Visual inertial odometry enabled 3D ultrasound and photoacoustic imaging

There is an increasing need for 3D ultrasound and photoacoustic (USPA) imaging technology for real-time monitoring of dynamic changes in vasculature or molecular markers in various malignancies. Current 3D USPA systems utilize expensive 3D transducer arrays, mechanical arms or limited-range linear stages to reconstruct the 3D volume of the object being imaged. In this study, we developed, characterized, and demonstrated an economical, portable, and clinically translatable handheld device for 3D USPA imaging. An off-the-shelf, low-cost visual odometry system (the Intel RealSense T265 camera equipped with simultaneous localization and mapping technology) to track free hand movements during imaging was attached to the USPA transducer. Specifically, we integrated the T265 camera into a commercially available USPA imaging probe to acquire 3D images and compared it to the reconstructed 3D volume acquired using a linear stage (ground truth). We were able to reliably detect 500 µm step sizes with 90.46% accuracy. Various users evaluated the potential of handheld scanning, and the volume calculated from the motion-compensated image was not significantly different from the ground truth. Overall, our results, for the first time, established the use of an off-the-shelf and low-cost visual odometry system for freehand 3D USPA imaging that can be seamlessly integrated into several photoacoustic imaging systems for various clinical applications.

A comparison of point-tracking algorithms in ultrasound videos from the upper limb

Tracking points in ultrasound (US) videos can be especially useful to characterize tissues in motion. Tracking algorithms that analyze successive video frames, such as variations of Optical Flow and Lucas-Kanade (LK), exploit frame-to-frame temporal information to track regions of interest. In contrast, convolutional neural-network (CNN) models process each video frame independently of neighboring frames. In this paper, we show that frame-to-frame trackers accumulate error over time. We propose three interpolation-like methods to combat error accumulation and show that all three methods reduce tracking errors in frame-to-frame trackers. On the neural-network end, we show that a CNN-based tracker, DeepLabCut (DLC), outperforms all four frame-to-frame trackers when tracking tissues in motion. DLC is more accurate than the frame-to-frame trackers and less sensitive to variations in types of tissue movement. The only caveat found with DLC comes from its non-temporal tracking strategy, leading to jitter between consecutive frames. Overall, when tracking points in videos of moving tissue, we recommend using DLC when prioritizing accuracy and robustness across movements in videos, and using LK with the proposed error-correction methods for small movements when tracking jitter is unacceptable.

Respiratory Inductance Plethysmography to Assess Fatigability during Repetitive Work

Cumulative fatigue during repetitive work is associated with occupational risk and productivity reduction. Usually, subjective measures or muscle activity are used for a cumulative evaluation; however, Industry 4.0 wearables allow overcoming the challenges observed in those methods. Thus, the aim of this study is to analyze alterations in respiratory inductance plethysmography (RIP) to measure the asynchrony between thorax and abdomen walls during repetitive work and its relationship with local fatigue. A total of 22 healthy participants (age: 27.0 ± 8.3 yrs; height: 1.72 ± 0.09 m; mass: 63.4 ± 12.9 kg) were recruited to perform a task that includes grabbing, moving, and placing a box in an upper and lower shelf. This task was repeated for 10 min in three trials with a fatigue protocol between them. Significant main effects were found from Baseline trial to the Fatigue trials (p < 0.001) for both RIP correlation and phase synchrony. Similar results were found for the activation amplitude of agonist muscle (p < 0.001), and to the muscle acting mainly as a joint stabilizer (p < 0.001). The latter showed a significant effect in predicting both RIP correlation and phase synchronization. Both RIP correlation and phase synchronization can be used for an overall fatigue assessment during repetitive work.

COVID-19 and Mycobacterium Tuberculosis Coinfection: A Case Report

COVID-19 is a global pandemic, with attendant high morbidity and mortality. There is no previous documentation of its coinfection with Mycobacterium tuberculosis; the single most common cause of death from an infectious disease. Management and survival from this "cruel duel" in a low resource country will be daunting. We report the case of a middle-aged man who survived and the lessons learned from a COVID-19 treatment centre in the north-central of Nigeria. The patient presented with symptoms and clinical features of COVID-19 and Mycobacterium tuberculosis was confirmed with laboratory investigation. The patient commenced anti-tuberculous medications, received nutritional support and other supportive treatment for COVID-19 infection. He was discharged home to continue follow up at the medical outpatient and the DOTS clinic. Early recognition and prompt treatment are critical for a favourable clinical outcome.

Characterization of laser ultrasound source signals in biological tissues for imaging applications

Short optical pulses emitted from a tunable Q-switched laser (800 to 2000 nm) generate laser ultrasound (LUS) signals at the surface of biological tissue. The LUS signal's acoustic frequency content, dependence on sample type, and optical wavelength are observed in the far field. The experiments yield a reference dataset for the design of noncontact LUS imaging systems. Measurements show that the majority of LUS signal energy in biological tissues is within the 0.5 and 3 MHz frequency bands and the total acoustic energy generated increases with the optical absorption coefficient of water, which governs tissue optical absorption in the infrared range. The experimental results also link tissue surface roughness and acoustic attenuation with limited LUS signal bandwidth in biological tissue. Images constructed using 810-, 1064-, 1550-, and 2000-nm generation laser wavelengths and a contact piezoelectric receiver demonstrates the impact of the generation laser wavelength on image quality. A noncontact LUS-based medical imaging system has the potential to be an effective medical imaging device. Such a system may mitigate interoperator variability associated with current medical ultrasound imaging techniques and expand the scope of imaging applications for ultrasound.

Ultrasound Shear Wave Elastography: Variations of Liver Fibrosis Assessment as a Function of Depth, Force and Distance from Central Axis of the Transducer with a Comparison of Different Systems

We evaluated variation in fibrosis staging caused by depth, pre-load force and measurement off-axis distance on different ultrasound shear wave elastography (SWE) systems prospectively in 20 patients with diffuse liver disease. Shear wave speed (SWS) was measured with transient elastography, acoustic radiation force impulse (ARFI) and 2-D shear wave elastography (SWE). ARFI and 2-D-SWE measurements were obtained at different depths (3, 5 and 7 cm), with different pre-load forces (4, 7 and 10N and variable) and at 0, 2 and 4cm off the central axis of the transducer. A single, blinded pathologist staged fibrosis using the METAVIR system (F0-F4). Area under the receiver operating characteristic curve was charted to differentiate significant fibrosis (F ≥ 2). Depth was the only factor found to influence ARFI-derived values; no acquisition factors were found to affect 2-D-SWE SWS values. ARFI and 2-D-SWE for diagnosis of significant fibrosis at a depth of 7cm along the central axis had good diagnostic performance (areas under the receiver operating characteristic curve: 0.92 and 0.82, respectively), comparable to that of transient elastography. Further investigation of this finding will likely be of interest.

Controlled angular and radial scanning for super resolution concentric circular imaging

Poor motion estimation and subsequent registration are detrimental to super-resolution (SR). In this paper, we present a camera sampling method for achieving SR in concentric circular trajectory sampling (CCTS). Using this method, we can precisely control regular radial and angular shifts in CCTS. SR techniques can be subsequently applied ring by ring in radial and angular dimensions. Not only does the proposed camera sampling method eliminate the transient behavior and increases the sampling speed in CCTS, it also preserves the SR accuracy. Our experimental results demonstrate that our approach can accurately discriminate SR pixels from blurry images.

Quantification of Very Low Concentrations of Leukocyte Suspensions In Vitro by High-Frequency Ultrasound

Accurate measurement of very low cerebrospinal fluid (CSF) white blood cell (WBC) concentration is key to the diagnosis of bacterial meningitis, lethal if not promptly treated. Here we show that high frequency ultrasound (HFUS) can detect CSF WBC in vitro in concentrations relevant to meningitis diagnosis with a much finer precision than gold standard manual counting in a Fuchs-Rosenthal chamber. WBC concentrations in a mock CSF model, in the range 0-50 WBC/μL, have been tested and compared to gold standard ground truth. In this range, excellent agreement (Cohen's kappa [κ] = 0.78-90) (Cohen 1960) was observed between HFUS and the gold standard method. The presented experimental set-up allowed us to detect WBC concentrations as low as 2 cells/μL. HFUS shows promise as a low-cost, reliable and automated technology to measure very low CSF WBC concentrations for the diagnosis of early meningitis.

A single element 3D ultrasound tomography system

Over the past decade, substantial effort has been directed toward developing ultrasonic systems for medical imaging. With advances in computational power, previously theorized scanning methods such as ultrasound tomography can now be realized. In this paper, we present the design, error analysis, and initial backprojection images from a single element 3D ultrasound tomography system. The system enables volumetric pulse-echo or transmission imaging of distal limbs. The motivating clinical applications include: improving prosthetic fittings, monitoring bone density, and characterizing muscle health. The system is designed as a flexible mechanical platform for iterative development of algorithms targeting imaging of soft tissue and bone. The mechanical system independently controls movement of two single element ultrasound transducers in a cylindrical water tank. Each transducer can independently circle about the center of the tank as well as move vertically in depth. High resolution positioning feedback (~1μm) and control enables flexible positioning of the transmitter and the receiver around the cylindrical tank; exchangeable transducers enable algorithm testing with varying transducer frequencies and beam geometries. High speed data acquisition (DAQ) through a dedicated National Instrument PXI setup streams digitized data directly to the host PC. System positioning error has been quantified and is within limits for the imaging requirements of the motivating applications.

Concentric circle scanning system for large-area and high-precision imaging

Large-area manufacturing surfaces containing micro- and nano-scale features and large-view biomedical targets motivate the development of large-area, high-resolution and high-speed imaging systems. Compared to constant linear velocity scans and raster scans, constant angular velocity scans can significantly attenuate transient behavior while increasing the speed of imaging. In this paper, we theoretically analyze and evaluate the speed, acceleration and jerks of concentric circular trajectory sampling (CCTS). We then present a CCTS imaging system that demonstrates less vibration and lower mapping errors than raster scanning for creating a Cartesian composite image, while maintaining comparably fast scanning speed for large scanning area.

Handheld Force Controlled Ultrasound Probe

An actuated handheld force-feedback controlled ultrasound probe has been developed. The controller maintains a prescribed contact force between the probe and a patient’s body. The device will enhance the diagnostic capability of free-hand elastography, swept-force compound imaging and make it easier for a technician to acquire repeatable (i.e., directly comparable) images over time. The mechanical system consists of an ultrasound probe, a ball-screw-driven linear actuator, and a force/torque sensor. The feedback controller commands the motor to rotate the ball screw to translate the ultrasound probe in order to maintain a desired contact force. In preliminary user studies, it was found that the control system maintained a constant contact force with 1.7 times less variation than human subjects provided with a visual force display. Users without a visual force display were only able to maintain a constant force with 20 times worse variation than the automatic controller. The system was also used to determine the viscoelastic properties of soft tissues.

Complex regulation of human c-kit transcription by promoter repressors, activators, and specific myb elements

The c-kit proto-oncogene is expressed in several tissues during development. To understand the mechanisms controlling the expression of this gene, we characterized the human c-kit promoter. Expression is controlled transcriptionally. The 5'-flanking DNA was used to make promoter deletion-reporter constructs that were tested in cells that were either positive or negative for endogenous c-Kit. The results demonstrate that DNA, to at least position -4100, directs transcription well in both positive and negative cells. Addition of DNA from position -4100 to -5500 causes a reduction in expression to near-basal levels in c-Kit-negative cells but has little effect in c-Kit-positive cells. The DNA from -4100 to -5500 was tested for repressor function. It inhibits transcription from some heterologous promoters in c-Kit-negative cells. Likewise, this segment inhibits transcription from the homologous proximal promoter in a cell-specific manner, but the entire promoter is necessary for complete repression in c-Kit-negative cells. Two Myb binding motifs were also identified, and their role in regulating transcription was examined by mutation and functional testing. One, MYB1, acts as a partial repressor, whereas the other, MYB2, is a positive element that appears essential for expression. Binding proteins to both sites were characterized by several methods. MYB1 binds and responds functionally to c-Myb, but MYB2 does not. The results of these studies indicate that the regulation of c-kit transcription is complex, involving interactions among several activators and repressors.

Overexpression of the proto-oncogene/translation factor 4E in breast-carcinoma cell lines

The expression of the proto-oncogene, translation factor elF-4E, was examined in breast-cell lines: 5 carcinomas and 2 normal. At the protein level, elF-4E was 10 times higher in the carcinoma lines than in normal cells, which is comparable to the level found in breast-cancer biopsies. The elevation appears to be due to increased transcription, since the elF-4E mRNA was correspondingly increased. These results demonstrate that cells isolated from naturally occurring breast carcinomas maintain an elevated expression of the factor. Turnover rates for elF-4E (mRNA and protein) were determined for normal and cancer cells. We found that elF-4e mRNA is relatively stable during an 8-hr incubation with Actinomycin D, but the half-life of the protein is fairly short (approximately 4.5 hr). This suggests that, in proliferating cells, elF-4E may be turning over rapidly, possibly to fine-tune the changes in translation rates which occur during the cell cycle.

Overexpression of the proto-oncogene/translation factor 4E in breast-carcinoma cell lines

The expression of the proto-oncogene, translation factor elF-4E, was examined in breast-cell lines: 5 carcinomas and 2 normal. At the protein level, elF-4E was 10 times higher in the carcinoma lines than in normal cells, which is comparable to the level found in breast-cancer biopsies. The elevation appears to be due to increased transcription, since the elF-4E mRNA was correspondingly increased. These results demonstrate that cells isolated from naturally occurring breast carcinomas maintain an elevated expression of the factor. Turnover rates for elF-4E (mRNA and protein) were determined for normal and cancer cells. We found that elF-4e mRNA is relatively stable during an 8-hr incubation with Actinomycin D, but the half-life of the protein is fairly short (approximately 4.5 hr). This suggests that, in proliferating cells, elF-4E may be turning over rapidly, possibly to fine-tune the changes in translation rates which occur during the cell cycle.

Estimation of adult HIV prevalence as of the end of 1994 in India

It is estimated that as of the end of 1994 approximately 1,750,000 adults were infected with HIV in India. This estimate is based upon a review of data provided by the National AIDS Control Organization. The methods to reach such estimate are succinctly reviewed and a series of scenarios presented.