Optimizing In Vivo Data Acquisition for Robust Clinical Microvascular Imaging Using Ultrasound Localization Microscopy

TL;DR

This study optimizes ultrasound localization microscopy (ULM) data acquisition by analyzing microbubble signals during bolus injections in pigs and humans, enhancing microvascular imaging quality and consistency for clinical use.

Contribution

It introduces a quantitative approach to determine optimal acquisition timing and settings, improving ULM robustness and standardization in clinical microvascular imaging.

Findings

Optimal acquisition window of ~10 seconds in pigs during rapid wash-out

Flexible imaging window of 1-2 minutes in humans during slower wash-out

Successful demonstration of robust ULM in pig and human kidneys

Abstract

Ultrasound localization microscopy (ULM) enables microvascular imaging at spatial resolutions beyond the acoustic diffraction limit, offering significant clinical potentials. However, ULM performance relies heavily on microbubble (MB) signal sparsity, the number of detected MBs, and signal-to-noise ratio (SNR), all of which vary in clinical scenarios involving bolus MB injections. These sources of variations underscore the need to optimize MB dosage, data acquisition timing, and imaging settings in order to standardize and optimize ULM of microvasculature. This pilot study investigated temporal changes in MB signals during bolus injections in both pig and human models to optimize data acquisition for clinical ULM. Quantitative indices were developed to evaluate MB signal quality, guiding selection of acquisition timing that balances the MB localization quality and adequate MB counts. The effects of transmitted voltage and dosage were also explored. In the pig model, a relatively short window (approximately 10 seconds) for optimal acquisition was identified during the rapid wash-out phase, highlighting the need for real-time MB signal monitoring during data acquisition. The slower wash-out phase in humans allowed for a more flexible imaging window of 1-2 minutes, while trade-offs were observed between localization quality and MB density (or acquisition length) at different wash-out phase timings. Guided by these findings, robust ULM imaging was achieved in both pig and human kidneys using a short period of data acquisition, demonstrating its feasibility in clinical practice. This study provides insights into optimizing data acquisition for consistent and reproducible ULM, paving the way for its standardization and broader clinical applications.