Mikhail G. Danilouchkine

An Inverse Method for Imaging the Local Elasticity of Atherosclerotic Coronary Plaques

The rupture of thin-cap fibroatheroma (TCFA) plaques is a major cause of acute coronary events. A TCFA has a trombogenic soft lipid core, shielded from the blood stream by a thin, possibly inflamed, stiff cap. The majority of atherosclerotic plaques resemble a TCFA in terms of overall structural composition, but have a more complex, heterogeneous morphology. An assessment of the material distribution is vital for quantifying the plaques mechanical stability and for determining the effect of plaque-stabilizing pharmaceutical agents. We describe a new automated inverse elasticity method, intravascular ultrasound (IVUS) modulography, which is capable of reconstructing a heterogeneous Youngs modulus distribution. The elastogram (i.e., spatial strain distribution) of the plaque is the input for the method, and is measured using the clinically available technique, IVUS elastography. Our method incorporates a novel divide-and-conquer strategy, allowing the reconstruction of TCFAs as well as heterogeneous plaques with localized regions of soft, weakened tissue. The method was applied to ex vivo elastograms, which were simulated from the cross sections of postmortem human coronary plaques. To demonstrate the clinical feasibility of the method, measured elastograms from human atherosclerotic coronary arteries were analyzed. One elastogram was measured in vitro; the other, in vivo . The method approximated the true Youngs modulus distribution of all simulated plaques, while the in vitro reconstruction was in agreement with histology. In conclusion, the IVUS modulography in combination with the IVUS elastography has strong potential to become an all-encompassing modality for detecting plaques, for assessing the information related to their rupture-proneness, and for imaging their heterogeneous elastic material composition.

Comparison of fundamental, second harmonic, and superharmonic imaging: a simulation study

In medical ultrasound, fundamental imaging (FI) uses the reflected echoes from the same spectral band as that of the emitted pulse. The transmission frequency determines the trade-off between penetration depth and spatial resolution. Tissue harmonic imaging (THI) employs the second harmonic of the emitted frequency band to construct images. Recently, superharmonic imaging (SHI) has been introduced, which uses the third to the fifth (super) harmonics. The harmonic level is determined by two competing phenomena: nonlinear propagation and frequency dependent attenuation. Thus, the transmission frequency yielding the optimal trade-off between the spatial resolution and the penetration depth differs for THI and SHI. This paper quantitatively compares the concepts of fundamental, second harmonic, and superharmonic echocardiography at their optimal transmission frequencies. Forward propagation is modeled using a 3D-KZK implementation and the iterative nonlinear contrast source (INCS) method. Backpropagation is assumed to be linear. Results show that the fundamental lateral beamwidth is the narrowest at focus, while the superharmonic one is narrower outside the focus. The lateral superharmonic roll-off exceeds the fundamental and second harmonic roll-off. Also, the axial resolution of SHI exceeds that of FI and THI. The far-field pulse-echo superharmonic pressure is lower than that of the fundamental and second harmonic. SHI appears suited for echocardiography and is expected to improve its image quality at the cost of a slight reduction in depth-of-field.

Left Ventricular Border Tracking Using Cardiac Motion Models and Optical Flow

The use of automated methods is becoming increasingly important for assessing cardiac function quantitatively and objectively. In this study, we propose a method for tracking three-dimensional (3-D) left ventricular contours. The method consists of a local optical flow tracker and a global tracker, which uses a statistical model of cardiac motion in an optical-flow formulation. We propose a combination of local and global trackers using gradient-based weights. The algorithm was tested on 35 echocardiographic sequences, with good results (surface error: 1.35 ± 0.46 mm, absolute volume error: 5.4 ± 4.8 mL). This demonstrates the methods potential in automated tracking in clinical quality echocardiograms, facilitating the quantitative and objective assessment of cardiac function.

Probabilistic framework for tracking in artifact-prone 3D echocardiograms

The analysis of echocardiograms, whether visual or automated, is often hampered by ultrasound artifacts which obscure the moving myocardial wall. In this study, a probabilistic framework for tracking the endocardial surface in 3D ultrasound images is proposed, which distinguishes between visible and artifact-obscured myocardium. Motion estimation of visible myocardium relies more on a local, data-driven tracker, whereas tracking of obscured myocardium is assisted by a global, statistical model of cardiac motion. To make this distinction, the expectation-maximization algorithm is applied in a stationary and dynamic frame-of-reference. Evaluation on 35 three-dimensional echocardiographic sequences shows that this artifact-aware tracker gives better results than when no distinction is made. In conclusion, the proposed tracker is able to reduce the influence of artifacts, potentially improving quantitative analysis of clinical quality echocardiograms.

Accuracy in Prediction of Catheter Rotation in IVUS With Feature-Based Optical Flow—A Phantom Study

The quantitative assessment of and compensation for catheter rotation in intravascular ultrasound images presents a fundamental problem for noninvasive characterization of the mechanical properties of the coronary arteries. A method based on the scale-space optical flow algorithm with a feature-based weighting scheme is proposed to account for the aforementioned artifact. The computed vector field, describing the misalignment between two consecutive frames, allows the quantitative assessment of the amount of vessel wall tissue motion, which is directly related to the catheter rotation. Algorithm accuracy and robustness were demonstrated on two tissue-mimicking phantoms, subjected to controlled amount of angular deviation. The proposed method shows a great reliability in the prediction of catheter rotational motion up to 4deg.

Dual-pulse frequency compounded superharmonic imaging

Tissue second-harmonic imaging is currently the default mode in commercial diagnostic ultrasound systems. A new modality, superharmonic imaging (SHI), combines the third through fifth harmonics originating from nonlinear wave propagation through tissue. SHI could further improve the resolution and quality of echographic images. The superharmonics have gaps between the harmonics because the transducer has a limited bandwidth of about 70% to 80%. This causes ghost reflection artifacts in the superharmonic echo image. In this work, a new dual-pulse frequency compounding (DPFC) method to eliminate these artifacts is introduced. In the DPFC SHI method, each trace is constructed by summing two firings with slightly different center frequencies. The feasibility of the method was established using a single-element transducer. Its acoustic field was modeled in KZK simulations and compared with the corresponding measurements obtained with a hydrophone apparatus. Subsequently, the method was implemented on and optimized for a setup consisting of an interleaved phased-array transducer (44 elements at 1 MHz and 44 elements at 3.7 MHz, optimized for echocardiography) and a programmable ultrasound system. DPFC SHI effectively suppresses the ghost reflection artifacts associated with imaging using multiple harmonics. Moreover, compared with the single-pulse third harmonic, DPFC SHI improved the axial resolution by 3.1 and 1.6 times at the -6-dB and -20-dB levels, respectively. Hence, DPFC offers the possibility of generating harmonic images of a higher quality at a cost of a moderate frame rate reduction.

Improving IVUS palpography by incorporation of motion compensation based on block matching and optical flow

Intravascular ultrasound (IVUS) strain imaging of the luminal layer in coronary arteries, coined as IVUS palpography, utilizes conventional radio frequency (RF) signals acquired at 2 different levels of a compressional load. The signals are cross-correlated to obtain the microscopic tissue displacements, which can be directly translated into local strain of the vessel wall. However, (apparent) tissue motion and nonuniform deformation of the vessel wall, due to catheter wiggling, reduce signal correlation and result in invalid strain estimates. Implications of probe motion were studied on the tissue-mimicking phantom. The measured circumferential tissue displacement and level of the speckle decorrelation amounted to 12deg and 0.58, respectively, for the catheter displacement of 456 mum. To compensate for the motion artifacts in IVUS palpography, a novel method based on the feature-based scale-space optical flow (OF), and classical block matching (BM) algorithm, were employed. The computed OF vector and BM displacement fields quantify the amount of local tissue misalignment in consecutive frames. Subsequently, the extracted circumferential displacements are used to realign the signals before strain computation. Motion compensation reduces the RF signal decorrelation and increases the number of valid strain estimates. The advantage of applying the motion correction in IVUS palpography was demonstrated in a midscale validation study on 14 in vivo pullbacks. Both methods substantially increase the number of valid strain estimates in the partial and compounded palpograms. Mean relative improvement in the number of valid strain estimates with motion compensation in comparison to one without motion compensation amounts to 28% and 14%, respectively. Implementation of motion compensation methods boosts the diagnostic value of IVUS palpography.

A study of coronary artery rotational motion with dense scale-space optical flow in intravascular ultrasound

This paper describes a novel method for estimating tissue motion in two-dimensional intravascular ultrasound (IVUS) images of a coronary artery. It is based on the classical Lukas-Kanade (LK) algorithm for optical flow (OF). The OF vector field quantifies the amount of misalignment between two consecutive frames in a sequence of images. From the theoretical standpoint, two fundamental improvements are proposed in this paper. First, using a simplified representation of the vessel wall as a medium with randomly distributed scatterers, it was shown that the OF equation satisfies the integral brightness conservation law. Second, a scale-space embedding for the OF equation was derived under the assumption of spatial consistency in IVUS acquisitions. The spatial coherence is equivalent to a locally affine motion model. The latter effectively captures and appropriately describes a complex deformation pattern of the coronary vessel wall under the varying physiological conditions (i.e. pulsatile blood pressure). The accuracy of OF tracking was estimated on the tissue-mimicking phantoms subjected to the controlled amount of angular deviation. Moreover, the performance of the classical LK and proposed approach was compared using the simulated IVUS images with an atherosclerotic lesion. The experimental results showed robust and reliable performance of up to 5 degrees of rotation, which is within the plausible range of circumferential displacement of the coronary arteries. Subsequently, the algorithm was used to analyze vessel wall motion in 18 IVUS pullbacks from 16 patients. The in vivo experiments revealed that the motion of coronary arteries is primarily determined by the cardiac contraction.

Dual pulse frequency compounded super harmonic imaging for phased array transducers

Second harmonic imaging is currently the standard in commercial echographic systems. A new modality, super harmonic imaging (SHI), is based on combining the 3rd to 5th harmonic generated during sound propagation in tissue. This emerging modality could further enhance resolution and quality of echographic images. To meet the bandwidth requirement for SHI an interleaved phased array was developed. Array elements used in transmission generally have bandwidths of ∼ 80% leading to gaps between harmonics in the spectral domain. This causes ripple artifacts in the echo image. Last year we introduced a new dual pulse frequency compounding method to reduce these artifacts and showed initial single element results [1]. In this work we implement and optimize the dual pulse method for an interleaved array on an ultrasound system and research its imaging characteristics, i.e. point spread functions (PSF). In the dual pulse SHI method each trace is constructed by the summing of two firings, the second slightly frequency shifted compared to the first. To study the dual pulse methods performance an interleaved array (44 1 MHz and 44 3.7 MHz elements, optimized for echocardiography) was used in combination with a fully programmable ultrasound system. Initial estimates for the frequencies of the first and second pulses as well as the pulse duration were optimized experimentally. Our findings confirm that the transfer functions of both transducer and system have to be taken into account to determine the optimal transmission frequencies for the dual pulse SHI method. Moreover, a trade off exists between dual pulse signal length and peak intensity. The optimal results with the dual pulse technique were achieved using a transmission length of 2.5 cycles and transmission frequencies of 0.87 MHz and 1.12 MHz. The lateral beam widths of the optimal dual pulse signal are 1.2 times smaller at the −6 dB level and equal at the −20 dB level compared to the third harmonic. The axial beam widths of the optimal dual pulse signal are 3.1 times smaller at the −6 dB level and 1.6 times smaller at the −20 dB level compared to the third harmonic. Not only does dual pulse method solve the ripple artifacts associated with imaging using multiple harmonic bands, dual pulse SHI has markedly improved axial and lateral resolutions compared to the third harmonic at higher than second harmonic intensities.

Automated analysis of three-dimensional stress echocardiography

Real-time three-dimensional (3D) ultrasound imaging has been proposed as an alternative for two-dimensional stress echocardiography for assessing myocardial dysfunction and underlying coronary artery disease. Analysis of 3D stress echocardiography is no simple task and requires considerable expertise. In this paper, we propose methods for automated analysis, which may provide a more objective and accurate diagnosis. Expert knowledge is incorporated via statistical modelling of patient data. Methods for identifying anatomical views, detecting endocardial borders, and classification of wall motion are described and shown to provide favourable results. We also present software developed especially for analysis of 3D stress echocardiography in clinical practice. Interobserver agreement in wall motion scoring is better using the dedicated software (96%) than commercially available software not dedicated for this purpose (79%). The developed tools may provide useful quantitative and objective parameters to assist the clinical expert in the diagnosis of left ventricular function.