Impact of temporal resolution on LV myocardial regional strain assessment with real-time 3D ultrasound.

Non-invasive quantification of regional left ventricular (LV) deformation is crucial for the identification of clinical and subclinical myocardial dysfunction in various conditions. Several software tools now exist to provide regional LV strain estimation for echocardiography images. In this paper, we experimentally investigated the impact of real-time three-dimensional (RT3D) ultrasound temporal resolution on the precision of an integrated speckle-tracking framework. We compared temporal displacement and strain profiles acquired at three different frame rates on five normal volunteers. Results showed that estimated displacement fields and regional strain measurements were more homogeneous and of larger amplitude at higher frame rates.

Simulation study of amplitude-modulated (AM) harmonic motion imaging (HMI) for stiffness contrast quantification with experimental validation.

The objective of this study is to show that Harmonic Motion Imaging (HMI) can be used as a reliable tumor-mapping technique based on the tumor's distinct stiffness at the early onset of disease. HMI is a radiation-force-based imaging method that generates a localized vibration deep inside the tissue to estimate the relative tissue stiffness based on the resulting displacement amplitude. In this paper, a finite-element model (FEM) study is presented, followed by an experimental validation in tissue-mimicking polyacrylamide gels and excised human breast tumors ex vivo. This study compares the resulting tissue motion in simulations and experiments at four different gel stiffnesses and three distinct spherical inclusion diameters. The elastic moduli of the gels were separately measured using mechanical testing. Identical transducer parameters were used in both the FEM and experimental studies, i.e., a 4.5-MHz single-element focused ultrasound (FUS) and a 7.5-MHz diagnostic (pulse-echo) transducer. In the simulation, an acoustic pressure field was used as the input stimulus to generate a localized vibration inside the target. Radiofrequency (rf) signals were then simulated using a 2D convolution model. A one-dimensional cross-correlation technique was performed on the simulated and experimental rf signals to estimate the axial displacement resulting from the harmonic radiation force. In order to measure the reliability of the displacement profiles in estimating the tissue stiffness distribution, the contrast-transfer efficiency (CTE) was calculated. For tumor mapping ex vivo, a harmonic radiation force was applied using a 2D raster-scan technique. The 2D HMI images of the breast tumor ex vivo could detect a malignant tumor (20 x 10 mm2) surrounded by glandular and fat tissues. The FEM and experimental results from both gels and breast tumors ex vivo demonstrated that HMI was capable of detecting and mapping the tumor or stiff inclusion with various diameters or stiffnesses. HMI may thus constitute a promising technique in tumor detection (>3 mm in diameter) and mapping based on its distinct stiffness.

Design and evaluation of a hybrid passive and active gravity neutral orthosis (GNO).

Neuromuscular diseases (NMD), including Spinal Muscular Atrophy (SMA) and Duchenne Muscular Dystrophy (DMD), result in progressive muscular weakness that often leaves patients functionally dependent on caregivers for many activities of daily living (ADL) such as eating, bathing, grooming (touching the face and head), reaching (grabbing for objects), and dressing. In severe cases, patients are unable to perform even the simplest of activities from exploring their 3D space to touching their own face. The ability to move and initiate age appropriate tasks, such as playing and exploration, are considered to be of vital importance to both their physical and cognitive development. Therefore, to improve quality of life and reduce dependence on caregivers in children and young adults with NMD, we designed, built and evaluated an assistive, active orthosis to support arm function. The goal of this project is the development and evaluation of a mechanical arm orthosis to both encourage and assist functional arm movement while providing the user a sense of independence and control over one's own body.

An integrated motion capture system for evaluation of neuromuscular disease patients.

There currently exist a variety of methods for evaluating movement in patients suffering from neuromuscular diseases (NMD). These tests are primarily performed in the clinical setting and evaluated by highly trained individuals, rather than evaluating patient in their natural environments (i.e., home or school). Currently available automated motion capture modalities offer a highly accurate means of assessing general motion, but are also limited to a highly controlled setting. Recent advances in MEMS technology have introduced the possibility of robust motion capture in uncontrolled environments, while minimizing user interference with self-initiated motion, especially in weaker subjects. The goal of this study is to design and evaluate a MEMS-sensor-based system for motion capture in the NMD patient population. The highly interdisciplinary effort has led to significant progress toward the implementation of a new device, which is accurate, clinically relevant, and highly affordable.

A novel noninvasive technique for pulse-wave imaging and characterization of clinically-significant vascular mechanical properties in vivo.

The pulse-wave velocity (PWV) has been used as an indicator of vascular stiffness, which can be an early predictor of cardiovascular mortality. A noninvasive, easily applicable method for detecting the regional pulse wave (PW) may contribute as a future modality for risk assessment. The purpose of this study was to demonstrate the feasibility and reproducibility of PW imaging (PWI) during propagation along the abdominal aortic wall by acquiring electrocardiography-gated (ECG-gated) radiofrequency (rf) signals noninvasively. An abdominal aortic aneurysm (AAA) was induced using a CaCl2 model in order to investigate the utility of this novel method for detecting disease. The abdominal aortas of twelve normal and five CaCl2 mice were scanned at 30 MHz and electrocardiography (ECG) was acquired simultaneously. The radial wall velocities were mapped with 8000 frames/s. Propagation of the PW was demonstrated in a color-coded ciné-loop format all cases. In the normal mice, the wave propagated in linear fashion from a proximal to a distal region. However, in CaCl2 mice, multiple waves were initiated from several regions (i.e., most likely initiated from various calcified regions within the aortic wall). The regional PWV in normal aortas was 2.70 +/- 0.54 m/s (r2 = 0.85 +/- 0.06, n = 12), which was in agreement with previous reports using conventional techniques. Although there was no statistical difference in the regional PWV between the normal and CaCl2-treated aortas (2.95 +/- 0.90 m/s (r2 = 0.51 +/- 0.22, n = 5)), the correlation coefficient was found to be significantly lower in the CaCl2-treated aortas (p < 0.01). This state-of-the-art technique allows noninvasive mapping of vascular disease in vivo. In future clinical applications, it may contribute to the detection of early stages of cardiovascular disease, which may decrease mortality among high-risk patients.