Echocardiography is an excellent tool for visualizing heart anatomy and function, however inadequate and suboptimal visualization of the heart is becoming problematic as the overweight and obese population in the United States has increased dramatically over the last two decades. Inadequate or suboptimal visualization of the heart leads to increased exam time, decreased patient throughput, diminished quality or indeterminate diagnosis, and possible referral of the patient to other imaging procedures. These additional and alternative imaging methods can increase the costs associated with care and can potentially require the patient to have invasive or hazardous imaging procedures. We have previously developed a new ultrasonic imaging method, called Harmonic Spatial Coherence (HSC) imaging, that greatly enhances image quality by suppressing noise in the ultrasound image that is typically encountered in difficult-to-image patients. This is particularly important to echocardiography, in which diagnoses of cardiac anatomy and function are unobtainable in 12?64% of conventional echocardiograms. We have previously developed a prototype ultrasound imaging system that can display HSC images in real-time and have used this system to show that HSC imaging is vastly superior to conventional tissue harmonic imaging (THI) in visualizing the interior borders of the heart (i.e. the endocardium). In this project, we propose to translate our HSC imaging technique to clinical use in echocardiography by developing techniques to enable HSC imaging on a modern clinical ultrasound system. We propose to utilize this system in a large clinical study over two institutions to demonstrate its utility in clinically meaningful tasks and measurements. In addition, we propose development of several strategies that will enable easier implementation of this technique on modern ultrasound scanners. These strategies will reduce its computational burden and enable it to be applied to a wide array of modern scanners. In addition, these strategies should allow HSC to be applied to 3D echocardiography, an increasingly utilized modality due to the availability of high-quality matrix transducers. The outcome of this work will yield an imaging solution for the difficult-to-image patient that can be rapidly deployed across modern ultrasound imaging systems and echocardiography clinics.

Public Health Relevance

In this project, we propose to develop a technique that makes better ultrasound images of the heart in people so that clinicians can improve the care they provide to these patients. We will study the ability of this technique in patients to image and measure heart function by building it on an ultrasound system used by healthcare professionals and testing it on patients who have poor quality ultrasound images.

National Institute of Health (NIH)
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Research Project (R01)
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Biomedical Imaging Technology Study Section (BMIT)
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King, Randy Lee
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Stanford University
Schools of Medicine
United States
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Hyun, Dongwoon; Abou-Elkacem, Lotfi; Perez, Valerie A et al. (2018) Improved Sensitivity in Ultrasound Molecular Imaging With Coherence-Based Beamforming. IEEE Trans Med Imaging 37:241-250
Hyun, Dongwoon; Crowley, Anna Lisa C; Dahl, Jeremy J (2017) Efficient Strategies for Estimating the Spatial Coherence of Backscatter. IEEE Trans Ultrason Ferroelectr Freq Control 64:500-513
Lediju Bell, Muyinatu A; Dahl, Jeremy J; Trahey, Gregg E (2015) Resolution and brightness characteristics of short-lag spatial coherence (SLSC) images. IEEE Trans Ultrason Ferroelectr Freq Control 62:1265-76
Kakkad, Vaibhav; Dahl, Jeremy; Ellestad, Sarah et al. (2015) In vivo application of short-lag spatial coherence and harmonic spatial coherence imaging in fetal ultrasound. Ultrason Imaging 37:101-16
Li, You Leo; Dahl, Jeremy J (2015) Coherent flow power Doppler (CFPD): flow detection using spatial coherence beamforming. IEEE Trans Ultrason Ferroelectr Freq Control 62:1022-35
Pinton, Gianmarco; Trahey, Gregg; Dahl, Jeremy (2014) Spatial coherence in human tissue: implications for imaging and measurement. IEEE Trans Ultrason Ferroelectr Freq Control 61:1976-87
Hyun, Dongwoon; Trahey, Gregg E; Jakovljevic, Marko et al. (2014) Short-lag spatial coherence imaging on matrix arrays, part 1: Beamforming methods and simulation studies. IEEE Trans Ultrason Ferroelectr Freq Control 61:1101-12
Jakovljevic, Marko; Byram, Brett C; Hyun, Dongwoon et al. (2014) Short-lag spatial coherence imaging on matrix arrays, part II: Phantom and in vivo experiments. IEEE Trans Ultrason Ferroelectr Freq Control 61:1113-22
Dahl, Jeremy J; Sheth, Niral M (2014) Reverberation clutter from subcutaneous tissue layers: simulation and in vivo demonstrations. Ultrasound Med Biol 40:714-26
Lediju Bell, Muyinatu A; Goswami, Robi; Kisslo, Joseph A et al. (2013) Short-lag spatial coherence imaging of cardiac ultrasound data: initial clinical results. Ultrasound Med Biol 39:1861-74

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