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

Local hippocampal fast gamma rhythms precede brain-wide hyperemic patterns during spontaneous rodent REM sleep

Rapid eye movement sleep (REMS) is a peculiar brain state combining the behavioral components of sleep and the electrophysiological profiles of wake. After decades of research our understanding of REMS still is precluded by the difficulty to observe its spontaneous dynamics and the lack of multimodal recording approaches to build comprehensive datasets. We used functional ultrasound (fUS) imaging concurrently with extracellular recordings of local field potentials (LFP) to reveal brain-wide spatiotemporal hemodynamics of single REMS episodes. We demonstrate for the first time the close association between global hyperemic events – largely outmatching wake levels in most brain regions – and local hippocampal theta (6–10 Hz) and fast gamma (80–110 Hz) events in the CA1 region. In particular, the power of fast gamma oscillations strongly correlated with the amplitude of subsequent vascular events. Our findings challenge our current understanding of neurovascular coupling and question the evolutionary benefit of such energy-demanding patterns in REMS function.

Neural activity during REM sleep is similar to the waking state. Here, the authors measure blood volume with neurofunctional ultrasound imaging together with hippocampal neural activity during REM sleep and report that fast gamma oscillations are coupled to a brain-wide upregulation of vascular flow.

2D and 3D real-time passive cavitation imaging of pulsed cavitation ultrasound therapy in moving tissues

Pulsed cavitation ultrasound therapy (PCUT) is an effective non-invasive therapeutic approach in various medical indications that relies on the mechanical effects generated by cavitation bubbles. Even though limited by the poor contrast, conventional ultrasound B-Mode imaging has been widely used for the guidance and monitoring of the therapeutic procedure, allowing the visualization of the cavitation bubble cloud. However, the visualization of the bubble cloud is often limited in deep organs such as the liver and the heart and remains moreover completely subjective for the operator. Our goal is to develop a new imaging mode to better identify the cavitation cloud. Active and passive cavitation imaging methods have been developed but none of them has been able to locate the cavitation bubble created by PCUT in real-time and in moving organs. In this paper we propose a passive ultrasound imaging approach combined with a spatiotemporal singular value decomposition filter to detect and map the bubble cloud with high sensitivity and high contrast. In moving applications at a maximal motion speed of 10 mm s^-1, the contrast-to-noise ratio for passive cavitation imaging is up to 10 times higher than for active cavitation imaging, with a temporal resolution of about 100 ms. The mapping of the bubble cloud can be overlaid in real-time to the conventional B-Mode, which permits to locate the cavitation phenomena in relation to the anatomic image. Finally, we extend the technique to volumetric imaging and show its feasibility on moving phantoms.

3-D Velocity and Volume Flow Measurement In Vivo Using Speckle Decorrelation and 2-D High-Frame-Rate Contrast-Enhanced Ultrasound

Being able to measure 3-D flow velocity and volumetric flow rate effectively in the cardiovascular system is valuable but remains a significant challenge in both clinical practice and research. Currently, there has not been an effective and practical solution to the measurement of volume flow using ultrasound imaging systems due to challenges in existing 3-D imaging techniques and high system cost. In this study, a new technique for quantifying volumetric flow rate from the cross-sectional imaging plane of the blood vessel was developed by using speckle decorrelation (SDC), 2-D high-frame-rate imaging with a standard 1-D array transducer, microbubble contrast agents, and ultrasound imaging velocimetry (UIV). Through SDC analysis of microbubble signals acquired with a very high frame rate and by using UIV to estimate the two in-plane flow velocity components, the third and out-of-plane velocity component can be obtained over time and integrated to estimate volume flow. The proposed technique was evaluated on a wall-less flow phantom in both steady and pulsatile flow. UIV in the longitudinal direction was conducted as a reference. The influences of frame rate, mechanical index (MI), orientation of imaging plane, and compounding on velocity estimation were also studied. In addition, an in vivo trial on the abdominal aorta of a rabbit was conducted. The results show that the new system can estimate volume flow with an averaged error of 3.65% ± 2.37% at a flow rate of 360 mL/min and a peak velocity of 0.45 m/s, and an error of 5.03% ± 2.73% at a flow rate of 723 mL/min and a peak velocity of 0.8 m/s. The accuracy of the flow velocity and volumetric flow rate estimation directly depend on the imaging frame rate. With a frame rate of 6000 Hz, a velocity up to 0.8 m/s can be correctly estimated. A higher mechanical index (MI = 0.42) is shown to produce greater errors (up to 21.78±0.49%, compared to 3.65±2.37% at MI = 0.19). An in vivo trial, where velocities up to 1 m/s were correctly measured, demonstrated the potential of the technique in clinical applications.

High-Frame-Rate Contrast-Enhanced Ultrasound for Velocimetry in the Human Abdominal Aorta

Treatment of abdominal aortic (AA) aneurysms and stenotic lesions may be improved by analyzing their associated blood-flow patterns. Angle-independent blood-flow patterns in the AA can be obtained by combining echo-particle image velocimetry (ePIV) with high-frame-rate (HFR) contrast-enhanced ultrasonography. However, ePIV performance is affected by ultrasound contrast agent (UCA) concentration, microbubble stability, and tissue clutter. In this study, we assessed the influence of acoustic pressure and UCA concentration on image quality for ePIV analysis. We also compared amplitude modulation (AM) and singular value decomposition (SVD) as tissue suppression strategies for ePIV. Fourteen healthy volunteers were imaged in the region of the distal AA. We tested four different UCA bolus volumes (0.25, 0.5, 0.75, and 1.5 mL) and four different acoustic output pressures (mechanical indices: 0.01, 0.03, 0.06, and 0.09). As image quality metrics, we measured contrast-to-background ratio, bubble disruption ratio, and maximum normalized cross-correlation value during ePIV. At mechanical indices ≥ 0.06, we detected severe bubble destruction, suggesting that very low acoustic pressures should be used for ePIV. SVD was able to suppress tissue clutter better than AM. The maximum tracking correlation was affected by both UCA concentration and flow rate, where at high flow rates, lower UCA concentrations resulted in slightly higher correlation values but more signal drop-outs during late diastole. HFR ePIV was successfully performed in the AA of healthy volunteers and shows promise for future studies in patients.

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.

3-D Perfusion Imaging Using Principal Curvature Detection Rendering

Three-dimensional contrast-enhanced ultrasound (CEUS) imaging presents a clear advantage over its 2-D counterpart in detecting and characterizing suspicious lesions as it properly surveys the inherent heterogeneity of tumors. However, 3-D CEUS is also slow compared to 2-D CEUS and tends to undersample the microbubble wash-in. This makes it difficult to resolve the feeding vessels, an important oncogenic marker, from the background perfusion cloud. Contrast-enhanced Doppler is helpful in isolating this conduit flow, but requires too many pulses in conventional line-by-line beamforming design. Recent breakthroughs in plane-wave imaging have greatly accelerated the volumetric imaging frame rate, but volumetric Doppler angiography still remains challenging when considering real-time limitations on the Doppler ensemble length. In this work, we demonstrate the feasibility of volumetric CEUS angiography subjected to real-time imaging constraints. Namely, we show how principal curvature detection can significantly improve 3-D rendering of relatively noisy ultrasound angiograms without degrading the spatial resolution while subjected to a reasonable Doppler ensemble size. Singular value decomposition is also shown to be capable of identifying the quasi-stationary capillary perfusion.

SUSHI: Sparsity-Based Ultrasound Super-Resolution Hemodynamic Imaging

Identifying and visualizing vasculature within organs and tumors has major implications in managing cardiovascular diseases and cancer. Contrast-enhanced ultrasound scans detect slow-flowing blood, facilitating noninvasive perfusion measurements. However, their limited spatial resolution prevents the depiction of microvascular structures. Recently, super-localization ultrasonography techniques have surpassed this limit. However, they require long acquisition times of several minutes, preventing the detection of hemodynamic changes. We present a fast super-resolution method that exploits sparsity in the underlying vasculature and statistical independence within the measured signals. Similar to super-localization techniques, this approach improves the spatial resolution by up to an order of magnitude compared to standard scans. Unlike super-localization methods, it requires acquisition times of only tens of milliseconds. We demonstrate a temporal resolution of ~25 Hz, which may enable functional super-resolution imaging deep within the tissue, surpassing the temporal resolution limitations of current super-resolution methods, e.g., in neural imaging. The subsecond acquisitions make our approach robust to motion artifacts, simplifying in vivo use of super-resolution ultrasound.

On the Effects of Spatial Sampling Quantization in Super-Resolution Ultrasound Microvessel Imaging

Ultrasound super-resolution (SR) microvessel imaging technologies are rapidly emerging and evolving. The unprecedented combination of imaging resolution and penetration promises a wide range of preclinical and clinical applications. This paper concerns spatial quantization error in SR imaging, a common issue that involves a majority of current SR imaging methods. While quantization error can be alleviated by the microbubble localization process (e.g., via upsampling or parametric fitting), it is unclear to what extent the localization process can suppress the spatial quantization error induced by discrete sampling. It is also unclear when low spatial sampling frequency will result in irreversible quantization errors that cannot be suppressed by the localization process. This paper had two goals: 1) to systematically investigate the effect of quantization in SR imaging and establish principles of adequate SR imaging spatial sampling that yield minimal quantization error with proper localization methods and 2) to compare the performance of various localization methods and study the level of tolerance of each method to quantization. We conducted experiments on a small wire target and on a microbubble flow phantom. We found that the Fourier analysis of an oversampled spatial profile of the microbubble signal could provide reliable guidance for selecting beamforming spatial sampling frequency. Among various localization methods, parametric Gaussian fitting and centroid-based localization on upsampled data had better microbubble localization performance and were less susceptible to quantization error than peak intensity-based localization methods. When spatial sampling resolution was low, parametric Gaussian fitting-based localization had the best performance in suppressing quantization error, and could produce acceptable SR microvessel imaging with no significant quantization artifacts. The findings from this paper can be used in practice to help intelligently determine the minimum requirement of spatial sampling for robust microbubble localization to avoid adding or even reduce the burden of computational cost and data storage that are commonly associated with SR imaging.

4-D Intracardiac Ultrasound Vector Flow Imaging-Feasibility and Comparison to Phase-Contrast MRI

In vivo characterization of intracardiac blood velocity vector fields may provide new clinical information but is currently not available for bedside evaluation. In this paper, 4-D vector flow imaging for intracardiac flow assessment is demonstrated using a clinical ultrasound (US) system and a matrix array transducer, without the use of contrast agent. Two acquisition schemes were developed, one for full volumetric coverage of the left ventricle (LA) at 50 vps and a 3-D thick-slice setup with continuous frame acquisition (4000 vps), both utilizing ECG-gating. The 3-D vector velocity estimates were obtained using a novel method combining phase and envelope information. In vitro validation in a rotating tissue-mimicking phantom revealed velocity estimates in compliance with the ground truth, with a linear regression slope of 0.80, 0.77, and 1.03 for the , , and velocity components, and with standard deviations of 2.53, 3.19, and 0.95 cm/s, respectively. In vivo measurements in a healthy LV showed good agreement with PC-MRI. Quantitative analysis of energy loss (EL) and kinetic energy (KE) further showed similar trends, with peak KE at 1.5 and 2.4 mJ during systole and 3.6 and 3.1 mJ for diastole for US and PC-MRI. Similar for EL, 0.15- 0.2 and 0.7 mW was found during systole and 0.6 and 0.7 mW during diastole, for US and PC-MRI, respectively. Overall, a potential for US as a future modality for 4D cardiac vector flow imaging was demonstrated, which will be further evaluated in clinical studies.

Adaptive Multifocus Beamforming for Contrast-Enhanced-Super-Resolution Ultrasound Imaging in Deep Tissue

Contrast-enhanced-super-resolution ultrasound imaging, also referred to as ultrasound localization microscopy, can resolve vessels that are smaller than the diffraction limit and has recently been able to generate super-resolved vascular images of shallow in vivo structures in small animals. To fully translate this technology to the clinic, it is advantageous to be able to detect microbubbles at deeper locations in tissue while maintaining a short acquisition time. Current implementations of this imaging method rely on plane-wave imaging. This method has the advantage of maximizing the frame rate, which is important due to the large amount of frames required for super-resolution processing. However, the wide planar beam used to illuminate the field of view produces poor contrast and low sensitivity bubble detection. Here, we propose an "adaptive multifocus" sequence, a new ultrasound imaging sequence that combines the high frame rate feature of a plane wave with the increased bubble detection sensitivity of a focused beam. This sequence simultaneously sonicates two or more foci with a single emission, hence retaining a high frame rate, yet achieving improved sensitivity to microbubbles. In the limit of one target, the beam reduces to a conventional focused transmission; and for an infinite number of targets, it converges to plane-wave imaging. Numerical simulations, using the full-wave code, are performed to compare the point spread function of the proposed sequence to that generated by the plane-wave emission. Our numerical results predict an improvement of up to 15 dB in the signal-to-noise ratio. Ex vivo experiments of a tissue-embedded microtube phantom are used to generate super-resolved images and to compare the adaptive beamforming approach to plane-wave imaging. These experimental results show that the adaptive multifocus sequence successfully detects 744 microbubble events at 60 mm when they are undetectable by the plane-wave sequence under the same imaging conditions. At a shallower depth of 44 mm, the proposed adaptive multifocus method detects 6.9 times more bubbles than plane-wave imaging (1763 versus 257 bubble events).

Multi-parametric functional ultrasound imaging of cerebral hemodynamics in a cardiopulmonary resuscitation model

Patient mortality at one year reaches 90% after out-of-hospital cardiac arrest and resuscitation. Temperature management is one of the main strategies proposed to improve patient outcome after resuscitation and preclinical studies have shown neuroprotective effects when hypothermia is achieved rapidly, although the underlying mechanisms have not yet been elucidated. State-of-the-art brain imaging technologies can bring new insights into the early cerebral events taking place post cardiac arrest and resuscitation. In this paper, we characterized cerebral hemodynamics in a post-cardiac arrest rabbit model using functional ultrasound imaging. Ultrasound datasets were processed to map the dynamic changes in cerebral blood flow and cerebral vascular resistivity with a 10 second repetition rate while animals underwent cardiac arrest and a cardiopulmonary resuscitation. We report that a severe transient hyperemia takes place in the brain within the first twenty minutes post resuscitation, emphasizing the need for fast post-cardiac arrest care. Furthermore, we observed that this early hyperemic event is not spatially homogeneous and that maximal cerebral hyperemia happens in the hippocampus. Finally, we show that rapid cooling induced by total liquid ventilation reduces early cerebral hyperemia, which could explain the improved neurological outcome reported in preclinical studies.

Multidimensional Clutter Filter Optimization for Ultrasonic Perfusion Imaging

Combinations of novel pulse-echo acquisitions and clutter filtering techniques can improve the sensitivity and the specificity of power Doppler (PD) images, thus reducing the need for exogenous contrast enhancement. We acquire echoes following bursts of Doppler pulse transmissions sparsely applied in regular patterns over long durations. The goal is to increase the sensitivity of the acquisition to slow disorganized patterns of motion from the peripheral blood perfusion. To counter a concomitant increase in clutter signal power, we arrange the temporal echo acquisitions into two data-array axes, combine them with a spatial axis for the tissue region of interest, and apply 3-D singular-value decomposition (SVD) clutter filtering. Successful separation of blood echoes from other echo signal sources requires that we partition the 3-D SVD core tensor. Unfortunately, the clutter and blood subspaces do not completely uncouple in all situations, so we developed a statistical classifier that identifies the core tensor subspace dominated by tissue clutter power. This paper describes an approach to subspace partitioning as required for optimizing PD imaging of peripheral perfusion. The technique is validated using echo simulation, flow-phantom data, and in vivo data from a murine melanoma model. We find that for narrow eigen-bandwidth clutter signals, we can routinely map phantom flows and tumor perfusion signals at speeds less than 3 mL/min. The proposed method is well suited to peripheral perfusion imaging applications.

Adaptive Spatiotemporal Filtering for Coronary Ultrafast Doppler Angiography

The heart's supply of oxygen and nutrients relies on the coronary vasculature, which branches from millimeter-sized arteries down to micrometer-sized capillaries. To date, imaging technologies can only detect large epicardial coronary vessels, whereas the intramural coronary vasculature remains invisible due to cardiac motion. We recently introduced coronary ultrafast Doppler angiography, a noninvasive vascular imaging technology based on ultrafast ultrasound that enables the visualization of epicardial and intramural coronary vasculature in humans. In this letter we describe, using an open-chest swine data set, the adaptive spatiotemporal filtering method that was developed for the detection of slow blood flows embedded in rapid myocardial motion.

In Vivo Visualization of Vasculature in Adult Zebrafish by Using High-Frequency Ultrafast Ultrasound Imaging

OBJECTIVE

Zebrafish has been recently considered an ideal vertebrate for studying developmental biology, genetics, particularly for modeling tumorigenesis, angiogenesis, and regeneration in vivo. However, when a zebrafish matures completely, its body loses transparency, thus making conventional optical imaging techniques difficult for imaging internal anatomy and vasculature. Acoustic wave penetration outperforms optical methods, high-frequency (>30 MHz) ultrasound (HFUS) was consequently an alternative imaging modality for adult zebrafish imaging, particularly for echocardiography However, visualizing peripheral vessels in a zebrafish by using conventional HFUS is still difficult.

METHODS

In the present study, high-frequency micro-Doppler imaging (HFμDI) based on ultrafast ultrasound imaging was proposed for zebrafish dorsal vascular mapping in vivo. HFμDI uses a 40-MHz ultrasound transducer, which is an ultrafast ultrasound imaging technology with the highest frequency available currently. Blood flow signals were extracted using an eigen-based clutter filter with different settings. Experiments were performed on an 8-month-old wild-type AB-line adult zebrafish.

RESULTS

Blood vessels, including intersegmental vessels, parachordal vessel, dorsal longitudinal anastomotic vessel, and dorsal aorta, from the dorsal side of the zebrafish were clearly observed in two-dimensional (2-D) and 3-D HFμDI.

CONCLUSION

The maximum image depth of HFμDI and the minimal diameter of vessel can be detected were 4 mm and 36 μm, respectively; they were determined without any use of microbubbles. The maximum flow velocity range was approximately 3-4 mm/s on the dorsal vessels of the adult zebrafish.

SIGNIFICANCE

Compared with conventional ultrasound Doppler imaging, HFμDI exhibited superior small vessel imaging.

Non-contrast agent based small vessel imaging of human thyroid using motion corrected power Doppler imaging

Singular value based spatiotemporal clutter filtering (SVD-STF) can significantly improve the sensitivity of blood flow imaging in small vessels without using contrast agents. However, despite effective clutter filtering, large physiological motion in thyroid imaging can impact coherent integration of the Doppler signal and degrade the visualization of the underlying vasculature. In this study, we hypothesize that motion correction of the clutter filtered Doppler ensemble, prior to the power Doppler estimation, can considerably improve the visualization of smalls vessels in suspicious thyroid nodules. We corroborated this hypothesis by conducting in vivo experiments on 10 female patients in the age group 44-82 yrs, with at least one thyroid nodule suspicious of malignancy, with recommendation for fine needle aspiration biopsy. Ultrasound images were acquired using a clinical ultrasound scanner, implemented with compounded plane wave imaging. Axial and lateral displacements associated with the thyroid nodules were estimated using 2D normalized cross-correlation. Subsequently, the tissue clutter associated with the Doppler ensemble was suppressed using SVD-STF. Motion correction of the clutter-filtered Doppler ensemble was achieved using a spline based sub-pixel interpolation. The results demonstrated that power Doppler images of thyroid nodules were noticeably degraded due to large physiological motion of the pulsating carotid artery in the proximity. The resultant power Doppler images were corrupted with signal distortion, motion blurring and occurrence of artificial shadow vessels and displayed visibly low signal-to-background contrast. In contrast, the power Doppler images obtained from the motion corrected ultrasound data addressed the issue and considerabley improved the visualization of blood flow. The signal-to-noise ratio and the contrast-to-noise ratio increased by up to 15.2 dB and 12.1 dB, respectively. Across the ten subjects, the highest improvement was observed for the nodule with the largest motion. These preliminary results show the ability of using motion correction to improve the visualization of small vessel blood flow in thyroid, without using any contrast agents. The results of this feasibility study were encouraging, and warrant further development and more in vivo validation in moving tissues and organs.

Microvessel ultrasound of neonatal brain parenchyma: feasibility, reproducibility, and normal imaging features by superb microvascular imaging (SMI)

Objectives

To evaluate the feasibility and reproducibility of superb microvascular imaging (SMI) of the neonatal brain and to describe normal imaging features.

Methods

We performed transcranial ultrasound with SMI in 19 healthy term-born neonates. SMI was done according to a structured examination protocol, using two linear 18 MHz and 14 MHz transducers. Superficial and deep scans were acquired in the coronal and sagittal planes, using the left and right superior frontal gyri as anatomical landmarks. All SMI views were imaged by monochrome and colour SMI and evaluated with respect to visibility of extrastriatal (i.e. cortical and medullary) and striatal microvessels.

Results

We have described normal morphologic features of intraparenchymal brain microvasculature as “short parallel” cortical vessels, “smoothly curved” medullary vessels, and deep striatal vessels. In general, SMI performance was better on coronal views than on sagittal views. On superficial coronal scans, cortical microvessels were identifiable in 90–100%, medullary microvessels in 95–100%. On deep scans, cortical and medullary microvessels were visible in all cases, while striatal microvessels were identifiable in 71% of cases.

Conclusions

Cerebral SMI ultrasound is feasible and well-reproducible and provides a novel non-invasive imaging tool for the assessment of intraparenchymal brain microvasculature (extrastriatal and striatal microvessels) in neonates without the use of contrast.

Key Points

• Superb microvascular imaging (SMI) of the neonatal brain is feasible and reproducible.

• SMI depicts extrastriatal and striatal microvessels.

• SMI detects two types of extrastriatal microvessels: cortical and medullary.

Electronic supplementary material

The online version of this article (10.1007/s00330-018-5743-1) contains supplementary material, which is available to authorized users.

Super-resolution ultrasound imaging method for microvasculature in vivo with a high temporal accuracy

Traditional ultrasound imaging techniques are limited in spatial resolution to visualize angiogenic vasa vasorum that is considered as an important marker for atherosclerotic plaque progression and vulnerability. The recently introduced super-resolution imaging technique based on microbubble center localization has shown potential to achieve unprecedented high spatial resolution beyond the acoustic diffraction limit. However, a major drawback of the current super-resolution imaging approach is low temporal resolution because it requires a large number of imaging frames. In this study, a new imaging sequence and signal processing approach for super-resolution ultrasound imaging are presented to improve temporal resolution by employing deconvolution and spatio-temporal-interframe-correlation based data acquisition. In vivo feasibility of the developed technology is demonstrated and evaluated in imaging vasa vasorum in the rabbit atherosclerosis model. The proposed method not only identifies a tiny vessel with a diameter of 41 μm, 5 times higher spatial resolution than the acoustic diffraction limit at 7.7 MHz, but also significantly improves temporal resolution that allows for imaging vessels over cardiac motion.

Ultrasound Imaging and Measurement of Choroidal Blood Flow

Purpose

The choroid is a vascular network providing the bulk of the oxygen and nutrient supply to the retina and may play a pivotal role in retinal disease pathogenesis. While optical coherence tomography angiography provides an en face depiction of the choroidal vasculature, it does not reveal flow dynamics. In this report, we describe the use of plane-wave ultrasound to image and characterize choroidal blood flow.

Methods

We scanned both eyes of 12 healthy subjects in a horizontal plane superior to the optic nerve head using an 18-MHz linear array. Plane-wave data were acquired over 10 transmission angles that were coherently compounded to produce 1000 images/sec for 3 seconds. These data were processed to produce a time series of power Doppler images and spectrograms depicting choroidal flow velocity. Analysis of variance was used to characterize peak systolic, and end diastolic velocities and resistive index, and their variability between scans, eyes, and subjects.

Results

Power Doppler images showed distinct arterioles within a more diffuse background. Choroidal flow was moderately pulsatile, with peak systolic velocity averaging approximately 10 mm/sec and resistive index of 0.55. There was no significant difference between left and right eyes, but significant variation among subjects.

Conclusions

Plane-wave ultrasound visualized individual arterioles and allowed measurement of flow over the cardiac cycle. Characterization of choroidal flow dynamics offers a novel means for assessment of the choroid's role in ocular disease.

Translational Relevance

Characterization of choroidal flow dynamics offers a novel means for assessment of the choroid's role in ocular disease.

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.

Impact of Encapsulation on in vitro and in vivo Performance of Volatile Nanoscale Phase-Shift Perfluorocarbon Droplets

Phase-shift droplets can be converted by sound from low-echogenicity, liquid-core agents into highly echogenic microbubbles. Many proposed applications in imaging and therapy take advantage of the high spatiotemporal control over this dynamic transition. Although some studies have reported increased circulation time of the droplets compared with microbubbles, few have directly explored the impact of encapsulation on droplet performance. With the goal of developing nanoscale droplets with increased circulatory persistence, we first evaluate the half-life of several candidate phospholipid encapsulations in vitro at clinical frequencies. To evaluate in vivo circulatory persistence, we develop a technique to periodically measure droplet vaporization from high-frequency B-mode scans of a mouse kidney. Results show that longer acyl chain phospholipids can dramatically reduce droplet degradation, increasing median half-life in vitro to 25.6 min-a 50-fold increase over droplets formed from phospholipids commonly used for clinical microbubbles. In vivo, the best-performing droplet formulations showed a median half-life of 18.4 min, more than a 35-fold increase in circulatory half-life compared with microbubbles with the same encapsulation in vivo. These findings also point to possible refinements that may improve nanoscale phase-shift droplet performance beyond those measured here.

ASAP: Super-Contrast Vasculature Imaging Using Coherence Analysis and High Frame-Rate Contrast Enhanced Ultrasound

The very high frame rate afforded by ultrafast ultrasound, combined with microbubble contrast agents, opens new opportunities for imaging tissue microvasculature. However, new imaging paradigms are required to obtain superior image quality from the large amount of acquired data while allowing real-time implementation. In this paper, we report a technique-acoustic sub-aperture processing (ASAP)-capable of generating very high contrast/signal-to-noise ratio (SNR) images of macro-and microvessels, with similar computational complexity to classical power Doppler (PD) imaging. In ASAP, the received data are split into subgroups. The reconstructed data from each subgroup are temporally correlated over frames to generate the final image. As signals in subgroups are correlated but the noise is not, this substantially reduces the noise floor compared to PD. Using a clinical imaging probe, the method is shown to visualize vessels down to $200~\mu \text{m}$ with a SNR of 10 dB higher than PD and to resolve microvascular flow/perfusion information in rabbit kidneys noninvasively in vivo at multiple centimeter depths. With careful filter design, the technique also allows the estimation of flow direction and the separation of fast flow from tissue perfusion. ASAP can readily be implemented into hardware/firmware for real-time imaging and can be applied to contrast enhanced and potentially noncontrast imaging and 3-D imaging.

Ultrasound Localization Microscopy and Super-Resolution: A State of the Art

Because it drives the compromise between resolution and penetration, the diffraction limit has long represented an unreachable summit to conquer in ultrasound imaging. Within a few years after the introduction of optical localization microscopy, we proposed its acoustic alter ego that exploits the micrometric localization of microbubble contrast agents to reconstruct the finest vessels in the body in-depth. Various groups now working on the subject are optimizing the localization precision, microbubble separation, acquisition time, tracking, and velocimetry to improve the capacity of ultrasound localization microscopy (ULM) to detect and distinguish vessels much smaller than the wavelength. It has since been used in vivo in the brain, the kidney, and tumors. In the clinic, ULM is bound to improve drastically our vision of the microvasculature, which could revolutionize the diagnosis of cancer, arteriosclerosis, stroke, and diabetes.

Background Removal and Vessel Filtering of Noncontrast Ultrasound Images of Microvasculature

OBJECTIVE

Recent advances in ultrasound Doppler imaging have made it possible to visualize small vessels with diameters near the imaging resolution limits using spatiotemporal singular value thresholding of long ensembles of ultrasound data. However, vessel images derived based on this method present severe intensity variations and additional background noise that limits visibility and subsequent processing such as centerline extraction and morphological analysis. The goal of this paper is to devise a method to enhance vessel-background separation directly on the power Doppler images by exploiting blood echo-noise independence.

METHOD

We present a two-step algorithm to mitigate these adverse effects when using singular value thresholding for obtaining gross vasculature images. Our method comprises a morphological-based filtering for removing global and local background signals and a multiscale Hessian-based vessel enhancement filtering to further improve the vascular structures. We applied our method for in vivo imaging of the microvasculature of kidney in one healthy subject, liver in five healthy subjects, thyroid nodules in five patients, and breast tumors in five patients.

RESULTS

Singular value thresholding, top-hat filtering, and Hessian-based vessel enhancement filtering each provided an average peak-to-side level gain of 1.11, 18.55, and 2.26 dB, respectively, resulting in an overall gain of 21.92 dB when compared to the conventional power Doppler imaging using infinite impulse response filtering.

CONCLUSION

Singular value thresholding combined with morphological and Hessian-based vessel enhancement filtering provides a powerful tool for visualization of the deep-seated small vessels using long ultrasound echo ensembles without requiring any type of contrast enhancing agents.

SIGNIFICANCE

This method provides a fast and cost-effective modality for in vivo assessment of the microvasculature suitable for both clinical and preclinical applications.

High-Frame-Rate Contrast-enhanced US Particle Image Velocimetry in the Abdominal Aorta: First Human Results

Purpose To study the feasibility of high-frame-rate (HFR) contrast material-enhanced (CE) ultrasound particle image velocimetry (PIV), or echo PIV, in the abdominal aorta. Materials and Methods Fifteen healthy participants (six men; median age, 23 years [age range, 18-34 years]; median body mass index, 20.3 kg/m² [range, 17.3-24.9 kg/m²]) underwent HFR CE US. US microbubbles were injected at incremental doses (0.25, 0.5, 0.75, and 1.5 mL), with each dose followed by US measurement to determine the optimal dosage. Different US mechanical index values were evaluated (0.09, 0.06, 0.03, and 0.01) in a diverging wave acquisition scheme. PIV analysis was performed via pairwise cross-correlation of all captured images. Participants also underwent phase-contrast MRI. The echo PIV and phase-contrast MRI velocity profiles were compared via calculation of similarity index and relative difference in peak velocity. Results Visualization of the aortic bifurcation with HFR CE US was successful in all participants. Optimal echo PIV results were achieved with the lowest contrast agent dose of 0.25 mL in combination with the lowest mechanical indexes (0.01 or 0.03). Substantial bubble destruction occurred at higher mechanical indexes (≥0.06). Flow patterns were qualitatively similar in the echo PIV and MR images. The echo PIV and MRI velocity profiles showed good agreement (similarity index, 0.98 and 0.99; difference in peak velocity, 8.5% and 17.0% in temporal and spatial profiles, respectively). Conclusion Quantification of blood flow in the human abdominal aorta with US particle image velocimetry (echo PIV) is feasible. Use of echo PIV has potential in the clinical evaluation of aortic disease. © RSNA, 2018 Online supplemental material is available for this article.

A High-Efficiency Super-Resolution Reconstruction Method for Ultrasound Microvascular Imaging

The emergence of super-resolution imaging makes it possible to display the microvasculatures clearly using ultrasound imaging, which is of great importance in the early diagnosis of cancer. At present, the super-resolution performance can only be achieved when the sampling signal is long enough (usually more than 10,000 frames). Thus, the imaging time resolution is not suitable for clinical use. In this paper, we proposed a novel super-resolution reconstruction method, which is proved to have a satisfactory resolution using shorter sampling signal sequences. In the microbubble localization step, the integrated form of the 2D Gaussian function is innovatively adopted for image deconvolution in our method, which enhances the accuracy of microbubble positioning. In the trajectory tracking step, for the first time the averaged shifted histogram technique is presented for the visualization, which greatly improves the precision of reconstruction. In vivo experiments on rabbits were conducted to verify the effectiveness of the proposed method. Compared to the conventional reconstruction method, our method significantly reduces the Full-Width-at-Half-Maximum (FWHM) by 50% using only 400-frame signals. Besides, there is no significant increase in the running time using the proposed method. Considering its imaging performance and used frame number, the conclusion can be drawn that the proposed method advances the application of super-resolution imaging to the clinical use with a much higher time resolution.

Simultaneous Vascular Strain and Blood Vector Velocity Imaging Using High-Frequency Versus Conventional-Frequency Plane Wave Ultrasound: A Phantom Study

Plaque strain and blood vector velocity imaging of stenosed arteries are expected to aid in diagnosis and prevention of cerebrovascular disease. Ultrafast plane wave imaging enables simultaneous strain and velocity estimation. Multiple ultrasound vendors are introducing high-frequency ultrasound probes and systems. This paper investigates whether the use of high-frequency ultrafast ultrasound is beneficial for assessing blood velocities and strain in arteries. The performance of strain and blood flow velocity estimation was compared between a high-frequency transducer (MS250, fc = 21 MHz) and a clinically utilized transducer (L12-5, fc = 9 MHz). Quantitative analysis based on straight tube phantom experiments revealed that the MS250 outperformed the L12-5 in the superficial region: low velocities near the wall were more accurately estimated and wall strains were better resolved. At greater than 2-cm echo depth, the L12-5 performed better due to the high attenuation of the MS250 probe. Qualitative comparison using a perfused patient-specific carotid bifurcation phantom confirmed these findings. Thus, in conclusion, for strain and blood velocity estimation for depths up to ~2 cm, a high-frequency probe is recommended.

Combining Acoustic Trapping With Plane Wave Imaging for Localized Microbubble Accumulation in Large Vessels

The capability of accumulating microbubbles using ultrasound could be beneficial for enhancing targeted drug delivery. When microbubbles are used to deliver a therapeutic payload, there is a need to track them, for a localized release of the payload. In this paper, a method for localizing microbubble accumulation with fast image guidance is presented. A linear array transducer performed trapping of microbubble populations interleaved with plane wave imaging, through the use of a composite pulse sequence. The acoustic trap in the pressure field was created parallel with the direction of flow in a model of a vessel section. The acoustic trapping force resultant from the large gradients in the acoustic field was engendered to directly oppose the flowing microbubbles. This was demonstrated numerically with field simulations, and experimentally using an Ultrasound Array Research Platform II. SonoVue microbubbles at clinically relevant concentrations were pumped through a tissue-mimicking flow phantom and exposed to either the acoustic trap or a control ultrasonic field composed of a single-peak acoustic radiation force beam. Under the flow condition at a shear rate of 433 s^-1, the use of the acoustic trap led to lower speed estimations ( ) in the center of the acoustic field, and an enhancement of 71% ± 28%( ) in microbubble image brightness.

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.

Non-invasive spinal vibration testing using ultrafast ultrasound imaging: A new way to measure spine function

Ultrafast ultrasound imaging is used to capture driven spinal vibrations as a new method for non-invasive spinal testing in living subjects. Previously, it has been shown that accelerometer-based vibration testing in cadaveric models can reveal the presence, location and magnitude of spinal pathology. However, this process remains an invasive procedure as current non-invasive sensors are inadequate. In this paper, the ability of non-invasive ultrafast ultrasound to quantify in vivo vertebral vibration response across a broad range of frequencies (10–100Hz) in anesthetized pig models is investigated. Close agreement with invasive accelerometer measurements is achieved using the non-invasive ultrasound method, opening up unique opportunities to investigate spinal pathologies.

Two-Stage Motion Correction for Super-Resolution Ultrasound Imaging in Human Lower Limb

The structure of microvasculature cannot be resolved using conventional ultrasound (US) imaging due to the fundamental diffraction limit at clinical US frequencies. It is possible to overcome this resolution limitation by localizing individual microbubbles through multiple frames and forming a superresolved image, which usually requires seconds to minutes of acquisition. Over this time interval, motion is inevitable and tissue movement is typically a combination of large- and small-scale tissue translation and deformation. Therefore, super-resolution (SR) imaging is prone to motion artifacts as other imaging modalities based on multiple acquisitions are. This paper investigates the feasibility of a two-stage motion estimation method, which is a combination of affine and nonrigid estimation, for SR US imaging. First, the motion correction accuracy of the proposed method is evaluated using simulations with increasing complexity of motion. A mean absolute error of 12.2 was achieved in simulations for the worst-case scenario. The motion correction algorithm was then applied to a clinical data set to demonstrate its potential to enable in vivo SR US imaging in the presence of patient motion. The size of the identified microvessels from the clinical SR images was measured to assess the feasibility of the two-stage motion correction method, which reduced the width of the motion-blurred microvessels to approximately 1.5-fold.

Evaluation of parotid glands in healthy children and adolescents using shear wave elastography and superb microvascular imaging

OBJECTIVES

We aim to determine parotid gland elasticity values from healthy children and adolescents using shear wave elastography (SWE). We also define the degree of vascularity using superb microvascular imaging (SMI), power Doppler (PD), and color Doppler (CD) and compare SMI with CD and PD.

MATERIALS AND METHODS

A total of 100 cases, comprising 50 girls and 50 boys, with ages ranging from 3 to 17 years were included in this prospective study. SWE, SMI, PD, and CD measurements were taken from both parotid glands, and the relationships with sex, age, and body mass index (BMI) were determined. The SMI was compared with the PD and CD.

RESULTS

The median elasticity values measured with SWE were 8.37 ± 2.09 kPa and 1.68 ± 0.26 m/s on the right and 8.33 ± 2.04 kPa and 1.69 ± 0.26 m/s on the left. There were significant positive correlations present for those aged below and above 10 years and for BMI with elasticity values. The median vascular spot numbers measured using SMI, PD, and CD were 5 ± 1.70, 3.5 ± 1.45, and 2 ± 1.1 on the right and 4 ± 1.7, 4 ± 1.43, and 2 ± 1.05 on the left, respectively. The median values obtained with SMI were significantly higher than the median values obtained with both PD and CD.

CONCLUSION

This study determined the reference SWE, SMI, PD, and CD values for normal parotid glands in healthy children and adolescents. Elasticity values were affected by age and BMI. There was no correlation between vascularity values and age, sex, or BMI. SMI provided more detailed information about vascularity compared with the other methods.

Motion model ultrasound localization microscopy for preclinical and clinical multiparametric tumor characterization

Super-resolution imaging methods promote tissue characterization beyond the spatial resolution limits of the devices and bridge the gap between histopathological analysis and non-invasive imaging. Here, we introduce motion model ultrasound localization microscopy (mULM) as an easily applicable and robust new tool to morphologically and functionally characterize fine vascular networks in tumors at super-resolution. In tumor-bearing mice and for the first time in patients, we demonstrate that within less than 1 min scan time mULM can be realized using conventional preclinical and clinical ultrasound devices. In this context, next to highly detailed images of tumor microvascularization and the reliable quantification of relative blood volume and perfusion, mULM provides multiple new functional and morphological parameters that discriminate tumors with different vascular phenotypes. Furthermore, our initial patient data indicate that mULM can be applied in a clinical ultrasound setting opening avenues for the multiparametric characterization of tumors and the assessment of therapy response.

Motion model ultrasound localization microscopy for preclinical and clinical multiparametric tumor characterization

Super-resolution imaging methods promote tissue characterization beyond the spatial resolution limits of the devices and bridge the gap between histopathological analysis and non-invasive imaging. Here, we introduce motion model ultrasound localization microscopy (mULM) as an easily applicable and robust new tool to morphologically and functionally characterize fine vascular networks in tumors at super-resolution. In tumor-bearing mice and for the first time in patients, we demonstrate that within less than 1 min scan time mULM can be realized using conventional preclinical and clinical ultrasound devices. In this context, next to highly detailed images of tumor microvascularization and the reliable quantification of relative blood volume and perfusion, mULM provides multiple new functional and morphological parameters that discriminate tumors with different vascular phenotypes. Furthermore, our initial patient data indicate that mULM can be applied in a clinical ultrasound setting opening avenues for the multiparametric characterization of tumors and the assessment of therapy response.

The vascular structure of tumors impacts diagnosis, prognosis and drug response; however, imaging methods to analyse this important feature have been hindered by spatial resolution limitations. Here the authors present a tool called motion model ultrasound localization microscopy to morphologically and functionally characterize fine vascular networks in tumors at super-resolution.

Speckle Tracking of Tendon Displacement in the Carpal Tunnel: Improved Quantification Using Singular Value Decomposition

Ultrasound is a real-time image modality enabling the analysis of tendon dynamics for the diagnosis of carpal tunnel syndrome. Automatic tendon displacement quantification algorithms based on speckle tracking generally suffer from underestimation due to stationary background present in the tendon region. We propose an improved quantification method using singular value decomposition (SVD) filtering to suppress the clutter. The accuracy of our improved speckle tracking (IST) method was validated against a ground truth and compared to the accuracy of our original block matching (OBM) algorithm and commercial tissue tracking (CTT) software. The methods were evaluated in experiments involving six human cadaver arms. The ground-truth displacements were generated by tracking metal markers inserted in the tendons. The relative displacement errors with respect to the ground truth for IST were 12 ± 16.9%, which was significantly lower than for OBM (19.7 ± 20.8%) and for CTT (25.8 ± 18.4%). These findings show that SVD filtering improves the tendon tracking by reducing underestimation due to clutter.

Power cavitation-guided blood-brain barrier opening with focused ultrasound and microbubbles

Image-guided monitoring of microbubble-based focused ultrasound (FUS) therapies relies on the accurate localization of FUS-stimulated microbubble activity (i.e. acoustic cavitation). Passive cavitation imaging with ultrasound arrays can achieve this, but with insufficient spatial resolution. In this study, we address this limitation and perform high-resolution monitoring of acoustic cavitation-mediated blood-brain barrier (BBB) opening with a new technique called power cavitation imaging. By synchronizing the FUS transmit and passive receive acquisition, high-resolution passive cavitation imaging was achieved by using delay and sum beamforming with absolute time delays. Since the axial image resolution is now dependent on the duration of the received acoustic cavitation emission, short pulses of FUS were used to limit its duration. Image sets were acquired at high-frame rates for calculation of power cavitation images analogous to power Doppler imaging. Power cavitation imaging displays the mean intensity of acoustic cavitation over time and was correlated with areas of acoustic cavitation-induced BBB opening. Power cavitation-guided BBB opening with FUS could constitute a standalone system that may not require MRI guidance during the procedure. The same technique can be used for other acoustic cavitation-based FUS therapies, for both safety and guidance.

Testicular ultrasensitive Doppler preliminary experience: a feasibility study

Background Ultrasensitive Doppler is a novel non-invasive ultrasound (US) Doppler technique that improves sensitivity and resolution for the detection of slow flow. Purpose To investigate the feasibility of ultrasensitive Doppler (USD) for testicular disease diagnosis, using both qualitative and quantitative results. Material and Methods This prospective study was conducted in 160 successive men referred for scrotal US including B-mode and conventional Color-Doppler. A new USD sequence and algorithm dedicated to academic research were implemented into the US system. The quality criterion for a successful examination was the detection of well delineated intratesticular vessels. Qualitative USD results were described in terms of tumor vascular architecture and flow intensity for different pathologies for 41 patients. The testicular vascularization (TV), defined as a vessel's surface ratio, was quantified using customized MATLAB® software and compared in azoospermic and normal patients. Results USD was acquired successfully in 153/160 patients (95.6%). The tumor vascular architecture differed depending on the nature of the tumors. Leydig cell tumors exhibited mostly circumferential vascularization, while germ cell tumors exhibited straight vessels through the tumors, or anarchic vascular maps. USD improved the diagnostic performance of testicular Doppler US in a case of incomplete spermatic cord torsion and acute epididymitis. The reproducibility of TV measurements established an interclass correlation of 0.801. Non-Klinefelter syndrome non-obstructive azoospermia patients exhibited a lower TV compared to normal patients, to Klinefelter syndrome, and to obstructive azoospermia patients ( P < 0.002, P < 0.005, and P < 0.05, respectively). Conclusion Testicular USD can become a promising technique for improving US diagnosis of tumors, acute scrotum, and for determining infertility status.

Receiver-Operating Characteristic Analysis of Eigen-Based Clutter Filters for Ultrasound Color Flow Imaging

The eigen-based filter has theoretically established itself as a potent solution in ultrasound color flow imaging (CFI) for combating against clutter arising from moving tissues. Yet, it remains poorly understood on how much gain in flow detection sensitivity and specificity can be delivered by this adaptive clutter filter. Here, we investigated the receiver operating characteristic (ROC) of the eigen-based clutter filter to statistically evaluate its efficacy. Our investigation was conducted using a new vascular phantom testbed that incorporated both intrinsic tissue motion (vessel pulsation: 7.58 cm/s peak velocity) and extrinsic tissue motion (vibration: 5-Hz frequency, 2.98 cm/s peak velocity), as well as pulsatile flow (pulse rate: 60 beats/min; systolic flow rate: 6.5 mL/s). The eigen-filter (single-ensemble formulation) was applied to CFI raw data sets obtained from the phantom's short-axis view (slow-time ensemble size: 12; pulse repetition frequency: 2 kHz; and ultrasound frequency: 5 MHz), and post-filter Doppler power was compared between flow and tissue regions. Results show that, in the presence of vessel pulsation and tissue vibration, the eigen-filter yielded a high true positive rate in depicting flow pixels in CFI frames (0.945 and 0.917, respectively, during peak systole and end diastole at 60° beam-flow angle), while maintaining a low false alarm rate (0.10) in rendering tissue pixels. Also, the eigen-filter posed ROC curves whose area under curve was higher than those for the polynomial regression filter (statistically significant; t-test p values were less than 0.05). These findings serve well to substantiate the merit of using eigen-filters to enhance the vascular visualization capability of CFI.

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.

Spatiotemporal matrix image formation for programmable ultrasound scanners

As programmable ultrasound scanners become more common in research laboratories, it is increasingly important to develop robust software-based image formation algorithms that can be obtained in a straightforward fashion for different types of probes and sequences with a small risk of error during implementation. In this work, we argue that as the computational power keeps increasing, it is becoming practical to directly implement an approximation to the matrix operator linking reflector point targets to the corresponding radiofrequency signals via thoroughly validated and widely available simulations software. Once such a spatiotemporal forward-problem matrix is constructed, standard and thus highly optimized inversion procedures can be leveraged to achieve very high quality images in real time. Specifically, we show that spatiotemporal matrix image formation produces images of similar or enhanced quality when compared against standard delay-and-sum approaches in phantoms and in vivo, and show that this approach can be used to form images even when using non-conventional probe designs for which adapted image formation algorithms are not readily available.

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.

Improved Super-Resolution Ultrasound Microvessel Imaging With Spatiotemporal Nonlocal Means Filtering and Bipartite Graph-Based Microbubble Tracking

Super-resolution ultrasound microvessel imaging with contrast microbubbles has recently been proposed by multiple studies, demonstrating outstanding resolution with high potential for clinical applications. This paper aims at addressing the potential noise issue in in vivo human super-resolution imaging with ultrafast plane-wave imaging. The rich spatiotemporal information provided by ultrafast imaging presents features that allow microbubble signals to be separated from background noise. In addition, the high-frame-rate recording of microbubble data enables the implementation of robust tracking algorithms commonly used in particle tracking velocimetry. In this paper, we applied the nonlocal means (NLM) denoising filter on the spatiotemporal domain of the microbubble data to preserve the microbubble tracks caused by microbubble movement and suppress random background noise. We then implemented a bipartite graph-based pairing method with the use of persistence control to further improve the microbubble signal quality and microbubble tracking fidelity. In an in vivo rabbit kidney perfusion study, the NLM filter showed effective noise rejection and substantially improved microbubble localization. The bipartite graph pairing and persistence control demonstrated further noise reduction, improved microvessel delineation, and a more consistent microvessel blood flow speed measurement. With the proposed methods and freehand scanning on a free-breathing rabbit, a single microvessel cross-sectional profile with full-width at half-maximum of could be imaged at approximately 2-cm depth (ultrasound transmit center frequency = 8 MHz, theoretical spatial resolution ). Cortical microvessels that are apart can also be clearly separated. These results suggest that the proposed methods have good potential in facilitating robust in vivo clinical super-resolution microvessel imaging.

Robust principal component analysis in optical micro-angiography

Background

Recent development of optical micro-angiography (OMAG) utilizes principal component analysis (PCA), where linear-regression filter is employed to separate static and blood flow signals within optical coherence tomography (OCT). While PCA is relatively simple and computationally efficient, the technique is sensitive to and easily skewed by outliers. In this paper, robust PCA (RPCA) is thus introduced to tackle this issue in traditional PCA.

Methods

We first provide brief theoretical background of PCA and RPCA in the context of OMAG where coherent (complex) OCT signals are utilized to contrast blood flow. We then compare PCA and RPCA on sets of 4D-OCT complex data (3 dimensions in space and 1 dimension in time), which are collected from microfluidic phantoms and in vivo nail-fold tissue.

Results

In phantom experiments, both analyses perform relatively well since there are little motion within our observation time window, albeit small tail-noise artifacts from PCA. In nail-fold experiment, PCA suffers from tissue motion, from which RPCA does not seem to be affected. Results from RPCA also show enhancements of other dynamic signals, which are likely from the intercellular fluid. This unwanted result is yet to be proven useful for clinical applications.

Conclusions

Traditional PCA method employs linear-regression filter and is sensitive to outliers (tail-noise and motion artifacts). RPCA method is robust against outliers, but is currently computationally expensive.

Overcoming the acoustic diffraction limit in photoacoustic imaging by the localization of flowing absorbers

The resolution of photoacoustic imaging deep inside scattering media is limited by the acoustic diffraction limit. In this Letter, taking inspiration from super-resolution imaging techniques developed to beat the optical diffraction limit, we demonstrate that the localization of individual optical absorbers can provide super-resolution photoacoustic imaging well beyond the acoustic diffraction limit. As a proof-of-principle experiment, photoacoustic cross-sectional images of microfluidic channels were obtained with a 15 MHz linear capacitive micromachined ultrasonic transducer array, while absorbing beads were flown through the channels. The localization of individual absorbers allowed us to obtain a super-resolved cross-sectional image of the channels by reconstructing both the channel width and position with an accuracy better than λ/10. Given the discrete nature of endogenous absorbers such as red blood cells, or that of exogenous particular contrast agents, localization is a promising approach to push the current resolution limits of photoacoustic imaging.

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.

Toward optimization of in vivo super-resolution ultrasound imaging using size-selected microbubble contrast agents

PURPOSE

Microvascular processes play key roles in many diseases including diabetes. Improved understanding of the microvascular changes involved in disease development could offer crucial insight into the relationship of these changes to disease pathogenesis. Super-resolution ultrasound (SR-US) imaging has showed the potential to visualize microvascular detail down to the capillary level (i.e., subwavelength resolution), but optimization is still necessary. The purpose of this study was to investigate in vivo SR-US imaging of skeletal muscle microvascularity using microbubble (MB) contrast agents of various size and concentration while evaluating different ultrasound (US) system level parameters such as imaging frame rate and image acquisition length.

METHODS

An US system equipped with a linear array transducer was used in a harmonic imaging mode at low transmit power. C57BL/6J mice fed a normal diet were used in this study. An assortment of size-selected MB contrast agents (1-2 μm, 3-4 μm, and 5-8 μm in diameter) were slowly infused in the tail vein at various doses (1.25 × 10⁷ , 2.5 × 10⁷ , or 5 × 10⁷  MBs). US image data were collected before MB injection and thereafter for 10 min at 30 frames per s (fps). The US transducer was fixed throughout and between each imaging period to help capture microvascular patterns along the same image plane. An adaptive SR-US image processing technique was implemented using custom Matlab software.

RESULTS

Experimental findings illustrate the use of larger MB results in better SR-US images in terms of skeletal muscle microvascular detail. A dose of 2.5 × 10⁷  MBs resulted in SR-US images with optimal spatial resolution. An US imaging rate of at least 20 fps and image acquisition length of at least 8 min also resulted in SR-US images with pronounced microvascular detail.

CONCLUSIONS

This study indicates that MB size and dose and US system imaging rate and data acquisition length have significant impact on the quality of in vivo SR-US images of skeletal muscle microvascularity.

Ultrasound localization microscopy to image and assess microvasculature in a rat kidney

The recent development of ultrasound localization microscopy, where individual microbubbles (contrast agents) are detected and tracked within the vasculature, provides new opportunities for imaging the vasculature of entire organs with a spatial resolution below the diffraction limit. In stationary tissue, recent studies have demonstrated a theoretical resolution on the order of microns. In this work, single microbubbles were localized in vivo in a rat kidney using a dedicated high frame rate imaging sequence. Organ motion was tracked by assuming rigid motion (translation and rotation) and appropriate correction was applied. In contrast to previous work, coherence-based non-linear phase inversion processing was used to reject tissue echoes while maintaining echoes from very slowly moving microbubbles. Blood velocity in the small vessels was estimated by tracking microbubbles, demonstrating the potential of this technique to improve vascular characterization. Previous optical studies of microbubbles in vessels of approximately 20 microns have shown that expansion is constrained, suggesting that microbubble echoes would be difficult to detect in such regions. We therefore utilized the echoes from individual MBs as microscopic sensors of slow flow associated with such vessels and demonstrate that highly correlated, wideband echoes are detected from individual microbubbles in vessels with flow rates below 2 mm/s.