A pilot study to measure vascular compliance changes during fistula maturation using open-source software

Belmont, Barry; Park, Dae Woo; Shih, Albert J.; Leavitt, Matthew; Plattner, Brett; Henke, Peter K.; Weitzel, William F.

doi:10.1177/1129729818773307

Cited by 9 publications

(26 citation statements)

References 16 publications

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“…These findings may have significant clinical implications. First, these independent intramural strain measurements support recent observations that this open-source data can be used to detect very small overall wall deformation, that is, the 1%–7% overall strain values in previous studies 4,5,14–16 corresponds to 50–350 μm excursions for an average size 5 mm diameter vessel. Second, and perhaps more exciting, these results imply that we and other researchers have an opportunity to expand the technology further by leveraging the information available in this rich B-mode ultrasound cine loop dataset.…”

Section: Discussionsupporting

confidence: 85%

“…Previously developed open-source software 4,5 was used to measure vascular distensibility (tracking vessel wall diameter changes over time) of brachial and radial arteries using standard ultrasound B-mode DICOM cine loop data. For consistency of measurement of vessel distensibility, two points along an imaginary vertical line in the center of the vessel were selected in the first frame of the ultrasound cine loop.…”

Section: Methodsmentioning

confidence: 99%

“…We previously tested speckle tracking methods using DICOM data to measure vascular distensibility. 4,5 Since distensibility is determined by tracking the pulsation of the vessel using points on opposite sides of the vessel wall, the points tracked are separated by distances related to the vessel diameter, that is, several millimeters. Since high frequency (>7 MHz) RF speckle tracking has sufficiently high resolution, it allows measurement of the gradient of the displacement within the vessel wall, 6,8 that is, submillimeter resolution within the vessel wall (intramural vascular strain).…”

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confidence: 99%

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Detecting High-Resolution Intramural Vascular Wall Strain Signals Using DICOM Data

et al. 2021

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Maintaining dialysis vascular access is a source of considerable morbidity in patients with end-stage renal disease (ESRD). High-resolution radiofrequency (RF) ultrasound vascular strain imaging has been applied experimentally in the vascular access setting to assist in diagnosis and management. Unfortunately, high-resolution RF data are not routinely accessible to clinicians. In contrast, the standard DICOM formatted B-mode ultrasound data are widely accessible. However, B-mode, representing the envelope of the RF signal, is of much lower resolution. If strain imaging could use open-source B-mode data, these imaging techniques could be more broadly investigated. We conducted experiments to detect wall strain signals with submillimeter tracking resolutions ranging from 0.2 mm (3 pixels) to 0.65 mm (10 pixels) using DICOM B-mode data. We compared this submillimeter tracking to the overall vascular distensibility as the reference measurements to see if high-strain resolution strain could be detected using open-source B-Mode data. We measured the best-fit coefficient of determination between signals, expressed as the percentage of strain waveforms that exhibited a correlation with a p value of 0.05 or less. The lowest percentage was 86.7%, and most were 90% and higher. This indicates high-resolution strain signals can be detected within the vessel wall using B-mode DICOM data.

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Section: Discussionsupporting

confidence: 85%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Detecting High-Resolution Intramural Vascular Wall Strain Signals Using DICOM Data

et al. 2021

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“…8,21 We have developed an open source ultrasound software program for the automated measurement of vessel diameter, distensibility and wall shear rate. 13,14,17 Here, we apply this novel speckle tracking technology employing readily accessible DICOM data to examine the effect of interventional procedures on vascular distensibility.…”

Section: Discussionmentioning

confidence: 99%

“…12 More recently, vascular access distensibility has been shown to change during dialysis fistula maturation. 13,14 We are developing algorithms and software based on ultrasound speckle tracking that provide high-resolution wall compliance (distensibility) measurements. [13][14][15][16][17][18] Although these methods were originally developed to use the high resolution radiofrequency data from ultrasound images, [13][14][15][16][17][18] we sought to test their ability to measure motion with high precision using lower resolution DICOM data, which are readily available in standard ultrasound images.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound speckle tracking to detect vascular distensibility changes from angioplasty and branch ligation in a radio-cephalic fistula: Use of novel open source software

et al. 2020

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We used novel open source software, based on an ultrasound speckle tracking algorithm, to examine the distensibility of the vessel wall of the inflow artery, anastomosis, and outflow vein before and after two procedures. An 83-year-old white man with a poorly maturing radio-cephalic fistula received an angioplasty at the anastomosis followed by branch ligation 28 days later. Duplex Doppler measurements corroborated the blood flow related changes anticipated from the interventions. The experimental distensibility results showed that it is technically feasible to measure subtle vessel wall motion changes with high resolution (sub-millimeter) using standard Digital Imaging and Communications in Medicine (DICOM) ultrasound data, which are readily available on conventional ultrasound scanners. While this methodology was originally developed using high resolution radiofrequency from ultrasound data, the goal of this study was to use DICOM data, which makes this technology accessible to a wide range of users.

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Semiautomated Software to Improve Stability and Reduce Operator‐Induced Variation in Vascular Ultrasound Speckle Tracking

Rajaram

Thelen

Hamilton

et al. 2022

J of Ultrasound Medicine

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Objectives Ultrasound is useful in predicting arteriovenous fistula (AVF) maturation, which is essential for hemodialysis in end‐stage renal disease patients. We developed ultrasound software that measures circumferential vessel wall strain (distensibility) using conventional ultrasound Digital Imaging and Communications in Medicine (DICOM) data. We evaluated user‐induced variability in measurement of arterial wall distensibility and upon finding considerable variation we developed and tested 2 methods for semiautomated measurement. Methods Ultrasound scanning of arteries of 10 subjects scheduled for AVF surgery were performed. The top and bottom of the vessel wall were tracked using the Kanade‐Lucas‐Tomasi (KLT) feature‐tracking algorithm over the stack of images in the DICOM cine loops. The wall distensibility was calculated from the change of vessel diameter over time. Two semiautomated methods were used for comparison. Results The location of points selected by users for the cine loops varied significantly, with a maximum spread of up to 120 pixels (7.8 mm) for the top and up to 140 pixels (9.1 mm) for the bottom of the vessel wall. This variation in users' point selection contributed to the variation in distensibility measurements (ranging from 5.63 to 41.04%). Both semiautomated methods substantially reduced variation and were highly correlated with the median distensibility values obtained by the 10 users. Conclusions Minimizing user‐induced variation by standardizing point selection will increase reproducibility and reliability of distensibility measurements. Our recent semiautomated software may help expand use in clinical studies to better understand the role of vascular wall compliance in predicting the maturation of fistulas.

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A pilot study to measure vascular compliance changes during fistula maturation using open-source software

Abstract: This study demonstrates that the change in vessel diameter and distensibility related to the healthy remodeling as the vein dilates during maturation.

Cited by 9 publications

References 16 publications

Detecting High-Resolution Intramural Vascular Wall Strain Signals Using DICOM Data

Detecting High-Resolution Intramural Vascular Wall Strain Signals Using DICOM Data

Ultrasound speckle tracking to detect vascular distensibility changes from angioplasty and branch ligation in a radio-cephalic fistula: Use of novel open source software

Semiautomated Software to Improve Stability and Reduce Operator‐Induced Variation in Vascular Ultrasound Speckle Tracking

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