Resolution and Speckle Reduction in Cardiac Imaging

Ultrasound-New Techniques Are Extending the Applications

BACKGROUND

Sonography is often the first imaging procedure to be used in diagnostic investigation of the abdomen. The aim of this article is to provide a new interdisciplinary overview of recent groundbreaking advances in this modality.

METHODS

A selective survey of the literature in PubMed was conducted. The literature search was carried out in 2021-2022 and included publications over the period 2004-2022.

RESULTS

The novel sonographic software techniques can be divided into algorithms that deal with conventional B-scan optimization and new programs that extend the scope of sonographic examination. The latter include elastography, contrast-enhanced sonography, and image fusion in combination with other cross-sectional imaging modalities. Elastography can be used to assess the presence of steatosis, fibrosis, or cirrhosis in patients with liver disease. One study reported diagnostic accuracy of 84-87% for the diagnosis of significant fibrosis (F2), 89-91% for the diagnosis of severe fibrosis (F3), and 92-93% for the diagnosis of liver cirrhosis (F4). Contrast-enhanced sonography is used for evaluation of tumors and trauma. A prospective multicenter study found sensitivity of 95.8% for the characterization of malignant lesions and specificity of 83.1% for benign lesions. Image fusion has the potential to improve the diagnostic assessment of parenchymatous organs, vascular conditions, and the prostate.

CONCLUSION

With continuous improvement of the B-scan and the development of high-frequency probes and novel investigation techniques, sonography has become established as an increasingly autonomous examination procedure.

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.

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.