Volume stitching in three-dimensional echocardiography: distortion analysis and extension to real time

Optimization of Thyroid Volume Determination by Stitched 3D-Ultrasound Data Sets in Patients with Structural Thyroid Disease

Ultrasound (US) is the most important imaging method for the assessment of structural disorders of the thyroid. A precise volume determination is relevant for therapy planning and outcome monitoring. However, the accuracy of 2D-US is limited, especially in cases of organ enlargements and deformations. Software-based "stitching" of separately acquired 3D-US data revealed precise volume determination in thyroid phantoms. The purpose of this study is to investigate the feasibility and accuracy of 3D-US stitching in patients with structural thyroid disease. A total of 31 patients from the clinical routine were involved, receiving conventional 2D-US (conUS), sensor-navigated 3D-US (3DsnUS), mechanically-swept 3D-US (3DmsUS), and I-124-PET/CT as reference standard. Regarding 3DsnUS and 3DmsUS, separately acquired 3D-US images (per thyroid lobe) were merged to one comprehensive data set. Subsequently, anatomical correctness of the stitching process was analysed via secondary image fusion with the I-124-PET images. Volumetric determinations were conducted by the ellipsoid model (EM) on conUS and CT, and manually drawn segmental contouring (MC) on 3DsnUS, 3DmsUS, CT, and I-124-PET/CT. Mean volume of the thyroid glands was 44.1 ± 25.8 mL (I-124-PET-MC = reference). Highly significant correlations (all p < 0.0001) were observed for conUS-EM (r = 0.892), 3DsnUS-MC (r = 0.988), 3DmsUS-MC (r = 0.978), CT-EM (0.956), and CT-MC (0.986), respectively. The mean volume differences (standard deviations, limits of agreement) in comparison with the reference were -10.50 mL (±11.56 mL, -33.62 to 12.24), -3.74 mL (±3.74 mL, -11.39 to 3.78), and 0.62 mL (±4.79 mL, -8.78 to 10.01) for conUS-EM, 3DsnUS-MC, and 3DmsUS-MC, respectively. Stitched 3D-US data sets of the thyroid enable accurate volumetric determination even in enlarged and deformed organs. The main limitation of high time expenditure may be overcome by artificial intelligence approaches.

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.

Multi-line transmission in 3-D with reduced crosstalk artifacts: a proof of concept study

Multi-line transmission (MLT) is a technique in which ultrasound pulses for several directions are transmitted simultaneously. The purpose is increased frame rate, which is especially important in 3-D echocardiography. Compared with techniques purely based on parallel beamformation, MLT avoids the need for reducing the transmit aperture and thus maintains a high harmonic signal level. The main disadvantage is that artifacts are caused by cross-talk between the simultaneous beams. In a conventional MLT implementation, simultaneous transmits would be spaced regularly in the azimuth and elevation planes. However, using rectangular geometry arrays, most of the acoustic side-lobe energy is concentrated along these planes. The results in this work show that the crosstalks can be pushed below the typical display range of 50 dB used in cardiac applications if the parallel transmit directions are aligned along the transverse diagonal of the array. Dispositions with 2 to 5 MLT for a typical cardiac 2-D phased-array were investigated using simulation software. Using the proposed alignment, the maximal crosstalk artifact amplitudes decreased 20 to 30 dB compared with conventional MLT dispositions. In water-tank measurements, side-lobe levels of a commercially available rectangular probe were 15 to 25 dB lower along the transverse diagonal, confirming that similar suppressions can be expected using actual transducers.

Real-time 4D ultrasound mosaicing and visualization

Intra-cardiac 3D ultrasound imaging has enabled new minimally invasive procedures. Its narrow field of view, however, limits its efficacy in guiding beating heart procedures where geometrically complex and spatially extended moving anatomic structures are often involved. In this paper, we present a system that performs electrocardiograph gated 4D mosaicing and visualization of 3DUS volumes. Real-time operation is enabled by GPU implementation. The method is validated on phantom and porcine heart data.

In vivo micro-image mosaicing

Recent advances in optical imaging have led to the development of miniature microscopes that can be brought to the patient for visualizing tissue structures in vivo. These devices have the potential to revolutionize health care by replacing tissue biopsy with in vivo pathology. One of the primary limitations of these microscopes, however, is that the constrained field of view can make image interpretation and navigation difficult. In this paper, we show that image mosaicing can be a powerful tool for widening the field of view and creating image maps of microanatomical structures. First, we present an efficient algorithm for pairwise image mosaicing that can be implemented in real time. Then, we address two of the main challenges associated with image mosaicing in medical applications: cumulative image registration errors and scene deformation. To deal with cumulative errors, we present a global alignment algorithm that draws upon techniques commonly used in probabilistic robotics. To accommodate scene deformation, we present a local alignment algorithm that incorporates deformable surface models into the mosaicing framework. These algorithms are demonstrated on image sequences acquired in vivo with various imaging devices including a hand-held dual-axes confocal microscope, a miniature two-photon microscope, and a commercially available confocal microendoscope.

A composite high-frame-rate system for clinical cardiovascular imaging

High frame-rate ultrasound RF data acquisition has been proved to be critical for novel cardiovascular imaging techniques, such as high-precision myocardial elastography, pulse wave imaging (PWI), and electromechanical wave imaging (EWI). To overcome the frame-rate limitations on standard clinical ultrasound systems, we developed an automated method for multi-sector ultrasound imaging through retrospective electrocardiogram (ECG) gating on a clinically used open architecture system. The method achieved both high spatial (64 beam density) and high temporal resolution (frame rate of 481 Hz) at an imaging depth up to 11 cm and a 100% field of view in a single breath-hold duration. Full-view imaging of the left ventricle and the abdominal aorta of healthy human subjects was performed using the proposed technique in vivo. ECG and ultrasound RF signals were simultaneously acquired on a personal computer (PC). Composite, full-view frames both in RF- and B-mode were reconstructed through retrospective combination of seven small (20%) juxtaposed sectors using an ECG-gating technique. The axial displacement of the left ventricle, in both long-axis and short-axis views, and that of the abdominal aorta, in a long-axis view, were estimated using a RF-based speckle tracking technique. The electromechanical wave and the pulse wave propagation were imaged in a ciné-loop using the proposed imaging technique. Abnormal patterns of such wave propagation can serve as indicators of early cardiovascular disease. This clinical system could thus expand the range of applications in cardiovascular elasticity imaging for quantitative, noninvasive diagnosis of myocardial ischemia or infarction, arrhythmia, abdominal aortic aneurysms, and early-stage atherosclerosis.