Four-dimensional fetal cardiac imaging in a cohort of fetuses with suspected congenital heart disease.

BACKGROUND: Fetal cardiac magnetic resonance imaging (MRI) requires high spatial and temporal resolution and robustness to random fetal motion to capture the dynamics of the beating fetal heart. Slice-to-volume reconstruction techniques can produce high-resolution isotropic images while compensating for random fetal motion. OBJECTIVE: The objective of this study was to evaluate image quality for slice-to-volume reconstruction of four-dimensional balanced steady-state free precession (bSSFP) imaging of the fetal heart. MATERIALS AND METHODS: A cohort of 13 women carrying fetuses with congenital heart disease were imaged with real-time bSSFP sequences. Real-time bSSFP sequences were post-processed using a slice-to-volume reconstruction algorithm to produce retrospectively gated 4-D sequences with isotropic spatial resolution. Two radiologists evaluated slice-to-volume reconstruction image quality on a scale from 0 to 4 using 11 categories based on a segmental approach to defining cardiac anatomy and pathology. A score of 0 corresponded to cardiac structures not visualized at all and four corresponded to high quality and distinct appearance of structures. RESULTS: In 11 out of 13 cases, the average radiologist score of image quality across all categories was 3.0 or greater. In the remaining two cases, slice-to-volume reconstruction was not possible due to insufficient image quality in the acquisition. CONCLUSION: Slice-to-volume reconstruction has the potential to produce isotropic images with high spatial and temporal resolution that can display the anatomy of the fetal heart in arbitrary imaging planes retrospectively. More rapid, motion-robust acquisitions may be necessary to successfully reconstruct the fetal heart in all patients.

Radial sequences and compressed sensing in pediatric body magnetic resonance imaging.

Magnetic resonance imaging (MRI) is often an ideal imaging modality for children of any age for any anatomy and for many pathologies. MRI sequences can be prescribed to produce high-resolution images of anatomical structures, characterize tissue composition, and detect physiological states and organ function. Shortening imaging sequences in any manner possible has been a topic of research and development in MRI since its emergence. Selection of imaging sequence parameters influences more than just the appearance and signal qualities of the imaged tissues; these details along with spatial encoding and data readout steps determine the time it takes to acquire an image. As each piece of image data is acquired and encoded with spatial and temporal information it is stored in k-space. As k-space is filled, either completely or partially, a diagnostic image or physiological data can be reconstructed. Shortening the length of time required for the readout step by efficiently filling k-space using compressed sensing and radial techniques is the subject of this manuscript.

Data Quality Assessment for Super-Resolution Fetal Brain MR Imaging: A Retrospective 1.5 T Study.

BACKGROUND: Super-resolution is a promising technique to create isotropic image volumes from stacks of two-dimensional (2D) motion-corrupted images in fetal magnetic resonance imaging (MRI). PURPOSE: To determine an acquisition quality metric and correlate that metric with radiologist perception of three-dimensional (3D) image quality. STUDY TYPE: Retrospective. SUBJECTS: Eighty-seven patients, mean gestational age 29 ± 6 weeks. FIELD STRENGTH/SEQUENCE: 1.5 T/2D fast spin-echo. ASSESSMENT: Four radiologists (L.G., D.M.E.B., P.C., and J.V.; 31, 21, 7, and 7 years' experience, respectively) graded reconstructions on a 0 to 4 scale for overall appearance and visibility of specific anatomy. During reconstruction, slices were labeled as inliers based on correlation between a simulated vs. actual acquisition. The fraction of brain voxels in inlier slicers vs. total brain voxels was measured for each acquisition. STATISTICAL TESTS: Paired sample t test, Pearson's correlation, intra-class correlation. RESULTS: The average brain mask inlier fraction for all acquisitions was 0.8. There was a statistically significant correlation (0.71) between overall reconstruction appearance and number of acquisitions with inlier fraction above 0.73. There was low correlation (0.21, P = 0.05) between the number of acquisitions used in the reconstruction and overall score when no data quality measure was considered. Similar results were found for ratings of specific anatomy. Statistically significant differences in overall perception of image quality were found when using three vs. four, four vs. five, and three vs. five high-quality acquisitions in the reconstruction. Five high-quality acquisitions were sufficient to yield an average radiologist rating of 3.59 out of 4.0 for overall image quality. DATA CONCLUSION: Reconstruction quality can be reliably predicted using the brain mask inlier fraction. Real-time super-resolution protocols could exploit this to terminate acquisition when enough high-quality acquisitions have been collected. To achieve consistent 3D image quality it may be necessary to acquire more than five scans to compensate for severely motion-corrupted acquisitions. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: 1.

Activated brown adipose tissue and its relationship to adiposity and metabolic markers: an exploratory study.

Objective: To explore relationships between PET/CT characteristics of cold-activated brown adipose tissue (BAT), measures of adiposity and metabolic markers.Methods: We conducted a post-hoc analysis of a study which utilized PET/CT to characterize BAT. 25 men ages 18-24 (BMI 19.4 to 35.9 kg/m2) were studied. Fasting blood samples were collected. Body composition was measured using DXA. An individualized cooling protocol was utilized to activate BAT prior to imaging with PET/CT.Results: There was an inverse relationship between fasting serum glucose and BAT volume (r = -0.40, p = 0.048). A marginally significant inverse relationship was also noted between fasting glucose and total BAT activity (r = -0.40, p = 0.05). In addition, a positive correlation was observed between serum FGF21 and SUVmax (r = 0.51, p = 0.01). No significant correlations were noted for measures of BAT activity or volume and other indicators of adiposity or glucose metabolism.Conclusions: The presence of active BAT may be associated with lower fasting glucose in young men. BAT activity may also be correlated with levels of FGF21, suggesting that BAT may lower glucose levels via an FGF21 dependent pathway. Further studies are needed to clarify mechanisms by which BAT may impact glucose metabolism.

Evaluation of low-contrast detectability for iterative reconstruction in pediatric abdominal computed tomography: a phantom study.

BACKGROUND: Iterative reconstruction is offered by all vendors to achieve similar or better CT image quality at lower doses than images reconstructed with filtered back-projection. OBJECTIVE: The purpose of this study was to investigate the dose-reduction potential for pediatric abdominal CT imaging when using either a commercially available hybrid or a commercially available model-based iterative reconstruction algorithm from a single manufacturer. MATERIALS AND METHODS: A phantom containing four low-contrast inserts and a uniform background with total attenuation equivalent to the abdomen of an average 8-year-old child was imaged on a CT scanner (IQon; Philips Healthcare, Cleveland, OH). We reconstructed images using both hybrid iterative reconstruction (iDose4) and model-based iterative reconstruction (Iterative Model Reconstruction). The four low-contrast inserts had circular cross-section with diameters of 3 mm, 5 mm, 7 mm and 10 mm and contrasts of 14 Hounsfield units (HU), 7 HU, 5 HU and 3 HU, respectively. Helical scans with identical kilovoltage (kV), pitch, rotation time, and collimation were repeated on the phantom at volume CT dose index (CTDIvol) of 2.0 milligrays (mGy), 3.0 mGy, 4.5 mGy and 6.0 mGy. We measured the contrast-to-noise ratio (CNR) in each rod across scans. Additionally, we collected sub-images containing each rod and sub-images containing the background and used them in two-alternative forced choice observer experiments with four observers (two radiologists and two physicists). We calculated the dose-reduction potential of both iterative reconstruction algorithms relative to a scan performed at 6 mGy and reconstructed with filtered back-projection. RESULTS: We calculated dose-reduction potential by either matching average equal observer performance in the two-alternative forced choice experiments or matching CNR. When matching CNR, the dose-reduction potential was 34% to 45% for hybrid iterative reconstruction and 89% to 95% for model-based iterative reconstruction. When matching average observer performance, the dose-reduction potential was 9% to 30% for hybrid iterative reconstruction and 57% to 74% for model-based iterative reconstruction. The range in dose-reduction potential depended on the rod size and contrast level. CONCLUSION: Observer performance in this phantom study indicates that the dose-reduction potential indicated by an observer study is less than that of CNR; extrapolating the results to clinical studies suggests that the dose-reduction potential would also be less.

MRI characterization of brown adipose tissue under thermal challenges in normal weight, overweight, and obese young men.

PURPOSE: To implement quantitative Dixon magnetic resonance imaging (MRI) methods for brown adipose tissue (BAT) characterization at inactive and cold-activated states in normal weight, overweight, and obese subjects. The hypotheses are that MRI characteristics of BAT would differentiate between nonobese and obese subjects, and activation of BAT in response to thermal challenges that are detected by MRI would be correlated with BAT activity measured by positron emission tomography / computed tomography (PET/CT). MATERIALS AND METHODS: Fifteen male subjects (20.7 ± 1.5 years old) including six normal weight, five overweight, and four obese subjects participated in the study. A multiecho Dixon MRI sequence was performed on a 1.5T scanner. MRI was acquired under thermoneutral, nonshivering thermogenesis, and subsequent warm-up conditions. Fat fraction (FF), R2*, and the number of double bonds (ndb) were measured by solving an optimization problem that fits in- and out-of-phase MR signal intensities to the fat-water interference models. Imaging acquisition and postprocessing were performed by two MRI physicists. In each subject, Dixon MRI measurements of FF, R2*, and ndb were calculated for each voxel within all BAT regions of interest (ROIs) under each thermal condition. Mean FF, R2*, and ndb were compared between nonobese (ie, normal-weight/overweight) and obese subjects using the two-sample t-test. Receiver operating characteristic (ROC) analyses were performed to differentiate nonobese vs. obese subjects. BAT MRI measurement changes in response to thermal condition changes were compared with hypermetabolic BAT volume/activity measured by PET/CT using the Pearson's correlation. In addition, BAT MRI measurements were compared with body adiposity using the Pearson's correlation. P < 0.05 was considered statistically significant. RESULTS: Obese subjects showed higher FF and lower R2* than nonobese subjects under all three thermal conditions (P < 0.01). ROC analyses demonstrated that FF and R2* were excellent predictors for the differentiation of nonobese from obese subjects (100% specificity and 100% sensitivity). FF changes under thermal challenges were correlated with hypermetabolic BAT volume (r = -0.55, P = 0.04 during activation, and r = 0.72, P = 0.003 during deactivation), and with BAT activity (r = 0.69, P = 0.006 during deactivation), as measured by PET/CT. FF and R2* under all three thermal conditions were highly correlated with body adiposity (P ≤ 0.002). CONCLUSION: MRI characteristics of BAT differentiated between nonobese and obese subjects in both inactivated and activated states. BAT activation detected by Dixon MRI in response to thermal challenges were correlated with glucose uptake of metabolically active BAT. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:936-947.

Post-Procedure Evaluation of Microwave Ablations of Hepatocellular Carcinomas Using Electrode Displacement Elastography.

Microwave ablation has been used clinically as an alternative to surgical resection. However, lack of real-time imaging to assess treated regions may compromise treatment outcomes. We previously introduced electrode displacement elastography (EDE) for strain imaging and verified its feasibility in vivo on porcine animal models. In this study, we evaluated EDE on 44 patients diagnosed with hepatocellular carcinoma, treated using microwave ablation. The ablated region was identified on EDE images for 40 of the 44 patients. Ablation areas averaged 13.38 ± 4.99 cm2 on EDE, compared with 7.61 ± 3.21 cm2 on B-mode imaging. Contrast and contrast-to-noise ratios obtained with EDE were 232% and 98%, respectively, significantly higher than values measured on B-mode images (p < 0.001). This study indicates that EDE is feasible in patients and provides improved visualization of the ablation zone compared with B-mode ultrasound.

Improvement in CT image resolution due to the use of focal spot deflection and increased sampling.

When patient anatomy is positioned away from a CT scanner's isocenter, scans of limited diagnostic value may result. Yet in some cases, positioning of patient anatomy far from isocenter is unavoidable. This study examines the effect of posi-tion and reconstruction algorithm on image resolution achieved by a CT scanner operating in a high resolution (HR) scan mode which incorporates focal spot deflection and acquires an increased number of projections per rotation. Images of a metal bead contained in a phantom were acquired on a GE CT750 HD scanner with multiple reconstruction algorithms, in the normal and HR scan mode, and at two positions, scanner isocenter and 15 cm directly above isocenter. The images of the metal bead yielded two-dimensional point spread functions which were averaged along two perpendicular directions to yield line spread functions. Fourier transforms of the line spread functions yielded radial and azimuthal modulation transfer functions (MTFs). At isocenter, the radial and azimuthal MTFs were aver-aged. MTF improvement depended on image position and modulation direction. The results from a single algorithm, Edge, can be generalized to other algorithms. At isocenter, the 10% MTF cutoff was 14.4 cycles/cm in normal and HR mode. At 15 cm above isocenter, the 10% cutoff was 6.0 and 8.5 cycles/cm for the azimuthal and radial MTFs in normal mode. In HR mode, the azimuthal and radial MTF 10% cutoff was 8.3 and 10.3 cycles/cm. Our results indicate that the best image resolu-tion is achieved at scanner isocenter and that the azimuthal resolution degrades more significantly than the radial resolution. For the GE CT750 HD CT scanner, the resolution is significantly enhanced by the HR scan mode away from scanner isocenter, and the use of the HR scan mode has much more of an impact on image resolution away from isocenter than the choice of algorithm.

Technical Note: Confirming the prescribed angle of CT localizer radiographs and c-arm projection acquisitions.

PURPOSE: Accurate CT radiograph angle is not usually important in diagnostic CT. However, there are applications in radiation oncology and interventional radiology in which the orientation of the x-ray source and detector with respect to the patient is clinically important. The authors present a method for measuring the accuracy of the tube/detector assembly with respect to the prescribed tube/detector position for CT localizer, fluoroscopic, and general radiograph imaging using diagnostic, mobile, and c-arm based CT systems. METHODS: A mathematical expression relating the x-ray projection of two metal BBs is related to gantry angle. Measurement of the BBs at a prescribed gantry (i.e., c-arm) angle can be obtained and using this relation the prescribed versus actual gantry angle compared. No special service mode or proprietary information is required, only access to projection images is required. Projection images are available in CT via CT localizer radiographs and in the interventional setting via fluorography. RESULTS: The technique was demonstrated on two systems, a mobile CT scanner and a diagnostic CT scanner. The results confirmed a known issue with the mobile scanner and accurately described the CT localizer angle of the diagnostic system tested. CONCLUSIONS: This method can be used to quantify gantry angle, which is important when projection images are used for procedure guidance, such as in brachytherapy and interventional radiology applications.

A Wiki Based CT Protocol Management System.

At the University of Wisconsin Madison Department of Radiology, CT protocol management requires maintenance of thousands of parameters for each scanner. Managing CT protocols is further complicated by the unique configurability of each scanner. Due to recent Joint Commission requirements, now all CT protocol changes must be documented and reviewed by a site's CT protocol optimization team. The difficulty of managing the CT protocols was not in assembling the protocols, but in managing and implementing changes. This is why a wiki based solution for protocol management was implemented. A wiki inherently keeps track of all changes, logging who made the changes and when, allowing for editing and viewing permissions to be controlled, as well as allowing protocol changes to be instantly relayed to all scanner locations.

CT protocol management: simplifying the process by using a master protocol concept.

This article explains a method for creating CT protocols for a wide range of patient body sizes and clinical indications, using detailed tube current information from a small set of commonly used protocols. Analytical expressions were created relating CT technical acquisition parameters which can be used to create new CT protocols on a given scanner or customize protocols from one scanner to another. Plots of mA as a function of patient size for specific anatomical regions were generated and used to identify the tube output needs for patients as a function of size for a single master protocol. Tube output data were obtained from the DICOM header of clinical images from our PACS and patient size was measured from CT localizer radiographs under IRB approval. This master protocol was then used to create 11 additional master protocols. The 12 master protocols were further combined to create 39 single and multiphase clinical protocols. Radiologist acceptance rate of exams scanned using the clinical protocols was monitored for 12,857 patients to analyze the effectiveness of the presented protocol management methods using a two-tailed Fisher's exact test. A single routine adult abdominal protocol was used as the master protocol to create 11 additional master abdominal protocols of varying dose and beam energy. Situations in which the maximum tube current would have been exceeded are presented, and the trade-offs between increasing the effective tube output via 1) decreasing pitch, 2) increasing the scan time, or 3) increasing the kV are discussed. Out of 12 master protocols customized across three different scanners, only one had a statistically significant acceptance rate that differed from the scanner it was customized from. The difference, however, was only 1% and was judged to be negligible. All other master protocols differed in acceptance rate insignificantly between scanners. The methodology described in this paper allows a small set of master protocols to be adapted among different clinical indications on a single scanner and among different CT scanners.

Scatterer number density considerations in reference phantom-based attenuation estimation.

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.

Mean scatterer spacing estimation in normal and thermally coagulated ex vivo bovine liver.

The liver has been hypothesized to have a unique arrangement of microvasculature that presents as an arrangement of quasiperiodic scatterers to an interrogating ultrasound pulse. The mean scatterer spacing (MSS) of these quasiperiodic scatterers has been proposed as a useful quantitative ultrasound biomarker for characterizing liver tissue. Thermal ablation is an increasingly popular method for treating hepatic tumors, and ultrasonic imaging approaches for delineating the extent of thermal ablation are in high demand. In this work, we examine the distribution of estimated MSS in thermally coagulated bovine liver and normal untreated bovine liver ex vivo. We estimate MSS by detecting local maxima in the spectral coherence function of radio frequency echoes from a clinical transducer, the Siemens VFX 9L4 transducer operating on an S2000 scanner. We find that normal untreated bovine liver was characterized by an MSS of approximately 1.3 mm. We examined regions of interest 12 mm wide laterally, and ranging from 12 mm to 18 mm axially, in 2 mm increments. Over these parameters, the mode of the MSS estimates was between 1.25 and 1.37 mm. On the other hand, estimation of MSS in thermally coagulated liver tissue yields a distribution of MSS estimates whose mode varied between 0.45 and 1.0 mm when examining regions of interest over the same sizes. We demonstrate that the estimated MSS in thermally coagulated liver favors small spacings because the randomly positioned scatterers in this tissue are better modeled as aperiodic scatterers. The submillimeter spacings result from the fact that this was the most probable spacing to be estimated if the discretely sampled spectral coherence function was a uniformly random two-dimensional function.

Alterations in Ultrasound Scattering Following Thermal Ablation in ex vivo Bovine Liver.

Thermal ablation is a minimally invasive cancer treatment which has been rapidly gaining clinical acceptance. It is well known that thermal ablation increases the acoustic attenuation and shear modulus of tissue. In this work, we examine changes to the spatial distribution of scatterers in liver tissue following thermal ablation. Acoustic scatterers within liver tissue have frequently been modeled as pseudo-periodic. The positions of pseudo-periodic scatterers have been Gamma distributed along the beam dimension, and these scatterers are characterized by their mean scatterer spacing (MSS). Prior work have demonstrated significant changes in MSS due to diffuse liver disease, such as steatosis progressing to cirrhosis. However, relatively few results have been reported regarding changes in MSS following thermal ablation. In this study, we estimated MSS in ex vivo bovine liver by detecting local maxima in spectral coherence functions calculated using Thomson's multi-taper method. We examined a large number of uncorrelated regions of interest recorded from five normal bovine livers (~300 images from each animal). We also examined a large number of ROI's from five bovine livers following thermal coagulation. All bovine livers were obtained from a commercial meat production facility immediately following animal sacrifice and imaged within 12 hours. Thermal coagulation was induced by heating liver in saline water baths at 80° C for 45 minutes. For normal, unheated liver an MSS of approximately 1.5 mm was estimated. Following thermal ablation, an MSS of approximately 0.5 mm in thermally coagulated tissue was obtained. Frequently, studies estimating MSS in liver tissue provide an MSS estimate regardless of the state of tissue. Authors rarely present what their MSS estimation algorithm would produce if it were applied to tissue which is better modeled as a collection of uniformly, randomly distributed scatterers lacking periodicity. In this study, we found that thermal coagulation results in a loss of periodicity. The MSS of 0.5 mm corresponds to the value that a spectral coherence-based MSS algorithm would produce if presented with a signal that was generated from uniform, randomly distributed scatterers.

Coherence of Ultrasound Radiofrequency Echoes from the Liver Estimated Using Multi-Taper Calculation.

Acoustic scattering from the microvasculature in the liver is frequently modeled by a quasi-periodic distribution of point scatterers. The received echoes from such an arrangement of scatterers has random but correlated phase at frequency components corresponding to the average spacing of the quasi-periodic scatterers. The extent of the correlation between different frequency components is measured by calculating signal coherence. To date in ultrasound, estimators for coherence have used windowed short-time FFTs of radiofrequency data where the windows selected have been chosen ad hoc. Using receiver operating characteristic analysis (ROC), we show that Slepian sequences provide an estimator which more reliably distinguishes between liver and ablated tissue in an ex vivo setting than estimators using the Hann, Hamming, or Blackman-Harris window. For a gate length of 7 mm or 21 wavelengths we achieve an area under the ROC curve of 0.93 with Slepian sequences for coherence calculations.

Mean scatterer spacing estimation using multi-taper coherence.

It has been hypothesized that estimates of mean scatterer spacing are useful indicators for pathological changes to the liver. A commonly employed estimator of the mean scatterer spacing is the location of the maximum of the collapsed average of coherence of the ultrasound radio-frequency signal. To date, in ultrasound, estimators for this quantity have been calculated with a single taper. Using frequency-domain Monte Carlo simulations, we demonstrate that multi-taper estimates of coherence are superior to single-taper estimates for predicting mean scatterer spacing. Scattering distributions were modeled with Gamma-distributed scatterers for fractional standard deviations in scatterer spacings of 5, 10, and 15% at a mean scatterer spacing of 1 mm. Additionally, we demonstrate that we can distinguish between ablated liver tissue and unablated liver tissue based on signal coherence. We find that, on the average, signal coherence is elevated in the liver relative to signal coherence of received echoes from thermally ablated tissue. Additionally, our analysis indicates that a tissue classifier utilizing the multi-taper estimate of coherence has the potential to distinguish between ablated and unablated tissue types better than a single-taper estimate of coherence. For a gate length of 5 mm, we achieved an error rate of only 8.7% when sorting 23 ablated and 23 unablated regions of interest (ROIs) into classes based on multi-taper calculations of coherence.

Bayesian regularization applied to ultrasound strain imaging.

Noise artifacts due to signal decorrelation and reverberation are a considerable problem in ultrasound strain imaging. For block-matching methods, information from neighboring matching blocks has been utilized to regularize the estimated displacements. We apply a recursive Bayesian regularization algorithm developed by Hayton et al. [Artif. Intell., vol. 114, pp. 125-156, 1999] to phase-sensitive ultrasound RF signals to improve displacement estimation. The parameter of regularization is reformulated, and its meaning examined in the context of strain imaging. Tissue-mimicking experimental phantoms and RF data incorporating finite-element models for the tissue deformation and frequency-domain ultrasound simulations are used to compute the optimal parameter with respect to nominal strain and algorithmic iterations. The optimal strain regularization parameter was found to be twice the nominal strain and did not vary significantly with algorithmic iterations. The technique demonstrates superior performance over median filtering in noise reduction at strains 5% and higher for all quantitative experiments performed. For example, the strain SNR was 11 dB higher than that obtained using a median filter at 7% strain. It has to be noted that for applied deformations lower than 1%, since signal decorrelation errors are minimal, using this approach may degrade the displacement image.

Ultrasound attenuation measurements using a reference phantom with sound speed mismatch.

Ultrasonic attenuation may be measured accurately with clinical systems and array transducers by using reference phantom methods (RPM) to account for diffraction and other system dependencies on echo signals. Assumptions with the RPM are that the speeds of sound in the sample (c(sam)) and in the reference medium (c(ref)) are the same and that they match the speed assumed in the system beamformer (c(bf)). This work assesses the accuracy of attenuation measurements by the RPM when these assumptions are not met. Attenuation was measured for two homogeneous phantoms, one with a speed of sound of 1500 m/s and the other with a sound speed of 1580 m/s. Both have an attenuation coefficient approximately equal to that of the reference, in which the speed of sound is 1540 m/s. Echo signals from the samples and the reference were acquired from a Siemens S2000 scanner with a 9L4 linear array transducer. Separate acquisitions were obtained with c(bf) at its default value of 1540 m/s and when it was set at values matching the speeds of sound of the phantoms. Simulations were also performed using conditions matching those of the experiment. RPM-measured attenuation coefficients exhibited spatially-dependent biases when c(sam) differed from c(df) and c(ref). Mean errors of 19% were seen for simulated data, with the maximum errors in attenuation measurements occurring for regions of interest near the transmit focus. Biases were minimized (mean error with simulated data was 5.6%) using c(bf) that matched c(sam) and assuring that power spectra used for attenuation computations in the sample are from precisely the same depth as those from the reference. Setting the transmit focus well beyond the depth range used to compute attenuation values minimized the bias.