In vivo bistatic dual-aperture ultrasound imaging and elastography of the abdominal aorta.

Introduction: In this paper we introduce in vivo multi-aperture ultrasound imaging and elastography of the abdominal aorta. Monitoring of the geometry and growth of abdominal aortic aneurysms (AAA) is paramount for risk stratification and intervention planning. However, such an assessment is limited by the lateral lumen-wall contrast and resolution of conventional ultrasound. Here, an in vivo dual-aperture bistatic imaging approach is shown to improve abdominal ultrasound and strain imaging quality significantly. By scanning the aorta from different directions, a larger part of the vessel circumference can be visualized. Methods: In this first-in-man volunteer study, the performance of multi-aperture ultrasound imaging and elastography of the abdominal aortic wall was assessed in 20 healthy volunteers. Dual-probe acquisition was performed in which two curved array transducers were aligned in the same imaging plane. The transducers alternately transmit and both probes receive simultaneously on each transmit event, which allows for the reconstruction of four ultrasound signals. Automatic probe localization was achieved by optimizing the coherence of the trans-probe data, using a gradient descent algorithm. Speckle-tracking was performed on the four individual bistatic signals, after which the respective axial displacements were compounded and strains were calculated. Results: Using bistatic multi-aperture ultrasound imaging, the image quality of the ultrasound images, i.e., the angular coverage of the wall, was improved which enables accurate estimation of local motion dynamics and strain in the abdominal aortic wall. The motion tracking error was reduced from 1.3 mm ± 0.63 mm to 0.16 mm ± 0.076 mm, which increased the circumferential elastographic signal-to-noise ratio (SNRe) by 12.3 dB ± 8.3 dB on average, revealing more accurate and homogeneous strain estimates compared to single-perspective ultrasound. Conclusion: Multi-aperture ultrasound imaging and elastography is feasible in vivo and can provide the clinician with vital information about the anatomical and mechanical state of AAAs in the future.

Increasing abdominal aortic aneurysm curvature visibility using 3D dual probe bistatic ultrasound imaging combined with probe translation.

High frame rate ultrasound (US) imaging techniques in 3D are promising tools for capturing abdominal aortic aneurysms (AAAs) over time, however, with the limited number of channel-to-element connections current footprints are small, which limits the field of view. Moreover, the maximal steering angle of the ultrasound beams in transmit and the maximal receptance angle in receive are insufficient for capturing the curvy shape of the AAA. Therefore, an approach is needed towards large arrays. In this study, high frame rate bistatic 3D US data (17 Hz) were acquired with two synchronized matrix arrays positioned at different locations (multi-aperture imaging) using a translation stage to simulate what a larger array with limited channel-to-element connections can potentially achieve. Acquisitions were performed along an AAA shaped phantom with different probe tilting angles (0 up to ± 30°). The performance of different multi-aperture configurations was quantified using the generalized contrast-to-noise ratio of the wall and lumen (gCNR). Furthermore, a parametric model of the multi-aperture system was used to estimate in which AAA wall regions the contrast is expected to be high. This was evaluated for AAAs with increasing diameters and curvature. With an eight-aperture 0° probe angle configuration a 69 % increase in field of view was measured in the longitudinal direction compared to the field of view of a single aperture configuration. When increasing the number of apertures from two to eight, the gCNR improved for the upper wall and lower wall by 35 % and 13 % (monostatic) and by 36 % and 13 % (bistatic). Contrast improvements up to 22 % (upper wall) and 12 % (lower wall) are achieved with tilted probe configurations compared to non-tilted configurations. Moreover, with bistatic imaging with tilted probe configurations gCNR improvements up to 4 % (upper wall) and 7 % (lower wall) are achieved compared to monostatic imaging. Furthermore, imaging with a larger inter-probe distance improved the gCNR for a ± 15° probe angle configuration. The gCNR has an expected pattern over time, where the contrast is lower when there is more wall motion (systole) and higher when motion is reduced (diastole). Furthermore, a higher frame rate (45 Hz) yields a lower gCNR, because fewer compound angles are used. The results of the parametric model suggest that a flat array is suitable for imaging AAA shapes with limited curvature, but that it is not suitable for imaging larger AAA shapes with more curvature. According to the model, tilted multi-aperture configurations combined with bistatic imaging can achieve a larger region with high contrast compared to non-tilted configurations. The findings of the model are in agreement with experimental findings. To conclude, this study demonstrates the vast improvements in field of view and AAA wall visibility that a large, sparsely populated 3D array can potentially achieve when imaging AAAs compared to single or dual aperture imaging. In the future, larger arrays, less thermal noise, more steering, and more channel-to-element connections combined with carefully chosen orientations of (sub-) apertures will likely advance 3D imaging of AAAs.

Enhanced Needle Visualization With Reflection Tuned Apodization Based on the Radon Transform for Ultrasound Imaging.

In ultrasound (US)-guided interventions, accurately tracking and visualizing needles during in-plane insertions are significant challenges due to strong directional specular reflections. These reflections violate the geometrical delay and apodization estimations in the conventional delay and sum beamforming (DASB) degrading the visualization of needles. This study proposes a novel reflection tuned apodization (RTA) to address this issue and facilitate needle enhancement through DASB. The method leverages both temporal and angular information derived from the Radon transforms of the radio frequency (RF) data from plane-wave imaging to filter the specular reflections from the needle and their directivity. The directivity information is translated into apodization center maps through time-to-space mapping in the Radon domain, which is subsequently integrated into DASB. We assess the influence of needle angulations, projection angles in the Radon transform, needle gauge sizes, and the presence of multiple specular interfaces on the approach. The analysis shows that the method surpasses conventional DASB in enhancing the image quality of needle interfaces while preserving the diffuse scattering from the surrounding tissues without significant computational overhead. The work offers promising prospects for improved outcomes in US-guided interventions and better insights into characterizing US reflections with Radon transforms.

Automatic Probe Localization in Multiaperture Ultrasound by Radon Domain Signal Matching.

In multiaperture ultrasound, several ultrasound probes with different insonification angles are combined to increase the field of view and angular coverage of image structures. A full reconstruction incorporating all possible combinations of transmitting and receiving probes has been shown to improve resolution, contrast, and angular coverage beyond what can be achieved by the registration of single images from different probes. A major challenge in multiaperture imaging is the correct determination of relative probe locations. A registration based on the content of images from different probes is challenging due to the decorrelation of image structures and speckle with increasing angle between the probes. We propose a probe localization method for plane-wave ultrasound that uses solely the receive dataset of a nontransmitting probe. The localization is performed by signal tracking in the Radon domain. To demonstrate that the method does not rely on common structures in the individual images, we show that a satisfying localization can be performed in pure speckle for angles, where the speckle patterns have completely decorrelated. The method shows potential for real-time probe localization in free-hand multiprobe ultrasound imaging or for flexible and wearable multiarray combination of multiple capacitive micromachined (CMUT)-based systems in the future.

Enabling strain imaging in realistic Eulerian ultrasound simulation methods.

Cardiovascular strain imaging is continually improving due to ongoing advances in ultrasound acquisition and data processing techniques. The phantoms used for validation of new methods are often burdensome to make and lack flexibility to vary mechanical and acoustic properties. Simulations of US imaging provide an alternative with the required flexibility and ground truth strain data. However, the current Lagrangian US strain imaging models cannot simulate heterogeneous speed of sound distributions and higher-order scattering, which limits the realism of the simulations. More realistic Eulerian modelling techniques exist but have so far not been used for strain imaging. In this research, a novel sampling scheme was developed based on a band-limited interpolation of the medium, which enables accurate strain simulation in Eulerian methods. The scheme was validated in k-Wave using various numerical phantoms and by a comparison with Field II. The method allows for simulations with a large range in strain values and was accurate with errors smaller than -60 dB. Furthermore, an excellent agreement with the Fourier theory of US scattering was found. The ability to perform simulations with heterogeneous speed of sound distributions was demonstrated using a pulsating artery model. The developed sampling scheme contributes to more realistic strain imaging simulations, in which the effect of heterogenous acoustic properties can be taken into account.

Coherent Bistatic 3-D Ultrasound Imaging Using Two Sparse Matrix Arrays.

In the last decade, many advances have been made in high frame rate 3-D ultrasound imaging, including more flexible acquisition systems, transmit (TX) sequences, and transducer arrays. Compounding multiangle transmits of diverging waves has shown to be fast and effective for 2-D matrix arrays, where heterogeneity between transmits is key in optimizing the image quality. However, the anisotropy in contrast and resolution remains a drawback that cannot be overcome with a single transducer. In this study, a bistatic imaging aperture is demonstrated that consists of two synchronized matrix ( 32×32 ) arrays, allowing for fast interleaved transmits with a simultaneous receive (RX). First, for a single array, the aperture efficiency for high volume rate imaging was evaluated between sparse random arrays and fully multiplexed arrays. Second, the performance of the bistatic acquisition scheme was analyzed for various positions on a wire phantom and was showcased in a dynamic setup mimicking the human abdomen and aorta. Sparse array volume images were equal in resolution and lower in contrast compared to fully multiplexed arrays but can efficiently minimize decorrelation during motion for multiaperture imaging. The dual-array imaging aperture improved the spatial resolution in the direction of the second transducer, reducing the average volumetric speckle size with 72% and the axial-lateral eccentricity with 8%. In the aorta phantom, the angular coverage increased by a factor of 3 in the axial-lateral plane, raising the wall-lumen contrast with 16% compared to single-array images, despite accumulation of thermal noise in the lumen.

A Radon diffraction theorem for plane wave ultrasound imaging.

The rising demand on high frame rate ultrasound imaging applications necessitates the development of fast algorithms for plane wave image reconstruction. We introduce a new class of plane wave reconstructions that relies on a relation between receive data and image data in the Radon domain. This relation is derived for arbitrary dimensions and validated on multiple two-dimensional plane wave data sets. We further present a mathematical relation between conventional delay-and-sum and Fourier domain reconstruction methods and the method proposed. Our analysis shows that they all rely on the same physical model with slight variations in certain filtering steps and, therefore, the new Radon domain reconstruction yields similar results as other methods in terms of image quality. However, we show that our method offers a huge potential to improve computation time by reducing the number of applied projections and to improve image quality by introducing nonlinear operations in the Radon domain, e.g., for edge enhancement. As the Radon transform retains both angular and temporal information, the relation also provides new insights on the fundamentals of plane wave imaging that can be leveraged for optimizing acquisition schemes or for developing novel compounding strategies in the future.

An aberration correction approach for single and dual aperture ultrasound imaging of the abdomen.

Abdominal ultrasound image quality is hampered by phase aberration, that is mainly caused by the large speed-of-sound (SoS) differences between fat and muscle tissue in the abdominal wall. The mismatch between the assumed and actual SoS distribution introduces general blurring of the ultrasound images, and acoustic refraction can lead to geometric distortion of the imaged features. Large aperture imaging or dual-transducer imaging can improve abdominal imaging at deep locations by providing increased contrast and resolution. However, aberration effects for large aperture imaging can be even more severe, which limits its full potential. In this study, a model-based aberration correction method for arbitrary acquisition schemes is introduced for delay-and-sum (DAS) beamforming and its performance was analyzed for both single- and dual-transducer ultrasound imaging. The method employs aberration corrected wavefront arrival times, using manually assigned local SoS values. Two wavefront models were compared. The first model is based on a straight ray approximation, and the second model on the Eikonal equation, which is solved by a multi-stencils fast marching method. Their accuracy for abdominal imaging was evaluated in acoustic simulations and phantom experiments involving tissue-mimicking and porcine material with large SoS contrast (∼100 m/s). The lateral resolution was improved by up to 90% in simulations and up to 65% in experiments compared to standard DAS, in which the use of Eikonal beamforming generally outperformed straight ray beamforming. Moreover, geometric distortions were mitigated in multi-aperture imaging, leading to a reduction in position error of around 80%. A study on the sensitivity of the aberration correction to shape and SoS of aberrating layers was performed, showing that even with imperfect segmentations or SoS values, aberration correction still outperforms standard DAS.

Multiperspective Photoacoustic Imaging Using Spatially Diverse CMUTs.

Photoacoustic imaging (PAI) is a promising technique to assess different constituents in tissue. In PAI, the propagating waves are low-amplitude, isotropic, and broadband. A common approach in PAI is the use of a single linear or curved piezoelectric transducer array to perform both PA and ultrasound imaging. These systems provide freedom, agility, and versatility for performing imaging, but have limited field of view (FOV) and directivity that degrade the final image quality. Capacitive micromachined ultrasonic transducers (CMUTs) have a great potential to be used for PAI since they provide larger bandwidth and better cost efficiency. In this study, to improve the FOV, resolution, and contrast, we propose a multiperspective PAI (MP-PAI) approach using multiple CMUTs on a flexible array with shared channels. The designed array was used to perform MP-PAI in an in vitro experiment using a plaque mimicking phantom where the images were compounded both incoherently and coherently. The MP-PAI approach showed a significant improvement in overall image quality. Using only three CMUTs led to about 20% increase in generalized-contrast-to-noise ratio (gCNR), 2-dB improvement in peak signal-to-noise ratio (PSNR), and double the structural coverage in comparison to a single CMUT setup. In numerical studies, the MP-PAI was thoroughly evaluated for both the coherent and incoherent compounding methods. The assessments showed that the image quality further improved for increased number of transducers and angular coverage. For 15 transducers, the improvement for resolution and contrast could be up to three times the amount in a single-perspective image. Nonetheless, the most prominent improvement of MP-PAI was its ability to resolve the structural information of the phantoms.

Modeling toolchain for realistic simulation of photoacoustic data acquisition.

SIGNIFICANCE: Physics-based simulations of photoacoustic (PA) signals are used to validate new methods, to characterize PA setups and to generate training datasets for machine learning. However, a thoroughly validated PA simulation toolchain that can simulate realistic images is still lacking. AIM: A quantitative toolchain was developed to model PA image acquisition in complex tissues, by simulating both the optical fluence and the acoustic wave propagation. APPROACH: Sampling techniques were developed to decrease artifacts in acoustic simulations. The performance of the simulations was analyzed by measuring the point spread function (PSF) and using a rotatable three-channel phantom, filled with cholesterol, a human carotid plaque sample, and porcine blood. Ex vivo human plaque samples were simulated to validate the methods in more complex tissues. RESULTS: The sampling techniques could enhance the quality of the simulated PA images effectively. The resolution and intensity of the PSF in the turbid medium matched the experimental data well. Overall, the appearance, signal-to-noise ratio and speckle of the images could be simulated accurately. CONCLUSIONS: A PA toolchain was developed and validated, and the results indicate a great potential of PA simulations in more complex and heterogeneous media.

High frame rate multi-perspective cardiac ultrasound imaging using phased array probes.

Ultrasound (US) imaging is used to assess cardiac disease by assessing the geometry and function of the heart utilizing its high spatial and temporal resolution. However, because of physical constraints, drawbacks of US include limited field-of-view, refraction, resolution and contrast anisotropy. These issues cannot be resolved when using a single probe. Here, an interleaved multi-perspective 2-D US imaging system was introduced, aiming at improved imaging of the left ventricle (LV) of the heart by acquiring US data from two separate phased array probes simultaneously at a high frame rate. In an ex-vivo experiment of a beating porcine heart, parasternal long-axis and apical views of the left ventricle were acquired using two phased array probes. Interleaved multi-probe US data were acquired at a frame rate of 170 frames per second (FPS) using diverging wave imaging under 11 angles. Image registration and fusion algorithms were developed to align and fuse the US images from two different probes. First- and second-order speckle statistics were computed to characterize the resulting probability distribution function and point spread function of the multi-probe image data. First-order speckle analysis showed less overlap of the histograms (reduction of 34.4%) and higher contrast-to-noise ratio (CNR, increase of 27.3%) between endocardium and myocardium in the fused images. Autocorrelation results showed an improved and more isotropic resolution for the multi-perspective images (single-perspective: 0.59 mm × 0.21 mm, multi-perspective: 0.35 mm × 0.18 mm). Moreover, mean gradient (MG) (increase of 74.4%) and entropy (increase of 23.1%) results indicated that image details of the myocardial tissue can be better observed after fusion. To conclude, interleaved multi-perspective high frame rate US imaging was developed and demonstrated in an ex-vivo experimental setup, revealing enlarged field-of-view, and improved image contrast and resolution of cardiac images.

Multiperspective Bistatic Ultrasound Imaging and Elastography of the Ex Vivo Abdominal Aorta.

Knowledge of aneurysm geometry and local mechanical wall parameters using ultrasound (US) can contribute to a better prediction of rupture risk in abdominal aortic aneurysms (AAAs). However, aortic strain imaging using conventional US is limited by the lateral lumen-wall contrast and resolution. In this study, ultrafast multiperspective bistatic (MP BS) imaging is used to improve aortic US, in which two curved array transducers receive simultaneously on each transmit event. The advantage of such bistatic US imaging on both image quality and strain estimations was investigated by comparing it to single-perspective monostatic (SP MS) and MP monostatic (MP MS) imaging, i.e., alternately transmitting and receiving with either transducer. Experimental strain imaging was performed in US simulations and in an experimental study on porcine aortas. Different compounding strategies were tested to retrieve the most useful information from each received US signal. Finally, apart from the conventional sector grid in curved array US imaging, a polar grid with respect to the vessel's local coordinate system is introduced. This new reconstruction method demonstrated improved displacement estimations in aortic US. The US simulations showed increased strain estimation accuracy using MP BS imaging bistatic imaging compared to MP MS imaging, with a decrease in the average relative error between 41% and 84% in vessel wall regions between transducers. In the experimental results, the mean image contrast-to-noise ratio was improved by up to 8 dB in the vessel wall regions between transducers. This resulted in an increased mean elastographic signal-to-noise ratio by about 15 dB in radial strain and 6 dB in circumferential strain.

Local and global distensibility assessment of abdominal aortic aneurysms in vivo from probe tracked 2D ultrasound images.

Rupture risk estimation of abdominal aortic aneurysm (AAA) patients is currently based on the maximum diameter of the AAA. Mechanical properties that characterize the mechanical state of the vessel may serve as a better rupture risk predictor. Non-electrocardiogram-gated (non-ECG-gated) freehand 2D ultrasound imaging is a fast approach from which a reconstructed volumetric image of the aorta can be obtained. From this 3D image, the geometry, volume, and maximum diameter can be obtained. The distortion caused by the pulsatility of the vessel during the acquisition is usually neglected, while it could provide additional quantitative parameters of the vessel wall. In this study, a framework was established to semi-automatically segment probe tracked images of healthy aortas (N = 10) and AAAs (N = 16), after which patient-specific geometries of the vessel at end diastole (ED), end systole (ES), and at the mean arterial pressure (MAP) state were automatically assessed using heart frequency detection and envelope detection. After registration AAA geometries were compared to the gold standard computed tomography (CT). Local mechanical properties, i.e., compliance, distensibility and circumferential strain, were computed from the assessed ED and ES geometries for healthy aortas and AAAs, and by using measured brachial pulse pressure values. Globally, volume, compliance, and distensibility were computed. Geometries were in good agreement with CT geometries, with a median similarity index and interquartile range of 0.91 [0.90-0.92] and mean Hausdorff distance and interquartile range of 4.7 [3.9-5.6] mm. As expected, distensibility (Healthy aortas: 80 ± 15·10-3 kPa-1; AAAs: 29 ± 9.6·10-3 kPa-1) and circumferential strain (Healthy aortas: 0.25 ± 0.03; AAAs: 0.15 ± 0.03) were larger in healthy vessels compared to AAAs. Circumferential strain values were in accordance with literature. Global healthy aorta distensibility was significantly different from AAAs, as was demonstrated with a Wilcoxon test (p-value = 2·10-5). Improved image contrast and lateral resolution could help to further improve segmentation to improve mechanical characterization. The presented work has demonstrated how besides accurate geometrical assessment freehand 2D ultrasound imaging is a promising tool for additional mechanical property characterization of AAAs.

Bandwidth Improvement in Ultrasound Image Reconstruction Using Deep Learning Techniques.

Ultrasound (US) imaging is a medical imaging modality that uses the reflection of sound in the range of 2-18 MHz to image internal body structures. In US, the frequency bandwidth (BW) is directly associated with image resolution. BW is a property of the transducer and more bandwidth comes at a higher cost. Thus, methods that can transform strongly bandlimited ultrasound data into broadband data are essential. In this work, we propose a deep learning (DL) technique to improve the image quality for a given bandwidth by learning features provided by broadband data of the same field of view. Therefore, the performance of several DL architectures and conventional state-of-the-art techniques for image quality improvement and artifact removal have been compared on in vitro US datasets. Two training losses have been utilized on three different architectures: a super resolution convolutional neural network (SRCNN), U-Net, and a residual encoder decoder network (REDNet) architecture. The models have been trained to transform low-bandwidth image reconstructions to high-bandwidth image reconstructions, to reduce the artifacts, and make the reconstructions visually more attractive. Experiments were performed for 20%, 40%, and 60% fractional bandwidth on the original images and showed that the improvements obtained are as high as 45.5% in RMSE, and 3.85 dB in PSNR, in datasets with a 20% bandwidth limitation.

Corrections to "Multiperspective Ultrasound Strain Imaging of the Abdominal Aorta".

In the above article [1], one error, (1), was found which has an impact on the results and interpretation of the image quality that was described in four sentences, (2)-(5). This correction does not mitigate the overall conclusion of this work, but does positively support improvements of the proposed method (multi-perspective ultrafast imaging) in comparison with the standard method (focused line-by-line imaging).

Multiperspective Ultrasound Strain Imaging of the Abdominal Aorta.

Current decision-making for clinical intervention of abdominal aortic aneurysms (AAAs) is based on the maximum diameter of the aortic wall, but this does not provide patient-specific information on rupture risk. Ultrasound (US) imaging can assess both geometry and deformation of the aortic wall. However, low lateral contrast and resolution are currently limiting the precision of both geometry and local strain estimates. To tackle these drawbacks, a multiperspective scanning mode was developed on a dual transducer US system to perform strain imaging at high frame rates. Experimental imaging was performed on porcine aortas embedded in a phantom of the abdomen, pressurized in a mock circulation loop. US images were acquired with three acquisition schemes: Multiperspective ultrafast imaging, single perspective ultrafast imaging, and conventional line-by-line scanning. Image registration was performed by automatic detection of the transducer surfaces. Multiperspective images and axial displacements were compounded for improved segmentation and tracking of the aortic wall, respectively. Performance was compared in terms of image quality, motion tracking, and strain estimation. Multiperspective compound displacement estimation reduced the mean motion tracking error over one cardiac cycle by a factor 10 compared to conventional scanning. Resolution increased in radial and circumferential strain images, and circumferential signal-to-noise ratio (SNRe) increased by 10 dB. Radial SNRe is high in wall regions moving towards the transducer. In other regions, radial strain estimates remain cumbersome for the frequency used. In conclusion, multiperspective US imaging was demonstrated to improve motion tracking and circumferential strain estimation of porcine aortas in an experimental set-up.

Photoacoustic clutter reduction by inversion of a linear scatter model using plane wave ultrasound measurements.

Photoacoustic imaging aims to visualize light absorption properties of biological tissue by receiving a sound wave that is generated inside the observed object as a result of the photoacoustic effect. In clinical applications, the strong light absorption in human skin is a major problem. When high amplitude photoacoustic waves that originate from skin absorption propagate into the tissue, they are reflected back by acoustical scatterers and the reflections contribute to the received signal. The artifacts associated with these reflected waves are referred to as clutter or skin echo and limit the applicability of photoacoustic imaging for medical applications severely. This study seeks to exploit the acoustic tissue information gained by plane wave ultrasound measurements with a linear array in order to correct for reflections in the photoacoustic image. By deriving a theory for clutter waves in k-space and a matching inversion approach, photoacoustic measurements compensated for clutter are shown to be recovered.

Optimized SNR simultaneous multispectral photoacoustic imaging with laser diodes.

Multispectral photoacoustic laser diode systems have multiple wavelengths available simultaneously. In addition to multispectral imaging, this can be exploited to increase the signal to noise ratio (SNR) by combining these wavelengths to form a combined image, but at the loss of spectral information. Here, a novel signal processing concept is introduced, which optimizes the SNR in the reconstructions of single wavelength data from combined acquisitions while simultaneously permitting to obtain a higher SNR fused image from the same data. The concept is derived for an arbitrary number of wavelengths; it is also applicable at low pulse repetition frequencies. The concept is applied in an experiment using two wavelengths, verifying the theoretical results.