Super-Resolution Ultrasound Localization Microscopy of Microvascular Structure and Flow for Distinguishing Metastatic Lymph Nodes – An Initial Human Study

Journal article

Zhu, J., Zhang, C., Christensen-Jeffries, K., Zhang, G., Harput, S., Dunsby, C., Huang, P. and Tang, M. (2022). Super-Resolution Ultrasound Localization Microscopy of Microvascular Structure and Flow for Distinguishing Metastatic Lymph Nodes – An Initial Human Study. Ultraschall in der Medizin - European Journal of Ultrasound. https://doi.org/10.1055/a-1917-0016
AuthorsZhu, J., Zhang, C., Christensen-Jeffries, K., Zhang, G., Harput, S., Dunsby, C., Huang, P. and Tang, M.
AbstractAbstract Purpose Detecting and distinguishing metastatic lymph nodes (LNs) from those with benign lymphadenopathy are crucial for cancer diagnosis and prognosis but remain a clinical challenge. A recent advance in super-resolution ultrasound (SRUS) through localizing individual microbubbles has broken the diffraction limit and tracking enabled in vivo noninvasive imaging of vascular morphology and flow dynamics at a microscopic level. In this study we hypothesize that SRUS enables quantitative markers to distinguish metastatic LNs from benign ones in patients with lymphadenopathy. Materials and Methods Clinical contrast-enhanced ultrasound image sequences of LNs from 6 patients with lymph node metastasis and 4 with benign lymphadenopathy were acquired and motion-corrected. These were then used to generate super-resolution microvascular images and super-resolved velocity maps. From these SRUS images, morphological and functional measures were obtained including micro-vessel density, fractal dimension, mean flow speed, and Local Flow Direction Irregularity (LFDI) measuring the variance in local flow direction. These measures were compared between pathologically proven reactive and metastasis LNs. Results Our initial results indicate that the difference in the indicator of flow irregularity (LFDI) derived from the SRUS images is statistically significant between the two groups. The LFDI is 60% higher in metastatic LNs compared with reactive nodes. Conclusion This pilot study demonstrates the feasibility of super-resolution ultrasound for clinical imaging of lymph nodes and the potential of using the irregularity of local blood flow directions afforded by SRUS for the characterization of LNs.
KeywordsRadiology, Nuclear Medicine and imaging
Year2022
JournalUltraschall in der Medizin - European Journal of Ultrasound
PublisherGeorg Thieme Verlag KG
ISSN0172-4614
1438-8782
Digital Object Identifier (DOI)https://doi.org/10.1055/a-1917-0016
Funder/ClientEngineering and Physical Sciences Research Council
National Institute for Health Research
Cancer Research UK
Publication dates
Online07 Oct 2022
Publication process dates
Deposited21 Oct 2022
Accepted02 Aug 2022
Accepted author manuscript
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Open
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Moubark, A.M., Alomari, Z., Harput, S., Cowell, D.M.J. and Freear, S. (2016). Enhancement of contrast and resolution of B-mode plane wave imaging (PWI) with non-linear filtered delay multiply and sum (FDMAS) beamforming. 2016 IEEE International Ultrasonics Symposium (IUS). Tours, France 18 - 21 Sep 2016 Institute of Electrical and Electronics Engineers (IEEE). https://doi.org/10.1109/ULTSYM.2016.7728536
Improved shear wave-front reconstruction method by aligning imaging beam angles with shear-wave polarization: Applied for shear compounding application
Hyder, S., Harput, S., Alomari, Z., Cowell, D.M.J., McLaughlan, J. and Freear, S. (2016). Improved shear wave-front reconstruction method by aligning imaging beam angles with shear-wave polarization: Applied for shear compounding application. 2016 IEEE International Ultrasonics Symposium (IUS). Tours, France 18 - 21 Sep 2016 Institute of Electrical and Electronics Engineers (IEEE). https://doi.org/10.1109/ULTSYM.2016.7728536
Simultaneous trapping and imaging of microbubbles at clinically relevant flow rates
Harput, S., Nie, L., Cowell, D.M.J., Carpenter, T., Raiton, B., McLaughlan, J. and Freear, S. (2016). Simultaneous trapping and imaging of microbubbles at clinically relevant flow rates. 2016 IEEE International Ultrasonics Symposium (IUS). Tours, France 18 - 21 Sep 2016 Institute of Electrical and Electronics Engineers (IEEE). https://doi.org/10.1109/ULTSYM.2016.7728393
Coupling of wideband impulses generated by granular chains into liquids for biomedical applications
Harput, S., Freear, S., Gelat, P., Saffari, N., Yang, J., Akanji, O., Thomas, P.J. and Hutchins, D.A. (2016). Coupling of wideband impulses generated by granular chains into liquids for biomedical applications. 2016 IEEE International Ultrasonics Symposium (IUS). Tours, France 18 - 21 Sep 2016 Institute of Electrical and Electronics Engineers (IEEE). https://doi.org/10.1109/ULTSYM.2016.7728481
Spatial Resolution and Contrast Enhancement in Photoacoustic Imaging with Filter Delay Multiply and Sum Beamforming Technique
Alshaya, A., Harput, S., Moubark, A.M., Cowell, D.M.J., McLaughlan, J. and Freear, S. (2016). Spatial Resolution and Contrast Enhancement in Photoacoustic Imaging with Filter Delay Multiply and Sum Beamforming Technique. 2016 IEEE International Ultrasonics Symposium (IUS). Tours, France 18 - 21 Sep 2016 Institute of Electrical and Electronics Engineers (IEEE). https://doi.org/10.1109/ULTSYM.2016.7728682
Specimen-agnostic guided wave inspection using recursive feedback
Adams, C., Harput, S., Cowell, D., Freear, S. and Charutz, D.M. (2016). Specimen-agnostic guided wave inspection using recursive feedback. 2016 IEEE International Ultrasonics Symposium (IUS). Tours, France 18 - 21 Sep 2016 Institute of Electrical and Electronics Engineers (IEEE). https://doi.org/10.1109/ULTSYM.2016.7728811
The Effect of Boundary Conditions on Resonant Ultrasonic Spherical Chains
Akanji, O, Yang, J., Hutchins, D., Thomas, P.J., Davis, L.A.J., Harput, S., Freear, S., Gelat, P.N. and Saffari, N. (2016). The Effect of Boundary Conditions on Resonant Ultrasonic Spherical Chains. IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control. 63 (11), pp. 1957-1966. https://doi.org/10.1109/TUFFC.2016.2576563
An adaptive array excitation scheme for the unidirectional enhancement of guided waves
Adams, C., Harput, S., Cowell, D., Carpenter, T.M., Charutz, D.M. and Freear, S. (2016). An adaptive array excitation scheme for the unidirectional enhancement of guided waves. IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control. 64 (2), pp. 441-451. https://doi.org/10.1109/TUFFC.2016.2628100
Contrast-enhanced ultrasound imaging with chirps: Signal processing and pulse compression
Harput, S., McLaughlan, J., Cowell, D. and Freear, S. (2015). Contrast-enhanced ultrasound imaging with chirps: Signal processing and pulse compression. 2015 IEEE International Ultrasonics Symposium (IUS). Taipei, Taiwan 21 Oct - 24 Nov 2015 https://doi.org/10.1109/ULTSYM.2015.0160
Ultrasonic propagation in finite-length granular chains
Hutchins, D.A., Yang, J., Akanji, O., Thomas, P.J., Davis, L.A.J., Freear, S., Harput, S., Saffari, N. and Gelat, P. (2015). Ultrasonic propagation in finite-length granular chains. Ultrasonics. 69, pp. 215-223. https://doi.org/10.1016/j.ultras.2015.10.018
Superharmonic imaging with chirp coded excitation: filtering spectrally overlapped harmonics
Harput, S., McLaughlan, J. and Cowell, D. M. J. (2014). Superharmonic imaging with chirp coded excitation: filtering spectrally overlapped harmonics. IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control. 61 (11), pp. 1802-1814. https://doi.org/10.1109/TUFFC.2014.006424
Ultrasonic Phased Array Device for Acoustic Imaging in Air
Harput, S. and Bozkurt, A. (2008). Ultrasonic Phased Array Device for Acoustic Imaging in Air. IEEE Sensors Journal. 8 (11), pp. 1755 - 1762. https://doi.org/10.1109/JSEN.2008.2004574