Spatially segmented SVD clutter filtering in cardiac blood flow imaging with diverging waves.

Ultrafast ultrasound imaging enables the visualization of rapidly changing blood flow dynamics in the chambers of the heart. Singular value decomposition (SVD) filters outperform conventional high pass clutter rejection filters for ultrafast blood flow imaging of small and shallow fields of view (e.g., functional imaging of brain activity). However, implementing SVD filters can be challenging in cardiac imaging due to the complex spatially and temporally varying tissue characteristics. To address this challenge, we describe a method that involves excluding the proximal portion of the image (near the chest wall) and divides the reduced field of view into overlapped segments, within which tissue signals are expected to be spatially and temporally coherent. SVD filtering with automatic selection of cut-off singular vector orders to remove tissue and noise signals is implemented for each segment. Auto-thresholding is based on the coherence of spatial singular vectors, delineating tissue, blood, and noise subspaces within a spatial similarity matrix calculated for each segment. Filtered blood flow signals from the segments are reconstructed and then combined and Doppler processing is used to form a set of blood flow images. Preliminary experimental results suggest that the spatially segmented approach improves the separation of the tissue and blood subsets in the spatial similarity matrix so that automatic thresholding is significantly improved, and tissue clutter can then be rejected more effectively in cardiac ultrafast imaging, compared to using the full field of view. In the case studied, spatially segmented SVD improved the rate of correct automatic selection of thresholds from 78% to 98.7% for the investigated cases and improved the post-filter power of blood signals by an average of more than 10 dB during a cardiac cycle.

Design optimization procedure for an orthopedic insole having a continuously variable stiffness/shape to reduce the plantar pressure in the foot of a diabetic patient.

Foot ulcers and lower-limb amputations are among the major problems in diabetic patients. Orthopedic insoles can reduce the risk of diabetic foot ulcers in patients through pressure redistribution on the bottom of the foot. The purpose of this study was to propose an optimization method to design the dedicated insoles for diabetic patients in order to decrease the maximum plantar pressure. At first, a three-dimensional finite element model of bones, ligaments and soft tissue of a diabetic patient's foot was created using CT scan images. Then, the foot plantar pressure was calculated by means of a finite element software. Next, the stiffness and shape of a simple flat insole were separately modified to reduce the maximum foot plantar pressure. The optimization method resulted in a dedicated insole design with a continuously variable stiffness/shape within its area that creates a smooth pressure distribution for the patient comfort. The results showed a 40% reduction in the maximum foot pressure, which we attribute to the modification of insole stiffness. In addition, the optimal shape of the proposed insole decreased the maximum plantar pressure by 25% compared to the flat insole.

Spectral Shift Originating from Non-linear Ultrasonic Wave Propagation and Its Effect on Imaging Resolution.

An amplitude-dependent downshift in the fundamental wave spectrum of a propagating ultrasonic pulse caused by non-linear wave propagation is described. The effects of non-linearity and the associated downshift on spatial resolution are also studied. The amounts of downshift and spatial resolution are extracted from the numerically simulated beam profile based on the KZK equation. Results for a 25-MHz transducer reveal that non-linear effects can lead to 58% additional downshift in the centre frequency of a pulse compared with a linear case with downshift caused only by attenuation. This additional downshift causes about 50% degradation in axial resolution. However, as the beam becomes narrower from the non-linear effects, the overall effect of non-linearity still leads to improved lateral resolution (≤26%). Therefore, as non-linearity increases with wave pressure, it is concluded that the increase in source pressure improves lateral resolution and degrades axial resolution.

Determination of the Ultrasonic Non-linearity Parameter B/A versus Frequency for Water.

For tissue characterization, it is desirable to determine B/A using high-frequency transducers. Moreover, an accurate estimate of B/A at elevated frequencies (or at least the assumption of frequency independence of B/A) is required to evaluate the safety of high-frequency systems. However, common finite-amplitude approaches become increasingly inaccurate at high frequencies. In this article, a practical variation of the finite-amplitude method is proposed which combines experiments with numerical simulations of the Khokhlov-Zabolotskaya-Kuznetsov equation and can be used at elevated frequencies. The results at low frequencies show that the proposed approach is accurate with lower uncertainties compared with the finite-amplitude method because it avoids assumptions and approximations. The measured values of B/A versus frequency for water at 2.25-20 MHz show that there is no statistically significant variation in B/A values with frequency, and therefore the assumption of frequency independence of B/A is realistic.

Non-linear Wave Propagation and Safety Standards for Diagnostic Ultrasound Devices.

Safety standards for clinical diagnostic ultrasonic devices were developed for use in relatively low-frequency systems (1-10 MHz), under the assumption that non-linear effects would be negligible. This article reviews ways in which neglecting non-linear wave propagation affects the measurements and calculations required to comply with safety standards and U.S. Food and Drug Administration guidance that recognizes these standards. An attempt is made to evaluate whether ignoring non-linear effects could result in significant error in the exposure quantities defined in these standards at either low or high frequencies, based on published literature. This article maintains that although non-linear effects have been considered in some parts of safety standards related to hydrophone requirements, the coverage is inadequate, especially for modern equipment with high working frequencies. A new approach is required to assess the magnitude of thermal heating for recently developed high-frequency systems to incorporate non-linear effects. In contrast, the current approach for evaluating the risk of cavitation can be used after appropriate modifications.