Acoustic Radiation Force Impulse (ARFI) Imaging-Based Needle Visualization

Abstract

Ultrasound-guided needle placement is widely used in the clinical setting, particularly for central venous catheter placement, tissue biopsy and regional anesthesia. Difficulties with ultrasound guidance in these areas often result from steep needle insertion angles and spatial offsets between the imaging plane and the needle. Acoustic Radiation Force Impulse (ARFI) imaging leads to improved needle visualization because it uses a standard diagnostic scanner to perform radiation force based elasticity imaging, creating a displacement map that displays tissue stiffness variations. The needle visualization in ARFI images is independent of needle-insertion angle and also extends needle visibility out of plane. Although ARFI images portray needles well, they often do not contain the usual B-mode landmarks. Therefore, a three-step segmentation algorithm has been developed to identify a needle in an ARFI image and overlay the needle prediction on a coregistered B-mode image. The steps are: (1) contrast enhancement by median filtration and Laplacian operator filtration, (2) noise suppression through displacement estimate correlation coefficient thresholding and (3) smoothing by removal of outliers and best-fit line prediction. The algorithm was applied to data sets from horizontal 18, 21 and 25 gauge needles between 0–4 mm offset in elevation from the transducer imaging plane and to 18G needles on the transducer axis (in plane) between 10° and 35° from the horizontal. Needle tips were visualized within 2 mm of their actual position for both horizontal needle orientations up to 1.5 mm offset in elevation from the transducer imaging plane and on-axis angled needles between 10°–35° above the horizontal orientation. We conclude that segmented ARFI images overlaid on matched B-mode images hold promise for improved needle visibility in many clinical applications.

Keywords

ARFI imaging nerve radiation force regional anesthesia ultrasound guidance ultrasound image segmentation

Get full access to this article

View all access options for this article.

References

Guidance on the use of ultrasound locating devices for placing central venous catheters, NICE Technology Appraisal 49 (National Inst Clinical Excellence, London, UK, 2002).

French

, Pitfalls of ultrasound guided vascular access: the use of three/four-dimensional ultrasound Anaesth 63, 806–813 (2008).

Abrahams

, Ultrasound guidance compared with electrical neurostimulation for peripheral nerve block: A systematic review and meta-analysis of randomized controlled trials Brit J Anaesth 103, 408–417 (2009).

Gray

. Ultrasound-guided regional anesthesia Anesth 104, 368–373 (2006).

Sites

Neal

Chan

. Ultrasound in regional anesthesia: where should the “focus” be set? Reg Anesth Pain Med 34, 531–533 (2009).

Nklein

, Piezoelectric vibrating needle and catheter for enhancing ultrasound-guided peripheral nerve blocks Anesth Analg 105, 1858–1860 (2007).

, Photoacoustic imaging of clinical metal needles in tissue J Biomed Opt 15, (2010).

Palmeri

, A finite-element method model of soft tissue response to impulsive acoustic radiation force IEEE Trans Ultrason Ferroelec Freq Contr 52, 1699–1712 (2005).

Nightingale

, On the feasibility of remote palpation using acoustic radiation force J Acoust Soc Amer 110, 625–634 (2001).

10.

Palmeri

, Ultrasonic tracking of acoustic radiation force-induced displacements in homogeneous media IEEE Trans Ultrason Ferroelec Freq Contr 53, 1300–1313 (2006).

11.

Nightingale

Palmeri

Trahey

. Analysis of contrast in images generated with transient acoustic radiation force Ultrasound Med Biology 32, 61–72 (2006).

12.

Palmeri

, On the feasibility of imaging peripheral nerves using acoustic radiation force impulse imaging Ultrasonic Imaging 31, 172–182 (2009).

13.

Larrabide

, Topological derivative: a tool for image processing Comp Struct 86, 1386–1403 (2008).

14.

Louizou

, Snakes based segmentation of the common carotid artery intima media Med Bio Eng Comput 45, 35–49 (2007).

15.

Sethian

. Evolution, implementation, and application of level set and fast marching methods for advancing fronts J Comp Phys 169, 503–555 (2001).

16.

Wang

. Laplacian operator-based edge detectors IEEE Trans Pattern Anal Mach Intel 29, 886–890 (2007).

17.

Canny

. A computational approach to edge detection IEEE Trans Pattern Anal Mach Intel 8, (1986).

18.

Íbeyli

Güler

. Feature extraction from Doppler ultrasound signals for automated diagnostic systems Comp Biol Med 35, 35–764 (2005).

19.

Gonzalez

Woods

. Digital Image Processing (Prentice-Hall, New Jersey 2001).

20.

Pathak

, Edge-guided boundary delineation in prostate ultrasound images IEEE Trans Med Imag 1, 1211–1219 (2000).

21.

Chalana

, Automatic fetal head measurements from sonographic images Acad Radiol 3, 628–635 (1996).

22.

Krivanek

Sonka

. Ovarian ultrasound image analysys: follicle segmentation IEEE Trans Med Imag 17, 935–944 (1998).

23.

Jain

Kasturi

Schunck

, Machine Vision (McGraw-Hill, Inc., Columbus, OH, 1995).

24.

Pinton

Dahl

Trahey

, Rapid tracking of small displacements with ultrasound IEEE Trans Ultrason Ferroelec Freq Contr 53, 1103–1117 (2006).

25.

Thomas

, Medical image processing toolbox in Matlab: Registration (University College of Antwerpen, Belgium 2006).

26.

Hall

Phantoms for elastography, in Proc IEEE Ultrasonics Symp (1996).

27.

Palmeri

. Imaging the mechanical properties of tissue with ultrasound: An investigation of the response of soft tissue to acoustic radiation force, Biomedical Engineering (Duke University, Durham, NC 2005).

28.

Nightingale

Imaging tissue mechanical properties using impulsive acoustic radiation force, in Proc IEEE Biomed Imag Symp, (2004).

29.

Dahl

, A parallel tracking method for acoustic radiation force impulse imaging IEEE Trans Ultras Ferroelec Freq Contr 54, 301–312 (2007).

30.

Loupas

Peterson

Gill

. Experimental evaluation of velocity and power estimation for ultrasound blood flow imaging, by means of a two-dimensional autocorrelation approach IEEE Trans Ultras Ferroelec Freq Contr 42, 689–699 (1995).

31.

Trahey

Allison

von Ramm

. Angle independent ultrasonic detection of blood flow IEEE Biomed Engin 34, 965–967 (1987).

32.

Chin

, Needle visualization in ultrasound-guided regional anesthesia: challenges and solutions Regional Anesth Pain Med 33, 532–544 (2008).

33.

Peng

Narouze

. Ultrasound-guided interventional procedures in pain medicine: a review of anatomy, sonoanatomy, and procedures Regional Anesth Pain Med 34, 458–474 (2009).