Visualisation of 4-D colour and power Doppler data

Signal losses with real-time three-dimensional power Doppler imaging

Power Doppler imaging (PDI) has been shown to be influenced by the wall filter when assessing arterial stenoses. Real-time 3-D Doppler imaging may likely become a widespread practice in the near future, but how the wall filter could affect PDI during the cardiac cycle has not been investigated. The objective of the study was to demonstrate that the wall filter may produce unexpected major signal losses in real-time 3-D PDI. To test our hypothesis, we first validated binary images obtained from analytical simulations with in vitro PDI acquisitions performed in a tube under pulsatile flow conditions. We then simulated PDI images in the presence of a severe stenosis, considering physiological conditions by finite element modeling. Power Doppler imaging simulations revealed important signal losses within the lumen area at different instants of the flow cycle, and there was a very good concordance between measured and predicted PDI binary images in the tube. Our results show that the wall filter may induce severe PDI signal losses that could negatively influence the assessment of vascular stenosis. Clinicians should therefore be aware of this cause of signal loss to properly interpret power Doppler angiographic images.

Blood flow in its context: combining 3D B-mode and color Doppler ultrasonic data

Visualization of volumetric multicomponent data sets is a high-dimensional problem, especially for color data. Medical 3D ultrasound (US) technology has rapidly advanced during the last few decades and scanners can now generate joint 3D scans of tissues (B-mode) and blood flow (power or color Doppler) in real time. Renderings of such data sets have to comprehensively convey both the relevant structures of the tissues that form the context for blood flow, as well as the distribution of blood flow itself. The narrow field of view in US data, which is often used to make real-time imaging possible, complicates volume exploration since only parts of organs are usually visible; that is, clearly defined anatomical landmarks are scarce. In addition, the noisy nature and low signal-to-contrast ratio of US data make effective visualization a challenge, whereby there are currently no convincing solutions for combined US B-mode and color Doppler data rendering. Therefore, displaying 2D slices out of the 3D data is still often the preferred visualization method. We present new combinations of photorealistic and nonphotorealistic rendering strategies for combined visualization of B-mode and color Doppler data, which are straightforward to implement, flexible, and suited for a wide range of US applications.

Automated quantitative volumetric breast ultrasound data-acquisition system

This paper describes the development and initial testing of an automated ultrasound imaging technique to acquire quantitative volumetric breast data; the clinical application being breast cancer diagnosis and management. A novel mechanical scanner has been designed and constructed to constrain the breast tissue without compromising the image, to acquire images of the majority of the breast using a conventional B-mode scanner and to maintain patient comfort. An algorithm to improve upon simple depth-dependent amplification by compensating for tissue-dependent attenuation is applied to the images, making the grey-scale values represent local scattering properties more closely. Registration techniques have been developed to correct for geometric errors arising in the data set because of tissue movement and variations in speed of sound in the tissues. The data sets are reconstructed into volumes and viewed interactively. A pilot study of seven patients was performed and selected results are presented to illustrate lesion features. The automated scan reduces operator-dependence, provides clear information on the 3-D tissue boundaries and provides a full record for monitoring or surgical planning.

Can color doppler predict the uniformity of HIFU-induced prostate tissue destruction?

BACKGROUND

Tissue blood perfusion influences the results of some hyperthermia and thermotherapy procedures, but its role in the outcome of prostate cancer treatment by high-intensity focused ultrasound (HIFU) has not been evaluated yet. We evaluated preoperative prostate color Doppler as a predictor of the efficacy of HIFU treatment.

METHODS

Thirty-five patients underwent pre- and post-contrast color Doppler examination of the prostate before HIFU treatment. Specific software was used to calculate, on color Doppler images, the color pixel density (CPD), and the specific flow (SF, i.e., mean velocity x CPD) in different regions of interest. Post-treatment sextant biopsies were obtained in 31 patients, 5.8 +/- 2.8 months after HIFU treatment.

RESULTS

No significant correlation was found between the uniformity of HIFU-induced tissue destruction observed on control biopsies and the pre-treatment CPD/SF values in any region of interest, either before or after contrast injection. On the other hand, history of radiation therapy was significantly associated with homogeneous tissue destruction and history of hormone therapy was significantly associated with incomplete tissue destruction.

CONCLUSIONS

Color Doppler cannot predict the uniformity of HIFU-induced tissue destruction. History of radiation therapy was found to be a factor of favorable prognosis and history of hormone therapy was found to be a factor of poor prognosis in our population.