First-in-human diagnostic study of hepatic steatosis with computed ultrasound tomography in echo mode (CUTE)

Stähli, Patrick; Becchetti, Chiara; Martiartu, Naiara Korta; Berzigotti, Annalisa; Frenz, Martin; Jaeger, Michael

doi:10.21203/rs.3.rs-1920871/v1

Cited by 7 publications

(10 citation statements)

References 39 publications

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“…Extending the methods from this paper for real-time layer-wise (as opposed to global) SoS estimation in vivo is another direction that our group is currently developing, following a similar trend as in [25]. Frameworks that have real-time capability for performing SoS estimation layer-wise, region-wise, or locally can be extremely useful for improved quantification of tissue health via the SoS biomarker [13].…”

Section: Limitations and Future Workmentioning

confidence: 94%

“…After all, the SoS, being an intrinsic acoustic property of human tissues, can potentially serve as a biomarker for tissue composition. Indeed, studies have shown that tissue SoS can help to assess intramuscular fat content [4], [5], detect age-related or cast-related muscle decay [6], [7], differentiate between benign and malignant tumors [8]- [10], and quantify accumulation of fat in the liver [11]- [13]. It would be advantageous to clinically derive tissue SoS estimates and, preferably, render this biomarker in parallel to real-time Bmode imaging that is known for its bedside applicability [14].…”

Section: Introductionmentioning

confidence: 99%

“…Through-transmission setups can provide accurate SoS measurements, but they require bilateral access to the tissue (frequently ex vivo) and often provide no imaging capabilities [6], [7], [15]- [17]. For local SoS estimation and USCT, both methods would result in a localized SoS map or image that can identify local structures not visible in the Bmode image or differentiate between various types of tissue [13], [18]- [20]. Early local SoS estimation methods with pulseecho ultrasound have relied on the use of computationally expensive algorithms [18], [19], although recent advances with improved real-time potential have shown initial promise in diagnosing pathological conditions in humans [21]- [25].…”

Section: Introductionmentioning

confidence: 99%

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Real-Time Speed-of-Sound Estimation In Vivo via Steered Plane Wave Ultrasound

Xiao,

Torre,

2024

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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Speed-of-sound (SoS) is an intrinsic acoustic property of human tissues and has been regarded as a potential biomarker of tissue health. To foster the clinical use of this emerging biomarker in medical diagnostics, it is important for SoS estimates to be derived and displayed in real-time. Here, we demonstrate that concurrent global SoS estimation and B-mode imaging can be achieved live on a portable ultrasound scanner. Our innovation is hinged upon the design of a novel pulse-echo SoS estimation framework that is based on steered plane wave imaging. It has accounted for the effects of refraction and imaging depth when the medium SoS differs from the nominal value of 1540 m/s that is conventionally used in medical imaging. The accuracy of our SoS estimation framework was comparatively analyzed with through-transmit timeof-flight measurements in vitro on 15 custom agar phantoms with different SoS values (1508 to 1682 m/s) and in vivo on human calf muscles (N = 9; SoS range: 1560 to 1586 m/s). Our SoS estimation framework has a mean signed difference of, respectively, -0.6±2.3 m/s in vitro and -2.2±11.2 m/s in vivo relative to the reference measurements. Additionally, our real-time system prototype has yielded simultaneous SoS estimates and B-mode imaging at an average frame rate of 18.1 fps. Overall, by realizing real-time tissue SoS estimation with B-mode imaging, our innovation can foster the use of tissue SoS as a biomarker in medical ultrasound diagnostics.

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Section: Limitations and Future Workmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Real-Time Speed-of-Sound Estimation In Vivo via Steered Plane Wave Ultrasound

Xiao,

Torre,

2024

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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“…CUTE has shown promising results in tissue-mimicking phantoms and in vivo [ 19 , 21 ]. In vivo echo shift data are, however, often marked by systematic elevated noise that can arise due to attenuation, aberration, and reverberations, among others, introducing artifacts in the SoS map.…”

Section: Introductionmentioning

confidence: 99%

Excluding Echo Shift Noise in Real-Time Pulse-Echo Speed-of-Sound Imaging

Yolgunlu

Martiartu

Gerber

et al. 2023

Sensors

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Computed ultrasound tomography in echo mode (CUTE) allows real-time imaging of the tissue speed of sound (SoS) using handheld ultrasound. The SoS is retrieved by inverting a forward model that relates the spatial distribution of the tissue SoS to echo shift maps detected between varying transmit and receive angles. Despite promising results, in vivo SoS maps often show artifacts due to elevated noise in echo shift maps. To minimize artifacts, we propose a technique where an individual SoS map is reconstructed for each echo shift map separately, as opposed to a single SoS map from all echo shift maps simultaneously. The final SoS map is then obtained as a weighted average over all SoS maps. Due to the partial redundancy between different angle combinations, artifacts that appear only in a subset of the individual maps can be excluded via the averaging weights. We investigate this real-time capable technique in simulations using two numerical phantoms, one with a circular inclusion and one with two layers. Our results demonstrate that the SoS maps reconstructed using the proposed technique are equivalent to the ones using simultaneous reconstruction when considering uncorrupted data but show significantly reduced artifact level for data that are corrupted by noise.

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“…This is the approach used in computed tomography in echo mode (CUTE), which tracks echo phase shifts caused by SoS heterogeneities when probing tissue at different angles [8]- [10]. CUTE has demonstrated unprecedented spatial and contrast resolution in tissue-mimicking phantoms [11] and is currently undergoing clinical evaluation [12]. This work presents an extension of CUTE to quantify the spatial distribution of US ATT in tissue.…”

Section: Introductionmentioning

confidence: 99%

Towards Attenuation Imaging with Computed Ultrasound Tomography in Echo Mode (CUTE)

Martiartu¹,

Yolgunlu²,

Stähli³

et al. 2022

Preprint

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<p>This work presents a novel attenuation imaging technique for pulse-echo ultrasound systems. In contrast to state-of-the-art techniques, we formulate the reconstruction in two dimensions relying on tissue insonifications with different steering angles. By beamforming backscattered echoes recorded by the transducer, we measure at each location the changes in the amplitudes of detected echoes with different transmissions and relate them to local tissue attenuation. This relationship assumes ultrasound waves propagate in straight paths; thus, we linearize the forward problem to provide suitable time-to-solutions for clinical practice. The presented technique is the natural extension of computed tomography in echo mode (CUTE), initially developed for tissue speed-of-sound quantification. The performance of our method is demonstrated in numerical examples with data computed using the k-Wave numerical solver for wave-propagation simulations. These examples consider tissue-mimicking media with varying heterogeneity in attenuation and echogenicity. The results show that our method can provide images with promising spatial and contrast resolution, as well as attenuation estimates independent of tissue echogenicity. This work represents a necessary first step towards multi-modal CUTE imaging of speed of sound and attenuation in tissue. </p>

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First-in-human diagnostic study of hepatic steatosis with computed ultrasound tomography in echo mode (CUTE)

Cited by 7 publications

References 39 publications

Real-Time Speed-of-Sound Estimation In Vivo via Steered Plane Wave Ultrasound

Real-Time Speed-of-Sound Estimation In Vivo via Steered Plane Wave Ultrasound

Excluding Echo Shift Noise in Real-Time Pulse-Echo Speed-of-Sound Imaging

Towards Attenuation Imaging with Computed Ultrasound Tomography in Echo Mode (CUTE)

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