Functional ultrasound imaging of intrinsic connectivity in the living rat brain with high spatiotemporal resolution

Functional Ultrasound Speckle Decorrelation-Based Velocimetry of the Brain

A high-speed, contrast-free, quantitative ultrasound velocimetry (vUS) for blood flow velocity imaging throughout the rodent brain is developed based on the normalized first-order temporal autocorrelation function of the ultrasound field signal. vUS is able to quantify blood flow velocity in both transverse and axial directions, and is validated with numerical simulation, phantom experiments, and in vivo measurements. The functional imaging ability of vUS is demonstrated by monitoring the blood flow velocity changes during whisker stimulation in awake mice. Compared to existing Power-Doppler- and Color-Doppler-based functional ultrasound imaging techniques, vUS shows quantitative accuracy in estimating both axial and transverse flow speeds and resistance to acoustic attenuation and high-frequency noise.

A Review of Acoustic Impedance Matching Techniques for Piezoelectric Sensors and Transducers

The coupling of waves between the piezoelectric generators, detectors, and propagating media is challenging due to mismatch in the acoustic properties. The mismatch leads to the reverberation of waves within the transducer, heating, low signal-to-noise ratio, and signal distortion. Acoustic impedance matching increases the coupling largely. This article presents standard methods to match the acoustic impedance of the piezoelectric sensors, actuators, and transducers with the surrounding wave propagation media. Acoustic matching methods utilizing active and passive materials have been discussed. Special materials such as nanocomposites, metamaterials, and metasurfaces as emerging materials have been presented. Emphasis is placed throughout the article to differentiate the difference between electric and acoustic impedance matching and the relation between the two. Comparison of various techniques is made with the discussion on capabilities, advantages, and disadvantages. Acoustic impedance matching for specific and uncommon applications has also been covered.

Functional imaging evidence for task-induced deactivation and disconnection of a major default mode network hub in the mouse brain

The default mode network (DMN) has been defined in functional brain imaging studies as a set of highly connected brain areas, which are active during wakeful rest and inactivated during task-based stimulation. DMN function is characteristically impaired in major neuropsychiatric diseases, emphasizing its interest for translational research. However, in the mouse, a major preclinical rodent model, there is still no functional imaging evidence supporting DMN deactivation and deconnection during high-demanding cognitive/sensory tasks. Here we have developed functional ultrasound (fUS) imaging to properly visualize both activation levels and functional connectivity patterns, in head-restrained awake and behaving mice, and investigated their modulation during a sensory-task, whisker stimulation. We identified reproducible and highly symmetric resting-state networks, with overall connectivity strength directly proportional to the wakefulness level of the animal. We show that unilateral whisker stimulation leads to the expected activation of the contralateral barrel cortex in lightly sedated mice, while interhemispheric inhibition reduces activity in the ipsilateral barrel cortex. Whisker stimulation also leads to elevated bilateral connectivity in the hippocampus. Importantly, in addition to functional changes in these major hubs of tactile information processing, whisker stimulation during genuine awake resting-state periods leads to highly specific reductions both in activation and interhemispheric correlation within the restrosplenial cortex, a major hub of the DMN. These results validate an imaging technique for the study of activation and connectivity in the lightly sedated awake mouse brain and provide evidence supporting an evolutionary preserved function of the DMN, putatively improving translational relevance of preclinical models of neuropsychiatric diseases.

Ultrafast ultrasound imaging pattern analysis reveals distinctive dynamic brain states and potent sub-network alterations in arthritic animals

Chronic pain pathologies, which are due to maladaptive changes in the peripheral and/or central nervous systems, are debilitating diseases that affect 20% of the European adult population. A better understanding of the mechanisms underlying this pathogenesis would facilitate the identification of novel therapeutic targets. Functional connectivity (FC) extracted from coherent low-frequency hemodynamic fluctuations among cerebral networks has recently brought light on a powerful approach to study large scale brain networks and their disruptions in neurological/psychiatric disorders. Analysis of FC is classically performed on averaged signals over time, but recently, the analysis of the dynamics of FC has also provided new promising information. Keeping in mind the limitations of animal models of persistent pain but also the powerful tool they represent to improve our understanding of the neurobiological basis of chronic pain pathogenicity, this study aimed at defining the alterations in functional connectivity, in a clinically relevant animal model of sustained inflammatory pain (Adjuvant-induced Arthritis) in rats by using functional ultrasound imaging, a neuroimaging technique with a unique spatiotemporal resolution (100 μm and 2 ms) and sensitivity. Our results show profound alterations of FC in arthritic animals, such as a subpart of the somatomotor (SM) network, occurring several weeks after the beginning of the disease. Also, we demonstrate for the first time that dynamic functional connectivity assessed by ultrasound can provide quantitative and robust information on the dynamic pattern that we define as brain states. While the main state consists of an overall synchrony of hemodynamic fluctuations in the SM network, arthritic animal spend statistically more time in two other states, where the fluctuations of the primary sensory cortex of the inflamed hind paws show asynchrony with the rest of the SM network. Finally, correlating FC changes with pain behavior in individual animals suggest links between FC alterations and either the cognitive or the emotional aspects of pain. Our study introduces fUS as a new translational tool for the enhanced understanding of the dynamic pain connectome and brain plasticity in a major preclinical model of chronic pain.

Functional ultrasound imaging of deep visual cortex in awake nonhuman primates

Nowadays, several techniques exist to study and better understand how the brain works (fMRI, EEG, electrophysiology, etc.). Each has its own advantages and disadvantages (spatiotemporal resolution, maximal recording depth, signal-to-noise ratio, etc.). In this article, we show that the new functional ultrasound (fUS) imaging technique is appropriate to record and map brain activity in awake primates on a scale previously unreachable. It allows distinguishing patterns similar to ocular dominance bands in the visual cortex through all layers of the cortex, which was impossible before with common techniques. This paper demonstrates the utility of fUS imaging for studying brain activity in awake primates and its interest to all neuroscientists.

Deep regions of the brain are not easily accessible to investigation at the mesoscale level in awake animals or humans. We have recently developed a functional ultrasound (fUS) technique that enables imaging hemodynamic responses to visual tasks. Using fUS imaging on two awake nonhuman primates performing a passive fixation task, we constructed retinotopic maps at depth in the visual cortex (V1, V2, and V3) in the calcarine and lunate sulci. The maps could be acquired in a single-hour session with relatively few presentations of the stimuli. The spatial resolution of the technology is illustrated by mapping patterns similar to ocular dominance (OD) columns within superficial and deep layers of the primary visual cortex. These acquisitions using fUS suggested that OD selectivity is mostly present in layer IV but with extensions into layers II/III and V. This imaging technology provides a new mesoscale approach to the mapping of brain activity at high spatiotemporal resolution in awake subjects within the whole depth of the cortex.

Spatial and Spectral Mapping and Decomposition of Neural Dynamics and Organization of the Mouse Brain with Multispectral Optoacoustic Tomography

In traditional optical imaging, limited light penetration constrains high-resolution interrogation to tissue surfaces. Optoacoustic imaging combines the superb contrast of optical imaging with deep penetration of ultrasound, enabling a range of new applications. We used multispectral optoacoustic tomography (MSOT) for functional and structural neuroimaging in mice at resolution, depth, and specificity unattainable by other neuroimaging modalities. Based on multispectral readouts, we computed hemoglobin gradient and oxygen saturation changes related to processing of somatosensory signals in different structures along the entire subcortical-cortical axis. Using temporal correlation analysis and seed-based maps, we reveal the connectivity between cortical, thalamic, and sub-thalamic formations. With the same modality, high-resolution structural tomography of intact mouse brain was achieved based on endogenous contrasts, demonstrating near-perfect matches with anatomical features revealed by histology. These results extend the limits of noninvasive observations beyond the reach of standard high-resolution neuroimaging, verifying the suitability of MSOT for small-animal studies.

4D Functional Imaging of the Rat Brain Using a Large Aperture Row-Column Array

Functional ultrasound imaging (fUS) recently emerged as a promising neuroimaging modality to image and monitor brain activity based on cerebral blood volume response (CBV) and neurovascular coupling. fUS offers very good spatial and temporal resolutions compared to fMRI gold standard as well as simplicity and portability. It was recently extended to 4D fUS imaging in preclinical settings although this approach remains limited and complex. Indeed 4D fUS requires a 2D matrix probe and specific hardware able to drive the N² elements of the probe with thousands of electronic channels. Several under-sampling approaches are currently investigated to limit the channel count and spread ultrasound 4D modalities. Among them, the Row Column Addressing (RCA) approach combined with ultrafast imaging is a compelling alternative using only N + N channels. We present a large field of view RCA probe prototype of 128 + 128 channels and 15 MHz central frequency adapted for preclinical imaging. Based on the Orthogonal Plane Wave compounding scheme, we were able to perform 4D vascular brain acquisitions at high volume rate. Doppler volumes of the whole rat brain were obtained in vivo at high rates (23 dB CNR at 156 Hz and 19 dB CNR at 313 Hz). Visual and whiskers stimulations were performed and the corresponding CBV increases were reconstructed in 3D with successful functional activation detected in the superior colliculus and somato-sensorial cortex respectively. This proof of concept study demonstrates for the first time the use of a low-channel count RCA array for in vivo 4D fUS imaging in the whole rat brain.

From Light to Sound: Photoacoustic and Ultrasound Imaging in Fundamental Research of Alzheimer's Disease

Alzheimer's disease (AD) causes severe cognitive dysfunction and has long been studied for the underlining physiological and pathological mechanisms. Several biomedical imaging modalities have been applied, including MRI, PET, and high-resolution optical microscopy, for research purposes. However, there is still a strong need for imaging tools that can provide high spatiotemporal resolutions with relatively deep penetration to enhance our understanding of AD pathology and monitor treatment progress in fundamental research. Photoacoustic (PA) imaging and ultrasound (US) imaging can potentially address these unmet needs in AD research. PA imaging provides functional information with endogenous and/or exogenous contrast, while US imaging provides structural information. Recent studies have demonstrated the ability to monitor physiological parameters in small-animal brains with PA and US imaging as well as the feasibility of using US imaging as a therapeutic tool for AD. This concise review aims to introduce recent advances in AD research using PA and US imaging, provide the fundamentals, and discuss the potentials and challenges for future advances.

Functional Ultrasound (fUS) During Awake Brain Surgery: The Clinical Potential of Intra-Operative Functional and Vascular Brain Mapping

Background and Purpose

Oncological neurosurgery relies heavily on making continuous, intra-operative tumor-brain delineations based on image-guidance. Limitations of currently available imaging techniques call for the development of real-time image-guided resection tools, which allow for reliable functional and anatomical information in an intra-operative setting. Functional ultrasound (fUS), is a new mobile neuro-imaging tool with unprecedented spatiotemporal resolution, which allows for the detection of small changes in blood dynamics that reflect changes in metabolic activity of activated neurons through neurovascular coupling. We have applied fUS during conventional awake brain surgery to determine its clinical potential for both intra-operative functional and vascular brain mapping, with the ultimate aim of achieving maximum safe tumor resection.

Methods

During awake brain surgery, fUS was used to image tumor vasculature and task-evoked brain activation with electrocortical stimulation mapping (ESM) as a gold standard. For functional imaging, patients were presented with motor, language or visual tasks, while the probe was placed over (ESM-defined) functional brain areas. For tumor vascular imaging, tumor tissue (pre-resection) and tumor resection cavity (post-resection) were imaged by moving the hand-held probe along a continuous trajectory over the regions of interest.

Results

A total of 10 patients were included, with predominantly intra-parenchymal frontal and temporal lobe tumors of both low and higher histopathological grades. fUS was able to detect (ESM-defined) functional areas deep inside the brain for a range of functional tasks including language processing. Brain tissue could be imaged at a spatial and temporal resolution of 300 μm and 1.5-2.0 ms respectively, revealing real-time tumor-specific, and healthy vascular characteristics.

Conclusion

The current study presents the potential of applying fUS during awake brain surgery. We illustrate the relevance of fUS for awake brain surgery based on its ability to capture both task-evoked functional cortical responses as well as differences in vascular characteristics between tumor and healthy tissue. As current neurosurgical practice is still pre-dominantly leaning on inherently limited pre-operative imaging techniques for tumor resection-guidance, fUS enters the scene as a promising alternative that is both anatomically and physiologically informative.

Adaptive background noise bias suppression in contrast-free ultrasound microvascular imaging

Non-invasive, contrast-free imaging of small vessel blood flow is diagnostically invaluable for detection, diagnosis and monitoring of disease. Recent advances in ultrafast imaging and tissue clutter-filtering have considerably improved the sensitivity of power Doppler (PD) imaging in detecting small vessel blood flow. However, suppression of tissue clutter exposes the depth-dependent time-gain compensated noise bias that noticeably degrades the PD image. We hypothesized that background suppression of PD images based on noise bias estimated from the entire clutter-filtered singular value spectrum can considerably improve flow signal visualization compared to currently existing techniques. To test our hypothesis, in vivo experiments were conducted on suspicious breast lesions in 10 subjects and deep-seated hepatic and renal microvasculatures in four healthy volunteers. Ultrasound PD images were acquired using a clinical ultrasound scanner, implemented with compounded plane wave imaging. The time gain compensated noise field was computed from the clutter-filtered Doppler ensemble (CFDE) based on its local spatio-temporal correlation, combined with low-rank signal estimation. Subsequently, the background bias in the PD images was suppressed by subtracting the estimated noise field. Background-suppressed PD images obtained using the proposed technique substantially improved visualization of the blood flow signal. The background bias in the noise suppressed PD images varied  <0.6 dB, independent of depth, which otherwise increased up to 13.8 dB. Further, the results demonstrated that the proposed technique efficaciously suppressed the background noise bias associated with smaller Doppler ensembles, which are challenging due to increased overlap between blood flow and noise components in the singular value spectrum. These preliminary results demonstrate the utility of the proposed technique to improve the visualization of small vessel blood flow in contrast-free PD images. The results of this feasibility study were encouraging, and warrant further development and additional in vivo validation.

Motor cortex neurovascular coupling: inputs from ultra-high-frequency ultrasound imaging in humans

OBJECTIVE

Neurovascular coupling reflects the link between neural activity and changes in cerebral blood flow. Despite many technical advances in functional exploration of the brain, including functional MRI, there are only a few reports of direct evidence of neurovascular coupling in humans. The authors aimed to explore, for the first time in humans, the local cerebral blood flow of the primary motor cortex using ultra-high-frequency ultrasound (UHF-US) Doppler imaging to detect low blood flow velocity (1 mm/sec).

METHODS

Four consecutive patients underwent awake craniotomy for glioma resection using cortical direct electrostimulation for brain mapping. The primary motor cortical area eliciting flexion of the contralateral forearm was identified. UHF-US color Doppler imaging of this cortical area was acquired at rest, during repeated spontaneous forearm flexion, and immediately after the movement's termination. In each condition, the surface areas of the detectable vessels were measured after extraction of non-zero-velocity colored pixels and summed.

RESULTS

During movement, local cerebral blood flow increased significantly by 14.4% (range 5%-30%) compared with baseline. Immediately after the termination of movements, the local hyperemia decreased significantly by 8.6% (range 1.9%-15.7%).

CONCLUSIONS

To the authors' knowledge, this study is the first to provide a real-time demonstration of the neurovascular coupling in the human cortex by ultrasound imaging. They assume that UHF-US may be used to gather original and advanced data on brain functioning, which could be used to help in the identification of functional cortical areas during brain surgery.Clinical trial registration no.: NCT03179176 (clinicaltrials.gov).

Wide Field-of-View Ultrafast Curved Array Imaging Using Diverging Waves

Ultrafast ultrasound imaging provides great opportunities for very high frame rate applications, such as shear wave elastography and microvascular imaging. However, ultrafast imaging with curved array transducers remains challenging in terms of element directivity and a limited field-of-view (FOV) for a fully synthetic area. In this paper, a wide FOV ultrafast curved array imaging method based on diverging wave transmissions is presented for high frame rate abdominal ultrasound applications. For this method, a theoretical model for a diverging wave solution based on a virtual point source originating from a circular line is proposed, and the FOV and element directivity are analyzed by this model. Furthermore, an integrated model for plane wave and diverging wave imaging along the location of the virtual point source is derived. The proposed method was evaluated with simulation, phantom, and in vivo studies. In the simulation and phantom studies, the image quality (i.e., spatial resolution, cystic resolution, and contrast-to-noise ratio), and effective FOV were assessed. For the in vivo study, a preliminary result from abdominal microvascular imaging, where diverging wave excitation was utilized to depict the vasculature, was also presented. In the renal cortex microvessels, the diverging wave imaging yielded a higher signal-to-clutter ratio value than the plane wave imaging, i.e., 6.35 vs. 4.26 dB, due to the wider synthetic field. These studies demonstrated that the proposed ultrafast curved array imaging technique based on diverging wave excitation allowed for an extended FOV with high spatiotemporal resolution.

4D functional ultrasound imaging of whole-brain activity in rodents

We extended the capabilities of functional ultrasound to whole-brain four-dimensional (4D) neuroimaging. Our multiplane-wave transmission scheme on matrix arrays at thousands of frames per second provides volumetric recordings of cerebral blood volume changes at high spatiotemporal resolution. We illustrated the approach in rats while providing multiple sensory stimuli, for 4D functional connectivity and during instantaneous tracking of epileptiform events.

Debiasing-Based Noise Suppression for Ultrafast Ultrasound Microvessel Imaging

Ultrasound microvessel imaging (UMI) based on the combination of singular value decomposition (SVD) clutter filtering and ultrafast plane wave imaging has recently demonstrated significantly improved Doppler sensitivity, especially to small vessels that are invisible to conventional Doppler imaging. Practical implementation of UMI is hindered by the high computational cost associated with SVD and low blood signal-to-noise ratio (SNR) in deep regions of the tissue due to the lack of transmit focusing of plane waves. Concerning the high computational cost, an accelerated SVD clutter filtering method based on randomized SVD (rSVD) and randomized spatial downsampling (rSD) was recently proposed by our group, which showed the feasibility of real-time implementation of UMI. Concerning the low blood flow SNR in deep imaging regions, here we propose a noise suppression method based on noise debiasing that can be easily applied to the accelerated SVD method to bridge the gap between real-time implementation and high imaging quality. The proposed method experimentally measures the noise-induced bias by collecting the noise signal using the identical imaging sequence as regular UMI, but with the ultrasound transmission turned off. The estimated bias can then be subtracted from the original power Doppler (PD) image to obtain effective noise suppression. The feasibility of the proposed method was validated under different ultrasound imaging parameters [including transmitting voltages and time-gain compensation (TGC) settings] with a phantom experiment. The noise-debiased images showed an increase of up to 15.3 and 13.4 dB in SNR as compared to original PD images on the blood flow phantom and an in vivo human kidney data set, respectively. The proposed noise suppression method has negligible computational cost and can be conveniently combined with the previously proposed accelerated SVD clutter filtering technique to achieve high quality, real-time UMI imaging.

Functional ultrasound imaging of the brain reveals propagation of task-related brain activity in behaving primates

Neuroimaging modalities such as MRI and EEG are able to record from the whole brain, but this comes at the price of either limited spatiotemporal resolution or limited sensitivity. Here, we show that functional ultrasound imaging (fUS) of the brain is able to assess local changes in cerebral blood volume during cognitive tasks, with sufficient temporal resolution to measure the directional propagation of signals. In two macaques, we observed an abrupt transient change in supplementary eye field (SEF) activity when animals were required to modify their behaviour associated with a change of saccade tasks. SEF activation could be observed in a single trial, without averaging. Simultaneous imaging of anterior cingulate cortex and SEF revealed a time delay in the directional functional connectivity of 0.27 ± 0.07 s and 0.9 ± 0.2 s for both animals. Cerebral hemodynamics of large brain areas can be measured at high spatiotemporal resolution using fUS.

Neuroimaging modalities such as MRI and EEG are able to record brain activity, but spatiotemporal resolution and sensitivity are limited. Here, the authors show how a recently developed method, functional ultrasound imaging (fUS), can measure brain activation during cognitive tasks in primates.

Functional Ultrasound Imaging of Spinal Cord Hemodynamic Responses to Epidural Electrical Stimulation: A Feasibility Study

This study presents the first implementation of functional ultrasound (fUS) imaging of the spinal cord to monitor local hemodynamic response to epidural electrical spinal cord stimulation (SCS) on two small and large animal models. SCS has been successfully applied to control chronic refractory pain and recently was evolved to alleviate motor impairment in Parkinson's disease and after spinal cord injury. At present, however, the mechanisms underlying SCS remain unclear, and current methods for monitoring SCS are limited in their capacity to provide the required sensitivity and spatiotemporal resolutions to evaluate functional changes in response to SCS. fUS is an emerging technology that has recently shown promising results in monitoring a variety of neural activities associated with the brain. Here we demonstrated the feasibility of performing fUS on two animal models during SCS. We showed in vivo spinal cord hemodynamic responses measured by fUS evoked by different SCS parameters. We also demonstrated that fUS has a higher sensitivity in monitoring spinal cord response than electromyography. The high spatial and temporal resolutions of fUS were demonstrated by localized measurements of hemodynamic responses at different spinal cord segments, and by reliable tracking of spinal cord responses to patterned electrical stimulations, respectively. Finally, we proposed optimized fUS imaging and post-processing methods for spinal cord. These results support feasibility of fUS imaging of the spinal cord and could pave the way for future systematic studies to investigate spinal cord functional organization and the mechanisms of spinal cord neuromodulation in vivo.

Evaluation of Brain Tumor in Small Animals Using Plane Wave-Based Power Doppler Imaging

Precisely evaluating the characteristics of a glioma tumor in vivo is challenging when performing surgical resection clinically. The infiltration characteristics of a tumor make precise resection difficult because of uncertainties about the surrounding vasculature and the relationships with functional structures. Magnetic resonance imaging is routinely used to distinguish the area of a glioma, but it cannot resolve details of the vascular network around or inside the tumor. Ultrasound imaging is a real-time imaging modality that has been applied clinically in intra-operative surgery, and the sensitivity of flow measurements in the brain is improved by ultrafast plane wave imaging. This study applies a plane wave-based power Doppler imaging method to visualize the blood flow distribution in glioma models in vivo. This new imaging method makes it possible to delineate the flow structure of a glioma tumor in the brain of a small animal. The tumor can be distinguished from normal brain tissue, and different sections of the tumor contain different flow structures. The normalized blood flow intensities (mean ± standard deviation) within regions of interest were 0.33 ± 0.13, 0.72 ± 0.15, 0.36 ± 0.23 and 0.06 ± 0.07 for the type I normal rat, type I glioma rat, type II normal rat and type II glioma rat, respectively. Quantification analysis verified the feasibility of using this plane wave-based Doppler imaging method to evaluate brain tumors in small animals.

High Frame Rate Ultrasound Particle Image Velocimetry for Estimating High Velocity Flow Patterns in the Left Ventricle

Echocardiographic determination of multicomponent blood flow dynamics in the left ventricle remains a challenge. In this paper, we compare contrast enhanced, high frame rate (HFR) (1000 frames/s) echo-particle image velocimetry (ePIV) against optical particle image velocimetry (oPIV, gold standard), in a realistic left ventricular (LV) phantom. We find that ePIV compares well to oPIV, even for the high velocity inflow jet (normalized RMSE = 9% ± 1%). In addition, we perform the method of proper orthogonal decomposition, to better qualify and quantify the differences between the two modalities. We show that ePIV and oPIV resolve very similar flow structures, especially for the lowest order mode with a cosine similarity index of 86%. The coarser resolution of ePIV does result in increased variance and blurring of smaller flow structures when compared to oPIV. However, both modalities are in good agreement with each other for the modes that constitute the bulk of the kinetic energy. We conclude that HFR ePIV can accurately estimate the high velocity diastolic inflow jet and the high energy flow structures in an LV setting.

3D functional ultrasound imaging of pigeons

Recent advances in ultrasound Doppler imaging have facilitated the technique of functional ultrasound (fUS) which enables visualization of brain-activity due to neurovascular coupling. As of yet, this technique has been applied to rodents as well as to human subjects during awake craniotomy surgery and human newborns. Here we demonstrate the first successful fUS studies on awake pigeons subjected to auditory and visual stimulation. To allow successful fUS on pigeons we improved the temporal resolution of fUS up to 20,000 frames per second with real-time visualization and continuous recording. We show that this gain in temporal resolution significantly increases the sensitivity for detecting small fluctuations in cerebral blood flow and volume which may reflect increased local neural activity. Through this increased sensitivity we were able to capture the elaborate 3D neural activity pattern evoked by a complex stimulation pattern, such as a moving light source. By pushing the limits of fUS further, we have reaffirmed the enormous potential of this technique as a new standard in functional brain imaging with the capacity to unravel unknown, stimulus related hemodynamics with excellent spatiotemporal resolution with a wide field of view.

Adaptive Spatiotemporal SVD Clutter Filtering for Ultrafast Doppler Imaging Using Similarity of Spatial Singular Vectors

Singular value decomposition of ultrafast imaging ultrasonic data sets has recently been shown to build a vector basis far more adapted to the discrimination of tissue and blood flow than the classical Fourier basis, improving by large factor clutter filtering and blood flow estimation. However, the question of optimally estimating the boundary between the tissue subspace and the blood flow subspace remained unanswered. Here, we introduce an efficient estimator for automatic thresholding of subspaces and compare it to an exhaustive list of thirteen estimators that could achieve this task based on the main characteristics of the singular components, namely the singular values, the temporal singular vectors, and the spatial singular vectors. The performance of those fourteen estimators was tested in vitro in a large set of controlled experimental conditions with different tissue motion and flow speeds on a phantom. The estimator based on the degree of resemblance of spatial singular vectors outperformed all others. Apart from solving the thresholding problem, the additional benefit with this estimator was its denoising capabilities, strongly increasing the contrast to noise ratio and lowering the noise floor by at least 5 dB. This confirms that, contrary to conventional clutter filtering techniques that are almost exclusively based on temporal characteristics, efficient clutter filtering of ultrafast Doppler imaging cannot overlook space. Finally, this estimator was applied in vivo on various organs (human brain, kidney, carotid, and thyroid) and showed efficient clutter filtering and noise suppression, improving largely the dynamic range of the obtained ultrafast power Doppler images.

Multi-scale mapping along the auditory hierarchy using high-resolution functional UltraSound in the awake ferret

A major challenge in neuroscience is to longitudinally monitor whole brain activity across multiple spatial scales in the same animal. Functional UltraSound (fUS) is an emerging technology that offers images of cerebral blood volume over large brain portions. Here we show for the first time its capability to resolve the functional organization of sensory systems at multiple scales in awake animals, both within small structures by precisely mapping and differentiating sensory responses, and between structures by elucidating the connectivity scheme of top-down projections. We demonstrate that fUS provides stable (over days), yet rapid, highly-resolved 3D tonotopic maps in the auditory pathway of awake ferrets, thus revealing its unprecedented functional resolution (100/300µm). This was performed in four different brain regions, including very small (1-2 mm3 size), deeply situated subcortical (8 mm deep) and previously undescribed structures in the ferret. Furthermore, we used fUS to map long-distance projections from frontal cortex, a key source of sensory response modulation, to auditory cortex.

Neonatal brain resting-state functional connectivity imaging modalities

Infancy is the most critical period in human brain development. Studies demonstrate that subtle brain abnormalities during this state of life may greatly affect the developmental processes of the newborn infants. One of the rapidly developing methods for early characterization of abnormal brain development is functional connectivity of the brain at rest. While the majority of resting-state studies have been conducted using magnetic resonance imaging (MRI), there is clear evidence that resting-state functional connectivity (rs-FC) can also be evaluated using other imaging modalities. The aim of this review is to compare the advantages and limitations of different modalities used for the mapping of infants' brain functional connectivity at rest. In addition, we introduce photoacoustic tomography, a novel functional neuroimaging modality, as a complementary modality for functional mapping of infants' brain.

Functional ultrasound neuroimaging: a review of the preclinical and clinical state of the art

In the last decade, ultrasound imaging has gained new capabilities and produced new insights in the field of neuroscience. The development of new concepts, such as ultrafast ultrasound, has enhanced Doppler sensitivity by orders of magnitude and has paved the way for ultrasonic functional neuroimaging. In this review, we position ultrasound in the field of neuroimaging and discuss how it complements current tools available to neurobiologists and clinicians.

Simultaneous positron emission tomography and ultrafast ultrasound for hybrid molecular, anatomical and functional imaging

Positron emission tomography-computed tomography (PET-CT) is the most sensitive molecular imaging modality, but it does not easily allow for rapid temporal acquisition. Ultrafast ultrasound imaging (UUI)-a recently introduced technology based on ultrasonic holography-leverages frame rates of up to several thousand images per second to quantitatively map, at high resolution, haemodynamic, biomechanical, electrophysiological and structural parameters. Here, we describe a pre-clinical scanner that registers PET-CT and UUI volumes acquired simultaneously and offers multiple combinations for imaging. We demonstrate that PET-CT-UUI allows for simultaneous images of the vasculature and metabolism during tumour growth in mice and rats, as well as for synchronized multi-modal cardiac cine-loops. Combined anatomical, functional and molecular imaging with PET-CT-UUI represents a high-performance and clinically translatable technology for biomedical research.

High-resolution deep functional imaging of the whole mouse brain by photoacoustic computed tomography in vivo

Photoacoustic computed tomography (PACT) is a non-invasive imaging technique offering high contrast, high resolution, and deep penetration in biological tissues. We report a PACT system equipped with a high frequency linear transducer array for mapping the microvascular network of a whole mouse brain with the skull intact and studying its hemodynamic activities. The linear array was scanned in the coronal plane to collect data from different angles, and full-view images were synthesized from the limited-view images in which vessels were only partially revealed. We investigated spontaneous neural activities in the deep brain by monitoring the concentration of hemoglobin in the blood vessels and observed strong interhemispherical correlations between several chosen functional regions, both in the cortical layer and in the deep regions. We also studied neural activities during an epileptic seizure and observed the epileptic wave spreading around the injection site and the wave propagating in the opposite hemisphere.

Hemispherical photoacoustic imaging of myocardial infarction: in vivo detection and monitoring

OBJECTIVES

This study aimed to demonstrate the capacity for noninvasive localisation and characterisation of myocardial infarction (MI) in vivo using a hemispherical photoacoustic imaging (PAI) system. MI remains a leading cause of morbidity and mortality worldwide. To enable optimal treatment of patients, timely and accurate diagnosis and longitudinal monitoring is critical.

METHODS

Ischaemia was induced in Balb/c mice by ligation of the left anterior descending artery. The hemispherical PAI system, equipped with 128 ultrasonic transducers spirally distributed on the surface, along with parallel data acquisition, was applied for imaging of the mouse heart.

RESULTS

Our study showed that hemispherical PAI can delineate thoracic vessels and the morphology of the entire heart. Longitudinal PAI images revealed gradual expansion of the infarcted area along with necrosis and fibrosis, which were quantitatively validated by triphenyltetrazolium chloride staining. After MI modelling, the photoacoustic (PA) signal intensity decreased by 399.1 ± 56.3 (p < 0.001), a ~2.5-fold reduction compared to that of healthy cardiac tissue. The calculated size of the enlarged heart, 10.4 ± 6.0 mm² (p < 0.001), represents an increase of ~18% versus that of a healthy heart.

CONCLUSIONS

PAI enables MI diagnosis and injury localisation with its capabilities for both deep organ imaging and lesion region differentiation.

KEY POINTS

• Photoacoustic imaging (PAI), combining optical absorption and ultrasonic resolution, can delineate cardiac anatomy. • PAI can diagnose myocardial infarction lesions with 10 mm imaging depth in vivo. • Quantified results are in excellent agreement with enzyme and histological examinations. • PAI can serve as a complementary modality to SPECT and ultrasound imaging. • This study will encourage further PAI development for clinical use.

Noise Equalization for Ultrafast Plane Wave Microvessel Imaging

Ultrafast plane wave microvessel imaging significantly improves ultrasound Doppler sensitivity by increasing the number of Doppler ensembles that can be collected within a short period of time. The rich spatiotemporal plane wave data also enable more robust clutter filtering based on singular value decomposition. However, due to the lack of transmit focusing, plane wave microvessel imaging is very susceptible to noise. This paper was designed to: 1) study the relationship between ultrasound system noise (primarily time gain compensation induced) and microvessel blood flow signal and 2) propose an adaptive and computationally cost-effective noise equalization method that is independent of hardware or software imaging settings to improve microvessel image quality.

Architecture of an Ultrasound System for Continuous Real-Time High Frame Rate Imaging

High frame rate (HFR) imaging methods based on the transmission of defocused or plane waves rather than focused beams are increasingly popular. However, the production of HFR images poses severe requirements both in the transmission and the reception sections of ultrasound scanners. In particular, major technical difficulties arise if the images must be continuously produced in real-time, i.e., without any acquisition interruption nor loss of data. This paper presents the implementation of the real-time HFR-compounded imaging application in the ULA-OP 256 research platform. The beamformer sustains an average output sample rate of 470 MSPS. This allows continuously producing coherently compounded images, each of 64 lines by 1280 depths (here corresponding to 15.7 mm width and 45 mm depth, respectively), at frame rates up to 5.3 kHz. Imaging tests addressed to evaluate the achievable speed and quality performance were conducted on phantom. Results obtained by real-time compounding frames obtained with different numbers of steering angles between +7.5° and -7.5° are presented.

Transcranial Functional Ultrasound Imaging in Freely Moving Awake Mice and Anesthetized Young Rats without Contrast Agent

Functional ultrasound (fUS) imaging by ultrasensitive Doppler detection of blood volume was previously reported to measure adult rat brain activation and functional connectivity with unmatched spatiotemporal sampling (100 μm, 1 ms), but skull-induced attenuation of ultrasonic waves imposed skull surgery or contrast agent use. Also, fUS feasibility remains to be validated in mice, a major pre-clinical model organism. In the study described here, we performed full-depth ultrasensitive Doppler imaging and 3-D Doppler tomography of the entire mouse brain under anesthesia, non-invasively through the intact skull and skin, without contrast agents. Similar results were obtained in anesthetized young rats up to postnatal day 35, thus enabling longitudinal studies on postnatal brain development. Using a newly developed ultralight ultrasonic probe and an optimized ultrasonic sequence, we also performed minimally invasive full-transcranial fUS imaging of brain vasculature and whisker stimulation-induced barrel cortex activation in awake and freely moving mice, validating transcranial fUS for brain imaging, without anesthesia-induced bias, for behavioral studies.

Single-impulse Panoramic Photoacoustic Computed Tomography of Small-animal Whole-body Dynamics at High Spatiotemporal Resolution

Imaging of small animals has played an indispensable role in preclinical research by providing high dimensional physiological, pathological, and phenotypic insights with clinical relevance. Yet pure optical imaging suffers from either shallow penetration (up to ~1-2 mm) or a poor depth-to-resolution ratio (~1/3), and non-optical techniques for whole-body imaging of small animals lack either spatiotemporal resolution or functional contrast. Here, we demonstrate that standalone single-impulse photoacoustic computed tomography (SIP-PACT) mitigates these limitations by combining high spatiotemporal resolution (125-µm in-plane resolution, 50 µs / frame data acquisition and 50-Hz frame rate), deep penetration (48-mm cross-sectional width in vivo), anatomical, dynamical and functional contrasts, and full-view fidelity. By using SIP-PACT, we imaged in vivo whole-body dynamics of small animals in real time and obtained clear sub-organ anatomical and functional details. We tracked unlabeled circulating melanoma cells and imaged the vasculature and functional connectivity of whole rat brains. SIP-PACT holds great potential for both pre-clinical imaging and clinical translation.

Advanced optoacoustic methods for multiscale imaging of in vivo dynamics

Visualization of dynamic functional and molecular events in an unperturbed in vivo environment is essential for understanding the complex biology of living organisms and of disease state and progression. To this end, optoacoustic (photoacoustic) sensing and imaging have demonstrated the exclusive capacity to maintain excellent optical contrast and high resolution in deep-tissue observations, far beyond the penetration limits of modern microscopy. Yet, the time domain is paramount for the observation and study of complex biological interactions that may be invisible in single snapshots of living systems. This review focuses on the recent advances in optoacoustic imaging assisted by smart molecular labeling and dynamic contrast enhancement approaches that enable new types of multiscale dynamic observations not attainable with other bio-imaging modalities. A wealth of investigated new research topics and clinical applications is further discussed, including imaging of large-scale brain activity patterns, volumetric visualization of moving organs and contrast agent kinetics, molecular imaging using targeted and genetically expressed labels, as well as three-dimensional handheld diagnostics of human subjects.

Accelerated Singular Value-Based Ultrasound Blood Flow Clutter Filtering With Randomized Singular Value Decomposition and Randomized Spatial Downsampling

Singular value decomposition (SVD)-based ultrasound blood flow clutter filters have recently demonstrated substantial improvement in clutter rejection for ultrafast plane wave microvessel imaging, and have become the commonly used clutter filtering method for many novel ultrafast imaging applications such as functional ultrasound and super-resolution imaging. At present, however, the computational burden of SVD remains as a major hurdle for practical implementation and clinical translation of this method. To address this challenge, in the study we present two blood flow clutter filtering methods based on randomized SVD (rSVD) and randomized spatial downsampling to accelerate SVD clutter filtering with minimal compromise to the clutter filter performance. rSVD accelerates SVD computation by approximating the k largest singular values, while random downsampling accelerates both full SVD and rSVD by decomposing the original large data matrix into small matrices that can be processed in parallel. An in vitro blood flow phantom study with the presence of heavy tissue clutter showed significantly improved computational performance using the proposed methods with minimal deterioration to the clutter filter performance (less than 3-dB reduction in blood to clutter ratio, less than 0.2-cm²/s² increase in flow mean squared error, less than 0.1-cm/s increase in the standard deviation of the vessel blood flow signal, and less than 0.3-cm/s increase in tissue clutter velocity for both full SVD and rSVD when the downsampling factor was less than 20× ). The maximum acceleration was about threefold from randomized spatial downsampling, and approximately another threefold from rSVD. An in vivo rabbit kidney perfusion study showed that rSVD provided comparable performance to full SVD in clutter rejection in vivo (maximum difference of blood to clutter ratio was less than 0.6 dB), and random downsampling provided artifact-free perfusion imaging results when combined with both full SVD and rSVD. The blood to clutter ratio was still above 10 dB with a downsampling factor of 60× . We also demonstrated real-time microvessel imaging feasibility (~40-ms processing time) by combining rSVD with random downsampling. The findings and methods presented in this paper may greatly facilitate the new area of ultrafast microvessel imaging research.

Transcranial focused ultrasound: a new tool for non-invasive neuromodulation

Ultrasound (US) is widely known for its utility as a biomedical imaging modality. An abundance of evidence has recently accumulated showing that US is also useful for non-invasively modulating brain circuit activity. Through a series of studies discussed in this short review, it has recently become recognized that transcranial focused ultrasound can exert mechanical (non-thermal) bioeffects on neurons and cells to produce focal changes in the activity of brain circuits. In addition to highlighting scientific breakthroughs and observations that have driven the development of the field of ultrasonic neuromodulation, this study also provides a discussion of mechanisms of action underlying the ability of ultrasound to physically stimulate and modulate brain circuit activity. Exemplifying some forward-looking tools that can be developed by integrating ultrasonic neuromodulation with other advanced acoustic technologies, some innovative acoustic imaging, beam forming, and focusing techniques are briefly reviewed. Finally, the future outlook for ultrasonic neuromodulation is discussed, specifically in the context of applications employing transcranial focused ultrasound for the investigation, diagnosis, and treatment of neuropsychiatric disorders.

Broadband gradient impedance matching using an acoustic metamaterial for ultrasonic transducers

High-quality broadband ultrasound transducers yield superior imaging performance in biomedical ultrasonography. However, proper design to perfectly bridge the energy between the active piezoelectric material and the target medium over the operating spectrum is still lacking. Here, we demonstrate a new anisotropic cone-structured acoustic metamaterial matching layer that acts as an inhomogeneous material with gradient acoustic impedance along the ultrasound propagation direction. When sandwiched between the piezoelectric material unit and the target medium, the acoustic metamaterial matching layer provides a broadband window to support extraordinary transmission of ultrasound over a wide frequency range. We fabricated the matching layer by etching the peeled silica optical fibre bundles with hydrofluoric acid solution. The experimental measurement of an ultrasound transducer equipped with this acoustic metamaterial matching layer shows that the corresponding -6 dB bandwidth is able to reach over 100%. This new material fully enables new high-end piezoelectric materials in the construction of high-performance ultrasound transducers and probes, leading to considerably improved resolutions in biomedical ultrasonography and compact harmonic imaging systems.

Light controls cerebral blood flow in naive animals

Optogenetics is increasingly used to map brain activation using techniques that rely on functional hyperaemia, such as opto-fMRI. Here we test whether light stimulation protocols similar to those commonly used in opto-fMRI or to study neurovascular coupling modulate blood flow in mice that do not express light sensitive proteins. Combining two-photon laser scanning microscopy and ultrafast functional ultrasound imaging, we report that in the naive mouse brain, light per se causes a calcium decrease in arteriolar smooth muscle cells, leading to pronounced vasodilation, without excitation of neurons and astrocytes. This photodilation is reversible, reproducible and energy-dependent, appearing at about 0.5 mJ. These results impose careful consideration on the use of photo-activation in studies involving blood flow regulation, as well as in studies requiring prolonged and repetitive stimulations to correct cellular defects in pathological models. They also suggest that light could be used to locally increase blood flow in a controlled fashion.

Combination of optogenetics and BOLD fMRI is routinely used to map neuronal activity upon photostimulation. Here the authors show that light, shone at intensities used in optogenetic studies, dilates vessels and increases blood flow independently of exogenous light-sensitive proteins in the mouse brain.

Contrast enhanced ultrasound by real-time spatiotemporal filtering of ultrafast images

Contrast enhanced ultrasound (CEUS) takes advantage of the nonlinear behaviour of injected microbubbles. If these contrast techniques yield good specificity between bubbles and tissues, they suffer some drawbacks, inherently linked to their dependence on nonlinear content. In recent years, plane-wave ultrasound reached frame rates of up to 20 000 fps. In this study we propose a linear technique for CEUS that takes advantage of these very high frame rates to separate bubbles from tissue without requiring nonlinearities. Data-driven spatiotemporal filtering operations are used to separate different features in the image on the basis of coherence both in space and time. Such filter recently proved to improve Doppler sensitivity (Demene et al 2015 IEEE Trans. Med. Imaging 34 2271-85). In contrast with bubbles, even slow moving ones, tissues are highly coherent both in space and time. Therefore, singular value decomposition (SVD) seems to be a powerful tool for the separation of contrast agents and tissues. In this paper, we apply SVD processing to linear ultrafast ultrasound images for CEUS Doppler. The contrast levels reached by this technique were compared to those of a nonlinear gold standard sequence (PMPI Doppler) through a flow phantom study. The SVD technique reached contrast-to-tissue ratios (CTR) up to 10 dB higher in vitro, and proved to be robust in terms of probe motion and slow flow. A trial was also conducted on a transplanted human kidney, already imaged by means of power Doppler (Claudon et al 1999 Am. J. Roentgenol. 173 41-6) and microbubbles (Kay et al 2009 Clin. Radiol. 64 1081-7). Contrast levels yielded by the SVD technique measured up to 13 dB higher than those of PMPI Doppler.

Transcriptomic regulations in oligodendroglial and microglial cells related to brain damage following fetal growth restriction

Fetal growth restriction (FGR) is a major complication of human pregnancy, frequently resulting from placental vascular diseases and prenatal malnutrition, and is associated with adverse neurocognitive outcomes throughout life. However, the mechanisms linking poor fetal growth and neurocognitive impairment are unclear. Here, we aimed to correlate changes in gene expression induced by FGR in rats and abnormal cerebral white matter maturation, brain microstructure, and cortical connectivity in vivo. We investigated a model of FGR induced by low-protein-diet malnutrition between embryonic day 0 and birth using an interdisciplinary approach combining advanced brain imaging, in vivo connectivity, microarray analysis of sorted oligodendroglial and microglial cells and histology. We show that myelination and brain function are both significantly altered in our model of FGR. These alterations, detected first in the white matter on magnetic resonance imaging significantly reduced cortical connectivity as assessed by ultrafast ultrasound imaging. Fetal growth retardation was found associated with white matter dysmaturation as shown by the immunohistochemical profiles and microarrays analyses. Strikingly, transcriptomic and gene network analyses reveal not only a myelination deficit in growth-restricted pups, but also the extensive deregulation of genes controlling neuroinflammation and the cell cycle in both oligodendrocytes and microglia. Our findings shed new light on the cellular and gene regulatory mechanisms mediating brain structural and functional defects in malnutrition-induced FGR, and suggest, for the first time, a neuroinflammatory basis for the poor neurocognitive outcome observed in growth-restricted human infants. GLIA 2016;64:2306-2320.

Recent advances in mesoscopic-scale imaging in animal models of ischemic stroke

PURPOSE OF REVIEW

This article provides an overview of the recent literature regarding the application of in-vivo brain imaging techniques to animal models of ischemic stroke.

RECENT FINDINGS

Major breakthroughs concerned the effects of sensory stimulation on neuronal function, local hemodynamics, and tissue outcome in the hyperacute phase of stroke; the novel application to stroke of hybrid scanners allowing simultaneous PET and magnetic resonance; the refinements of magnetic resonance-based oxygen imaging, allowing to map the ischemic penumbra in a completely noninvasive way; the implementation of new PET ligands to selectively map poststroke neuronal death and neuroinflammation; and the use of novel mesoscale imaging techniques to demonstrate the major role of interhemispheric connectivity in poststroke plasticity and functional recovery.

SUMMARY

The array of techniques to map in vivo the key pathophysiological brain processes involved in stroke is currently enlarging at an amazing pace. This is paralleled by ever-increasing sophistication in postprocessing tools. The combination of techniques allowing simultaneous access to several variables is particularly powerful as it affords unprecedented insights into the intimate processes underlying the tissue and neuronal changes that follow a stroke. These major leaps forward will hopefully lead to therapeutic breakthroughs aiming at improving functional outcome after stroke.

Review of ultrasound image guidance in external beam radiotherapy part II: intra-fraction motion management and novel applications

Imaging has become an essential tool in modern radiotherapy (RT), being used to plan dose delivery prior to treatment and verify target position before and during treatment. Ultrasound (US) imaging is cost-effective in providing excellent contrast at high resolution for depicting soft tissue targets apart from those shielded by the lungs or cranium. As a result, it is increasingly used in RT setup verification for the measurement of inter-fraction motion, the subject of Part I of this review (Fontanarosa et al 2015 Phys. Med. Biol. 60 R77-114). The combination of rapid imaging and zero ionising radiation dose makes US highly suitable for estimating intra-fraction motion. The current paper (Part II of the review) covers this topic. The basic technology for US motion estimation, and its current clinical application to the prostate, is described here, along with recent developments in robust motion-estimation algorithms, and three dimensional (3D) imaging. Together, these are likely to drive an increase in the number of future clinical studies and the range of cancer sites in which US motion management is applied. Also reviewed are selections of existing and proposed novel applications of US imaging to RT. These are driven by exciting developments in structural, functional and molecular US imaging and analytical techniques such as backscatter tissue analysis, elastography, photoacoustography, contrast-specific imaging, dynamic contrast analysis, microvascular and super-resolution imaging, and targeted microbubbles. Such techniques show promise for predicting and measuring the outcome of RT, quantifying normal tissue toxicity, improving tumour definition and defining a biological target volume that describes radiation sensitive regions of the tumour. US offers easy, low cost and efficient integration of these techniques into the RT workflow. US contrast technology also has potential to be used actively to assist RT by manipulating the tumour cell environment and by improving the delivery of radiosensitising agents. Finally, US imaging offers various ways to measure dose in 3D. If technical problems can be overcome, these hold potential for wide-dissemination of cost-effective pre-treatment dose verification and in vivo dose monitoring methods. It is concluded that US imaging could eventually contribute to all aspects of the RT workflow.

Large-scale functional connectivity networks in the rodent brain

Resting-state functional Magnetic Resonance Imaging (rsfMRI) of the human brain has revealed multiple large-scale neural networks within a hierarchical and complex structure of coordinated functional activity. These distributed neuroanatomical systems provide a sensitive window on brain function and its disruption in a variety of neuropathological conditions. The study of macroscale intrinsic connectivity networks in preclinical species, where genetic and environmental conditions can be controlled and manipulated with high specificity, offers the opportunity to elucidate the biological determinants of these alterations. While rsfMRI methods are now widely used in human connectivity research, these approaches have only relatively recently been back-translated into laboratory animals. Here we review recent progress in the study of functional connectivity in rodent species, emphasising the ability of this approach to resolve large-scale brain networks that recapitulate neuroanatomical features of known functional systems in the human brain. These include, but are not limited to, a distributed set of regions identified in rats and mice that may represent a putative evolutionary precursor of the human default mode network (DMN). The impact and control of potential experimental and methodological confounds are also critically discussed. Finally, we highlight the enormous potential and some initial application of connectivity mapping in transgenic models as a tool to investigate the neuropathological underpinnings of the large-scale connectional alterations associated with human neuropsychiatric and neurological conditions. We conclude by discussing the translational potential of these methods in basic and applied neuroscience.

Spatiotemporal Clutter Filtering of Ultrafast Ultrasound Data Highly Increases Doppler and fUltrasound Sensitivity

Ultrafast ultrasonic imaging is a rapidly developing field based on the unfocused transmission of plane or diverging ultrasound waves. This recent approach to ultrasound imaging leads to a large increase in raw ultrasound data available per acquisition. Bigger synchronous ultrasound imaging datasets can be exploited in order to strongly improve the discrimination between tissue and blood motion in the field of Doppler imaging. Here we propose a spatiotemporal singular value decomposition clutter rejection of ultrasonic data acquired at ultrafast frame rate. The singular value decomposition (SVD) takes benefits of the different features of tissue and blood motion in terms of spatiotemporal coherence and strongly outperforms conventional clutter rejection filters based on high pass temporal filtering. Whereas classical clutter filters operate on the temporal dimension only, SVD clutter filtering provides up to a four-dimensional approach (3D in space and 1D in time). We demonstrate the performance of SVD clutter filtering with a flow phantom study that showed an increased performance compared to other classical filters (better contrast to noise ratio with tissue motion between 1 and 10mm/s and axial blood flow as low as 2.6 mm/s). SVD clutter filtering revealed previously undetected blood flows such as microvascular networks or blood flows corrupted by significant tissue or probe motion artifacts. We report in vivo applications including small animal fUltrasound brain imaging (blood flow detection limit of 0.5 mm/s) and several clinical imaging cases, such as neonate brain imaging, liver or kidney Doppler imaging.