SURF imaging for contrast agent detection

Three-dimensional super resolution ultrasound imaging with a multi-frequency hemispherical phased array

BACKGROUND

High resolution imaging of the microvasculature plays an important role in both diagnostic and therapeutic applications in the brain. However, ultrasound pulse-echo sonography imaging the brain vasculatures has been limited to narrow acoustic windows and low frequencies due to the distortion of the skull bone, which sacrifices axial resolution since it is pulse length dependent.

PURPOSE

To overcome the detect limit, a large aperture 256-module sparse hemispherical transmit/receive array was used to visualize the acoustic emissions of ultrasound-vaporized lipid-coated decafluorobutane nanodroplets flowing through tube phantoms and within rabbit cerebral vasculature in vivo via passive acoustic mapping and super resolution techniques.

METHODS

Nanodroplets were vaporized with 55 kHz burst-mode ultrasound (burst length = 145 μs, burst repetition frequency = 9-45 Hz, peak negative acoustic pressure = 0.10-0.22 MPa), which propagates through overlying tissues well without suffering from severe distortions. The resulting emissions were received at a higher frequency (612 or 1224 kHz subarray) to improve the resulting spatial resolution during passive beamforming. Normal resolution three-dimensional images were formed using a delay, sum, and integrate beamforming algorithm, and super-resolved images were extracted via Gaussian fitting of the estimated point-spread-function to the normal resolution data.

RESULTS

With super resolution techniques, the mean lateral (axial) full-width-at-half-maximum image intensity was 16 ± 3 (32 ± 6) μm, and 7 ± 1 (15 ± 2) μm corresponding to ∼1/67 of the normal resolution at 612 and 1224 kHz, respectively. The mean positional uncertainties were ∼1/350 (lateral) and ∼1/180 (axial) of the receive wavelength in water. In addition, a temporal correlation between nanodroplet vaporization and the transmit waveform shape was observed, which may provide the opportunity to enhance the signal-to-noise ratio in future studies.

CONCLUSIONS

Here, we demonstrate the feasibility of vaporizing nanodroplets via low frequency ultrasound and simultaneously performing spatial mapping via passive beamforming at higher frequencies to improve the resulting spatial resolution of super resolution imaging techniques. This method may enable complete four-dimensional vascular mapping in organs where a hemispherical array could be positioned to surround the target, such as the brain, breast, or testicles.

Very Low Frequency Radial Modulation for Deep Penetration Contrast-Enhanced Ultrasound Imaging

Contrast-enhanced ultrasound imaging allows vascular imaging in a variety of diseases. Radial modulation imaging is a contrast agent-specific imaging approach for improving microbubble detection at high imaging frequencies (≥7.5 MHz), with imaging depth limited to a few centimeters. To provide high-sensitivity contrast-enhanced ultrasound imaging at high penetration depths, a new radial modulation imaging strategy using a very low frequency (100 kHz) ultrasound modulation wave in combination with imaging pulses ≤5 MHz is proposed. Microbubbles driven at 100 kHz were imaged in 10 successive oscillation states by manipulating the pulse repetition frequency to unlock the frame rate from the number of oscillation states. Tissue background was suppressed using frequency domain radial modulation imaging (F-RMI) and singular value decomposition-based radial modulation imaging (S-RMI). One hundred-kilohertz modulation resulted in significantly higher microbubble signal magnitude (63-88 dB) at the modulation frequency relative to that without 100-kHz modulation (51-59 dB). F-RMI produced images with high contrast-to-tissue ratios (CTRs) of 15 to 22 dB in a stationary tissue phantom, while S-RMI further improved the CTR (19-26 dB). These CTR values were significantly higher than that of amplitude modulation pulse inversion images (11.9 dB). In the presence of tissue motion (1 and 10 mm/s), S-RMI produced high-contrast images with CTR up to 18 dB; however, F-RMI resulted in minimal contrast enhancement in the presence of tissue motion. Finally, in transcranial ultrasound imaging studies through a highly attenuating ex vivo cranial bone, CTR values with S-RMI were as high as 23 dB. The proposed technique demonstrates successful modulation of microbubble response at 100 kHz for the first time. The presented S-RMI low-frequency radial modulation imaging strategy represents the first demonstration of real-time (20 frames/s), high-penetration-depth radial modulation imaging for contrast-enhanced ultrasound imaging.

Equivalent time active cavitation imaging

RATIONALE

Despite the development of a large number of neurologically active drugs, brain diseases are difficult to treat due to the inability of many drugs to penetrate the blood-brain barrier. High-intensity focused ultrasound blood-brain barrier opening in a site-specific manner could significantly expand the spectrum of available drug treatments. However, without monitoring, brain damage and off target effects can occur during these treatments. While some methods can monitor inertial cavitation, temperature increase, or passively monitor cavitation events, to the best of our knowledge none of them can actively and spatiotemporally map the high intensity focused ultrasound pressure field during treatment.

METHODS

Here we detail the development of a novel ultrasound imaging modality called Equivalent Time Active Cavitation Imaging capable of characterizing the high-intensity focused ultrasound pressure field through stable cavitation events across the field of view with an ultrafast active imaging setup. This work introduces 1) a novel plane wave sequence whose transmit delays increase linearly with transmit events enabling the sampling of high-frequency cavitation events, and 2) an algorithm allowing the filtration of the microbubble signal for pressure field mapping. The pressure measurements with our modality were first carried out in vitro for hydrophone comparison and then in vivo during blood-brain barrier opening treatment in mice.

RESULTS

This study demonstrates the ability of our modality to spatiotemporally characterize a modulation pressure field with an active imaging setup. The resulting pressure field mapping reveals a good correlation with hydrophone measurements. Further proof is provided experimentally in vivo with promising results.

CONCLUSION

This proof of concept establishes the first steps towards a novel ultrasound modality for monitoring focused ultrasound blood-brain barrier opening, allowing new possibilities for a safe and precise monitoring method.

High-Frequency Multipulse, Plane-Wave Acoustic Contrast Imaging

Multipulse (MP) ultrasound contrast agent (UCA) imaging is a method to increase the contrast-to-background (CBR) ratio in regions of blood flow. Plane-wave imaging allows high frame rates, and with high-frequency ultrasound, fine-spatial and temporal resolution. MP and plane-wave imaging have not been applied to high-frequency ultrasound. Here, an 18-MHz linear array was employed to implement the MP methods of pulse inversion (PI) and amplitude modulation (AM) using high-speed, multiangle, compound plane-wave imaging. A flow of the UCA DEFINITY^© at a dilution ratio of 2000:1 circulating through a 2-mm-diameter flow channel in a tissue-mimicking phantom was used to characterize CBR and compared with cases of standard, multiangle compound plane-wave imaging. The relative improvement of PI and AM versus standard plane-wave imaging ranged from 5 to 10 dB. The CBR was observed to be stable over a 60-min time duration for a 2000:1 dilution ratio and a 2000:1 dilution ratio provided an optimal CBR.

Ultrafast Radial Modulation Imaging

Radial modulation imaging improves the detection of microbubbles at high frequency using a dual ultrasonic excitation. However, the synchronization between the imaging pulses is nontrivial because microbubbles need to be interrogated in the compression and the rarefaction phase, and the time-delay difference from dispersion has to be corrected. To address these issues, we propose the use of ultrafast radial modulation imaging (uRMI). In this technique, a beat frequency between the modulation pulse (around 1 MHz) and the ultrafast pulse-repetition frequency was exploited to separate microbubbles from tissue phantom in vitro. This led to a modulated images' set in the spectral domain of the slow time that may then be demodulated through a digital lock-in amplifier to retrieve the contrast image. Ultrafast RMI, applied on a flow phantom with microbubbles, provided a contrast-to-tissue ratio from 7.2 to 14.8 dB at 15 MHz. For flow speed lower than 0.05 mL/min, uRMI (16 dB) provided a better contrast-to-tissue ratio than other techniques: singular value decomposition spatiotemporal filter (11 dB), amplitude modulation (9 dB), or microbubbles disruption (6 dB). This technique may then be suitable to improve the detection of targeted microbubbles, in ultrasound molecular imaging applications, and the detection of extremely slow microbubbles moving in the finest vessels in ultrasound localization microscopy.

Dual-Frequency Piezoelectric Endoscopic Transducer for Imaging Vascular Invasion in Pancreatic Cancer

Cancers of the pancreas have the poorest prognosis among all cancers, as many tumors are not detected until surgery is no longer a viable option. Surgical viability is typically determined via endoscopic ultrasound imaging. However, many patients who may be eligible for resection are not offered surgery due to diagnostic challenges in determining vascular or lymphatic invasion. In this paper, we describe the development of a dual-frequency piezoelectric transducer for rotational endoscopic imaging designed to transmit at 4 MHz and receive at 20 MHz in order to image microbubble-specific superharmonic signals. Imaging performance is assessed in a tissue-mimicking phantom at depths from 1 cm [contrast-to-tissue ratio (CTR) = 21.6 dB] to 2.5 cm (CTR = 11.4 dB), in ex vivo porcine vessels, and in vivo in a rodent. The prototyped 1.1-mm aperture transducer demonstrates contrast-specific imaging of microbubbles in a 200- [Formula: see text]-diameter tube through the wall of a 1-cm-diameter porcine artery, suggesting such a device may enable direct visualization of small vessels from within the lumen of larger vessels such as the portal vein or superior mesenteric vein.

Analysis of acoustic impedance matching in dual-band ultrasound transducers

Dual-frequency band probes are needed for ultrasound (US) reverberation suppression and are useful for image-guided US therapy. A challenge is to design transducer stacks that achieve high bandwidth and efficiency at both operating frequencies when the frequencies are widely separated with a frequency ratio ∼6:1-20:1. This paper studies the loading and backing conditions of transducers in such stacks. Three stack configurations are presented and analyzed using one-dimensional models. It is shown that a configuration with three layers of material separating the transducers is favorable, as it reduces high frequency ringing by ∼20 dB compared to other designs, and matches the low frequency (LF) transducer to the load at a lower frequency. In some cases, the LF load matching is governed by a simple mass-spring interaction in spite of having a complicated matching structure. The proposed design should yield improved performance of reverberation suppression algorithms. Its suitability for reduction of probe heating, also in single-band probes, should be investigated.

Adaptive reverberation noise delay estimation for reverberation suppression in dual band ultrasound imaging

The behavior of the propagation delays introduced in dual frequency band ultrasound imaging is discussed. In particular, the delay of reverberation noise components is examined. Using a delay corrected subtraction (DCS) method, it is possible to suppress the reverberation noise if the behavior of the propagation delays is known. Here, a signal adaptive estimation for the reverberation delay is introduced and applied through DCS to suppress reverberation noise in a numerically simulated signal. The reverberation reduction is compared to DCS suppression using a simpler delay estimation and shows that a signal based adaptive estimation yields a improved suppression of reverberation noise. The study indicates that the advantage of the adaptive estimation is highest when the medium has changing nonlinearity with depth.

Methods for reverberation suppression utilizing dual frequency band imaging

Reverberations impair the contrast resolution of diagnostic ultrasound images. Tissue harmonic imaging is a common method to reduce these artifacts, but does not remove all reverberations. Dual frequency band imaging (DBI), utilizing a low frequency pulse which manipulates propagation of the high frequency imaging pulse, has been proposed earlier for reverberation suppression. This article adds two different methods for reverberation suppression with DBI: the delay corrected subtraction (DCS) and the first order content weighting (FOCW) method. Both methods utilize the propagation delay of the imaging pulse of two transmissions with alternating manipulation pressure to extract information about its depth of first scattering. FOCW further utilizes this information to estimate the content of first order scattering in the received signal. Initial evaluation is presented where both methods are applied to simulated and in vivo data. Both methods yield visual and measurable substantial improvement in image contrast. Comparing DCS with FOCW, DCS produces sharper images and retains more details while FOCW achieves best suppression levels and, thus, highest image contrast. The measured improvement in contrast ranges from 8 to 27 dB for DCS and from 4 dB up to the dynamic range for FOCW.

Dual-frequency chirp imaging for contrast detection

The method of dual-frequency (DF) difference excitation is capable of generating a low-frequency envelope component as the driving force of commercial contrast microbubbles by using a high-frequency pulse. Although the DF difference excitation method provides good lateral resolution in high-frequency contrast imaging, it suffers from degraded axial resolution because a longer-than-usual envelope component is required to induce the oscillation of microbubbles. In this study, a coded excitation technique (i.e. chirp waveform) is combined with the DF difference excitation method (also referred to as the DF chirp excitation method) to improve the axial resolution of contrast imaging while maintaining the impinging insonation energy. B-mode images were constructed to compare the performance of the DF chirp excitation method with the conventional tone-burst pulse method. Results indicate that the proposed DF chirp excitation method can provide better axial resolution after pulse compression. Moreover, as compared to the tone-burst pulse with the same pulse duration, the pulse compression results in a higher signal-to-noise ratio because of the temporal concentration of the received energy. Nevertheless, images with the DF chirp excitation method demonstrated noticeable image artefacts resulting from the range sidelobes. The DF chirp excitation method also produced obvious tissue harmonic generation that could degrade the contrast-to-tissue ratio at higher acoustic pressures.

Contrast imaging by non-overlapping dual frequency band transmit pulse complexes

SURF contrast imaging, as described previously in the literature, is a contrast agent detection technique achieved by processing of the received signals from transmitted dual frequency band pulse complexes with overlapping high-frequency (HF) and low-frequency (LF) pulses. The transmitted HF pulses are used for image reconstruction, whereas the transmitted LF pulses are used to manipulate the scattering properties of the contrast agent. As with harmonic contrast agent detection techniques, nonlinear wave propagation will, in most situations, also limit the specificity with the SURF contrast technique when transmitting overlapping HF and LF pulses. The present paper proposes an alternative SURF contrast imaging technique using transmit dual frequency band pulse complexes with non-overlapping HF and LF pulses. If the frequency of the LF manipulation pulse is close to the bubble resonance frequency, numerical simulations indicate a significant ring-down effect of the LF bubble radius response. Utilizing this bubble ring-down effect and transmitting the HF pulse just after the LF pulse, a contrast agent specificity approaching infinity accompanied by a contrast agent sensitivity only for contrast bubbles having resonance frequencies within a narrow frequency range may be obtained.

Nonlinear propagation delay and pulse distortion resulting from dual frequency band transmit pulse complexes

A method of acoustic imaging is discussed that potentially can improve the diagnostic capabilities of medical ultrasound. The method, given the name second order ultrasound field imaging, is achieved by the processing of the received signals from transmitted dual frequency band pulse complexes with at least partly overlapping high frequency (HF) and low frequency (LF) pulses. The transmitted HF pulses are used for image reconstruction whereas the transmitted LF pulses are used to manipulate the elastic properties of the medium observed by the HF imaging pulses. In the present paper, nonlinear propagation effects observed by a HF imaging pulse due to the presence of a LF manipulation pulse is discussed. When using dual frequency band transmit pulse complexes with a large separation in center frequency (e.g., 1:10), these nonlinear propagation effects are manifested as a nonlinear HF propagation delay and a HF pulse distortion different from conventional harmonic distortion. In addition, with different transmit foci for the HF and LF pulses, nonlinear aberration will occur.

Post-processing enhancement of reverberation-noise suppression in dual-frequency SURF imaging

A post-processing adjustment technique to enhance dual-frequency second-order ultrasound field (SURF) reverberation-noise suppression imaging in medical ultrasound is analyzed. Two variant methods are investigated through numerical simulations. They both solely involve post-processing of the propagated high-frequency (HF) imaging wave fields, which in real-time imaging corresponds to post-processing of the beamformed receive radio-frequency signals. Hence, the transmit pulse complexes are the same as for the previously published SURF reverberation-suppression imaging method. The adjustment technique is tested on simulated data from propagation of SURF pulse complexes consisting of a 3.5-MHz HF imaging pulse added to a 0.5-MHz low-frequency soundspeed manipulation pulse. Imaging transmit beams are constructed with and without adjustment. The post-processing involves filtering, e.g., by a time-shift, to equalize the two SURF HF pulses at a chosen depth. This depth is typically chosen to coincide with the depth where the first scattering or reflection occurs for the reverberation noise one intends to suppress. The beams realized with post-processing show energy decrease at the chosen depth, especially for shallow depths where, in a medical imaging situation, a body-wall is often located. This indicates that the post-processing may further enhance the reverberation- suppression abilities of SURF imaging. Moreover, it is shown that the methods might be utilized to reduce the accumulated near-field energy of the SURF transmit-beam relative to its imaging region energy. The adjustments presented may therefore potentially be utilized to attain a slightly better general suppression of multiple scattering and multiple reflection noise compared with non-adjusted SURF reverberation-suppression imaging.

Nonlinear propagation acoustics of dual-frequency wide-band excitation pulses in a focused ultrasound system

In this article, acoustic propagation effects of dual-frequency wide-band excitation pulses in a focused ultrasound system are demonstrated in vitro. A designed and manufactured dual-frequency band annular array capable of transmitting 0.9/7.5 MHz center frequency wide-band pulses was used for this purpose. The dual-frequency band annular array, has been designed using a bi-layer piezo-electric stack. Water tank measurements demonstrate the function of the array by activating the low- and high-frequency layers individually and simultaneously. The results show that the array works as intended. Activating the low- and high-frequency layers individually, results in less than -50 dB signal level from the high- and low-frequency layers respectively. Activating both layers simultaneously, produce a well defined dual-frequency pulse. The presence of the low-frequency pulse leads to compression, expansion, and a time delay of the high-frequency pulse. There is a phase shift between the low- and high-frequency pulse as it propagates from the array to the focus. This makes the latter described effects also dependent on the array configuration. By varying the low-frequency pressure, a shift of up to 0.5 MHz in center frequency of a 8.0 MHz transmitted high-frequency pulse is observed at the array focus. The results demonstrate the high propagation complexity of dual-frequency pulses.

Utilizing dual frequency band transmit pulse complexes in medical ultrasound imaging

A method of acoustic imaging that potentially can improve the diagnostic capabilities of medical ultrasound is presented. The method, given the name SURF (Second order UltRasound Field) imaging, is achieved by processing the received signals from transmitted dual frequency band pulse complexes with at least partly overlapping high frequency (HF) and low frequency (LF) pulses. The transmitted HF pulses are used for image reconstruction, whereas the transmitted LF pulses are used to manipulate the elastic properties of the medium observed by the HF imaging pulses. The present paper discusses fundamental concepts in relation to the use of dual frequency band pulse complexes for medical ultrasound imaging.

Transmit beams adapted to reverberation noise suppression using dual-frequency SURF imaging

A method that uses dual-frequency pulse complexes of widely separated frequency bands to suppress noise caused by multiple scattering or multiple reflections in medical ultrasound imaging is presented. The excitation pulse complexes are transmitted to generate a second order ultrasound field (SURF) imaging synthetic transmit beam. This beam has reduced amplitude near the transducer, which illustrates the multiple scattering suppression ability of the imaging method. Field simulations solving a nonlinear wave equation are used to calculate SURF imaging beams, which are compared with beams for pulse inversion (PI) and fundamental imaging. In addition, a combined SURF and PI beam generation is described and compared with the beams mentioned above. A quality ratio, relating the energy within the near-field to that within the imaging region, is defined and used to score the multiple scattering and multiple reflection suppression abilities when imaging with the different beams. The realized combined SURF-PI beam scores highest, followed by SURF, PI (that score equally well), and the fundamental. The amplitude in the imaging region and therefore also the SNR is highest for the fundamental followed by SURF, PI, and SURF-PI. The work hence indicates that when substituting PI for SURF, one may trade increased SNR into use of increased imaging frequencies without loss of multiple scattering and multiple reflection noise suppression.