Eigenspace based minimum variance beamforming applied to ultrasound imaging of acoustically hard tissues

Minimum variance (MV) based beamforming techniques have been successfully applied to medical ultrasound imaging. These adaptive methods offer higher lateral resolution, lower sidelobes, and better definition of edges compared to delay and sum beamforming (DAS). In standard medical ultrasound, the bone surface is often visualized poorly, and the boundaries region appears unclear. This may happen due to fundamental limitations of the DAS beamformer, and different artifacts due to, e.g., specular reflection, and shadowing. The latter can degrade the robustness of the MV beamformers as the statistics across the imaging aperture is violated because of the obstruction of the imaging beams. In this study, we employ forward/backward averaging to improve the robustness of the MV beamforming techniques. Further, we use an eigen-spaced minimum variance technique (ESMV) to enhance the edge detection of hard tissues. In simulation, in vitro, and in vivo studies, we show that performance of the ESMV beamformer depends on estimation of the signal subspace rank. The lower ranks of the signal subspace can enhance edges and reduce noise in ultrasound images but the speckle pattern can be distorted.

A more fundamental approach to the derivation of nonlinear acoustic wave equations with fractional loss operators (L)

A corrected derivation of nonlinear wave propagation equations with fractional loss operators is presented. The fundamental approach is based on fractional formulations of the stress-strain and heat flux definitions but uses the energy equation and thermodynamic identities to link density and pressure instead of an erroneous fractional form of the entropy equation as done in Prieur and Holm ["Nonlinear acoustic wave equations with fractional loss operators," J. Acoust. Soc. Am. 130(3), 1125-1132 (2011)]. The loss operator of the obtained nonlinear wave equations differs from the previous derivations as well as the dispersion equation, but when approximating for low frequencies the expressions for the frequency dependent attenuation and velocity dispersion remain unchanged.

Applying Thomson's multitaper approach to reduce speckle in medical ultrasound imaging

To reduce the variance of speckle in coherent imaging systems, one must average images with different speckle realizations. Traditionally, these images have been formed by observing the target region from slightly different angles (spatial compounding) or by varying the involved temporal frequencies (frequency compounding). In this paper, we investigate a third option based on Thomson's multitaper approach to power spectrum estimation. The tapers are applied spatially, as array weights. Our investigations, based on both recorded ultrasound data and simulations, verify that the multitaper approach can be used for speckle reduction at a rate comparable to that of the more traditional method of spatial compounding. Because of the spectral concentration of the tapers, an added benefit is reduced side lobe levels, which can result in steeper edges and better definition of cyst-like structures.

Simultaneous monitoring of static and dynamic intracranial pressure parameters from two separate sensors in patients with cerebral bleeds: comparison of findings

BACKGROUND

We recently reported that in an experimental setting the zero pressure level of solid intracranial pressure (ICP) sensors can be altered by electrostatics discharges. Changes in the zero pressure level would alter the ICP level (mean ICP); whether spontaneous changes in mean ICP happen in clinical settings is not known. This can be addressed by comparing the ICP parameters level and waveform of simultaneous ICP signals. To this end, we retrieved our recordings in patients with cerebral bleeds wherein the ICP had been recorded simultaneously from two different sensors.

MATERIALS AND METHODS

During a time period of 10 years, 17 patients with cerebral bleeds were monitored with two ICP sensors simultaneously; sensor 1 was always a solid sensor while Sensor 2 was a solid -, a fluid - or an air-pouch sensor. The simultaneous signals were analyzed with automatic identification of the cardiac induced ICP waves. The output was determined in consecutive 6-s time windows, both with regard to the static parameter mean ICP and the dynamic parameters (mean wave amplitude, MWA, and mean wave rise time, MWRT). Differences in mean ICP, MWA and MWRT between the two sensors were determined. Transfer functions between the sensors were determined to evaluate how sensors reproduce the ICP waveform.

RESULTS

Comparing findings in two solid sensors disclosed major differences in mean ICP in 2 of 5 patients (40%), despite marginal differences in MWA, MWRT, and linear phase magnitude and phase. Qualitative assessment of trend plots of mean ICP and MWA revealed shifts and drifts of mean ICP in the clinical setting. The transfer function analysis comparing the solid sensor with either the fluid or air-pouch sensors revealed more variable transfer function magnitude and greater differences in the ICP waveform derived indices.

CONCLUSIONS

Simultaneous monitoring of ICP using two solid sensors may show marked differences in static ICP but close to identity in dynamic ICP waveforms. This indicates that shifts in ICP baseline pressure (sensor zero level) occur clinically; trend plots of the ICP parameters also confirm this. Solid sensors are superior to fluid - and air pouch sensors when evaluating the dynamic ICP parameters.

Fast simulation of second harmonic ultrasound field using a quasi-linear method

Nonlinear propagation of sound has been exploited in the last 15 years in medical ultrasound imaging through tissue harmonic imaging (THI). THI creates an image by filtering the received ultrasound echo around the second harmonic frequency band. This technique produces images of enhanced quality due to reduced body wall reverberation, lower perturbations from off-axis echoes, and multiple scattering of reduced amplitude. In order to optimize the image quality it is essential to be able to predict the amplitude level and spatial distribution of the propagating ultrasound pulse. A method based on the quasi-linear approximation has been developed to quickly provide an estimate of the ultrasound pulse. This method does not need to propagate the pulse stepwise from the source plane to the desired depth; it directly computes a transverse profile at any depth from the definitions of the transducer and the pulse. The computation handles three spatial dimensions which allows for any transducer geometry. A comparison of pulse forms, transverse profiles, as well as axial profiles obtained by this method and state-of-the-art simulators, the KZKTexas code, and Abersim, shows a satisfactory match. The computation time for the quasi-linear method is also smaller than the time required by the other methods.

High Levels of S100A12 Are Associated With Recent Plaque Symptomatology in Patients With Carotid Atherosclerosis

Background and Purpose—

Atherosclerosis is a progressive chronic disease, in which inflammation plays a key role. The calcium-binding proteins calgranulins including S100A8, S100A9, and S100A12 are involved in many cellular activities and pathological processes including inflammation. We therefore hypothesized that calgranulins may be markers of plaque instability in patients with carotid atherosclerosis.

Methods—

Plasma levels of S100A8/A9 and S100A10 were measured in 159 consecutive patients with high-grade carotid stenosis and in 22 healthy control subjects. The mRNA levels of calgranulins were also measured within the atherosclerotic carotid plaques, and their regulation was analyzed in vitro in monocytes.

Results—

Our main findings were: (1) plasma levels of S100A12 were significantly higher in patients with carotid atherosclerosis compared with healthy control subjects with the highest levels in patients with the most recent symptoms (ie, within 2 months); (2) plasma levels of S100A8/S100A9 showed a modest increase in patients with symptoms in the previous 2 to 6 months but not in the other patients; (3) mRNA levels of S100A8, S100A9, and S100A12 showed increased expression in atherosclerotic carotid plaques from patients with the most recent symptoms compared with the remaining patients; (4) in THP-1 monocytes, activation of Toll-like receptors 2 and 4 increased mRNA levels of S100A8, S100A9, and S10012 and interleukin-1β, interferon γ, and releasate from thrombin-activated platelets significantly enhanced the expression of S100A12.

Conclusions—

Our findings support a link between calgranulins and atherogenesis and suggest that these mediators, and in particular S100A12, may be related to plaque instability.

Minimum variance beamforming applied to ultrasound imaging with a partially shaded aperture

Shadowing of an imaging aperture occurs when ultrasound beams are partially obstructed by an acoustically hard tissue, e.g., bone tissue. This effect leads to reduced resolution and, in some cases, geometrical distortion. In this paper, we initially introduce a binary apodization model to simulate effects of the shadowing on the point scatterers located close to a bone structure. Further, in a simulation study and an in vitro experiment, the minimum variance (MV) beamforming method is employed to image scatterers partly located in the shadow of bone. We show that the MV beamformer can result in a distorted image when the imaging aperture is highly obstructed by the bone structure. This distortion can be seen as an apparent lateral shift of the point spread function and a decrease in the sensitivity. Based on the signal power across the aperture, we adaptively determine the shadowed elements and discard their corresponding data from the covariance matrix to improve the MV beamformer performance. This modified MV beamformer can retain the resolution and compensate for the apparent lateral shifting and signal attenuation for the shadowed point scatterers.

Visfatin/NAMPT: a multifaceted molecule with diverse roles in physiology and pathophysiology

Visfatin/NAMPT (nicotinamide phosphoribosyltransferase) is a protein with several suggested functions. Although the first discovery of this molecule as a pre-B-cell colony-enhancing factor suggested primarily a cytokine function, its rediscovery as the key enzyme in nicotinamide adenine dinucleotide generation has considerably widened its potential biological activities. Although originally thought to be produced in adipose tissue (i.e., adipocytes and infiltrating macrophages), its production seems to involve other cells and tissues such as skeletal muscle, liver, immune cells, cardiomyocytes, and the brain. Visfatin/NAMPT has both intracellular and extracellular effects influencing several signaling pathways. Its broad spectrum of effects is mirrored by its potential involvement in a wide range of disorders including human immunodeficiency virus infection, septicemia, myocardial failure, atherosclerosis, metabolic disorders, inflammatory diseases, malignancies, and neurodegenerative disorders and aging. Moreover, studies on visfatin/NAMPT in atherosclerotic disorders suggest a rather complex role of this molecule in pathophysiology, potentially mediating both adaptive and maladaptive responses.

MRI FINDINGS AFTER AN EXPERIMENTAL DISC LESION

Purpose: A minipig model was used to demonstrate MRI findings in the first three months after an annular disruption. Methods: An incision was made into one of the lumbar discs in each of eight minipigs in the outer and middle parts of the annulus. The remaining intact discs in the lumbar and thoracolumbar regions were used as controls. MR imaging was performed one month and three months after trauma using both a 1.0 T and a 1.5 T MR unit. The histologic analysis was also carried out to demonstrate morphological changes in disc. Results: Eighty-eight percent of the injured discs had a diminished area of bright signal in the nucleus pulposus, also in cases where no signs of trauma in the annulus could be detected in MRI. The degeneration process of the nucleus pulposus was shown to progress during follow-up. High intensity zones were detected in 50% of the injured discs and they tended to appear already after one month follow-up. Histological examination showed that the high-intensity zone contained clusters of nuclear cells originating in the nucleus pulposus. Conclusion: It is concluded that lesions producing high-intensity zones can be induced in an experimental animal model and it can already be detected one month after the trauma. Degeneration process of the nucleus is generally initiated after a peripheral annular lesion.

Linking multiple relaxation, power-law attenuation, and fractional wave equations

The acoustic wave attenuation is described by an experimentally established frequency power law in a variety of complex media, e.g., biological tissue, polymers, rocks, and rubber. Recent papers present a variety of acoustical fractional derivative wave equations that have the ability to model power-law attenuation. On the other hand, a multiple relaxation model is widely recognized as a physically based description of the acoustic loss mechanisms as developed by Nachman et al. [J. Acoust. Soc. Am. 88, 1584-1595 (1990)]. Through assumption of a continuum of relaxation mechanisms, each with an effective compressibility described by a distribution related to the Mittag-Leffler function, this paper shows that the wave equation corresponding to the multiple relaxation approach is identical to a given fractional derivative wave equation. This work therefore provides a physically based motivation for use of fractional wave equations in acoustic modeling.

Time-reversal multiple signal classification in case of noise: a phase-coherent approach

The problem of locating point-like targets beyond the classical resolution limit is revisited. Although time-reversal MUltiple SIgnal Classification (MUSIC) is known for its super-resolution ability in localization of point scatterers, in the presence of noise this super-resolution property will easily break down. In this paper a phase-coherent version of time-reversal MUSIC is proposed, which can overcome this fundamental limit. The algorithm has been tested employing synthetic multiple scattering data based on the Foldy-Lax model, as well as experimental ultrasound data acquired in a water tank. Using a limited frequency band, it was demonstrated that the phase-coherent MUSIC algorithm has the potential of giving significantly better resolved scatterer locations than standard time-reversal MUSIC.

A causal and fractional all-frequency wave equation for lossy media

This work presents a lossy partial differential acoustic wave equation including fractional derivative terms. It is derived from first principles of physics (mass and momentum conservation) and an equation of state given by the fractional Zener stress-strain constitutive relation. For a derivative order α in the fractional Zener relation, the resulting absorption α(k) obeys frequency power-laws as α(k) ∝ ω(1+α) in a low-frequency regime, α(k) ∝ ω(1-α/2) in an intermediate-frequency regime, and α(k) ∝ ω(1-α) in a high-frequency regime. The value α=1 corresponds to the case of a single relaxation process. The wave equation is causal for all frequencies. In addition the sound speed does not diverge as the frequency approaches infinity. This is an improvement over a previously published wave equation building on the fractional Kelvin-Voigt constitutive relation.

Nicotinamide phosphoribosyltransferase and lipid accumulation in macrophages

BACKGROUND

Accumulation of modified low-density lipoprotein (LDL) in macrophages is a key event in all stages of atherogenesis. We have previously shown increased level of nicotinamide phosphoribosyltransferase (nampt) in symptomatic, compared to asymptomatic, atherosclerotic carotid lesions, primarily located to macrophages. Here we sought to investigate the regulation and effect of intracellular nampt in macrophages.

MATERIALS AND METHODS

The expression of nampt was assessed by real-time PCR in THP-1 cells that was exposed to different pro-atherogenic stimuli. The effect of nampt on lipid accumulation was examined in phorbol myristate acetate-differentiated THP-1 and in primary monocyte-derived macrophages.

RESULTS

Our main findings were: (1) Nampt is increased during macrophage differentiation. (2) Tumor necrosis factor (TNF)α, oxidized (ox)LDL, and hypoxia increased nampt expression in macrophages, with further enhancing effect when these stimuli were combined. The effect of hypoxia seems to involve hypoxia inducing factor 1α. (3) Silencing of nampt increased lipid accumulation in macrophages as shown by increased protein levels of the lipid droplet marker adipose differentiation-related protein (ADRP). (4) A specific inhibitor of nampt enzymatic activity, increased ADRP and cholesterol levels in oxLDL stimulated macrophages, and enhanced the binding of acetylated LDL in these cells. (5). Nampt inhibition decreased the relative amount of cholesterol efflux in oxLDL-exposed macrophages.

CONCLUSIONS

Our data suggest that the regulation of nampt in macrophages is linked to pro-atherogenic stimuli, potentially mediating counteracting effects on lipid accumulation and foam cell formation. These findings suggest a rather complex role of nampt in atherogenesis, potentially mediating both adaptive and maladaptive responses.

Nonlinear acoustic wave equations with fractional loss operators

Fractional derivatives are well suited to describe wave propagation in complex media. When introduced in classical wave equations, they allow a modeling of attenuation and dispersion that better describes sound propagation in biological tissues. Traditional constitutive equations from solid mechanics and heat conduction are modified using fractional derivatives. They are used to derive a nonlinear wave equation which describes attenuation and dispersion laws that match observations. This wave equation is a generalization of the Westervelt equation, and also leads to a fractional version of the Khokhlov-Zabolotskaya-Kuznetsov and Burgers' equations.

Cognitive function in adult offspring of women with Type 1 diabetes

AIMS

Maternal diabetes may affect offspring cognitive function. The objective of the study was to evaluate cognitive function and potential predictors hereof in adult offspring of women with Type 1 diabetes.

METHODS

We conducted a follow-up study of adult offspring of women with Type 1 diabetes (n = 158) and a reference group from the background population (n = 118). The main outcome measure was offspring cognitive function measured by global cognitive score, derived from Raven's Progressive Matrices and three verbal subtests from the Weschler Adult Intelligence Scale.

RESULTS

Offspring of women with Type 1 diabetes obtained lower global cognitive scores (94.8 vs. 100.0, P = 0.004) than offspring from the background population. When adjusted for confounders, the groups no longer differed significantly (difference 0.4, 95% CI -3.3 to 4.). Positive predictors of cognitive function in offspring of women with diabetes were family social class, parental educational level, maternal diabetes duration, male gender and offspring age, whereas parity ≥ 1 and gestational age < 34 weeks were negative predictors. We found no association with maternal glycaemia during pregnancy or with neonatal hypoglycaemia.

CONCLUSIONS

Impaired cognitive function in adult offspring of women with Type 1 diabetes compared with the background population apparently reflects differences with respect to well-known confounders. However, harmful effects of maternal hyperglycaemia may be mediated through delivery at < 34 weeks.

A low-complexity data-dependent beamformer

The classical problem of choosing apodization functions for a beamformer involves a trade-off between main lobe width and side lobe level, i.e., a trade-off between resolution and contrast. To avoid this trade-off, the application of adaptive beamforming, such as minimum variance beamforming, to medical ultrasound imaging has been suggested. This has been an active topic of research in medical ultrasound imaging in the recent years, and several authors have demonstrated significant improvements in image resolution. However, the improvement comes at a considerable cost. Where the complexity of a conventional beamformer is linear with the number of elements [O(M)], the complexity of a minimum variance beamformer is as high as O(M³). In this paper, we have applied a method based on an idea by Vignon and Burcher which is data-adaptive, but selects the apodization function between several predefined windows, giving linear complexity. In the proposed method, we select an apodization function for each depth along a scan line based on the optimality criterion of the minimum variance beamformer. However, unlike the minimum variance beamformer, which has an infinite solution space, we limit the number of possible outcomes to a set of predefined windows. The complexity of the method is then only P times that of the conventional method, where P is the number of predefined windows. The suggested method gives significant improvement in image resolution at a low cost. The method is robust, can handle coherent targets, and is easy to implement. It may also be used as a classifier because the selected window gives information about the object being imaged. We have applied the method to simulated data of wire targets and a cyst phantom, and to experimental RF data from a heart phantom using P = 4 and P = 12. The results show significant improvement in image resolution compared with delay-and-sum.

Low sidelobe limited diffraction beams in the nonlinear regime

In linear propagation, sidelobe levels of Bessel limited diffraction beams are only about 8 dB down relative to the mainlobe. In the nonlinear regime, these beams will have a region near the source where the side-lobe level of the second harmonic is 16 dB down, but this region has usually been considered to be so small that it is of little practical interest. In this paper it is shown that when there are only 1 to 3 sidelobes in a finite aperture Bessel beam, the second harmonic field will have low sidelobes for distances up to half of the depth of field. This result is backed up by simulations. In a medium with absorption, previous theory has shown that the sidelobes of the Bessel beam will also be reduced but only for absorption that was too high to be of practical use. Simulations presented here show that for breast tissue, which only has about 10% of the absorption of previous criteria, one will still get sidelobes which are comparable to that of a rectangular aperture even when the sidelobes would be high in a non-absorbing medium.