Cable shared dual-frequency catheter for intravascular ultrasound

A Backing-Layer-Shared Miniature Dual-Frequency Ultrasound Probe for Intravascular Ultrasound Imaging: In Vitro and Ex Vivo Validations

Intravascular ultrasound (IVUS) imaging has been extensively utilized to visualize atherosclerotic coronary artery diseases and to guide coronary interventions. To receive ultrasound signals within the vessel wall safely and effectively, miniaturized ultrasound transducers that meet the strict size constraints and have a simple manufacturing procedure are highly demanded. In this work, the first known IVUS probe that employs a backing-layer-shared dual-frequency structure and a single coaxial cable is introduced, featuring a small thickness and easy interconnection procedure. The dual-frequency transducer is designed to have center frequencies of 30 MHz and 80 MHz, and both have an aperture size of 0.5 mm × 0.5 mm. The total thickness of the dual-frequency transducer is less than 700 µm. In vitro phantom imaging and ex vivo porcine coronary artery imaging experiments are conducted. The low-frequency transducer achieves spatial resolutions of 40 µm axially and 321 µm laterally, while the high-frequency transducer exhibits axial and lateral resolutions of 17 µm and 247 µm, respectively. A bandpass filter is utilized to separate the ultrasound images. Combining in vitro phantom imaging analysis with ex vivo imaging validation, a comprehensive demonstration of the promising application of the proposed miniature ultrasound probe is established.

Pre-Matching Circuit for High-Frequency Ultrasound Transducers

High-frequency ultrasound transducers offer higher spatial resolution than low-frequency ultrasound transducers; however, their maximum sensitivity are lower. Matching circuits are commonly utilized to increase the amplitude of high-frequency ultrasound transducers because the size of the piezoelectric material decreases as the operating frequency of the transducer increases. Thus, it lowers the limit of the applied voltage to the piezoelectric materials. Additionally, the electrical impedances of ultrasound transducers generally differ at the resonant-, center-, and anti-resonant-frequencies. The currently developed most-matching circuits provide electrical matching at the center frequency ranges for ultrasound transmitters and transducers. In addition, matching circuits with transmitters are more difficult to use to control the echo signal quality of the transducers because it is harder to control the bandwidth and gain of an ultrasound transmitter working in high-voltage operation. Therefore, we provide a novel pre-matching circuit method to improve the amplitude and bandwidth of high-frequency ultrasound transducers at the resonant-, center-, and anti-resonant-frequency ranges, with an ultrasound receiver and transducer. To verify the pre-matching circuit, pulse-echo response tests were conducted on the ultrasound transducers. The results show that the designed pre-matching circuits provide higher amplitude (5.63- and 2.02-times) and wider bandwidth (175.55% and 62.01%) for the high-frequency ultrasound transducer compared to the original circuit without a pre-matching circuit, and the parallel capacitor with a series-inductor circuit, respectively; therefore, the proposed pre-matching circuit is an appropriate solution for improving the amplitudes and bandwidths of high-frequency ultrasound transducers over wide frequency ranges.

Progress in Probe-Based Sensing Techniques for In Vivo Diagnosis

Advancements in robotic surgery help to improve the endoluminal diagnosis and treatment with minimally invasive or non-invasive intervention in a precise and safe manner. Miniaturized probe-based sensors can be used to obtain information about endoluminal anatomy, and they can be integrated with medical robots to augment the convenience of robotic operations. The tremendous benefit of having this physiological information during the intervention has led to the development of a variety of in vivo sensing technologies over the past decades. In this paper, we review the probe-based sensing techniques for the in vivo physical and biochemical sensing in China in recent years, especially on in vivo force sensing, temperature sensing, optical coherence tomography/photoacoustic/ultrasound imaging, chemical sensing, and biomarker sensing.

Recent Advancements in Ultrasound Transducer: From Material Strategies to Biomedical Applications

Ultrasound is extensively studied for biomedical engineering applications. As the core part of the ultrasonic system, the ultrasound transducer plays a significant role. For the purpose of meeting the requirement of precision medicine, the main challenge for the development of ultrasound transducer is to further enhance its performance. In this article, an overview of recent developments in ultrasound transducer technologies that use a variety of material strategies and device designs based on both the piezoelectric and photoacoustic mechanisms is provided. Practical applications are also presented, including ultrasound imaging, ultrasound therapy, particle/cell manipulation, drug delivery, and nerve stimulation. Finally, perspectives and opportunities are also highlighted.

Dual-Resonance (16/32 MHz) Piezoelectric Transducer With a Single Electrical Connection for Forward-Viewing Robotic Guidewire

Peripheral artery disease (PAD) affects more than 200 million people globally. Minimally invasive endovascular procedures can provide relief and salvage limbs while reducing injury rates and recovery times. Unfortunately, when a calcified chronic total occlusion is encountered, ~25% of endovascular procedures fail due to the inability to advance a guidewire using the view provided by fluoroscopy. To enable a sub-millimeter, robotically steerable guidewire to cross these occlusions, a novel single-element, dual-band transducer is developed that provides simultaneous multifrequency, forward-viewing imaging with high penetration depth and high spatial resolution while requiring only a single electrical connection. The design, fabrication, and acoustic characterization of this device are described, and proof-of-concept imaging is demonstrated in an ex vivo porcine artery after integration with a robotically steered guidewire. Measured center frequencies of the developed transducer were 16 and 32 MHz, with -6 dB fractional bandwidths of 73% and 23%, respectively. When imaging a 0.2-mm wire target at a depth of 5 mm, measured -6 dB target widths were 0.498 ± 0.02 and 0.268 ± 0.01 mm for images formed at 16 and 32 MHz, respectively. Measured SNR values were 33.3 and 21.3 dB, respectively. The 3-D images of the ex vivo artery demonstrate high penetration for visualizing vessel morphology at 16 MHz and ability to resolve small features close to the transducer at 32 MHz. Using images acquired simultaneously at both frequencies as part of an integrated forward-viewing, guidewire-based imaging system, an interventionalist could visualize the best path for advancing the guidewire to improve outcomes for patients with PAD.

Evaluation of Blood Induced Influence for High-Definition Intravascular Ultrasound (HD-IVUS)

High-definition intravascular ultrasound (HD-IVUS) utilizing more than 80 MHz frequency to assess atherosclerotic plaque, can theoretically achieve an axial resolution of less than [Formula: see text]. However, the blood is a high-attenuation source at high frequency, which would affect the imaging quality. There has been no research evaluating the blood-induced influence on HD-IVUS imaging. And whether a temporary removal of blood is needed for HD-IVUS is unknown. In this study, an ultrahigh-frequency (100 MHz) ultrasound transducer was developed to evaluate the blood-induced attenuation for HD-IVUS imaging. A series of tungsten-wire phantom images in saline and blood at varying hematocrits were obtained. The images showed that blood did influence the ultrahigh-frequency imaging quality greatly. The signal-to-noise ratio (SNR) decrease by 71.7% in porcine whole blood compared to that in saline at the same depth of 2.3 mm. Moreover, the potential flushing schemes for HD-IVUS were studied in varying hematocrits. Three flushing agents commonly used in intravascular optical coherence tomography (IV-OCT) were investigated, including iohexol, mannitol, and dextran 5% and saline as the control group. The attenuation of blood in varying hematocrits/flushing agents was measured from 90 to 110 MHz. The result indicated dextran 5% was a suitable flushing agent for HD-IVUS due to its less signal attenuation compared to others.

Mechanically Rotating Intravascular Ultrasound (IVUS) Transducer: A Review

Intravascular ultrasound (IVUS) is a valuable imaging modality for the diagnosis of atherosclerosis. It provides useful clinical information, such as lumen size, vessel wall thickness, and plaque composition, by providing a cross-sectional vascular image. For several decades, IVUS has made remarkable progress in improving the accuracy of diagnosing cardiovascular disease that remains the leading cause of death globally. As the quality of IVUS images mainly depends on the performance of the IVUS transducer, various IVUS transducers have been developed. Therefore, in this review, recently developed mechanically rotating IVUS transducers, especially ones exploiting piezoelectric ceramics or single crystals, are discussed. In addition, this review addresses the history and technical challenges in the development of IVUS transducers and the prospects of next-generation IVUS transducers.

Recent Advances in Transducers for Intravascular Ultrasound (IVUS) Imaging

As a well-known medical imaging methodology, intravascular ultrasound (IVUS) imaging plays a critical role in diagnosis, treatment guidance and post-treatment assessment of coronary artery diseases. By cannulating a miniature ultrasound transducer mounted catheter into an artery, the vessel lumen opening, vessel wall morphology and other associated blood and vessel properties can be precisely assessed in IVUS imaging. Ultrasound transducer, as the key component of an IVUS system, is critical in determining the IVUS imaging performance. In recent years, a wide range of achievements in ultrasound transducers have been reported for IVUS imaging applications. Herein, a comprehensive review is given on recent advances in ultrasound transducers for IVUS imaging. Firstly, a fundamental understanding of IVUS imaging principle, evaluation parameters and IVUS catheter are summarized. Secondly, three different types of ultrasound transducers (piezoelectric ultrasound transducer, piezoelectric micromachined ultrasound transducer and capacitive micromachined ultrasound transducer) for IVUS imaging are presented. Particularly, the recent advances in piezoelectric ultrasound transducer for IVUS imaging are extensively examined according to their different working mechanisms, configurations and materials adopted. Thirdly, IVUS-based multimodality intravascular imaging of atherosclerotic plaque is discussed. Finally, summary and perspectives on the future studies are highlighted for IVUS imaging applications.

High-efficiency high-voltage class F amplifier for high-frequency wireless ultrasound systems

This paper presents a novel amplifier that satisfies both low distortion and high efficiency for high-frequency wireless ultrasound systems with limited battery life and size. While increasing the amplifier efficiency helps to address the problems for wireless ultrasound systems, it can cause signal distortion owing to harmonic components. Therefore, a new type of class F amplifier is designed to achieve high efficiency and low distortion. In the amplifier, the resonant circuit at each stage controls the harmonic components to reduce distortion and improve efficiency. Transformers with a large shunt resistor are also helpful to reduce the remaining noise in the input signal. The proposed class F amplifier is tested using simulations, and the voltage and current waveforms are analyzed to achieve correct operation with adequate efficiency and distortion. The measured performance of the class F amplifier has a gain of 23.2 dB and a power added efficiency (PAE) of 88.9% at 25 MHz. The measured DC current is 121 mA with a variance of less than 1% when the PA is operating. We measured the received echo signal through the pulse-echo response using a 25-MHz transducer owing to the compatibility of the designed class F amplifier with high- frequency transducers. The measured total harmonic distortion (THD) of the echo signal was obtained as 4.5% with a slightly low ring-down. The results show that the low THD and high PAE of the new high-efficiency and high-voltage amplifier may increase battery life and reduce the cooling fan size, thus providing a suitable environment for high-frequency wireless ultrasound systems.

Using optical coherence tomography and intravascular ultrasound imaging to quantify coronary plaque cap thickness and vulnerability: a pilot study

Background

Detecting coronary vulnerable plaques in vivo and assessing their vulnerability have been great challenges for clinicians and the research community. Intravascular ultrasound (IVUS) is commonly used in clinical practice for diagnosis and treatment decisions. However, due to IVUS limited resolution (about 150–200 µm), it is not sufficient to detect vulnerable plaques with a threshold cap thickness of 65 µm. Optical Coherence Tomography (OCT) has a resolution of 15–20 µm and can measure fibrous cap thickness more accurately. The aim of this study was to use OCT as the benchmark to obtain patient-specific coronary plaque cap thickness and evaluate the differences between OCT and IVUS fibrous cap quantifications. A cap index with integer values 0–4 was also introduced as a quantitative measure of plaque vulnerability to study plaque vulnerability.

Methods

Data from 10 patients (mean age: 70.4; m: 6; f: 4) with coronary heart disease who underwent IVUS, OCT, and angiography were collected at Cardiovascular Research Foundation (CRF) using approved protocol with informed consent obtained. 348 slices with lipid core and fibrous caps were selected for study. Convolutional Neural Network (CNN)-based and expert-based data segmentation were performed using established methods previously published. Cap thickness data were extracted to quantify differences between IVUS and OCT measurements.

Results

For the 348 slices analyzed, the mean value difference between OCT and IVUS cap thickness measurements was 1.83% (p = 0.031). However, mean value of point-to-point differences was 35.76%. Comparing minimum cap thickness for each plaque, the mean value of the 20 plaque IVUS-OCT differences was 44.46%, ranging from 2.36% to 91.15%. For cap index values assigned to the 348 slices, the disagreement between OCT and IVUS assignments was 25%. However, for the OCT cap index = 2 and 3 groups, the disagreement rates were 91% and 80%, respectively. Furthermore, the observation of cap index changes from baseline to follow-up indicated that IVUS results differed from OCT by 80%.

Conclusions

These preliminary results demonstrated that there were significant differences between IVUS and OCT plaque cap thickness measurements. Large-scale patient studies are needed to confirm our findings.

Post-Voltage-Boost Circuit-Supported Single-Ended Class-B Amplifier for Piezoelectric Transducer Applications

Piezoelectric transducers are important devices that are triggered by amplifier circuits in mobile ultrasound systems. Therefore, amplifier performance is vital because it determines the acoustic piezoelectric transducer performances. Particularly, mobile ultrasound applications have strict battery performance and current consumption requirements; hence, amplifier devices should exhibit good efficiency because the direct current (DC) voltage in the battery are provided to the supply voltages of the amplifier, thus limiting the maximum DC drain voltages of the main transistors in the amplifier. The maximum DC drain voltages are related with maximum output power if the choke inductor in the amplifier is used. Therefore, a need to improve the amplifier performance of piezoelectric transducers exists for mobile ultrasound applications. In this study, a post-voltage-boost circuit-supported class-B amplifier used for mobile ultrasound applications was developed to increase the acoustic performance of piezoelectric transducers. The measured voltage of the post-voltage-boost circuit-supported class-B amplifier (62 V_P-P) is higher than that of only a class-B amplifier (50 V_P-P) at 15 MHz and 100 mV_P-P input. By performing the pulse-echo measurement test, the echo signal with the post-voltage-boost circuit-supported class-B amplifier (10.39 mV_P-P) was also noted to be higher than that with only a class-B amplifier (6.15 mV_P-P). Therefore, this designed post-voltage-boost circuit can help improve the acoustic amplitude of piezoelectric transducers used for mobile ultrasound applications.

30/80 MHz Bidirectional Dual-Frequency IVUS Feasibility Evaluated In Vivo and for Stent Imaging

Although intravascular ultrasound (IVUS) is an important tool in guiding complex coronary interventions, the resolution of existing commercial IVUS devices is considerably poorer than that of optical coherence tomography. Dual-frequency IVUS (DF IVUS), incorporating a second, higher frequency transducer, has been proposed as a possible method of overcoming this limitation. Although preliminary studies have shown that DF IVUS can produce complementary images, including large-scale morphology and high detail of superficial features, it has not yet been determined that this approach would be feasible in a more clinically relevant environment. The purpose of this study was to demonstrate the first in vivo use of a 30/80 MHz DF IVUS catheter in visualizing coronary vessels in a porcine model. In addition, two commercially available stents were studied in vitro and in vivo. Clear subjective improvement of visualization of superficial structures is demonstrated, and sufficient dynamic range is achieved to image through both the catheter sheath and blood in vivo.