Ultrasound elastography based on multiscale estimations of regularized displacement fields

Elasticity imaging is based on the measurements of local tissue deformation. The approach to ultrasound elasticity imaging presented in this paper relies on the estimation of dense displacement fields by a coarse-to-fine minimization of an energy function that combines constraints of conservation of echo amplitude and displacement field continuity. The multiscale optimization scheme presents several characteristics aimed at improving and accelerating the convergence of the minimization process. This includes the nonregularized initialization at the coarsest resolution and the use of adaptive configuration spaces. Parameters of the energy model and optimization were adjusted using data obtained from a tissue-like phantom material. Elasticity images from normal in vivo breast tissue were subsequently obtained with these parameters. Introducing a smoothness constraint into motion field estimation helped solve ambiguities due to incoherent motion, leading to elastograms less degraded by decorrelation noise than the ones obtained from correlation-based techniques.     

2-D locally regularized tissue strain estimation from radio-frequency ultrasound images: theoretical developments and results on experimental data

In this paper, a 2-D locally regularized strain estimation method for imaging deformation of soft biological tissues from radio-frequency (RF) ultrasound (US) data is introduced. Contrary to most 2-D techniques that model the compression-induced local displacement as a 2-D shift, our algorithm also considers a local scaling factor in the axial direction. This direction-dependent model of tissue motion and deformation is induced by the highly anisotropic resolution of RF US images. Optimal parameters are computed through the constrained maximization of a similarity criterion defined as the normalized correlation coefficient. Its value at the solution is then used as an indicator of estimation reliability, the probability of correct estimation increasing with the correlation value. In case of correlation loss, the estimation integrates an additional constraint, imposing local continuity within displacement and strain fields. Using local scaling factors and regularization increase the method's robustness with regard to decorrelation noise, resulting in a wider range of precise measurements. Results on simulated US data from a mechanically homogeneous medium subjected to successive uniaxial loadings demonstrate that our method is theoretically able to accurately estimate strains up to 17%. Experimental strain images of phantom and cut specimens of bovine liver clearly show the harder inclusions.     

Seed localization in Ultrasound and Registration to C-Arm Fluoroscopy Using Matched Needle Tracks for Prostate Brachytherapy

We propose a novel fiducial-free approach for the registration of C-arm fluoroscopy to 3-D ultrasound images of prostate brachytherapy implants to enable dosimetry. The approach involves the reliable detection of a subset of radioactive seeds from 3-D ultrasound, and the use of needle tracks in both ultrasound and fluoroscopy for registration. Seed detection in ultrasound is achieved through template matching in 3-D radio frequency ultrasound signals, followed by thresholding and spatial filtering. The resulting subset of seeds is registered to the complete reconstruction of the brachytherapy implant from multiple C-arm fluoroscopy views. To compensate for the deformation caused by the ultrasound probe, simulated warping is applied to the seed cloud from fluoroscopy. The magnitude of the applied warping is optimized within the registration process. The registration is performed in two stages. First, the needle track projections from fluoroscopy and ultrasound are matched. Only the seeds in the matched needles are then used as fiducials for point-based registration. We report results from a physical phantom with a realistic implant (average postregistration seed distance of 1.6 ± 1.2?mm) and from five clinical patient datasets (average error: 2.8 ± 1.5?mm over 128 detected seeds). We conclude that it is feasible to use RF ultrasound data, template matching, and spatial filtering to detect a reliable subset of brachytherapy seeds from ultrasound to enable registration to fluoroscopy for dosimetry.     

Three-dimensional cardiac strain estimation using spatio-temporal elastic registration of ultrasound images: a feasibility study

Current ultrasound methods for measuring myocardial strain are often limited to measurements in one or two dimensions. Cardiac motion and deformation however are truly 3-D. With the introduction of matrix transducer technology, 3-D ultrasound imaging of the heart has become feasible but suffers from low temporal and spatial resolution, making 3-D strain estimation challenging. In this paper, it is shown that automatic intensity-based spatio–temporal elastic registration of currently available 3-D volumetric ultrasound data sets can be used to measure the full 3-D strain tensor. The method was validated using simulated 3-D ultrasound data sets of the left ventricle (LV). Three types of data sets were simulated: a normal and symmetric LV with different heart rates, a more realistic asymmetric normal LV and an infarcted LV. The absolute error in the estimated displacement was between $0.47 pm 0.23$ and $1.00 pm 0.59$ mm, depending on heart rate and amount of background noise. The absolute error on the estimated strain was 9%–21% for the radial strain and 1%–4% for the longitudinal and circumferential strains. No large differences were found between the different types of data sets. The shape of the strain curves was estimated properly and the position of the infarcts could be identified correctly. Preliminary results on clinical data taken in vivo from three healthy volunteers and one patient with an apical aneurism confirmed these findings in a qualitative manner as the strain curves obtained with the proposed method have an amplitude and shape similar to what could be expected.      

Rapid registration for wide field of view freehand three-dimensional ultrasound

A freehand scanning protocol is the only way to acquire arbitrary large volumes of three-dimensional ultrasound (US) data. For some applications, multiple freehand sweeps are required to cover the area of interest. Aligning these multiple sweeps is difficult, typically requiring nonrigid image-based registration as well as the readings from the spatial locator attached to the US probe. Conventionally, nonrigid warps are achieved through general elastic spline deformations, which are expensive to compute and difficult to constrain. This paper presents an alternative registration technique, where the warp's degrees of freedom are carefully linked to the mechanics of the freehand scanning process. The technique is assessed through an extensive series of in vivo experiments, which reveal a registration precision of a few pixels with comparatively little computational load.     

Linear and nonlinear elastic modulus imaging: an application to breast cancer diagnosis

We reconstruct the in vivo spatial distribution of linear and nonlinear elastic parameters in ten patients with benign (five) and malignant (five) tumors. The mechanical behavior of breast tissue is represented by a modified Veronda-Westmann model with one linear and one nonlinear elastic parameter. The spatial distribution of these elastic parameters is determined by solving an inverse problem within the region of interest (ROI). This inverse problem solution requires the knowledge of the displacement fields at small and large strains. The displacement fields are measured using a free-hand ultrasound strain imaging technique wherein, a linear array ultrasound transducer is positioned on the breast and radio frequency echo signals are recorded within the ROI while the tissue is slowly deformed with the transducer. Incremental displacement fields are determined from successive radio-frequency frames by employing cross-correlation techniques. The rectangular regions of interest were subjectively selected to obtain low noise displacement estimates and therefore were variables that ranged from 346 to 849.6 mm2 . It is observed that malignant tumors stiffen at a faster rate than benign tumors and based on this criterion nine out of ten tumors were correctly classified as being either benign or malignant.     

Volume registration using needle paths and point landmarks for evaluation of interventional MRI treatments

We created a method for three-dimensional (3-D) registration of medical images (e.g., magnetic resonance imaging (MRI) or computed tomography) to images of physical tissue sections or to other medical images and evaluated its accuracy. Our method proved valuable for evaluation of animal model experiments on interventional-MRI guided thermal ablation and on a new localized drug delivery system. The method computes an optimum set of rigid body registration parameters by minimization of the Euclidean distances between automatically chosen correspondence points, along manually selected fiducial needle paths, and optional point landmarks, using the iterative closest point algorithm. For numerically simulated experiments, using two needle paths over a range of needle orientations, mean voxel displacement errors depended mostly on needle localization error when the angle between needles was at least 20 degrees. For parameters typical of our in vivo experiments, the mean voxel displacement error was < 0.35 mm. In addition, we determined that the distance objective function was a useful diagnostic for predicting registration quality. To evaluate the registration quality of physical specimens, we computed the misregistration for a needle not considered during the optimization procedure. We registered an ex vivo sheep brain MR volume with another MR volume and tissue section photographs, using various combinations of needle and point landmarks. Mean registration error was always < or = 0.54 mm for MR-to-MR registrations and < or = 0.52 mm for MR to tissue section registrations. We also applied the method to correlate MR volumes of radio-frequency induced thermal ablation lesions with actual tissue destruction. In this case, in vivo rabbit thigh volumes were registered to photographs of ex vivo tissue sections using two needle paths. Mean registration errors were between 0.7 and 1.36 mm over all rabbits, the largest error less than two MR voxel widths. We conclude that our method provides sufficient spatial correspondence to facilitate comparison of 3-D image data with data from gross pathology tissue sections and histology.     

Registered 3-D ultrasound and digital stereotactic mammography for breast biopsy guidance

Large core needle biopsy is a common procedure used to obtain histological samples when cancer is suspected in diagnostic breast images. The procedure is typically performed under image guidance, with freehand ultrasound and stereotactic mammography (SM) being the most common modalities used. To utilize the advantages of both modalities, a biopsy device combining three-dimensional ultrasound (3DUS) and digital SM imaging with computer-aided needle guidance was developed. An implementation of a stereo camera method was applied to SM calibration, providing a target localization error of 0.35 mm. The 3-D transformation between the two imaging modalities was then derived, with a target registration error of 0.52 mm. Finally, the needle guidance error of the device was evaluated using tissue-mimicking phantoms, showing a sample mean and standard deviation of 0.44 +/- 0.22 and 0.49 +/- 0.27 mm for targets planned from 3DUS and SM images, respectively. These results suggest that a biopsy procedure guided using this device would successfully sample breast lesions at a size greater than or equal to the smallest typically detected in mammographic screening (approximately 2 mm).     

A deformable registration method for automated morphometry of MRI brain images in neuropsychiatric research

Image registration methods play a crucial role in computational neuroanatomy. This paper mainly contributes to the field of image registration with the use of nonlinear spatial transformations. Particularly, problems connected to matching magnetic resonance imaging (MRI) brain image data obtained from various subjects and with various imaging conditions are solved here. Registration is driven by local forces derived from multimodal point similarity measures which are estimated with the use of joint intensity histogram and tissue probability maps. A spatial deformation model imitating principles of continuum mechanics is used. Five similarity measures are tested in an experiment with image data obtained from the Simulated Brain Database and a quantitative evaluation of the algorithm is presented. Results of application of the method in automated spatial detection of anatomical abnormalities in first-episode schizophrenia are presented.     

Brain shift estimation in image-guided neurosurgery using 3-D ultrasound

Intraoperative brain deformation is one of the most important causes affecting the overall accuracy of image-guided neurosurgical procedures. One option for correcting for this deformation is to acquire three-dimensional (3-D) ultrasound data during the operation and use this data to update the information provided by the preoperatively acquired MR data. For 12 patients 3-D ultrasound images have been reconstructed from freehand sweeps acquired during neurosurgical procedures. Ultrasound data acquired prior to and after opening the dura, but prior to surgery, have been quantitatively compared to the preoperatively acquired MR data to estimate the rigid component of brain shift at the first stages of surgery. Prior to opening the dura the average brain shift measured was 3.0 mm parallel to the direction of gravity, with a maximum of 7.5 mm, and 3.9 mm perpendicular to the direction of gravity, with a maximum of 8.2 mm. After opening the dura the shift increased on average 0.2 mm parallel to the direction of gravity and 1.4 mm perpendicular to the direction of gravity. Brain shift can be detected by acquiring 3-D ultrasound data during image-guided neurosurgery. Therefore, it can be used as a basis for correcting image data and preoperative planning for intraoperative deformations.     

Kinematics of the heart: strain-rate imaging from time-resolved three-dimensional phase contrast MRI

A four-dimensional mapping (three spatial dimensions + time) of myocardial strain-rate would help to describe the mechanical properties of the myocardium, which affect important physiological factors such as the pumping performance of the ventricles. Strain-rate represents the local instantaneous deformation of the myocardium and can be calculated from the spatial gradients of the velocity field. Strain-rate has previously been calculated using one-dimensional (ultrasound) or two-dimensional (2-D) magnetic resonance imaging) techniques. However, this assumes that myocardial motion only occurs in one direction or in one plane, respectively. This paper presents a method for calculation of the time-resolved three-dimensional (3-D) strain-rate tensor using velocity vector information in a 3-D spatial grid during the whole cardiac cycle. The strain-rate tensor provides full information of both magnitude and direction of the instantaneous deformation of the myocardium. A method for visualization of the full 3-D tensor is also suggested. The tensors are visualized using ellipsoids, which display the principal directions of strain-rate and the ratio between strain-rate magnitude in each direction. The presented method reveals the principal strain-rate directions without a priori knowledge of myocardial motion directions.     

Three-dimensional myocardial strain reconstruction from tagged MRI using a cylindrical B-spline model

In this paper, we present a new method for reconstructing three-dimensional (3-D) left ventricular myocardial strain from tagged magnetic resonance (MR) image data with a 3-D B-spline deformation model. The B-spline model is based on a cylindrical coordinate system that more closely fits the morphology of the myocardium than previously proposed Cartesian B-spline models and does not require explicit regularization. Our reconstruction method first fits a spatial coordinate B-spline displacement field to the tag line data. This displacement field maps each tag line point in the deformed myocardium back to its reference position (end-diastole). The spatial coordinate displacement field is then converted to material coordinates with another B-spline fit. Finally, strain is computed by analytically differentiating the material coordinate B-spline displacement field with respect to space. We tested our method with strains reconstructed from an analytically defined mathematical left ventricular deformation model and ten human imaging studies. Our results demonstrate that a quadratic cylindrical B-spline with a fixed number of control points can accurately fit a physiologically realistic range of deformations. The average 3-D reconstruction computation time is 20 seconds per time frame on a 450 MHz Sun Ultra80 workstation.     

Ultrasound current source density imaging

Surgery to correct severe heart arrhythmias usually requires detailed maps of the cardiac activation wave prior to ablation. The pinpoint electrical mapping procedure is laborious and limited by its spatial resolution (5-10 mm). We propose ultrasound current source density imaging (UCSDI), a direct 3-D imaging technique that potentially facilitates existing mapping procedures with superior spatial resolution. The technique is based on a pressure-induced change in resistivity known as the acoustoelectric (AE) effect, which is spatially confined to the ultrasound focus. AE-modulated voltage recordings are used to map and reconstruct current densities. In this preliminary study, we tested UCSDI under controlled conditions and compared it with conventional electrical mapping techniques. A 2-D dipole field was produced by a pair of electrodes in a bath of 0.9% NaCl solution. Boundary electrodes detected the AE signal while a 7.5-MHz focused ultrasound transducer was scanned across the bath. UCSDI located the current source and sink to within 1 mm of their actual positions. A future UCSDI system potentially provides real-time 3-D images of the cardiac activation wave coregistered with anatomical ultrasound and would greatly facilitate corrective procedures for heart abnormalities.     

Rapid elastic image registration for 3-D ultrasound

A Subvolume-based algorithm for elastic Ultrasound REgistration (SURE) was developed and evaluated. Designed primarily to improve spatial resolution in three-dimensional compound imaging, the algorithm registers individual image volumes nonlinearly before combination into compound volumes. SURE works in one or two stages, optionally using MIAMI Fuse software first to determine a global affine registration before iteratively dividing the volume into subvolumes and computing local rigid registrations in the second stage. Connectivity of the entire volume is ensured by global interpolation using thin-plate splines after each iteration. The performance of SURE was quantified in 20 synthetically deformed in vivo ultrasound volumes, and in two phantom scans, one of which was distorted at acquisition by placing an aberrating layer in the sound path. The aberrating layer was designed to induce beam aberrations reported for the female breast. Synthetic deformations of 1.5-2.5 mm were reduced by over 85% when SURE was applied to register the distorted image volumes with the original ones. Registration times were below 5 min on a 500-MHz CPU for an average data set size of 13 MB. In the aberrated phantom scans, SURE reduced the average deformation between the two volumes from 1.01 to 0.30 mm. This was a statistically significant (P = 0.01) improvement over rigid and affine registration transformations, which produced reductions to 0.59 and 0.50 mm, respectively.     

Nonrigid registration using free-form deformations: application tobreast MR images

In this paper we present a new approach for the nonrigid registration of contrast-enhanced breast MRI. A hierarchical transformation model of the motion of the breast has been developed. The global motion of the breast is modeled by an affine transformation while the local breast motion is described by a free-form deformation (FFD) based on B-splines. Normalized mutual information is used as a voxel-based similarity measure which is insensitive to intensity changes as a result of the contrast enhancement. Registration is achieved by minimizing a cost function, which represents a combination of the cost associated with the smoothness of the transformation and the cost associated with the image similarity. The algorithm has been applied to the fully automated registration of three-dimensional (3-D) breast MRI in volunteers and patients. In particular, we have compared the results of the proposed nonrigid registration algorithm to those obtained using rigid and affine registration techniques. The results clearly indicate that the nonrigid registration algorithm is much better able to recover the motion and deformation of the breast than rigid or affine registration algorithms.     

Comb-Push Ultrasound Shear Elastography (CUSE): A Novel Method for Two-Dimensional Shear Elasticity Imaging of Soft Tissues

Fast and accurate tissue elasticity imaging is essential in studying dynamic tissue mechanical properties. Various ultrasound shear elasticity imaging techniques have been developed in the last two decades. However, to reconstruct a full field-of-view 2-D shear elasticity map, multiple data acquisitions are typically required. In this paper, a novel shear elasticity imaging technique, comb-push ultrasound shear elastography (CUSE), is introduced in which only one rapid data acquisition (less than 35 ms) is needed to reconstruct a full field-of-view 2-D shear wave speed map (40 × 38 mm). Multiple unfocused ultrasound beams arranged in a comb pattern (comb-push) are used to generate shear waves. A directional filter is then applied upon the shear wave field to extract the left-to-right (LR) and right-to-left (RL) propagating shear waves. Local shear wave speed is recovered using a time-of-flight method based on both LR and RL waves. Finally, a 2-D shear wave speed map is reconstructed by combining the LR and RL speed maps. Smooth and accurate shear wave speed maps are reconstructed using the proposed CUSE method in two calibrated homogeneous phantoms with different moduli. Inclusion phantom experiments demonstrate that CUSE is capable of providing good contrast (contrast-to-noise ratio ≥ 25 dB) between the inclusion and background without artifacts and is insensitive to inclusion positions. Safety measurements demonstrate that all regulated parameters of the ultrasound output level used in CUSE sequence are well below the FDA limits for diagnostic ultrasound.     

Statistical properties of Jacobian maps and the realization of unbiased large-deformation nonlinear image registration

Maps of local tissue compression or expansion are often computed by comparing magnetic resonance imaging (MRI) scans using nonlinear image registration. The resulting changes are commonly analyzed using tensor-based morphometry to make inferences about anatomical differences, often based on the Jacobian map, which estimates local tissue gain or loss. Here, we provide rigorous mathematical analyses of the Jacobian maps, and use themto motivate a new numerical method to construct unbiased nonlinear image registration. First, we argue that logarithmic transformation is crucial for analyzing Jacobian values representing morphometric differences. We then examine the statistical distributions of log-Jacobian maps by defining the Kullback-Leibler (KL) distance on material density functions arising in continuum-mechanical models. With this framework, unbiased image registration can be constructed by quantifying the symmetric KL-distance between the identity map and the resulting deformation. Implementation details, addressing the proposed unbiased registration as well as the minimization of symmetric image matching functionals, are then discussed and shown to be applicable to other registration methods, such as inverse consistent registration. In the results section, we test the proposed framework, as well as present an illustrative application mapping detailed 3-D brain changes in sequential magnetic resonance imaging scans of a patient diagnosed with semantic dementia. Using permutation tests, we show that the symmetrization of image registration statistically reduces skewness in the log-Jacobian map.     

Beam Steering with Linear Arrays

The principles and techniques of real-time imaging with phased array ultrasound scanners are reviewed. Topics include 1) the geometric optics of beam steering and focusing with a linear array in the transmit and receive modes; 2) limitations on image data acquisition due to ultrasound propagation velocity; 3) optical diffraction theory for linear arrays including effects of amplitude grating lobes. Limitations on the image quality of phased array imaging systems are also discussed, including 1) nonideal response of array transducers; 2) target ambiguities caused by phase error grating lobes; 3) refraction errors; 4) delay line design. Finally, an analysis is presented of current techniques for improving ultrasound image quality using phased array methods including phase compensation, spatial compounding, frequency compounding, and parallel processing.     

Mammogram registration: a phantom-based evaluation of compressed breast thickness variation effects

The temporal comparison of mammograms is complex; a wide variety of factors can cause changes in image appearance. Mammogram registration is proposed as a method to reduce the effects of these changes and potentially to emphasize genuine alterations in breast tissue. Evaluation of such registration techniques is difficult since ground truth regarding breast deformations is not available in clinical mammograms. In this paper, we propose a systematic approach to evaluate sensitivity of registration methods to various types of changes in mammograms using synthetic breast images with known deformations. As a first step, images of the same simulated breasts with various amounts of simulated physical compression have been used to evaluate a previously described nonrigid mammogram registration technique. Registration performance is measured by calculating the average displacement error over a set of evaluation points identified in mammogram pairs. Applying appropriate thickness compensation and using a preferred order of the registered images, we obtained an average displacement error of 1.6 mm for mammograms with compression differences of 1-3 cm. The proposed methodology is applicable to analysis of other sources of mammogram differences and can be extended to the registration of multimodality breast data.     

Circular ultrasound compounding by designed matrix weighting

Spatial compounding is an imaging technique that aims to improve image contrast by combining partially decor-related images acquired at different angles or positions. In conventional spatial compounding, data sets are combined with equal weighting. Here, we describe an alternative method of reconstruction using algorithms which weight the data based on a "quality" matrix. The quality matrix is derived from beamforming characteristics. For each data set, the reliability of the data is assumed to vary spatially. By compounding the data based on the quality matrix, a complete image is formed. Here, we describe the construction of a rotational translation stage and tissue-mimicking phantoms that are used in conjunction with a commercial medical ultrasound machine to test our reconstruction algorithms. The new algorithms were found to increase the contrast-to-speckle ratio of simulated cysts and tumors by 61% from raw data, and to significantly increase edge definition of small embedded targets. The new method shows promise as a computationally efficient method of improving contrast and resolution in ultrasound images. The method should be particularly useful in breast imaging, where images from multiple angles can be acquired without interference from bone or air.