Synthetic Aperture Ultrasound Imaging

This paper, the first from a series of three papers on the application of coded excitation signals in medical ultrasound, discusses the basic principles and ultrasound-related problems of pulse compression. The concepts of signal modulation and matched filtering are given, and a simple model of attenuation relates the matched filter response with the ambiguity function, known from radar. Based on this analysis and the properties of the ambiguity function, the selection of coded waveforms suitable for ultrasound imaging is discussed. It is shown that linear frequency modulation (FM) signals have the best and most robust features for ultrasound imaging. Other coded signals such as nonlinear FM and binary complementary Golay codes also have been considered and characterized in terms of signal-to-noise ratio (SNR) and sensitivity to frequency shifts. Using the simulation program Field II, it is found that in the case of linear FM signals, a SNR improvement of 12 to 18 dB can be expected for large imaging depths in attenuating media, without any depth-dependent filter compensation. In contrast, nonlinear FM modulation and binary codes are shown to give a SNR improvement of only 4 to 9 dB when processed with a matched filter. Other issues, such as depth-dependent matched filtering and use of filters other than the matched filter (inverse and Wiener filters) also are addressed.

Use of modulated excitation signals in medical ultrasound. Part I: basic concepts and expected benefits

Resolution and penetration are primary criteria for clinical image quality. Conventionally, high bandwidth for resolution was achieved with a short pulse, which results in a tradeoff between resolution and penetration. Coded excitation extends the bounds of this tradeoff by increasing signal-to-noise ratio (SNR) through appropriate coding on transmit and decoding on receive. Although used for about 50 years in radar, coded excitation was successfully introduced into commercial ultrasound scanners only within the last 5 years. This delay is at least partly due to practical implementation issues particular to diagnostic ultrasound, which are the focus of this paper. After reviewing the basics of biphase and chirp coding, we present simulation results to quantify tradeoffs between penetration and resolution under frequency-dependent attenuation, dynamic focusing, and nonlinear propagation. Next, we compare chirp and Golay code performance with respect to image quality and system requirements, then we show clinical images that illustrate the current applications of coded excitation in B-mode, harmonic, and flow imaging.

Coded excitation for diagnostic ultrasound: a system developer's perspective

For pt.I, see ibid., vol.52, no.2, p.177-91 (2005). In the first paper, the superiority of linear FM signals was shown in terms of signal-to-noise ratio and robustness to tissue attenuation. This second paper in the series of three papers on the application of coded excitation signals in medical ultrasound presents design methods of linear FM signals and mismatched filters, in order to meet the higher demands on resolution in ultrasound imaging. It is shown that for the small time-bandwidth (TB) products available in ultrasound, the rectangular spectrum approximation is not valid, which reduces the effectiveness of weighting. Additionally, the distant range sidelobes are associated with the ripples of the spectrum amplitude and, thus, cannot be removed by weighting. Ripple reduction is achieved through amplitude or phase predistortion of the transmitted signals. Mismatched filters are designed to efficiently use the available bandwidth and at the same time to be insensitive to the transducer's impulse response. With these techniques, temporal sidelobes are kept below 60 to 100 dB, image contrast is improved by reducing the energy within the sidelobe region, and axial resolution is preserved. The method is evaluated first for resolution performance and axial sidelobes through simulations with the program Field II. A coded excitation ultrasound imaging system based on a commercial scanner and a 4 MHz probe driven by coded sequences is presented and used for the clinical evaluation of the coded excitation/compression scheme. The clinical images show a significant improvement in penetration depth and contrast, while they preserve both axial and lateral resolution. At the maximum acquisition depth of 15 cm, there is an improvement of more than 10 dB in the signal-to-noise ratio of the images. The paper also presents acquired images, using complementary Golay codes, that show the deleterious effects of attenuation on binary codes when processed with a matched filter, also confirmed by the presented simulated images.

Use of modulated excitation signals in medical ultrasound. Part II: design and performance for medical imaging applications

Sentinel lymph node (SLN) excision is included in various cancer guidelines to identify microscopic metastatic disease. Although effective, SLN excision is an invasive procedure requiring radioactive tracing. Novel imaging approaches assessing SLN metastatic status could improve or replace conventional lymph node excision protocols. In our first-in-human study, we used noninvasive multispectral optoacoustic tomography (MSOT) to image SLNs ex vivo and in vivo in patients with melanoma, to determine metastatic status. MSOT significantly improved the tumor metastasis detection rate in excised SLN (506 SLNs from 214 melanoma patients) compared with the conventional EORTC (European Organisation for Research and Treatment of Cancer) Melanoma Group protocol (22.9% versus 14.2%). MSOT combined with the near-infrared fluorophore indocyanine green reliably visualized SLNs in vivo in 20 patients, up to 5-cm penetration and with 100% concordance with (99m)Tc-marked SLN lymphoscintigraphy. MSOT identified cancer-free SLNs in vivo and ex vivo without a single false negative (189 total lymph nodes), with 100% sensitivity and 48 to 62% specificity. Our findings indicate that a noninvasive, nonradioactive MSOT-based approach can identify and determine SLN status and confidently rule out the presence of metastasis. The study further demonstrates that optoacoustic imaging strategies can improve the identification of SLN metastasis as an alternative to current invasive SLN excision protocols.

Metastatic status of sentinel lymph nodes in melanoma determined noninvasively with multispectral optoacoustic imaging.

Potential of coded excitation in medical ultrasound imaging.

Despite the enormous development in medical ultrasound (US) imaging over the last decades, penetration depth with satisfying image quality is often a problem in clinical practice. Coded excitation, used for years in radar techniques to increase signal-to-noise ratio (SNR), has recently been introduced in medical US scanning. In the present study, coded excitation using frequency-modulated US signals is implemented and evaluated in vivo.A total of nine male volunteers were scanned in three different abdominal locations, using both conventional pulsed and coded excitation. A modified scanner (B-K Medical model 3535) with transmitter and receiver boards developed in our group and a mechanical 4 MHz transducer were used. The system acquired coded and conventional US image frames interleaved, yielding identical acquisitions with the two techniques. Cine-loop sequences were evaluated by three experienced sonographers estimating penetration depth and scoring image quality of both conventional and coded imaging. The results showed a significant (p < 0.001) increase in penetration depth around 2 cm. Image quality was significantly (p < 0.001) better using codes at full usable depth and slightly, but also significantly (p < 0.05), better above depths, where the effect of coded excitation was noticeable to the sonographers. We conclude that the higher SNR offered by coded excitation gives improved image quality and provides increased penetration in medical US imaging. This increased SNR can, alternatively, be used to allow imaging at higher frequencies and thereby increase spatial resolution without any loss of penetration.

Clinical evaluation of chirp-coded excitation in medical ultrasound

Use of long encoded waveforms can be advantageous in ultrasound imaging, as long as the pulse compression mechanism ensures low range sidelobes and preserves both axial resolution and contrast. A coded excitation/compression scheme was previously presented by our group, which is based on a predistorted FM excitation and a mismatched compression filter designed for medical ultrasonic applications. The attenuation effect, analyzed in this paper using the ambiguity function and simulations, dictated the choice of the coded waveform. In this study clinical images, images of wire phantoms, and digital video demonstrate the applicability, clinical relevance, and improvement attained with the proposed scheme. A commercial scanner (B-K Medical 3535) was modified and interfaced to a software configurable transmitter board and to a sampling system with a 2 GB memory storage. The experimental system was programmed to allow alternating excitation on every second frame. That offers the possibility of direct comparison of the same set of image pairs; one with pulsed and one with encoded excitation. Abdominal clinical images from healthy volunteers were acquired and statistically analyzed by means of the auto-covariance matrix of the image data. The resolution laterally is retained, axially is improved, while there is a clear increase in penetration. Phantom images using the proposed FM-based scheme as well as complementary Golay codes were also acquired, in order to quantitatively evaluate the characteristics of the compressed output and its stability to attenuation. Images of a wire phantom in water show that the range sidelobes resulting from pulse compression are below the acoustic noise, which was at 50 dB for the pulsed images. For images acquired from an attenuation phantom, the proposed compression scheme was robust to frequency shifts resulting from attenuation. The range resolution is improved 12% by the coded scheme compared to a 2-cycle pulse excitation. For the maximum acquisition depth of 15 cm, where the coded excitations are primarily intended, the improvement in SNR was more than 10 dB, while the resolution was retained.

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Clinical use and evaluation of coded excitation in B-mode images

This paper presents an in-vivo study of synthetic transmit aperture (STA) imaging in comparison with conventional imaging, evaluating whether STA imaging is feasible in-vivo and whether the image quality obtained is comparable with traditional scanned imaging in terms of penetration depth, spatial resolution, contrast resolution and artifacts. Acquisition was performed using our research scanner RASMUS and a 5.5 MHz convex array transducer. STA imaging was acquired using circular wave emulation by 33-element subapertures and a 20 μs linear FM signal as excitation pulse. For conventional imaging, a 64 element aperture was used in transmit and receive with a 1.5 cycle sinusoid excitation pulse. Conventional and STA images were acquired interleaved, ensuring that the exact same anatomical location was scanned. Image sequences were recorded in real time and processed off-line. Seven male volunteers were scanned abdominally and the resulting images were compared by three medical doctors using randomized blinded presentation. Penetration and image quality were scored and evaluated statistically. Results showed slightly but significantly (0.48 cm, p = 0.008) increased penetration using STA. Image quality was also highly significantly ( p in-vivo ultrasound imaging using STA is feasible for abdominal imaging without severe motion artifacts. (E-mail: mhp@dadlnet.dk )

Morten Høgholm Pedersen

Papers

Synthetic Aperture Ultrasound Imaging

Potential of coded excitation in medical ultrasound imaging.

Clinical evaluation of chirp-coded excitation in medical ultrasound

Clinical use and evaluation of coded excitation in B-mode images

In-vivo evaluation of convex array synthetic aperture imaging