Massimo Mischi

Ben Luijten, Nishith Chennakeshava, Yonina C. Eldar et al.

Medical ultrasound imaging relies heavily on high-quality signal processing to provide reliable and interpretable image reconstructions. Conventionally, reconstruction algorithms where derived from physical principles. These algorithms rely on assumptions and approximations of the underlying measurement model, limiting image quality in settings were these assumptions break down. Conversely, more sophisticated solutions based on statistical modelling, careful parameter tuning, or through increased model complexity, can be sensitive to different environments. Recently, deep learning based methods, which are optimized in a data-driven fashion, have gained popularity. These model-agnostic techniques often rely on generic model structures, and require vast training data to converge to a robust solution. A relatively new paradigm combines the power of the two: leveraging data-driven deep learning, as well as exploiting domain knowledge. These model-based solutions yield high robustness, and require less parameters and training data than conventional neural networks. In this work we provide an overview of these techniques from recent literature, and discuss a wide variety of ultrasound applications. We aim to inspire the reader to further research in this area, and to address the opportunities within the field of ultrasound signal processing. We conclude with a future perspective on model-based deep learning techniques for medical ultrasound.

A. van Diepen, T. H. G. F. Bakkes, A. J. R. De Bie et al.

Although mechanical ventilation is a lifesaving intervention in the ICU, it has harmful side-effects, such as barotrauma and volutrauma. These harms can occur due to asynchronies. Asynchronies are defined as a mismatch between the ventilator timing and patient respiratory effort. Automatic detection of these asynchronies, and subsequent feedback, would improve lung ventilation and reduce the probability of lung damage. Neural networks to detect asynchronies provide a promising new approach but require large annotated data sets, which are difficult to obtain and require complex monitoring of inspiratory effort. In this work, we propose a model-based approach to generate a synthetic data set for machine learning and educational use by extending an existing lung model with a first-order ventilator model. The physiological nature of the derived lung model allows adaptation to various disease archetypes, resulting in a diverse data set. We generated a synthetic data set using 9 different patient archetypes, which are derived from measurements in the literature. The model and synthetic data quality have been verified by comparison with clinical data, review by a clinical expert, and an artificial intelligence model that was trained on experimental data. The evaluation showed it was possible to generate patient-ventilator waveforms including asynchronies that have the most important features of experimental patient-ventilator waveforms.

R. R. Wildeboer, R. J. G. van Sloun, C. K. Mannaerts et al.

Shear-wave elastography (SWE) permits local estimation of tissue elasticity, an important imaging marker in biomedicine. This recently-developed, advanced technique assesses the speed of a laterally-travelling shear wave after an acoustic radiation force "push" to estimate local Young's moduli in an operator-independent fashion. In this work, we show how synthetic SWE (sSWE) images can be generated based on conventional B-mode imaging through deep learning. Using side-by-side-view B-mode/SWE images collected in 50 patients with prostate cancer, we show that sSWE images with a pixel-wise mean absolute error of 4.5+/-0.96 kPa with regard to the original SWE can be generated. Visualization of high-level feature levels through t-Distributed Stochastic Neighbor Embedding reveals substantial overlap between data from two different scanners. Qualitatively, we examined the use of the sSWE methodology for B-mode images obtained with a scanner without SWE functionality. We also examined the use of this type of network in elasticity imaging in the thyroid. Limitations of the technique reside in the fact that networks have to be retrained for different organs, and that the method requires standardization of the imaging settings and procedure. Future research will be aimed at development of sSWE as an elasticity-related tissue typing strategy that is solely based on B-mode ultrasound acquisition, and the examination of its clinical utility.

Ruud J. G. van Sloun, Oren Solomon, Matthew Bruce et al.

Ultrasound localization microscopy has enabled super-resolution vascular imaging through precise localization of individual ultrasound contrast agents (microbubbles) across numerous imaging frames. However, analysis of high-density regions with significant overlaps among the microbubble point spread responses yields high localization errors, constraining the technique to low-concentration conditions. As such, long acquisition times are required to sufficiently cover the vascular bed. In this work, we present a fast and precise method for obtaining super-resolution vascular images from high-density contrast-enhanced ultrasound imaging data. This method, which we term Deep Ultrasound Localization Microscopy (Deep-ULM), exploits modern deep learning strategies and employs a convolutional neural network to perform localization microscopy in dense scenarios. This end-to-end fully convolutional neural network architecture is trained effectively using on-line synthesized data, enabling robust inference in-vivo under a wide variety of imaging conditions. We show that deep learning attains super-resolution with challenging contrast-agent densities, both in-silico as well as in-vivo. Deep-ULM is suitable for real-time applications, resolving about 70 high-resolution patches (128x128 pixels) per second on a standard PC. Exploiting GPU computation, this number increases to 1250 patches per second.