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At least 19 records

Performance Comparison of Object Detection Networks for Shrapnel Identification in Ultrasound Images

Ultrasound imaging is a critical tool for triaging and diagnosing subjects but only if images can be properly interpreted. Unfortunately, in remote or military medicine situations, the expertise to interpret images can be lacking. Machine-learning image interpretation models that are explainable to the end user and deployable in real time with ultrasound equipment have the potential to solve this problem. We have previously shown how a YOLOv3 (You Only Look Once) object detection algorithm can be used for tracking shrapnel, artery, vein, and nerve fiber bundle features in a tissue phantom. However, real-time implementation of an object detection model requires optimizing model inference time. Here, we compare the performance of five different object detection deep-learning models with varying architectures and trainable parameters to determine which model is most suitable for this shrapnel-tracking ultrasound image application. We used a dataset of more than 16,000 ultrasound images from gelatin tissue phantoms containing artery, vein, nerve fiber, and shrapnel features for training and evaluating each model. Every object detection model surpassed 0.85 mean average precision except for the detection transformer model. Overall, the YOLOv7tiny model had the higher mean average precision and quickest inference time, making it the obvious model choice for this ultrasound imaging application. Other object detection models were overfitting the data as was determined by lower testing performance compared with higher training performance. In summary, the YOLOv7tiny object detection model had the best mean average precision and inference time and was selected as optimal for this application. Next steps will implement this object detection algorithm for real-time applications, an important next step in translating AI models for emergency and military medicine.

60 APPLIED LIFE SCIENCES↗

An image classification deep-learning algorithm for shrapnel detection from ultrasound images

Ultrasound imaging is essential for non-invasively diagnosing injuries where advanced diagnostics may not be possible. However, image interpretation remains a challenge as proper expertise may not be available. In response, artificial intelligence algorithms are being investigated to automate image analysis and diagnosis. Here, we highlight an image classification convolutional neural network for detecting shrapnel in ultrasound images. As an initial application, different shrapnel types and sizes were embedded first in a tissue mimicking phantom and then in swine thigh tissue. The algorithm architecture was optimized stepwise by minimizing validation loss and maximizing F1 score. The final algorithm design trained on tissue phantom image sets had an F1 score of 0.95 and an area under the ROC curve of 0.95. It maintained higher than a 90% accuracy for each of 8 shrapnel types. When trained only on swine image sets, the optimized algorithm format had even higher metrics: F1 and area under the ROC curve of 0.99. Overall, the algorithm developed resulted in strong classification accuracy for both the tissue phantom and animal tissue. This framework can be applied to other trauma relevant imaging applications such as internal bleeding to further simplify trauma medicine when resources and image interpretation are scarce.

59 BASIC BIOLOGICAL SCIENCES↗

Using AI Segmentation Models to Improve Foreign Body Detection and Triage from Ultrasound Images

Medical imaging can be a critical tool for triaging casualties in trauma situations. In remote or military medicine scenarios, triage is essential for identifying how to use limited resources or prioritize evacuation for the most serious cases. Ultrasound imaging, while portable and often available near the point of injury, can only be used for triage if images are properly acquired, interpreted, and objectively triage scored. Here, we detail how AI segmentation models can be used for improving image interpretation and objective triage evaluation for a medical application focused on foreign bodies embedded in tissues at variable distances from critical neurovascular features. Ultrasound images previously collected in a tissue phantom with or without neurovascular features were labeled with ground truth masks. These image sets were used to train two different segmentation AI frameworks: YOLOv7 and U-Net segmentation models. Overall, both approaches were successful in identifying shrapnel in the image set, with U-Net outperforming YOLOv7 for single-class segmentation. Both segmentation models were also evaluated with a more complex image set containing shrapnel, artery, vein, and nerve features. YOLOv7 obtained higher precision scores across multiple classes whereas U-Net achieved higher recall scores. Using each AI model, a triage distance metric was adapted to measure the proximity of shrapnel to the nearest neurovascular feature, with U-Net more closely mirroring the triage distances measured from ground truth labels. Overall, the segmentation AI models were successful in detecting shrapnel in ultrasound images and could allow for improved injury triage in emergency medicine scenarios.

47 OTHER INSTRUMENTATION↗

Using Ultrasound Image Augmentation and Ensemble Predictions to Prevent Machine-Learning Model Overfitting

Deep learning predictive models have the potential to simplify and automate medical imaging diagnostics by lowering the skill threshold for image interpretation. However, this requires predictive models that are generalized to handle subject variability as seen clinically. Here, we highlight methods to improve test accuracy of an image classifier model for shrapnel identification using tissue phantom image sets. Using a previously developed image classifier neural network—termed ShrapML—blind test accuracy was less than 70% and was variable depending on the training/test data setup, as determined by a leave one subject out (LOSO) holdout methodology. Introduction of affine transformations for image augmentation or MixUp methodologies to generate additional training sets improved model performance and overall accuracy improved to 75%. Further improvements were made by aggregating predictions across five LOSO holdouts. This was done by bagging confidences or predictions from all LOSOs or the top-3 LOSO confidence models for each image prediction. Top-3 LOSO confidence bagging performed best, with test accuracy improved to greater than 85% accuracy for two different blind tissue phantoms. This was confirmed by gradient-weighted class activation mapping to highlight that the image classifier was tracking shrapnel in the image sets. Overall, data augmentation and ensemble prediction approaches were suitable for creating more generalized predictive models for ultrasound image analysis, a critical step for real-time diagnostic deployment.

60 APPLIED LIFE SCIENCES↗

Training Ultrasound Image Classification Deep-Learning Algorithms for Pneumothorax Detection Using a Synthetic Tissue Phantom Apparatus

Ultrasound (US) imaging is a critical tool in emergency and military medicine because of its portability and immediate nature. However, proper image interpretation requires skill, limiting its utility in remote applications for conditions such as pneumothorax (PTX) which requires rapid intervention. Artificial intelligence has the potential to automate ultrasound image analysis for various pathophysiological conditions. Training models require large data sets and a means of troubleshooting in real-time for ultrasound integration deployment, and they also require large animal models or clinical testing. Here, we detail the development of a dynamic synthetic tissue phantom model for PTX and its use in training image classification algorithms. The model comprises a synthetic gelatin phantom cast in a custom 3D-printed rib mold and a lung mimicking phantom. When compared to PTX images acquired in swine, images from the phantom were similar in both PTX negative and positive mimicking scenarios. We then used a deep learning image classification algorithm, which we previously developed for shrapnel detection, to accurately predict the presence of PTX in swine images by only training on phantom image sets, highlighting the utility for a tissue phantom for AI applications.

Boice, Emily N. (ORCID:0000000171802842)↗

A holey cavity for single-transducer 3D ultrasound imaging with physical optimization

Within the compressive sensing (CS) framework, one effective way to increase the likelihood of successful signal reconstruction is to employ random processes in the construction of the sensing matrix. This work presents a 3D holey cavity, with diverse frequency modes, to spectrally code, that is, randomize, the ultrasound wave fields. The simulated results show that the use of such a cavity enables imaging simple or complex targets, such as spheres or the letter E, by only a single transceiver—something that is not possible without the use of a coding structure like the cavity. The effect of noise on imaging results and the size of the targets on the first-order Born approximation (BA) are also investigated. Moreover, this study attempts to optimize the cavity, based on a single numerical metric, such as the sum of singular values (SSV) or mutual coherence (MC). Yet, it will be shown that neither of these metrics can consistently compare the norm-one imaging performance between two cavities of different materials or hole sizes. This leaves finding a quantitative metric for these kinds of optimizations an open problem.

42 ENGINEERING↗

Area-Preserving Mapping of 3D Carotid Ultrasound Images Using Density-Equalizing Reference Map

Carotid atherosclerosis is a focal disease at the bifurcations of the carotid artery. To quantitatively monitor the local changes in the vessel-wall-plus-plaque thickness (VWT) and compare the VWT distributions for different patients or for the same patients at different ultrasound scanning sessions, a mapping technique is required to adjust for the geometric variability of different carotid artery models. In this work, we propose a novel method called density-equalizing reference map (DERM) for mapping 3D carotid surfaces to a standardized 2D carotid template, with an emphasis on preserving the local geometry of the carotid surface by minimizing the local area distortion. The initial map was generated by a previously described arc-length scaling (ALS) mapping method, which projects a 3D carotid surface onto a 2D non-convex L-shaped domain. A smooth and area-preserving flattened map was subsequently constructed by deforming the ALS map using the proposed algorithm that combines the density-equalizing map and the reference map techniques. This combination allows, for the first time, one-to-one mapping from a 3D surface to a standardized non-convex planar domain in an area-preserving manner. Evaluations using 20 carotid surface models show that the proposed method reduced the area distortion of the flattening maps by over 80% as compared to the ALS mapping method.

60 APPLIED LIFE SCIENCES↗

Dual modality endocavity biopsy imaging system and method

A dual modality endocavity imaging and treatment system for detection of cancer and targeted biopsy and treatment procedures, comprising: a housing; a nuclear detector system housed within the housing and configured for detecting nuclear radiation imaging data; an ultrasound detector system housed within the housing for detecting ultrasound imaging data; a needle associated with the housing and adjustably positionable relative thereto; and a data processing module configured to receive the nuclear radiation imaging data and the ultrasound imaging data and to generate and output an image showing the relative position of the needle and an endocavity object of interest. The needle may include a distinct radiation signature to facilitate imaging thereof.

Lall, Terrence↗

A Resonant Metamaterial Line Array for Ultrasound Compressive Imaging

Abstract Acoustic metamaterials have been proposed for numerous applications including subwavelength imaging, impedance matching, and lensing. Yet, their application in compressive sensing and imaging has not been fully investigated. When metamaterials are used as resonators at certain frequencies, they can generate random radiation patterns in the transmitted waves from the transducers and received waves from a target. Compressive sensing favors such randomness inasmuch as it can increase incoherence by decreasing the amount of mutual information between any two different measurements. This study aims at assessing whether the use of resonating metamaterial unit cells in a single-layered non-optimized array between a number of ultrasound transceivers and targets can improve the sensing capacity, point-spread function of the sensing array (their beam focusing ability), and imaging performance in point-like target detection. The theoretical results are promising and can open the way for more efficient metamaterial designs with the aim of enhancing ultrasound imaging with lower number of transceivers compared to the regular systems.

Acoustics↗

On the Bandwidth and Beam Profile Characteristics of a Simple Low-Frequency Collimated Ultrasound Beam Source

We numerically investigate the bandwidth and collimation characteristics of ultrasound beams generated by a simple collimated ultrasound beam source that consists of a piezoelectric disk operated near its radial mode resonances. We simulate the ultrasound beam generated in a fluid medium as a function of the excitation frequency for two cases: (1) free piezoelectric disk that corresponds to zero-traction along the lateral edge and (2) fixed piezoelectric disk that corresponds to zero-displacement along the lateral edge. We present and discuss the physical mechanism underpinning the frequency-dependent collimation and bandwidth properties of the ultrasound beams. We observe that the collimated beam generated by the free disk repeatedly lengthens/shortens and also extends/retracts sidelobes with increasing frequency. Alternatively, fixing the piezoelectric disk results in a consistent beam profile shape across a broad range of frequencies. This facilitates generating broadband signals such as a Gaussian pulse or chirp, which are common in ultrasound imaging. Thus, the fixed piezoelectric disk finds application as a collimated ultrasound beam source in a wide range of applications including medical ultrasound imaging, scanning acoustic microscopy, sonar detection, and other nondestructive ultrasound inspection techniques.

47 OTHER INSTRUMENTATION↗

Breast Cancer Imaging and Characterization

Researchers at Los Alamos National Laboratory are developing a suite of ultrasound-waveform tomography and super-resolution ultrasound imaging technology that, while investigational at this time, may be able to provide significantly improved image resolution and characterization of early-stage cancers in a non-invasive and cost-effective manner. Breast cancer is the most frequently diagnosed cancer in U.S. women. Although current medical imaging technologies have improved, false positive rates for mammograms still range 50-60% after 10 yearly mammograms. This innovative ultrasound-imaging technology is patented and copyright protected. It has great potential to differentiate between cancerous and healthy tissue without the negative side effects of mammography. We are seeking a commercialization partner to license these technologies or participate in a Cooperative Research and Development Agreement (CRADA) to further develop a practical suite of products for commercial purposes, and where applicable seek any necessary FDA authorization of the technology.

59 BASIC BIOLOGICAL SCIENCES↗

Acoustics at the nanoscale (nanoacoustics): A comprehensive literature review. Part II: Nanoacoustics for biomedical imaging and therapy

We report in the past decade, acoustics at the nanoscale (i.e., nanoacoustics) has evolved rapidly with continuous and substantial expansion of capabilities and refinement of techniques. Motivated by research innovations in the last decade, for the first time, recent advancements of acoustics-associated nanomaterials/nanostructures and nanodevices for different applications are outlined in this comprehensive review, which is written in two parts. As part II of this two-part review, this paper concentrates on nanoacoustics in biomedical imaging and therapy applications, including molecular ultrasound imaging, photoacoustic imaging, ultrasound-mediated drug delivery and therapy, and photoacoustic drug delivery and therapy. Firstly, the recent developments of nanosized ultrasound and photoacoustic contrast agents as well as their various imaging applications are examined. Secondly, different types of nanomaterials/nanostructures as nanocarriers for ultrasound and photoacoustic therapies are discussed. Finally, a discussion of challenges and future research directions are provided for nanoacoustics in medical imaging and therapy.

47 OTHER INSTRUMENTATION↗

Noninvasive Detection, Tracking, and Characterization of Aerogel Implants Using Diagnostic Ultrasound

Medical implants are routinely tracked and monitored using different techniques, such as MRI, X-ray, and ultrasound. Due to the need for ionizing radiation, the two former methods pose a significant risk to tissue. Ultrasound imaging, however, is non-invasive and presents no known risk to human tissue. Aerogels are an emerging material with great potential in biomedical implants. While qualitative observation of ultrasound images by experts can already provide a lot of information about the implants and the surrounding structures, this paper describes the development and study of two simple B-Mode image analysis techniques based on attenuation measurements and echogenicity comparisons, which can further enhance the study of the biological tissues and implants, especially of different types of biocompatible aerogels.

36 MATERIALS SCIENCE↗

Deep learning models for interpretation of point of care ultrasound in military working dogs

Introduction: Military working dogs (MWDs) are essential for military operations in a wide range of missions. With this pivotal role, MWDs can become casualties requiring specialized veterinary care that may not always be available far forward on the battlefield. Some injuries such as pneumothorax, hemothorax, or abdominal hemorrhage can be diagnosed using point of care ultrasound (POCUS) such as the Global FAST® exam. This presents a unique opportunity for artificial intelligence (AI) to aid in the interpretation of ultrasound images. In this article, deep learning classification neural networks were developed for POCUS assessment in MWDs. Methods: Images were collected in five MWDs under general anesthesia or deep sedation for all scan points in the Global FAST® exam. For representative injuries, a cadaver model was used from which positive and negative injury images were captured. A total of 327 ultrasound clips were captured and split across scan points for training three different AI network architectures: MobileNetV2, DarkNet-19, and ShrapML. Gradient class activation mapping (GradCAM) overlays were generated for representative images to better explain AI predictions. Results: Performance of AI models reached over 82% accuracy for all scan points. The model with the highest performance was trained with the MobileNetV2 network for the cystocolic scan point achieving 99.8% accuracy. Across all trained networks the diaphragmatic hepatorenal scan point had the best overall performance. However, GradCAM overlays showed that the models with highest accuracy, like MobileNetV2, were not always identifying relevant features. Conversely, the GradCAM heatmaps for ShrapML show general agreement with regions most indicative of fluid accumulation. Discussion: Overall, the AI models developed can automate POCUS predictions in MWDs. Preliminarily, ShrapML had the strongest performance and prediction rate paired with accurately tracking fluid accumulation sites, making it the most suitable option for eventual real-time deployment with ultrasound systems. Further integration of this technology with imaging technologies will expand use of POCUS-based triage of MWDs.

59 BASIC BIOLOGICAL SCIENCES↗

Evaluation of Deep Learning Model Architectures for Point-of-Care Ultrasound Diagnostics

Point-of-care ultrasound imaging is a critical tool for patient triage during trauma for diagnosing injuries and prioritizing limited medical evacuation resources. Specifically, an eFAST exam evaluates if there are free fluids in the chest or abdomen but this is only possible if ultrasound scans can be accurately interpreted, a challenge in the pre-hospital setting. In this effort, we evaluated the use of artificial intelligent eFAST image interpretation models. Widely used deep learning model architectures were evaluated as well as Bayesian models optimized for six different diagnostic models: pneumothorax (i) B- or (ii) M-mode, hemothorax (iii) B- or (iv) M-mode, (v) pelvic or bladder abdominal hemorrhage and (vi) right upper quadrant abdominal hemorrhage. Models were trained using images captured in 27 swine. Using a leave-one-subject-out training approach, the MobileNetV2 and DarkNet53 models surpassed 85% accuracy for each M-mode scan site. The different B-mode models performed worse with accuracies between 68% and 74% except for the pelvic hemorrhage model, which only reached 62% accuracy for all model architectures. These results highlight which eFAST scan sites can be easily automated with image interpretation models, while other scan sites, such as the bladder hemorrhage model, will require more robust model development or data augmentation to improve performance. With these additional improvements, the skill threshold for ultrasound-based triage can be reduced, thus expanding its utility in the pre-hospital setting.

47 OTHER INSTRUMENTATION↗

Large Area Detection of Microstructural Defects with Multi-Mode Ultrasonic Signals

Cyclic loading or other stresses can lead to development of cracks and crack growth in mechanical structures, leading to eventual failure. While ultrasound imaging can be used for non-destructive testing of such structures, conventional ultrasound techniques are often limited by crack size, density, and areal coverage. An effective characterization of real-world, large-area structures is required at an early damage stage to prevent catastrophic failure and predict remaining life. In this study, a new nonlinear ultrasonic testing (NUT) method is proposed for large-area monitoring of practical structures with arbitrary complexity by using multiple-mode guided-wave ultrasonic signals. The proposed guided-wave NUT technique requires single-element transducers, simple electronics, and a mixed time-frequency domain signal processing. As a proof-of-concept demonstration, numerical simulations and experiments are performed on an A36 carbon steel beam assembly with previously formed microstructural defects that cause nonlinearities in ultrasonic response. The quadratic dependence of the nonlinear wave excitation on the input ultrasonic signal amplitude is shown by numerical simulations, and such a nonlinear ultrasonic response is experimentally observed in the zone with a high density of microstructural defects.

36 MATERIALS SCIENCE↗