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Catheter ablation is a common treatment for arrhythmia, but can fail if lesion lines are noncontiguous. Identification of gaps and nontransmural lesions can reduce the likelihood of treatment failure and recurrent arrhythmia. Intracardiac myocardial elastography (IME) is a strain imaging technique that provides visualization of the lesion line. Estimation of lesion size and gap resolution were evaluated in an open-chest canine model (${n} = 3$), and clinical feasibility was investigated in patients undergoing ablation to treat typical cavotricuspid isthmus (CTI) atrial flutter (${n} = 5$). A lesion line consisting of three lesions and two gaps was generated on the canine left ventricle via epicardial ablation. One lesion was generated in one canine right ventricle. Average lesion and gap areas were measured with high agreement (33 ± 14 and 30 ± 15 mm2, respectively) when compared against gross pathology (34 ± 19 and 26 ± 11 mm2, respectively). Gaps as small as 11 mm2 (3.6 mm on epicardial surface) were identifiable. Absolute error and relative error in estimated lesion area were 9.3 ± 8.4 mm2 and 31% ± 34%; error in estimated gap area was 11 ± 9.0 mm2 and 40% ± 29%. Flutter patients were imaged throughout the procedure. Strain was shown to be capable of differentiating between baseline and after ablation completion as confirmed by conduction block. In all patients, strain decreased in the CTI after ablation (mean paired difference of −17% ± 11%, ${p} < 0.05$). IME could potentially become a useful ablation monitoring tool in health facilities. [ABSTRACT FROM AUTHOR]

A high volume rate and high performance ultrasound imaging method based on a matrix array is proposed by using compressed sensing (CS) to reconstruct the complete dataset of synthetic transmit aperture (STA) from three-dimensional (3D) diverging wave transmissions (i.e. 3D CS-STA). Hereto, a series of apodized 3D diverging waves are transmitted from a fixed virtual source, with the ith row of a Hadamard matrix taken as the apodization coefficients in the ith transmit event. Then CS is used to reconstruct the complete dataset, based on the linear relationship between the backscattered echoes and the complete dataset of 3D STA. Finally, standard STA beamforming is applied on the reconstructed complete dataset to obtain the volumetric image. Four layouts of element numbering for apodizations and transmit numbers of 16, 32 and 64 are investigated through computer simulations and phantom experiments. Furthermore, the proposed 3D CS-STA setups are compared with 3D single-line-transmit (SLT) and 3D diverging wave compounding (DWC). The results show that, (i) 3D CS-STA has competitive lateral resolutions to 3D STA, and their contrast ratios (CRs) and contrast-to-noise ratios (CNRs) approach to those of 3D STA as the number of transmit events increases in noise-free condition. (ii) the tested 3D CS-STA setups show good robustness in complete dataset reconstruction in the presence of different levels of noise. (iii) 3D CS-STA outperforms 3D SLT and 3D DWC. More specifically, the 3D CS-STA setup with 64 transmit events and the Random layout achieves ~31% improvement in lateral resolution, ~14% improvement in ratio of the estimated-to-true cystic areas, a higher volume rate, and competitive CR/CNR when compared with 3D DWC. The results demonstrate that 3D CS-STA has great potential of providing high quality volumetric image with a higher volume rate. [ABSTRACT FROM AUTHOR]

Harmonic motion imaging for focused ultrasound (HMIFU) utilizes an amplitude-modulated HIFU beam to induce a localized focal oscillatory motion simultaneously estimated. The objective of this study is to develop and show the feasibility of a novel fast beamforming algorithm for image reconstruction using GPU-based sparse-matrix operation with real-time feedback. In this study, the algorithm was implemented onto a fully integrated, clinically relevant HMIFU system. A single divergent transmit beam was used while fast beamforming was implemented using a GPU-based delay-and-sum method and a sparse-matrix operation. Axial HMI displacements were then estimated from the RF signals using a 1-D normalized cross-correlation method and streamed to a graphic user interface with frame rates up to 15 Hz, a 100-fold increase compared to conventional CPU-based processing. The real-time feedback rate does not require interrupting the HIFU treatment. Results in phantom experiments showed reproducible HMI images and monitoring of 22 in vitro HIFU treatments using the new 2-D system demonstrated reproducible displacement imaging, and monitoring of 22 in vitro HIFU treatments using the new 2-D system showed a consistent average focal displacement decrease of 46.7\pm14.6% during lesion formation. Complementary focal temperature monitoring also indicated an average rate of displacement increase and decrease with focal temperature at 0.84\pm 1.15\%/^\circC, and 2.03\pm 0.93\%/^\circC, respectively. These results reinforce the HMIFU capability of estimating and monitoring stiffness related changes in real time. Current ongoing studies include clinical translation of the presented system for monitoring of HIFU treatment for breast and pancreatic tumor applications. [ABSTRACT FROM AUTHOR]

Abstract: Velocity of ultrasound waves has proved to be a useful indicator of bone biomechanical competence. A detailed understanding of the dependence of ultrasound parameters such as velocity on bone characteristics is a key to the development of bone quantitative ultrasound (QUS). The objective of this study is to investigate the relative contributions of porosity and mineralized matrix properties to the bulk compressional wave velocity (BCV) along the long bone axis. Cross-sectional slabs from the diaphysis of four human femurs were included in the study. Seven regions of interest (ROIs) were selected in each slab. BCV was measured in through-transmission at 5MHz. Impedance of the mineralized matrix (Zm ) and porosity (Por) were obtained from 50MHz scanning acoustic microscopy. Por and Zm had comparable effects on BCV along the bone axis (R =−0.57 and R =0.72, respectively). [Copyright &y& Elsevier]

There is evidence that quantitative ultrasound (QUS) at the proximal femur involves waves propagating circumferentially in the cortical shell. These waves, in theory, convey information on bone geometrical and material characteristics and thus have the potential to improve fracture risk prediction. In this work, the time-of-flight (TOF) of the first arriving signal (FAS) that corresponds to waves propagating circumferentially is considered. The relationships between the TOF of the FAS and geometrical features of the femoral neck are investigated. Five neck cross-sections from 11 human femurs from females (>65y) were extracted from 3-D X-ray quantitative computed tomography (XR-QCT) datasets. Geometrical parameters including cross-sectional area (CSA), minimum moment of inertia (I(min)) and section modulus (Z) were computed from femoral neck cross-section images. Two-dimensional numerical simulation of US propagation through femoral neck was performed and TOF of the FAS was estimated. TOF was best correlated with I(min): R(2)=0.82 (p=10(-4); RMSE=1390mm(4) [13%]) in the region between proximal and mid-femoral neck and with Z: R(2)=0.55 (p<10(-2); RMSE=480mm(3) [17%]) and CSA: R(2)=0.62 (p<5.10(-3); RMSE=22mm(2) [7%]) in the mid-femoral neck. The results suggest that QUS has the potential to assess proximal femur strength based on estimates of geometrical properties of the cortical shell. [ABSTRACT FROM AUTHOR]

Abstract: Quantitative ultrasound assessment of the cortical compartment of the femur neck (FN) is investigated with the goal of achieving enhanced fracture risk prediction. Measurements at the FN are influenced by bone size, shape and material properties. The work described here was aimed at determining which FN material properties have a significant impact on ultrasound propagation around 0.5 MHz and assessing the relevancy of different models. A methodology for the modeling of ultrasound propagation in the FN, with a focus on the modeling of bone elastic properties based on scanning acoustic microscopy data, is introduced. It is found that the first-arriving ultrasound signal measured in through-transmission at the FN is not influenced by trabecular bone properties or by the heterogeneities of the cortical bone mineralized matrix. In contrast, the signal is sensitive to variations in cortical porosity, which can, to a certain extent, be accounted for by effective properties calculated with the Mori-Tanaka method. [Copyright &y& Elsevier]