Error analysis of speed of sound reconstruction in ultrasound limited angle transmission tomography.

We have investigated limited angle transmission tomography to estimate speed of sound (SOS) distributions for breast cancer detection. That requires both accurate delineations of major tissues, in this case by segmentation of prior B-mode images, and calibration of the relative positions of the opposed transducers. Experimental sensitivity evaluation of the reconstructions with respect to segmentation and calibration errors is difficult with our current system. Therefore, parametric studies of SOS errors in our bent-ray reconstructions were simulated. They included mis-segmentation of an object of interest or a nearby object, and miscalibration of relative transducer positions in 3D. Close correspondence of reconstruction accuracy was verified in the simplest case, a cylindrical object in homogeneous background with induced segmentation and calibration inaccuracies. Simulated mis-segmentation in object size and lateral location produced maximum SOS errors of 6.3% within 10 mm diameter change and 9.1% within 5 mm shift, respectively. Modest errors in assumed transducer separation produced the maximum SOS error from miscalibrations (57.3% within 5 mm shift), still, correction of this type of error can easily be achieved in the clinic. This study should aid in designing adequate transducer mounts and calibration procedures, and in specification of B-mode image quality and segmentation algorithms for limited angle transmission tomography relying on ray tracing algorithms.

Real-Time Spatiotemporal Control of High-Intensity Focused Ultrasound Thermal Ablation Using Echo Decorrelation Imaging in ex Vivo Bovine Liver.

The ability to control high-intensity focused ultrasound (HIFU) thermal ablation using echo decorrelation imaging feedback was evaluated in ex vivo bovine liver. Sonications were automatically ceased when the minimum cumulative echo decorrelation within the region of interest exceeded an ablation control threshold, determined from preliminary experiments as -2.7 (log-scaled decorrelation per millisecond), corresponding to 90% specificity for local ablation prediction. Controlled HIFU thermal ablation experiments were compared with uncontrolled experiments employing two, five or nine sonication cycles. Means and standard errors of the lesion width, area and depth, as well as receiver operating characteristic curves testing ablation prediction performance, were computed for each group. Controlled trials exhibited significantly smaller average lesion area, width and treatment time than five-cycle or nine-cycle uncontrolled trials and also had significantly greater prediction capability than two-cycle uncontrolled trials. These results suggest echo decorrelation imaging is an effective approach to real-time HIFU ablation control.

Echo Decorrelation Imaging of Rabbit Liver and VX2 Tumor during In Vivo Ultrasound Ablation.

In open surgical procedures, image-ablate ultrasound arrays performed thermal ablation and imaging on rabbit liver lobes with implanted VX2 tumor. Treatments included unfocused (bulk ultrasound ablation, N = 10) and focused (high-intensity focused ultrasound ablation, N = 13) exposure conditions. Echo decorrelation and integrated backscatter images were formed from pulse-echo data recorded during rest periods after each therapy pulse. Echo decorrelation images were corrected for artifacts using decorrelation measured prior to ablation. Ablation prediction performance was assessed using receiver operating characteristic curves. Results revealed significantly increased echo decorrelation and integrated backscatter in both ablated liver and ablated tumor relative to unablated tissue, with larger differences observed in liver than in tumor. For receiver operating characteristic curves computed from all ablation exposures, both echo decorrelation and integrated backscatter predicted liver and tumor ablation with statistically significant success, and echo decorrelation was significantly better as a predictor of liver ablation. These results indicate echo decorrelation imaging is a successful predictor of local thermal ablation in both normal liver and tumor tissue, with potential for real-time therapy monitoring.

Acoustic attenuation imaging of tissue bulk properties with a priori information.

Attenuation of ultrasound waves traversing a medium is not only a result of absorption and scattering within a given tissue, but also of coherent scattering, including diffraction, refraction, and reflection of the acoustic wave at tissue boundaries. This leads to edge enhancement and other artifacts in most reconstruction algorithms, other than 3D wave migration with currently impractical, implementations. The presented approach accounts for energy loss at tissue boundaries by normalizing data based on variable sound speed, and potential density, of the medium using a k-space wave solver. Coupled with a priori knowledge of major sound speed distributions, physical attenuation values within broad ranges, and the assumption of homogeneity within segmented regions, an attenuation image representative of region bulk properties is constructed by solving a penalized weighted least squares optimization problem. This is in contradistinction to absorption or to conventional attenuation coefficient based on overall insertion loss with strong dependence on sound speed and impedance mismatches at tissue boundaries. This imaged property will be referred to as the bulk attenuation coefficient. The algorithm is demonstrated on an opposed array setup, with mean-squared-error improvements from 0.6269 to 0.0424 (dB/cm/MHz)2 for a cylindrical phantom, and 0.1622 to 0.0256 (dB/cm/MHz)2 for a windowed phantom.

Analysis of tissue changes, measurement system effects, and motion artifacts in echo decorrelation imaging.

Echo decorrelation imaging, a method for mapping ablation-induced ultrasound echo changes, is analyzed. Local echo decorrelation is shown to approximate the decoherence spectrum of tissue reflectivity. Effects of the ultrasound measurement system, echo signal windowing, electronic noise, and tissue motion on echo decorrelation images are determined theoretically, leading to a method for reduction of motion and noise artifacts. Theoretical analysis is validated by simulations and experiments. Simulated decoherence of the scattering medium was recovered with root-mean-square error less than 10% with accuracy dependent on the correlation window size. Motion-induced decorrelation measured in an ex vivo pubovisceral muscle model showed similar trends to theoretical motion-induced decorrelation for a 2.1 MHz curvilinear array with decorrelation approaching unity for 3-4 mm elevational displacement or 1-1.6 mm range displacement. For in vivo imaging of porcine liver by a 7 MHz linear array, theoretical decorrelation computed using image-based motion estimates correlated significantly with measured decorrelation (r = 0.931, N = 10). Echo decorrelation artifacts incurred during in vivo radiofrequency ablation in the same porcine liver were effectively compensated based on the theoretical echo decorrelation model and measured pre-treatment decorrelation. These results demonstrate the potential of echo decorrelation imaging for quantification of heat-induced changes to the scattering tissue medium during thermal ablation.

First-arrival traveltime sound speed inversion with a priori information.

PURPOSE: A first-arrival travel-time sound speed algorithm presented by Tarantola [Inverse Problem Theory and Methods for Model Parameter Estimation (SIAM, Philadelphia, PA, 2005)] is adapted to the medical ultrasonics setting. Through specification of a covariance matrix for the object model, the algorithm allows for natural inclusion of physical a priori information of the object. The algorithm's ability to accurately and robustly reconstruct a complex sound speed distribution is demonstrated on simulation and experimental data using a limited aperture. METHODS: The algorithm is first demonstrated generally in simulation with a numerical breast phantom imaged in different geometries. As this work is motivated by the authors' limited aperture dual sided ultrasound breast imaging system, experimental data are acquired with a Verasonics system with dual, 128 element, linear L7-4 arrays. The transducers are automatically calibrated for usage in the eikonal forward model.A priori information such as knowledge of correlated regions within the object is obtained via segmentation of B-mode images generated from synthetic aperture imaging. RESULTS: As one illustration of the algorithm's facility for inclusion ofa priori information, physically grounded regularization is demonstrated in simulation. The algorithm's practicality is then demonstrated through experimental realization in limited aperture cases. Reconstructions of sound speed distributions of various complexity are improved through inclusion of a priori information. The sound speed maps are generally reconstructed with accuracy within a few m/s. CONCLUSIONS: This paper demonstrates the ability to form sound speed images using two opposed commercial linear arrays to mimic ultrasound image acquisition in the compressed mammographic geometry. The ability to create reasonably good speed of sound images in the compressed mammographic geometry allows images to be readily coregistered to tomosynthesis image volumes for breast cancer detection and characterization studies.

Combined photoacoustic and acoustic imaging of human breast specimens in the mammographic geometry.

A photoacoustic volume imaging (PAVI) system was designed to study breast cancer detection and diagnosis in the mammographic geometry in combination with automated 3-D ultrasound (AUS). The goal of the work described here was to validate the design and evaluate its performance in human breast tissues for non-invasive imaging of deeply positioned structures covering such geometry. The good penetration of near-infrared light and high receiving sensitivity of a broad-bandwidth, 572-element, 2-D polyvinylidene fluoride (PVDF) array at a low center frequency of 1 MHz were used with 20 channel simultaneous acquisition. Pseudo-lesions filled with dilute blood were imaged in three human breast specimens at various depths up to 49 mm. With near-infrared light illumination and 256-sample averaging, the extrapolated maximum depth in imaging a 2.4-mm blood-rich lesion with a 3-dB contrast-to-noise ratio in a compressed breast was 54 mm. Three-dimensional photoacoustic volume image stacks of the breasts were co-registered with 3-D ultrasound image stacks, suggesting for the first time that PAVI, based on the intrinsic tissue contrast, can visualize tissue interfaces other than those with blood, including the inner skin surface and connective tissue sheets. With the designed system, PAVI revealed satisfactory imaging depth and sensitivity for coverage of the entire breast when imaged from both sides in the mammographic geometry with mild compression.

Breast mass characterization using 3-dimensional automated ultrasound as an adjunct to digital breast tomosynthesis: a pilot study.

OBJECTIVES: The purpose of this study was to retrospectively evaluate the effect of 3-dimensional automated ultrasound (3D-AUS) as an adjunct to digital breast tomosynthesis (DBT) on radiologists' performance and confidence in discriminating malignant and benign breast masses. METHODS: Two-view DBT (craniocaudal and mediolateral oblique or lateral) and single-view 3D-AUS images were acquired from 51 patients with subsequently biopsy-proven masses (13 malignant and 38 benign). Six experienced radiologists rated, on a 13-point scale, the likelihood of malignancy of an identified mass, first by reading the DBT images alone, followed immediately by reading the DBT images with automatically coregistered 3D-AUS images. The diagnostic performance of each method was measured using receiver operating characteristic (ROC) curve analysis and changes in sensitivity and specificity with the McNemar test. After each reading, radiologists took a survey to rate their confidence level in using DBT alone versus combined DBT/3D-AUS as potential screening modalities. RESULTS: The 6 radiologists had an average area under the ROC curve of 0.92 for both modalities (range, 0.89-0.97 for DBT and 0.90-0.94 for DBT/3D-AUS). With a Breast Imaging Reporting and Data System rating of 4 as the threshold for biopsy recommendation, the average sensitivity of the radiologists increased from 96% to 100% (P > .08) with 3D-AUS, whereas the specificity decreased from 33% to 25% (P > .28). Survey responses indicated increased confidence in potentially using DBT for screening when 3D-AUS was added (P < .05 for each reader). CONCLUSIONS: In this initial reader study, no significant difference in ROC performance was found with the addition of 3D-AUS to DBT. However, a trend to improved discrimination of malignancy was observed when adding 3D-AUS. Radiologists' confidence also improved with DBT/3DAUS compared to DBT alone.

Large Area MEMS Based Ultrasound Device for Cancer Detection.

We present image results obtained using a prototype ultrasound array which demonstrates the fundamental architecture for a large area MEMS based ultrasound device for detection of breast cancer. The prototype array consists of a tiling of capacitive Micro-Machined Ultrasound Transducers (cMUTs) which have been flip-chip attached to a rigid organic substrate. The pitch on the cMUT elements is 185 um and the operating frequency is nominally 9 MHz. The spatial resolution of the new probe is comparable to production PZT probes, however the sensitivity is reduced by conditions that should be correctable. Simulated opposed-view image registration and Speed of Sound volume reconstruction results for ultrasound in the mammographic geometry are also presented.

Effect of a gel retainment dam on automated ultrasound coverage in a dual-modality breast imaging system.

OBJECTIVE: The goal of this work was to evaluate a possible improvement in ultrasound coverage for a dual-modality breast imaging system in the mammographic geometry. METHODS: A pilot study was performed to evaluate use of a rubber dam to retain ultrasound gel and improve imaging coverage at the breast periphery on a combined imaging system consisting of an ultrasound scanner and a digital x-ray tomosynthesis unit. Several dams were constructed to encompass the shapes of various sizes of compressed breasts. Visual tracings of the breast-to-paddle contact area and breast periphery were made for 8 breasts to estimate coverage area. Two readers independently reviewed the resulting images and were asked to rate the overall breast image quality. RESULTS: The percentages of breast in contact with the paddle were greater (P < .01) and the linear dimensions of breast in contact with the paddle were larger (P < .05) with the rubber dam than without it. With the dam, the mean estimated area of the breast in contact with the paddle increased 14%, whereas the mean increase in the fraction of the total breast area in contact with paddle was 30%. The difference was due to the mean total projected area of the breast decreasing 12% as the dam was pressed against it. The image quality of automated ultrasound with the rubber dam was consistently judged to be superior to that without the dam. CONCLUSIONS: This method can enhance the absolute and percentage area of the breast in contact with the paddle, reducing noncontact gaps at the breast periphery. Gently pressing the breast periphery with the dam inserted toward the chest wall improves coverage in automated breast ultrasound scanning.

Hybrid beamforming and steering with reconfigurable arrays.

Reconfigurable arrays offer an advantage over traditional ultrasound arrays because of their flexibility in channel selection. To improve ultrasound beamforming and coverage through beam steering, we propose a hybrid beamforming technique to elongate the depth of focus of transmit beams and a method of element selection that improves steering capabilities that take advantage of array reconfigurability using annular rings. A local minimization technique to optimize the hybrid aperture is discussed in this paper. The chosen hybrid apertures covering four focal zones result in improved range in depth of focus when compared with pure spherical beams via point spread functions (PSF) and lesion signal-to-noise ratio (LSNR) calculations. Improvements were statistically significant at focal depth extremes. Our method of beam steering utilizing a quantized phase delay selection to minimize delay errors indicated better performance by removing an artifact present with traditional ringed element selection.