Current time-domain methods for assessing tissue motion by analysis from reflected ultrasound echoes-a review

Volumetric elasticity imaging with a 2-D CMUT array

This article reports the use of a two-dimensional (2-D) capacitive micro-machined ultrasound transducer (CMUT) to acquire radio-frequency (RF) echo data from relatively large volumes of a simple ultrasound phantom to compare three-dimensional (3-D) elasticity imaging methods. Typical 2-D motion tracking for elasticity image formation was compared with three different methods of 3-D motion tracking, with sum-squared difference (SSD) used as the similarity measure. Differences among the algorithms were the degree to which they tracked elevational motion: not at all (2-D search), planar search, combination of multiple planes and plane independent guided search. The cross-correlation between the predeformation and motion-compensated postdeformation RF echo fields was used to quantify motion tracking accuracy. The lesion contrast-to-noise ratio was used to quantify image quality. Tracking accuracy and strain image quality generally improved with increased tracking sophistication. When used as input for a 3-D modulus reconstruction, high quality 3-D displacement estimates yielded accurate and low noise modulus reconstruction.

3-D phantom and in vivo cardiac speckle tracking using a matrix array and raw echo data

Cardiac motion has been tracked using various methods, which vary in their invasiveness and dimensionality. One such noninvasive modality for cardiac motion tracking is ultrasound. Three-dimensional ultrasound motion tracking has been demonstrated using detected data at low volume rates. However, the effects of volume rate, kernel size, and data type (raw and detected) have not been sufficiently explored. First comparisons are made within the stated variables for 3-D speckle tracking. Volumetric data were obtained in a raw, baseband format using a matrix array attached to a high parallel receive beam count scanner. The scanner was used to acquire phantom and human in vivo cardiac volumetric data at 1000-Hz volume rates. Motion was tracked using phase-sensitive normalized cross-correlation. Subsample estimation in the lateral and elevational dimensions used the grid-slopes algorithm. The effects of frame rate, kernel size, and data type on 3-D tracking are shown. In general, the results show improvement of motion estimates at volume rates up to 200 Hz, above which they become stable. However, peak and pixel hopping continue to decrease at volume rates higher than 200 Hz. The tracking method and data show, qualitatively, good temporal and spatial stability (for independent kernels) at high volume rates.

Interlaboratory comparison of backscatter coefficient estimates for tissue-mimicking phantoms

Ultrasonic backscatter is useful for characterizing tissues and several groups have reported methods for estimating backscattering properties. Previous interlaboratory comparisons have been made to test the ability to accurately estimate the backscatter coefficient (BSC) by different laboratories around the world. Results of these comparisons showed variability in BSC estimates but were acquired only for a relatively narrow frequency range, and, most importantly, lacked reference to any independent predictions from scattering theory. The goal of this study was to compare Faran-scattering-theory predictions with cooperatively-measured backscatter coefficients for low-attenuating and tissue-like attenuating phantoms containing glass sphere scatterers of different sizes for which BSCs can independently be predicted. Ultrasonic backscatter measurementswere made for frequencies from 1 to 12 MHz. Backscatter coefficients were estimated using two different planar-reflector techniques at two laboratories for two groups of phantoms. Excellent agreement was observed between BSC estimates from both laboratories. In addition, good agreement with the predictions of Faran's theory was obtained, with average fractional (bias) errors ranging from 8-14%. This interlaboratory comparison demonstrates the ability to accurately estimate parameters derived from the BSC, including an effective scatterer size and the acoustic concentration, both of which may prove useful for diagnostic applications of ultrasound tissue characterization.

Two-dimensional blood velocity estimation with ultrasound: speckle tracking versus crossed-beam vector Doppler based on flow simulations in a carotid bifurcation model

Detailed imaging of complex blood flow may improve early diagnosis of cardiovascular disease. In clinical practice, non-invasive flow imaging has been limited to one-dimensional Doppler techniques. Searching for multi-dimensional estimators, research has given attention to speckle tracking (ST) and vector Doppler (VD). However, these techniques have yet to be validated for complex flow patterns as may arise in diseased arteries. In this work, the properties of ST and crossed-beam VD are compared with a ground truth for clinically relevant flow using an ultrasonic simulation environment coupled with the output from computational fluid dynamics (CFD). The statistical properties (n = 80) of ST and VD were first evaluated for stationary flow in a tube for varying vessel positions and angles, and for varying noise levels. The parameter study demonstrated VD to be a more robust axial velocity estimator, and similar results were obtained overall for the lateral velocity component. As an example, the relative standard deviation was 15% and 8% for ST compared with 3% and 10% for VD, for the axial and lateral velocity component, respectively. Further, performance was evaluated for pulsatile flow conditions in a stenosed carotid bifurcation model. A linear regression analysis showed that both methods overall had a good agreement to the CFD reference, however VD suffered from more spurious artifacts and was severely hampered by aliasing in parts of the cardiac cycle. ST was less accurate in estimating the axial component, but prevailed in estimating velocities well beyond the Nyquist range. Based on our simulations, both methods may be used to image complex flow behavior in the carotid bifurcation, however, considering also the scanning limitations of VD, ST may provide a more consistent and practical approach. Future work will entail in vitro and in vivo validation of these results.

Resolving the lateral component of blood flow velocity based on ultrasound speckle size change with scan direction and speed

Conventional blood flow velocity measurement using ultrasound is capable of resolving the axial component (i.e., that aligned with the ultrasound propagation direction) of the blood flow velocity vector. However, these Doppler-based methods are incapable of detecting blood flow in the direction normal to the ultrasound beam. In addition, these methods require repeated pulse-echo interrogation at the same spatial location. In this paper, we introduce a method which estimates the lateral component of blood flow within a single image frame using the observation that the speckle pattern corresponding to the blood reflectors (typically red blood cells) stretches (i.e., is "smeared") if the blood is moving in the same direction as the electronically-controlled transducer line selection in a 2D image. The situation is analogous to the observed elongation of a subject photographed with a moving camera. Here, we develop a relationship between speckle size, scan speed, and blood flow velocity. Experiments were performed with a blood flow phantom and high-frequency transducer of a commercially available ultrasound machine. Data was captured through an interface allowing access to the raw beam formed data. Blood flow with velocities ranging from 15 to 40 cm/s were investigated in this paper. Results show that there is a linear relationship between the reciprocal of the stretch factor and blood flow velocity. Two scan speeds were used in our experiments. When the scan velocity is 64.8 cm/s, compared with the theoretical model, fitting results based on experimental data gave us a linear relationship with average flow estimation error of 1.74+/-1.48 cm/s. When the scan velocity is 37.4 cm/s, the average estimation error is 0.65+/-0.45 cm/s.

Optimal thresholds of feature tracking for blood velocity and tissue motion estimation

Feature tracking is an algorithm for estimating blood flow velocity and tissue motion using pulse-echo ultrasound. In contrast to cross-correlation speckle-tracking techniques, feature tracking identifies features at discrete locations and corresponds them from frame to frame. Prior studies have demonstrated that feature-tracking estimates exhibit lower variance than those obtained by the conventional autocorrelation method and require less computational complexity than either speckle tracking or autocorrelation. To date, not much attention has been paid to the process by which trackable features (normally local maxima) are selected from the set of all available features. In the selection process, it is desired to minimize flow estimate variance while providing sufficient spatial and temporal coverage of flow area. Flow studies were performed with a blood flow phantom, 3.5-MHz spherically focused transducer, and a pulser/receiver. Values were selected for the amplitude threshold (based on the RMS value) and width thresholds (based on the wavelength corresponding to transducer center frequency). The performance of this method using different threshold values was evaluated by the estimate standard deviation and number of features available to track. Results show that an optimal width threshold occurs at about 40 to 45% of the transmission wavelength, while a trade-off exists between amplitude thresholds and spatial flow field coverage. Both the standard deviation of estimated velocities and number of available features decrease with increasing threshold (either amplitude or width). This affords a user a method of determining optimal feature tracking thresholds depending on the specific flow application. Judicious selection of feature thresholds can decrease the estimate standard deviation by more than 25%.

Ultrasound phase contrast thermal imaging with reflex transmission imaging methods in tissue phantoms

Thermal imaging measurements using ultrasound phase contrast have been performed in tissue phantoms heated with a focused ultrasound source. Back projection and reflex transmission imaging principles were used to detect sound speed-induced changes in the phase caused by an increase in the temperature. The temperature was determined from an empirical relationship for the temperature dependence on sound speed. The phase contrast was determined from changes in the sound field measured with a hydrophone scan conducted before and during applied heating. The lengthy scanning routine used to mimic a large two-dimensional array required a steady-state temperature distribution within the phantom. The temperature distribution in the phantom was validated with magnetic resonance (MR) thermal imaging measurements. The peak temperature was found to agree within 1 degrees C with MR, and good agreement was found between the temperature profiles. The spatial resolution was 0.3x0.3x0.3mm, comparing favorably with the 0.625x0.625x1.5-mm MR spatial resolution.

Colour flow and motion imaging

Colour flow imaging (CFI) is an ultrasound imaging technique whereby colour-coded maps of tissue velocity are superimposed on grey-scale pulse-echo images of tissue anatomy. The most widespread use of the method is to image the movement of blood through arteries and veins, but it may also be used to image the motion of solid tissue. The production of velocity information is technically more demanding than the production of the anatomical information, partly because the target of interest is often blood, which backscatters significantly less power than solid tissues, and partly because several transmit—receive cycles are necessary for each velocity estimate. This review first describes the various components of basic CFI systems necessary to generate the velocity information and to combine it with anatomical information. It then describes a number of variations on the basic autocorrelation technique, including cross-correlation-based techniques, power Doppler, Doppler tissue imaging, and three-dimensional (3D) Doppler imaging. Finally, a number of limitations of current techniques and some potential solutions are reviewed.

Phase rotation methods in filtering correlation coefficients for ultrasound speckle tracking

In speckle-tracking-based myocardial strain imaging, large interframe/volume peak-systolic strains cause peak hopping artifacts separating the highest correlation coefficient peak from the true peak. A correlation coefficient filter was previously designed to minimize peak hopping artifacts. For large strains, however, the correlation coefficient filter must follow the strain distribution to remove peak hopping effectively. This processing usually means interpolation and high computational load. To reduce the computational burden, a narrow band approximation using phase rotation is developed in this paper to facilitate correlation coefficient filtering. Correlation coefficients are first phase rotated to increase coherence, then filtered. Rotated phase angles are determined by the local strain and spatial position. This form of correlation coefficient filtering enhances true correlation coefficient peaks in large strain applications if decorrelation due to deformation does not completely destroy the coherence among neighboring correlation coefficients. The assumed strain used in the filter can also deviate from the true strain and still be effective. Further improvement in displacement estimation can be expected by combining correlation coefficient filtering with a new Viterbi-based displacement estimator.

Reduced peak-hopping artifacts in ultrasonic strain estimation using the Viterbi algorithm

Internal strain resulting from tissue deformation can be estimated by correlation processing of speckle patterns within complex (i.e., radio frequency) ultrasound images acquired during deformation. At large deformations, the magnitude of the correlation coefficient peak can be significantly lower than unity, so that random speckle correlations will exceed the true peak. This effect is called "peak hopping" and causes significant errors in displacement and deformation estimates. Here we investigate the Viterbi algorithm, a dynamic programming procedure, to overcome peak-hopping artifacts by finding the most likely sequence of hidden states in a sequence of observed events. It is well suited to motion estimation in elasticity-imaging studies because adjacent tissue elements remain adjacent following deformation. Particularly, tissue elements along an ultrasonic beam in one image lie along a 3-D continuous curve in the next image instant. The observed event in this case is the correlation coefficient of a pixel at a certain displacement. Radio-frequency data were generated before and after deformation with an average strain of 6%. Simulations were performed for a homogenous medium and for a medium with a stiffer inclusion. Results show that Viterbi processing of speckle-tracking outputs can significantly reduce peak-hopping artifacts.

A comparison of Doppler, tissue Doppler imaging, and strain rate imaging in the assessment of postexercise left ventricular function

Left ventricular (LV) function is characterized by contraction in the longitudinal, radial, and circumferential planes. Previous studies of postexercise changes in LV function have assessed global indices of LV function. The purpose of this study was to use 2-dimensional (2D) strain analysis to examine LV function following marathon running in the circumferential, radial, and longitudinal planes, and to compare these data with other global and regional indices of function. Fifteen (mean ± SD: age, 32 ± 7 years; stature, 1.76 ± 0.08 m; body mass, 77.8 ± 8.2 kg) competitors in the London Marathon were echocardiographically assessed pre- and postrace. 2D strain (ejection fraction (EF), Doppler (early (E) and late (A) trans-mitral filling), tissue Doppler imaging (TDI) (systolic (S′) and early diastolic (E′) wall-motion velocities); TDI-derived longitudinal strain (εTDI), and systolic and diastolic strain rate (SRTDI); and 2D-derived peak circumferential, radial, and longitudinal strain (ε2D), and systolic and diastolic strain rate (SR2D) were examined. Differences pre- and postrace completion were assessed using paired t tests, with alpha set at 0.01. All participants completed the marathon in a mean time of 213 ± 41 min. A varied response was observed for measures of LV systolic and diastolic function following completion of the marathon (mean ± SD): EF, 63 ± 6 vs. 63 ± 7% (p > 0.01); E:A, 1.70 ± 0.37 vs. 1.17 ± 0.37; E′:A′, 2.36 ± 0.79 vs. 1.60 ± 0.57 (p < 0.01); mean longitudinal εTDI, 19.1 ± 5.1 vs. 17.5 ± 4.2% (p < 0.01); mean longitudinal diastolic SRTDI, 1.81 ± 0.54 vs. 1.58 ± 0.51·s–1 (p < 0.01); mean longitudinal systolic SR2D, 0.73 ± 0.21 vs. 0.97 ± 0.22·s–1 (p < 0.01); mean longitudinal diastolic SR2D, 0.94 ± 0.34 vs. 1.01 ± 0.23·s–1 (p > 0.01); mean radial systolic SR2D, 1.20 ± 0.15 vs. 1.45 ± 0.32·s–1 (p < 0.01); mean radial diastolic SR2D, 1.19 ± 0.25 vs. 1.29 ± 0.41·s–1 (p > 0.01); mean circumferential systolic SR2D, –1.09 ± 0.16 vs. –1.24 ± 0.18·s–1 (p < 0.01); and mean circumferential diastolic SR2D, –1.27 ± 0.28 vs. –1.22 ± 0.31·s–1 (p > 0.01). Marathon running promotes a varied echocardiographic response, with some functional parameters showing no change, some increasing, and some decreasing postexercise. This varied response likely reflects the complexities of cardiac function and highlights the need to adopt a multimodality approach when assessing cardiac function following exercise.

Time-delay estimation in ultrasound echo signals using individual sample tracking

The performance of many signal-processing applications in ultrasound medical imaging, including elastography, blood flow imaging, tissue velocity imaging, and acoustic radiation force impulse imaging, depends on the performance of their time-delay estimators. In this paper, we present a new time-delay estimator based on the tracking of individual samples using a continuous representation of the echo signal. We also present the use of the same interpolation approach to improve the performance of the zero-crossing tracking delay estimator. Simulation results show that sample tracking algorithms significantly outperform commonly used window-based algorithms in terms of bias and standard deviation. Sample tracking algorithms also have higher sensitivity and resolution compared with traditional delay estimators, including recently introduced spline-based continuous time-delay estimators, because they provide the displacement of individual samples. Experimental results demonstrating the viability of sample tracking delay estimation are also presented.

Improving IVUS palpography by incorporation of motion compensation based on block matching and optical flow

Intravascular ultrasound (IVUS) strain imaging of the luminal layer in coronary arteries, coined as IVUS palpography, utilizes conventional radio frequency (RF) signals acquired at 2 different levels of a compressional load. The signals are cross-correlated to obtain the microscopic tissue displacements, which can be directly translated into local strain of the vessel wall. However, (apparent) tissue motion and nonuniform deformation of the vessel wall, due to catheter wiggling, reduce signal correlation and result in invalid strain estimates. Implications of probe motion were studied on the tissue-mimicking phantom. The measured circumferential tissue displacement and level of the speckle decorrelation amounted to 12 degrees and 0.58, respectively, for the catheter displacement of 456 microm. To compensate for the motion artifacts in IVUS palpography, a novel method based on the feature-based scale-space optical flow (OF), and classical block matching (BM) algorithm, were employed. The computed OF vector and BM displacement fields quantify the amount of local tissue misalignment in consecutive frames. Subsequently, the extracted circumferential displacements are used to realign the signals before strain computation. Motion compensation reduces the RF signal decorrelation and increases the number of valid strain estimates. The advantage of applying the motion correction in IVUS palpography was demonstrated in a midscale validation study on 14 in vivo pullbacks. Both methods substantially increase the number of valid strain estimates in the partial and compounded palpograms. Mean relative improvement in the number of valid strain estimates with motion compensation in comparison to one without motion compensation amounts to 28% and 14%, respectively. Implementation of motion compensation methods boosts the diagnostic value of IVUS palpography.

Accuracy in prediction of catheter rotation in IVUS with feature-based optical flow--a phantom study

The quantitative assessment of and compensation for catheter rotation in intravascular ultrasound images presents a fundamental problem for noninvasive characterization of the mechanical properties of the coronary arteries. A method based on the scale-space optical flow algorithm with a feature-based weighting scheme is proposed to account for the aforementioned artifact. The computed vector field, describing the misalignment between two consecutive frames, allows the quantitative assessment of the amount of vessel wall tissue motion, which is directly related to the catheter rotation. Algorithm accuracy and robustness were demonstrated on two tissue-mimicking phantoms, subjected to controlled amount of angular deviation. The proposed method shows a great reliability in the prediction of catheter rotational motion up to 4 degrees.

Changes in vascular and cardiac function after prolonged strenuous exercise in humans

Prolonged exercise has been shown to result in an acute depression in cardiac function. However, little is known about the effect of this type of exercise on vascular function. Therefore, the purpose of the present study was to investigate the impact of an acute bout of prolonged strenuous exercise on vascular and cardiac function and the appearance of biomarkers of cardiomyocyte damage in 15 male (32 +/- 10 yr) nonelite runners. The subjects were tested on two occasions, the day before and within an hour of finishing the London marathon (229 +/- 38 min). Function of the brachial and femoral arteries was determined using flow-mediated dilatation (FMD). Echocardiographic assessment of cardiac strain, strain rate, tissue velocities, and flow velocities during diastole and systole were also obtained. Venous blood samples were taken for later assessment of cardiac troponin I (cTnI), a biomarker of cardiomyocyte damage. Completion of the marathon resulted in a depression in femoral (P = 0.04), but not brachial (P = 0.96), artery FMD. There was no change, pre- vs. postmarathon, in vascular shear, indicating that the impaired femoral artery function was not related to hemodynamic changes. The ratio of peak early to atrial radial strain rate, a measure of left ventricular diastolic function, was reduced postmarathon (P = 0.006). Postrace cTnI was elevated in 12 of 13 runners, with levels above the recognized clinical threshold for damage in 7 of these. In conclusion, when taken together, these data suggest a transient depression in cardiac and leg vascular function following prolonged intensive exercise.

Displacement vector measurement using instantaneous ultrasound signal phase - multidimensional autocorrelation and doppler methods

Two new methods of measuring a multidimensional displacement vector using an instantaneous ultrasound signal phase are described, i.e., the multidimensional autocorrelation method (MAM) and multidimensional Doppler method (MDM). A high measurement accuracy is achieved by combining either method with the lateral Gaussian envelope cosine modulation method (LGECMM) or multidirectional synthetic aperture method (MDSAM). Measurement accuracy is evaluated using simulated noisy echo data. Both methods yield accurate measurements comparable to that of our previously developed cross-spectrum phase gradient method (MCSPGM); however, they require less computational time (the order, MDM < MAM approximate, equals MCSPGM) and would provide realtime measurements. Moreover, comparisons of LGECMM and MDSAM performed by geometrical evaluations clarifies that LGECMM has potentials to yield more accurate measurements with less computational time. Both MAM and MDM can be applied to the measurement of tissue strain, blood flow, sonar data, and other target motions.

Ultrasound monitoring of temperature change in liver tissue during laser thermotherapy: 10 degrees C intervals

In thermal tissue ablation, it is very important to control the increase in the temperature for having an efficient ablation therapy. We conducted this study to determine the efficacy of measuring pixel shift of ultrasound B-mode images as a function of change in tissue temperature. By fixing some micro thermocouples in liver tissues, temperature at different points was monitored invasively in vitro during laser-induced thermotherapy. According to our results optimum power and exposure time were determined for ultrasound temperature monitoring. Simultaneously, noninvasive temperature monitoring was performed with ultrasound B-mode images. These images were saved on computer from 25 degrees C to 95 degrees C with 10 degrees C steps. The speed of sound changes with each 10 degrees C temperature change that produce virtual shifts in the scatter positions. Using an image processing method, the pixel shift due to 10 degrees C temperature change was extracted by motion detection. The cubic regression function between the mean pixel shifts on ultrasound B-mode images caused by the change in speed of sound which in turn was a function of the mean change in temperature was evaluated. When temperature increased, pixel shift occurs in ultrasound images. The maximum pixel shift was observed between 60 to 70 degrees C. After 70 degrees C, the local pixel shift due to change in the speed of sound in liver tissue had an irregular decreasing. Pearson correlation coefficient between invasive and non-invasive measurements for 10 degrees C temperature changes was 0.93 and the non-linear function was suitable for monitoring of temperature. Monitoring of changes in temperature based on pixel shifts observed in ultrasound B-mode images in interstitial laser thermotherapy of liver seems a good modality.

In vivo validation of a novel method for regional myocardial wall motion analysis based on echocardiographic tissue tracking

The objective of this study was to validate a recently developed tissue tracking (TT) method for cardiac motion, by comparing it with precise invasive measurements of motion and to prove its capability to reflect moderate hemodynamic changes induced by asynchronous activation. In four open-chest sheep, sono-crystals measured the left ventricle(LV) equator's diameters simultaneously with 2D ultrasound acquisition. The LV was paced either from the posterior or from the lateral wall, just prior to the normal LV activation. Global functional indices were calculated based on the regional motions extracted by the TT method. The correlation coefficient between the shortening of the diameters and the global circumferential strain (GCS) was 0.99 +/- 0.004. The peak GCS differentiated between the pacing modes (paired t test, P < 0.05). The GCS, a measurement closely based on the TT method, followed the precise sono-crystals measurements and reflected moderate hemodynamic changes, thus providing a substantial proof of the TT method's accuracy and clinical value.

Theoretical quality assessment of myocardial elastography with in vivo validation

Myocardial elastography (ME), a radio frequency (RF)-based speckle tracking technique with one-dimensional (1-D) cross correlation and novel recorrelation methods in a 2-D search was proposed to estimate and fully image 2-D transmural deformation field and to detect abnormal cardiac function. A theoretical framework was first developed in order to evaluate the performance of 2-D myocardial elastography based on a previously developed 3-D finite-element model of the canine left ventricle. A normal (control) and an ischemic (left-circumflex, LCx) model, which more completely represented myocardial deformation than a kinematic model, were considered. A 2-D convolutional image formation model was first used to generate RF signals for quality assessment of ME in the normal and ischemic cases. A 3-D image formation model was further developed to investigate the effect of the out-of-plane motion on the 2-D, in-plane motion estimation. Both orthogonal, in-plane displacement components (i.e., lateral and axial) between consecutive RF frames were iteratively estimated. All the estimated incremental 2-D displacements from end-diastole (ED) to end-systole (ES) were then accumulated to acquire the cumulative 2-D displacements, which were further used to calculate the cumulative 2-D systolic finite strains. Furthermore, the cumulative systolic radial and circumferential strains, which were angle- and frame-rate independent, were obtained from the 2-D finite-strain components and imaged in full view to detect the ischemic region. We also explored the theoretical understanding of the limitations of our technique for the accurate depiction of disease and validated it in vivo against tagged magnetic resonance imaging (tMRI) in the case of a normal human myocardium in a 2-D short-axis (SA) echocardiographic view. The theoretical framework succeeded in demonstrating that the 2-D myocardial elastography technique was a reliable tool for the complete estimation and depiction of the in-plane myocardial deformation field as well as for accurate identification of pathological mechanical function using established finite-element, left-ventricular canine models. In a preliminary study, the 2-D myocardial elastography was shown capable of imaging myocardial deformation comparable to equivalent tMRI estimates in a clinical setting.

Compensating for bone interfaces and respiratory motion in high-intensity focused ultrasound

Bursts of focused ultrasound energy a thousand times more intense than diagnostic ultrasound have become a non-invasive option for treating cancer, from breast to prostate or uterine fibroid, during the last decade. Despite this progress, many issues still need to be addressed. First, the distortions caused by defocusing obstacles, such as the skull or ribs, on the ultrasonic therapeutic beam are still being investigated. Multi-element transducer technology must be used in order to achieve such transcranial or transcostal adaptive focusing. Second, the problem of motion artifacts, a key component in the treatment of abdominal lesions, has been shown significantly to influence the efficacy and treatment time. Though many methods have been proposed for the detection of organ motion, little work has been done to develop a comprehensive solution including motion tracking and feedback correction in real time. This paper is a review of the work achieved by authors in transcranial high-intensity focused ultrasound (HIFU), transcostal HIFU and motion compensated HIFU. For these three issues, the optimal solution can be reached using the same technology of multi-element transducers devices able to work both in transmit and receive modes.

Ultrasound motion estimation using a hierarchical feature weighting algorithm

The quality of ultrasonic images is usually influenced by speckle noises and the temporal decorrelation of the speckle patterns. Most traditional motion estimation algorithms are not suitable for speckle tracking in medical ultrasonic images which usually have a low signal-to-noise ratio (SNR). This paper proposes a new motion estimation algorithm that is designed for assessing the dense velocity fields of soft tissue motion in a sequence of ultrasonic B-mode images. We design a hierarchical maximum a posteriori estimator together with an adaptive feature weighted mechanism to estimate the motion field from an ultrasonic image sequence. The proposed method was compared with several existing motion estimation methods via a series of experiments with synthetic speckle image sequences. Performance was also tested on in vivo ultrasonic images. The experimental results show that motion can be assessed with better accuracy than other methods for synthetic speckle images and a good correspondence with clinicians' observations has also been achieved for clinical ultrasonic images.

Direct comparison of feature tracking and autocorrelation for velocity estimation

Feature tracking is an algorithm for estimating tissue motion and blood flow using pulse-echo ultrasound. It was proposed as a computationally simpler alternative to other techniques such as autocorrelation and time-domain cross correlation. The advantage of feature tracking is that it selectively extracts easily identifiable parts of the speckle signal (e.g., the local maxima), reducing the amount of information being processed. Studies on feature tracking to date have used stationary, speckle-generating targets to simulate blood flow. Also, feature tracking has not been compared with accepted commercial methods. This study directly compares feature tracking performance with the complex autocorrelation method, which is the most common color flow algorithm. Experiments were performed with both a rotating string phantom and a commercial flow phantom surrounded by tissue-mimicking material, using 2.25 MHz and 3.5 MHz transducers, under more realistic signal-to-clutter (-15 to -35 dB) and signal-to-noise ratios (SNR) (15 dB to 3 dB) than previous translating-phantom tests. The feature tracking approach is shown to produce mean estimates comparable to autocorrelation (R2 = 0.9954 and 0.9960 for 6-sample and 12-sample autocorrelation, respectively, and R2 = 0.9998 for both 6-sample and 12-sample feature tracking) for velocities ranging from 10 to 100 cm/s. The variance of feature-tracking estimates is shown to compare favorably to the complex autocorrelation approach using the same number of ensemble flow samples (19 to 28% lower standard deviation for 3.5 MHz, 36 to 55% lower standard deviation for 2.25 MHz). However, linear regression of the feature locations does not produce an appreciable improvement in estimation variance. Discussion of the need for further research, particularly in the areas of feature detection and feature correspondence, is given.

Noninvasive temperature estimation using sonographic digital images

OBJECTIVE

The purpose of this study was to develop and evaluate a speckle-tracking method for tissue temperature estimation due to heating fields using digital sonographic images.

METHODS

The temperature change estimation method is based on the thermal dependence of the ultrasound speed and the thermal expansion of the medium. Local changes in the speed of sound due to changes in the temperature produce apparent displacement of the scatterers, and the expansion introduces physical displacement. In our study, a new technique has been introduced in which the axial physical displacements were obtained from digital sonographic images. The axial speckle pattern displacement was determined with a cross-correlation algorithm. The displacement data were then used for computing the temperature changes. To monitor the temperature in real time, the computational time was decreased by restricting the search region in the cross-correlation algorithm and carrying out the cross-correlation function in the frequency domain via a fast Fourier transform algorithm.

RESULTS

Experiments were performed on tissue-mimicking phantoms. The imaging probe was a commercial linear array working at 10 MHz. In addition, the temperature changes during heating were measured invasively by negative temperature coefficient thermistors. There was good agreement between ultrasonic temperature estimations and invasive temperature measurements.

CONCLUSIONS

The proposed method verifies the capability of the speckle-tracking algorithm for determining both the magnitude and direction of displacement. The average error was 0.2 degrees C; the maximum error was 0.53 degrees C; and the SD was 0.19 degrees C. Therefore, the proposed algorithm is capable of extracting the temperature information from sonographic digital images.

Towards an acoustic model-based poroelastic imaging method: II. experimental investigation

Soft biological tissue contains mobile fluid. The volume fraction of this fluid and the ease with which it may be displaced through the tissue could be of diagnostic significance and may also have consequences for the validity with which strain images can be interpreted according to the traditional idealizations of elastography. In a previous paper, under the assumption of frictionless boundary conditions, the spatio-temporal behavior of the strain field inside a compressed cylindrical poroelastic sample was predicted (Berry et al. 2006). In this current paper, experimental evidence is provided to confirm these predictions. Finite element modeling was first used to extend the previous predictions to allow for the existence of contact friction between the sample and the compressor plates. Elastographic techniques were then applied to image the time-evolution of the strain inside cylindrical samples of tofu (a suitable poroelastic material) during sustained unconfined compression. The observed experimental strain behavior was found to be consistent with the theoretical predictions. In particular, every sample studied confirmed that reduced values of radial strain advance with time from the curved cylindrical surface inwards towards the axis of symmetry. Furthermore, by fitting the predictions of an analytical model to a time sequence of strain images, parametric images of two quantities, each related to one or more of three poroelastic material constants were produced. The two parametric images depicted the Poisson's ratio (nu(s)) of the solid matrix and the product of the aggregate modulus (H(A)) of the solid matrix with the permeability (k) of the solid matrix to the pore fluid. The means of the pixel values in these images, nu(s) = 0.088 (standard deviation 0.023) and H(A)k = 1.449 (standard deviation 0.269) x 10(-7) m(2) s(-1), were in agreement with values derived from previously published data for tofu (Righetti et al. 2005). The results provide the first experimental detection of the fluid-flow-induced characteristic diffusion-like behavior of the strain in a compressed poroelastic material and allow parameters related to the above material constants to be determined. We conclude that it may eventually be possible to use strain data to detect and measure characteristics of diffusely distributed mobile fluid in tissue spaces that are too small to be imaged directly.

Continuous delay estimation with polynomial splines

Delay estimation is used in ultrasonic imaging to estimate blood flow, determine phase aberration corrections, and to calculate elastographic images. Several algorithms have been developed to determine these delays. The accuracy of these methods depends in differing ways on noise, bandwidth, and delay range. In most cases relevant to delay estimation in ultrasonics, a subsample estimate of the delay is required. We introduce two new delay algorithms that use cubic polynomial splines to continuously represent the delay. These algorithms are compared to conventional delay estimators, such as normalized cross correlation and autocorrelation, and to another spline-based method. We present simulations that compare the algorithms' performance for varying amounts of noise, delay, and bandwidth. The proposed algorithms have better performance, in terms of bias and jitter, in a realistic ultrasonic imaging environment. The computational requirements of the new algorithms also are considered.

Differentiation of mild and severe stenosis with motion estimation in ultrasound images

Doppler ultrasound technique is now recognized as the best noninvasive screening test for carotid artery stenosis. Ultrasound does not calculate directly the degree of arterial narrowing, but relies on extrapolating the changes in blood flow parameters to an anatomical stenosis. This paper deals with the estimation of the stiffness indices of mild and severe stenosis of common carotid artery by motion estimation algorithm, focusing on their changes with the progression of atherosclerosis. 145 men with the mean age of 55 +/- 12 y who were healthy or had mild stenosis or severe stenosis were studied. For each ultrasound examination, matching longitudinal views of the common carotid artery were located, the frames were grabbed and processed with motion estimation algorithm and then diameter, cross-section changes and intima-media thickness of the right common carotid artery were estimated. The blood pressure was recorded in the right brachial artery using a semiautomatic device. The arterial diameter and cross-section changes and intima-media thickness were used together with the blood pressure measurements to estimate standard arterial stiffness indices. Relative diameter changes in carotid arteries with mild and severe stenosis were decreased by 22% to 48%, respectively, compared with healthy carotid artery. Systolic blood pressure in mild stenosis was approximately 4.4% lower and in severe stenosis was 2.0% higher compared with the healthy carotid. The stiffness indices were significantly different in the group of patients with severe stenosis (p-value < 0.05) compared with the healthy and mild stenosis subjects. It is concluded that, regarding the influence of atherosclerosis on the stiffness indices of right common carotid artery, we can differentiate mild and severe stenosis in carotid artery, through processing the sequential color Doppler ultrasound images by optical flow tracking algorithm.

Ultrasound low-velocity flow estimations using cross-correlation and decorrelation: a thread phantom study

In this paper, two time-domain flow velocity measurement methods, cross-correlation and decorrelation, were implemented and compared in measuring low blood-flow velocities, ranging from 0.05 to 5 cm/s, at known beam-vessel angles of 50-90 degrees in a thread phantom. Both methods achieved a significant correlation between the measured and the known velocities (r=0.99; P<0.001) in the thread phantom measurements, at 50-70 degrees beam-vessel angles. Although the cross-correlation method showed a significant correlation (r>0.99; P<0.001), this method caused large errors (>45%) at 80 degrees and 90 degrees , whereas the decorrelation method not only achieved a significant correlation (r>0.99; P<0.001) but also resulted in smaller errors (<19%) at 80 degrees and 90 degrees . This study demonstrates the potential of time-domain decorrelation method for measuring low flow velocity at large beam-vessel angles near perpendicular conditions.

Assessment of myocardial regional strain and strain rate by tissue tracking in B-mode echocardiograms

To date, established ultrasonic methods for myocardial regional deformation recovery are based on the Doppler effect, which has inherent limitations restricting its accuracy and use. The reported time domain methods show in vivo insufficient accuracy. A novel approach is elaborated mimicking the human observer who reaches robust diagnosis upon the B-mode data. In a region-of-interest (ROI), acoustic markers stable for tracking are selected. A weighting index presenting the quality of tracking of each marker is used for spatial polynomial fitting. For the feasibility study, a simple straight ROI was selected, which matches the septum. A thorough proof of concept is provided by comparing with a gold standard method and by applying the method to clinical datasets. The peak systolic longitudinal strains of 12 normals were -15% + -2.3% and, of 12 patients with a light-to-mild dysfunction of the apical-septal segment, they were -9% + -0.8% (p < 0.05). Enhancements of the method using spline fitting are introduced.

Motion compensation for intravascular ultrasound palpography

Rupture of vulnerable plaques in coronary arteries is the major cause of acute coronary syndromes. Most vulnerable plaques consist of a thin fibrous cap covering an atheromous core. These plaques can be identified using intravascular ultrasound (IVUS) palpography, which measures radial strain by cross-correlating RF signals at different intraluminal pressures. Multiple strain images (i.e., partial palpograms) are averaged per heart cycle to produce a more robust compounded palpogram. However, catheter motion due to cardiac activity causes misalignment of the RF signals and thus of the partial palpograms, resulting in less valid strain estimates. To compensate for in-plane catheter rotation and translation, we devised four methods based on block matching. The global rotation block matching (GRBM) and contour mapping (CMAP) methods measure catheter rotation, and local block matching (LBM) and catheter rotation and translation (CRT) estimate displacements of local tissue regions. These methods were applied to nine in vivo pullback acquisitions, made with a 20 MHz phased-array transducer. We found that all these methods significantly increase the number of valid strain estimates in the partial and compounded palpograms (P < 0.008). The best method, LBM, attained an average increase of 17% and 15%, respectively. Implementation of this method should improve the information coming from IVUS palpography, leading to better vulnerable plaque detection.

Rapid tracking of small displacements with ultrasound

Time-delay estimators, such as normalized cross correlation and phase-shift estimation, form the computational basis for elastography, blood flow measurements, and acoustic radiation force impulse (ARFI) imaging. This paper examines the performance of these algorithms for small displacements (less than half the ultrasound pulse wavelength). The effects of noise, bandwidth, stationary echoes, kernel size, downsampling, interpolation, and quadrature demodulation on the accuracy of the time delay estimates are measured in terms of bias and jitter. Particular attention is given to the accuracy and resolution of the displacement measurements and to the computational efficiency of the algorithms. In most cases, Loupas' two-dimensional (2-D) autocorrelator performs as well as the gold standard, normalized cross correlation. However, Loupas' algorithm's calculation time is significantly faster, and it is particularly suited to operate on the signal data format most commonly used in ultrasound scanners. These results are used to implement a real-time ARFI imaging system using a commercial ultrasound scanner and a computer cluster. Images processed with the algorithms are examined in an ex vivo liver ablation study.

Phase-coupled two-dimensional speckle tracking algorithm

A new two-dimensional (2-D) speckle tracking method for displacement estimation based on the gradients of the magnitude and phase of 2-D complex correlation in a search region is presented. The novelty of this approach is that it couples the phase and magnitude gradients near the correlation peak to determine its coordinates with sub-sample accuracy in both axial and lateral directions. This is achieved with a minimum level of lateral interpolation determined from the angles between the magnitude and phase gradient vectors on the sampled (laterally interpolated) 2-D cross-correlation grid. The key result behind this algorithm is that the magnitude gradient vectors' final approach to the true peak is orthogonal to the zero-phase contour. This leads to a 2-D robust projection on the zero-phase contour that results in subsample accuracy at interpolation levels well below those needed using previously proposed methods. A full description of the 2-D, phase-coupled approach is given, including two implementations based on a geometric projection and constrained optimization. In addition, a robust fast search algorithm that allows the localization of the true peak without the need for exhaustive search is given. Experimental validation on three data sets from speckle-generating phantoms undergoing uniform diagonal motion, uniform axial deformation, and nonuniform lateral flow is given. It is shown that estimated 2-D displacement fields obtained using the phase-coupled technique display a full range of values covering the dynamic range without evidence of quantization. In comparison, a previously published method using 1-D phase-projection after lateral interpolation produces severely quantized lateral displacement fields (at the same levels of interpolation as the 2-D, phase-coupled method).

Two-dimensional strain--a Doppler-independent ultrasound method for quantitation of regional deformation: validation in vitro and in vivo

BACKGROUND

A new 2-dimensional strain echocardiography (2DSE) method has been introduced that measures myocardial deformations by tracking localized acoustic markers. We compared strains measured in vitro and in vivo by 2DSE with those obtained by sonomicrometry.

METHODS

For the in vitro study, a tissue-mimicking gelatin block was cyclically compressed and longitudinal strains obtained by 2DSE and sonomicrometry crystals. For the in vivo study, arrays of crystals were implanted into the apical anteroseptal (test region) and midposterior (control region) in 16 open-chest pigs and strains measured by 2DSE and crystals at baseline and after acute ischemia.

RESULTS

In vitro, pooled data demonstrated good correlation (r = 0.99, P < .0001) and close agreement (bias +/- 2SD = 0.7 +/- 2.2%) of 2DSE and sonomicrometry. For a combination of low testing strains (5.4%) and strain rates (0.8 and 1.2 Hz), 2DSE overestimated strains by sonomicrometry. In vivo, linear regression analysis of pooled measurements demonstrated again a good correlation (r = 0.94, P < .0001) and agreement (1.1 +/- 7.5%) of 2DSE with sonomicrometry with a trend toward lower absolute values of strains by 2DSE.

CONCLUSION

The 2DSE demonstrated good overall correlation and agreement with sonomicrometry for the tested in vitro and in vivo values. Some caution with 2DSE measurements is needed for combinations of low strains and strain rates.

Sol-gel transition in agar-gelatin mixtures studied with transient elastography

Using the shear wave propagation in solids, the transient elastography technique has been developed to assess the elastic properties of soft tissues. Here, a new approach of transient elastography allows assessing the viscoelastic properties of soft tissues. In this paper, the method is used to follow-up the sol-gel transition of an agar-gelatin mixture noninvasively. The shear wave velocity and shear wave attenuation through the mixture were continuously monitored in the audible range of frequencies (from 50 Hz to 200 Hz). The observed changes in velocities and attenuations as a function of frequency confirmed the validity of the Voigt's model to describe the gel at its stable mechanical state. By a simple inverse problem approach, based on the one-dimensional (1-D) Helmholtz equation, the elasticity and the viscosity of such a mixture were recovered as a function of time. The results obtained are in good agreement with the literature and theoretical predictions. Overall, they demonstrate the high sensitivity of the transient elastography measurements to the rheological parameter changes in agar-gelatin mixtures during gelation.

Cardiac motion analysis from ultrasound sequences using nonrigid registration: validation against Doppler tissue velocity

Early detection of cardiac motion abnormalities is one of the main goals of quantitative cardiac image processing. This article presents a new method to compute the 2-D myocardial motion parameters from gray-scale 2-D echocardiographic sequences, making special emphasis on the validation of the proposed technique in comparison with Doppler tissue imaging. Myocardial motion is computed using a frame-to-frame nonrigid registration technique on the whole sequence. The key feature of our method is the use of an analytical representation of the myocardial displacement based on a semilocal parametric model of the deformation using Bsplines. Myocardial motion analysis is performed to obtain displacement, velocity and strain parameters. Robustness and speed are achieved by introducing a multiresolution optimization strategy. To validate the method, velocity measurements in three different regions-of-interest in the septum have been compared with those obtained with Doppler tissue velocity in healthy and pathologic subjects. Regression and Bland-Altman analysis show very good agreement between the two different approaches, with the great advantage that the new method overcomes the angle-dependency limitations of the Doppler techniques, providing both longitudinal and radial measurements.

Tracking quasi-stationary flow of weak fluorescent signals by adaptive multi-frame correlation

We have developed a novel cross-correlation technique to probe quasi-stationary flow of fluorescent signals in live cells at a spatial resolution that is close to single particle tracking. By correlating image blocks between pairs of consecutive frames and integrating their correlation scores over multiple frame pairs, uncertainty in identifying a globally significant maximum in the correlation score function has been greatly reduced as compared with conventional correlation-based tracking using the signal of only two consecutive frames. This approach proves robust and very effective in analysing images with a weak, noise-perturbed signal contrast where texture characteristics cannot be matched between only a pair of frames. It can also be applied to images that lack prominent features that could be utilized for particle tracking or feature-based template matching. Furthermore, owing to the integration of correlation scores over multiple frames, the method can handle signals with substantial frame-to-frame intensity variation where conventional correlation-based tracking fails. We tested the performance of the method by tracking polymer flow in actin and microtubule cytoskeleton structures labelled at various fluorophore densities providing imagery with a broad range of signal modulation and noise. In applications to fluorescent speckle microscopy (FSM), where the fluorophore density is sufficiently low to reveal patterns of discrete fluorescent marks referred to as speckles, we combined the multi-frame correlation approach proposed above with particle tracking. This hybrid approach allowed us to follow single speckles robustly in areas of high speckle density and fast flow, where previously published FSM analysis methods were unsuccessful. Thus, we can now probe cytoskeleton polymer dynamics in living cells at an entirely new level of complexity and with unprecedented detail.

Spatio-temporal nonrigid registration for ultrasound cardiac motion estimation

We propose a new spatio-temporal elastic registration algorithm for motion reconstruction from a series of images. The specific application is to estimate displacement fields from two-dimensional ultrasound sequences of the heart. The basic idea is to find a spatio-temporal deformation field that effectively compensates for the motion by minimizing a difference with respect to a reference frame. The key feature of our method is the use of a semi-local spatio-temporal parametric model for the deformation using splines, and the reformulation of the registration task as a global optimization problem. The scale of the spline model controls the smoothness of the displacement field. Our algorithm uses a multiresolution optimization strategy to obtain a higher speed and robustness. We evaluated the accuracy of our algorithm using a synthetic sequence generated with an ultrasound simulation package, together with a realistic cardiac motion model. We compared our new global multiframe approach with a previous method based on pairwise registration of consecutive frames to demonstrate the benefits of introducing temporal consistency. Finally, we applied the algorithm to the regional analysis of the left ventricle. Displacement and strain parameters were evaluated showing significant differences between the normal and pathological segments, thereby illustrating the clinical applicability of our method.

Evaluation of an ultrasonic echo-tracking method for measurements of arterial wall movements in two dimensions

The longitudinal movement of blood vessel walls has so far gained little or no attention, as it has been presumed that these movements are of a negligible magnitude. However, modern high-resolution ultrasound scanners can demonstrate that the inner layers of the arterial wall exhibit considerable movements in the longitudinal direction. This paper evaluates a new, noninvasive, echo-tracking technique, which simultaneously can track both the radial and the longitudinal movements of the arterial wall with high resolution in vivo. Initially, the method is evaluated in vitro using a specially designed ultrasound phantom, which is attached to and moved by an X-Y system, the movement of which was compared with two high-resolution triangulation lasers. The results show an inaccuracy of 2.5% full scale deflection (fsd), reproducibility of 12 microm and a resolution of 5 microm, which should be more than sufficient for in vivo studies. The ability of the method is also demonstrated in a limited in vivo study in which a preselected part of the inner vessel wall of the right common carotid artery of a healthy volunteer is tracked in two dimensions over many cardiac cycles. The results show well reproducible x-y movement loops in which the recorded radial and longitudinal movements both are of the magnitude millimetre.

Ultrasonic colour flow imaging

Real-time ultrasonic colour flow imaging, which was first demonstrated to be feasible only about a decade ago, has come into widespread clinical use. Ultrasound is scattered by ensembles of red blood cells. The ultrasonic frequency that gives the best signal-to-noise ratio for backscattering from blood depends on the required penetration. The frequency of ultrasound backscattered from flowing blood is shifted by the Doppler effect. The direction of flow can be determined by phase quadrature detection, and range selectivity can be provided by pulse-echo time-delay measurements. The Doppler frequency spectrum can be determined by Fourier analysis. Early two- and three-dimensional flow-imaging systems used slow manual scanning; velocity colour coding was introduced. Real-time colour flow imaging first became feasible when autocorrelation detection was used to extract the Doppler signal. Time-domain processing, which is a broad-band technique, was also soon shown to be practicable, for analysing both radio-frequency pulse-echo wavetrains and two-dimensional image speckle. Frequency- and time-domain processing both require effective cancellation of stationary echoes. The time-domain approach seems to have advantages in relation to both aliasing and the effects of attenuation in overlying tissues. Colour-coding schemes that can be interpreted without the need to refer to keys have been adopted, for both velocity and flow disturbance. Colour coding according to signal power has also been reintroduced. Three-dimensional display has been demonstrated. In interpreting colour flow images, it is important to understand the functions of critical system controls and the origins of artifacts. Various strategies can be adopted to increase the image frame rate. The problems of performance measurement and safety need to be kept under review. There are numerous opportunities for further development of ultrasonic colour flow imaging, including improvements in system design, methods of image display, the use of contrast agents and the solution of previously unexplored clinical problems.

3-D real-time motion correction in high-intensity focused ultrasound therapy

A method for tracking the 3-D motion of tissues in real-time is combined with a 2-D high-intensity focused ultrasound (US), or HIFU, multichannel system to correct for respiratory motion during HIFU therapy. Motion estimation is based on an accurate ultrasonic speckle-tracking method. A pulse-echo sequence is performed for a subset of the transducers of the phased array. For each of these subapertures, the displacement is estimated by computing the 1-D cross-correlation of the backscattered signals acquired at two different times. The 3-D motion vector is then computed by a triangulation algorithm. This technique is experimentally validated in phantoms moving as fast as 40 mm s(-1), and combined with HIFU sequences. A real-time feedback correction of the HIFU beam is achieved by adjusting the delays of each channel. The sonications "locked on target" are interleaved with very short motion-estimation sequences. Finally, in vitro experiments of "locked on target" HIFU therapy are performed in fresh moving tissues.

Plethysmographic arterial waveform strain discrimination by Fisher's method

Plethysmography has been used for over 50 years to measure gross change in tissue blood volume. Over the cardiac cycle, perfused tissue initially expands as the blood flow into the arterioles exceeds the flow through the capillary bed. Later in the cardiac cycle, the accumulated blood drains into the venous vasculature, allowing the tissue to return to its presystolic blood volume. Specific features in the plethysmographic waveform can be used to identify normal and abnormal perfusion. We are developing a Doppler strain-imaging technique to measure the local pulsatile expansion and relaxation of tissue analogous to the gross measurement of tissue volume change with conventional plethysmography. A phantom has been built to generate plethysmographic-style strains with amplitudes of less than 0.1% in a tissue-mimicking material. With Fisher's discriminant analysis, it is shown that normal and abnormal plethysmographic-style strains can be differentiated with high sensitivities using the Fourier components of the strain waveforms normalized to compensate for the variance in the strain amplitude estimate.

Tracking of regions-of-interest in myocardial contrast echocardiography

Analysis of intramyocardial perfusion by contrast echocardiography provides quantitative parameters for the assessment of ischemic disease. This analysis can be achieved by applying an ultrasound (US) burst of high mechanical index to destroy contrast bubbles, measuring various myocardial refilling parameters from the time curves obtained from regions-of-interest (ROIs) within the myocardial wall. To obtain reliable intensity curves, the position of the ROIs must be tracked to compensate for the heart motion along the sequence. In this work, we studied the use of optical flow techniques for ROI repositioning. Two block-matching and one differential technique were evaluated for this purpose. Performance was measured by comparing the result of automatic tracking with results of ROI repositioning by a human expert. This evaluation was carried out on experimental data from animals as well as on sequences from clinical studies. Results are considered to be accurate enough for clinical purposes, and computation times may allow for a real-time processing if incorporated into a US scanner.

Ultrasound elastography based on multiscale estimations of regularized displacement fields

Elasticity imaging is based on the measurements of local tissue deformation. The approach to ultrasound elasticity imaging presented in this paper relies on the estimation of dense displacement fields by a coarse-to-fine minimization of an energy function that combines constraints of conservation of echo amplitude and displacement field continuity. The multiscale optimization scheme presents several characteristics aimed at improving and accelerating the convergence of the minimization process. This includes the nonregularized initialization at the coarsest resolution and the use of adaptive configuration spaces. Parameters of the energy model and optimization were adjusted using data obtained from a tissue-like phantom material. Elasticity images from normal in vivo breast tissue were subsequently obtained with these parameters. Introducing a smoothness constraint into motion field estimation helped solve ambiguities due to incoherent motion, leading to elastograms less degraded by decorrelation noise than the ones obtained from correlation-based techniques.

AAPM/RSNA physics tutorial for residents: topics in US: beyond the basics: elasticity imaging with US

A new mode of imaging with ultrasonography (US) is under development in several laboratories around the world. This technique allows estimation of some measure of the viscoelastic properties of tissue. The information displayed in the images is a surrogate for that obtained with manual palpation. Fundamental concepts in elasticity imaging include stress, strain, and the elastic modulus; strain imaging has received the most attention from researchers. A system for elasticity imaging is under development that produces images of mechanical strain in real time by means of a freehand scanning technique. This system is integrated into a clinical US system without any external equipment and involves software changes only. Data obtained with this system demonstrate that the relative stiffness of many fibroadenomas changes as they and the surrounding tissue are deformed. At elasticity imaging of in vivo breast lesions, invasive ductal carcinomas appear, on average, more than twice as large on the elasticity image than on the B-mode image, but fibroadenomas and cysts are nearly equal in size on the two image types. The usefulness of this technology and the new information it provides suggest that it might soon be available on commercial US systems.

Maximum likelihood blood velocity estimator incorporating properties of flow physics

The aspect of correlation among the blood velocities in time and space has not received much attention in previous blood velocity estimators. The theory of fluid mechanics predicts this property of the blood flow. Additionally, most estimators based on a cross-correlation analysis are limited on the maximum velocity detectable. This is due to the occurrence of multiple peaks in the cross-correlation function. In this study a new estimator (CMLE), which is based on correlation (C) properties inherited from fluid flow and maximum likelihood estimation (MLE), is derived and evaluated on a set of simulated and in vivo data from the carotid artery. The estimator is meant for two-dimensional (2-D) color flow imaging. The resulting mathematical relation for the estimator consists of two terms. The first term performs a cross-correlation analysis on the signal segment in the radio frequency (RF)-data under investigation. The flow physic properties are exploited in the second term, as the range of velocity values investigated in the cross-correlation analysis are compared to the velocity estimates in the temporal and spatial neighborhood of the signal segment under investigation. The new estimator has been compared to the cross-correlation (CC) estimator and the previously developed maximum likelihood estimator (MLE). The results show that the CMLE can handle a larger velocity search range and is capable of estimating even low velocity levels from tissue motion. The CC and the MLE produce incorrect velocity estimates due to the multiple peaks, when the velocity search range is increased above the maximum detectable velocity. The root-mean square error (RMS) on the velocity estimates for the simulated data is on the order of 7 cm/s (14%) for the CMLE, and it is comparable to the RMS for the CC and the MLE. When the velocity search range is set to twice the limit of the CC and the MLE, the number of incorrect velocity estimates are 0, 19.1, and 7.2% for the CMLE, CC, and MLE, respectively. The ability to handle a larger search range and estimating low velocity levels was confirmed on in vivo data.