Three-dimensional echo: transition from theory to real-time, a technology now ready for prime time

Compressed sensing reconstruction of synthetic transmit aperture dataset for volumetric diverging wave imaging

A high volume rate and high performance ultrasound imaging method based on a matrix array is proposed by using compressed sensing (CS) to reconstruct the complete dataset of synthetic transmit aperture (STA) from three-dimensional (3D) diverging wave transmissions (i.e. 3D CS-STA). Hereto, a series of apodized 3D diverging waves are transmitted from a fixed virtual source, with the ith row of a Hadamard matrix taken as the apodization coefficients in the ith transmit event. Then CS is used to reconstruct the complete dataset, based on the linear relationship between the backscattered echoes and the complete dataset of 3D STA. Finally, standard STA beamforming is applied on the reconstructed complete dataset to obtain the volumetric image. Four layouts of element numbering for apodizations and transmit numbers of 16, 32 and 64 are investigated through computer simulations and phantom experiments. Furthermore, the proposed 3D CS-STA setups are compared with 3D single-line-transmit (SLT) and 3D diverging wave compounding (DWC). The results show that, (i) 3D CS-STA has competitive lateral resolutions to 3D STA, and their contrast ratios (CRs) and contrast-to-noise ratios (CNRs) approach to those of 3D STA as the number of transmit events increases in noise-free condition. (ii) the tested 3D CS-STA setups show good robustness in complete dataset reconstruction in the presence of different levels of noise. (iii) 3D CS-STA outperforms 3D SLT and 3D DWC. More specifically, the 3D CS-STA setup with 64 transmit events and the Random layout achieves ~31% improvement in lateral resolution, ~14% improvement in ratio of the estimated-to-true cystic areas, a higher volume rate, and competitive CR/CNR when compared with 3D DWC. The results demonstrate that 3D CS-STA has great potential of providing high quality volumetric image with a higher volume rate.

Doppler-Based Motion Compensation Strategies for 3-D Diverging Wave Compounding and Multiplane-Transmit Beamforming: A Simulation Study

Fast imaging of the heart has shown promise toward bringing new diagnostic information. Although most studies to date have been based on 2-D imaging technology, the ultimate diagnostic tool would enable fast 3-D echocardiography. Hereto, 3-D diverging wave compounding (DWC) and 3-D multiline-transmit (MLT) beamforming have recently been proposed. Moreover, in our recent study, a hybrid technique was proposed in which multiple planar diverging waves were transmitted [i.e., multiplane-transmit (MPT)]. The proposed 3MPT sequence was demonstrated to outperform $9 \times 9$ DWC and 16MLT-4MLA (i.e., multiline acquisition) while imaging moving targets. However, none of the investigated beamforming techniques made use of motion compensation (MoCo) strategies. In this paper, we therefore propose Doppler-based MoCo strategies for 3-D DWC and MPT and test them via computer simulations. It is demonstrated that the MoCo strategies proposed for both DWC and MPT are effective and significantly restore image quality. Moreover, the MPT beamforming with MoCo outperforms $9 \times 9$ DWC with MoCo in terms of contrast ratio and contrast-to-noise ratio. The proposed MPT beamforming with MoCo thus provides volumetric images with relatively high temporal resolution (~66 Hz) and high image quality that is minimally affected by motion artifacts.

Feasibility of Multiplane-Transmit Beamforming for Real-Time Volumetric Cardiac Imaging: A Simulation Study

Today's 3-D cardiac ultrasound imaging systems suffer from relatively low spatial and temporal resolution, limiting their applicability in daily clinical practice. To address this problem, 3-D diverging wave imaging with spatial coherent compounding (DWC) as well as 3-D multiline-transmit (MLT) imaging have recently been proposed. Currently, the former improves the temporal resolution significantly at the expense of image quality and the risk of introducing motion artifacts, whereas the latter only provides a moderate gain in volume rate but mostly preserves quality. In this paper, a new technique for real-time volumetric cardiac imaging is proposed by combining the strengths of both approaches. Hereto, multiple planar (i.e., 2-D) diverging waves are simultaneously transmitted in order to scan the 3-D volume, i.e., multiplane transmit (MPT) beamforming. The performance of a 3MPT imaging system was contrasted to that of a 3-D DWC system and that of a 3-D MLT system by computer simulations during both static and moving conditions of the target structures while operating at similar volume rate. It was demonstrated that for stationary targets, the 3MPT imaging system was competitive with both the 3-D DWC and 3-D MLT systems in terms of spatial resolution and sidelobe levels (i.e., image quality). However, for moving targets, the image quality quickly deteriorated for the 3-D DWC systems while it remained stable for the 3MPT system while operating at twice the volume rate of the 3-D-MLT system. The proposed MPT beamforming approach was thus demonstrated to be feasible and competitive to state-of-the-art methodologies.

Infective endocarditis: an update on the role of echocardiography

The evaluation of valvular and nonvalvular structures is of central importance in the diagnosis, management, and treatment of infective endocarditis (IE). The incidence of IE has remained constant due to changing substrate, with notably higher prevalence observed in the elderly. Mortality and morbidity continue to remain high, despite advances in medical and surgical treatment. This article reviews the technical and practical aspects of the use of echocardiography to evaluate patients with suspected IE.

Minimally redundant 2-D array designs for 3-D medical ultrasound imaging

In real-time ultrasonic 3-D imaging, in addition to difficulties in fabricating and interconnecting 2-D transducer arrays with hundreds of elements, there are also challenges in acquiring and processing data from a large number of ultrasound channels. The coarray (spatial convolution of the transmit and receive arrays) can be used to find efficient array designs that capture all of the spatial frequency content (a transmit-receive element combination corresponds to a spatial frequency) with a reduced number of active channels and firing events. Eliminating the redundancies in the transmit-receive element combinations and firing events reduces the overall system complexity and improves the frame rate. Here we explore four reduced redundancy 2-D array configurations for miniature 3-D ultrasonic imaging systems. Our approach is based on 1) coarray design with reduced redundancy using different subsets of linear arrays constituting the 2-D transducer array, and 2) 3-D scanning using fan-beams (narrow in one dimension and broad in the other dimension) generated by the transmit linear arrays. We form the overall array response through coherent summation of the individual responses of each transmit-receive array pairs. We present theoretical and simulated point spread functions of the array configurations along with quantitative comparison in terms of the front-end complexity and image quality.

Real-time three-dimensional echocardiography: technological gadget or clinical tool?

The complex anatomy of cardiac structures requires three-dimensional spatial orientation of images for a better understanding of structure and function, thereby improving image interpretation. Real-time three-dimensional echocardiography is a recently developed technique based on the design of an ultrasound transducer with a matrix array that rapidly acquires image data in a pyramidal volume. The simultaneous display of multiple tomographic images allows three-dimensional perspective and the anatomically correct examination of any structure within the volumetric image. As a consequence, it is less operator-dependent and hence more reproducible. Dedicated software systems and technologies are based on high-performance computers designed for graphic handling of three-dimensional images by providing possibilities beyond those obtainable with echocardiography. This methodology allows simultaneous display of multiple superimposed planes in an interactive manner as well as a quantitative assessment of cardiac volumes and ventricular mass in a three-dimensional format without a pre-established assumption of cardiac chamber geometry. In addition, myocardial contraction and/or perfusion abnormalities are clearly identified. Finally, real-time three-dimensional colour Doppler flow mapping enables complete visualisation of the regurgitant jet and new ways of assessing regurgitant lesion severity. Thus, this technique expands the abilities of non-invasive cardiology and may open new doors for the evaluation of cardiac diseases. In this article, current and future clinical applications of real-time three-dimensional echocardiography are reviewed.

Automatic image-based gating for 4D ultrasound

Four-dimensional (4D) ultrasound can be a powerful tool in adult and fetal echocardiography, enabling physicians to visualize planes that are not easily accessible using 2D ultrasound. However, despite the advances in the transducer technology, gating is still required to avoid motion artifacts during acquisition using mechanical probes or even 2D matrix array transducers in case of extended volume or color Doppler acquisitions. In fetal echocardiography, where an ECG signal is not readily available, image gating is used, which can both be computationally expensive and/or require user interaction. We present a new image gating technique that has both low computational requirements and is fully automatic. It is not only suitable for real-time gating of 4D ultrasound data sets during acquisition, but also suits well for lower-cost systems where computing resources are at a premium.