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The results of a quantitative study of the impact of sound speed errors on the spatial resolution and amplitude sensitivity of a commercial medical ultrasound scanner are presented in the context of their clinical significance. The beamforming parameters of the scanner were manipulated to produce sound speed errors ranging over +/-8% while imaging a wire target and an attenuating, speckle-generating phantom. For the wire target, these errors produced increases in lateral beam width of up to 320% and reductions in peak echo amplitude of up to 10.5 dB. In the speckle-generating phantom, these errors produced increases in speckle intensity correlation cell area of up to 92% and reductions in mean speckle brightness of up to 5.6 dB. These results are applied in statistical analyses of two detection tasks of clinical relevance. The first is of low contrast lesion detectability, predicting the changes in the correct decision probability as a function of lesion size, contrast, and sound speed error. The second is of point target detectability, predicting the changes in the correct decision probability as function of point target reflectivity and sound speed error. Representative results of these analyses are presented and their implications for clinical imaging are discussed. In general, sound speed errors have a more significant impact on point target detectability over lesion detectability by these analyses, producing up to a 22% reduction in correct decisions for a typical error.

Recombinant human erythropoietin (rHuEpo) increases haemoglobin mass (Hbmass) and maximal oxygen uptake ( O2 max).PurposeThis study defined the time course of changes in Hbmass, O2 max as well as running time trial performance following 4 weeks of rHuEpo administration to determine whether the laboratory observations would translate into actual improvements in running performance in the field.Methods19 trained men received rHuEpo injections of 50 IU•kg−1 body mass every two days for 4 weeks. Hbmass was determined weekly using the optimized carbon monoxide rebreathing method until 4 weeks after administration. O2 max and 3,000 m time trial performance were measured pre, post administration and at the end of the study.ResultsRelative to baseline, running performance significantly improved by ∼6% after administration (10∶30±1∶07 min:sec vs. 11∶08±1∶15 min:sec, p<0.001) and remained significantly enhanced by ∼3% 4 weeks after administration (10∶46±1∶13 min:sec, p<0.001), while O2 max was also significantly increased post administration (60.7±5.8 mL•min−1•kg−1 vs. 56.0±6.2 mL•min−1•kg−1, p<0.001) and remained significantly increased 4 weeks after rHuEpo (58.0±5.6 mL•min−1•kg−1, p = 0.021). Hbmass was significantly increased at the end of administration compared to baseline (15.2±1.5 g•kg−1 vs. 12.7±1.2 g•kg−1, p<0.001). The rate of decrease in Hbmass toward baseline values post rHuEpo was similar to that of the increase during administration (−0.53 g•kg−1•wk−1, 95% confidence interval (CI) (−0.68, −0.38) vs. 0.54 g•kg−1•wk−1, CI (0.46, 0.63)) but Hbmass was still significantly elevated 4 weeks after administration compared to baseline (13.7±1.1 g•kg−1, p<0.001).ConclusionRunning performance was improved following 4 weeks of rHuEpo and remained elevated 4 weeks after administration compared to baseline. These field performance effects coincided with rHuEpo-induced elevated O2 max and Hbmass.

A method for the direct estimation of the longitudinal speed of sound in a medium is presented. This estimator derives the speed of sound through analysis of pulse-echo data received across a single transducer array following a single transmission, and is analogous to methods used in exploration seismology. A potential application of this estimator is the dynamic correction of beamforming errors in medical imaging that result from discrepancy between the assumed and actual biological tissue velocities. The theoretical basis of this estimator is described and its function demonstrated in phantom experiments. Using a wire target, sound-speed estimates in water, methanol, ethanol, and n-butanol are compared to published values. Sound-speed estimates in two speckle-generating phantoms are also compared to expected values. The mean relative errors of these estimates are all less than 0.4%, and under the most ideal experimental conditions are less than 0.1%. The relative errors of estimates based on independent regions of speckle-generating phantoms have a standard deviation on the order of 0.5%. Simulation results showing the relative significance of potential sources of estimate error are presented. The impact of sound-speed errors on imaging and the potential of this estimator for phase aberration correction and tissue characterization are also discussed.

Nineteen well-trained cyclists (14 males and 5 females, mean initial .VO(2max) 62.3 ml kg(-1 )min(-1)) completed a multistage cycle ergometer test to determine maximal mean power output in 4 min (MMPO(4min)), maximal oxygen uptake (.VO(2max)) and maximal accumulated oxygen deficit (MAOD). The athletes were divided into three groups, each of which completed 5, 10 or 15 days of both a control condition (C) and live high:train low altitude exposure (LHTL). The C groups lived and trained at the ambient altitude of 610 m. The LHTL groups spent 8-10 h night(-1) in normobaric hypoxia at a simulated altitude of 2,650 m, and trained at the ambient altitude of 610 m. The changes to MMPO(4min), .VO(2max) and MAOD in response to LHTL altitude exposure were not significantly different for the 5-, 10- and 15-day treatment periods. For the pooled data from all three treatment periods, there were significant increases in MMPO(4min) [mean (SD) 5.15 (0.83) W kg(-1) vs 5.34 (0.78) W kg(-1)] and MAOD [50.1 (14.2) ml kg(-1) vs 54.9 (13.1) ml kg(-1)] in the LHTL athletes between pre- and post-altitude exposure. There were no significant changes in MMPO(4min) [5.09 (0.76) W kg(-1) vs 5.16 (0.86) W kg(-1)] or MAOD [50.5 (14.1) ml kg(-1) vs 49.1 (13.0) ml kg(-1)] in the C athletes over the corresponding period. There were significant increases in .VO(2max) in the athletes during both the LHTL [63.2 (9.0) ml kg(-1 )min(-1) vs 64.1 (9.0) ml kg(-1 )min(-1)] and C [62.0 (8.6) ml kg(-1 )min(-1) vs 63.4 (9.2) ml kg(-1 )min(-1)] conditions. In these athletes, there was no difference in the impact of 5, 10 or 15 days of LHTL on the increases observed in MMPO(4min), .VO(2max) or MAOD; and LHTL increased MMPO(4min) and MAOD more than training at low altitude alone.