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Ghigo N, Ramos-Palacios G, Bourquin C, Xing P, Wu A, Cortés N, Ladret H, Ikan L, Casanova C, Porée J, Sadikot A, Provost J. Dynamic Ultrasound Localization Microscopy Without ECG-Gating. ULTRASOUND IN MEDICINE & BIOLOGY 2024:S0301-5629(24)00230-8. [PMID: 38969526 DOI: 10.1016/j.ultrasmedbio.2024.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 05/04/2024] [Accepted: 05/22/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVE Dynamic Ultrasound Localization Microscopy (DULM) has first been developed for non-invasive Pulsatility measurements in the rodent brain. DULM relies on the localization and tracking of microbubbles (MBs) injected into the bloodstream, to obtain highly resolved velocity and density cine-loops. Previous DULM techniques required ECG-gating, limiting its application to specific datasets, and increasing acquisition time. The objective of this study is to eliminate the need for ECG-gating in DULM experiments by introducing a motion-matching method for time registration. METHODS We developed a motion-matching algorithm based on tissue Doppler that leverages the cyclic tissue motion within the brain. Tissue Doppler was estimated for each group of frames in the acquisitions, at multiple locations identified as local maxima in the skin above the skull. Subsequently, each group of frames was time-registered to a reference group by delaying it based on the maximum correlation value between their respective tissue Doppler signals. This synchronization ensured that each group of frames aligned with the brain tissue motion of the reference group, and consequently, with its cardiac cycle. As a result, velocities of MBs could be averaged to retrieve flow velocity variations over time. RESULTS Initially validated in ECG-gated acquisitions in a rat model (n = 1), the proposed method was successfully applied in a mice model in 2D (n = 3) and in a feline model in 3D (n = 1). Performing time-registration with the proposed motion-matching method or by using ECG-gating leads to similar results. For the first time, dynamic velocity and density cine-loops were extracted without the need for any information on the animal ECG, and complex dynamic markers such as the Pulsatility index were estimated. CONCLUSION Results suggest that DULM can be performed without external gating, enabling the use of DULM on any ULM dataset where enough MBs are detectable. Time registration by motion-matching represents a significant advancement in DULM techniques, making DULM more accessible by simplifying its experimental complexity.
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Affiliation(s)
- Nin Ghigo
- Department of Engineering Physics, Polytechnique Montréal, Montréal, Quebec, Canada.
| | | | - Chloé Bourquin
- Department of Engineering Physics, Polytechnique Montréal, Montréal, Quebec, Canada
| | - Paul Xing
- Department of Engineering Physics, Polytechnique Montréal, Montréal, Quebec, Canada
| | - Alice Wu
- Department of Engineering Physics, Polytechnique Montréal, Montréal, Quebec, Canada
| | - Nelson Cortés
- School of Optometry, University of Montreal, Montréal, Quebec, Canada
| | - Hugo Ladret
- School of Optometry, University of Montreal, Montréal, Quebec, Canada; Institut de Neurosciences de la Timone, UMR 7289, CNRS and Aix-Marseille Université, Marseille, France
| | - Lamyae Ikan
- School of Optometry, University of Montreal, Montréal, Quebec, Canada
| | | | - Jonathan Porée
- Department of Engineering Physics, Polytechnique Montréal, Montréal, Quebec, Canada
| | - Abbas Sadikot
- Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada
| | - Jean Provost
- Department of Engineering Physics, Polytechnique Montréal, Montréal, Quebec, Canada; Montreal Heart Institute, Montréal, Quebec, Canada
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Yan J, Huang B, Tonko J, Toulemonde M, Hansen-Shearer J, Tan Q, Riemer K, Ntagiantas K, Chowdhury RA, Lambiase PD, Senior R, Tang MX. Transthoracic ultrasound localization microscopy of myocardial vasculature in patients. Nat Biomed Eng 2024; 8:689-700. [PMID: 38710839 DOI: 10.1038/s41551-024-01206-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 03/30/2024] [Indexed: 05/08/2024]
Abstract
Myocardial microvasculature and haemodynamics are indicative of potential microvascular diseases for patients with symptoms of coronary heart disease in the absence of obstructive coronary arteries. However, imaging microvascular structure and flow within the myocardium is challenging owing to the small size of the vessels and the constant movement of the patient's heart. Here we show the feasibility of transthoracic ultrasound localization microscopy for imaging myocardial microvasculature and haemodynamics in explanted pig hearts and in patients in vivo. Through a customized data-acquisition and processing pipeline with a cardiac phased-array probe, we leveraged motion correction and tracking to reconstruct the dynamics of microcirculation. For four patients, two of whom had impaired myocardial function, we obtained super-resolution images of myocardial vascular structure and flow using data acquired within a breath hold. Myocardial ultrasound localization microscopy may facilitate the understanding of myocardial microcirculation and the management of patients with cardiac microvascular diseases.
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Affiliation(s)
- Jipeng Yan
- Ultrasound Lab for Imaging and Sensing, Department of Bioengineering, Imperial College London, London, UK
| | - Biao Huang
- Ultrasound Lab for Imaging and Sensing, Department of Bioengineering, Imperial College London, London, UK
| | - Johanna Tonko
- Institute of Cardiovascular Science, University College London, London, UK
| | - Matthieu Toulemonde
- Ultrasound Lab for Imaging and Sensing, Department of Bioengineering, Imperial College London, London, UK
| | - Joseph Hansen-Shearer
- Ultrasound Lab for Imaging and Sensing, Department of Bioengineering, Imperial College London, London, UK
| | - Qingyuan Tan
- Ultrasound Lab for Imaging and Sensing, Department of Bioengineering, Imperial College London, London, UK
| | - Kai Riemer
- Ultrasound Lab for Imaging and Sensing, Department of Bioengineering, Imperial College London, London, UK
| | | | - Rasheda A Chowdhury
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Pier D Lambiase
- Institute of Cardiovascular Science, University College London, London, UK
| | - Roxy Senior
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, UK
- Royal Brompton Hospital, London, UK
- Northwick Park Hospital, Harrow, UK
| | - Meng-Xing Tang
- Ultrasound Lab for Imaging and Sensing, Department of Bioengineering, Imperial College London, London, UK.
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Konofagou EE. Microbubble ultrasound maps hidden signs of heart disease. Nature 2024; 629:541-542. [PMID: 38741013 DOI: 10.1038/d41586-024-01194-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
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4
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Bourquin C, Porée J, Rauby B, Perrot V, Ghigo N, Belgharbi H, Bélanger S, Ramos-Palacios G, Cortes N, Ladret H, Ikan L, Casanova C, Lesage F, Provost J. Quantitative pulsatility measurements using 3D dynamic ultrasound localization microscopy. Phys Med Biol 2024; 69:045017. [PMID: 38181421 DOI: 10.1088/1361-6560/ad1b68] [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] [Received: 07/17/2023] [Accepted: 01/05/2024] [Indexed: 01/07/2024]
Abstract
A rise in blood flow velocity variations (i.e. pulsatility) in the brain, caused by the stiffening of upstream arteries, is associated with cognitive impairment and neurodegenerative diseases. The study of this phenomenon requires brain-wide pulsatility measurements, with large penetration depth and high spatiotemporal resolution. The development of dynamic ultrasound localization microscopy (DULM), based on ULM, has enabled pulsatility measurements in the rodent brain in 2D. However, 2D imaging accesses only one slice of the brain and measures only 2D-projected and hence biased velocities . Herein, we present 3D DULM: using a single ultrasound scanner at high frame rate (1000-2000 Hz), this method can produce dynamic maps of microbubbles flowing in the bloodstream and extract quantitative pulsatility measurements in the cat brain with craniotomy and in the mouse brain through the skull, showing a wide range of flow hemodynamics in both large and small vessels. We highlighted a decrease in pulsatility along the vascular tree in the cat brain, which could be mapped with ultrasound down to a few tens of micrometers for the first time. We also performed an intra-animal validation of the method by showing consistent measurements between the two sides of the Willis circle in the mouse brain. Our study provides the first step towards a new biomarker that would allow the detection of dynamic abnormalities in microvessels in the brain, which could be linked to early signs of neurodegenerative diseases.
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Affiliation(s)
- Chloé Bourquin
- Department of Engineering Physics, Polytechnique Montréal, Montréal, QC H3T 1J4, Canada
| | - Jonathan Porée
- Department of Engineering Physics, Polytechnique Montréal, Montréal, QC H3T 1J4, Canada
| | - Brice Rauby
- Department of Engineering Physics, Polytechnique Montréal, Montréal, QC H3T 1J4, Canada
| | - Vincent Perrot
- Department of Engineering Physics, Polytechnique Montréal, Montréal, QC H3T 1J4, Canada
| | - Nin Ghigo
- Department of Engineering Physics, Polytechnique Montréal, Montréal, QC H3T 1J4, Canada
| | - Hatim Belgharbi
- Department of Engineering Physics, Polytechnique Montréal, Montréal, QC H3T 1J4, Canada
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC 27599, United States of America
| | | | | | - Nelson Cortes
- School of Optometry, University of Montreal, Montréal, QC H3T 1P1, Canada
| | - Hugo Ladret
- School of Optometry, University of Montreal, Montréal, QC H3T 1P1, Canada
- Institut de Neurosciences de la Timone, UMR 7289, CNRS and Aix-Marseille Université, Marseille, F-13005, France
| | - Lamyae Ikan
- School of Optometry, University of Montreal, Montréal, QC H3T 1P1, Canada
| | - Christian Casanova
- School of Optometry, University of Montreal, Montréal, QC H3T 1P1, Canada
| | - Frédéric Lesage
- Department of Electrical Engineering, Polytechnique Montréal, Montréal, QC H3T 1J4, Canada
- Montreal Heart Institute, Montréal, QC H1T 1C8, Canada
| | - Jean Provost
- Department of Engineering Physics, Polytechnique Montréal, Montréal, QC H3T 1J4, Canada
- Montreal Heart Institute, Montréal, QC H1T 1C8, Canada
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Kim S, Jing B, Lane BA, Tempestti JM, Padala M, Veneziani A, Lindsey BD. Dynamic Coronary Blood Flow Velocity and Wall Shear Stress Estimation Using Ultrasound in an Ex Vivo Porcine Heart. Cardiovasc Eng Technol 2024; 15:65-76. [PMID: 37962814 PMCID: PMC10923141 DOI: 10.1007/s13239-023-00697-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE Wall shear stress (WSS) is a critically important physical factor contributing to atherosclerosis. Mapping the spatial distribution of local, oscillatory WSS can identify important mechanisms underlying the progression of coronary artery disease. METHODS In this study, blood flow velocity and time-varying WSS were estimated in the left anterior descending (LAD) coronary artery of an ex vivo beating porcine heart using ultrasound with an 18 MHz linear array transducer aligned with the LAD in a forward-viewing orientation. A pulsatile heart loop with physiologically-accurate flow was created using a pulsatile pump. The coronary artery wall motion was compensated using a local block matching technique. Next, 2D and 3D velocity magnitude and WSS maps in the LAD coronary artery were estimated at different time points in the cardiac cycle using an ultrafast Doppler approach. The blood flow velocity estimated using the presented approach was compared with a commercially-available, calibrated single element blood flow velocity measurement system. RESULTS The resulting root mean square error (RMSE) of 2D velocity magnitude acquired from a high frequency, linear array transducer was less than 8% of the maximum velocity estimated by the commercial system. CONCLUSION When implemented in a forward-viewing intravascular ultrasound device, the presented approach will enable dynamic estimation of WSS, an indicator of plaque vulnerability in coronary arteries.
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Affiliation(s)
- Saeyoung Kim
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, 801 Ferst Dr., Atlanta, GA, 30332, USA
- Interdisciplinary BioEngineering Graduate Program, Georgia Institute of Technology, 315 Ferst Dr., Atlanta, GA, 30332, USA
| | - Bowen Jing
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Dr NW, Atlanta, GA, 30332, USA
| | - Brooks A Lane
- Division of Cardiothoracic Surgery, Joseph P. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
- Structural Heart Research and Innovation Laboratory, Carlyle Fraser Heart Center, Emory University Hospital Midtown, Atlanta, GA, USA
| | | | - Muralidhar Padala
- Interdisciplinary BioEngineering Graduate Program, Georgia Institute of Technology, 315 Ferst Dr., Atlanta, GA, 30332, USA
- Division of Cardiothoracic Surgery, Joseph P. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
- Structural Heart Research and Innovation Laboratory, Carlyle Fraser Heart Center, Emory University Hospital Midtown, Atlanta, GA, USA
| | - Alessandro Veneziani
- Department of Mathematics, Emory University, 400 Dowman Dr NE, Atlanta, GA, 30322, USA
- Department of Computer Science, Emory University, 400 Dowman Dr NE, Atlanta, GA, 30322, USA
| | - Brooks D Lindsey
- Interdisciplinary BioEngineering Graduate Program, Georgia Institute of Technology, 315 Ferst Dr., Atlanta, GA, 30332, USA.
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Dr NW, Atlanta, GA, 30332, USA.
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Wahyulaksana G, Wei L, Voorneveld J, Hekkert MTL, Strachinaru M, Duncker DJ, De Jong N, van der Steen AFW, Vos HJ. Higher Order Singular Value Decomposition Filter for Contrast Echocardiography. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:1371-1383. [PMID: 37721879 DOI: 10.1109/tuffc.2023.3316130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Assessing the coronary circulation with contrast-enhanced echocardiography has high clinical relevance. However, it is not being routinely performed in clinical practice because the current clinical tools generally cannot provide adequate image quality. The contrast agent's visibility in the myocardium is generally poor, impaired by motion and nonlinear propagation artifacts. The established multipulse contrast schemes (MPCSs) and the more experimental singular value decomposition (SVD) filter also fall short to solve these issues. Here, we propose a scheme to process amplitude modulation/amplitude-modulated pulse inversion (AM/AMPI) echoes with higher order SVD (HOSVD) instead of conventionally summing the complementary pulses. The echoes from the complementary pulses form a separate dimension in the HOSVD algorithm. Then, removing the ranks in that dimension with dominant coherent signals coming from tissue scattering would provide the contrast detection. We performed both in vitro and in vivo experiments to assess the performance of our proposed method in comparison with the current standard methods. A flow phantom study shows that HOSVD on AM pulsing exceeds the contrast-to-background ratio (CBR) of conventional AM and an SVD filter by 10 and 14 dB, respectively. In vivo porcine heart results also demonstrate that, compared to AM, HOSVD improves CBR in open-chest acquisition (up to 19 dB) and contrast ratio (CR) in closed-chest acquisition (3 dB).
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7
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Baranger J, Villemain O, Goudot G, Dizeux A, Le Blay H, Mirault T, Messas E, Pernot M, Tanter M. The fundamental mechanisms of the Korotkoff sounds generation. SCIENCE ADVANCES 2023; 9:eadi4252. [PMID: 37792931 PMCID: PMC10550233 DOI: 10.1126/sciadv.adi4252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/05/2023] [Indexed: 10/06/2023]
Abstract
Blood pressure measurement is the most widely performed clinical exam to predict mortality risk. The gold standard for its noninvasive assessment is the auscultatory method, which relies on listening to the so-called "Korotkoff sounds" in a stethoscope placed at the outlet of a pneumatic arm cuff. However, more than a century after their discovery, the origin of these sounds is still debated, which implies a number of clinical limitations. We imaged the Korotkoff sound generation in vivo at thousands of images per second using ultrafast ultrasound. We showed with both experience and theory that Korotkoff sounds are paradoxically not sound waves emerging from the brachial artery but rather shear vibrations conveyed in surrounding tissues by the nonlinear pulse wave propagation. When these shear vibrations reached the stethoscope, they were synchronous, correlated, and comparable in intensity with the Korotkoff sounds. Understanding this mechanism could ultimately improve blood pressure measurement and provide additional understanding of arterial mechanical properties.
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Affiliation(s)
- Jerome Baranger
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| | - Olivier Villemain
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| | - Guillaume Goudot
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
- Université Paris Cité, Inserm UMR 970, PARCC, Vascular Medicine Department, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Alexandre Dizeux
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| | - Heiva Le Blay
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| | - Tristan Mirault
- Université Paris Cité, Inserm UMR 970, PARCC, Vascular Medicine Department, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Emmanuel Messas
- Université Paris Cité, Inserm UMR 970, PARCC, Vascular Medicine Department, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Mathieu Pernot
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| | - Mickael Tanter
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
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8
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Demeulenaere O, Mateo P, Ferrera R, Chiaroni PM, Bizé A, Dai J, Sambin L, Gallet R, Tanter M, Papadacci C, Ghaleh B, Pernot M. Assessment of coronary microcirculation alterations in a porcine model of no-reflow using ultrasound localization microscopy: a proof of concept study. EBioMedicine 2023; 94:104727. [PMID: 37487415 PMCID: PMC10382870 DOI: 10.1016/j.ebiom.2023.104727] [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] [Received: 04/17/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Coronary microvascular obstruction also known as no-reflow phenomenon is a major issue during myocardial infarction that bears important prognostic implications. Alterations of the microvascular network remains however challenging to assess as there is no imaging modality in the clinics that can image directly the coronary microvascular vessels. Ultrasound Localization Microscopy (ULM) imaging was recently introduced to map microvascular flows at high spatial resolution (∼10 μm). In this study, we developed an approach to image alterations of the microvascular coronary flow in ex vivo perfused swine hearts. METHODS A porcine model of myocardial ischemia-reperfusion was used to obtain microvascular coronary alterations and no-reflow. Four female hearts with myocardial infarction in addition to 6 controls were explanted and placed immediately in a dedicated preservation and perfusion box manufactured for ultrasound imaging. Microbubbles (MB) were injected into the vasculature to perform Ultrasound Localization Microscopy (ULM) imaging and a linear ultrasound probe mounted on a motorized device was used to scan the heart on multiple slices. The coronary microvascular anatomy and flow velocity was reconstructed using dedicated ULM algorithms and analyzed quantitatively. FINDINGS We were able to image the coronary microcirculation of ex vivo swine hearts at a resolution of tens of microns and measure flow velocities ranging from 10 mm/s in arterioles up to more than 200 mm/s in epicardial arteries. Under different aortic perfusion pressures, we measured in large arteries of a subset of control hearts an increase of flow velocity from 31 ± 11 mm/s at 87 mmHg to 47 ± 17 mm/s at 132 mmHg (N = 3 hearts, P < 0.05). This increase was compared with a control measurement with a flowmeter in the aorta. We also compared 6 control hearts to 4 hearts in which no-reflow was induced by the occlusion and reperfusion of a coronary artery. Using average MB velocity and average density of MB per unit of surface as two ULM quantitative markers of perfusion, we were able to detect areas of coronary no-reflow in good agreement with a control anatomical pathology analysis of the cardiac tissue. In the no-reflow zone, we measured an average perfusion of 204 ± 305 MB/mm2 compared to 3182 ± 1302 MB/mm2 in the surrounding re-perfused area. INTERPRETATION We demonstrated this approach can directly image and quantify coronary microvascular obstruction and no-reflow on large mammal perfused hearts. This is a first step for noninvasive, quantitative and affordable assessment of the coronary microcirculation function and particularly coronary microvascular anatomy in the infarcted heart. This approach has the potential to be extended to other clinical situations characterized by microvascular dysfunction. FUNDING This study was supported by the French National Research Agency (ANR) under ANR-21-CE19-0002 grant agreement.
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Affiliation(s)
- Oscar Demeulenaere
- Physics for Medicine, ESPCI, INSERM U1273, CNRS UMR 8063, PSL University, Paris, France
| | - Philippe Mateo
- Physics for Medicine, ESPCI, INSERM U1273, CNRS UMR 8063, PSL University, Paris, France
| | - René Ferrera
- CarMeN, 27102 INSERM U1060, INRA U1397, INSA de Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Villeurbanne, France
| | - Paul-Mathieu Chiaroni
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, F-94700, Créteil, France; APHP, Hôpitaux Universitaires Henri Mondor, Service de Cardiologie, F-94000, Créteil, France
| | - Alain Bizé
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, F-94700, Créteil, France
| | - Jianping Dai
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, F-94700, Créteil, France
| | - Lucien Sambin
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, F-94700, Créteil, France
| | - Romain Gallet
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, F-94700, Créteil, France; APHP, Hôpitaux Universitaires Henri Mondor, Service de Cardiologie, F-94000, Créteil, France
| | - Mickaël Tanter
- Physics for Medicine, ESPCI, INSERM U1273, CNRS UMR 8063, PSL University, Paris, France
| | - Clément Papadacci
- Physics for Medicine, ESPCI, INSERM U1273, CNRS UMR 8063, PSL University, Paris, France.
| | - Bijan Ghaleh
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, F-94700, Créteil, France
| | - Mathieu Pernot
- Physics for Medicine, ESPCI, INSERM U1273, CNRS UMR 8063, PSL University, Paris, France
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Song P, Rubin JM, Lowerison MR. Super-resolution ultrasound microvascular imaging: Is it ready for clinical use? Z Med Phys 2023; 33:309-323. [PMID: 37211457 PMCID: PMC10517403 DOI: 10.1016/j.zemedi.2023.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/31/2023] [Accepted: 04/01/2023] [Indexed: 05/23/2023]
Abstract
The field of super-resolution ultrasound microvascular imaging has been rapidly growing over the past decade. By leveraging contrast microbubbles as point targets for localization and tracking, super-resolution ultrasound pinpoints the location of microvessels and measures their blood flow velocity. Super-resolution ultrasound is the first in vivo imaging modality that can image micron-scale vessels at a clinically relevant imaging depth without tissue destruction. These unique capabilities of super-resolution ultrasound provide structural (vessel morphology) and functional (vessel blood flow) assessments of tissue microvasculature on a global and local scale, which opens new doors for many enticing preclinical and clinical applications that benefit from microvascular biomarkers. The goal of this short review is to provide an update on recent advancements in super-resolution ultrasound imaging, with a focus on summarizing existing applications and discussing the prospects of translating super-resolution imaging to clinical practice and research. In this review, we also provide brief introductions of how super-resolution ultrasound works, how does it compare with other imaging modalities, and what are the tradeoffs and limitations for an audience who is not familiar with the technology.
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Affiliation(s)
- Pengfei Song
- Department of Electrical and Computer Engineering, University of Illinois Urbana-Champaign, United States; Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, United States; Department of Bioengineering, University of Illinois Urbana-Champaign, United States; Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, United States.
| | - Jonathan M Rubin
- Department of Radiology, University of Michigan, Ann Arbor, United States
| | - Matthew R Lowerison
- Department of Electrical and Computer Engineering, University of Illinois Urbana-Champaign, United States; Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, United States
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Riemer K, Toulemonde M, Yan J, Lerendegui M, Stride E, Weinberg PD, Dunsby C, Tang MX. Fast and Selective Super-Resolution Ultrasound In Vivo With Acoustically Activated Nanodroplets. IEEE TRANSACTIONS ON MEDICAL IMAGING 2023; 42:1056-1067. [PMID: 36399587 DOI: 10.1109/tmi.2022.3223554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Perfusion by the microcirculation is key to the development, maintenance and pathology of tissue. Its measurement with high spatiotemporal resolution is consequently valuable but remains a challenge in deep tissue. Ultrasound Localization Microscopy (ULM) provides very high spatiotemporal resolution but the use of microbubbles requires low contrast agent concentrations, a long acquisition time, and gives little control over the spatial and temporal distribution of the microbubbles. The present study is the first to demonstrate Acoustic Wave Sparsely-Activated Localization Microscopy (AWSALM) and fast-AWSALM for in vivo super-resolution ultrasound imaging, offering contrast on demand and vascular selectivity. Three different formulations of acoustically activatable contrast agents were used. We demonstrate their use with ultrasound mechanical indices well within recommended safety limits to enable fast on-demand sparse activation and destruction at very high agent concentrations. We produce super-localization maps of the rabbit renal vasculature with acquisition times between 5.5 s and 0.25 s, and a 4-fold improvement in spatial resolution. We present the unique selectivity of AWSALM in visualizing specific vascular branches and downstream microvasculature, and we show super-localized kidney structures in systole (0.25 s) and diastole (0.25 s) with fast-AWSALM outperforming microbubble based ULM. In conclusion, we demonstrate the feasibility of fast and selective imaging of microvascular dynamics in vivo with subwavelength resolution using ultrasound and acoustically activatable nanodroplet contrast agents.
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11
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Functional ultrasound localization microscopy reveals brain-wide neurovascular activity on a microscopic scale. Nat Methods 2022; 19:1004-1012. [PMID: 35927475 PMCID: PMC9352591 DOI: 10.1038/s41592-022-01549-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 06/14/2022] [Indexed: 12/02/2022]
Abstract
The advent of neuroimaging has increased our understanding of brain function. While most brain-wide functional imaging modalities exploit neurovascular coupling to map brain activity at millimeter resolutions, the recording of functional responses at microscopic scale in mammals remains the privilege of invasive electrophysiological or optical approaches, but is mostly restricted to either the cortical surface or the vicinity of implanted sensors. Ultrasound localization microscopy (ULM) has achieved transcranial imaging of cerebrovascular flow, up to micrometre scales, by localizing intravenously injected microbubbles; however, the long acquisition time required to detect microbubbles within microscopic vessels has so far restricted ULM application mainly to microvasculature structural imaging. Here we show how ULM can be modified to quantify functional hyperemia dynamically during brain activation reaching a 6.5-µm spatial and 1-s temporal resolution in deep regions of the rat brain. Functional ultrasound localization microscopy monitors cerebrovascular blood flow by detecting the flow of injected microbubbles, providing access to brain activity at high spatiotemporal resolution.
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Zhang N, Nguyen MB, Mertens L, Barron DJ, Villemain O, Baranger J. Improving coronary ultrafast Doppler angiography using fractional moving blood volume and motion-adaptive ensemble length. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac7430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/27/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Coronary microperfusion assessment is a key parameter for understanding cardiac function. Currently, coronary ultrafast Doppler angiography is the only non-invasive clinical imaging technique able to assess coronary microcirculation quantitatively in humans. In this study, we propose to use fractional moving blood volume (FMBV), proportional to the red blood cell concentration, as a metric for perfusion. FMBV compares the power Doppler in a region of interest (ROI) inside the myocardium to the power Doppler of a reference area in the heart chamber, fully filled with blood. This normalization gives then relative values of the ROI blood filling. However, due to the impact of ultrasound attenuation and elevation focus on power Doppler values, the reference area and the ROI need to be at the same depth to allow this normalization. This condition is rarely satisfied in vivo due to the cardiac anatomy. Hereby, we propose to locally compensate the attenuation between the ROI and the reference, by measuring the attenuation law on a phantom. We quantified the efficiency of this approach by comparing FMBV with and without compensation on a flow phantom. Compensated FMBV was able to estimate the ground-truth FMBV with less than 5% variation. This method was then adapted to the in vivo case of myocardial perfusion imaging during heart surgery on human neonates. The translation from in vitro to in vivo required an additional clutter filtering step to ensure that blood signals could be correctly identified in the fast-moving myocardium. We applied the singular value decomposition filter on temporal sliding windows whose lengths were a function of myocardium motion. This motion-adaptive temporal sliding window approach was able to improve blood and tissue separation in terms of contrast-to-noise ratio, as compared to well-established constant-length sliding window approaches. Therefore, compensated FMBV and singular value decomposition assisted with motion-adaptive temporal sliding windows improves the quantification of blood volume in coronary ultrafast Doppler angiography.
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Coronary Flow Assessment Using 3-Dimensional Ultrafast Ultrasound Localization Microscopy. JACC: CARDIOVASCULAR IMAGING 2022; 15:1193-1208. [DOI: 10.1016/j.jcmg.2022.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 01/24/2022] [Accepted: 02/17/2022] [Indexed: 11/23/2022]
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Bourquin C, Poree J, Lesage F, Provost J. In Vivo Pulsatility Measurement of Cerebral Microcirculation in Rodents Using Dynamic Ultrasound Localization Microscopy. IEEE TRANSACTIONS ON MEDICAL IMAGING 2022; 41:782-792. [PMID: 34710041 DOI: 10.1109/tmi.2021.3123912] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
An increased pulse pressure, due to arteries stiffening with age and cardiovascular disease, may lead to downstream brain damage in microvessels and cognitive decline. Brain-wide imaging of the pulsatility propagation from main feeding arteries to capillaries in small animals could improve our understanding of the link between pulsatility and cognitive decline. However, it requires higher spatiotemporal resolution and penetration depth than currently available with existing brain imaging techniques. Herein, we show the feasibility of performing Dynamic Ultrasound Localization Microscopy (DULM), a novel imaging approach to capture hemodynamics with a subwavelength resolution. By producing cine-loops of flowing microbubbles in 2D in the whole rodent brain lasting several cardiac cycles, DULM performed pulsatility measurements in microvessels in-depth, in vivo, with and without craniotomy. Cortical veins and arteries were shown to have a significatively different pulsatility index and the method was compared against Contrast Enhanced Ultrafast Ultrasound Doppler (CEUFD) pulsatility measurements.
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