Non-contrast power Doppler ultrasound imaging for early assessment of trans-arterial chemoembolization of liver tumors

Abstract

Trans-arterial chemoembolization (TACE) is an important yet variably effective treatment for management of hepatic malignancies. Lack of response can be in part due to inability to assess treatment adequacy in real-time. Gold-standard contrast enhanced computed tomography and magnetic resonance imaging, although effective, suffer from treatment-induced artifacts that prevent early treatment evaluation. Non-contrast ultrasound is a potential solution but has historically been ineffective at detecting treatment response. Here, we propose non-contrast ultrasound with recent perfusion-focused advancements as a tool for immediate evaluation of TACE. We demonstrate initial feasibility in an 11-subject pilot study. Treatment-induced changes in tumor perfusion are detected best when combining adaptive demodulation (AD) and singular value decomposition (SVD) techniques. Using a 0.5 s (300-sample) ensemble size, AD + SVD resulted in a 7.42 dB median decrease in tumor power after TACE compared to only a 0.06 dB median decrease with conventional methods.

Ultrasound liver tumor segmentation using adaptively regularized kernel-based fuzzy C means with enhanced level set algorithm

“…The use of image processing techniques has spread across various applications, such as pattern recognition (Veerashetty et al , 2020; Virupakshappa et al , 2019), biomedical applications (Prasath et al , 2019; Virupakshappa et al , 2018), steganography (Ambika et al , 2019; Veerashetty et al , 2021), computer vision and so on (Ambika et al , 2020). On the basis of World Health Organization data, liver disease remains the ninth leading cause of death globally among women and fifth leading cause of death among men (Liu et al , 2017; Tierney et al , 2019; Abdelaziz et al , 2020; Mubarak et al , 2020). In order to diagnose liver disease, several imaging modalities are available such as Computerized Tomography (CT), Ultrasound, Magnetic Resonance Imagining (MRI), Histopathology, Positron Emission Tomography (PET), Angiography and so on (Ferraioli et al , 2018; Lin et al , 2018).…”