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Biomedical subjects

Zvi Friedman

Publications and source records attributed to Zvi Friedman.

8 recordsLinked to original sources

Delineation of cardiac twist by a sonographically based 2-dimensional strain analysis method: an in vitro validation study.

OBJECTIVE: Normal left ventricular contraction involves a twisting component that helps augment stroke volume, the unwinding of which also very usefully contributes to early diastolic filling. Abnormalities of cardiac twist have been related to abnormal cardiac function. We sought to quantify the twisting action using a new sonographically based angle-independent motion-detecting echo method. METHODS: A twist model was developed with a variable-speed motor to rotate a wheel in water bath. A freshly harvested pig heart was mounted on it as a twist phantom. Short axis views were acquired with a GE/VingMed Vivid 7 system (GE Healthcare, Milwaukee, WI) at 3.5 MHz and more than 100 frames/s. Eight different speeds (30-100 cycles/min of winding and unwinding) were studied at 5 degrees of rotation (10 degrees , 20 degrees , 30 degrees , 40 degrees , and 50 degrees ). Data were analyzed off-line for twist analysis with a new 2-dimensional speckle-tracking-based program (2-dimensional strain rate method [2DSR]) embedded in EchoPac software (GE Healthcare). Ten freshly harvested pig hearts were studied in this model. RESULTS: The 2DSR program tracked the twist well (mean determination at 10 degrees = 16.88 degrees +/- 1.81 degrees [SD]; at 20 degrees = 26.5 degrees +/- 1.05 degrees ; at 30 degrees = 36.47 degrees +/- 1.31 degrees ; at 40 degrees = 44.03 degrees +/- 1.39 degrees ; and at 50 degrees = 54.1 degrees +/- 1.96 degrees ). CONCLUSIONS: The 2DSR program can be used to study twisting action of the heart.

Animals↗

The combined effect of spatial compounding and nonlinear filtering on the speckle reduction in ultrasound images.

Recently, a spatial compounding ultrasound imaging method was presented that utilizes a conventional 64-element phased array transducer with two unfocused pistons, each placed at one of the sides of the phased array transducer. This method is augmented here by inclusion of nonlinear filtering of the compounded images. The combined effects of the specific spatial compounding and nonlinear filtering on speckle reduction in the generated ultrasound images are studied and evaluated in two stages: First, the image quality is studied when nonlinear filtering is used as part of the spatial compounding. The study is performed by simulations using the Field II program, by processing several B-mode images of a kidney. The second stage compares the results obtained by the simulations to those obtained by in vitro laboratory experiments. Five different compounding strategies and two nonlinear filters, Gaussian and anisotropic diffusion, are investigated and evaluated in terms of image quality parameters-contrast and signal-to-noise ratio. It is shown that the combination of "averaging+nonlinear Gaussian filtering" produces the greatest improvement of image quality. When compared to a conventional phased array imaging system, the spatial compounding method that includes the conventional 64-element phased array transducer with two unfocused pistons, and employs the "averaging+nonlinear Gaussian filtering" strategy, obtains improvement in SNR that has reached 334%. Thus, though this method necessitates a somewhat wider probe, it produces significantly improved images.

Computer Simulation↗

Two-dimensional acoustic pattern derived strain parameters closely correlate with one-dimensional tissue Doppler derived strain measurements.

BACKGROUND: Two-dimensional strain echocardiography (2D-SE) calculates tissue velocities via frame-to-frame tracking of unique acoustic markers within the image and provides strain parameters in two dimensions. Novel 2D-SE software allows semi-automated strain measurements and increased averaging capabilities optimizing signal-noise ratio. AIM: We tested whether 2D-SE and the currently used and well-validated tissue Doppler derived strain echocardiography (TD-SE) yield similar information in the clinical setting. METHODS AND RESULTS: We performed 2D-SE and TD-SE on 17 patients with amyloid cardiomyopathy and 10 age-matched healthy volunteers. Single walls from standard apical views (2- and 4-chamber) were acquired at high frame rates ( approximately 200fps). Offline analysis was performed by observers blinded to clinical data using the EchoPAC program with custom 2D-SE software. Longitudinal strain rate and strain from the basal, mid and apical segments of the septal and lateral walls were determined by each method (TD-SE and 2D-SE). Ejection fraction was >0.55 in healthy volunteers and ranged from 0.30 to 0.80 in cardiomyopathy group. A total of 54 walls (162 segments) were examined. Acceptable quality strain data was available in 92% and 85% segments by 2D-SE and TD-SE, respectively. Two-dimensional strain echocardiography values correlated closely with TD-SE values (r=0.94 and 0.96 for strain rate and strain, respectively). CONCLUSIONS: Deformation analysis by 2D-SE is feasible in a clinical setting and 2D-SE values correlate closely with TD-SE measurements over a wide range of global systolic function. Two-dimensional strain echocardiography may help to facilitate the routine clinical implementation of deformation analysis.

Acoustics↗

Global longitudinal strain: a novel index of left ventricular systolic function.

BACKGROUND: Echocardiographic estimation of global left ventricular (LV) function is subjective and time consuming. Our aim was to develop a novel approach for assessment of global LV function from 2-dimensional echocardiographic images METHODS: Novel computer software for tissue tracking was developed and applied as follows: digital loops were acquired from apical 2-, 3-, and 4-chamber views and a line was loosely traced along the LV endocardium at the frame wherein it was best defined. Around this line, the software selected natural acoustic markers moving with the tissue. Automatic frame-by-frame tracking of these markers during the heart cycle yielded a measure of contractility along the selected region of interest. Global longitudinal strain (GLS) and GLS rate (GLSR) were calculated for the entire U-shaped length of LV myocardium (basal, mid, and apical segments of 2 opposite walls in each view). To test this software, computer-derived GLS and GLSR were analyzed by a nonechocardiographer, blinded to the echocardiographic interpretation, in 27 consecutive patients after myocardial infarction (MI) (age 64.4 +/- 12.9 years; 19 men; mean wall-motion score index of 1.79 +/- 0.44) and compared with those obtained in 12 consecutive control patients (age 59.0 +/- 9.7 years; 8 women), with a normal echocardiographic study. RESULTS: GLS and GLSR, averaged from the 3 apical views, differed significantly in patients post-MI compared with control patients (GLS -14.7 +/- 5.1% vs -24.1 +/- 2.9% and GLSR -0.57 +/- 0.21/s vs -1.02 +/- 0.09/s for patients post-MI vs control patients, respectively; both P <.0001). There was a good linear correlation between the wall-motion score index and the GLS and GLSR (R = 0.68 and R = 0.67, respectively; both P <.0001). A cut-off value for GLS of -21% had 92% sensitivity and 89% specificity and a cut-off value for GLSR -0.9/s had 92% sensitivity and 96% specificity for the detection of patients post-MI. CONCLUSIONS: GLS and GLSR are novel indices for assessment of global LV function from 2-dimensional echocardiographic images. Early validation studies with the method are suggestive of high sensitivity and specificity in the detection of LV systolic dysfunction in patients post-MI.

Adult↗

The combined effect of nonlinear filtration and window size on the accuracy of tissue displacement estimation using detected echo signals.

In cardiac elastography, the regional strain and strain rate imaging is based on displacement estimation of tissue sections within the heart muscle carried out with various block-matching techniques (cross-correlation, sum of absolute differences, sum of squared differences, etc.). The accuracy of these techniques depends on a combination of ultrasonic imaging parameters such as ultrasonic frequency of interrogation, signal-to-noise ratio, size of a kernel used in a block-matching algorithm, type of data and speckle decorrelation. In this paper, we discuss the possibility to enhance the accuracy of the displacement estimation via nonlinear filtering of B-mode images before block-matching operation. The combined effect of a filter algorithm and a kernel size on the accuracy of the displacement estimation is analyzed using a 36-frame sequence of grayscale B-mode images of a human heart acquired by an ultrasound system operating at 1.77 MHz. It is shown that the nonlinear filtering of images enables to obtain the desired accuracy (less than one pixel) of the displacement estimation with smaller kernels than without filtering. These results are obtained for two filters--an adaptive anisotropic diffusion filter and a nonlinear Gaussian filter chain.

Algorithms↗

Improving motion estimation by accounting for local image distortion.

Cardiac elastography is a useful diagnostic technique for detection of heart function abnormalities, based on analysis of echocardiograms. The analysis of the regional heart motion allows assessing the extent of myocardial ischemia and infarction. In this paper, a new two-stage algorithm for cardiac motion estimation is proposed, where the data is taken from a sequence of 2D echocardiograms. The method combines the advantages of block-matching and optical flow techniques. The first stage employs a standard block-matching algorithm (sum of absolute differences) to provide a displacement estimate with accuracy of up to one pixel. At the second stage, this estimate is corrected by estimating the parameters of a local image transform within a test window. The parameters of the image transform are estimated in the least-square sense. In order to account for typical heart motions, like contraction/expansion, translation and rotation, a local affine model is assumed within the test window. The accuracy of the new algorithm is evaluated using a sequence of 500 grayscale B-mode images, which are generated as distorted, but known copies of an original ROI, taken from a real echocardiogram. The accuracy of the motion estimation is expressed in terms of errors: maximum absolute error, root-mean-square error, average error and standard deviation. The errors of the proposed algorithm are compared with these of the known block-matching technique with cross-correlation and interpolation in the sub-pixel space. Statistical analysis of the errors shows that the proposed algorithm provides more accurate estimates of the heart motion than the cross-correlation technique with interpolation in the sub-pixel space.

Algorithms↗

A new method of spatial compounding imaging.

A new method of spatial compound imaging is presented that improves image quality without the usual requirement to decrease the frame rate. The new method of imaging utilizes three transducers for data acquisition. The transducer located at the center of the transducer system is a phased array probe that acts as both transmitter and receiver. The other transducers are unfocused pistons that act only as receivers. Envelope data acquired by each transducer are combined to form a final image with improved quality (speckle contrast, target detectability and lateral resolution). It is shown that the improvement in speckle contrast depends on the correlation between individual images acquired by the transducers. The effective aperture approach is used for analytic estimation of the correlation between images in order to optimize the lateral separation between transducers. Using simulations, several compounding strategies have been performed to find the strategy that maximizes image quality. The central frequency of 2.5 MHz is used in simulations. Quantitative analysis of simulated B-mode images shows that the new method of imaging efficiently improves visibility, detectability, and lateral resolution of low contrast regions. The image frame rate is preserved because multiple scans are not required for the spatial compounding.

Computer Simulation↗

A new method of ultrasound color flow mapping.

Conventional ultrasound color flow mapping systems estimate and visualize only the axial velocity component. To obtain the transverse velocity component a modification of a multiple-beam method is proposed. The new two-dimensional color flow mapping system has a small size and consists of three transducers. The central transducer is an appodized and focused phased array. The other transducers are unfocused probes. Three transducers act as receivers and the central transducer operates as a transmitter. All receivers acquire rf scan lines that are then processed to estimate three axial velocity components using an autocorrelation method. These estimates are then combined to estimate the transverse velocity component, taking into account the geometric relationships among three transducers. Two algorithms for transverse velocity estimation are proposed. The first uses the Doppler angle estimate for calculation of the transverse velocity component. The other algorithm calculates the transverse velocity component directly from the axial components. The accuracy of the flow velocity estimators is estimated by simulations. Analysis of accuracy allows choosing the more effective algorithm for two-dimensional velocity estimation, which is insensitive to variations of the Doppler angle.

Algorithms↗