal configurations demonstrates the limitations of the simplified linear derating scheme. The results suggest that patient-specific in situ PRP estimation would allow for increases in transmit pressures, particularly for tightly focused beams, to improve diagnostic image quality while ensuring patient safety.

Frequency-Dependent Spatial Coherence in Conventional and Chirp Transmissions

The development of adaptive imaging techniques is contingent on the accurate and repeatable characterization of ultrasonic image quality. Adaptive transmit frequency selection, filtering, and frequency compounding all offer the ability to improve target conspicuity by balancing the effects of imaging resolution, the signal-to-clutter ratio, and speckle texture, but these strategies rely on the ability to capture image quality at each desired frequency. We investigate the use of broadband linear frequency-modulated transmissions, also known as chirps, to expedite the interrogation of frequency-dependent tissue spatial coherence for real-time implementations of frequency-based adaptive imaging strategies. Chirp-collected measurements of coherence are compared to those acquired by individually transmitted conventional pulses over a range of fundamental and harmonic frequencies, in order to evaluate the ability of chirps to recreate conventionally acquired coherence. Simulation and measurements in a uniform phantom free of acoustic clutter indicate that chirps replicate not only the mean coherence in a region-of-interest but also the distribution of coherence values over frequency. Results from acquisitions in porcine abdominal and human liver models show that prediction accuracy improves with chirp length. Chirps are also able to predict frequency-dependent decreases in coherence in both porcine abdominal and human liver models for fundamental and pulse inversion harmonic imaging. This work indicates that the use of chirps is a viable strategy to improve the efficiency of variable frequency coherence mapping, thus presenting an avenue for real-time implementations for frequency-based adaptive strategies.

Reverberation Noise Suppression in Ultrasound Channel Signals Using a 3D Fully Convolutional Neural Network

Diffuse reverberation is ultrasound image noise caused by multiple reflections of the transmitted pulse before returning to the transducer, which degrades image quality and impedes the estimation of displacement or flow in techniques such as elastography and Doppler imaging. Diffuse reverberation appears as spatially incoherent noise in the channel signals, where it also degrades the performance of adaptive beamforming methods, sound speed estimation, and methods that require measurements from channel signals. In this paper, we propose a custom 3D fully convolutional neural network (3DCNN) to reduce diffuse reverberation noise in the channel signals. The 3DCNN was trained with channel signals from simulations of random targets that include models of reverberation and thermal noise. It was then evaluated both on phantom and in-vivo experimental data. The 3DCNN showed improvements in image quality metrics such as generalized contrast to noise ratio (GCNR), lag one coherence (LOC) contrast-to-noise ratio (CNR) and contrast for anechoic regions in both phantom and in-vivo experiments. Visually, the contrast of anechoic regions was greatly improved. The CNR was improved in some cases, however the 3DCNN appears to strongly remove uncorrelated and low amplitude signal. In images of in-vivo carotid artery and thyroid, the 3DCNN was compared to short-lag spatial coherence (SLSC) imaging and spatial prediction filtering (FXPF) and demonstrated improved contrast, GCNR, and LOC, while FXPF only improved contrast and SLSC only improved CNR.

Correlation length ratio as a parameter for determination of fiber-like structures in soft tissues

Quantitative ultrasound methods can provide valuable information about the microstructure of a material or tissue. This works well when the common assumptions of homogeneity, isotropy, and diffuse scattering conditions are valid. In biological tissues, however, these assumptions are often violated because the microstructure of biological tissues is often heterogeneous and anisotropic. The microstructure of biological tissues can change with disease, and therefore accurate identification and description of a tissue's microstructure can offer important clinical insight. To address the challenge of evaluating the microstructure of biological tissues, here we introduce a novel parameter called the correlation length ratio (CLR), a ratio of lateral to axial correlation lengths for backscattered echo signals. We developed it to determine the presence of fiber-like structures in soft tissues by comparing this value in tissue to a threshold determined from a reference material that is homogeneous, isotropic, and provides diffuse scattering. We tested this novel parameter in phantoms with spherical scattering sources, in an anisotropic phantom (containing elongated fibers), and in human biceps muscle. We found that the CLR accurately detected the presence of elongated structures in both the anisotropic phantom and muscle. These results encourage further exploration of this novel parameter in microstructurally complex tissues.

Advances in ultrasonography: image formation and quality assessment

Delay-and-sum (DAS) beamforming is widely used for generation of B-mode images from echo signals obtained with an array probe composed of transducer elements. However, the resolution and contrast achieved with DAS beamforming are determined by the physical specifications of the array, e.g., size and pitch of elements. To overcome this limitation, adaptive imaging methods have recently been explored extensively thanks to the dissemination of digital and programmable ultrasound systems. On the other hand, it is also important to evaluate the performance of such adaptive imaging methods quantitatively to validate whether the modification of the image characteristics resulting from the developed method is appropriate. Since many adaptive imaging methods have been developed and they often alter image characteristics, attempts have also been made to update the methods for quantitative assessment of image quality. This article provides a review of recent developments in adaptive imaging and image quality assessment.

An Automated ALARA Method for Ultrasound: An Obstetric Ultrasound Feasibility Study

OBJECTIVES

Ultrasound users are advised to observe the ALARA (as low as reasonably achievable) principle, but studies have shown that most do not monitor acoustic output metrics. We developed an adaptive ultrasound method that could suggest acoustic output levels based on real-time image quality feedback using lag-one coherence (LOC).

METHODS

Lag-one coherence as a function of the mechanical index (MI) was assessed in 35 healthy volunteers in their second trimester of pregnancy. While imaging the placenta or the fetal abdomen, the system swept through 16 MI values ranging from 0.15 to 1.20. The LOC-versus-MI data were fit with a sigmoid curve, and the ALARA MI was selected as the point at which the fit reached 98% of its maximum.

RESULTS

In this study, the ALARA MI values were between 0.35 and 1.03, depending on the acoustic window. Compared to a default MI of 0.8, the pilot acquisitions suggested a lower ALARA MI 80% of the time. The contrast, contrast-to-noise ratio, generalized contrast-to-noise ratio, and LOC all followed sigmoidal trends with an increasing MI. The R2 of the fit was statistically significantly greater for LOC than the other metrics (P < .017).

CONCLUSIONS

These results suggest that maximum image quality can be achieved with acoustic output levels lower than the US Food and Drug Administration limits in many cases, and an automated tool could be used in real time to find the ALARA MI for specific imaging conditions. Our results support the feasibility of an automated, LOC-based implementation of the ALARA principle for obstetric ultrasound.

Intrinsic Tradeoffs in Multi-Covariate Imaging of Sub-Resolution Targets

Multi-covariate Imaging of Sub-resolution Targets (MIST) is an estimation-based method of imaging the statistics of diffuse scattering targets. MIST estimates the contributions of a set of covariance models to the echo data covariance matrix. Models are defined based on a spatial decomposition of the theoretical transmit intensity distribution into ON-axis and OFF-axis contributions, delineated by a user-specified spatial cutoff. We define this cutoff as the region of interest width (ROI width). In our previous work, we selected the ROI width as the first zero crossing separating the mainlobe from the sidelobe regions. This article explores the effects of varying two key parameters on MIST image quality: 1) ROI width and 2) the degree of spatial averaging of the measured echo data covariance matrix. These results demonstrate a fundamental tradeoff between resolution and speckle texture. We characterize MIST imaging performance across these tunable parameters in a number of simulated, phantom, and in vivo liver applications. We consider performance in noise, fidelity to native contrast, resolution, and speckle texture. MIST is also compared with varying levels of spatial and frequency compounding, demonstrating quantitative improvements in image quality at comparable levels of speckle reduction. In an in vivo example, optimized MIST images demonstrated 20.2% and 13.4% improvements in contrast-to-noise ratio over optimized spatial and frequency compounding images, respectively. These results present a framework for selecting MIST parameters to maximize speckle signal-to-noise ratio without an appreciable loss in resolution.

Accurate and Precise Time-Delay Estimation for Ultrasound Elastography With Prebeamformed Channel Data

Free-hand palpation ultrasound elastography is a noninvasive approach for detecting pathological alteration in tissue. In this method, the tissue is compressed by a handheld probe and displacement of each sample is estimated, a process which is also known as time-delay estimation (TDE). Even with the simplifying assumption that ignores out of plane motion, TDE is an ill-posed problem requiring estimation of axial and lateral displacements for each sample from its intensity. A well-known class of methods for making elastography a well-posed problem is regularized optimization-based methods, which imposes smoothness regularization in the associated cost function. In this article, we propose to utilize channel data that have been compensated for time gain and time delay (introduced by transmission) instead of postbeamformed radio frequency (RF) data in the optimization problem. We name our proposed method Channel data for GLobal Ultrasound Elastography (CGLUE). We analytically derive bias and variances of TDE as functions of data noise for CGLUE and Global Ultrasound Elastography (GLUE) and use the Cauchy-Schwarz inequality to prove that CGLUE provides a TDE with lower bias and variance error. To further illustrate the improved performance of CGLUE, the results of simulation, experimental phantom, and ex-vivo experiments are presented.

Incoherent Clutter Suppression Using Lag-One Coherence

The lag-one coherence (LOC), derived from the correlation between the nearest-neighbor channel signals, provides a reliable measure of clutter which, under certain assumptions, can be directly related to the signal-to-noise ratio of individual channel signals. This offers a direct means to decompose the beamsum output power into contributions from speckle and spatially incoherent noise originating from acoustic clutter and thermal noise. In this study, we applied a novel method called lag-one spatial coherence adaptive normalization (LoSCAN) to locally estimate and compensate for the contribution of spatially incoherent clutter from conventional delay-and-sum (DAS) images. Suppression of incoherent clutter by LoSCAN resulted in improved image quality without introducing many of the artifacts common to other adaptive imaging methods. In simulations with known targets and added channel noise, LoSCAN was shown to restore native contrast and increase DAS dynamic range by as much as 10-15 dB. These improvements were accompanied by DAS-like speckle texture along with reduced focal dependence and artifact compared with other adaptive methods. Under in vivo liver and fetal imaging conditions, LoSCAN resulted in increased generalized contrast-to-noise ratio (gCNR) in nearly all matched image pairs ( N = 366 ) with average increases of 0.01, 0.03, and 0.05 in good-, fair-, and poor-quality DAS images, respectively, and overall changes in gCNR from -0.01 to 0.20, contrast-to-noise ratio (CNR) from -0.05 to 0.34, contrast from -9.5 to -0.1 dB, and texture μ/σ from -0.37 to -0.001 relative to DAS.

Coherence-based quantification of acoustic clutter sources in medical ultrasound

The magnitudes by which aberration and incoherent noise sources, such as diffuse reverberation and thermal noise, contribute to degradations in image quality in medical ultrasound are not well understood. Theory predicting degradations in spatial coherence and contrast in response to combinations of incoherent noise and aberration levels is presented, and the theoretical values are compared to those from simulation across a range of magnitudes. A method to separate the contributions of incoherent noise and aberration in the spatial coherence domain is also presented and applied to predictions for losses in contrast. Results indicate excellent agreement between theory and simulations for beamformer gain and expected contrast loss due to incoherent noise and aberration. Error between coherence-predicted aberration contrast loss and measured contrast loss differs by less than 1.5 dB on average, for a -20 dB native contrast target and aberrators with a range of root-mean-square time delay errors. Results also indicate in the same native contrast target the contribution of aberration to contrast loss varies with channel signal-to-noise ratio (SNR), peaking around 0 dB SNR. The proposed framework shows promise to improve the standard by which clutter reduction strategies are evaluated.

A Spatial Coherence Beamformer Design for Power Doppler Imaging

Acoustic clutter is a primary source of image degradation in ultrasound imaging. In the context of flow imaging, tissue and acoustic clutter signals are often much larger in magnitude than the blood signal, which limits the sensitivity of conventional power Doppler in SNR-limited environments. This has motivated the development of coherence-based beamformers, including Coherent Flow Power Doppler (CFPD), which have demonstrated efficacy in mitigating sources of diffuse clutter. However, CFPD uses a measure of normalized coherence, which incurs a non-linear relationship between image intensity and the magnitude of the blood echo. As a result, CFPD is not a robust approach to study gradation of blood signal energy, which depicts the fractional moving blood volume. We propose the application of mutual intensity, rather than normalized coherence, to retain the clutter suppression capability inherent in coherence beamforming, while preserving the underlying signal energy. Feasibility of this approach was shown via Field II simulations, phantoms, and in vivo human liver data. In addition, we derive an adaptive statistical threshold for the suppression of residual noise signals. Overall, this beamformer design shows promise as an alternative technique to depict flow volume gradation in cluttered imaging environments.

The Generalized Contrast-to-Noise Ratio: A Formal Definition for Lesion Detectability

In the last 30 years, the contrast-to-noise ratio (CNR) has been used to estimate the contrast and lesion detectability in ultrasound images. Recent studies have shown that the CNR cannot be used with modern beamformers, as dynamic range alterations can produce arbitrarily high CNR values with no real effect on the probability of lesion detection. We generalize the definition of CNR based on the overlap area between two probability density functions. This generalized CNR (gCNR) is robust against dynamic range alterations; it can be applied to all kind of images, units, or scales; it provides a quantitative measure for contrast; and it has a simple statistical interpretation, i.e., the success rate that can be expected from an ideal observer at the task of separating pixels. We test gCNR on several state-of-the-art imaging algorithms and, in addition, on a trivial compression of the dynamic range. We observe that CNR varies greatly between the state-of-the-art methods, with improvements larger than 100%. We observe that trivial compression leads to a CNR improvement of over 200%. The proposed index, however, yields the same value for compressed and uncompressed images. The tested methods showed mismatched performance in terms of lesion detectability, with variations in gCNR ranging from -0.08 to +0.29. This new metric fixes a methodological flaw in the way we study contrast and allows us to assess the relevance of new imaging algorithms.

Converting Coherence to Signal-to-noise Ratio for Enhancement of Adaptive Ultrasound Imaging

High-frame-rate ultrasound is an emerging technique for functional ultrasound imaging. However, the lateral spatial resolution and contrast in high-frame-rate ultrasound with an unfocused transmit beam are inherently lower than those in conventional ultrasonic imaging based on the line-by-line acquisition using a focused ultrasonic beam because of the low directivity of the transmit beam. Coherence-based beamforming methods were introduced in ultrasound imaging for improvement of image quality. Such methods improve the lateral spatial resolution using the coherence among ultrasonic echo signals received by individual transducer elements. In this study, a new method based on the signal-to-noise ratio (SNR) among the element echo signals was developed for enhancement of the effect of the coherence factor (CF), which was previously developed for improvement in spatial resolution and contrast. In the proposed method, a new factor, namely, SNR factor, was introduced, and the relationship between the previously developed CF and SNR factor was discussed. The proposed method was implemented in plane wave imaging, and the performance was evaluated by simulated and phantom experiments. In simulation, the lateral spatial resolution and contrast obtained with the conventional CF were 0.23 mm and 47.0 dB, respectively, which were significantly better than 0.39 mm and 15.3 dB obtained by conventional delay-and-sum (DAS) beamforming. Using the proposed method, the lateral spatial resolution and contrast were further improved to 0.12 mm and 69.8 dB, respectively. Similar trends were found also in phantom experiments.

Speckle coherence of piecewise-stationary stochastic targets

The van Cittert-Zernike (VCZ) theorem describes the propagation of spatial covariance from an incoherent source distribution, such as backscatter from stochastic targets in pulse-echo imaging. These stochastic targets are typically assumed statistically stationary and spatially incoherent with uniform scattering strength. In this work, the VCZ theorem is applied to a piecewise-stationary scattering model. Under this framework, the spatial covariance of the received echo data is demonstrated as the linear superposition of covariances from distinct spatial regions. This theory is analytically derived from fundamental physical principles, and validated through simulation studies demonstrating superposition and scaling. Simulations show that linearity is preserved over various depths and transmit apodizations, and in the presence of noise. These results provide a general framework to decompose spatial covariance into contributions from distinct regions of interest, which may be applied to advanced imaging methods. While the simulation tools used for validation are specific to ultrasound, this analysis is generally applicable to other coherent imaging applications involving stochastic targets. This covariance decomposition provides the physical basis for a recently described imaging method, Multi-covariate Imaging of Sub-resolution Targets.

Multi-covariate Imaging of Sub-resolution Targets

Conventional B-mode ultrasound imaging assumes that targets consist of collections of point scatterers. Diffraction, however, presents a fundamental limit on a scanner's ability to resolve individual scatterers in most clinical imaging environments. Well-known optics and ultrasound literature has characterized these diffuse scattering targets as spatially incoherent and statistically stationary. In this paper, we apply a piecewise-stationary statistical model to diffuse scattering targets, in which the covariance of backscattered echoes can be described as the linear superposition of constituent components corresponding to echoes from distinct spatial regions in the field. Using this framework, we present Multi-covariate Imaging of Sub-resolution Targets (MIST), a novel estimation-based method to image the statistical properties of diffuse scattering targets, based on a decomposition of aperture domain spatial covariance. The mathematical foundations of the estimator are analytically derived, and MIST is evaluated in phantom, simulation, and in vivo studies, demonstrating consistent improvements in contrast-to-noise ratio and speckle statistics across imaging targets, without an apparent loss in resolution.

Short-lag Spatial Coherence Imaging in 1.5-D and 1.75-D Arrays: Elevation Performance and Array Design Considerations

Short-lag spatial coherence (SLSC) imaging has demonstrated improved performance over conventional B-Mode ultrasound imaging. Previous work has evaluated the performance of SLSC using 2-D matrix arrays in simulation and in vivo studies across various levels of subaperture beamforming, demonstrating improved contrast-to-noise ratio (CNR) and speckle signal-to-noise ratio (SNR) over 1-D arrays. This work explores the application of SLSC imaging in 1.5-D and 1.75-D arrays to quantify the impacts of elevation element count, mirroring, and Fresnel element spacing on SLSC image quality. Through simulation and in vivo studies, increased elevation element count was shown to improve CNR and speckle SNR relative to 1-D SLSC and B-Mode images. Elevation mirroring (1.5-D) was shown to force the inclusion of long lags into the SLSC calculation, introducing additional decorrelation and reducing image quality relative to 1.75-D arrays with individually-connected elements. These results demonstrate the effectiveness of SLSC imaging in 1.5-D and 1.75-D arrays.