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Biomedical subjects

A Fenster

Publications and source records attributed to A Fenster.

At least 19 recordsLinked to original sources

3D thoracoscopic ultrasound volume measurement validation in an ex vivo and in vivo porcine model of lung tumours.

The purpose of this study was to validate the accuracy and reliability of volume measurements obtained using three-dimensional (3D) thoracoscopic ultrasound (US) imaging. Artificial "tumours" were created by injecting a liquid agar mixture into spherical moulds of known volume. Once solidified, the "tumours" were implanted into the lung tissue in both a porcine lung sample ex vivo and a surgical porcine model in vivo. 3D US images were created by mechanically rotating the thoracoscopic ultrasound probe about its long axis while the transducer was maintained in close contact with the tissue. Volume measurements were made by one observer using the ultrasound images and a manual-radial segmentation technique and these were compared with the known volumes of the agar. In vitro measurements had average accuracy and precision of 4.76% and 1.77%, respectively; in vivo measurements had average accuracy and precision of 8.18% and 1.75%, respectively. The 3D thoracoscopic ultrasound can be used to accurately and reproducibly measure "tumour" volumes both in vivo and ex vivo.

Agar↗

3D ultrasound analysis of carotid plaque volume and surface morphology.

Morphological characterization of carotid plaques has been used for risk stratification and evaluation of response to therapy, evaluation of new risk factors, genetic research, and for quantifying effects of new anti-atherosclerotic therapies. We developed a 3D US system that allows detailed studies of carotid plaques in 3D. Our software includes 3D reconstruction, viewing, manual and semi-automated segmentation of carotid plaques, and surface morphology analysis to be used for quantitative tracking of plaque changes. We evaluated our plaque quantification software by examining plaque volume measurement accuracy, variability, and plaque surface morphology. We used vascular test phantoms to study segmentation accuracy, and used 48 3D US carotid plaques of patients ranging in size from 13.2 mm(3) to 544.0 mm(3) to study plaque volume measurement variability. We compared results from the semi-automated plaque measurements to the results obtained from manual measurements, which were used as the "gold" standard. We developed a surface plaque morphology quantification technique based on the segmented plaque surface curvature and used it to analyze plaques. Accuracy of plaque volume measurements for the simulated plaques ranged from 4.2% to 1.5% for volumes ranging from 68.5 mm(3) to 286 mm(3). The variability study showed that coefficients of variation in the measurement of plaque volume decreased with increasing plaque size for both inter- (90.8-3.9%) and intra-observer (70.2-3.1%) measurements over the plaque sizes measured. Surface morphology analysis showed that 1 mm ulceration could be quantified and monitored for changes over time. The automated plaque quantification approach showed a little higher intra-observer variability than the manual technique, and its performance was better for segmenting the wall than the lumen. Our results indicate that our approach is sensitive tool and can be used in studies of plaque progression and regression as it relates to atherosclerosis treatment effects and can be used effectively in longitudinal studies for direct measurement carotid plaque volume.

Algorithms↗

Volume measurement variability in three-dimensional high-frequency ultrasound images of murine liver metastases.

The identification and quantification of tumour volume measurement variability is imperative for proper study design of longitudinal non-invasive imaging of pre-clinical mouse models of cancer. Measurement variability will dictate the minimum detectable volume change, which in turn influences the scheduling of imaging sessions and the interpretation of observed changes in tumour volume. In this paper, variability is quantified for tumour volume measurements from 3D high-frequency ultrasound images of murine liver metastases. Experimental B16F1 liver metastases were analysed in different size ranges including less than 1 mm3, 1-4 mm3, 4-8 mm3 and 8-70 mm3. The intra- and inter-observer repeatability was high over a large range of tumour volumes, but the coefficients of variation (COV) varied over the volume ranges. The minimum and maximum intra-observer COV were 4% and 14% for the 1-4 mm3 and <1 mm3 tumours, respectively. For tumour volumes measured by segmenting parallel planes, the maximum inter-slice distance that maintained acceptable measurement variability increased from 100 to 600 microm as tumour volume increased. Comparison of free breathing versus ventilated animals demonstrated that respiratory motion did not significantly change the measured volume. These results enable design of more efficient imaging studies by using the measured variability to estimate the time required to observe a significant change in tumour volume.

Algorithms↗

Poly(vinyl alcohol) cryogel phantoms for use in ultrasound and MR imaging.

Poly(vinyl alcohol) cryogel, PVA-C, is presented as a tissue-mimicking material, suitable for application in magnetic resonance (MR) imaging and ultrasound imaging. A 10% by weight poly(vinyl alcohol) in water solution was used to form PVA-C, which is solidified through a freeze-thaw process. The number of freeze-thaw cycles affects the properties of the material. The ultrasound and MR imaging characteristics were investigated using cylindrical samples of PVA-C. The speed of sound was found to range from 1520 to 1540 m s(-1), and the attenuation coefficients were in the range of 0.075-0.28 dB (cm MHz)(-1). T1 and T2 relaxation values were found to be 718-1034 ms and 108-175 ms, respectively. We also present applications of this material in an anthropomorphic brain phantom, a multi-volume stenosed vessel phantom and breast biopsy phantoms. Some suggestions are made for how best to handle this material in the phantom design and development process.

Animals↗

3D ultrasound guided breast biopsy system.

Stereotactic X-ray mammography (SM) and ultrasound (US) guidance are commonly used techniques for breast biopsy. While SM provides 3D targeting information and US provides real-time guidance, both techniques have limitations. SM is a long and uncomfortable procedure and the US guided procedure is inherently 2D, requiring a skilled physician for both safety and accuracy. We have developed a 3D US-guided biopsy system to integrate with SM. The dual modality breast biopsy system combines the advantages of both approaches with 3D US and SM targeting, near real-time 3D and real-time 2D US guidance, breast stabilisation and a confined needle trajectory. Our goal is to be able to biopsy a larger percentage of suspicious masses using ultrasound, by clarifying ambiguous structures with mammographic imaging. Using breast phantoms, we have shown that our ultrasound guided biopsy system was capable of targeting artificial lesions that were 3.2 mm in diameter, with a 96% success rate. Through this study, we also demonstrated that our system was equivalent to current clinical practice, for an in vitro biopsy task. Metal beads in known relative positions allowed us to determine the geometry of the SM system, so that stereotactic mammography could be registered to 3D US images. The target registration error was found to be 1.6 mm. This error was dominated by positioning error in the vertical direction (perpendicular to the film surface). As an adjunct to SM, we propose that 3D US could provide more complete imaging information for target identification and real-time monitoring of needle insertion, as well as providing a means for rapid confirmation of biopsy success.

Biopsy, Needle↗

The development and evaluation of a three-dimensional ultrasound-guided breast biopsy apparatus.

We have designed a prototype three-dimensional ultrasound guidance (3D USB) apparatus to improve the breast biopsy procedure. Features from stereotactic mammography and free-hand US-guided biopsy have been combined with 3D US imaging. This breast biopsy apparatus accurately guides a needle into position for the sampling of target tissue. We have evaluated this apparatus in three stages. First, by testing the placement accuracy of a needle in a tissue mimicking phantom. Second, with tissue mimicking phantoms that had embedded lesions for biopsy. Finally, by comparison to free-hand US-guided biopsy, using chicken breast phantoms. The first two stages of evaluation quantified the mechanical biases in the 3D USB apparatus. Compensating for these, a 96% success rate in targeting 3.2 mm "lesions" in chicken breast phantoms was achieved when using the 3D USB apparatus. The expert radiologists performing biopsies with free-hand US guidance achieved a 94.5% success rate. This has proven an equivalence between our apparatus, operated by non-experts, and free-hand biopsy performed by expert radiologists, for 3.2 mm lesions in vitro, with a 95% confidence.

Animals↗

In vitro investigation of calcium distribution and tissue thickness in the human thoracic aorta.

Atherosclerosis represents a significant cause of morbidity and mortality in the western world. Manifestations of atherosclerotic disease among the elderly include the development of raised lesions that often include calcified regions with material properties similar to bone. There is little information available about the amount and distribution of these calcified plaques within the human aorta, partly due to the difficulty in obtaining this information during in vivo studies. We report the results of a cadaveric investigation of thoracic aortic wall thickness, diameter and calcium content. A non-destructive x-ray imaging technique was used to obtain two-dimensional maps of total thickness and mineral content in excised thoracic aortic specimens. In a study of 39 individuals (23 male and 16 female, aged 20-92 years) we report a significant non-linear correlation between calcium burden and age, with calcium deposition most commonly occurring proximal to the ostia of major branching vessels. We also found a significant linear correlation between age and both total aortic wall thickness and aortic diameter. An improved understanding of the pathological changes in the ageing thoracic aorta may be useful in the development of strategies to reduce the undesirable vessel calcification associated with atherosclerosis.

Adult↗

A real vessel phantom for flow imaging: 3-D Doppler ultrasound of steady flow.

Vascular phantoms are used to assess the capabilities of various imaging techniques, such as x-ray CT and angiography, and B-mode, power Doppler, and colour Doppler ultrasound (US). They should, therefore, accurately mimic the vasculature, blood, and surrounding tissue, in regard to both imaging properties and vessel geometry. In the past, a variety of walled and wall-less vessel models have been used. However, these models only approximate the true vessel geometry, and generally lack pathologic features such as plaques or calcifications. To amend these deficiencies, we have developed a real vessel phantom for US and x-ray studies, which comprises a fixed human vessel specimen, cannulated onto two acrylic tubes, and embedded in agar in an acrylic box. Earlier, we demonstrated a good overall correlation between x-ray angiography, CT, and 3-D B-mode US images of this phantom. Here, we extend its use to flow imaging with 3-D power and 3-D colour Doppler US.

Humans↗

In vitro simulation and quantification of temporal jitter artifacts in ECG-gated dynamic three-dimensional echocardiography.

The image quality of dynamic 3-D echocardiography is limited by temporal jitter artifacts that result from the asynchronous acquisition of video frames with the cardiac cycle. This paper analyzes the source and extent of these artifacts using in vitro studies. Dynamic 3-D images of a myocardial motion phantom were reconstructed and analyzed for eight cardiac motion patterns. The extent of temporal jitter artifacts was quantified, first, from the images by computing temporal jitter maps and, second, predicted from the motion waveforms. Temporal jitter appeared as a pattern of streak artifacts converging at the axis of rotation of the imaging plane, for the rotational scanning approach used in our study. The results of the experimental analysis techniques were compared with the waveform analysis using linear regression analysis. The least squares line showed good correlation between the data (r > 0.9) and its deviation from the line of identity was calculated to be <9%.

Artifacts↗

Quantitative assessment of in vitro jets based on three-dimensional color Doppler reconstruction.

Three-dimensional (3-D) color Doppler imaging of flow jets was performed to investigate the effects of flow rate and orifice size on jet volumes. Flow jets were generated using a flow model to simulate mitral regurgitation. This flow model consisted of a ventricular chamber, a valvular plate and an atrial chamber. Steady flow was driven through circular orifices having diameters of 2.5, 3.5, 4.5, and 6 mm, respectively, with flow rates of 5, 10, 15, 20, and 25 mL/s to form free jets in the atrial chamber. An ATL Ultramark 9 HDI system was used to perform 3-D color Doppler imaging of the flow jets. A transesophageal probe was rotated by a stepper motor to create 3-D color Doppler images of the jets. The color jet volumes for different hemodynamic conditions were measured and then compared with the theoretical predictions. Results showed that the jet volume estimated from the 3-D color Doppler was directly proportional to the flow rate and inversely proportional to the orifice size. The estimated jet volumes correlated well (r > 0.95) with theoretical predictions. This study supports the use of color jet volume as a parameter to quantify mitral regurgitation.

Blood Flow Velocity↗

Evaluation of voxel-based registration of 3-D power Doppler ultrasound and 3-D magnetic resonance angiographic images of carotid arteries.

Spatial registration and fusion of ultrasound (US) images with other modalities may aid clinical interpretation. We implemented and evaluated on patient data an automated retrospective registration of magnetic resonance angiography (MRA) carotid bifurcation images with 3-D power Doppler ultrasound (PD US) and indirectly with 3-D B-mode US. Volumes were initially thresholded to reduce the uncorrelated noise signals. The registration algorithm subsequently maximized the mutual information measure between the PD US and 3-D MRA via iterative simplex search to find best "rigid body" transformation. We rated the performance of the algorithm visually on (n = 5) clinical MRA and 3-D PD US datasets. We also evaluated quantitatively the effect of thresholding, initial misalignment of the paired volumes and the reproducibility registration. We investigated the effect of image artefacts by simulation experiments. Preregistration misalignments of up to 5 mm in the transaxial plane, up to 10 mm along the axis of the carotids and up to 40 degrees resulted in 107 of 110 successful registrations, with translational and rotational errors of 0.32 mm +/- 0.3 mm and 1.6 +/- 2.1 degrees. The algorithm was not affected by missing arterial segments of up to 8 mm in length. The average registration time was 4 min. We conclude that the algorithm could be applied to 3-D US PD and MRA data for automated multimodality registration of carotid vessels without the use of fiducials.

Algorithms↗

Three-dimensional ultrasound-guided core needle breast biopsy.

A new core needle breast biopsy system guided by 3-D ultrasound (US) is proposed. Our device provides rapid imaging and real-time guidance, as well as breast stabilization and a needle guidance apparatus using 3-D imaging. The targeting accuracy of our device was tested by inserting a 14-gauge biopsy needle into agar phantoms under 3-D US guidance. A total of 18 0.8-mm stainless-steel beads embedded in the phantoms defined each of the four target positions tested. Positioning accuracy was calculated by comparing needle tip position to the preinsertion bead position, as measured by three observers three times each on 3-D US. The interobserver standard error of measurement was no more than 0.14 mm for the beads and 0.27 mm for the needle tips. A 3-D principal component analysis was performed to obtain the population distribution of needle tip position relative to the target beads for the four target positions. The 3-D 95% confidence intervals were found to have total widths ranging from 0.43 to 1.71 mm, depending on direction and bead position.

Biopsy, Needle↗

An automated segmentation method for three-dimensional carotid ultrasound images.

We have developed an automated segmentation method for three-dimensional vascular ultrasound images. The method consists of two steps: an automated initial contour identification, followed by application of a geometrically deformable model (GDM). The formation of the initial contours requires the input of a single seed point by the user, and was shown to be insensitive to the placement of the seed within a structure. The GDM minimizes contour energy, providing a smoothed final result. It requires only three simple parameters, all with easily selectable values. The algorithm is fast, performing segmentation on a 336 x 352 x 200 volume in 25 s when running on a 100 MHz 9500 Power Macintosh prototype. The segmentation algorithm was tested on stenosed vessel phantoms with known geometry, and the segmentation of the cross-sectional areas was found to be within 3% of the true area. The algorithm was also applied to two sets of patient carotid images, one acquired with a mechanical scanner and the other with a freehand scanning system, with good results on both.

Algorithms↗

Three-dimensional ultrasound imaging.

Ultrasound is an inexpensive and widely used imaging modality for the diagnosis and staging of a number of diseases. In the past two decades, it has benefited from major advances in technology and has become an indispensable imaging modality, due to its flexibility and non-invasive character. In the last decade, research investigators and commercial companies have further advanced ultrasound imaging with the development of 3D ultrasound. This new imaging approach is rapidly achieving widespread use with numerous applications. The major reason for the increase in the use of 3D ultrasound is related to the limitations of 2D viewing of 3D anatomy, using conventional ultrasound. This occurs because: (a) Conventional ultrasound images are 2D, yet the anatomy is 3D, hence the diagnostician must integrate multiple images in his mind. This practice is inefficient, and may lead to variability and incorrect diagnoses. (b) The 2D ultrasound image represents a thin plane at some arbitrary angle in the body. It is difficult to localize the image plane and reproduce it at a later time for follow-up studies. In this review article we describe how 3D ultrasound imaging overcomes these limitations. Specifically, we describe the developments of a number of 3D ultrasound imaging systems using mechanical, free-hand and 2D array scanning techniques. Reconstruction and viewing methods of the 3D images are described with specific examples. Since 3D ultrasound is used to quantify the volume of organs and pathology, the sources of errors in the reconstruction techniques as well as formulae relating design specification to geometric errors are provided. Finally, methods to measure organ volume from the 3D ultrasound images and sources of errors are described.

Animals↗

Evaluation of 3-D colour Doppler ultrasound for the measurement of proximal isovelocity surface area.

Three-dimensional (3-D) colour Doppler ultrasound (US) enables flow rate estimation across a diseased valve without the need for a priori geometric assumptions. This study quantitatively evaluates the accuracy of 3-D colour Doppler US for measuring the flow rate (8. 3-75 mL/s) through a valve using the proximal flow convergence field. Flow rate measurements by this 3-D technique underestimate flow through finite circular orifices due to two major sources of error: 1. surface area slicing technique (18.3% +/- 3.8%) and 2. Doppler angle effect (41.0% +/- 1.5%). Combined total underestimation is 51% +/- 3.3%. To utilize 3-D US, the development of an improved proximal isovelocity surface area (PISA) measurement technique and a correction factor for the Doppler angle effect is required.

Blood Flow Velocity↗

Optimum scan spacing for three-dimensional ultrasound by speckle statistics.

A technique is introduced to determine the spacing between acquired two-dimensional (2-D) planes necessary to maintain resolution in the scan direction while maximizing scan speed for 3-D ultrasound (US) imaging. We performed statistical analysis on a series of 3-D scans of agar blocks with different image spacings, quantifying speckle size (S(c)) as the full-width half-maximum (FWHM) of the autocovariance function. S(c) was approximately constant at small 2-D image-plane spacings, but increased after the scan spacing surpassed some optimum point. Optimum spacing ranged between 0.075 and 0.4 mm, increasing with the axial depth and the number of focal zones. This latter dependence is a result of successive sampling by the US machine and the digitizer at unequal rates, as demonstrated through an analysis of the noise power spectra. This analysis predicted that S(c) may be significantly reduced by using a transducer sampling rate that is twice the digitization rate. This technique permits the calculation of the most efficient scan spacings for 3-D US imaging.

Artifacts↗

Three-dimensional echocardiography: assessment of inter- and intra-operator variability and accuracy in the measurement of left ventricular cavity volume and myocardial mass.

Accurate left ventricular (LV) volume and mass estimation is a strong predictor of cardiovascular morbidity and mortality. We propose that our technique of 3D echocardiography provides an accurate quantification of LV volume and mass by the reconstruction of 2D images into 3D volumes, thus avoiding the need for geometric assumptions. We compared the accuracy and variability in LV volume and mass measurement using 3D echocardiography with 2D echocardiography, using in vitro studies. Six operators measured the LV volume and mass of seven porcine hearts, using both 3D and 2D techniques. Regression analysis was used to test the accuracy of results and an ANOVA test was used to compute variability in measurement. LV volume measurement accuracy was 9.8% (3D) and 18.4% (2D); LV mass measurement accuracy was 5% (3D) and 9.2% (2D). Variability in LV volume quantification with 3D echocardiography was %SEMinter = 13.5%, %SEMintra = 11.4%, and for 2D echocardiography was %SEMinter = 21.5%, %SEMintra = 19.1%. We derived an equation to predict uncertainty in measurement of LV volume and mass using 3D echocardiography, the results of which agreed with our experimental results to within 13%. 3D echocardiography provided twice the accuracy for LV volume and mass measurement and half the variability for LV volume measurement as compared with 2D echocardiography.

Analysis of Variance↗

Analysis of geometrical distortion and statistical variance in length, area, and volume in a linearly scanned 3-D ultrasound image.

A linearly scanned three-dimensional (3-D) ultrasound imaging system is considered. The transducer array is initially oriented along the x axis and aimed in the y direction. After being tilted by an angle theta about the x axis, and then swiveled by an angle phi about the y axis, it is translated in the z direction, in steps of size d, to acquire a series of parallel two-dimendional (2-D) images. From these, the 3-D image is reconstructed, using the nominal values of the parameters (phi, theta, d). Thus, any systematic or random errors in these, relative to their actual values (phi0, theta0, d0), will respectively cause distortions or variances in length, area, and volume in the reconstructed 3-D image, relative to the 3-D object. Here, we analyze these effects. Compact linear approximations are derived for the relative distortions as functions of the parameter errors, and hence, for the relative variances as functions of the parameter variances. Also, exact matrix formulas for the relative distortions are derived for arbitrary values of (phi, theta, d) and (phi0, theta0, d0). These were numerically compared to the linear approximations and to measurements from simulated 3-D images of a cubical object and real 3-D images of a wire phantom. In every case tested, the theory was confirmed within experimental error (0.5%).

Artifacts↗