Journal
UROLITHIASIS
Volume 47, Issue 2, Pages 181-188Publisher
SPRINGER
DOI: 10.1007/s00240-018-1036-z
Keywords
Ultrasonography; Kidney; Kidney calculi
Categories
Funding
- Vanderbilt Institute of Surgery and Engineering (VISE) Pilot and Feasibility Award
- VISE Surgeon in Residence Award [R01EB020040]
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Ultrasound imaging for kidney stones suffers from poorer sensitivity, diminished specificity, and overestimation of stone size compared to computed tomography (CT). The purpose of this study was to demonstrate in vitro feasibility of novel ultrasound imaging methods comparing traditional B-mode to advanced beamforming techniques including plane wave synthetic focusing (PWSF), short-lag spatial coherence (SLSC) imaging, mid-lag spatial coherence (MLSC) imaging with incoherent compounding, and aperture domain model image reconstruction (ADMIRE). The ultrasound techniques were evaluated using a research-based ultrasound system applied to an in vitro kidney stone model at 4 and 8cm depths. Stone diameter sizing and stone contrast were compared among the different techniques. Analysis of variance was used to analyze the differences among group means, with p<0.05 considered significant, and a Student's ttest was used to compare each method with B-mode, with p<0.0025 considered significant. All stones were detectable with each method. MLSC performed best with stone sizing and stone contrast compared to B-mode. On average, B-mode sizing error +/- SD was >1mm (1.2 +/- 1.1mm), while those for PWSF, ADMIRE, and MLSC were <1mm (-0.3 +/- 2.9mm, 0.6 +/- 0.8, 0.8 +/- 0.8, respectively). Subjectively, MLSC appeared to suppress the entire background thus highlighting only the stone. The ADMIRE and SLSC techniques appeared to highlight the stone shadow relative to the background. The detection and sizing of stones in vitro are feasible with advanced beamforming methods with ultrasound. Future work will include imaging stones at greater depths and evaluating the performance of these methods in human stone formers.
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