Browsing by Author "Bradway, David P"

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Open Access
Acoustic radiation force impulse imaging (ARFI) on an IVUS circular array.
(Ultrason Imaging, 2014-04) Patel, Vivek; Dahl, Jeremy J; Bradway, David P; Doherty, Joshua R; Lee, Seung Yun; Smith, Stephen W
Our long-term goal is the detection and characterization of vulnerable plaque in the coronary arteries of the heart using intravascular ultrasound (IVUS) catheters. Vulnerable plaque, characterized by a thin fibrous cap and a soft, lipid-rich necrotic core is a precursor to heart attack and stroke. Early detection of such plaques may potentially alter the course of treatment of the patient to prevent ischemic events. We have previously described the characterization of carotid plaques using external linear arrays operating at 9 MHz. In addition, we previously modified circular array IVUS catheters by short-circuiting several neighboring elements to produce fixed beamwidths for intravascular hyperthermia applications. In this paper, we modified Volcano Visions 8.2 French, 9 MHz catheters and Volcano Platinum 3.5 French, 20 MHz catheters by short-circuiting portions of the array for acoustic radiation force impulse imaging (ARFI) applications. The catheters had an effective transmit aperture size of 2 mm and 1.5 mm, respectively. The catheters were connected to a Verasonics scanner and driven with pushing pulses of 180 V p-p to acquire ARFI data from a soft gel phantom with a Young's modulus of 2.9 kPa. The dynamic response of the tissue-mimicking material demonstrates a typical ARFI motion of 1 to 2 microns as the gel phantom displaces away and recovers back to its normal position. The hardware modifications applied to our IVUS catheters mimic potential beamforming modifications that could be implemented on IVUS scanners. Our results demonstrate that the generation of radiation force from IVUS catheters and the development of intravascular ARFI may be feasible.
Open Access
Contrast in intracardiac acoustic radiation force impulse images of radiofrequency ablation lesions.
(Ultrason Imaging, 2014-04) Eyerly, Stephanie A; Bahnson, Tristram D; Koontz, Jason I; Bradway, David P; Dumont, Douglas M; Trahey, Gregg E; Wolf, Patrick D
We have previously shown that intracardiac acoustic radiation force impulse (ARFI) imaging visualizes tissue stiffness changes caused by radiofrequency ablation (RFA). The objectives of this in vivo study were to (1) quantify measured ARFI-induced displacements in RFA lesion and unablated myocardium and (2) calculate the lesion contrast (C) and contrast-to-noise ratio (CNR) in two-dimensional ARFI and conventional intracardiac echo images. In eight canine subjects, an ARFI imaging-electroanatomical mapping system was used to map right atrial ablation lesion sites and guide the acquisition of ARFI images at these sites before and after ablation. Readers of the ARFI images identified lesion sites with high sensitivity (90.2%) and specificity (94.3%) and the average measured ARFI-induced displacements were higher at unablated sites (11.23 ± 1.71 µm) than at ablated sites (6.06 ± 0.94 µm). The average lesion C (0.29 ± 0.33) and CNR (1.83 ± 1.75) were significantly higher for ARFI images than for spatially registered conventional B-mode images (C = -0.03 ± 0.28, CNR = 0.74 ± 0.68).
Open Access
Feasibility of Swept Synthetic Aperture Ultrasound Imaging.
(IEEE Trans Med Imaging, 2016-07) Bottenus, Nick; Long, Will; Zhang, Haichong K; Jakovljevic, Marko; Bradway, David P; Boctor, Emad M; Trahey, Gregg E
Ultrasound image quality is often inherently limited by the physical dimensions of the imaging transducer. We hypothesize that, by collecting synthetic aperture data sets over a range of aperture positions while precisely tracking the position and orientation of the transducer, we can synthesize large effective apertures to produce images with improved resolution and target detectability. We analyze the two largest limiting factors for coherent signal summation: aberration and mechanical uncertainty. Using an excised canine abdominal wall as a model phase screen, we experimentally observed an effective arrival time error ranging from 18.3 ns to 58 ns (root-mean-square error) across the swept positions. Through this clutter-generating tissue, we observed a 72.9% improvement in resolution with only a 3.75 dB increase in side lobe amplitude compared to the control case. We present a simulation model to study the effect of calibration and mechanical jitter errors on the synthesized point spread function. The relative effects of these errors in each imaging dimension are explored, showing the importance of orientation relative to the point spread function. We present a prototype device for performing swept synthetic aperture imaging using a conventional 1-D array transducer and ultrasound research scanner. Point target reconstruction error for a 44.2 degree sweep shows a reconstruction precision of 82.8 μm and 17.8 μm in the lateral and axial dimensions respectively, within the acceptable performance bounds of the simulation model. Improvements in resolution, contrast and contrast-to-noise ratio are demonstrated in vivo and in a fetal phantom.
Open Access
In vivo guidance and assessment of liver radio-frequency ablation with acoustic radiation force elastography.
(Ultrasound Med Biol, 2008-10) Fahey, Brian J; Nelson, Rendon C; Hsu, Stephen J; Bradway, David P; Dumont, Douglas M; Trahey, Gregg E
The initial results from clinical trials investigating the utility of acoustic radiation force impulse (ARFI) imaging for use with radio-frequency ablation (RFA) procedures in the liver are presented. To date, data have been collected from 6 RFA procedures in 5 unique patients. Large displacement contrast was observed in ARFI images of both pre-ablation malignancies (mean 7.5 dB, range 5.7-11.9 dB) and post-ablation thermal lesions (mean 6.2 dB, range 5.1-7.5 dB). In general, ARFI images provided superior boundary definition of structures relative to the use of conventional sonography alone. Although further investigations are required, initial results are encouraging and demonstrate the clinical promise of the ARFI method for use in many stages of RFA procedures.
Open Access
Intracardiac acoustic radiation force impulse imaging: a novel imaging method for intraprocedural evaluation of radiofrequency ablation lesions.
(Heart Rhythm, 2012-11) Eyerly, Stephanie A; Bahnson, Tristram D; Koontz, Jason I; Bradway, David P; Dumont, Douglas M; Trahey, Gregg E; Wolf, Patrick D
BACKGROUND: Arrhythmia recurrence after cardiac radiofrequency ablation (RFA) for atrial fibrillation has been linked to conduction through discontinuous lesion lines. Intraprocedural visualization and corrective ablation of lesion line discontinuities could decrease postprocedure atrial fibrillation recurrence. Intracardiac acoustic radiation force impulse (ARFI) imaging is a new imaging technique that visualizes RFA lesions by mapping the relative elasticity contrast between compliant-unablated and stiff RFA-treated myocardium. OBJECTIVE: To determine whether intraprocedure ARFI images can identify RFA-treated myocardium in vivo. METHODS: In 8 canines, an electroanatomical mapping-guided intracardiac echo catheter was used to acquire 2-dimensional ARFI images along right atrial ablation lines before and after RFA. ARFI images were acquired during diastole with the myocardium positioned at the ARFI focus (1.5 cm) and parallel to the intracardiac echo transducer for maximal and uniform energy delivery to the tissue. Three reviewers categorized each ARFI image as depicting no lesion, noncontiguous lesion, or contiguous lesion. For comparison, 3 separate reviewers confirmed RFA lesion presence and contiguity on the basis of functional conduction block at the imaging plane location on electroanatomical activation maps. RESULTS: Ten percent of ARFI images were discarded because of motion artifacts. Reviewers of the ARFI images detected RFA-treated sites with high sensitivity (95.7%) and specificity (91.5%). Reviewer identification of contiguous lesions had 75.3% specificity and 47.1% sensitivity. CONCLUSIONS: Intracardiac ARFI imaging was successful in identifying endocardial RFA treatment when specific imaging conditions were maintained. Further advances in ARFI imaging technology would facilitate a wider range of imaging opportunities for clinical lesion evaluation.