Ultrasound Needle Visibility in Contrast Mode Imaging: An In Vitro and Ex Vivo Study

Rominger, Marga B.; Martini, Katharina; Dappa, Evelyn; Puippe, Gilbert; Klingmüller, V.; Frauenfelder, Thomas; Sanabria, Sergio J.

doi:10.1055/s-0043-101511

Cited by 4 publications

(6 citation statements)

References 18 publications

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“…Nevertheless, it was possible to distinguish between needles primed with an undiluted contrast agent and one primed with a contrast-enhanced background. Another limitation of using a water bath phantom is the inability to evaluate the B-mode needle visibility meaningfully due to the inherent good B-mode visibility in liquids [ 9 ]. Taken together, this underscores the need for a follow-up in vivo study of the described priming methods, including an evaluation of both the CEUS-mode and B-mode visibility.…”

Section: Discussionmentioning

confidence: 99%

“…However, the analysis of the B-mode visibility was waived due to the inherent limitations related to using a water bath. The latter since good B-mode needle visibility is obtained in liquids despite low MI [ 9 ]. The B-mode image part of the recordings, however, was used to position the regions of interests (ROIs) correctly and to add arrows to clarify the end position of the needles for the assessors in the qualitative evaluation (see Fig.…”

Section: Methodsmentioning

confidence: 99%

“…Performing biopsies under the guidance of contrast-enhanced ultrasound (CEUS) may be valuable to avoid targeting necrotic (non-diagnostic) tumor areas and to enable a biopsy of focal lesions only visible in the contrast-specific imaging-mode (CEUS-mode) [ 1 – 7 ]. Dual-screen imaging is recommended, with the CEUS-mode image on one side to visualize the lesion, accompanied by a B-mode image on the other side to track the needle because of the inferior CEUS-mode needle visibility [ 7 – 9 ]. To avoid disrupting the ultrasound contrast agent (USCA) microbubbles, the dual-screen B-mode image is of a low mechanical index (MI) and thus, of a lower image quality than in the conventional B-mode [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound Contrast Agent Priming of Biopsy and Introducer Needles by Using a Small Syringe to Improve Needle Visibility in a Phantom Model

Thunswärd

Österberg

Åhlström

2023

Cardiovasc Intervent Radiol

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Purpose Biopsy under the guidance of contrast-enhanced ultrasound is sometimes useful. Needle visualization in contrast-specific imaging-mode is often poor; however, it may be improved by priming the needles with an ultrasound contrast agent. This study aimed to evaluate needle priming methods using the ultrasound contrast agent sulfur hexafluoride and a 1 mL syringe. Material and Methods Two kinds of biopsy needles, side-notch and full core, and one kind of introducer needle were primed using non-primed needles as controls (n = 180). Recordings of punctures were performed in a water bath phantom to which the ultrasound contrast agent had also been added. Contrast-specific imaging-mode needle visibility was evaluated for the entire needles and the needle tips, respectively, quantitatively by calculating the contrast-to-noise ratio and qualitatively via grading by three radiologists. Results The contrast-to-noise ratio following the ultrasound contrast agent priming was superior compared to the controls for the entire needles of all three types (p < 0.001) and for the needle tips of the core biopsy needles and introducer needles (p < 0.001). However, the ratio was equal to the controls for the needle tips of the side-notch biopsy needles (p = 0.19). Needle visibility following the ultrasound contrast agent priming was qualitatively superior compared to the controls for both the entire needles and the needle tips, and the difference was considered clinically relevant by the assessors (p < 0.001). Conclusion The ultrasound contrast agent needle priming methods described increased the contrast-specific imaging-mode needle visibility in a phantom model. Nonetheless, the results also need to be confirmed in vivo.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ultrasound Contrast Agent Priming of Biopsy and Introducer Needles by Using a Small Syringe to Improve Needle Visibility in a Phantom Model

Thunswärd

Österberg

Åhlström

2023

Cardiovasc Intervent Radiol

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“…Beam steering is a common and known method by which a US transmitter can transmit an acoustic beam at any angle (θ) in the lateral plane [39]- [41]. Figure 2(c) shows an arrangement where a small number of elements are considered for the simplicity of explanation.…”

Section: B Image Formationmentioning

confidence: 99%

Needle Aligned Ultrasound Image-Guided Access Through Dual-Segment Array

Rahaman

Tang

Gao

et al. 2023

IEEE Trans. Biomed. Eng.

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Ultrasound (US) guided access for percutaneous nephrolithotomy (PCNL) is gaining popularity in the urology community as it reduces radiation risk. The most popular technique involves manual image-needle alignment. A misaligned needle however needs to be retracted and reinserted, resulting in a lengthened operation time and complications such as bleeding. These limitations can be mitigated through the coregistration between the US array and needle. The through-hole array concept provides the primary solution, including a hole at the center of the array. Because of the central opening, the image-needle alignment is achieved inherently. Previous literature has described applications that are limited to superficial and intravascular procedures, suggesting that developing a throughhole array for deeper target applications would be a new breakthrough. Objective. Here, we present a dual-segment array with a central opening. As the prototype development, two segments of 32-element arrays are combined with an open space of 10 mm in length in between them. Method. We conducted phantom and ex-vivo studies considering the target depth of the 80-100 mm range. The image quality and needle visibility are evaluated by comparing the signal-to-noise ratio (SNR), full width at half maximum (FWHM), and contrast-to-noise ratio (CNR) results measured with a no-hole linear array under equivalent conditions. An ex-vivo study is performed using porcine kidneys with ceramic balls embedded to evaluate the needle access accuracy. Results and conclusion.The mean needle access error of 20 trials is found to be 2.94±1.09 mm, suggesting its potential impact on realizing a simple and intuitive deep US image-guided access.

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“…To improve the success rate and reduce the risks of complications, it is important to visualize the trajectory of the needle and the needle tip [5,6]. In contrast-specific imaging mode (CEUS mode), the needle is sometimes difficult to visualize due to the vivid enhancement of the parenchymatous organs [7,8]. A common approach is using a split-screen mode, showing one CEUS mode image alongside one B-mode image [1,2,7,8].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Contrast Agent Needle Priming: Impact on Sonographic Biopsy Needle Visibility in a Porcine Liver Model

Thunswärd,

Bergkvist,

Vishnevskaya

et al. 2024

Cardiovasc Intervent Radiol

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Purpose The visibility of biopsy needles in contrast-specific imaging mode can be improved by priming them with an ultrasound contrast agent (previously demonstrated in a phantom model/ex vivo). The purpose of this study was to validate this priming method in a porcine in vivo model. Materials and Methods Using a small syringe, full-core biopsy needles were primed with sulfur hexafluoride, an ultrasound contrast agent, with non-primed needles serving as controls (n = 30 + 30). Liver punctures were performed in a porcine model following intravenous administration of the same ultrasound contrast agent. Needle visibility, both in their entirety and at the tips, was evaluated in split-screen mode using contrast-specific imaging and B-mode (low mechanical index). The assessment included quantitative analysis, calculating the contrast-to-noise ratio, and qualitative evaluation through structured grading by three radiologists. Results After needle priming, the contrast-to-noise ratio was superior for the needle in its entirety in contrast-specific imaging mode (p < 0.001) and slightly inferior in B-mode (p = 0.008). No differences were observed for the needle tips in either imaging mode. Qualitatively, the needle visibility was deemed clinically superior after needle priming throughout in contrast-specific imaging mode (p < 0.001), whereas no clinically relevant differences in B-mode for either the needle in its entirety (p = 0.11) or the needle tip (p = 1) were observed. Conclusion In this in vivo porcine liver model experiment, priming biopsy needles with ultrasound contrast agent improved needle visibility in contrast-specific imaging mode but slightly reduced it in B-mode. These findings support the method’s use for biopsies requiring target visualization in contrast-specific imaging mode. No level of evidence. Graphical Abstract

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Ultrasound Needle Visibility in Contrast Mode Imaging: An In Vitro and Ex Vivo Study

Abstract: Abstr Ac tPurpose To evaluate needle visibility in ultrasound under contrast mode conditions. Materials and Methods

Cited by 4 publications

References 18 publications

Ultrasound Contrast Agent Priming of Biopsy and Introducer Needles by Using a Small Syringe to Improve Needle Visibility in a Phantom Model

Ultrasound Contrast Agent Priming of Biopsy and Introducer Needles by Using a Small Syringe to Improve Needle Visibility in a Phantom Model

Needle Aligned Ultrasound Image-Guided Access Through Dual-Segment Array

Ultrasound Contrast Agent Needle Priming: Impact on Sonographic Biopsy Needle Visibility in a Porcine Liver Model

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