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Biomedical subjects

Ernest J Feleppa

Publications and source records attributed to Ernest J Feleppa.

10 recordsLinked to original sources

Improved visualization of high-intensity focused ultrasound lesions.

Spectral parameter imaging in both the fundamental and harmonic of backscattered radio-frequency (RF) data were used for immediate visualization of high-intensity focused ultrasound (HIFU) lesion sites. A focused 5-MHz HIFU transducer with a coaxial 9-MHz focused single-element diagnostic transducer was used to create and scan lesions in chicken breast and freshly excised rabbit liver. B-mode images derived from the backscattered RF signal envelope were compared with midband fit (MBF) spectral parameter images in the fundamental (9-MHz) and harmonic (18-MHz) bands of the diagnostic probe. Images of HIFU-induced lesions derived from the MBF to the calibrated spectrum showed improved contrast (approximately 3 dB) of tumor margins versus surround compared with images produced from the conventional signal envelope. MBF parameter images produced from the harmonic band showed higher contrast in attenuated structures (core, shadow) compared with either the conventional envelope (3.3 dB core; 11.6 dB shadow) or MBF images of the fundamental band (4.4 dB core; 7.4 dB shadow). The gradient between the lesion and surround was 3.4 dB/mm, 6.9 dB/mm and 17.2 dB/mm for B-mode, MBF-fundamental mode and MBF-harmonic mode, respectively. Images of threshold and "popcorn" lesions produced in freshly excised rabbit liver were most easily visualized and boundaries best-defined using MBF-harmonic mode.

Animals↗

On the statistics of ultrasonic spectral parameters.

Several factors affect the accuracy and precision of ultrasonic spectrum analysis, which is used for characterization of normal and diseased tissue in a variety of organs. For example, averaging procedures and the sequence of operations affect the accuracy and precision of spectrum analysis. Averaging procedures and logarithmic conversion (i.e., conversion to dB) introduce a constant bias that affects spectral amplitudes and the values of intercept and midband fit; the bias depends on the sequencing of the log conversion and averaging as well as the number of independent spectra or spectral parameters that are averaged. We derive expressions that permit correction of such biases. Furthermore, we show that standard deviations for slope and midband-fit estimation can be minimized by averaging spectra before dB conversion and before computing spectral parameters by linear regression. Experimental results using phantoms agree remarkably with theoretical predictions for the data window functions studied in this article, Hamming and rectangular.

Humans↗

75 MHz ultrasound biomicroscopy of anterior segment of eye.

Very high frequency ultrasound (35-50 MHz) has had a significant impact upon clinical imaging of the anterior segment of the eye, offering an axial resolution as small as 30 microm. Higher frequencies, while potentially offering even finer resolution, are more affected by absorption in ocular tissues and even in the fluid coupling medium. Our aim was to develop and apply improved transducer technology utilizing frequencies beyond those routinely used for ultrasound biomicroscopy of the eye. A 75-MHz lithium niobate transducer with 2 mm aperture and 6 mm focal length was fabricated. We scanned the ciliary body and cornea of a human eye six years post-LASIK. Spectral parameter images were produced from the midband fit to local calibrated power spectra. Images were compared with those produced using a 35 MHz lithium niobate transducer of similar fractional bandwidth and focal ratio. The 75-MHz transducer was found to have a fractional bandwidth (-6 dB) of 61%. Images of the post-LASIK cornea showed higher stromal backscatter at 75 MHz than at 35 MHz. The improved lateral resolution resulted in better visualization of discontinuities in Bowman's layer, indicative of microfolds or breaks occurring at the time of surgery. The LASIK surface was evident as a discontinuity in stromal backscatter between the stromal component of the flap and the residual stroma. The iris and ciliary body were visualized despite attenuation by the overlying sclera. Very high frequency ultrasound imaging of the anterior segment of the eye has been restricted to the 35-50 MHz band for over a decade. We showed that higher frequencies can be used in vivo to image the cornea and anterior segment. This improvement in resolution and high sensitivity to backscatter from the corneal stroma will provide benefits in clinical diagnostic imaging of the anterior segment.

Adult↗

Effects of ultrasonic exposure parameters on myocardial lesions induced by high-intensity focused ultrasound.

OBJECTIVE: This study evaluated variables relevant to creating myocardial lesions using high-intensity focused ultrasound (HIFU). Without an effective means of tracking heart motion, lesion formation in the moving ventricle can be accomplished by intermittent delivery of HIFU energy synchronized by electrocardiographic triggering. In anticipation of future clinical applications, multiple lesions were created by brief HIFU pulses in calf myocardial tissue ex vivo. METHODS: Experiments used f-number 1.1 spherical cap HIFU transducers operating near 5 MHz with in situ spatial average intensities of 13 and 7.4 kW/cm2 at corresponding depths of 10 and 25 mm in the tissue. The distance from the HIFU transducer to the tissue surface was measured with a 7.5-MHz A-mode transducer coaxial and confocal with the HIFU transducer. After exposures, fresh, unstained tissue was dissected to measure visible lesion length and width. Lesion dimensions were plotted as functions of pulse parameters, cardiac structure, tissue temperature, and focal depth. RESULTS: Lesion size in ex vivo tissue depended strongly on the total exposure time but did not depend strongly on pulse duration. Lesion width depended strongly on the pulse-to-pulse interval, and lesion width and length depended strongly on the initial tissue temperature. CONCLUSIONS: High-intensity focused ultrasound creates well-demarcated lesions in ex vivo cardiac muscle without damaging intervening or distal tissue. These initial studies suggest that HIFU offers an effective, noninvasive method for ablating myocardial tissues to treat several important cardiac diseases.

Animals↗

Interlaboratory comparison of ultrasonic backscatter coefficient measurements from 2 to 9 MHz.

OBJECTIVE: As are the attenuation coefficient and sound speed, the backscatter coefficient is a fundamental ultrasonic property that has been used to characterize many tissues. Unfortunately, there is currently far less standardization for the ultrasonic backscatter measurement than for the other two, as evidenced by a previous American Institute of Ultrasound in Medicine (AIUM)-sponsored interlaboratory comparison of ultrasonic backscatter, attenuation, and speed measurements (J Ultrasound Med 1999; 18:615-631). To explore reasons for these disparities, the AIUM Endowment for Education and Research recently supported this second interlaboratory comparison, which extends the upper limit of the frequency range from 7 to 9 MHz. METHODS: Eleven laboratories were provided with standard test objects designed and manufactured at the University of Wisconsin (Madison, WI). Each laboratory was asked to perform ultrasonic measurements of sound speed, attenuation coefficients, and backscatter coefficients. Each laboratory was blinded to the values of the ultrasonic properties of the test objects at the time the measurements were performed. RESULTS: Eight of the 11 laboratories submitted results. The range of variation of absolute magnitude of backscatter coefficient measurements was about 2 orders of magnitude. If the results of 1 outlier laboratory are excluded, then the range is reduced to about 1 order of magnitude. Agreement regarding frequency dependence of backscatter was better than reported in the previous interlaboratory comparison. For example, when scatterers were small compared with the ultrasonic wavelength, experimental frequency-dependent backscatter coefficient data obtained by the participating laboratories were usually consistent with the expected Rayleigh scattering behavior (proportional to frequency to the fourth power). CONCLUSIONS: Greater standardization of backscatter measurement methods is needed. Measurements of frequency dependence of backscatter are more consistent than measurements of absolute magnitude.

1-Propanol↗

In vitro investigation of detectability of colorectal lymph nodes and diagnosis of lymph node metastasis in colorectal cancer using B-mode sonography.

PURPOSE: The aim of this in vitro study was to assess the feasibility of using high-frequency sonography to identify colorectal lymph nodes and to diagnose colorectal lymph node metastasis. METHODS: In part 1 of this study, resected colorectal tissues from 13 patients with colorectal cancer were scanned in a water bath using B-mode sonography performed at high frequency (10 MHz) to identify lymph nodes. The colorectal tissues were then carefully dissected to remove all lymph nodes. Detectability was calculated as the ratio of the number of sonographically detected nodes to the total number of histopathologically confirmed nodes. Student's t test was performed to compare sizes between these groups; a p value of less than 0.05 was considered significant. In part 2, 4 features of lymph nodes identified on B-mode sonography--size, shape, border, and echogenicity--and their combinations were evaluated for their ability to diagnose lymph node metastasis. Discriminant and receiver operating characteristic curve analyses were performed. RESULTS: In part 1, B-mode sonography performed in vitro detected 79 (48%) of the 165 histopathologically identified lymph nodes and 34 (87%) of the 39 histopathologically identified metastatic nodes. The mean size, or mean longest axis (+/- standard deviation), of the sonographically detected nodes (6.4 +/- 2.9 mm) was significantly larger than that of undetected nodes (3.6 +/- 1.7 mm; p < 0.01). In part 2, the most effective feature distinguishing metastatic from nonmetastatic lymph nodes was echogenicity, followed by size, shape, and border. However, a combination of at least 2 features (eg, echogenicity and size) provided better distinction of nodes than did any 1 feature. In the receiver operating characteristic curve of the 4-feature combination, an increase in sensitivity is accompanied by a decrease in specificity: at a sensitivity of 100%, specificities decreased to 60% or less. However, even with the optimal combination of features, the sensitivity and specificity did not both reach 85% at any operating point. CONCLUSIONS: The results of this node-by-node in vitro study show the current limitations and potential of sonography for assessing colorectal lymph nodes. High-frequency sonography may be insufficient for identifying lymph node metastasis in colorectal cancer.

Adenocarcinoma↗

Adaptive spectral strain estimators for elastography.

In conventional elastography, internal tissue deformations, induced by external compression applied to the tissue surface, are estimated by cross-correlation analysis of echo signals obtained before and after compression. Conventionally, strains are estimated by computing the gradient of estimated displacement. However, gradient-based algorithms are highly susceptible to noise and decorrelation, which could limit their utility. We previously developed strain estimators based on a frequency-domain (spectral) formulation that were shown to be more robust but less precise compared to conventional strain estimators, In this paper, we introduce a novel spectral strain estimator that estimates local strain by maximizing the correlation between the spectra of pre- and postcompression echo signals using iterative frequency-scaling of the latter; we also discuss a variation of this algorithm that may be computationally more efficient but less precise. The adaptive spectral strain estimator combines the advantages of time- and frequency-domain methods and has outperformed conventional estimators in experiments and 2-D finite-element simulations.

Algorithms↗

Recent developments in tissue-type imaging (TTI) for planning and monitoring treatment of prostate cancer.

Because current methods of imaging prostate cancer are inadequate, biopsies cannot be effectively guided and treatment cannot be effectively planned and targeted. Therefore, our research is aimed at ultrasonically characterizing cancerous prostate tissue so that we can image it more effectively and thereby provide improved means of detecting, treating and monitoring prostate cancer. We base our characterization methods on spectrum analysis of radiofrequency (rf) echo signals combined with clinical variables such as prostate-specific antigen (PSA). Tissue typing using these parameters is performed by artificial neural networks. We employed and evaluated different approaches to data partitioning into training, validation, and test sets and different neural network configuration options. In this manner, we sought to determine what neural network configuration is optimal for these data and also to assess possible bias that might exist due to correlations among different data entries among the data for a given patient. The classification efficacy of each neural network configuration and data-partitioning method was measured using relative-operating-characteristic (ROC) methods. Neural network classification based on spectral parameters combined with clinical data generally produced ROC-curve areas of 0.80 compared to curve areas of 0.64 for conventional transrectal ultrasound imaging combined with clinical data. We then used the optimal neural network configuration to generate lookup tables that translate local spectral parameter values and global clinical-variable values into pixel values in tissue-type images (TTIs). TTIs continue to show cancerous regions successfully, and may prove to be particularly useful clinically in combination with other ultrasonic and nonultrasonic methods, e.g., magnetic-resonance spectroscopy.

Biopsy↗

Ultrasonic spectrum-analysis and neural-network classification as a basis for ultrasonic imaging to target brachytherapy of prostate cancer.

Conventional B-mode ultrasound is the standard means of imaging the prostate for guiding prostate biopsies and planning brachytherapy of prostate cancer. Yet B-mode images do not allow adequate visualization of cancerous lesions of the prostate. Ultrasonic tissue-typing imaging based on spectrum analysis of radiofrequency echo signals has shown promise for overcoming the limitations of B-mode imaging for visualizing prostate tumors. Tissue typing based on radiofrequency spectrum analysis uses nonlinear methods, such as neural networks, to classify tissue by using spectral-parameter and clinical-variable values. Two- and three-dimensional images based on these methods show potential for improving the guidance of prostate biopsies and the targeting of radiotherapy of prostate cancer. Two-dimensional images have been imported into instrumentation for real-time biopsy guidance and into commercial dose-planning software for brachytherapy planning. Three-dimensional renderings seem to be capable of depicting locations and volumes of cancer foci.

Brachytherapy↗

Emerging ultrasound technologies for early markers of disease.

Ultrasound has been a popular clinical imaging modality for decades. It is well established as a means of displaying the macroscopic anatomy of soft-tissue structures. While conventional ultrasound methodologies (i.e., B-mode and Doppler methods) are well proven and continue to advance technically on a daily basis, e.g. by extending into higher frequencies and taking advantage of harmonic phenomena in tissues, fundamentally new ultrasound technologies also are emerging and offer exciting promise for making significant improvements in the clinical imaging of disease. These emerging methods include spectrum analysis, elasticity imaging, contrast-agent methods, and advanced flow detection and measurement techniques. Each provides independent information and, used alone, each can provide powerful new imaging capabilities; combined with each other, their capabilities may be even greater in many applications; and all in principle can be used in concert with other imaging modalities to offer the possibility of further improvements in disease detection, evaluation, and monitoring.

Contrast Media↗