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Carotid plaque segmentation in ultrasound longitudinal B-mode images using deep learning is presented in this work. We report on 101 severely stenotic carotid plaque patients. A standard U-Net is compared with a dilated U-Net architecture in which the dilated convolution layers were used in the bottleneck. Both a fully automatic and a semi-automatic approach with a bounding box was implemented. The performance degradation in plaque segmentation due to errors in the bounding box is quantified. We found that the bounding box significantly improved the performance of the networks with U-Net Dice coefficients of 0.48 for automatic and 0.83 for semi-automatic segmentation of plaque. Similar results were also obtained for the dilated U-Net with Dice coefficients of 0.55 for automatic and 0.84 for semi-automatic when compared to manual segmentations of the same plaque by an experienced sonographer. A 5% error in the bounding box in both dimensions reduced the Dice coefficient to 0.79 and 0.80 for U-Net and dilated U-Net respectively.

Quantitative ultrasound has been used to assess carotid plaque tissue composition. Here, we compute the attenuation coefficient (AC) in vivo with the optimum power spectral shift estimator (OPSSE) and reference phantom method (RPM), extract AC parameters and form parametric maps. Differences between OPSSE and RPM AC parameters are computed. Relationships between AC parameters, surgical scores and histopathology assessments are examined. Kendall's τ correlations between OPSSE AC and surgical scores are significant, including those between cholesterol and Standard Deviation (adjusted p = 0.038); thrombus and Minimum (adjusted p = 0.002), Maximum (adjusted p = 0.021) and Standard Deviation (adjusted p = 0.001); ulceration and Average (adjusted p = 0.033), Median (unadjusted p = 0.013), Maximum (unadjusted p = 0.039) and Mode (adjusted p = 0.009). The strongest correlations with histopathology are percentage cholesterol and Median OPSSE (unadjusted p = 0.007); percentage hemorrhage and Minimum OPSSE (adjusted p < 0.001); hemosiderin score and Median OPSSE (adjusted p = 0.010); and percentage calcium and Percentage Non-physical RPM Pixels (unadjusted p = 0.014). Kruskal-Wallis H and Dunn's post hoc tests have the ability to distinguish between groups (p < 0.05). Results suggest AC parameters may assist in vivo evaluation of carotid plaque vulnerability., Competing Interests: Conflict of interest disclosure C.N.S., S.S., S.M.W. and R.J.D. declare no conflicts of interest. T.D.C. has received honoraria from Actelion, AbbVie, Bayer, La Jolla and Merck. C.C.M. is the author of textbooks published by Davies Publishing Inc. and of chapters of textbooks published by Elsevier and Wolters–Kluwer, and has contracted research grants from W. L. Gore & Associates to the University of Wisconsin—Madison (not associated with this work). T.V. has a research agreement with Siemens Medical Solutions for use of the ultrasound research interface for radiofrequency data collection., (Copyright © 2020 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Objective: Ultrasound Lagrangian carotid strain imaging (LCSI) utilizes physiological deformation caused by arterial pressure variations to generate strain tensor maps of the vessel walls and plaques. LCSI has been criticized for the lack of normalization of magnitude-based strain indices to physiological stimuli, namely blood pressure. We evaluated the impact of normalization of magnitude-based strain indices to blood pressure measured immediately after the acquisition of radiofrequency (RF) data loops for LCSI., Materials and Methods: A complete clinical ultrasound examination along with RF data loops for LCSI was performed on 50 patients (30 males and 20 females) who presented with >60% carotid stenosis and were scheduled for carotid endarterectomy. Cognition was assessed using the 60-minute neuropsychological test protocol., Results: For axial strains correlation of maximum accumulated strain indices (MASI), cognition scores were -0.46 for non-normalized and -0.45, -0.49, -0.37, and -0.48 for systolic, diastolic, pulse pressure, and mean arterial pressure normalized data, respectively. The corresponding area under the curve (AUC) values for classifiers designed using maximum likelihood estimation of a binormal distribution with a median-split of the executive function cognition scores were 0.73, 0.70, 0.71, 0.70, and 0.71, respectively., Conclusions: No significant differences in the AUC estimates were obtained between normalized and non-normalized magnitude-based strain indices., (© 2019 Wiley Periodicals, Inc.)

Objectives: The purpose of this study was to determine the reliability of grayscale median (GSM) measurements across different ultrasound (US) systems and effects of gain on GSM values., Methods: Two vessels in a grayscale vascular phantom were imaged with 7 US systems at 3 gain settings. Two human participants were imaged at 3 gain settings. Each image was normalized, standardized, and segmented by expert and novice readers using grayscale analysis software. The concordance correlation coefficient (CCC) assessed agreement of GSM values for each system across gain settings and vessels and between readers. The intraclass correlation coefficient (ICC) assessed system-level reader concordance across gain settings and vessels. A general linear mixed model for repeated measures was used to assess within- and between-system mean GSM values., Results: Grayscale median measurements performed on images from the same US system yielded excellent (CCC) (95% confidence intervals): 0.85 (0.75, 0.92) to 0.96 (0.92, 0.98). ICC per system were 0.94 to 0.98 for the expert reader and 0.85 to 0.95 for the novice reader. Gain adjustments above and below an optimal setting contributed to significantly different intrasystem GSM values on 4 of 7 systems in the near zone and 5 of 7 systems in the far zone (P < .05). Intersystem GSM values differed on 5 of 7 systems (P < .05). Images from the human participants showed differences in GSM values at optimum gain values ± 10 dB/%., Conclusions: Grayscale median measurements are highly reproducible when obtained from the same US system with similar gain settings. Grayscale median values differ significantly across gain values and between systems. Researchers should consider the impact of US system and gain settings on GSM values when working to minimize system- and operator-dependent factors., (© 2018 by the American Institute of Ultrasound in Medicine.)

Photoacoustic imaging (PAI) is an evolving real-time imaging modality that combines the higher contrast of optical imaging with the higher spatial resolution of ultrasound imaging. We utilized dual-wavelength PAI for the diagnosis and monitoring of myocardial ischemia by assessing variations in blood oxygen saturation estimated in a murine model. The use of high-frequency ultrasound in conjunction with PAI enabled imaging of anatomic and functional changes associated with ischemia. Myocardial ischemia was established in eight mice by ligating the left anterior descending artery (LAD). Longitudinal results reveal that PAI is sensitive to acute myocardial ischemia, with a rapid decline in blood oxygen saturation (p ˂ 0.001) observed after LAD ligation (30 min: 33.05 ± 6.80%, 80 min: 36.59 ± 5.22%, 120 min: 36.70 ± 9.46%, 24 h: 40.55 ± 13.04%) compared with baseline (87.83 ± 5.73%). Variation in blood oxygen saturation was found to be linearly correlated with ejection fraction (%), fractional shortening (%) and stroke volume (µL), with Pearson's correlation coefficient values of 0.66, 0.67 and 0.77, respectively (p ˂ 0.001). Our results indicate that PAI has the potential for real-time diagnosis and monitoring of acute myocardial ischemia., (Copyright © 2018 World Federation for Ultrasound in Medicine and Biology. Published by Elsevier Inc. All rights reserved.)

OBJECTIVE This article describes the use of ultrasound measurements of physical strain within carotid atherosclerotic plaques as a measure of instability and the potential for vascular cognitive decline, microemboli, and white matter changes. METHODS Asymptomatic patients with significant (> 60%) carotid artery stenosis were studied for dynamic measures of plaque instability, presence of microemboli, white matter changes, and vascular cognitive decline in comparison with normative controls and premorbid state. RESULTS Although classically asymptomatic, these patients showed vascular cognitive decline. The degree of strain instability measured within the atherosclerotic plaque directly predicted vascular cognitive decline in these patients thought previously to be asymptomatic according to classic criteria. Furthermore, 26% of patients showed microemboli, and patients had twice as much white matter hyperintensity as controls. CONCLUSIONS These data show that physical measures of plaque instability are possible through interpretation of ultrasound strain data during pulsation, which may be more clinically relevant than solely measuring degree of stenosis. The data also highlight the importance of understanding that the definition of symptoms should not be limited to motor, speech, and vision function but underscore the role of vascular cognitive decline in the pathophysiology of carotid atherosclerotic disease. Clinical trial registration no.: NCT02476396 (clinicaltrials.gov).

Thermal ablation of soft tissue changes the tissue microstructure and, consequently, induces changes in its acoustic properties. Although B-mode ultrasound provides high-resolution and high-frame-rate images of ablative therapeutic procedures, it is not particularly effective at delineating boundaries of ablated regions because of poor contrast in echogenicity between ablated and surrounding normal tissue. Quantitative ultrasound techniques can provide quantitative estimates of acoustic properties, such as backscatter and attenuation coefficients, and differentiate ablated and unablated regions more effectively, with the potential for monitoring minimally invasive thermal therapies. In this study, a previously introduced attenuation estimation method was used to create quantitative attenuation coefficient maps for 11 microwave ablation procedures performed on refrigerated ex vivo bovine liver. The attenuation images correlate well with the pathologic images of the ablated region. The mean attenuation coefficient for regions of interest drawn inside and outside the ablated zones were 0.9 (±0.2) and 0.45 (±0.15) dB/cm/MHz, respectively. These estimates agree with reported values in the literature and establish the usefulness of non-invasive attenuation imaging for monitoring therapeutic procedures in the liver., (Copyright © 2017 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Ultrasonic attenuation is one of the primary parameters of interest in Quantitative Ultrasound (QUS). Non-invasive monitoring of tissue attenuation can provide valuable diagnostic and prognostic information to the physician. The Reference Phantom Method (RPM) was introduced as a way of mitigating some of the system-related effects and biases to facilitate clinical QUS applications. In this paper, under the assumption of diffuse scattering, a probabilistic model of the backscattered signal spectrum is used to derive a theoretical lower bound on the estimation variance of the attenuation coefficient using the Spectral-Difference RPM. The theoretical lower bound is compared to simulated and experimental attenuation estimation statistics in tissue-mimicking (TM) phantoms. Estimation standard deviation (STD) of the sample attenuation in a region of interest (ROI) of the TM phantom is measured for various combinations of processing parameters, including Radio-Frequency (RF) data block length (i.e., window length) from 3 to 17 mm, RF data block width from 10 to 100 A-lines, and number of RF data blocks per attenuation estimation ROI from 3 to 10. In addition to the Spectral-Difference RPM, local attenuation estimation for simulated and experimental data sets was also performed using a modified implementation of the Spectral Fit Method (SFM). Estimation statistics of the SFM are compared to theoretical variance predictions from the literature. 1 Measured STD curves are observed to lie above the theoretical lower bound curves, thus experimentally verifying the validity of the derived bounds. This theoretical framework benefits tissue characterization efforts by isolating processing parameter ranges that could provide required precision levels in estimation of the ultrasonic attenuation coefficient using Spectral Difference methods.

Inflammation and angiogenesis play major roles in carotid plaque vulnerability. The purpose of this study was to determine whether gray-scale features of carotid plaques are associated with histologic markers for inflammation. Thirty-eight individuals completed a dedicated research carotid ultrasound exam before carotid endarterectomy. Gray-scale analysis was performed on plaque images to measure plaque echogenicity (gray-scale median [GSM] pixel brightness), plaque area, presence of discrete white areas (DWAs) and the percent of black area near the lumen on any one component of the plaque. Plaques with higher ultrasound GSM had greater percent calcification (p = 0.013) on histopathology. Presence of an ultrasound DWA was associated with more plaque hemosiderin (p = 0.0005) and inflammation (p = 0.019) on histopathology examination. The percent of plaque black area in any one component was associated with a higher score for macroscopic ulceration (p = 0.028). Ultrasound plaque characteristics (GSM, DWAs and black areas) represent histopathologic markers associated with plaque vulnerability. ClinicalTrials.gov identifier: NCT02476396., (Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

We reconstruct the elastic modulus distribution for one tissue mimicking (TM) phantom and two in vivo biopsy-confirmed liver tumors using curvilinear ultrasound echo data. Spatial distribution of the relative elastic modulus values is determined by solving an inverse problem within a region of interest (ROI). This inverse problem solution requires knowledge of the ultrasonically measured displacement field in a uniform rectilinear grid to ensure that the resolution on the resultant relative elastic modulus elastogram will be uniform over the entire ROI. Taking advantage of a new speckle tracking algorithm, two different displacement tracking strategies are investigated: 1) sector-shaped ultrasound data were converted to ultrasound data on a rectilinear grid prior to speckle tracking and 2) axial and lateral displacements directly obtained from sector-shaped data were converted to vertical and horizontal displacements on a rectilinear grid after speckle tracking. Compared with strain elastography (SE), TM phantom results show that relative elastic modulus imaging (REMI) using Strategy 2 provided higher contrast-to-noise ratios (>300% and 25% increases compared with SE and REMI using Strategy 1, respectively). Furthermore, in phantoms, REMI using Strategy 2 more accurately (a 1.3% difference to shear wave elastography measurements) estimated the elastic contrast ratio between the target and the background, compared with both SE (20%-25%) and REMI using Strategy 1 (4.1%). It was also observed that relative modulus elastograms were more consistent with anatomical structures visualized on corresponding B-mode images for the two in vivo liver cases. Overall, we conclude that applying REMI is feasible for abdominal organs such as the liver. Strategy 2 offered improved and consistent results for the data investigated.

Estimation of frequency-dependent ultrasonic attenuation is an important aspect of tissue characterization. Along with other acoustic parameters studied in quantitative ultrasound, the attenuation coefficient can be used to differentiate normal and pathological tissue. The spectral centroid downshift (CDS) method is one the most common frequencydomain approaches applied to this problem. In this study, a statistical analysis of this method's performance was carried out based on a parametric model of the signal power spectrum in the presence of electronic noise. The parametric model used for the power spectrum of received RF data assumes a Gaussian spectral profile for the transmit pulse, and incorporates effects of attenuation, windowing, and electronic noise. Spectral moments were calculated and used to estimate second-order centroid statistics. A theoretical expression for the variance of a maximum likelihood estimator of attenuation coefficient was derived in terms of the centroid statistics and other model parameters, such as transmit pulse center frequency and bandwidth, RF data window length, SNR, and number of regression points. Theoretically predicted estimation variances were compared with experimentally estimated variances on RF data sets from both computer-simulated and physical tissue-mimicking phantoms. Scan parameter ranges for this study were electronic SNR from 10 to 70 dB, transmit pulse standard deviation from 0.5 to 4.1 MHz, transmit pulse center frequency from 2 to 8 MHz, and data window length from 3 to 17 mm. Acceptable agreement was observed between theoretical predictions and experimentally estimated values with differences smaller than 0.05 dB/cm/MHz across the parameter ranges investigated. This model helps predict the best attenuation estimation variance achievable with the CDS method, in terms of said scan parameters.

Attenuation estimation and imaging have the potential to be a valuable tool for tissue characterization, particularly for indicating the extent of thermal ablation therapy in the liver. Often the performance of attenuation estimation algorithms is characterized with numerical simulations or tissue-mimicking phantoms containing a high scatterer number density (SND). This ensures an ultrasound signal with a Rayleigh distributed envelope and a signal-to-noise ratio (SNR) approaching 1.91. However, biological tissue often fails to exhibit Rayleigh scattering statistics. For example, across 1647 regions of interest in five ex vivo bovine livers, we obtained an envelope SNR of 1.10 ± 0.12 when the tissue was imaged with the VFX 9L4 linear array transducer at a center frequency of 6.0 MHz on a Siemens S2000 scanner. In this article, we examine attenuation estimation in numerical phantoms, tissue-mimicking phantoms with variable SNDs and ex vivo bovine liver before and after thermal coagulation. We find that reference phantom-based attenuation estimation is robust to small deviations from Rayleigh statistics. However, in tissue with low SNDs, large deviations in envelope SNR from 1.91 lead to subsequently large increases in attenuation estimation variance. At the same time, low SND is not found to be a significant source of bias in the attenuation estimate. For example, we find that the standard deviation of attenuation slope estimates increases from 0.07 to 0.25 dB/cm-MHz as the envelope SNR decreases from 1.78 to 1.01 when estimating attenuation slope in tissue-mimicking phantoms with a large estimation kernel size (16 mm axially × 15 mm laterally). Meanwhile, the bias in the attenuation slope estimates is found to be negligible (<0.01 dB/cm-MHz). We also compare results obtained with reference phantom-based attenuation estimates in ex vivo bovine liver and thermally coagulated bovine liver., (Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Purpose: Attenuation imaging has a promising role in the detection of tissue abnormalities. The authors have previously compared three different frequency domain ultrasound attenuation estimation methods, for accuracy and bias. The mean estimated attenuation value in a region of interest has been the determining factor of how well a method performs; however, the noise level has not been quantified for attenuation estimated using different methods., Methods: The authors compare three different frequency domain ultrasound attenuation estimation methods [the reference phantom method (RPM), the centroid downshift method (CEN), and the hybrid method (HYB)] using the signal to noise ratio (SNR) metric. Both simulated and experimental tissue-mimicking phantoms are used in the performance comparison study, evaluating the impact of the variation in acoustical properties., Results: For attenuation estimation in a tissue-mimicking phantom with a known attenuation coefficient of 0.5 dB/cm/MHz, all the three methods estimated the attenuation coefficient to be ≈ 0.49 dB/cm/MHz for a transmit center frequency of 6 MHz, however, the signal to noise ratio obtained was found to be 8.5, 5.7, and 2.2 for the HYB, RPM, and CEN methods, respectively. These results demonstrate the need for the SNR metric in the comparison of different algorithms and to evaluate the impact of varying different ultrasound system and tissue parameters., Conclusions: In this paper, the authors demonstrate that although the estimated mean attenuation value with a region of interest may be closely estimated using different methods, the signal to noise ratio obtained of the estimates can vary significantly. The centroid downshift method presented with the lowest signal-to-noise ratio of the methods compared. The hybrid method was the least susceptible to changes in the acoustical properties and provided unbiased attenuation coefficient estimates with the highest signal-to-noise ratios.

Absolute backscatter coefficients in tissue-mimicking phantoms were experimentally determined in the 5-50 MHz frequency range using a broadband technique. A focused broadband transducer from a commercial research system, the VisualSonics Vevo 770, was used with two tissue-mimicking phantoms. The phantoms differed regarding the thin layers covering their surfaces to prevent desiccation and regarding glass bead concentrations and diameter distributions. Ultrasound scanning of these phantoms was performed through the thin layer. To avoid signal saturation, the power spectra obtained from the backscattered radio frequency signals were calibrated by using the signal from a liquid planar reflector, a water-brominated hydrocarbon interface with acoustic impedance close to that of water. Experimental values of absolute backscatter coefficients were compared with those predicted by the Faran scattering model over the frequency range 5-50 MHz. The mean percent difference and standard deviation was 54% ± 45% for the phantom with a mean glass bead diameter of 5.40 μm and was 47% ± 28% for the phantom with 5.16 μm mean diameter beads.

Minimally invasive therapies such as radiofrequency ablation have been developed to treat cancers of the liver, prostate and kidney without invasive surgery. Prior work has demonstrated that ultrasound echo shifts due to temperature changes can be utilized to track the temperature distribution in real time. In this paper, a motion compensation algorithm is evaluated to reduce the impact of cardiac and respiratory motion on ultrasound-based temperature tracking methods. The algorithm dynamically selects the next suitable frame given a start frame (selected during the exhale or expiration phase where extraneous motion is reduced), enabling optimization of the computational time in addition to reducing displacement noise artifacts incurred with the estimation of smaller frame-to-frame displacements at the full frame rate. A region of interest that does not undergo ablation is selected in the first frame and the algorithm searches through subsequent frames to find a similarly located region of interest in subsequent frames, with a high value of the mean normalized cross-correlation coefficient value. In conjunction with dynamic frame selection, two different two-dimensional displacement estimation algorithms namely a block matching and multilevel cross-correlation are compared. The multi-level cross-correlation method incorporates tracking of the lateral tissue expansion in addition to the axial deformation to improve the estimation performance. Our results demonstrate the ability of the proposed motion compensation using dynamic frame selection in conjunction with the two-dimensional multilevel cross-correlation to track the temperature distribution.

In the current practice of ultrasound elastography, only the axial component of the displacement vector is estimated and used to produce strain images. A method was recently proposed by our group to estimate both the axial and lateral components of a displacement vector using RF echo signal data acquired along multiple angular insonification directions of the ultrasound beam. Previous work has demonstrated that it is important to choose appropriate values for the maximum beam angle and angular increment to achieve optimal performance with this technique. In this paper, we present error propagation analysis using the least-square fitting process for the optimization of the angular increment and the maximum beam steered angle. Ultrasound simulations are performed to corroborate the theoretical prediction of the optimal values for the maximum beam angle and angular increment. Selection of the optimal parameters depends on system parameters, such as center frequency and aperture size. For typical system parameters, the optimal maximum beam angle is around 10 degrees for axial strain estimation and around 15 degrees for lateral strain estimation. The optimal angular increment is around 4 degrees-6 degrees, which indicates that only five to seven beam angles are required for this strain-tensor estimation technique.

Attenuation estimation methods for medical ultrasound are important because attenuation properties of soft tissue can be used to distinguish between benign and malignant tumors and to detect diffuse disease. The classical spectral shift method and the spectral difference method are the most commonly used methods for the estimation of the attenuation; however, they both have specific limitations. Classical spectral shift approaches for estimating ultrasonic attenuation are more sensitive to local spectral noise artifacts and have difficulty in compensating for diffraction effects because of beam focusing. Spectral difference approaches, on the other hand, fail to accurately estimate attenuation coefficient values at tissue boundaries that also possess variations in the backscatter. In this paper, we propose a hybrid attenuation estimation method that combines the advantages of the spectral difference and spectral shift methods to overcome their specific limitations. The proposed hybrid method initially uses the spectral difference approach to reduce the impact of system-dependent parameters including diffraction effects. The normalized power spectrum that includes variations because of backscatter changes is then filtered using a Gaussian filter centered at the transmit center frequency of the system. A spectral shift method, namely the spectral cross-correlation algorithm is then used to compute spectral shifts from these filtered power spectra to estimate the attenuation coefficient. Ultrasound simulation results demonstrate that the estimation accuracy of the hybrid method is better than the centroid downshift method (spectral shift method), in uniformly attenuating regions. In addition, this method is also stable at boundaries with variations in the backscatter when compared with the reference phantom method (spectral difference method). Experimental results using tissue-mimicking phantom also illustrate that the hybrid method is more robust and provides accurate attenuation estimates in both uniformly attenuating regions and across boundaries with backscatter variations. The proposed hybrid method preserves the advantages of both the spectral shift and spectral difference approaches while eliminating the disadvantages associated with each of these methods, thereby improving the accuracy and robustness of the attenuation estimation.

Two-dimensional (2D) transducer arrays represent a promising solution for implementing real time three-dimensional (3D) ultrasound elastography. 2D arrays enable electronic steering and focusing of ultrasound beams throughout a 3D volume along with improved slice thickness performance when compared to one-dimensional (1D) transducer arrays. Therefore, signal decorrelation caused by tissue motion in the elevational (out-of-plane) direction needs to be considered. In this paper, a closed form expression is derived for the correlation coefficient between pre- and postdeformation ultrasonic radio frequency signals. Signal decorrelation due to 3D motion of scatterers within the ultrasonic beam has been considered. Computer simulations are performed to corroborate the theoretical results. Strain images of a spherical inclusion phantom generated using 1D and 2D array transducers are obtained using a frequency domain simulation model. Quantitative image quality parameters, such as the signal-to-noise and contrast-to-noise ratios obtained using 1D, 2D, and 3D motion tracking algorithms, are compared to evaluate the performance with the 3D strain imaging system. The effect of the aperture size for 2D arrays and other factors that affect signal decorrelation are also discussed.

Ultrasound imaging with two-dimensional (2D) arrays has garnered broad interest from scanner manufacturers and researchers for real time three-dimensional (3D) applications. Previously the authors described a frequency domain B-mode imaging model applicable for linear and phased array transducers. In this paper, the authors extend this model to incorporate 2D array transducers. Further approximations can be made based on the fact that the dimensions of the 2D array element are small. The model is compared with the widely used ultrasound simulation program FIELD II, which utilizes an approximate form of the time domain impulse response function. In a typical application, errors in simulated RF waveforms are less than 4% regardless of the steering angle for distances greater than 2 cm, yet computation times are on the order of 1/35 of those incurred using FIELD II. The 2D model takes into account the effects of frequency-dependent attenuation, backscattering, and dispersion. Modern beam-forming techniques such as apodization, dynamic aperture, dynamic receive focusing, and 3D beam steering can also be simulated.

Estimation of the local attenuation coefficient in soft tissue is important both for clinical diagnosis and for further analysis of ultrasound B-mode images. However, it is difficult to extract spectral properties in a small region of interest from noisy backscattered ultrasound radio frequency (RF) signals. Diffraction effects due to transducer beam focal properties also have to be corrected for accurate estimation of the attenuation coefficient. In this paper, we propose a new attenuation estimation method using spectral cross-correlation between consecutive power spectra obtained from the backscattered RF signals at different depths. Since the spectral cross-correlation method estimates the spectral shift by comparing the entire power spectra, it is more robust and stable to the spectral noise artifacts in the backscattered RF signals. A diffraction compensation technique using a reference phantom with a known attenuation coefficient value is also presented. Local attenuation coefficient estimates obtained using spectral cross-correlation are within 2.3% of the actual value with small estimation variances, as demonstrated in the simulation results.

Many studies have shown that atherosclerosis changes the ultrasonic attenuation properties of the vessel wall and plaque. Accurate estimation of the attenuation coefficient slope could therefore provide an early indication of atherosclerosis and the differentiation between low, mild and highly-attenuating plaque within the vessel. However, the traditional reference phantom method that fits the power spectrum in a region of interest fails to accurately estimate the attenuation coefficient for small irregular shaped ex-vivo plaque specimens. This discrepancy was primarily due to partial volume effects and the unknown backscatter coefficient of the plaque sample. We have developed a method based on the reference-phantom method that utilizes the difference in the acoustic power above and below the sample to accurately compute values of the attenuation coefficient ex vivo. Our results demonstrate that this approach overcomes the two drawbacks mentioned earlier and provides accurate estimates of the attenuation coefficient slope for small excised tissue samples.

Unlike researchers in magnetic resonance imaging who have considerable access to high level tools and to data at a very basic level on their scanners, those involved with ultrasound have found little in the way of meaningful and widespread access to even the most basic echo signals in their clinical systems. Interest has emerged, however, in ultrasound research interfaces on commercial scanners to provide access to raw ultrasound data and control of basic research functions. This paper describes initial experience gained on one such ultrasound system. The Ultrasonix 500RP system provides research access to the data at multiple points in the signal processing chain and allows control over most imaging parameters. The Ultrasonix system allows for three methods of research control. One is implemented along with the standard clinical imaging software using "mouseover" screens on the periphery of the application window. These screens are configured by the user to display various signal processing variables, which can be modified in real time. Second, the system can be controlled via a user-written remote control client application interacting through the clinical exam software. Lastly, the user can write a complete application which initializes the basic ultrasound module but need not use the Ultrasonix clinical exam software. All of the modes can be done locally on the scanner itself or via a network, and are based on software developed in C++ with libraries supplied with the scanner. Two examples are presented in this paper from the evaluation of the system in "real world" applications. Measurements of absolute backscatter coefficients and attenuation coefficients versus frequency are shown and elastograms utilizing spatial compounding are described.

Objective: This article describes a new research ultrasound scanner that can be programmed to produce elastograms and backscatter parametric images in real time. Its performance was evaluated in a clinical setting., Methods: Radio frequency data were acquired from 13 patients with thyroid nodules and from 4 normal thyroids, along with reference phantom data. Scatterer size was deduced by measuring the backscatter versus frequency and fitting data to a model. Strain was obtained by a cross-correlation method, comparing precompression and postcompression radio frequency signals. Scatterer size contrast was defined as the observed contrast between the "normal" and "abnormal" tissue in the same gland or, when considering diffuse conditions, by comparing with normal values. Strain contrast was estimated if abnormal and normal tissue was captured in the same palpation, that is, excluding diffuse disease, which was the case for 9 subjects., Results: On scatterer size images, 4 nodules exhibited positive contrast versus the adjacent normal parenchyma, indicating larger scatterers. Five nodules were isoechoic, and 4 had negative contrast. Four nodules exhibited positive strain contrast, indicating that they were softer than the normal parenchyma. Two nodules had the same brightness, and 3 were darker than the background thyroid tissue on strain images., Conclusions: Contrast was observed between nodules and thyroid parenchymal tissue for both types of parametric images. Further work is needed to determine whether the diagnostic importance of these parameters in characterizing thyroid nodules might be worthwhile. Both modes must be of a sufficient frame rate to provide real-time feedback to operators, which will require further work.

Signal decorrelation is a major source of error in the displacements estimated using correlation techniques for elastographic imaging. Previous papers have addressed the variation in the correlation coefficient as a function of the applied compression for a finite window size and an insonification angle of zero degrees. The recent use of angular beam-steered radio-frequency echo signals for spatial angular compounding and shear strain estimation have demonstrated the need for understanding signal decorrelation artifacts for data acquired at different beam angles. In this paper, we provide both numerical and closed form theoretical solutions of the correlation between pre- and post-compression radio-frequency echo signals acquired at a specified beam angle. The expression for the correlation coefficient obtained is a function of the beam angle and the applied compression for a finite duration window. Accuracy of the theoretical results is verified using tissue-mimicking phantom experiments on a uniformly elastic phantom using beam-steered data acquisitions on a linear array transducer. The theory predicts a faster decorrelation with changes in the beam or insonification angle for longer radio-frequency echo signal segments and at deeper locations in the medium. Theoretical results provide useful information for improving angular compounding and shear strain estimation techniques for elastography.

Delineation of radiofrequency-ablation-induced coagulation (thermal lesion) boundaries is an important clinical problem that is not well addressed by conventional imaging modalities. Elastography, which produces images of the local strain after small, externally applied compressions, can be used for visualization of thermal coagulations. This paper presents an automated segmentation approach for thermal coagulations on 3-D elastographic data to obtain both area and volume information rapidly. The approach consists of a coarse-to-fine method for active contour initialization and a gradient vector flow, active contour model for deformable contour optimization with the help of prior knowledge of the geometry of general thermal coagulations. The performance of the algorithm has been shown to be comparable to manual delineation of coagulations on elastograms by medical physicists (r = 0.99 for volumes of 36 radiofrequency-induced coagulations). Furthermore, the automatic algorithm applied to elastograms yielded results that agreed with manual delineation of coagulations on pathology images (r = 0.96 for the same 36 lesions). This algorithm has also been successfully applied on in vivo elastograms.

Spatial-angular compounding is a new technique that enables the reduction of noise artifacts in ultrasound elastography. Under this method, compounded elastograms are obtained from a spatially weighted average of local strain estimated from radio frequency (rf) echo signals acquired at different insonification angles. In previous work, the acquisition of the rf signals was performed through the lateral translation of a phased-array transducer. Clinical applications of angular compounding would, however, require the utilization of beam steering on linear-array transducers to obtain angular data sets, which is more efficient than translating phased-array transducers. In this article, we investigate the performance of angular compounding for elastography by using beam steering on a linear-array transducer. Quantitative experimental results demonstrate that spatial angular compounding provides significant improvement in both the elastographic signal-to-noise ratio and the contrast-to-noise ratio. For the linear array transducer used in this study, the optimum angular increment is around 1.5 degrees-3.75 degrees, and the maximum angle that can be used in angular compounding should not exceed 10 degrees.

Objective: To evaluate propagation velocity of acoustic waves through the lens and vitreous body of pigs, dogs, and rabbits and determine whether there were associations between acoustic wave speed and age, temperature, and time after enucleation., Sample Population: 9 pig, 40 dog, and 20 rabbit lenses and 16 pig, 17 dog, and 23 rabbit vitreous bodies., Procedure: Acoustic wave velocities through the ocular structures were measured by use of the substitution technique., Results: Mean sound wave velocities in lenses of pigs, dogs, and rabbits were 1,681, 1,707, and 1,731 m/s, respectively, at 36 degrees C. Mean sound wave velocities in the vitreous body of pigs, dogs, and rabbits were 1,535, 1,535, and 1,534 m/s, respectively, at 38 degrees C. The sound wave speed through the vitreous humor, but not the lens, increased linearly with temperature. An association between wave speed and age was observed in the rabbit tissues. Time after enucleation did not affect the velocity of sound in the lens or vitreous body. The sound wave speed conversion factors for lenses, calculated with respect to human ocular tissue at 36 degrees C, were 1.024, 1.040, and 1.055 for pig, dog, and rabbit lenses, respectively., Conclusions and Clinical Relevance: Conversion factors for the speed of sound through lens tissues are needed to avoid underestimation of the thickness of the lens and axial length of the eye in dogs during comparative A-mode ultrasound examinations. These findings are important for accurate calculation of intraocular lens power required to achieve emmetropia in veterinary patients after surgical lens extraction.

A set of five tissue-mimicking phantoms with cylindrical inclusions were produced for assessing long-term stability of geometry and elastic properties and assessing accuracy of determination of elastic properties. The base aqueous materials were either gelatin or a mixture of agar and gelatin. Stiffness was controlled by selection of the volume percent consisting of microscopic safflower oil droplets. Cylinder diameters remained unchanged within 1% or 2% over many months. Strain ratios from elastograms of the phantoms were stable over many months, implying that elastic contrasts were also stable. Test samples, called production samples, for measurement of Young's moduli were made at the time of manufacture of each phantom and were stored separately from one another. Each production sample was homogeneous and consisted of either inclusion material or background material. For all five phantoms, it was found that the elastic contrast computed using Young's modulus values determined using the production samples accurately represented the true elastic contrasts in the corresponding phantom. This finding was established by the fact that the (true) elastic contrasts determined using samples excised from the phantoms themselves agreed with the elastic contrasts obtained using the homogeneous production samples.

Spatial-angular compounding is a new technique that enables the reduction of noise artifacts in ultrasound elastography. Previous results using spatial angular compounding, however, were based on the use of the tissue incompressibility assumption. Compounded elastograms were obtained from a spatially-weighted average of local strain estimated from radiofrequency echo signals acquired at different insonification angles. In this paper, we present a new method for reducing the noise artifacts in the axial strain elastogram utilizing a least-squares approach on the angular displacement estimates that does not use the incompressibility assumption. This method produces axial strain elastograms with higher image quality, compared to noncompounded axial strain elastograms, and is referred to as the least-squares angular-compounding approach for elastography. To distinguish between these two angular compounding methods, the spatial-angular compounding with angular weighting based on the tissue incompressibility assumption is referred to as weighted compounding. In this paper, we compare the performance of the two angular-compounding techniques for elastography using beam steering on a linear-array transducer. Quantitative experimental results demonstrate that least-squares compounding provides comparable but smaller improvements in both the elastographic signal-to-noise ratio and the contrast-to-noise ratio, as compared to the weighted-compounding method. Ultrasound simulation results suggest that the least-squares compounding method performs better and provide accurate and robust results when compared to the weighted compounding method, in the case where the incompressibility assumption does not hold.

A theoretical analysis of the correlation between radio-frequency (RF) echo signal data acquired from the same location but at different angles is presented. The accuracy of the theoretical results is verified with computer simulations. Refinements to previous analyses of the correlation of RF signals originating from the same spatial location at different angular positions are made. We extend the analysis to study correlation of RF signals coming from different spatial locations and eventually correlation of RF signal segments that intersect at the same spatial location. The theory predicts a faster decorrelation with a change in the insonification angle for longer RF echo signal segments. As the RF signal segment becomes shorter, the decorrelation rate with angle is slower and approaches the limit corresponding to the correlation of RF signals originating from the same spatial location. Theoretical results provide a clear understanding of angular compounding techniques used to improve the signal-to-noise ratio in ultrasonic parametric imaging and in elastography.

Ultrasonic scatterer size estimates generally have large variances due to the inherent noise of spectral estimates used to calculate size. Compounding partially correlated size estimates associated with the same tissue, but produced with data acquired from different angles of incidence, is an effective way to reduce the variance without making dramatic sacrifices in spatial resolution. This work derives theoretical approximations for the correlation between these size estimates, and the coherence between their associated spectral estimates, as functions of ultrasonic system parameters. A Gaussian spatial autocorrelation function is assumed to adequately model scatterer shape. Both approximations compare favorably with simulation results, which consider validation near the focus. Utilization of the correlation/coherence expressions for statistical analysis and optimization is discussed. Approximations, such as the invariance of phase and amplitude terms with angle, are made to obtain closed-form solutions to the derived spectral coherence near the focus and permit analytical optimization analysis. Results indicate that recommended parameter adjustments for performance improvement generally depend upon whether, for the system under consideration, the primary source of change in total coherence with rotation is phase term variation due to the change in the relative position of scattering sites, or field amplitude term variation due to beam movement.

The feasibility of estimating and imaging scatterer size using backscattered ultrasound signals and spectral analysis techniques was demonstrated previously. In many cases, size estimation, although computationally intensive, has proven to be useful for monitoring, diagnosing, and studying disease. However, a difficulty that is encountered in imaging scatterer size is the large estimator variance caused by statistical fluctuations in echo signals from random media. This paper presents an approach for reducing these statistical uncertainties. Multiple scatterer size estimates are generated for each image pixel using data acquired from several different directions. These estimates are subsequently compounded to yield a single estimate that has a reduced variance. In this feasibility study, compounding was achieved by translating a sectored-array transducer in a direction parallel to the acquired image plane. Angular compounding improved the signal-to-noise ratio (SNR) in scatterer size images. The improvement is proportional to the square root of the effective number of statistically independent views available for each image pixel.

Techniques to image elasticity parameters (i.e., elastography) have recently become of great interest to researchers. In this paper we use conventional ultrasound elastography and x-ray CT to image radio frequency (RF) ablation sites of excised canine liver enclosed in gelatin. Thermal coagulations of different sizes were produced by applying the RF procedure for various times and end point temperatures. Dimensions, areas and volumes computed from CT and elastography were compared with those on whole mount pathology specimens. Ultrasound elastography exhibited high contrast for the thermal coagulations and performed better than CT. The correlation between pathology and elastography for this sample set of 40 thermal coagulations (r = 0.94 for volume estimation, r = 0.87 for area estimation) is better than the correlation between pathology and CT (r = 0.89 for volume estimation, r = 0.82 for area estimation).

A method that combines both spatial and frequency compounding is described for measuring attenuation in tissue. The technique applies a reference phantom to account for imaging system dependencies of echo signals. Emphasis is given to local attenuation estimates, to reduce the variance of the attenuation measurements over small regions of interest (ROI) and to enable coarse attenuation imaging. Experiments using a uniform phantom show that the standard deviation of local attenuation estimates within a ROI drops when greater degrees of compounding are applied. Attenuation images of a specially designed phantom containing inclusions with attenuation contrast illustrate the accuracy and precision of the technique.

A theoretical expression for the variance of scatterer size estimates is derived for a modified least squares size estimator used in conjunction with a reference phantom method for backscatter coefficient measurement. A Gaussian spatial autocorrelation function is assumed. Simulations and phantom experiments were performed to verify the results for backscatter and size variances. The dependence of size estimate errors upon free experimental parameters is explored. Implications of the findings for the optimization of scatterer size estimation are discussed. The utility of scatterer size parametric imaging is examined through the signal to noise ratio comparison with standard ultrasonic B-mode imaging.

Purpose: This paper discusses an application of particle filtering for estimating shear wave velocity in tissue using ultrasound elastography data. Shear wave velocity estimates are of significant clinical value as they help differentiate stiffer areas from softer areas which is an indicator of potential pathology. Methods: Radio-frequency ultrasound echo signals are used for tracking axial displacements and obtaining the time-to-peak displacement at different lateral locations. These time-to-peak data are usually very noisy and cannot be used directly for computing velocity. In this paper, the denoising problem is tackled using a hidden Markov model with the hidden states being the unknown (noiseless) time-to-peak values. A particle filter is then used for smoothing out the time-to-peak curve to obtain a fit that is optimal in a minimum mean squared error sense. Results: Simulation results from synthetic data and finite element modeling suggest that the particle filter provides lower mean squared reconstruction error with smaller variance as compared to standard filtering methods, while preserving sharp boundary detail. Results from phantom experiments show that the shear wave velocity estimates in the stiff regions of the phantoms were within 20% of those obtained from a commercial ultrasound scanner and agree with estimates obtained using a standard method using least-squares fit. Estimates of area obtained from the particle filtered shear wave velocity maps were within 10% of those obtained from B-mode ultrasound images. Conclusions: The particle filtering approach can be used for producing visually appealing SWV reconstructions by effectively delineating various areas of the phantom with good image quality properties comparable to existing techniques. [ABSTRACT FROM AUTHOR]

Purpose: Quantification of stiffness changes may provide important diagnostic information and aid in the early detection of cancers. Shear wave elastography is an imaging technique that assesses tissue stiffness using acoustic radiation force as an alternate to manual palpation reported previously with quasistatic elastography. In this study, the elastic properties of tissue mimicking materials, including agar, polyacrylamide (PAA), and silicone, are evaluated with an objective to determine material characteristics which resemble normal and cancerous prostate tissue. Methods: Acoustic properties and stiffness of tissue mimicking phantoms were measured using compressional mechanical testing and shear wave elastography using supersonic shear imaging. The latter is based on the principles of shear waves generated using acoustic radiation force. The evaluation included tissue mimicking materials (TMMs) within the prostate at different positions and sizes that could mimic cancerous and normal prostate tissue. Patient data on normal and prostate cancer tissues quantified using biopsy histopathology were used to validate the findings. Pathologist reports on histopathology were blinded to mechanical testing and elastographic findings. Results: Young's modulus values of 86.2 ± 4.5 and 271.5 ± 25.7 kPa were obtained for PAA mixed with 2% Al2O3 particles and silicone, respectively. Young's modulus of TMMs from mechanical compression testing showed a clear trend of increasing stiffness with an increasing percentage of agar. The silicone material had higher stiffness values when compared with PAA with Al2O3. The mean Young's modulus value in cancerous tissue was 90.5 ± 4.5 kPa as compared to 93.8 ± 4.4 and 86.2 ± 4.5 kPa obtained with PAA with 2% Al2O3 phantom at a depth of 52.4 and 36.6 mm, respectively. Conclusions: PAA mixed with Al2O3 provides the most suitable tissue mimicking material for prostate cancer tumor material, while agar could form the surrounding background to simulate normal prostate tissue. [ABSTRACT FROM AUTHOR]

Purpose: Previous publications have reported on the use of one-dimensional cross-correlation analysis with beam-steered echo signals. However, this approach fails to accurately track displacements at larger depths (>4.5 cm) due to lower signal-to-noise. In this paper, the authors present the use of adaptive parallelogram shaped two-dimensional processing blocks for deformation tracking. Methods: Beam-steered datasets were acquired using a VFX 9L4 linear array transducer operated at a 6 MHz center frequency for steered angles from -15 to 15° in increments of 1°, on both uniformly elastic and single-inclusion tissue-mimicking phantoms. Echo signals were acquired to a depth of 65 mm with the focus set at 40 mm corresponding to the center of phantom. Estimated angular displacements along and perpendicular to the beam direction are used to compute axial and lateral displacement vectors using a least-squares approach. Normal and shear strain tensor component are then estimated based on these displacement vectors. Results: Their results demonstrate that parallelogram shaped two-dimensional deformation tracking significantly improves spatial resolution (factor of 7.79 along the beam direction), signal-to-noise (5 dB improvement), and contrast-to-noise (8-14 dB improvement) associated with strain imaging using beam steering on linear array transducers. Conclusions: Parallelogram shaped two-dimensional deformation tracking is demonstrated in beam-steered radiofrequency data, enabling its use in the estimation of normal and shear strain components. [ABSTRACT FROM AUTHOR]