Motion compensation for intravascular ultrasound palpography

Dynamic Coronary Blood Flow Velocity and Wall Shear Stress Estimation Using Ultrasound in an Ex Vivo Porcine Heart

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.

Key Technologies of New Type of Intravascular Ultrasound Image Processing

Since entering the 21st century, the application of ultrasound technology has developed rapidly. Intravascular ultrasound technology has been widely used in the diagnosis and treatment of cardiovascular diseases. With the help of computer image processing technology, it can provide clinicians with more accurate diagnosis. Based on the information to improve the success rate of clinical treatment. Based on this, this article combines the development history of intravascular ultrasound technology, explores the principles of new intravascular ultrasound technology, and analyzes the application of new intravascular ultrasound technology. On this basis, the preprocessing of intravascular ultrasound image data is discussed, involving the acquisition of intravascular ultrasound image data and image analysis. On this basis, explore the combined application of new intravascular ultrasound technology and other imaging examination methods, such as X-rays to use three-dimensional image technology to reconstruct new intravascular ultrasound image sequences, and provide doctors with clearer morphology and properties of tube wall lesions. In order to make a more accurate diagnosis of the lesion, a more detailed and accurate treatment plan can be given, which has extremely high clinical application value.

High contrast power Doppler imaging in side-viewing intravascular ultrasound imaging via angular compounding

The ability to assess likelihood of plaque rupture can determine the course of treatment in coronary artery disease. One indicator of plaque vulnerability is the development of blood vessels within the plaque, or intraplaque neovascularization. In order to visualize these vessels with increased sensitivity in the cardiac catheterization lab, a new approach for imaging blood flow in small vessels using side-viewing intravascular ultrasound (IVUS) is proposed. This approach based on compounding adjacent angular acquisitions was evaluated in tissue mimicking phantoms and ex vivo vessels. In phantom studies, the Doppler CNR increased from 3.3 ± 1.0 to 13 ± 2.6 (conventional clutter filtering) and from 1.9 ± 0.15 to 7.5 ± 1.1 (SVD filtering) as a result of applying angular compounding. When imaging flow at a rate of 5.6 mm/s in 200 µm tubes adjacent to the lumen of ex vivo porcine arteries, the Doppler CNR increased from 5.3 ± 0.95 to 7.2 ± 1.3 (conventional filtering) and from 23 ± 3.3 to 32 ± 6.7 (SVD filtering). Applying these strategies could allow increased sensitivity to slow flow in side-viewing intravascular ultrasound imaging.

Image-Based Gating of Intravascular Ultrasound Sequences Using the Phase Information of Dual-Tree Complex Wavelet Transform Coefficients

Intravascular ultrasound (IVUS) is a widely used interventional imaging technique for the assessment of atherosclerosis plaque. Due to pulsatile heart motions, transverse and longitudinal motions are observed during in vivo pullbacks of IVUS sequences. These motion artifacts can mislead the volume-based data retrieved from IVUS studies and hinder the visualization of the vessel condition. To overcome this problem, a new fully automatic image-based gating algorithm was proposed in the current study. We utilized the phase information of the dual-tree complex wavelet transform (DT-CWT) coefficients to detect the motion of edge-like structures. For each IVUS sequence, first, six motion signals were detected by analyzing the phase of DT-CWT coefficients in six different directions. Then, the three best motion signals were selected by analyzing the frequency properties of each signal. Subsequently, these extracted signals were filtered using a modified Butterworth band-pass filter and the gated sequence was formed by using a combination of them. The proposed method was compared to four state-of-the-art methods and its frequency spectrum had more accurate characteristics in the cardiac frequency. In addition, the gated sequence extracted by the proposed method had the highest similarity to the extracted gated sequence by the physician.

Real-time volumetric lipid imaging in vivo by intravascular photoacoustics at 20 frames per second

Lipid deposition can be assessed with combined intravascular photoacoustic/ultrasound (IVPA/US) imaging. To date, the clinical translation of IVPA/US imaging has been stalled by a low imaging speed and catheter complexity. In this paper, we demonstrate imaging of lipid targets in swine coronary arteries in vivo, at a clinically useful frame rate of 20 s-1. We confirmed image contrast for atherosclerotic plaque in human samples ex vivo. The system is on a mobile platform and provides real-time data visualization during acquisition. We achieved an IVPA signal-to-noise ratio of 20 dB. These data show that clinical translation of IVPA is possible in principle.

Motion artifacts associated with in vivo endoscopic OCT images of the esophagus

3-D optical coherence tomography (OCT) has been extensively investigated as a potential screening and/or surveillance tool for Barrett's esophagus (BE). Understanding and correcting motion artifact may improve image interpretation. In this work, the motion trace was analyzed to show the physiological origin (respiration and heart beat) of the artifacts. Results showed that increasing balloon pressure did not sufficiently suppress the physiological motion artifact. An automated registration algorithm was designed to correct such artifacts. The performance of the algorithm was evaluated in images of normal porcine esophagus and demonstrated in images of BE in human patients.

Image-based cardiac phase retrieval in intravascular ultrasound sequences

Longitudinal motion during in vivo pullbacks acquisition of intravascular ultrasound (IVUS) sequences is a major artifact for 3-D exploring of coronary arteries. Most current techniques are based on the electrocardiogram (ECG) signal to obtain a gated pullback without longitudinal motion by using specific hardware or the ECG signal itself. We present an image-based approach for cardiac phase retrieval from coronary IVUS sequences without an ECG signal. A signal reflecting cardiac motion is computed by exploring the image intensity local mean evolution. The signal is filtered by a band-pass filter centered at the main cardiac frequency. Phase is retrieved by computing signal extrema. The average frame processing time using our setup is 36 ms. Comparison to manually sampled sequences encourages a deeper study comparing them to ECG signals.

Reconstructive compounding for IVUS palpography

This study proposes a novel algorithm for luminal strain reconstruction from sparse irregularly sampled strain measurements. It is based on the normalized convolution (NC) algorithm. The novel extension comprises the multilevel scheme, which takes into account the variable sampling density of the available strain measurements during the cardiac cycle. The proposed algorithm was applied to restore luminal strain values in intravascular ultrasound (IVUS) palpography. The procedure of reconstructing and averaging the strain values acquired during one cardiac cycle forms a technique, coined as reconstructive compounding. The accuracy of strain reconstruction was initially tested on the luminal strain map, computed from 3 in vivo IVUS pullbacks. The high quality of strain restoration was observed after systematically removing up to 90% of the initial elastographic measurements. The restored distributions accurately reproduced the original strain patterns and the error did not exceed 5%. The experimental validation of the reconstructed compounding technique was performed on 8 in vivo IVUS pullbacks. It demonstrated that the relative decrease in number of invalid strain estimates amounts to 92.05 +/- 6.03% and 99.17 +/- 0.92% for the traditional and reconstructive strain compounding schemes, respectively. In conclusion, implementation of the reconstructive compounding scheme boosts the diagnostic value of IVUS palpography.

In vivo attenuation and equivalent scatterer size parameters for atherosclerotic carotid plaque: preliminary results

We have previously reported on the equivalent scatterer size, attenuation coefficient, and axial strain properties of atherosclerotic plaque ex vivo. Since plaque structure and composition may be damaged during a carotid endarterectomy procedure, characterization of in vivo properties of atherosclerotic plaque is essential. The relatively shallow depth of the carotid artery and plaque enables non-invasive evaluation of carotid plaque utilizing high frequency linear-array transducers. We investigate the ability of the attenuation coefficient and equivalent scatterer size parameters to differentiate between calcified, and lipidic plaque tissue. Softer plaques especially lipid rich and those with a thin fibrous cap are more prone to rupture and can be classified as unstable or vulnerable plaque. Preliminary results were obtained from 10 human patients whose carotid artery was scanned in vivo to evaluate atherosclerotic plaque prior to a carotid endarterectomy procedure. Our results indicate that the equivalent scatterer size obtained using Faran's scattering theory for calcified regions are in the 120-180 microm range while softer regions have larger equivalent scatterer size distribution in the 280-470 microm range. The attenuation coefficient for calcified regions as expected is significantly higher than that for softer regions. In the frequency bandwidth ranging from 2.5 to 7.5 MHz, the attenuation coefficient for calcified regions lies between 1.4 and 2.5 dB/cm/MHz, while that for softer regions lies between 0.3 and 1.3 dB/cm/MHz.

Approaching artery rigid dynamics in IVUS

Tissue biomechanical properties (like strain and stress) are playing an increasing role in diagnosis and long-term treatment of intravascular coronary diseases. Their assessment strongly relies on estimation of vessel wall deformation. Since intravascular ultrasound (IVUS) sequences allow visualizing vessel morphology and reflect its dynamics, this technique represents a useful tool for evaluation of tissue mechanical properties. Image misalignment introduced by vessel-catheter motion is a major artifact for a proper tracking of tissue deformation. In this work, we focus on compensating and assessing IVUS rigid in-plane motion due to heart beating. Motion parameters are computed by considering both the vessel geometry and its appearance in the image. Continuum mechanics laws serve to introduce a novel score measuring motion reduction in in vivo sequences. Synthetic experiments validate the proposed score as measure of motion parameters accuracy; whereas results in in vivo pullbacks show the reliability of the presented methodologies in clinical cases.

Estimation of the transverse strain tensor in the arterial wall using IVUS image registration

Intravascular ultrasound (IVUS) elastography is an imaging technique that obtains the local mechanical properties of the artery wall and atherosclerotic plaques through strain measurements using IVUS. Knowledge of these mechanical properties may provide crucial information that can help in estimating plaque composition and its vulnerability. Here, we present a new method to estimate the transverse strain tensor of the arterial wall based on nonrigid image registration using IVUS images. This method registers a pair of images acquired at a vessel site under different levels of luminal pressure. The 2-D displacement field in the vessel cross-section is estimated from image registration; then the displacement field is used to calculate the 2-D local strain tensor. From the strain tensor, the strain in any direction in the cross-section can be obtained; here, the radial and circumferential strain distributions are presented. This strain estimation method has been validated with synthetic motion IVUS images and evaluated using the IVUS images of a polyvinyl alcohol cryogel phantom. The accuracy of the estimated strain and the ability of the method to overcome IVUS system noise are demonstrated.

Improving IVUS palpography by incorporation of motion compensation based on block matching and optical flow

Intravascular ultrasound (IVUS) strain imaging of the luminal layer in coronary arteries, coined as IVUS palpography, utilizes conventional radio frequency (RF) signals acquired at 2 different levels of a compressional load. The signals are cross-correlated to obtain the microscopic tissue displacements, which can be directly translated into local strain of the vessel wall. However, (apparent) tissue motion and nonuniform deformation of the vessel wall, due to catheter wiggling, reduce signal correlation and result in invalid strain estimates. Implications of probe motion were studied on the tissue-mimicking phantom. The measured circumferential tissue displacement and level of the speckle decorrelation amounted to 12 degrees and 0.58, respectively, for the catheter displacement of 456 microm. To compensate for the motion artifacts in IVUS palpography, a novel method based on the feature-based scale-space optical flow (OF), and classical block matching (BM) algorithm, were employed. The computed OF vector and BM displacement fields quantify the amount of local tissue misalignment in consecutive frames. Subsequently, the extracted circumferential displacements are used to realign the signals before strain computation. Motion compensation reduces the RF signal decorrelation and increases the number of valid strain estimates. The advantage of applying the motion correction in IVUS palpography was demonstrated in a midscale validation study on 14 in vivo pullbacks. Both methods substantially increase the number of valid strain estimates in the partial and compounded palpograms. Mean relative improvement in the number of valid strain estimates with motion compensation in comparison to one without motion compensation amounts to 28% and 14%, respectively. Implementation of motion compensation methods boosts the diagnostic value of IVUS palpography.

Sparse registration for three-dimensional stress echocardiography

Three-dimensional (3-D) stress echocardiography is a novel technique for diagnosing cardiac dysfunction. It involves evaluating wall motion of the left ventricle, by visually analyzing ultrasound images obtained in rest and in different stages of stress. Since the acquisitions are performed minutes apart, variabilities may exist in the visualized cross-sections. To improve anatomical correspondence between rest and stress, aligning the images is essential. We developed a new intensity-based, sparse registration method to retrieve standard anatomical views from 3-D stress images that were equivalent to the manually selected views in the rest images. Using sparse image planes, the influence of common image artifacts could be reduced. We investigated different similarity measures and different levels of sparsity. The registration was tested using data of 20 patients and quantitatively evaluated based on manually defined anatomical landmarks. Alignment was best using sparse registration with two long-axis and two short-axis views; registration errors were reduced significantly, to the range of interobserver variabilities. In 91% of the cases, the registration result was qualitatively assessed as better than or equal to the manual alignment. In conclusion, sparse registration improves the alignment of rest and stress images, with a performance similar to manual alignment. This is an important step towards objective quantification in 3-D stress echocardiography.

Preliminary in vivo atherosclerotic carotid plaque characterization using the accumulated axial strain and relative lateral shift strain indices

In this paper, we explore two parameters or strain indices related to plaque deformation during the cardiac cycle, namely, the maximum accumulated axial strain in plaque and the relative lateral shifts between plaque and vessel wall under in vivo clinical ultrasound imaging conditions for possible identification of vulnerable plaque. These strain indices enable differentiation between calcified and lipidic plaque tissue utilizing a new perspective based on the stiffness and mobility of the plaque. In addition, they also provide the ability to distinguish between softer plaques that undergo large deformations during the cardiac cycle when compared to stiffer plaque tissue. Soft plaques that undergo large deformations over the cardiac cycle are more prone to rupture and to release micro-emboli into the cerebral bloodstream. The ability to identify vulnerable plaque, prone to rupture, would significantly enhance the clinical utility of this method for screening patients. We present preliminary in vivo results obtained from ultrasound radio frequency data collected over 16 atherosclerotic plaque patients before these patients undergo a carotid endarterectomy procedure. Our preliminary in vivo results indicate that the maximum accumulated axial strain over a cardiac cycle and the maximum relative lateral shift or displacement of the plaque are useful strain indices that provide differentiation between soft and calcified plaques.

Azimuthal registration of image sequences affected by nonuniform rotation distortion

Imaging modalities that use a mechanically rotated endoscopic probe to scan a tubular volume, such as an artery, often suffer from image degradation due to nonuniform rotation distortion (NURD). In this paper, we present a new method to align individual lines in a sequence of images. It is based on dynamic time warping, finding a continuous path through a cost matrix that measures the similarity between regions of two frames being aligned. The path represents the angular mismatch corresponding to the NURD. The prime advantage of this novel approach compared to earlier work is the line-to-line continuity, which accurately captures slow intraframe variations in rotational velocity of the probe. The algorithm is optimized using data from a clinically available intravascular optical coherence tomography (OCT) instrument in a realistic vessel phantom. Its efficacy is demonstrated on an in vivo recording, and compared with conventional global rotation block matching. Intravascular OCT is a particularly challenging modality for motion correction because, in clinical situations, the image is generally undersampled, and correlation between the speckle in different lines or frames is absent. The algorithm can be adapted to ingest data frame-by-frame, and can be implemented to work in real time.

Accuracy in prediction of catheter rotation in IVUS with feature-based optical flow--a phantom study

The quantitative assessment of and compensation for catheter rotation in intravascular ultrasound images presents a fundamental problem for noninvasive characterization of the mechanical properties of the coronary arteries. A method based on the scale-space optical flow algorithm with a feature-based weighting scheme is proposed to account for the aforementioned artifact. The computed vector field, describing the misalignment between two consecutive frames, allows the quantitative assessment of the amount of vessel wall tissue motion, which is directly related to the catheter rotation. Algorithm accuracy and robustness were demonstrated on two tissue-mimicking phantoms, subjected to controlled amount of angular deviation. The proposed method shows a great reliability in the prediction of catheter rotational motion up to 4 degrees.

Modelling of image-catheter motion for 3-D IVUS

Three-dimensional intravascular ultrasound (IVUS) allows to visualize and obtain volumetric measurements of coronary lesions through an exploration of the cross sections and longitudinal views of arteries. However, the visualization and subsequent morpho-geometric measurements in IVUS longitudinal cuts are subject to distortion caused by periodic image/vessel motion around the IVUS catheter. Usually, to overcome the image motion artifact ECG-gating and image-gated approaches are proposed, leading to slowing the pullback acquisition or disregarding part of IVUS data. In this paper, we argue that the image motion is due to 3-D vessel geometry as well as cardiac dynamics, and propose a dynamic model based on the tracking of an elliptical vessel approximation to recover the rigid transformation and align IVUS images without loosing any IVUS data. We report an extensive validation with synthetic simulated data and in vivo IVUS sequences of 30 patients achieving an average reduction of the image artifact of 97% in synthetic data and 79% in real-data. Our study shows that IVUS alignment improves longitudinal analysis of the IVUS data and is a necessary step towards accurate reconstruction and volumetric measurements of 3-D IVUS.

Automated tracking of the mitral valve annulus motion in apical echocardiographic images using multidimensional dynamic programming

We developed a semiautomatic method for tracking the mitral valve annulus (MVA) in echocardiographic images, in particular, tracking the septal and the lateral mitral valve hinge points. The algorithm is based on multidimensional dynamic programming combined with apodized block matching. The method was tested on single-beat apical four chamber image sequences of 20 patients with acute myocardial infarction. The automated tracking results were evaluated by comparing them with the average manual tracking results of two experts. The mitral valve hinge point displacements and the total mitral excursions obtained by the automatic technique agreed well with those obtained manually and outperformed two commonly used tracking methods (forward tracking and minimum tracking). In conclusion, this novel semiautomatic tracking method is clinically valuable and capable of tracking the MVA motion within the limits of interobserver variability. The technique is robust, even in low frame rate, redigitized VCR images of clinical quality.

Robust intravascular optical coherence elastography by line correlations

We present a new method for intravascular optical coherence elastography, which is robust against motion artefacts. It employs the correlation between adjacent lines, instead of subsequent frames. Pressure to deform the tissue is applied synchronously with the line scan rate of the optical coherence tomography (OCT) instrument. The viability of the method is demonstrated with a simulation study. We find that the root mean square (rms) error of the displacement estimate is 0.55 microm, and the rms error of the strain is 0.6%. It is shown that high-strain spots in the vessel wall, such as observed at the sites of vulnerable atherosclerotic lesions, can be detected with the technique.

A simulation study on tissue harmonic imaging with a single-element intravascular ultrasound catheter

Recently, in vivo feasibility of tissue harmonic imaging with a mechanically rotated intravascular ultrasound (IVUS) catheter was experimentally demonstrated. To isolate the second harmonic signal content, a combination of pulse inversion and analog filtering was used. In this paper the development of a simulation tool to investigate nonlinear IVUS beams is reported, and the influence of transducer rotation and axial catheter-to-tissue motion on the efficiency of PI signal processing is evaluated. Nonlinear beams were simulated in homogeneous tissue-mimicking media at a transmit frequency of 20 MHz, which resulted in second harmonic pressure fields at 40 MHz. The competing effects of averaging and decorrelation between neighboring rf lines on the signal-to-noise ratio (SNR) were studied for a single point scatterer. An optimal SNR was achieved when lines were combined over 3 degrees - 3.75 degrees. When the transducer was rotated with respect to point scatterers, simulating the acoustic response of tissue, the fundamental frequency suppression using PI degraded rapidly with increasing interpulse angles. The effect of axial catheter-to-tissue motion on the efficiency of pulse inversion seemed to be of less influence for realistic motion values. The results of this study will aid in the optimization of harmonic IVUS imaging systems.