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Gan K, Jiang X, Shen Q, Yuan J, Chen Y, Ge Y, Wang Y. Multi-angle speed-of-sound imaging with sparse sampling to characterize medical tissue properties. ULTRASONICS 2024; 144:107450. [PMID: 39222597 DOI: 10.1016/j.ultras.2024.107450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 08/19/2024] [Accepted: 08/28/2024] [Indexed: 09/04/2024]
Abstract
Medical Speed-of-sound (SoS) imaging, which can characterize medical tissue properties better by quantifying their different SoS, is an effective imaging method compared with conventional B-mode ultrasound imaging. As a commonly used diagnostic instrument, a hand-held array probe features convenient and quick inspection. However, artifacts will occur in the single-angle SoS imaging, resulting in indistinguishable tissue boundaries. In order to build a high-quality SoS image, a number of raw data are needed, which will bring difficulties to data storage and processing. Compressed sensing (CS) theory offers theoretical support to the feasibility that a sparse signal can be rebuilt with random but less sampling data. In this study, we proposed an SoS reconstruction method based on CS theory to process signals obtained from a hand-held linear array probe with a passive reflector positioned on the opposite side. The SoS reconstruction method consists of three parts. Firstly, a sparse transform basis is selected appropriately for a sparse representation of the original signal. Then, considering the mathematical principles of SoS imaging, the ray-length matrix is used as a sparse measurement matrix to observe the original signal, which represents the length of the acoustic propagation path. Finally, the orthogonal matching pursuit algorithm is introduced for image reconstruction. The experimental result of the phantom proves that SoS imaging can clearly distinguish tissues that show similar echogenicity in B-mode ultrasound imaging. The simulation and experimental results show that our proposed method holds promising potential for reconstructing precision SoS images with fewer signal samplings, transmission, and storage.
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Affiliation(s)
- Kexin Gan
- School of Electronic Science and Engineering, Nanjing University, Nanjing 210023, China
| | - Xiaoyi Jiang
- School of Electronic Science and Engineering, Nanjing University, Nanjing 210023, China
| | - Qinghong Shen
- School of Electronic Science and Engineering, Nanjing University, Nanjing 210023, China
| | - Jie Yuan
- School of Electronic Science and Engineering, Nanjing University, Nanjing 210023, China.
| | - Ying Chen
- School of Electronic Science and Engineering, Nanjing University, Nanjing 210023, China
| | - Yun Ge
- School of Electronic Science and Engineering, Nanjing University, Nanjing 210023, China
| | - Yuxin Wang
- School of Electronic Science and Engineering, Nanjing University, Nanjing 210023, China
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2
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Ferraioli G, Barr RG, Berzigotti A, Sporea I, Wong VWS, Reiberger T, Karlas T, Thiele M, Cardoso AC, Ayonrinde OT, Castera L, Dietrich CF, Iijima H, Lee DH, Kemp W, Oliveira CP, Sarin SK. WFUMB Guidelines/Guidance on Liver Multiparametric Ultrasound. Part 2: Guidance on Liver Fat Quantification. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:1088-1098. [PMID: 38658207 DOI: 10.1016/j.ultrasmedbio.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/26/2024]
Abstract
The World Federation for Ultrasound in Medicine and Biology (WFUMB) has promoted the development of this document on multiparametric ultrasound. Part 2 is a guidance on the use of the available tools for the quantification of liver fat content with ultrasound. These are attenuation coefficient, backscatter coefficient, and speed of sound. All of them use the raw data of the ultrasound beam to estimate liver fat content. This guidance has the aim of helping the reader in understanding how they work and interpret the results. Confounding factors are discussed and a standardized protocol for measurement acquisition is suggested to mitigate them. The recommendations were based on published studies and experts' opinion but were not formally graded because the body of evidence remained low at the time of drafting this document.
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Affiliation(s)
- Giovanna Ferraioli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
| | - Richard Gary Barr
- Department of Radiology, Northeastern Ohio Medical University, Youngstown, OH, USA
| | - Annalisa Berzigotti
- Department for Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ioan Sporea
- Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Center for Advanced Research in Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Vincent Wai-Sun Wong
- Department of Medicine and Therapeutics, Medical Data Analytics Centre, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Thomas Reiberger
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria; Christian-Doppler Laboratory for Portal Hypertension and Liver Fibrosis, Medical University of Vienna, Vienna, Austria
| | - Thomas Karlas
- Department of Medicine II, Division of Gastroenterology, Leipzig University Medical Center, Leipzig, Germany
| | - Maja Thiele
- Center for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark; Department for Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ana Carolina Cardoso
- Hepatology Division, School of Medicine, Federal University of Rio de Janeiro, Clementino, Fraga Filho Hospital, Rio de Janeiro, RJ, Brazil
| | - Oyekoya Taiwo Ayonrinde
- Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch, WA, Australia; Medical School, The University of Western Australia, Crawley, WA, Australia; Curtin Medical School, Curtin University, Bentley, WA, Australia
| | - Laurent Castera
- Université Paris-Cité, Inserm UMR1149, Centre de Recherche sur l'Inflammation, Paris, France; Service d'Hépatologie, Hôpital Beaujon, Assistance-Publique Hôpitaux de Paris, Clichy, France
| | - Christoph Frank Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem and Permancence, Bern, Switzerland
| | - Hiroko Iijima
- Department of Gastroenterology, Division of Hepatobiliary and Pancreatic Disease, Hyogo Medical University, Nishinomiya, Hyogo, Japan; Ultrasound Imaging Center, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Dong Ho Lee
- Department of Radiology, College of Medicine, Seoul National University Hospital, Seoul National University, Seoul, Republic of Korea
| | - William Kemp
- Department of Gastroenterology, Alfred Hospital, Melbourne, Australia; Department of Medicine, Central Clinical School, Monash University, Melbourne, Australia
| | - Claudia P Oliveira
- Gastroenterology Department, Laboratório de Investigação (LIM07), Hospital das Clínicas de São Paulo, HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
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Yin H, Fan Y, Yu J, Xiong B, Zhou B, Sun Y, Wang L, Zhu Y, Xu H. Quantitative US fat fraction for noninvasive assessment of hepatic steatosis in suspected metabolic-associated fatty liver disease. Insights Imaging 2024; 15:159. [PMID: 38902550 PMCID: PMC11190099 DOI: 10.1186/s13244-024-01728-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 05/19/2024] [Indexed: 06/22/2024] Open
Abstract
OBJECTIVES To evaluate the agreement between quantitative ultrasound system fat fraction (USFF) and proton magnetic resonance spectroscopy (1H-MRS) and the diagnostic value of USFF in assessing metabolic-associated fatty liver disease (MAFLD). METHODS The participants with or suspected of MAFLD were prospectively recruited and underwent 1H-MRS, USFF, and controlled attenuation parameter (CAP) measurements. The correlation between USFF and 1H-MRS was assessed using Pearson correlation coefficients. The USFF diagnostic performance for different grades of steatosis was evaluated using receiver operating characteristic curve analysis (ROC) and was compared with CAP, visual hepatic steatosis grade (VHSG). RESULTS A total of 113 participants (mean age 44.79 years ± 13.56 (SD); 71 males) were enrolled, of whom 98 (86.73%) had hepatic steatosis (1H-MRS ≥ 5.56%). USFF showed a good correlation (Pearson r = 0.76) with 1H-MRS and showed a linear relationship, which was superior to the correlation between CAP and 1H-MRS (Pearson r = 0.61). The USFF provided high diagnostic performance for different grades of hepatic steatosis, with ROC from 0.84 to 0.98, and the diagnostic performance was better than that of the CAP and the VHSG. The cut-off values of the USFF were different for various grades of steatosis, and the cut-off values for S1, S2, and S3 were 12.01%, 19.98%, and 22.22%, respectively. CONCLUSIONS There was a good correlation between USFF and 1H-MRS. Meanwhile, USFF had good diagnostic performance for hepatic steatosis and was superior to CAP and VHSG. USFF represents a superior method for noninvasive quantitative assessment of MAFLD. CRITICAL RELEVANCE STATEMENT Quantitative ultrasound system fat fraction (USFF) accurately assesses liver fat content and has a good correlation with magnetic resonance spectroscopy (1H-MRS) for the assessment of metabolic-associated fatty liver disease (MAFLD), as well as for providing an accurate quantitative assessment of hepatic steatosis. KEY POINTS Current diagnostic and monitoring modalities for metabolic-associated fatty liver disease have limitations. USFF correlated well with 1H-MRS and was superior to the CAP. USFF has good diagnostic performance for steatosis, superior to CAP and VHSG.
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Affiliation(s)
- Haohao Yin
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, 200032, China
| | - Yunling Fan
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, 200032, China
| | - Jifeng Yu
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, 200032, China
| | - Bing Xiong
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, 200032, China
| | - Boyang Zhou
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, 200032, China
| | - Yikang Sun
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, 200032, China
| | - Lifan Wang
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, 200032, China
| | - Yuli Zhu
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, 200032, China.
| | - Huixiong Xu
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, 200032, China.
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Xiao D, Torre PDL, Yu ACH. Real-Time Speed-of-Sound Estimation In Vivo via Steered Plane Wave Ultrasound. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2024; 71:673-686. [PMID: 38687663 DOI: 10.1109/tuffc.2024.3395490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Speed-of-sound (SoS) is an intrinsic acoustic property of human tissues and has been regarded as a potential biomarker of tissue health. To foster the clinical use of this emerging biomarker in medical diagnostics, it is important for SoS estimates to be derived and displayed in real time. Here, we demonstrate that concurrent global SoS estimation and B-mode imaging can be achieved live on a portable ultrasound scanner. Our innovation is hinged upon the design of a novel pulse-echo SoS estimation framework that is based on steered plane wave imaging. It has accounted for the effects of refraction and imaging depth when the medium SoS differs from the nominal value of 1540 m/s that is conventionally used in medical imaging. The accuracy of our SoS estimation framework was comparatively analyzed with through-transmit time-of-flight measurements in vitro on 15 custom agar phantoms with different SoS values (1508-1682 m/s) and in vivo on human calf muscles ( N = 9 ; SoS range: 1560-1586 m/s). Our SoS estimation framework has a mean signed difference (MSD) of - 0.6 ± 2.3 m/s in vitro and - 2.2 ± 11.2 m/s in vivo relative to the reference measurements. In addition, our real-time system prototype has yielded simultaneous SoS estimates and B-mode imaging at an average frame rate of 18.1 fps. Overall, by realizing real-time tissue SoS estimation with B-mode imaging, our innovation can foster the use of tissue SoS as a biomarker in medical ultrasound diagnostics.
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Kubale R, Schneider G, Lessenich CPN, Buecker A, Wassenberg S, Torres G, Gurung A, Hall T, Labyed Y. Ultrasound-Derived Fat Fraction for Hepatic Steatosis Assessment: Prospective Study of Agreement With MRI PDFF and Sources of Variability in a Heterogeneous Population. AJR Am J Roentgenol 2024; 222:e2330775. [PMID: 38506537 DOI: 10.2214/ajr.23.30775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
BACKGROUND. Metabolic dysfunction-associated steatotic liver disease is a growing global public health concern. Quantitative ultrasound measurements, such as ultrasound-derived fat fraction (UDFF), could provide noninvasive, cost-effective, and portable steatosis evaluation. OBJECTIVE. The purpose of this article was to evaluate utility of UDFF for steatosis assessment using proton density fat fraction (PDFF) as reference in patients undergoing liver MRI for heterogeneous indications and to assess UDFF variability. METHODS. This prospective study included a primary analysis of 187 patients (mean age, 53.8 years; 112 men, 75 women) who underwent 3-T liver MRI for any clinical indication from December 2020 to July 2021. Patients underwent investigational PDFF measurement, including determination of PDFFwhole-liver (mean PDFF of entire liver), and PDFFvoxel (PDFF in single voxel within right lobe, measured by MR spectroscopy), as well as investigational ultrasound with UDFF calculation (mean of five inter-costal measurements) within 1 hour after MRI. In a subanalysis, 21 of these patients underwent additional UDFF measurements 1, 3, and 5 hours after meal consumption. The study also included repeatability and reproducibility analysis of 30 patients (mean age, 26.3 years; 10 men, 20 women) who underwent clinical abdominal ultrasound between November 2022 and January 2023; in these patients, three operators sequentially performed UDFF measurements. RESULTS. In primary analysis, UDFF and PDFFwhole-liver measurements showed intra-class correlation coefficient (ICC) of 0.79. In Bland-Altman analysis, UDFF and PDFFvoxel measurements showed mean difference of 1.5% (95% CI, 0.6-2.4%), with 95% limits of agreement from -11.0% to 14.0%. UDFF measurements exhibited AUC for detecting PDFFvoxel at historic thresholds of 6.5% and greater, 17.4% and greater, and 22.1% and greater of 0.90, 0.95, and 0.95, respectively. In subanalysis, mean UDFF was not significantly different across time points with respect to meal consumption (p = .21). In repeatability and reproducibility analysis, ICC for intraoperator repeatability ranged from 0.98 to 0.99 and for interoperator reproducibility from 0.90 to 0.96. Visual assessment of patient-level data plots indicated increasing variability of mean UDFF measurements across operators and of intercostal measurements within individual patients with increasing steatosis. CONCLUSION. UDFF showed robust agreement with PDFF, diagnostic performance for steatosis grades, and intraoperator repeatability and interoperator reproducibility. Nonetheless, UDFF exhibited bias toward slightly larger values versus PDFF; intraoperator and interoperator variation increased with increasing steatosis. CLINICAL IMPACT. UDFF shows promise for steatosis assessment across diverse populations, although continued optimization remains warranted.
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Affiliation(s)
- Reinhard Kubale
- Clinic of Diagnostic and Interventional Radiology, Saarland University Hospital, Kirrberger Strasse Geb. 50.1, 66424 Homburg, Germany
| | - Guenther Schneider
- Clinic of Diagnostic and Interventional Radiology, Saarland University Hospital, Kirrberger Strasse Geb. 50.1, 66424 Homburg, Germany
| | - Carl P N Lessenich
- Clinic of Diagnostic and Interventional Radiology, Saarland University Hospital, Kirrberger Strasse Geb. 50.1, 66424 Homburg, Germany
| | - Arno Buecker
- Clinic of Diagnostic and Interventional Radiology, Saarland University Hospital, Kirrberger Strasse Geb. 50.1, 66424 Homburg, Germany
| | | | | | - Arati Gurung
- Siemens Healthineers Ultrasound Division, Issaquah, WA
| | - Timothy Hall
- Department of Medical Physics, University of Wisconsin, Madison, WI
| | - Yassin Labyed
- Siemens Healthineers Ultrasound Division, Issaquah, WA
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Pan Y, Wang X, Qiang Y, Wang N, Liu R, Yang G, Zhang Z, He X, Yu Y, Zheng H, Qiu W. A New Method of Plane-Wave Ultrasound Imaging Based on Reverse Time Migration. IEEE Trans Biomed Eng 2024; 71:1628-1639. [PMID: 38133968 DOI: 10.1109/tbme.2023.3346194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
Coherent plane-wave compounding technique enables rapid ultrasound imaging with comparable image quality to traditional B-mode imaging that relies on focused beam transmission. However, existing methods assume homogeneity in the imaged medium, neglecting the heterogeneity in sound velocities and densities present in real tissues, resulting in noise reverberation. This study introduces the Reverse Time Migration (RTM) method for ultrasound plane-wave imaging to overcome this limitation, which is combined with a method for estimating the speed of sound in layered media. Simulation results in a homogeneous background demonstrate that RTM reduces side lobes and grating lobes by approximately 30 dB, enhancing the contrast-to-noise ratio by 20% compared to conventional delay and sum (DAS) beamforming. Moreover, RTM achieves superior imaging outcomes with fewer compounding angles. The lateral resolution of the RTM with 5-9 angle compounding is able to achieve the effectiveness of the DAS method with 15-19 angle compounding, and the CNR of the RTM with 11-angle compounding is almost the same as that of the DAS with 21-angle compounding. In a heterogeneous background, experimental simulations and in vitro wire phantom experiments confirm RTM's capability to correct depth imaging, focusing reflected waves on point targets. In vitro porcine tissue experiments enable accurate imaging of layer interfaces by estimating the velocities of multiple layers containing muscle and fat. The proposed imaging procedure optimizes velocity estimation in complex media, compensates for the impact of velocity differences, provides more reliable imaging results.
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Beuret S, Heriard-Dubreuil B, Martiartu NK, Jaeger M, Thiran JP. Windowed Radon Transform for Robust Speed-of-Sound Imaging With Pulse-Echo Ultrasound. IEEE TRANSACTIONS ON MEDICAL IMAGING 2024; 43:1579-1593. [PMID: 38109237 DOI: 10.1109/tmi.2023.3343918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
In recent years, methods estimating the spatial distribution of tissue speed of sound with pulse-echo ultrasound are gaining considerable traction. They can address limitations of B-mode imaging, for instance in diagnosing fatty liver diseases. Current state-of-the-art methods relate the tissue speed of sound to local echo shifts computed between images that are beamformed using restricted transmit and receive apertures. However, the aperture limitation affects the robustness of phase-shift estimations and, consequently, the accuracy of reconstructed speed-of-sound maps. Here, we propose a method based on the Radon transform of image patches able to estimate local phase shifts from full-aperture images. We validate our technique on simulated, phantom and in-vivo data acquired on a liver and compare it with a state-of-the-art method. We show that the proposed method enhances the stability to changes of beamforming speed of sound and to a reduction of the number of insonifications. In particular, the deployment of pulse-echo speed-of-sound estimation methods onto portable ultrasound devices can be eased by the reduction of the number of insonifications allowed by the proposed method.
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Higa T, Ketterling JA, Mamou J, Hoerig C, Nagano N, Hirata S, Yoshida K, Yamaguchi T. Relationship between transmission/reception conditions of high-frequency plane wave compounding and evaluation accuracy of extended amplitude envelope statistics. JAPANESE JOURNAL OF APPLIED PHYSICS (2008) 2024; 63:04SP81. [PMID: 38911013 PMCID: PMC11192551 DOI: 10.35848/1347-4065/ad3a70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
The double-Nakagami (DN) model provides a method for analyzing the amplitude envelope statistics of quantitative ultrasound (QUS). In this study, the relationship between the sound field characteristics and the robustness of QUS evaluation was evaluated using five HF linear array probes and tissue-mimicking phantoms. Compound plane-wave imaging (CPWI) was used to acquire echo data. Five phantoms containing two types of scatterers were used to mimic fatty liver tissue. After clarifying the relationship between the sound field characteristics of the probes and QUS parameters, DN QUS parameters in 10 rat livers with different lipidification were evaluated using one HF linear array probe. For both phantom and in situ liver analyses, correlations between fat content and multiple QUS parameters were confirmed, suggesting that the combination of CPWI using a HF linear array probe with the DN model is a robust method for quantifying fatty liver and has potential clinical diagnostic applications.
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Affiliation(s)
- Taisei Higa
- Graduate School of Science and Engineering, Chiba University, Yayoicho, Inage, Chiba 263-8522, Japan
| | - Jeffrey A. Ketterling
- Department of Radiology, Weill Cornell Medicine, New York, NY 10022, United States of America
| | - Jonathan Mamou
- Department of Radiology, Weill Cornell Medicine, New York, NY 10022, United States of America
| | - Cameron Hoerig
- Department of Radiology, Weill Cornell Medicine, New York, NY 10022, United States of America
| | - Nahoko Nagano
- Center for Frontier Medical Engineering, Chiba University, Yayoicho, Inage, Chiba 263-8522, Japan
| | - Shinnosuke Hirata
- Center for Frontier Medical Engineering, Chiba University, Yayoicho, Inage, Chiba 263-8522, Japan
| | - Kenji Yoshida
- Center for Frontier Medical Engineering, Chiba University, Yayoicho, Inage, Chiba 263-8522, Japan
| | - Tadashi Yamaguchi
- Center for Frontier Medical Engineering, Chiba University, Yayoicho, Inage, Chiba 263-8522, Japan
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Guillaumin JB, Djerroudi L, Aubry JF, Tardivon A, Dizeux A, Tanter M, Vincent-Salomon A, Berthon B. Biopathologic Characterization and Grade Assessment of Breast Cancer With 3-D Multiparametric Ultrasound Combining Shear Wave Elastography and Backscatter Tensor Imaging. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:474-483. [PMID: 38195266 DOI: 10.1016/j.ultrasmedbio.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/17/2023] [Accepted: 12/03/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVE Despite recent improvements in medical imaging, the final diagnosis and biopathologic characterization of breast cancers currently still requires biopsies. Ultrasound is commonly used for clinical examination of breast masses. B-Mode and shear wave elastography (SWE) are already widely used to detect suspicious masses and differentiate benign lesions from cancers. But additional ultrasound modalities such as backscatter tensor imaging (BTI) could provide relevant biomarkers related to tissue organization. Here we describe a 3-D multiparametric ultrasound approach applied to breast carcinomas in the aims of (i) validating the ability of BTI to reveal the underlying organization of collagen fibers and (ii) assessing the complementarity of SWE and BTI to reveal biopathologic features of diagnostic interest. METHODS Three-dimensional SWE and BTI were performed ex vivo on 64 human breast carcinoma samples using a linear ultrasound probe moved by a set of motors. Here we describe a 3-D multiparametric representation of the breast masses and quantitative measurements combining B-mode, SWE and BTI. RESULTS Our results reveal for the first time that BTI can capture the orientation of the collagen fibers around tumors. BTI was found to be a relevant marker for assessing cancer stages, revealing a more tangent tissue orientation for in situ carcinomas than for invasive cancers. In invasive cases, the combination of BTI and SWE parameters allowed for classification of invasive tumors with respect to their grade with an accuracy of 95.7%. CONCLUSION Our results highlight the potential of 3-D multiparametric ultrasound imaging for biopathologic characterization of breast tumors.
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Affiliation(s)
- Jean-Baptiste Guillaumin
- Physics for Medicine Institute, ESPCI Paris, PSL Research University, Inserm U1273, CNRS UMR 8063, Paris, France
| | | | - Jean-François Aubry
- Physics for Medicine Institute, ESPCI Paris, PSL Research University, Inserm U1273, CNRS UMR 8063, Paris, France.
| | | | - Alexandre Dizeux
- Physics for Medicine Institute, ESPCI Paris, PSL Research University, Inserm U1273, CNRS UMR 8063, Paris, France
| | - Mickaël Tanter
- Physics for Medicine Institute, ESPCI Paris, PSL Research University, Inserm U1273, CNRS UMR 8063, Paris, France
| | | | - Béatrice Berthon
- Physics for Medicine Institute, ESPCI Paris, PSL Research University, Inserm U1273, CNRS UMR 8063, Paris, France
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10
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Mori S, Onoda K, Arakawa M, Kanai H. Estimation error in speed of sound caused by rotation of measured cross-section from short-axis plane of blood vessels: a preliminary study. J Med Ultrason (2001) 2024; 51:49-57. [PMID: 38032505 DOI: 10.1007/s10396-023-01383-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/19/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE Estimating the speed of sound (SoS) in ultrasound propagation media is important for improving the quality of B-mode images and for quantitative tissue characterization. We have been studying a method for estimating the SoS by measuring the reception time distribution of waves scattered from a scatterer at the elements in a probe. Previously, the measurement cross section was assumed to be perpendicular to the long axis of the blood vessel. In this study, we experimentally investigated the relationship between rotation angle [Formula: see text] of the probe relative to the short-axis plane of the blood vessel and the estimated SoS, [Formula: see text]. METHODS Water tank and phantom experiments were conducted to investigate the characteristics of [Formula: see text] and element signals when the probe was rotated. RESULTS The received signal powers at the elements around both edges greatly decreased as [Formula: see text] increased. We introduced a parameter representing the decrease in power, [Formula: see text], in the received signal at the elements at both edges relative to the center element. [Formula: see text] was estimated to be larger as [Formula: see text] increased, especially for [Formula: see text]. [Formula: see text] also increased as [Formula: see text] increased. An approximately proportional relationship existed between the errors in [Formula: see text] and [Formula: see text]. CONCLUSION Based on these results, we can distinguish between the presence and the absence of SoS misestimations using the difference in power among the elements in the received signal. In the absence of misestimation, we can obtain the true SoS, even if the target has a non-negligible size, by applying our previously proposed methods.
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Affiliation(s)
- Shohei Mori
- Graduate School of Engineering, Tohoku University, 6-6-05 Aoba, Aramaki, Aoba, Sendai, Miyagi, 980-8579, Japan.
| | - Keiji Onoda
- Graduate School of Biomedical Engineering, Tohoku University, 6-6-05 Aoba, Aramaki, Aoba, Sendai, Miyagi, 980-8579, Japan
| | - Mototaka Arakawa
- Graduate School of Engineering, Tohoku University, 6-6-05 Aoba, Aramaki, Aoba, Sendai, Miyagi, 980-8579, Japan
- Graduate School of Biomedical Engineering, Tohoku University, 6-6-05 Aoba, Aramaki, Aoba, Sendai, Miyagi, 980-8579, Japan
| | - Hiroshi Kanai
- Graduate School of Engineering, Tohoku University, 6-6-05 Aoba, Aramaki, Aoba, Sendai, Miyagi, 980-8579, Japan
- Graduate School of Biomedical Engineering, Tohoku University, 6-6-05 Aoba, Aramaki, Aoba, Sendai, Miyagi, 980-8579, Japan
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11
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Nagaoka R, Omura M, Hasegawa H. Investigation of a method to estimate the average speed of sound using phase variances of element signals for ultrasound compound imaging. J Med Ultrason (2001) 2024; 51:17-28. [PMID: 37947986 PMCID: PMC10954954 DOI: 10.1007/s10396-023-01378-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/06/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE In the receive beamforming of an ultrasonography system, a B-mode image is reconstructed by assuming an average speed of sound (SoS) as a constant value. In our previous studies, we proposed a method for estimating the average SoS based on the coherence factor (CF) and the reciprocal of phase variances of element signals in delay-and-sum (DAS) beamforming. In this paper, we investigate the accuracy of estimation of the average SoS for compound imaging. METHODS For this purpose, two numerical simulations were performed with k-Wave software. Also, the estimation methods based on the CF and the reciprocal were applied to in vivo data from the common carotid artery, and B-mode images were reconstructed using the estimated average SoS. RESULTS In the first numerical simulation using an inhomogeneous phantom, the relationship between the accuracy and the transmission angles for the estimation was investigated, and the root mean squared errors (RMSEs) of estimates obtained based on the CF and the reciprocal of the phase variance were 1.25 ± 0.09, and 0.765 ± 0.17% at the transmission sequence of steering angles of (- 10°, - 5°, 0°, 5°, 10°), respectively. In the second numerical simulation using a cyst phantom, lateral resolutions were improved by reconstructing the image using the estimates obtained using the proposed strategy (reciprocal). By the proposed strategy, improvement of the continuity of the lumen-intima interface in the lateral direction was observed in the in vivo experiment. CONCLUSION Consequently, the results indicated that the proposed strategy was beneficial for estimation of the average SoS and image reconstruction.
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Affiliation(s)
- Ryo Nagaoka
- Faculty of Engineering, University of Toyama, 3190 Gofuku, Toyama, 930-8555, Japan.
| | - Masaaki Omura
- Faculty of Engineering, University of Toyama, 3190 Gofuku, Toyama, 930-8555, Japan
| | - Hideyuki Hasegawa
- Faculty of Engineering, University of Toyama, 3190 Gofuku, Toyama, 930-8555, Japan
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12
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Omidvar A, Rohling R, Cretu E, Cresswell M, Hodgson AJ. Shape estimation of flexible ultrasound arrays using spatial coherence: A preliminary study. ULTRASONICS 2024; 136:107171. [PMID: 37774644 DOI: 10.1016/j.ultras.2023.107171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/01/2023]
Abstract
A flexible ultrasound array can potentially provide a larger field-of-view, enhanced imaging resolution, and less operator dependency compared to conventional rigid transducer arrays. However, such transducer arrays require information about relative element positions for beamforming and reconstructing geometrically accurate sonograms. In this study, we assess the potential utility of using spatial coherence of backscattered radiofrequency data to estimate transducer array shape (inverse problem). The methodology is evaluated through 1) simulation of flexible arrays and 2) blinded in vivo experiments using commercial rigid transducer arrays on various anatomical targets (shoulder, forearm, scapular, posterior calf muscles, and abdomen) and multi-purpose ultrasound phantoms. The average Euclidean error of shape estimation is below 0.1 wavelengths for simulated arrays and below 1.4 wavelengths (median: 0.58 wavelengths) for real arrays. The complex wavelet structural similarity index between the B-mode images reconstructed with estimated and ground truth array shapes is above 99 % and 96 %, for simulations and experiments, respectively. These findings suggest that optimizing for spatial coherence may be an effective way to estimate the unknown shape of conformal ultrasound arrays.
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Affiliation(s)
- Amirhossein Omidvar
- School of Biomedical Engineering, University of British Columbia, Vancouver, Canada.
| | - Robert Rohling
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, Canada; Department of Mechanical Engineering, University of British Columbia, Vancouver, Canada.
| | - Edmond Cretu
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, Canada.
| | - Mark Cresswell
- Department of Radiology, University of British Columbia, Vancouver, Canada; St. Paul's Hospital, Vancouver, Canada.
| | - Antony J Hodgson
- School of Biomedical Engineering, University of British Columbia, Vancouver, Canada; Department of Mechanical Engineering, University of British Columbia, Vancouver, Canada.
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13
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Wang X, Bamber JC, Esquivel-Sirvent R, Ormachea J, Sidhu PS, Thomenius KE, Schoen S, Rosenzweig S, Pierce TT. Ultrasonic Sound Speed Estimation for Liver Fat Quantification: A Review by the AIUM-RSNA QIBA Pulse-Echo Quantitative Ultrasound Initiative. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:2327-2335. [PMID: 37550173 DOI: 10.1016/j.ultrasmedbio.2023.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 08/09/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a significant cause of diffuse liver disease, morbidity and mortality worldwide. Early and accurate diagnosis of NALFD is critical to identify patients at risk of disease progression. Liver biopsy is the current gold standard for diagnosis and prognosis. However, a non-invasive diagnostic tool is desired because of the high cost and risk of complications of tissue sampling. Medical ultrasound is a safe, inexpensive and widely available imaging tool for diagnosing NAFLD. Emerging sonographic tools to quantitatively estimate hepatic fat fraction, such as tissue sound speed estimation, are likely to improve diagnostic accuracy, precision and reproducibility compared with existing qualitative and semi-quantitative techniques. Various pulse-echo ultrasound speed of sound estimation methodologies have been investigated, and some have been recently commercialized. We review state-of-the-art in vivo speed of sound estimation techniques, including their advantages, limitations, technical sources of variability, biological confounders and existing commercial implementations. We report the expected range of hepatic speed of sound as a function of liver steatosis and fibrosis that may be encountered in clinical practice. Ongoing efforts seek to quantify sound speed measurement accuracy and precision to inform threshold development around meaningful differences in fat fraction and between sequential measurements.
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Affiliation(s)
- Xiaohong Wang
- Center for Ultrasound Research and Translation, Massachusetts General Hospital, Boston, MA, USA
| | - Jeffrey C Bamber
- Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | | | | | - Paul S Sidhu
- Department of Radiology, King's College Hospital, London, UK
| | - Kai E Thomenius
- Center for Ultrasound Research and Translation, Massachusetts General Hospital, Boston, MA, USA
| | - Scott Schoen
- Center for Ultrasound Research and Translation, Massachusetts General Hospital, Boston, MA, USA
| | | | - Theodore T Pierce
- Center for Ultrasound Research and Translation, Massachusetts General Hospital, Boston, MA, USA; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
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14
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Bureau F, Robin J, Le Ber A, Lambert W, Fink M, Aubry A. Three-dimensional ultrasound matrix imaging. Nat Commun 2023; 14:6793. [PMID: 37880210 PMCID: PMC10600255 DOI: 10.1038/s41467-023-42338-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023] Open
Abstract
Matrix imaging paves the way towards a next revolution in wave physics. Based on the response matrix recorded between a set of sensors, it enables an optimized compensation of aberration phenomena and multiple scattering events that usually drastically hinder the focusing process in heterogeneous media. Although it gave rise to spectacular results in optical microscopy or seismic imaging, the success of matrix imaging has been so far relatively limited with ultrasonic waves because wave control is generally only performed with a linear array of transducers. In this paper, we extend ultrasound matrix imaging to a 3D geometry. Switching from a 1D to a 2D probe enables a much sharper estimation of the transmission matrix that links each transducer and each medium voxel. Here, we first present an experimental proof of concept on a tissue-mimicking phantom through ex-vivo tissues and then, show the potential of 3D matrix imaging for transcranial applications.
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Affiliation(s)
- Flavien Bureau
- Institut Langevin, ESPCI Paris, PSL University, CNRS, 75005, Paris, France
| | - Justine Robin
- Institut Langevin, ESPCI Paris, PSL University, CNRS, 75005, Paris, France
- Physics for Medicine, ESPCI Paris, PSL University, INSERM, CNRS, Paris, France
| | - Arthur Le Ber
- Institut Langevin, ESPCI Paris, PSL University, CNRS, 75005, Paris, France
| | - William Lambert
- Institut Langevin, ESPCI Paris, PSL University, CNRS, 75005, Paris, France
- Hologic / SuperSonic Imagine, 135 Rue Emilien Gautier, 13290, Aix-en-Provence, France
| | - Mathias Fink
- Institut Langevin, ESPCI Paris, PSL University, CNRS, 75005, Paris, France
| | - Alexandre Aubry
- Institut Langevin, ESPCI Paris, PSL University, CNRS, 75005, Paris, France.
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15
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Schweizer D, Rau R, Bezek CD, Kubik-Huch RA, Goksel O. Robust Imaging of Speed of Sound Using Virtual Source Transmission. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:1308-1318. [PMID: 37549087 DOI: 10.1109/tuffc.2023.3303172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Speed of sound (SoS) is a novel imaging biomarker for assessing the biomechanical characteristics of soft tissues. SoS imaging in the pulse-echo mode using conventional ultrasound (US) systems with hand-held transducers has the potential to enable new clinical uses. Recent work demonstrated that diverging waves (DWs) from a single element (SE) transmit to outperform plane-wave sequences. However, SE transmits have severely limited power and hence produce a low signal-to-noise ratio (SNR) in echo data. We herein propose Walsh-Hadamard (WH) coded and virtual-source (VS) transmit sequences for the improved SNR in SoS imaging. We additionally present an iterative method of estimating beamforming (BF) SoS in the medium, which otherwise confounds SoS reconstructions due to beamforming inaccuracies in the images used for reconstruction. Through numerical simulations, phantom experiments, and in vivo imaging data, we show that WH is not robust against motion, which is often unavoidable in clinical imaging scenarios. Our proposed VS sequence is shown to provide the highest SoS reconstruction performance, especially robust to motion artifacts. In phantom experiments, despite having a comparable SoS root-mean-square error (RMSE) of 17.5-18.0 m/s at rest, with a minor axial probe motion of ≈ 0.67 mm/s the RMSE for SE, WH, and VS already deteriorate to 20.2, 105.4, and 19.0 m/s, respectively, showing that WH produces unacceptable results, not robust to motion. In the clinical data, the high SNR and motion resilience of VS sequences are seen to yield superior contrast compared to SE and WH sequences.
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16
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Ali R, Brevett T, Zhuang L, Bendjador H, Podkowa AS, Hsieh SS, Simson W, Sanabria SJ, Herickhoff CD, Dahl JJ. Aberration correction in diagnostic ultrasound: A review of the prior field and current directions. Z Med Phys 2023; 33:267-291. [PMID: 36849295 PMCID: PMC10517407 DOI: 10.1016/j.zemedi.2023.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/17/2022] [Accepted: 01/09/2023] [Indexed: 02/27/2023]
Abstract
Medical ultrasound images are reconstructed with simplifying assumptions on wave propagation, with one of the most prominent assumptions being that the imaging medium is composed of a constant sound speed. When the assumption of a constant sound speed are violated, which is true in most in vivoor clinical imaging scenarios, distortion of the transmitted and received ultrasound wavefronts appear and degrade the image quality. This distortion is known as aberration, and the techniques used to correct for the distortion are known as aberration correction techniques. Several models have been proposed to understand and correct for aberration. In this review paper, aberration and aberration correction are explored from the early models and correction techniques, including the near-field phase screen model and its associated correction techniques such as nearest-neighbor cross-correlation, to more recent models and correction techniques that incorporate spatially varying aberration and diffractive effects, such as models and techniques that rely on the estimation of the sound speed distribution in the imaging medium. In addition to historical models, future directions of ultrasound aberration correction are proposed.
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Affiliation(s)
- Rehman Ali
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Thurston Brevett
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Louise Zhuang
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Hanna Bendjador
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Anthony S Podkowa
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Scott S Hsieh
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Walter Simson
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Sergio J Sanabria
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA; University of Deusto/ Ikerbasque Basque Foundation for Science, Bilbao, Spain
| | - Carl D Herickhoff
- Department of Biomedical Engineering, University of Memphis, TN, USA
| | - Jeremy J Dahl
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA.
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17
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Fetzer DT, Pierce TT, Robbin ML, Cloutier G, Mufti A, Hall TJ, Chauhan A, Kubale R, Tang A. US Quantification of Liver Fat: Past, Present, and Future. Radiographics 2023; 43:e220178. [PMID: 37289646 DOI: 10.1148/rg.220178] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Fatty liver disease has a high and increasing prevalence worldwide, is associated with adverse cardiovascular events and higher long-term medical costs, and may lead to liver-related morbidity and mortality. There is an urgent need for accurate, reproducible, accessible, and noninvasive techniques appropriate for detecting and quantifying liver fat in the general population and for monitoring treatment response in at-risk patients. CT may play a potential role in opportunistic screening, and MRI proton-density fat fraction provides high accuracy for liver fat quantification; however, these imaging modalities may not be suited for widespread screening and surveillance, given the high global prevalence. US, a safe and widely available modality, is well positioned as a screening and surveillance tool. Although well-established qualitative signs of liver fat perform well in moderate and severe steatosis, these signs are less reliable for grading mild steatosis and are likely unreliable for detecting subtle changes over time. New and emerging quantitative biomarkers of liver fat, such as those based on standardized measurements of attenuation, backscatter, and speed of sound, hold promise. Evolving techniques such as multiparametric modeling, radiofrequency envelope analysis, and artificial intelligence-based tools are also on the horizon. The authors discuss the societal impact of fatty liver disease, summarize the current state of liver fat quantification with CT and MRI, and describe past, currently available, and potential future US-based techniques for evaluating liver fat. For each US-based technique, they describe the concept, measurement method, advantages, and limitations. © RSNA, 2023 Online supplemental material is available for this article. Quiz questions for this article are available through the Online Learning Center.
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Affiliation(s)
- David T Fetzer
- From the Department of Radiology (D.T.F.) and Department of Internal Medicine, Division of Digestive and Liver Diseases (A.M.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6-230-BF, Dallas, TX 75390-9316; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (T.T.P.); Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Departments of Radiology and Biomedical Engineering, Laboratory of Biorheology and Medical Ultrasonics, University of Montréal Hospital Research Center, Montréal, Quebec, Canada (G.C.); Department of Medical Physics, University of Wisconsin, Madison, Wis (T.J.H.); Department of Radiology, University of Kansas Medical Center, Kansas City, Kan (A.C.); Department of Diagnostic and Interventional Radiology, University Hospital Homburg/Saar, Homburg, Germany (R.K.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM) and Université de Montréal, Montréal, Quebec, Canada (A.T.)
| | - Theodore T Pierce
- From the Department of Radiology (D.T.F.) and Department of Internal Medicine, Division of Digestive and Liver Diseases (A.M.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6-230-BF, Dallas, TX 75390-9316; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (T.T.P.); Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Departments of Radiology and Biomedical Engineering, Laboratory of Biorheology and Medical Ultrasonics, University of Montréal Hospital Research Center, Montréal, Quebec, Canada (G.C.); Department of Medical Physics, University of Wisconsin, Madison, Wis (T.J.H.); Department of Radiology, University of Kansas Medical Center, Kansas City, Kan (A.C.); Department of Diagnostic and Interventional Radiology, University Hospital Homburg/Saar, Homburg, Germany (R.K.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM) and Université de Montréal, Montréal, Quebec, Canada (A.T.)
| | - Michelle L Robbin
- From the Department of Radiology (D.T.F.) and Department of Internal Medicine, Division of Digestive and Liver Diseases (A.M.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6-230-BF, Dallas, TX 75390-9316; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (T.T.P.); Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Departments of Radiology and Biomedical Engineering, Laboratory of Biorheology and Medical Ultrasonics, University of Montréal Hospital Research Center, Montréal, Quebec, Canada (G.C.); Department of Medical Physics, University of Wisconsin, Madison, Wis (T.J.H.); Department of Radiology, University of Kansas Medical Center, Kansas City, Kan (A.C.); Department of Diagnostic and Interventional Radiology, University Hospital Homburg/Saar, Homburg, Germany (R.K.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM) and Université de Montréal, Montréal, Quebec, Canada (A.T.)
| | - Guy Cloutier
- From the Department of Radiology (D.T.F.) and Department of Internal Medicine, Division of Digestive and Liver Diseases (A.M.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6-230-BF, Dallas, TX 75390-9316; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (T.T.P.); Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Departments of Radiology and Biomedical Engineering, Laboratory of Biorheology and Medical Ultrasonics, University of Montréal Hospital Research Center, Montréal, Quebec, Canada (G.C.); Department of Medical Physics, University of Wisconsin, Madison, Wis (T.J.H.); Department of Radiology, University of Kansas Medical Center, Kansas City, Kan (A.C.); Department of Diagnostic and Interventional Radiology, University Hospital Homburg/Saar, Homburg, Germany (R.K.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM) and Université de Montréal, Montréal, Quebec, Canada (A.T.)
| | - Arjmand Mufti
- From the Department of Radiology (D.T.F.) and Department of Internal Medicine, Division of Digestive and Liver Diseases (A.M.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6-230-BF, Dallas, TX 75390-9316; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (T.T.P.); Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Departments of Radiology and Biomedical Engineering, Laboratory of Biorheology and Medical Ultrasonics, University of Montréal Hospital Research Center, Montréal, Quebec, Canada (G.C.); Department of Medical Physics, University of Wisconsin, Madison, Wis (T.J.H.); Department of Radiology, University of Kansas Medical Center, Kansas City, Kan (A.C.); Department of Diagnostic and Interventional Radiology, University Hospital Homburg/Saar, Homburg, Germany (R.K.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM) and Université de Montréal, Montréal, Quebec, Canada (A.T.)
| | - Timothy J Hall
- From the Department of Radiology (D.T.F.) and Department of Internal Medicine, Division of Digestive and Liver Diseases (A.M.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6-230-BF, Dallas, TX 75390-9316; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (T.T.P.); Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Departments of Radiology and Biomedical Engineering, Laboratory of Biorheology and Medical Ultrasonics, University of Montréal Hospital Research Center, Montréal, Quebec, Canada (G.C.); Department of Medical Physics, University of Wisconsin, Madison, Wis (T.J.H.); Department of Radiology, University of Kansas Medical Center, Kansas City, Kan (A.C.); Department of Diagnostic and Interventional Radiology, University Hospital Homburg/Saar, Homburg, Germany (R.K.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM) and Université de Montréal, Montréal, Quebec, Canada (A.T.)
| | - Anil Chauhan
- From the Department of Radiology (D.T.F.) and Department of Internal Medicine, Division of Digestive and Liver Diseases (A.M.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6-230-BF, Dallas, TX 75390-9316; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (T.T.P.); Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Departments of Radiology and Biomedical Engineering, Laboratory of Biorheology and Medical Ultrasonics, University of Montréal Hospital Research Center, Montréal, Quebec, Canada (G.C.); Department of Medical Physics, University of Wisconsin, Madison, Wis (T.J.H.); Department of Radiology, University of Kansas Medical Center, Kansas City, Kan (A.C.); Department of Diagnostic and Interventional Radiology, University Hospital Homburg/Saar, Homburg, Germany (R.K.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM) and Université de Montréal, Montréal, Quebec, Canada (A.T.)
| | - Reinhard Kubale
- From the Department of Radiology (D.T.F.) and Department of Internal Medicine, Division of Digestive and Liver Diseases (A.M.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6-230-BF, Dallas, TX 75390-9316; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (T.T.P.); Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Departments of Radiology and Biomedical Engineering, Laboratory of Biorheology and Medical Ultrasonics, University of Montréal Hospital Research Center, Montréal, Quebec, Canada (G.C.); Department of Medical Physics, University of Wisconsin, Madison, Wis (T.J.H.); Department of Radiology, University of Kansas Medical Center, Kansas City, Kan (A.C.); Department of Diagnostic and Interventional Radiology, University Hospital Homburg/Saar, Homburg, Germany (R.K.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM) and Université de Montréal, Montréal, Quebec, Canada (A.T.)
| | - An Tang
- From the Department of Radiology (D.T.F.) and Department of Internal Medicine, Division of Digestive and Liver Diseases (A.M.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6-230-BF, Dallas, TX 75390-9316; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (T.T.P.); Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Departments of Radiology and Biomedical Engineering, Laboratory of Biorheology and Medical Ultrasonics, University of Montréal Hospital Research Center, Montréal, Quebec, Canada (G.C.); Department of Medical Physics, University of Wisconsin, Madison, Wis (T.J.H.); Department of Radiology, University of Kansas Medical Center, Kansas City, Kan (A.C.); Department of Diagnostic and Interventional Radiology, University Hospital Homburg/Saar, Homburg, Germany (R.K.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM) and Université de Montréal, Montréal, Quebec, Canada (A.T.)
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18
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Collin R, Magnin B, Gaillard C, Nicolas C, Abergel A, Buchard B. Prospective study comparing hepatic steatosis assessment by magnetic resonance imaging and four ultrasound methods in 105 successive patients. World J Gastroenterol 2023; 29:3548-3560. [PMID: 37389233 PMCID: PMC10303516 DOI: 10.3748/wjg.v29.i22.3548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/04/2023] [Accepted: 05/12/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is becoming a major health problem, resulting in hepatic, metabolic and cardio-vascular morbidity.
AIM To evaluate new ultrasonographic tools to detect and measure hepatic steatosis.
METHODS We prospectively included 105 patients referred to our liver unit for NAFLD suspicion or follow-up. They underwent ultrasonographic measurement of liver sound speed estimation (SSE) and attenuation coefficient (AC) using Aixplorer MACH 30 (Supersonic Imagine, France), continuous controlled attenuation parameter (cCAP) using Fibroscan (Echosens, France) and standard liver ultrasound with hepato-renal index (HRI) calculation. Hepatic steatosis was then classified according to magnetic resonance imaging proton density fat fraction (PDFF). Receiver operating curve (ROC) analysis was performed to evaluate the diagnostic performance in the diagnosis of steatosis.
RESULTS Most patients were overweight or obese (90%) and had metabolic syndrome (70%). One third suffered from diabetes. Steatosis was identified in 85 patients (81%) according to PDFF. Twenty-one patients (20%) had advanced liver disease. SSE, AC, cCAP and HRI correlated with PDFF, with respective Spearman correlation coefficient of -0.39, 0.42, 0.54 and 0.59 (P < 0.01). Area under the receiver operating characteristic curve (AUROC) for detection of steatosis with HRI was 0.91 (0.83-0.99), with the best cut-off value being 1.3 (Se = 83%, Sp = 98%). The optimal cCAP threshold of 275 dB/m, corresponding to the recent EASL-suggested threshold, had a sensitivity of 72% and a specificity of 80%. Corresponding AUROC was 0.79 (0.66-0.92). The diagnostic accuracy of cCAP was more reliable when standard deviation was < 15 dB/m with an AUC of 0.91 (0.83-0.98). An AC threshold of 0.42 dB/cm/MHz had an AUROC was 0.82 (0.70-0.93). SSE performed moderately with an AUROC of 0.73 (0.62-0.84).
CONCLUSION Among all ultrasonographic tools evaluated in this study, including new-generation tools such as cCAP and SSE, HRI had the best performance. It is also the simplest and most available method as most ultrasound scans are equipped with this module.
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Affiliation(s)
- Remi Collin
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges 87000, France
- Department of Hepatology and Gastroenterology, Clermont-Ferrand University Hospital, Clermont-Ferrand 63000, France
| | - Benoit Magnin
- Department of Radiology, Clermont-Ferrand University Hospital, Clermont-Ferrand 63000, France
| | - Constance Gaillard
- Department of Radiology, Clermont-Ferrand University Hospital, Clermont-Ferrand 63000, France
| | - Carine Nicolas
- Department of Hepatology and Gastroenterology, Clermont-Ferrand University Hospital, Clermont-Ferrand 63000, France
| | - Armand Abergel
- Department of Hepatology and Gastroenterology, Clermont-Ferrand University Hospital, Clermont-Ferrand 63000, France
| | - Benjamin Buchard
- Department of Hepatology and Gastroenterology, Clermont-Ferrand University Hospital, Clermont-Ferrand 63000, France
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19
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Jang W, Song JS. Non-Invasive Imaging Methods to Evaluate Non-Alcoholic Fatty Liver Disease with Fat Quantification: A Review. Diagnostics (Basel) 2023; 13:diagnostics13111852. [PMID: 37296703 DOI: 10.3390/diagnostics13111852] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 05/17/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Hepatic steatosis without specific causes (e.g., viral infection, alcohol abuse, etc.) is called non-alcoholic fatty liver disease (NAFLD), which ranges from non-alcoholic fatty liver (NAFL) to non-alcoholic steatohepatitis (NASH), fibrosis, and NASH-related cirrhosis. Despite the usefulness of the standard grading system, liver biopsy has several limitations. In addition, patient acceptability and intra- and inter-observer reproducibility are also concerns. Due to the prevalence of NAFLD and limitations of liver biopsies, non-invasive imaging methods such as ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) that can reliably diagnose hepatic steatosis have developed rapidly. US is widely available and radiation-free but cannot examine the entire liver. CT is readily available and helpful for detection and risk classification, significantly when analyzed using artificial intelligence; however, it exposes users to radiation. Although expensive and time-consuming, MRI can measure liver fat percentage with magnetic resonance imaging proton density fat fraction (MRI-PDFF). Specifically, chemical shift-encoded (CSE)-MRI is the best imaging indicator for early liver fat detection. The purpose of this review is to provide an overview of each imaging modality with an emphasis on the recent progress and current status of liver fat quantification.
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Affiliation(s)
- Weon Jang
- Department of Radiology, Jeonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Jeonbuk, Republic of Korea
- Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju 54907, Jeonbuk, Republic of Korea
- Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Jeonbuk, Republic of Korea
| | - Ji Soo Song
- Department of Radiology, Jeonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Jeonbuk, Republic of Korea
- Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju 54907, Jeonbuk, Republic of Korea
- Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Jeonbuk, Republic of Korea
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20
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Mori S, Kanai H, Arakawa M. Speed-of-sound estimation in ultrasound propagation medium by considering size of target scatterer. J Med Ultrason (2001) 2023; 50:151-165. [PMID: 36905494 DOI: 10.1007/s10396-023-01282-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/05/2022] [Indexed: 03/12/2023]
Abstract
PURPOSE Accurate speed-of-sound (SoS) estimation in an ultrasound propagation medium improves imaging quality and contributes to better diagnosis of diseases. In conventional time-delay-based SoS estimation approaches studied by several groups, a received wave is assumed to be scattered from an ideal point scatterer. In these approaches, the SoS is overestimated when the target scatterer has a non-negligible size. In this paper, we propose the SoS estimation method that considers target size. METHODS In the proposed method, the error ratio of the estimated SoS using the conventional time-delay-based approach is determined from measurable parameters using the geometric relationship between the received elements and target. Subsequently, the SoS erroneously estimated using conventional estimation, assuming the ideal point scatterer as a target, is corrected by the determined estimation error ratio. To validate the proposed method, the SoS in water was estimated for several wire sizes. RESULTS The SoS in the water was overestimated using the conventional SoS estimation method, with a maximum positive error of 38 m/s. The proposed method corrected the SoS estimates, and the errors were suppressed to within 6 m/s, irrespective of the wire diameter. CONCLUSION The present results demonstrate that the proposed method can estimate the SoS by considering the target size without using information on the true SoS, true target depth, and true target size, which is applicable to in vivo measurements.
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Affiliation(s)
- Shohei Mori
- Graduate School of Engineering, Tohoku University, Sendai, Miyagi, 980-8579, Japan.
| | - Hiroshi Kanai
- Graduate School of Engineering, Tohoku University, Sendai, Miyagi, 980-8579, Japan.,Graduate School of Biomedical Engineering, Tohoku University, Sendai, Miyagi, 980-8579, Japan
| | - Mototaka Arakawa
- Graduate School of Engineering, Tohoku University, Sendai, Miyagi, 980-8579, Japan.,Graduate School of Biomedical Engineering, Tohoku University, Sendai, Miyagi, 980-8579, Japan
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21
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Solberg S, Amini N, Zaza Y, Angelsen BAJ, Hansen R. Estimation of fat content in soft tissues using dual frequency ultrasound-A phantom study. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:1766. [PMID: 37002069 DOI: 10.1121/10.0017601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 02/25/2023] [Indexed: 05/18/2023]
Abstract
This paper presents an initial investigation into the use of dual frequency pulse-echo ultrasound, second order ultrasound field (SURF) imaging, to measure the fat content of soft tissues. The SURF imaging method was used to measure the non-linear bulk elasticity (NBE) of several fatty phantoms that were created by mixing different mass fractions of soybean oil uniformly into agar phantoms. The median of the measured NBE within the estimation region was found to increase linearly with fat mass fraction (R2 = 0.99), from 1.7 GPa-1 at 9.6% fat to 2.52 GPa-1 at 63.6% fat, thus, showing promise as a sensitive parameter for fat content measurement. Comparisons to mixture laws in earlier literature are made, and the most important error sources that need to be considered for the in vivo applications of the method are discussed.
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Affiliation(s)
| | | | - Yamen Zaza
- SURF Technology AS, 7491 Trondheim, Norway
| | - Bjørn A J Angelsen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - Rune Hansen
- Department of Health Research, SINTEF Digital, 7465 Trondheim, Norway
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22
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Ultrasound-based hepatic fat quantification: current status and future directions. Clin Radiol 2023; 78:187-200. [PMID: 36411088 DOI: 10.1016/j.crad.2022.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 09/22/2022] [Accepted: 10/06/2022] [Indexed: 11/19/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a spectrum of disease from fatty accumulation (steatosis), necro-inflammation though to fibrosis. It is of increasing global prevalence as a hepatic manifestation of the metabolic syndrome. Although accurate histopathology and magnetic resonance imaging techniques for hepatic fat quantification exist, these are limited by invasiveness and availability, respectively. Ultrasonography is potentially ideal for assessing and monitoring hepatic steatosis given the examination is rapid and readily available. Traditional ultrasound methods include qualitative B-mode for imaging markers, such as increased hepatic parenchymal echogenicity compared to adjacent renal cortex are commonplace; however, there is acknowledged significant interobserver variability and they are suboptimal for detecting mild steatosis. Recently quantitative ultrasound metrics have been investigated as biomarkers for hepatic steatosis. These methods rely on changes in backscatter, attenuation, and speed of sound differences encountered in a steatotic liver. Prospective studies using quantitative ultrasound parameters show good diagnostic performance even at low steatosis grades and in NAFLD. This review aims to define the clinical need for ultrasound-based assessments of liver steatosis, to describe briefly the physics that underpins the various techniques available, and to assess the evidence base for the effectiveness of the techniques that are available commercially from various ultrasound vendors.
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23
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Nam K, Torkzaban M, Halegoua-DeMarzio D, Wessner CE, Lyshchik A. Improving diagnostic accuracy of ultrasound texture features in detecting and quantifying hepatic steatosis using various beamforming sound speeds. Phys Med Biol 2023; 68:10.1088/1361-6560/acb635. [PMID: 36696691 PMCID: PMC10009771 DOI: 10.1088/1361-6560/acb635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/25/2023] [Indexed: 01/26/2023]
Abstract
Objective.While ultrasound image texture has been utilized to detect and quantify hepatic steatosis, the texture features extracted using a single (conventionally 1540 m s-1) beamforming speed of sound (SoS) failed to achieve reliable diagnostic performance. This study aimed to investigate if the texture features extracted using various beamforming SoSs can improve the accuracy of hepatic steatosis detection and quantification.Approach.Patients with suspected non-alcoholic fatty liver disease underwent liver biopsy or MRI proton density fat fraction (PDFF) as part of standard of care, were prospectively enrolled. The radio-frequency data from subjects' right and left liver lobes were collected using 6 beamforming SoSs: 1300, 1350, 1400, 1450, 1500 and 1540 m s-1and analyzed offline. The texture features, i.e. Contrast, Correlation, Energy and Homogeneity from gray-level co-occurrence matrix of normalized envelope were obtained from a region of interest in the liver parenchyma.Main results.Forty-three subjects (67.2%) were diagnosed with steatosis while 21 had no steatosis. Homogeneity showed the area under the curve (AUC) of 0.75-0.82 and 0.58-0.81 for left and right lobes, respectively with varying beamforming SoSs. The combined Homogeneity value over 1300-1540 m s-1from left and right lobes showed the AUC of 0.90 and 0.81, respectively. Furthermore, the combined Homogeneity values from left and right lobes over 1300-1540 m s-1improved the AUC to 0.94. The correlation between texture features and steatosis severity was improved by using the images from various beamforming SoSs. The combined Contrast values over 1300-1540 m s-1from left and right lobes demonstrated the highest correlation (r= 0.90) with the MRI PDFF while the combined Homogeneity values over 1300-1540 m s-1from left and right lobes showed the highest correlation with the biopsy grades (r= -0.81).Significance.The diagnostic accuracy of ultrasound texture features in detecting and quantifying hepatic steatosis was improved by combining its values extracted using various beamforming SoSs.
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Affiliation(s)
- Kibo Nam
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Mehnoosh Torkzaban
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Dina Halegoua-DeMarzio
- Department of Medicine, Division of Gastroenterology & Hepatology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Corinne E. Wessner
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107, USA
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24
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Robin J, Demené C, Heiles B, Blanvillain V, Puke L, Perren F, Tanter M. In vivoadaptive focusing for clinical contrast-enhanced transcranial ultrasound imaging in human. Phys Med Biol 2023; 68. [PMID: 36595330 DOI: 10.1088/1361-6560/acabfb] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
Objective. Imaging the human brain vasculature with high spatial and temporal resolution remains challenging in the clinic today. Transcranial ultrasound is still scarcely used for cerebrovascular imaging, due to low sensitivity and strong phase aberrations induced by the skull bone that only enable the proximal part major brain vessel imaging, even with ultrasound contrast agent injection (microbubbles).Approach. Here, we propose an adaptive aberration correction technique for skull bone aberrations based on the backscattered signals coming from intravenously injected microbubbles. Our aberration correction technique was implemented to image brain vasculature in human adults through temporal and occipital bone windows. For each subject, an effective speed of sound, as well as a phase aberration profile, were determined in several isoplanatic patches spread across the image. This information was then used in the beamforming process.Main results. This aberration correction method reduced the number of artefacts, such as ghost vessels, in the images. It improved image quality both for ultrafast Doppler imaging and ultrasound localization microscopy (ULM), especially in patients with thick bone windows. For ultrafast Doppler images, the contrast was increased by 4 dB on average, and for ULM, the number of detected microbubble tracks was increased by 38%.Significance. This technique is thus promising for better diagnosis and follow-up of brain pathologies such as aneurysms, arterial stenoses, arterial occlusions, microvascular disease and stroke and could make transcranial ultrasound imaging possible even in particularly difficult-to-image human adults.
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Affiliation(s)
- Justine Robin
- Physics for Medicine Paris, INSERM, ESPCI Paris, PSL Research University, CNRS, France.,LUNIC Laboratory, Neurocenter University of Geneva, Switzerland
| | - Charlie Demené
- Physics for Medicine Paris, INSERM, ESPCI Paris, PSL Research University, CNRS, France.,LUNIC Laboratory, Neurocenter University of Geneva, Switzerland
| | - Baptiste Heiles
- Physics for Medicine Paris, INSERM, ESPCI Paris, PSL Research University, CNRS, France
| | - Victor Blanvillain
- Physics for Medicine Paris, INSERM, ESPCI Paris, PSL Research University, CNRS, France
| | - Liene Puke
- LUNIC Laboratory, Neurocenter University of Geneva, Switzerland
| | - Fabienne Perren
- LUNIC Laboratory, Neurocenter University of Geneva, Switzerland.,Dept. of Clinical Neurosciences, Universities of Geneva and Fribourg, Switzerland
| | - Mickael Tanter
- Physics for Medicine Paris, INSERM, ESPCI Paris, PSL Research University, CNRS, France
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25
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Lambert W, Cobus LA, Robin J, Fink M, Aubry A. Ultrasound Matrix Imaging-Part II: The Distortion Matrix for Aberration Correction Over Multiple Isoplanatic Patches. IEEE TRANSACTIONS ON MEDICAL IMAGING 2022; 41:3921-3938. [PMID: 35976837 DOI: 10.1109/tmi.2022.3199483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This is the second article in a series of two which report on a matrix approach for ultrasound imaging in heterogeneous media. This article describes the quantification and correction of aberration, i.e. the distortion of an image caused by spatial variations in the medium speed-of-sound. Adaptive focusing can compensate for aberration, but is only effective over a restricted area called the isoplanatic patch. Here, we use an experimentally-recorded matrix of reflected acoustic signals to synthesize a set of virtual transducers. We then examine wave propagation between these virtual transducers and an arbitrary correction plane. Such wave-fronts consist of two components: (i) An ideal geometric wave-front linked to diffraction and the input focusing point, and; (ii) Phase distortions induced by the speed-of-sound variations. These distortions are stored in a so-called distortion matrix, the singular value decomposition of which gives access to an optimized focusing law at any point. We show that, by decoupling the aberrations undergone by the outgoing and incoming waves and applying an iterative strategy, compensation for even high-order and spatially-distributed aberrations can be achieved. After a numerical validation of the process, ultrasound matrix imaging (UMI) is applied to the in-vivo imaging of a gallbladder. A map of isoplanatic modes is retrieved and is shown to be strongly correlated with the arrangement of tissues constituting the medium. The corresponding focusing laws yield an ultrasound image with drastically improved contrast and transverse resolution. UMI thus provides a flexible and powerful route towards computational ultrasound.
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26
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Fetzer DT, Rosado-Mendez IM, Wang M, Robbin ML, Ozturk A, Wear KA, Ormachea J, Stiles TA, Fowlkes JB, Hall TJ, Samir AE. Pulse-Echo Quantitative US Biomarkers for Liver Steatosis: Toward Technical Standardization. Radiology 2022; 305:265-276. [PMID: 36098640 PMCID: PMC9613608 DOI: 10.1148/radiol.212808] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/07/2022] [Accepted: 04/14/2022] [Indexed: 11/11/2022]
Abstract
Excessive liver fat (steatosis) is now the most common cause of chronic liver disease worldwide and is an independent risk factor for cirrhosis and associated complications. Accurate and clinically useful diagnosis, risk stratification, prognostication, and therapy monitoring require accurate and reliable biomarker measurement at acceptable cost. This article describes a joint effort by the American Institute of Ultrasound in Medicine (AIUM) and the RSNA Quantitative Imaging Biomarkers Alliance (QIBA) to develop standards for clinical and technical validation of quantitative biomarkers for liver steatosis. The AIUM Liver Fat Quantification Task Force provides clinical guidance, while the RSNA QIBA Pulse-Echo Quantitative Ultrasound Biomarker Committee develops methods to measure biomarkers and reduce biomarker variability. In this article, the authors present the clinical need for quantitative imaging biomarkers of liver steatosis, review the current state of various imaging modalities, and describe the technical state of the art for three key liver steatosis pulse-echo quantitative US biomarkers: attenuation coefficient, backscatter coefficient, and speed of sound. Lastly, a perspective on current challenges and recommendations for clinical translation for each biomarker is offered.
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Affiliation(s)
| | | | - Michael Wang
- From the Department of Radiology, University of Texas Southwestern
Medical Center, Dallas, Tex (D.T.F.); Departments of Medical Physics (I.M.R.M.,
T.J.H.) and Radiology (I.M.R.M.), University of Wisconsin, Institutes for
Medical Research, 1111 Highland Ave, Room 1005, Madison, WI 53705; General
Electric Healthcare, Milwaukee, Wis (M.W.); Department of Radiology, University
of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Department of Radiology,
Massachusetts General Hospital, Boston, Mass (A.O.); U.S. Food and Drug
Administration, Silver Spring, Md (K.A.W.); Department of Electrical and
Computer Engineering, University of Rochester, Rochester, NY (J.O.); Department
of Natural Sciences, Kettering University, Flint, Mich (T.A.S.); Departments of
Biomedical Engineering and Radiology, University of Michigan, Ann Arbor, Mich
(J.B.F.); RSNA Quantitative Imaging Biomarkers Alliance (T.J.H.); and Center for
Ultrasound Research & Translation, Department of Radiology, Massachusetts
General Hospital, Harvard Medical School, Boston, Mass (A.E.S.)
| | - Michelle L. Robbin
- From the Department of Radiology, University of Texas Southwestern
Medical Center, Dallas, Tex (D.T.F.); Departments of Medical Physics (I.M.R.M.,
T.J.H.) and Radiology (I.M.R.M.), University of Wisconsin, Institutes for
Medical Research, 1111 Highland Ave, Room 1005, Madison, WI 53705; General
Electric Healthcare, Milwaukee, Wis (M.W.); Department of Radiology, University
of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Department of Radiology,
Massachusetts General Hospital, Boston, Mass (A.O.); U.S. Food and Drug
Administration, Silver Spring, Md (K.A.W.); Department of Electrical and
Computer Engineering, University of Rochester, Rochester, NY (J.O.); Department
of Natural Sciences, Kettering University, Flint, Mich (T.A.S.); Departments of
Biomedical Engineering and Radiology, University of Michigan, Ann Arbor, Mich
(J.B.F.); RSNA Quantitative Imaging Biomarkers Alliance (T.J.H.); and Center for
Ultrasound Research & Translation, Department of Radiology, Massachusetts
General Hospital, Harvard Medical School, Boston, Mass (A.E.S.)
| | - Arinc Ozturk
- From the Department of Radiology, University of Texas Southwestern
Medical Center, Dallas, Tex (D.T.F.); Departments of Medical Physics (I.M.R.M.,
T.J.H.) and Radiology (I.M.R.M.), University of Wisconsin, Institutes for
Medical Research, 1111 Highland Ave, Room 1005, Madison, WI 53705; General
Electric Healthcare, Milwaukee, Wis (M.W.); Department of Radiology, University
of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Department of Radiology,
Massachusetts General Hospital, Boston, Mass (A.O.); U.S. Food and Drug
Administration, Silver Spring, Md (K.A.W.); Department of Electrical and
Computer Engineering, University of Rochester, Rochester, NY (J.O.); Department
of Natural Sciences, Kettering University, Flint, Mich (T.A.S.); Departments of
Biomedical Engineering and Radiology, University of Michigan, Ann Arbor, Mich
(J.B.F.); RSNA Quantitative Imaging Biomarkers Alliance (T.J.H.); and Center for
Ultrasound Research & Translation, Department of Radiology, Massachusetts
General Hospital, Harvard Medical School, Boston, Mass (A.E.S.)
| | - Keith A. Wear
- From the Department of Radiology, University of Texas Southwestern
Medical Center, Dallas, Tex (D.T.F.); Departments of Medical Physics (I.M.R.M.,
T.J.H.) and Radiology (I.M.R.M.), University of Wisconsin, Institutes for
Medical Research, 1111 Highland Ave, Room 1005, Madison, WI 53705; General
Electric Healthcare, Milwaukee, Wis (M.W.); Department of Radiology, University
of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Department of Radiology,
Massachusetts General Hospital, Boston, Mass (A.O.); U.S. Food and Drug
Administration, Silver Spring, Md (K.A.W.); Department of Electrical and
Computer Engineering, University of Rochester, Rochester, NY (J.O.); Department
of Natural Sciences, Kettering University, Flint, Mich (T.A.S.); Departments of
Biomedical Engineering and Radiology, University of Michigan, Ann Arbor, Mich
(J.B.F.); RSNA Quantitative Imaging Biomarkers Alliance (T.J.H.); and Center for
Ultrasound Research & Translation, Department of Radiology, Massachusetts
General Hospital, Harvard Medical School, Boston, Mass (A.E.S.)
| | - Juvenal Ormachea
- From the Department of Radiology, University of Texas Southwestern
Medical Center, Dallas, Tex (D.T.F.); Departments of Medical Physics (I.M.R.M.,
T.J.H.) and Radiology (I.M.R.M.), University of Wisconsin, Institutes for
Medical Research, 1111 Highland Ave, Room 1005, Madison, WI 53705; General
Electric Healthcare, Milwaukee, Wis (M.W.); Department of Radiology, University
of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Department of Radiology,
Massachusetts General Hospital, Boston, Mass (A.O.); U.S. Food and Drug
Administration, Silver Spring, Md (K.A.W.); Department of Electrical and
Computer Engineering, University of Rochester, Rochester, NY (J.O.); Department
of Natural Sciences, Kettering University, Flint, Mich (T.A.S.); Departments of
Biomedical Engineering and Radiology, University of Michigan, Ann Arbor, Mich
(J.B.F.); RSNA Quantitative Imaging Biomarkers Alliance (T.J.H.); and Center for
Ultrasound Research & Translation, Department of Radiology, Massachusetts
General Hospital, Harvard Medical School, Boston, Mass (A.E.S.)
| | - Timothy A. Stiles
- From the Department of Radiology, University of Texas Southwestern
Medical Center, Dallas, Tex (D.T.F.); Departments of Medical Physics (I.M.R.M.,
T.J.H.) and Radiology (I.M.R.M.), University of Wisconsin, Institutes for
Medical Research, 1111 Highland Ave, Room 1005, Madison, WI 53705; General
Electric Healthcare, Milwaukee, Wis (M.W.); Department of Radiology, University
of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Department of Radiology,
Massachusetts General Hospital, Boston, Mass (A.O.); U.S. Food and Drug
Administration, Silver Spring, Md (K.A.W.); Department of Electrical and
Computer Engineering, University of Rochester, Rochester, NY (J.O.); Department
of Natural Sciences, Kettering University, Flint, Mich (T.A.S.); Departments of
Biomedical Engineering and Radiology, University of Michigan, Ann Arbor, Mich
(J.B.F.); RSNA Quantitative Imaging Biomarkers Alliance (T.J.H.); and Center for
Ultrasound Research & Translation, Department of Radiology, Massachusetts
General Hospital, Harvard Medical School, Boston, Mass (A.E.S.)
| | - J. Brian Fowlkes
- From the Department of Radiology, University of Texas Southwestern
Medical Center, Dallas, Tex (D.T.F.); Departments of Medical Physics (I.M.R.M.,
T.J.H.) and Radiology (I.M.R.M.), University of Wisconsin, Institutes for
Medical Research, 1111 Highland Ave, Room 1005, Madison, WI 53705; General
Electric Healthcare, Milwaukee, Wis (M.W.); Department of Radiology, University
of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Department of Radiology,
Massachusetts General Hospital, Boston, Mass (A.O.); U.S. Food and Drug
Administration, Silver Spring, Md (K.A.W.); Department of Electrical and
Computer Engineering, University of Rochester, Rochester, NY (J.O.); Department
of Natural Sciences, Kettering University, Flint, Mich (T.A.S.); Departments of
Biomedical Engineering and Radiology, University of Michigan, Ann Arbor, Mich
(J.B.F.); RSNA Quantitative Imaging Biomarkers Alliance (T.J.H.); and Center for
Ultrasound Research & Translation, Department of Radiology, Massachusetts
General Hospital, Harvard Medical School, Boston, Mass (A.E.S.)
| | - Timothy J. Hall
- From the Department of Radiology, University of Texas Southwestern
Medical Center, Dallas, Tex (D.T.F.); Departments of Medical Physics (I.M.R.M.,
T.J.H.) and Radiology (I.M.R.M.), University of Wisconsin, Institutes for
Medical Research, 1111 Highland Ave, Room 1005, Madison, WI 53705; General
Electric Healthcare, Milwaukee, Wis (M.W.); Department of Radiology, University
of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Department of Radiology,
Massachusetts General Hospital, Boston, Mass (A.O.); U.S. Food and Drug
Administration, Silver Spring, Md (K.A.W.); Department of Electrical and
Computer Engineering, University of Rochester, Rochester, NY (J.O.); Department
of Natural Sciences, Kettering University, Flint, Mich (T.A.S.); Departments of
Biomedical Engineering and Radiology, University of Michigan, Ann Arbor, Mich
(J.B.F.); RSNA Quantitative Imaging Biomarkers Alliance (T.J.H.); and Center for
Ultrasound Research & Translation, Department of Radiology, Massachusetts
General Hospital, Harvard Medical School, Boston, Mass (A.E.S.)
| | - Anthony E. Samir
- From the Department of Radiology, University of Texas Southwestern
Medical Center, Dallas, Tex (D.T.F.); Departments of Medical Physics (I.M.R.M.,
T.J.H.) and Radiology (I.M.R.M.), University of Wisconsin, Institutes for
Medical Research, 1111 Highland Ave, Room 1005, Madison, WI 53705; General
Electric Healthcare, Milwaukee, Wis (M.W.); Department of Radiology, University
of Alabama at Birmingham, Birmingham, Ala (M.L.R.); Department of Radiology,
Massachusetts General Hospital, Boston, Mass (A.O.); U.S. Food and Drug
Administration, Silver Spring, Md (K.A.W.); Department of Electrical and
Computer Engineering, University of Rochester, Rochester, NY (J.O.); Department
of Natural Sciences, Kettering University, Flint, Mich (T.A.S.); Departments of
Biomedical Engineering and Radiology, University of Michigan, Ann Arbor, Mich
(J.B.F.); RSNA Quantitative Imaging Biomarkers Alliance (T.J.H.); and Center for
Ultrasound Research & Translation, Department of Radiology, Massachusetts
General Hospital, Harvard Medical School, Boston, Mass (A.E.S.)
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27
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Sanabria SJ, Pirmoazen AM, Dahl J, Kamaya A, El Kaffas A. Comparative Study of Raw Ultrasound Data Representations in Deep Learning to Classify Hepatic Steatosis. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:2060-2078. [PMID: 35914993 DOI: 10.1016/j.ultrasmedbio.2022.05.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 06/15/2023]
Abstract
Adiposity accumulation in the liver is an early-stage indicator of non-alcoholic fatty liver disease. Analysis of ultrasound (US) backscatter echoes from liver parenchyma with deep learning (DL) may offer an affordable alternative for hepatic steatosis staging. The aim of this work was to compare DL classification scores for liver steatosis using different data representations constructed from raw US data. Steatosis in N = 31 patients with confirmed or suspected non-alcoholic fatty liver disease was stratified based on fat-fraction cutoff values using magnetic resonance imaging as a reference standard. US radiofrequency (RF) frames (raw data) and clinical B-mode images were acquired. Intermediate image formation stages were modeled from RF data. Power spectrum representations and phase representations were also calculated. Co-registered patches were used to independently train 1-, 2- and 3-D convolutional neural networks (CNNs), and classifications scores were compared with cross-validation. There were 67,800 patches available for 2-D/3-D classification and 1,830,600 patches for 1-D classification. The results were also compared with radiologist B-mode annotations and quantitative ultrasound (QUS) metrics. Patch classification scores (area under the receiver operating characteristic curve [AUROC]) revealed significant reductions along successive stages of the image formation process (p < 0.001). Patient AUROCs were 0.994 for RF data and 0.938 for clinical B-mode images. For all image formation stages, 2-D CNNs revealed higher patch and patient AUROCs than 1-D CNNs. CNNs trained with power spectrum representations converged faster than those trained with RF data. Phase information, which is usually discarded in the image formation process, provided a patient AUROC of 0.988. DL models trained with RF and power spectrum data (AUROC = 0.998) provided higher scores than conventional QUS metrics and multiparametric combinations thereof (AUROC = 0.986). Radiologist annotations indicated lower hepatic steatosis classification accuracies (Acc = 0.914) with respect to magnetic resonance imaging proton density fat fraction that DL models (Acc = 0.989). Access to raw ultrasound data combined with artificial intelligence techniques may offer superior opportunities for quantitative tissue diagnostics than conventional sonographic images.
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Affiliation(s)
- Sergio J Sanabria
- Department of Radiology, Stanford University, Stanford, California, USA; Deusto Institute of Technology, University of Deusto/Ikerbasque, Basque Foundation for Science, Bilbao, Spain.
| | - Amir M Pirmoazen
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Jeremy Dahl
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Aya Kamaya
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Ahmed El Kaffas
- Department of Radiology, Stanford University, Stanford, California, USA
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Bozic D, Podrug K, Mikolasevic I, Grgurevic I. Ultrasound Methods for the Assessment of Liver Steatosis: A Critical Appraisal. Diagnostics (Basel) 2022; 12:2287. [PMID: 36291976 PMCID: PMC9600709 DOI: 10.3390/diagnostics12102287] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/14/2022] [Accepted: 09/17/2022] [Indexed: 08/10/2023] Open
Abstract
The prevalence of the non-alcoholic fatty liver disease has reached major proportions, being estimated to affect one-quarter of the global population. The reference techniques, which include liver biopsy and the magnetic resonance imaging proton density fat fraction, have objective practical and financial limitations to their routine use in the detection and quantification of liver steatosis. Therefore, there has been a rising necessity for the development of new inexpensive, widely applicable and reliable non-invasive diagnostic tools. The controlled attenuation parameter has been considered the point-of-care technique for the assessment of liver steatosis for a long period of time. Recently, many ultrasound (US) system manufacturers have developed proprietary software solutions for the quantification of liver steatosis. Some of these methods have already been extensively tested with very good performance results reported, while others are still under evaluation. This manuscript reviews the currently available US-based methods for diagnosing and grading liver steatosis, including their classification and performance results, with an appraisal of the importance of this armamentarium in daily clinical practice.
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Affiliation(s)
- Dorotea Bozic
- Department of Gastroenterology and Hepatology, University Hospital Center Split, Spinčićeva 1, 21 000 Split, Croatia
| | - Kristian Podrug
- Department of Gastroenterology and Hepatology, University Hospital Center Split, Spinčićeva 1, 21 000 Split, Croatia
| | - Ivana Mikolasevic
- Department of Gastroenterology and Hepatology, University Hospital Center Rijeka, Krešimirova 42, 51 000 Rijeka, Croatia
| | - Ivica Grgurevic
- Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, Avenija Gojka Šuška 6, 10 000 Zagreb, Croatia
- School of Medicine, University of Zagreb, Šalata 2, 10 000 Zagreb, Croatia
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Ino M, Yoshida K, Hirata S, Ito K, Yamaguchi T. Assessment of the frequency dependence of acoustic properties on material, composition, and scatterer size of the medium. J Med Ultrason (2001) 2022; 49:569-578. [PMID: 36098894 DOI: 10.1007/s10396-022-01235-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/21/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of this study was to elucidate the frequency dependence of the speed of sound (SoS) and attenuation coefficients in phantoms with controlled attenuation properties (scatterer density, scatterer size, absorption control material) and rat livers. METHODS The frequency dependence of SoS and attenuation coefficients were evaluated with ultrasound (1-15 MHz) by observing multiple phantoms with different scatterer sizes, densities, and presence or absence of evaporated milk as absorbing media. Normal and fatty model rat livers were examined with the same protocol. RESULTS The phantom results revealed that the scatterer density and SoS of the base media were the dominant factors causing the changes in SoS. Frequency dependence was not observed in SoS. Assessment of the attenuation coefficient showed that the frequency dependence was mainly affected by absorption attenuation when the scatterer was as small as a hepatocyte (i.e. ≤ 10 µm). Scattering attenuation was also observed to affect frequency dependence when the scatterer was as large as lipid droplets (i.e. ≤ 40 µm). CONCLUSION Assuming a consistent size of the main scatterers in the evaluation medium, the frequency dependence of the SoS and attenuation coefficients may provide insight into the scatterer density and the contribution of absorption and scattering attenuation. Further studies in the higher frequency band (up to about 50 MHz) are expected to advance the clinical application of high-frequency ultrasound.
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Affiliation(s)
- Mai Ino
- Graduate School of Science and Engineering, Chiba University, 1-33 Yayoicho, Inage, Chiba, 2638522, Japan.
| | - Kenji Yoshida
- Center for Frontier Medical Engineering, Chiba University, 1-33 Yayoicho, Inage, Chiba, 2638522, Japan
| | - Shinnosuke Hirata
- Center for Frontier Medical Engineering, Chiba University, 1-33 Yayoicho, Inage, Chiba, 2638522, Japan
| | - Kazuyo Ito
- Institute of Engineering, Tokyo University of Agriculture and Technology, 2-24-16 Nakacho, Koganei, Tokyo, 1848588, Japan.,Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, The Academia, 20 College Road, Discovery Tower Level 6, Singapore, 169856, Singapore
| | - Tadashi Yamaguchi
- Center for Frontier Medical Engineering, Chiba University, 1-33 Yayoicho, Inage, Chiba, 2638522, Japan.
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Guan X, Chen YC, Xu HX. New horizon of ultrasound for screening and surveillance of non-alcoholic fatty liver disease spectrum. Eur J Radiol 2022; 154:110450. [PMID: 35917757 DOI: 10.1016/j.ejrad.2022.110450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/01/2022] [Accepted: 07/19/2022] [Indexed: 12/07/2022]
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Cassinotto C, Jacq T, Anselme S, Ursic-Bedoya J, Blanc P, Faure S, Belgour A, Guiu B. Diagnostic Performance of Attenuation to Stage Liver Steatosis with MRI Proton Density Fat Fraction as Reference: A Prospective Comparison of Three US Machines. Radiology 2022; 305:353-361. [PMID: 35819322 DOI: 10.1148/radiol.212846] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background US tools to quantify liver fat content have recently been made clinically available by different vendors, but comparative data on their accuracy are lacking. Purpose To compare the diagnostic performances of the attenuation parameters of US machines from three different manufacturers (vendors 1, 2, and 3) in participants who underwent liver fat quantification with the MRI-derived proton density fat fraction (PDFF). Materials and Methods From July 2020 to June 2021, consecutive participants with chronic liver disease were enrolled in this prospective single-center study and underwent MRI PDFF quantification (reference standard) and US on the same day. US was performed with two different machines from among three vendors assessed. Areas under the receiver operating characteristic curve (AUCs) for the staging of liver steatosis (MRI PDFF: ≥5.5% for grade ≥S1 and ≥15.5% for grade ≥S2) were calculated in test and validation samples and then compared between vendors in the study sample. Results A total of 534 participants (mean age, 60 years ± 13 [SD]; 320 men) were evaluated. Failure of measurements occurred in less than 1% of participants for all vendors. Correlation coefficients with the MRI PDFF were 0.71, 0.73, and 0.54 for the attenuation coefficients of vendors 1, 2, and 3, respectively. In the test sample, AUCs for diagnosis of steatosis grade S1 and higher and grade S2 and higher were 0.89 and 0.93 for vendor 1 attenuation, 0.88 and 0.92 for vendor 2 attenuation, and 0.79 and 0.79 for vendor 3 attenuation, respectively. In the validation sample, a threshold value of 0.65 for vendor 1 and 0.66 for vendor 2 yielded sensitivity of 77% and 84% and specificity of 78% and 85%, respectively, for diagnosis of grade S1 and higher. Vendor 2 attenuation had greater AUCs than vendor 3 attenuation (P = .001 and P = .003) for diagnosis of grade S1 and higher and grade S2 and higher, respectively, and vender 2 had greater AUCs for attenuation than vendor 1 for diagnosis of grade S2 and higher (P = .04). For all vendors, attenuation was not associated with liver stiffness (correlation coefficients <0.05). Conclusion To stage liver steatosis, attenuation coefficient accuracy varied among US devices across vendors when using MRI proton density fat fraction quantification as the reference standard, with some demonstrating excellent diagnostic performance and similar cutoff values. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Dubinsky in this issue.
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Affiliation(s)
- Christophe Cassinotto
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
| | - Tony Jacq
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
| | - Sophie Anselme
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
| | - José Ursic-Bedoya
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
| | - Pierre Blanc
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
| | - Stéphanie Faure
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
| | - Ali Belgour
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
| | - Boris Guiu
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
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Long J, Trahey G, Bottenus N. Spatial Coherence in Medical Ultrasound: A Review. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:975-996. [PMID: 35282988 PMCID: PMC9067166 DOI: 10.1016/j.ultrasmedbio.2022.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/10/2022] [Accepted: 01/16/2022] [Indexed: 05/28/2023]
Abstract
Traditional pulse-echo ultrasound imaging heavily relies on the discernment of signals based on their relative magnitudes but is limited in its ability to mitigate sources of image degradation, the most prevalent of which is acoustic clutter. Advances in computing power and data storage have made it possible for echo data to be alternatively analyzed through the lens of spatial coherence, a measure of the similarity of these signals received across an array. Spatial coherence is not currently explicitly calculated on diagnostic ultrasound scanners but a large number of studies indicate that it can be employed to describe image quality, to adaptively select system parameters and to improve imaging and target detection. With the additional insights provided by spatial coherence, it is poised to play a significant role in the future of medical ultrasound. This review details the theory of spatial coherence in pulse-echo ultrasound and key advances made over the last few decades since its introduction in the 1980s.
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Affiliation(s)
- James Long
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA.
| | - Gregg Trahey
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | - Nick Bottenus
- Department of Mechanical Engineering, University of Colorado Boulder, Boulder, Colorado, USA
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33
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Ali R, Dahl J. Angular spectrum method for curvilinear arrays: Theory and application to Fourier beamforming. JASA EXPRESS LETTERS 2022; 2:052001. [PMID: 35601935 PMCID: PMC9119002 DOI: 10.1121/10.0010536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/28/2022] [Indexed: 06/15/2023]
Abstract
Fourier beamforming techniques for medical ultrasound imaging have largely been limited to linear transducer arrays. This work extends the angular spectrum method to curvilinear arrays and demonstrates a migration-based Fourier beamforming technique that has implications for sound speed estimation and distributed aberration correction for abdominal imaging applications. When compared to Field II simulations, the proposed angular spectrum method simulates the pressure field from a focused transmission to within 3.7% normalized root mean square error. The resulting Fourier beamforming technique is then compared to virtual source synthetic aperture using in vivo abdominal imaging examples where resolution and imaging quality improvements are observed.
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Affiliation(s)
- Rehman Ali
- Department of Electrical Engineering, Stanford University, Stanford, California 94305, USA
| | - Jeremy Dahl
- Department of Radiology, Stanford University School of Medicine, Palo Alto, California 94304, USA ,
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34
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Ormachea J, Parker KJ. A Preliminary Study of Liver Fat Quantification Using Reported Ultrasound Speed of Sound and Attenuation Parameters. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:675-684. [PMID: 35039191 DOI: 10.1016/j.ultrasmedbio.2021.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
The quantification of liver fat as a diagnostic assessment of steatosis remains an important priority for non-invasive imaging systems. We derive a framework in which the unknown fat volume percentage can be estimated from a pair of ultrasound measurements. The precise estimation of ultrasound speed of sound and attenuation within the liver is found to be sufficient for estimating fat volume assuming a classic model of the properties of a composite elastic material. In this model, steatosis is represented as a random dispersion of spherical fat vacuoles with acoustic properties similar to those of edible oils. Using values of speed of sound and attenuation from the literature in which normal and steatotic livers were studied near 3.5 MHz, we describe agreement of the new estimation method with independent measures of fat. This framework holds the potential for translation to clinical scanners with which the two ultrasound measurements can be made and used for improved quantitative assessment of steatosis.
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Affiliation(s)
- Juvenal Ormachea
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, New York, USA
| | - Kevin J Parker
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, New York, USA.
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35
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Ali R, Telichko AV, Wang H, Sukumar UK, Vilches-Moure JG, Paulmurugan R, Dahl JJ. Local Sound Speed Estimation for Pulse-Echo Ultrasound in Layered Media. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:500-511. [PMID: 34723801 PMCID: PMC9127706 DOI: 10.1109/tuffc.2021.3124479] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Our previous methodology in local sound speed estimation utilized time delays measured by the cross correlation of delayed full-synthetic aperture channel data to estimate the average speed of sound. However, focal distortions in this methodology lead to biased estimates of the average speed of sound, which, in turn, leads to biased estimates of the local speed of sound. Here, we demonstrate the bias in the previous methodology and introduce a coherence-based average sound speed estimator that eliminates this bias and is computationally much cheaper in practice. Because this coherence-based approach estimates the average sound speed in the medium over an equally spaced grid in depth rather than time, we derive a refined model that relates the local and average speeds of sound as a function of depth in layered media. A fast, closed-form inversion of this model yields highly accurate local sound speed estimates. The root-mean-square (rms) error of local sound speed reconstruction in simulations of two-layer media is 4.6 and 2.5 m/s at 4 and 8 MHz, respectively. This work examines the impact of frequency, f -number, aberration, and reverberation on sound speed estimation. Phantom and in vivo experiments in rats further validate the coherence-based sound speed estimator.
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36
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Hyun D, Wiacek A, Goudarzi S, Rothlubbers S, Asif A, Eickel K, Eldar YC, Huang J, Mischi M, Rivaz H, Sinden D, van Sloun RJG, Strohm H, Bell MAL. Deep Learning for Ultrasound Image Formation: CUBDL Evaluation Framework and Open Datasets. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:3466-3483. [PMID: 34224351 PMCID: PMC8818124 DOI: 10.1109/tuffc.2021.3094849] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Deep learning for ultrasound image formation is rapidly garnering research support and attention, quickly rising as the latest frontier in ultrasound image formation, with much promise to balance both image quality and display speed. Despite this promise, one challenge with identifying optimal solutions is the absence of unified evaluation methods and datasets that are not specific to a single research group. This article introduces the largest known international database of ultrasound channel data and describes the associated evaluation methods that were initially developed for the challenge on ultrasound beamforming with deep learning (CUBDL), which was offered as a component of the 2020 IEEE International Ultrasonics Symposium. We summarize the challenge results and present qualitative and quantitative assessments using both the initially closed CUBDL evaluation test dataset (which was crowd-sourced from multiple groups around the world) and additional in vivo breast ultrasound data contributed after the challenge was completed. As an example quantitative assessment, single plane wave images from the CUBDL Task 1 dataset produced a mean generalized contrast-to-noise ratio (gCNR) of 0.67 and a mean lateral resolution of 0.42 mm when formed with delay-and-sum beamforming, compared with a mean gCNR as high as 0.81 and a mean lateral resolution as low as 0.32 mm when formed with networks submitted by the challenge winners. We also describe contributed CUBDL data that may be used for training of future networks. The compiled database includes a total of 576 image acquisition sequences. We additionally introduce a neural-network-based global sound speed estimator implementation that was necessary to fairly evaluate the results obtained with this international database. The integration of CUBDL evaluation methods, evaluation code, network weights from the challenge winners, and all datasets described herein are publicly available (visit https://cubdl.jhu.edu for details).
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Ferraioli G, Berzigotti A, Barr RG, Choi BI, Cui XW, Dong Y, Gilja OH, Lee JY, Lee DH, Moriyasu F, Piscaglia F, Sugimoto K, Wong GLH, Wong VWS, Dietrich CF. Quantification of Liver Fat Content with Ultrasound: A WFUMB Position Paper. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2803-2820. [PMID: 34284932 DOI: 10.1016/j.ultrasmedbio.2021.06.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 05/19/2021] [Accepted: 06/07/2021] [Indexed: 06/13/2023]
Abstract
New ultrasound methods that can be used to quantitatively assess liver fat content have recently been developed. These quantitative ultrasound (QUS) methods are based on the analysis of radiofrequency echoes detected by the transducer, allowing calculation of parameters for quantifying the fat in the liver. In this position paper, after a section dedicated to the importance of quantifying liver steatosis in patients with non-alcoholic fatty liver disease and another section dedicated to the assessment of liver fat with magnetic resonance, the current clinical studies performed using QUS are summarized. These new methods include spectral-based techniques and techniques based on envelope statistics. The spectral-based techniques that have been used in clinical studies are those estimating the attenuation coefficient and those estimating the backscatter coefficient. Clinical studies that have used tools based on the envelope statistics of the backscattered ultrasound are those performed by using the acoustic structure quantification or other parameters derived from it, such as the normalized local variance, and that performed by estimating the speed of sound. Experts' opinions are reported.
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Affiliation(s)
- Giovanna Ferraioli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Medical School University of Pavia, Pavia, Italy
| | - Annalisa Berzigotti
- Hepatology Dept., University Clinic for Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, University of Bern, Switzerland
| | - Richard G Barr
- Department of Radiology, Northeastern Ohio Medical University, Rootstown, Ohio, USA
| | - Byung I Choi
- Department of Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Xin Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Odd Helge Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, and Department of Clinical Medicine, University of Bergen, Norway
| | - Jae Young Lee
- Departments of Health and Science and Technology and Medical Device Management and Research, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
| | - Dong Ho Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Fuminori Moriyasu
- Department of Gastroenterology and Hepatology, International University of Health and Welfare, Sanno Hospital, Tokyo, Japan
| | - Fabio Piscaglia
- Unit of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, Department of Medical and Surgical Sciences, University of Bologna S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Katsutoshi Sugimoto
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
| | - Grace Lai-Hung Wong
- Medical Data Analytic Centre and Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - Vincent Wai-Sun Wong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Christoph F Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permancence, Bern, Switzerland.
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Bendjador H, Décombas-Deschamps S, Dioguardi Burgio M, Sartoris R, Van Beers B, Vilgrain V, Deffieux T, Tanter M. The SVD beamformer with diverging waves: a proof-of-concept for fast aberration correction. Phys Med Biol 2021; 66. [PMID: 34433145 DOI: 10.1088/1361-6560/ac2129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/25/2021] [Indexed: 11/11/2022]
Abstract
The rise of ultrafast ultrasound imaging-with plane or diverging waves - paved the way to new applications of ultrasound in biomedical applications. However, propagation through complex layers (typically fat, muscle, and bone) hinder considerably the image quality, especially because of sound speed heterogeneities. In difficult-to-image patients, in the case of the hepatic steatosis for instance, a good image and a reliable sound speed quantification are crucial to provide a powerful non-invasive diagnosis tool. In this work, we proposed to adapt the singular value decomposition (SVD) beamformer method for diverging waves and thus present a novel aberration correction approach for widely used curved arrays. We probed its efficiency experimentally bothin vitroandin vivo. Besides the proposed matrix formalism, we explored the physical meaning of the SVD of ultrafast data. Finally, we demonstrated the ability of the technique to improve the image quality and offer new perspectives particularly in quantitative liver imaging.
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Affiliation(s)
- Hanna Bendjador
- Physics for Medicine Paris, INSERM, CNRS, ESPCI Paris, Paris Sciences et Lettres University, 17 rue Moreau, 75012 Paris, France
| | - Sofiane Décombas-Deschamps
- Physics for Medicine Paris, INSERM, CNRS, ESPCI Paris, Paris Sciences et Lettres University, 17 rue Moreau, 75012 Paris, France
| | - Marco Dioguardi Burgio
- Assistance Publique hôpitaux de Paris, APHP Nord, Department of Radiology, Hôpital Beaujon, Clichy, France
| | - Riccardo Sartoris
- Assistance Publique hôpitaux de Paris, APHP Nord, Department of Radiology, Hôpital Beaujon, Clichy, France
| | - Bernard Van Beers
- Assistance Publique hôpitaux de Paris, APHP Nord, Department of Radiology, Hôpital Beaujon, Clichy, France.,Université de Paris, Centre de recherche sur l'inflammation (CRI), INSERM U1149, F-75018 Paris, France
| | - Valérie Vilgrain
- Assistance Publique hôpitaux de Paris, APHP Nord, Department of Radiology, Hôpital Beaujon, Clichy, France
| | - Thomas Deffieux
- Physics for Medicine Paris, INSERM, CNRS, ESPCI Paris, Paris Sciences et Lettres University, 17 rue Moreau, 75012 Paris, France
| | - Mickaël Tanter
- Physics for Medicine Paris, INSERM, CNRS, ESPCI Paris, Paris Sciences et Lettres University, 17 rue Moreau, 75012 Paris, France
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Marie S, Tripp DKK, Cherrington NJ. Exogenous Drug Disposition as a Diagnostic Biomarker Strategy for Non-Alcoholic Steatohepatitis. Drug Metab Dispos 2021; 50:492-499. [PMID: 34531312 DOI: 10.1124/dmd.121.000413] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 09/13/2021] [Indexed: 11/22/2022] Open
Abstract
Non-alcoholic steatohepatitis (NASH) is the progressive form of non-alcoholic fatty liver disease (NAFLD) and is diagnosed by a liver biopsy. Due to the invasiveness of a biopsy, the majority of patients with NASH are undiagnosed. Additionally, the prevalence of NAFLD and NASH creates the need for a simple screening method to differentiate patients with NAFLD versus NASH. Non-invasive strategies for diagnosing NAFLD versus NASH have been developed, typically relying on imaging techniques and endogenous biomarker panels. However, each technique has limitations, and none can accurately predict the associated functional impairment of drug metabolism and disposition. The function of several drug metabolizing enzymes and drug transporters have been described in NASH that impacts drug pharmacokinetics. The aim of this review is to give an overview of the existing non-invasive strategies to diagnose NASH, and to propose a novel strategy based on altered pharmacokinetics using an exogenous biomarker whose disposition and elimination pathways are directly impacted by disease progression. Altered disposition of safe and relatively inert exogenous compounds may provide the sensitivity and specificity needed to differentiate patients with NAFLD and NASH to facilitate a direct indication of hepatic impairment on drug metabolism and prevent subsequent adverse drug reactions. Significance Statement This review provides an overview of the main non-invasive techniques (imaging and panels of biomarkers) used to diagnose non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) along with a biopsy. Pharmacokinetic changes have been identified in NASH and this review proposes a new approach to predict NASH and the related risk of adverse drug reactions, based on the assessment of drug elimination disruption using exogenous biomarkers.
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Affiliation(s)
- Solène Marie
- Pharmacology and Toxicology, University of Arizona, United States
| | - David K K Tripp
- Pharmacology and Toxicology, University of Arizona, United States
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40
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Cloutier G, Destrempes F, Yu F, Tang A. Quantitative ultrasound imaging of soft biological tissues: a primer for radiologists and medical physicists. Insights Imaging 2021; 12:127. [PMID: 34499249 PMCID: PMC8429541 DOI: 10.1186/s13244-021-01071-w] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/07/2021] [Indexed: 12/26/2022] Open
Abstract
Quantitative ultrasound (QUS) aims at quantifying interactions between ultrasound and biological tissues. QUS techniques extract fundamental physical properties of tissues based on interactions between ultrasound waves and tissue microstructure. These techniques provide quantitative information on sub-resolution properties that are not visible on grayscale (B-mode) imaging. Quantitative data may be represented either as a global measurement or as parametric maps overlaid on B-mode images. Recently, major ultrasound manufacturers have released speed of sound, attenuation, and backscatter packages for tissue characterization and imaging. Established and emerging clinical applications are currently limited and include liver fibrosis staging, liver steatosis grading, and breast cancer characterization. On the other hand, most biological tissues have been studied using experimental QUS methods, and quantitative datasets are available in the literature. This educational review addresses the general topic of biological soft tissue characterization using QUS, with a focus on disseminating technical concepts for clinicians and specialized QUS materials for medical physicists. Advanced but simplified technical descriptions are also provided in separate subsections identified as such. To understand QUS methods, this article reviews types of ultrasound waves, basic concepts of ultrasound wave propagation, ultrasound image formation, point spread function, constructive and destructive wave interferences, radiofrequency data processing, and a summary of different imaging modes. For each major QUS technique, topics include: concept, illustrations, clinical examples, pitfalls, and future directions.
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Affiliation(s)
- Guy Cloutier
- Laboratory of Biorheology and Medical Ultrasonics, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), 900 St-Denis, Montréal, Québec, H2X 0A9, Canada.
- Department of Radiology, Radio-oncology, and Nuclear Medicine, Université de Montréal, Montréal, Québec, Canada.
- Institute of Biomedical Engineering, Université de Montréal, Montréal, Québec, Canada.
| | - François Destrempes
- Laboratory of Biorheology and Medical Ultrasonics, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), 900 St-Denis, Montréal, Québec, H2X 0A9, Canada
| | - François Yu
- Department of Radiology, Radio-oncology, and Nuclear Medicine, Université de Montréal, Montréal, Québec, Canada
- Institute of Biomedical Engineering, Université de Montréal, Montréal, Québec, Canada
- Microbubble Theranostics Laboratory, CRCHUM, Montréal, Québec, Canada
| | - An Tang
- Department of Radiology, Radio-oncology, and Nuclear Medicine, Université de Montréal, Montréal, Québec, Canada
- Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
- Laboratory of Medical Image Analysis, Montréal, CRCHUM, Canada
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41
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Parker KJ, Ormachea J. The quantification of liver fat from wave speed and attenuation. Phys Med Biol 2021; 66. [PMID: 34192672 DOI: 10.1088/1361-6560/ac1023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/30/2021] [Indexed: 12/19/2022]
Abstract
A framework is developed for estimating the volume fraction of fat in steatotic livers from viscoelastic measures of shear wave speed and attenuation. These measures are emerging on clinical ultrasound systems' elastography options so this approach can become widely available for assessing and monitoring steatosis. The framework assumes a distribution of fat vesicles as spherical inhomogeneities within the liver and uses a composite rheological model (Christensen 1969J. Mech. Phys. Solids1723-41) to determine the shear modulus as a function of increasing volume of fat within the liver. We show that accurate measurements of shear wave speed and attenuation provide the necessary and sufficient information to solve for the unknown fat volume and the underlying liver stiffness. Extension of the framework to compression wave measurements is also possible. Data from viscoelastic phantoms, human liver studies, and steatotic animal livers are shown to provide reasonable estimates of the volume fraction of fat.
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Affiliation(s)
- K J Parker
- Department of Electrical and Computer Engineering, University of Rochester, 724 Computer Studies Building, Box 270231, Rochester, NY 14627, United States of America
| | - J Ormachea
- Department of Electrical and Computer Engineering, University of Rochester, 724 Computer Studies Building, Box 270231, Rochester, NY 14627, United States of America
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Benjamin A, Ely G, Anthony BW. 2D speed of sound mapping using a multilook reflection ultrasound tomography framework. ULTRASONICS 2021; 114:106393. [PMID: 33588114 DOI: 10.1016/j.ultras.2021.106393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/16/2021] [Accepted: 02/02/2021] [Indexed: 06/12/2023]
Abstract
Quantitative ultrasound (QUS) has emerged as a viable tool in diagnosing and staging the onset and progression of various diseases. Within the field of QUS, shear wave elastography (SWE) has emerged as the clinical standard for quantifying and correlating the stiffness of tissue to its underlying pathology. Despite its widespread use, SWE suffers from drawbacks that limit its widespread clinical use; among these are low-frame rates, long settling times, and high sensitivity to operating conditions. Longitudinal speed of sound (SOS) has emerged as a viable alternative to SWE. We propose a framework to obtain 2D sound speed maps using a commercial ultrasound probe. A commercial ultrasound probe is localized in space and used to scan a domain of interest from multiple vantage points; the use of a reflector at the far end of the domain allows us to measure the round trip travel times to and from it. The known locations of the probe and the measured travel times are used to estimate the depth and inclination of the reflector as well as the unknown sound speed map. The use of multiple looks increases the effective aperture of the ultrasound probe and allows for a higher fidelity reconstruction of sound speed maps. We validate the framework using simulated and experimental data and propose a rigorous framework to quantify the uncertainty of the estimated sound speed maps.
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Affiliation(s)
- Alex Benjamin
- Device Realization and Computational Instrumentation Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
| | - Gregory Ely
- Device Realization and Computational Instrumentation Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Brian W Anthony
- Device Realization and Computational Instrumentation Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
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43
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Popa A, Șirli R, Popescu A, Bâldea V, Lupușoru R, Bende F, Cotrău R, Sporea I. Ultrasound-Based Quantification of Fibrosis and Steatosis with a New Software Considering Transient Elastography as Reference in Patients with Chronic Liver Diseases. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:1692-1703. [PMID: 33832824 DOI: 10.1016/j.ultrasmedbio.2021.02.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/30/2021] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
The goal of this study was to evaluate the performance of two new ultrasound-based techniques (ShearWave PLUS elastography [2-D-SWE PLUS], SSp PLUS Imaging [SSp PLUS]) implemented on the Aixplorer Mach 30 ultrasound system (Supersonic Imagine, Aix-en-Provence, France) for the non-invasive assessment of liver steatosis and fibrosis, using transient elastography (TE) with the controlled attenuation parameter (CAP) as reference. This monocentric cross-sectional study included 133 consecutive adult patients with chronic hepatopathies. Liver stiffness and steatosis were evaluated in the same session using the techniques mentioned above. An excellent correlation was observed between liver stiffness measurements obtained with 2-D-SWE PLUS and TE (r = 0.92, p < 0.0001). The best cutoff value of 2-D-SWE PLUS for predicting F≥2 was 6.8 kPa; for F≥3, 8.4 kPa; and for F4, 11 kPa. With respect to steatosis evaluation, a strong negative correlation between CAP and SSp PLUS values (r = -0.70, p < 0.0001) was obtained. The best SSp PLUS cutoff value for predicting steatosis was 1537 m/s.
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Affiliation(s)
- Alexandru Popa
- Department of Gastroenterology and Hepatology, ''Victor Babeș'' University of Medicine and Pharmacy, Timișoara, România
| | - Roxana Șirli
- Department of Gastroenterology and Hepatology, ''Victor Babeș'' University of Medicine and Pharmacy, Timișoara, România
| | - Alina Popescu
- Department of Gastroenterology and Hepatology, ''Victor Babeș'' University of Medicine and Pharmacy, Timișoara, România
| | - Victor Bâldea
- Department of Gastroenterology and Hepatology, ''Victor Babeș'' University of Medicine and Pharmacy, Timișoara, România.
| | - Raluca Lupușoru
- Department of Gastroenterology and Hepatology, ''Victor Babeș'' University of Medicine and Pharmacy, Timișoara, România; Department of Functional Science, "Victor Babeș" University of Medicine and Pharmacy Timișoara, Romania
| | - Felix Bende
- Department of Gastroenterology and Hepatology, ''Victor Babeș'' University of Medicine and Pharmacy, Timișoara, România
| | - Radu Cotrău
- Department of Gastroenterology and Hepatology, ''Victor Babeș'' University of Medicine and Pharmacy, Timișoara, România
| | - Ioan Sporea
- Department of Gastroenterology and Hepatology, ''Victor Babeș'' University of Medicine and Pharmacy, Timișoara, România
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44
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Liu F. Ultrasound-based techniques for noninvasive diagnosis of liver steatosis in nonalcoholic fatty liver disease. Shijie Huaren Xiaohua Zazhi 2021; 29:543-549. [DOI: 10.11569/wcjd.v29.i10.543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) has become a worldwide medical and social problem. Although nonalcoholic steatosis can be reversed, some patients still progress to nonalcoholic steatohepatitis, liver cirrhosis, and even liver cancer. Therefore, early diagnosis and accurate disease assessment of NAFLD have become an important basis for its intervention treatment and prognosis improvement. Although liver biopsy is the gold standard for the diagnosis of NAFLD, it is not an ideal reference standard, and MRI-PDFF is more often used in clinical research. The non-invasive examination based on ultrasound detection has also become a hot spot of NAFLD research. This paper discusses the ultrasonic diagnosis technology for liver steatosis in NAFLD, with an aim to provide a safe and practical basis for the diagnosis, disease evaluation, and treatment intervention of NAFLD.
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Affiliation(s)
- Fang Liu
- Tianjin Third Central Hospital, Tianjin Institute of Hepatobiliary Disease, Artificial Cell Engineering Technology Research Center, Tianjin 300170, China
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45
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Popa A, Bende F, Șirli R, Popescu A, Bâldea V, Lupușoru R, Cotrău R, Fofiu R, Foncea C, Sporea I. Quantification of Liver Fibrosis, Steatosis, and Viscosity Using Multiparametric Ultrasound in Patients with Non-Alcoholic Liver Disease: A "Real-Life" Cohort Study. Diagnostics (Basel) 2021; 11:diagnostics11050783. [PMID: 33926073 PMCID: PMC8146051 DOI: 10.3390/diagnostics11050783] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 04/20/2021] [Accepted: 04/25/2021] [Indexed: 12/17/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. This study aimed to evaluate the performance of four ultrasound-based techniques for the non-invasive multiparametric (MPUS) assessment of liver fibrosis (LF), steatosis (HS), and inflammation in patients with NAFLD. We included 215 consecutive adult patients with NAFLD (mean age: 54.9 ± 11.7; 54.5% were male), in whom LF, HS, and viscosity were evaluated in the same session using four new ultrasound-based techniques embedded on the Aixplorer MACH 30 system: ShearWave Elastography (2D-SWE.PLUS), Sound Speed Plane-wave UltraSound (SSp.PLUS), Attenuation Plane-wave UltraSound (Att.PLUS), and Viscosity Plane-wave UltraSound (Vi.PLUS). Transient Elastography (TE) with Controlled Attenuation Parameter (CAP) (FibroScan) were considered as control. All elastographic measurements were performed according to guidelines. Valid liver stiffness measurements (LSM) were obtained in 98.6% of patients by TE, in 95.8% of patients by 2D-SWE.PLUS/Vi.PLUS, and in 98.1% of patients by Att.PLUS/SSp.PLUS, respectively. Therefore, 204 subjects were included in the final analysis. A strong correlation between LSMs by 2D-SWE.PLUS and TE (r = 0.89) was found. The best 2D-SWE.PLUS cut-off value for the presence of significant fibrosis (F ≥ 2) was 7 kPa. Regarding steatosis, SSp.PLUS correlated better than Att.PLUS with CAP values: (r = −0.74) vs. (r = 0.45). The best SSp.PLUS cut-off value for predicting the presence of significant steatosis was 1524 m/s. The multivariate regression analysis showed that Vi.PLUS values were associated with BMI and LSM by 2D-SWE.PLUS. In conclusion, MPUS was useful for assessing fibrosis, steatosis, and inflammation in a single examination in patients with NAFLD.
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46
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Bhatt M, Yazdani L, Destrempes F, Allard L, Nguyen BN, Tang A, Cloutier G. Multiparametric in vivo ultrasound shear wave viscoelastography on farm-raised fatty duck livers: human radiology imaging applied to food sciences. Poult Sci 2021; 100:100968. [PMID: 33607316 PMCID: PMC7900601 DOI: 10.1016/j.psj.2020.12.065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/14/2020] [Accepted: 12/18/2020] [Indexed: 12/19/2022] Open
Abstract
Nine mulard ducks that were being raised for foie gras (steatosis) production went through in vivo shear wave (SW) elastography imaging of their liver during the force-feeding period to investigate changes in liver tissue characteristics. A total of 4 imaging sessions at an interval of 3 to 4 d were conducted at the farm on each animal. Three ducks were sacrificed at the second, third, and fourth imaging sessions for histopathology analysis of all animals at these time points. Six SW elastography parameters were evaluated: SW speed, SW attenuation, SW dispersion, Young's modulus, viscosity, and shear modulus. Shear waves of different frequencies propagate with different phase velocities. Thus, SW speed and other dependent parameters such as Young's modulus, viscosity, and shear modulus were computed at 2 frequencies: 75 and 202 Hz. Each parameter depicted a statistically significant trend along the force-feeding process (P-values between 0.001 and 0.0001). The fat fraction of the liver increased over the 12-day period of feeding. All parameters increased monotonically over time at 75 Hz, whereas modal relations were seen at 202 Hz. Shear wave dispersion measured between 75 and 202 Hz depicted a plateau from day 5. Based on this validation, proposed imaging methods are aimed to be used in the future on naturally fed ducks and geese.
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Affiliation(s)
- Manish Bhatt
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montréal, Québec, Canada H2X 0A9
| | - Ladan Yazdani
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montréal, Québec, Canada H2X 0A9; Institute of Biomedical Engineering, University of Montreal, Montréal, Québec, Canada H3C 3J7
| | - François Destrempes
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montréal, Québec, Canada H2X 0A9
| | - Louise Allard
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montréal, Québec, Canada H2X 0A9
| | - Bich N Nguyen
- Service of Pathology, University of Montreal Hospital (CHUM), Montréal, Québec, Canada H2X 0C1
| | - An Tang
- Institute of Biomedical Engineering, University of Montreal, Montréal, Québec, Canada H3C 3J7; Laboratory of Medical Image Analysis, CRCHUM, Montréal, Québec, Canada H2X 0A9; Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montréal, Québec, Canada H3T 1J4
| | - Guy Cloutier
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montréal, Québec, Canada H2X 0A9; Institute of Biomedical Engineering, University of Montreal, Montréal, Québec, Canada H3C 3J7; Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montréal, Québec, Canada H3T 1J4.
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47
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Weber TD, Khetan N, Yang R, Mertz J. Ultrasound differential phase contrast using backscattering and the memory effect. APPLIED PHYSICS LETTERS 2021; 118:124103. [PMID: 33785963 PMCID: PMC8004294 DOI: 10.1063/5.0048071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 03/09/2021] [Indexed: 05/08/2023]
Abstract
We describe a simple and fast technique to perform ultrasound differential phase contrast (DPC) imaging in arbitrarily thick scattering media. Although configured in a reflection geometry, DPC is based on transmission imaging and is a direct analog of optical differential interference contrast. DPC exploits the memory effect and works in combination with standard pulse-echo imaging, with no additional hardware or data requirements, enabling complementary phase contrast (in the transverse direction) without any need for intensive numerical computation. We experimentally demonstrate the principle of DPC using tissue phantoms with calibrated speed-of-sound inclusions.
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Affiliation(s)
- Timothy D. Weber
- Department of Biomedical Engineering, Boston University, Boston Massachusetts 02215, USA
| | - Nikunj Khetan
- Department of Mechanical Engineering, Boston University, Boston Massachusetts 02215, USA
| | - Ruohui Yang
- Department of Biomedical Engineering, Boston University, Boston Massachusetts 02215, USA
| | - Jerome Mertz
- Department of Biomedical Engineering, Boston University, Boston Massachusetts 02215, USA
- Author to whom correspondence should be addressed:
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48
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Ruby L, Sanabria SJ, Martini K, Frauenfelder T, Jukema GN, Goksel O, Rominger MB. Quantification of immobilization-induced changes in human calf muscle using speed-of-sound ultrasound: An observational pilot study. Medicine (Baltimore) 2021; 100:e23576. [PMID: 33725923 PMCID: PMC7982197 DOI: 10.1097/md.0000000000023576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 11/05/2020] [Indexed: 11/25/2022] Open
Abstract
Short-term immobilization leads to fatty muscular degeneration, which is associated with various negative health effects. Based on literature showing very high correlations between MRI Dixon fat fraction and Speed-of-Sound (SoS), we hypothesized that we can detect short-term-immobilization-induced differences in SoS.Both calves of 10 patients with a calf cast on one side for a mean duration of 41 ± 26 days were examined in relaxed position using a standard ultrasound machine. Calf perimeters were measured for both sides. A flat Plexiglas-reflector, placed vertically on the opposite side of the probe with the calf in-between, was used as a timing reference for SoS. SoS was both manually annotated by two readers and assessed by an automatic annotation algorithm. The thickness values of the subcutaneous fat and muscle layers were manually read from the B-mode images. Differences between the cast and non-cast calves were calculated with a paired t test. Correlation analysis of SoS and calf perimeter was performed using Pearson's correlation coefficient.Paired t test showed significant differences between the cast and non-cast side for both SoS (P < .01) and leg perimeter (P < .001). SoS was reduced with the number of days after cast installment (r = -0.553, P = .097). No significant differences were found for muscle layer thickness, subcutaneous fat layer thickness, mean fat echo intensity, or mean muscle echo intensity.Short-term-immobilization led to a significant reduction in SoS in the cast calf compared to the healthy calf, indicating a potential role of SoS as a biomarker in detecting immobilization-induced fatty muscular degeneration not visible on B-mode ultrasound.
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Affiliation(s)
- Lisa Ruby
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland
| | - Sergio J. Sanabria
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland
- Deusto Institute of Technology, University of Deusto / IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Katharina Martini
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland
| | - Thomas Frauenfelder
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland
| | - Gerrolt Nico Jukema
- Deusto Institute of Technology, University of Deusto / IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
- Department of Trauma, University Hospital Zurich
| | - Orcun Goksel
- Computer-assisted Applications in Medicine (CAiM), ETH Zurich, Zürich, Switzerland
| | - Marga B. Rominger
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland
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49
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Trujillo MJ, Chen J, Rubin JM, Gao J. Non-invasive imaging biomarkers to assess nonalcoholic fatty liver disease: A review. Clin Imaging 2021; 78:22-34. [PMID: 33721575 DOI: 10.1016/j.clinimag.2021.02.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/25/2021] [Accepted: 02/28/2021] [Indexed: 02/07/2023]
Abstract
This review summarizes the current state of non-invasive diagnosis of non-alcoholic fatty liver disease (NAFLD). This begins with a brief discussion of blood-based analysis (serum biomarkers) then progresses through various imaging modalities (imaging biomarkers) including magnetic resonance (MR), computed tomography (CT), and ultrasound-based imaging methods. The review concludes with comment on the advantages, disadvantages, and prospects of commercially available modalities and the impact they may have on diagnosis and management of patients with NAFLD.
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Affiliation(s)
| | - Johnson Chen
- Weill Cornell Medicine, Cornell University, NY, New York, USA
| | | | - Jing Gao
- Rocky Vista University, Ivins, UT, USA; Weill Cornell Medicine, Cornell University, NY, New York, USA.
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50
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Perrot V, Polichetti M, Varray F, Garcia D. So you think you can DAS? A viewpoint on delay-and-sum beamforming. ULTRASONICS 2021; 111:106309. [PMID: 33360053 DOI: 10.1016/j.ultras.2020.106309] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/29/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
Delay-and-sum (DAS) is the most widespread digital beamformer in high-frame-rate ultrasound imaging. Its implementation is simple and compatible with real-time applications. In this viewpoint article, we describe the fundamentals of DAS beamforming. The underlying theory and numerical approach are detailed so that users can be aware of its functioning and limitations. In particular, we discuss the importance of the f-number and speed of sound on image quality, and propose one solution to set their values from a physical viewpoint. We suggest determining the f-number from the directivity of the transducer elements and the speed of sound from the phase dispersion of the delayed signals. Simplified Matlab codes are provided for the sake of clarity and openness. The effect of the f-number and speed of sound on the lateral resolution and contrast-to-noise ratio was investigated in vitro and in vivo. If not properly preset, these two factors had a substantial negative impact on standard metrics of image quality (namely CNR and FWHM). When beamforming with DAS in vitro or in vivo, it is recommended to optimize these parameters in order to use it wisely and prevent image degradation.
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Affiliation(s)
- Vincent Perrot
- CREATIS, CNRS UMR 5220, INSERM U1206, Université Lyon 1, INSA Lyon, France
| | - Maxime Polichetti
- CREATIS, CNRS UMR 5220, INSERM U1206, Université Lyon 1, INSA Lyon, France
| | - François Varray
- CREATIS, CNRS UMR 5220, INSERM U1206, Université Lyon 1, INSA Lyon, France
| | - Damien Garcia
- CREATIS, CNRS UMR 5220, INSERM U1206, Université Lyon 1, INSA Lyon, France.
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