Visualizing the Tumor Microvasculature With a Nonlinear Plane-Wave Doppler Imaging Scheme Based on Amplitude Modulation.

Imaging with ultrasonic plane waves enables the combination of Doppler and microbubble contrast-enhanced imaging without compromising the Doppler ensemble length, as is the case for conventional line-by-line imaging, thus maintaining flow sensitivity. This permits the separation of conduit flow in large vessels from the perfusion background and the presentation of velocity estimates in real-time. However, the ability to differentiate perfusion from the tissue signal is limited by the contrast-to-tissue (CTR) ratio achieved with the contrast-enhanced pulsing sequence, independently of the acquisition length. One way to improve the CTR is to use a Doppler sequence based on amplitude modulation instead of one based on pulse inversion. In this work, we discuss how amplitude modulation can be adapted to Doppler processing. We show that amplitude modulation Doppler, like pulse inversion Doppler, can separate the signal of moving tissue from that of moving microbubbles, while achieving a better contrast-to-tissue ratio than pulse inversion Doppler, both in vitro and in vivo. Both amplitude modulation Doppler and pulse inversion Doppler yield similar velocity estimates when the bandwidth of the RF echo is properly compensated. Finally, we demonstrate how amplitude modulation Doppler can be used to reveal both the conduit flow and the capillary perfusion at high frame rates in an in vivo tumor.