Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, 430071, People's Republic of China.
Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, People's Republic of China.
Med Phys. 2019 Nov;46(11):4992-5001. doi: 10.1002/mp.13776. Epub 2019 Sep 11.
Respiratory motion correction is necessary for the quantitative analysis of liver contrast-enhanced ultrasound (CEUS) image sequences. Most respiratory motion correction methods are based on the dual mode of CEUS image sequences, including contrast and grayscale image sequences. Due to free-breathing motion, the acquired two-dimensional (2D) ultrasound cine might show the in-plane and out-of-plane motion of tumors. The registration of an entire 2D ultrasound contrast image sequence based on out-of-plane images is ineffective. For the respiratory motion correction of CEUS sequences, the reference image is usually considered the standard for the deletion of any out-of-plane images. Most methods used for the selection of the reference image are subjective in nature. Here, a quantitative selection method for an optimal reference image from CEUS image sequences in the B mode and contrast mode was explored.
The original high-dimensional ultrasound grayscale image data were mapped into a two-dimensional space using Laplacian Eigenmaps (LE), and K-means clustering was adopted. The center image of the larger cluster with a near-peak contrast intensity was considered the optimal ultrasound reference image. In the ultrasound grayscale image sequence, the images with the maximum correlations to the reference image in the same time interval were selected as the corrected image sequence. The effectiveness of this proposed method was then validated on 18 CEUS cases of VX2 tumors in rabbit livers.
Correction smoothed the time-intensity curves (TICs) extracted from the region of interest of the CEUS image sequences. Before correction, the average of the total mean structural similarity (TMSSIM) and the average of the mean correlation coefficient (MCC) from the image sequences were 0.45 ± 0.11 and 0.67 ± 0.16, respectively, and after correction, the average TMSSIM and MCC increased (P < 0.001) by 31% to 0.59 ± 0.11 and by 21% to 0.81 ± 0.11, respectively. The average deviation value (DV) index of the TICs from the image sequences prior to correction was 92.16 ± 18.12, and correction reduced the average to 31.71 ± 7.31. The average TMSSIM and MCC values after correction using the mean frame of the reference image (MBMFRI) were clearly lower than those after correction using the proposed method (P < 0.001). Moreover, the average DV after correction using the MBMFRI was obviously higher than that after correction using the proposed method (P < 0.001).
The breathing frequency of rabbits is notably faster than that of human beings, but the proposed correction method could reduce the effect of the respiratory motion in the CEUS image sequences. The reference image was selected quantitatively, which could improve the accuracy of the quantitative analysis of rabbit liver CEUS sequences using the reference image method based on the current standard of manual selection and the MBMFRI. This easy-to-operate method can potentially be used in both animal studies and clinical applications.
肝脏对比增强超声(CEUS)图像序列的定量分析需要进行呼吸运动校正。大多数呼吸运动校正方法都基于 CEUS 图像序列的双模式,包括对比和灰度图像序列。由于自由呼吸运动,获得的二维(2D)超声电影可能会显示肿瘤的平面内和平面外运动。基于平面外图像的整个 2D 超声对比图像序列的配准是无效的。对于 CEUS 序列的呼吸运动校正,参考图像通常被认为是删除任何平面外图像的标准。用于选择参考图像的大多数方法本质上都是主观的。在这里,探索了一种从 B 模式和对比模式的 CEUS 图像序列中选择最佳参考图像的定量方法。
使用拉普拉斯特征映射(LE)将原始高维超声灰度图像数据映射到二维空间,并采用 K 均值聚类。具有接近峰值对比度的较大聚类的中心图像被认为是最佳超声参考图像。在超声灰度图像序列中,选择与同一时间间隔内参考图像具有最大相关性的图像作为校正图像序列。然后,在 18 例兔肝 VX2 肿瘤的 CEUS 病例中验证了该方法的有效性。
校正使从 CEUS 图像序列的感兴趣区域提取的时间强度曲线(TIC)平滑化。校正前,图像序列的总平均结构相似性(TMSSIM)和平均相关系数(MCC)的平均值分别为 0.45±0.11 和 0.67±0.16,校正后,TMSSIM 和 MCC 的平均值分别增加(P<0.001)31%至 0.59±0.11 和 21%至 0.81±0.11。校正前 TIC 图像序列的平均偏差值(DV)为 92.16±18.12,校正后平均降低至 31.71±7.31。使用参考图像的平均帧(MBMFRI)校正后的平均 TMSSIM 和 MCC 值明显低于使用所提出方法校正后的值(P<0.001)。此外,使用 MBMFRI 校正后的平均 DV 明显高于使用所提出方法校正后的 DV(P<0.001)。
兔的呼吸频率明显快于人类,但所提出的校正方法可以减少 CEUS 图像序列中呼吸运动的影响。通过定量选择参考图像,可以提高基于当前手动选择标准和 MBMFRI 的兔肝 CEUS 序列参考图像法的定量分析准确性。这种易于操作的方法可用于动物研究和临床应用。