Three-dimensional US for Quantification of Volumetric Blood Flow:                    Multisite Multisystem Results from within the Quantitative Imaging Biomarkers                    Alliance

Kripfgans, Oliver D.; Pintér, Š.; Baiu, C; Bruce, Matthew; Carson, Paul L.; Chen, Shigao; Erpelding, Todd N.; Gao, Jing; Lockhart, Mark E.; Milkowski, Andy; Obuchowski, Nancy A.; Robbin, Michelle L.; Rubin, Jonathan M.; Zagzebski, James A.; Fowlkes, J. Brian

doi:10.1148/radiol.2020191332

Cited by 15 publications

(6 citation statements)

References 22 publications

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“…Multiple evaluations of the GSI method in phantoms and animals have shown excellent accuracies even in circumstances in which the standard Doppler method would likely fail because of flow situations that do not adhere to the strict assumptions made with that technique. 17,31 In conclusion, this study suggests that the GSI 3D approach to flow quantification is much more precise than the current spectral Doppler method. Furthermore, it is not hard to believe that flow measurements using this method will be easier to perform than those with the spectral method, particularly since the requirements of angle correction and vessel diameter measurement are no longer necessary.…”

Section: Discussionmentioning

confidence: 65%

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Comparison of Variations Between Spectral Doppler and Gaussian Surface Integration Methods for Umbilical Vein Blood Volume Flow

Rubin

Fowlkes

et al. 2020

J of Ultrasound Medicine

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Objectives We are studying a new method for estimating blood volume flow that uses 3‐dimensional ultrasound to measure the total integrated flux through an ultrasound‐generated Gaussian surface that intersects the umbilical cord. This method makes none of the assumptions typically required with standard 1‐dimensional spectral Doppler volume flow estimates. We compared the variations in volume flow estimates between techniques in the umbilical vein. Methods The study was Institutional Review Board approved, and all 12 patients gave informed consent. Because we had no reference standard for the true umbilical vein volume flow, we compared the variations of the measurements for the flow measurement techniques. At least 3 separate spectral Doppler and 3 separate Gaussian surface measurements were made along the umbilical vein. Means, standard deviations, and coefficients of variation (standard deviation/mean) for the flow estimation techniques were calculated for each patient. P < .05 was considered significant. Results The ranges of the mean volume flow estimates were 174 to 577 mL/min for the spectral Doppler method and 100 to 341 mL/min for the Gaussian surface integration (GSI) method. The mean standard deviations (mean ± SD) were 161 ± 95 and 45 ± 48 mL/min for the spectral Doppler and GSI methods, respectively (P < .003). The mean coefficients of variation were 0.46 ± 0.17 and 0.18 ± 0.14 for the spectral Doppler and GSI methods respectively (P < 0.002). Conclusions The new volume flow estimation method using 3‐dimensional ultrasound appears to have significantly less variation in estimates than the standard 1‐dimensional spectral Doppler method.

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Section: Discussionmentioning

confidence: 65%

“…That is not to say that the GSI flow method is not accurate. Multiple evaluations of the GSI method in phantoms and animals have shown excellent accuracies even in circumstances in which the standard Doppler method would likely fail because of flow situations that do not adhere to the strict assumptions made with that technique 17,31 …”

Section: Discussionmentioning

confidence: 99%

Comparison of Variations Between Spectral Doppler and Gaussian Surface Integration Methods for Umbilical Vein Blood Volume Flow

Rubin

Fowlkes

et al. 2020

J of Ultrasound Medicine

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“…It has been recently proven that three-dimensional ultrasound may be a novel, promising, potentially easily accessible and accurate tool in quantification of volumetric blood flow [35].…”

Section: Discussionmentioning

confidence: 99%

Volumetric Flow Assessment in Doppler Ultrasonography in Risk Stratification of Patients with Internal Carotid Stenosis and Occlusion

Kaszczewski

Elwertowski

Leszczyński

et al. 2022

JCM

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(1) Background: Alterations of blood flow volume in extracranial arteries may be related to the risk of occurrence of neurological symptoms. The aim of this study was the estimation of cerebral blood flow (CBF) in Doppler ultrasonography, as well as comparison of the flow volume in asymptomatic patients over 65 years old with ≥50%, and symptomatic patients with ≥70% internal carotid artery (ICA) stenosis, in order to assess whether the changes in the CBF correlates with the presence of neurological symptoms. (2) Methods: 308 patients over 65 years old were included in the retrospective cohort observational study: 154 asymptomatic with ≥50% ICA stenosis, 123 healthy volunteers, and 31 symptomatic referred for surgical treatment. The study group was split according to ICA stenosis (50–69%, 70–99% and occlusion). In all patients an extensive Doppler ultrasound examination with measurements of flow volume in common, internal, external carotid (ECA) and vertebral arteries (VA) was performed. (3) Results: Among asymptomatic (A) and symptomatic (S) patients with carotid stenosis 3 subgroups were identified: 57/154—37% (A) and 8/31—25.5% (S)—with significantly increased flow volume (CBF higher than reference range: average CBF + std. dev in the group of healthy volunteers), 67/154—43.5% (A) and 12/31—39% (S)—with similar to reference group flow volume (CBF within range average ± std.dev), and 30/154—19.5% (A) and 11/31—35.5% (S)—with decreased flow volume in extracranial arteries (flow lower than average-std.dev. in healthy volunteers). In symptomatic patients the percentage of patients with significant compensatory increased flow tends to raise with the severity of the stenosis, while simultaneous decline of number of patients with mild compensation (unchanged total CBF) is observed. The percentage of patients without compensation remains unchanged. In the group referred for surgical treatment (symptomatic, ≥70% ICA stenosis) the percentage of patients with flow compensation is twice as low as in the asymptomatic ones with similar degree of the ICA stenosis (8/31—25.8% vs. 26/53—49%, p = 0.04). Compensatory elevated flow was observed most frequently in ECA. (4) Conclusions: The presence of significant volumetric flow compensation has protective influence on developing ischaemic symptoms, including TIA or stroke. The assessment of cerebral inflow in Doppler ultrasonography may provide novel and easily accessible tool of identifying patients prone to cerebral ischaemia. The multivessel character of compensation with enhanced role of ECA justifies the importance of including this artery in the estimation of CBF.

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“…The RAB6‐D is a mechanical 3D probe while the X6‐1 and XL14‐3 transducers are 2D arrays capable of 3D imaging. The 3D acquisitions were required in order to measure umbilical cord blood volume flow using the Gaussian surface integration method 15–20 . However, umbilical venous spectra were acquired in standard 1D pulse wave (PW) mode with Doppler angles less than 60° in all cases.…”

Section: Methodsmentioning

confidence: 99%

Umbilical Vein Pulse Wave Spectral Analysis: A Possible Method for Placental Assessment Through Evaluation of Maternal and Fetal Flow Components

Rubin

Fowlkes

Pintér

et al. 2021

J of Ultrasound Medicine

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Objectives-Placental blood flow analysis is complicated by having both maternal and fetal flow components. Using the Fast Fourier Transform (FFT) of the umbilical venous pulse wave spectra (PW) envelope, we could simultaneously assess maternal/fetal blood flow in the placenta and investigate if normal and intrauterine growth restriction (IUGR)/pre-eclamptic pregnancies could be distinguished.Methods-This retrospective study included normal gestations (N = 11) and gestations with IUGR, pre-eclampsia, or both (N = 13). Umbilical vein PW were acquired and spectral envelopes were identified as a function of time and analyzed by FFT. Base-10 logarithms of the ratios of the maternal/fetal spectral peaks (LRSP) were compared in normal and IUGR/pre-eclamptic populations (two-tailed t-test). Body mass index (BMI), gestational age at scan time, placental position, and weight-normalized umbilical vein blood volume flow (two-tailed t-test, analysis of variance [ANOVA] analysis) were tested. P < .05 was considered significant.Results-The LRSP for normal and IUGR/pre-eclamptic pregnancies were 0.141 AE 0.180 and À0.072 AE 0.262 (mean AE standard deviation), respectively (P = .033). We detected differences between normal gestations and combinations of LRSP and weight-normalized umbilical venous blood flows. Placental effects based on LRSPs and blood flow may act synergistically in cases with both pre-eclampsia and IUGR (P = .014). No other significant associations were seen.Conclusions-In this preliminary study, we showed that umbilical venous flow contains markers related to placental maternal/fetal blood flow, which can be used to assess IUGR and pre-eclampsia. When coupled with umbilical cord blood flow, this new marker may potentially identify the primary causes of the two conditions. Key Words-placenta; spectral analysis; umbilical cord Doppler; umbilical vein Doppler P lacental insufficiency is a broad term that has been associated with a range of maternal and fetal complications including intrauterine growth restriction (IUGR) and pre-eclampsia. The association of growth restriction with pre-eclampsia is thought to be due to alterations in the normal blood flow through the placenta during pregnancy. 1,2 Unfortunately, assessment of placental blood flow is difficult, since it is complicated by Cover image article

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Three-dimensional US for Quantification of Volumetric Blood Flow: Multisite Multisystem Results from within the Quantitative Imaging Biomarkers Alliance

Cited by 15 publications

References 22 publications

Comparison of Variations Between Spectral Doppler and Gaussian Surface Integration Methods for Umbilical Vein Blood Volume Flow

Comparison of Variations Between Spectral Doppler and Gaussian Surface Integration Methods for Umbilical Vein Blood Volume Flow

Volumetric Flow Assessment in Doppler Ultrasonography in Risk Stratification of Patients with Internal Carotid Stenosis and Occlusion

Umbilical Vein Pulse Wave Spectral Analysis: A Possible Method for Placental Assessment Through Evaluation of Maternal and Fetal Flow Components

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