• 대한의용생체공학회:의공학회지
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• 제27권1호
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• pp.22-29
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• 2006

This paper proposes an efficient array beamforming method using spatial matched filtering for ultrasound imaging. In the proposed method, ultrasound waves are transmitted from an array subaperture with fixed transmit focus as in conventional array imaging. At receive, radio frequency (RF) echo signals from each receive channel are passed through a spatial matched filter that is constructed based on the system transmit-receive spatial impulse response. The filtered echo signals are then summed. The filter remaps and spatially registers the acoustic energy from each element so that the pulse-echo impulse response of the summed output is focused with acceptably low side lobes. Analytical beam pattern analysis and simulation results using a linear array show that the proposed spatial filtering method can provide more improved spatial resolution and contrast-to-noise ratio (CNR) compared with conventional dynamic receive focusing (DRF) method by implementing two-way dynamically focused beam pattern throughout the field.

• Korean Journal of Radiology
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• 제23권11호
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• pp.1067-1077
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• 2022

Objective: To determine whether Sonazoid-enhanced ultrasound (SZUS) was noninferior to SonoVue-enhanced ultrasound (SVUS) in diagnosing hepatocellular carcinoma (HCC) using the same diagnostic criteria. Materials and Methods: This prospective, single-center, noninferiority study (NCT04847726) enrolled 105 at-risk participants (71 male; mean age ± standard deviation, 63 ± 11 years; range, 26-86 years) with treatment-naïve solid hepatic nodules (≥ 1 cm). All participants underwent same-day SZUS (experimental method) and SVUS (control method) for one representative nodule per participant. Images were interpreted by three readers (the operator and two independent readers). All malignancies were diagnosed histopathologically, while the benignity of other lesions was confirmed by follow-up stability or pathology. The primary endpoint was per-lesion diagnostic accuracy for HCC pooled across three readers using the conventional contrast-enhanced ultrasound diagnostic criteria, including arterial phase hyperenhancement followed by mild (assessed within 2 minutes after contrast injection) and late (≥ 60 seconds with a delay of 5 minutes) washout. The noninferiority delta was -10%p. Furthermore, different time delays were compared as washout criteria in SZUS, including delays of 2, 5, and > 10 minutes. Results: A total of 105 lesions (HCCs [n = 61], non-HCC malignancies [n = 19], and benign [n = 25]) were evaluated. Using the 5-minutes washout criterion, per-lesion accuracy of SZUS pooled across the three readers (72.4%; 95% confidence interval [CI], 64.1%-79.3%) was noninferior to that of SVUS (71.4%; 95% CI, 63.1%-78.6%), meeting the statistical criterion for non-inferiority (difference of 0.95%p; 95% CI, -3.8%p-5.7%p). The arterial phase hyperenhancement combined with the 5-minutes washout criterion showed the same sensitivity as that of the > 10-minutes criterion (59.0% vs. 59.0%, p = 0.989), and the specificities were not significantly different (90.9% vs. 86.4%, p = 0.072). Conclusion: SZUS was noninferior to SVUS for diagnosing HCC in at-risk patients using the same diagnostic criteria. No significant improvement in HCC diagnosis was observed by extending the washout time delay from 5 to 10 minutes.

• 대한전자공학회:학술대회논문집
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• 대한전자공학회 2005년도 추계종합학술대회
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• pp.399-402
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• 2005

For efficient and accurate diagnosis of ultrasound images, the time gain compensation (TGC) and dynamic range (DR) control of the ultrasound echo signal are important. TGC is for compensating the attenuation of the ultrasound echo signal along the depth, and DR is used to control the image contrast. In this paper, we propose an algorithm for finding the optimized values of TGC and DR automatically. For TGC, the degree of compensation is determined along the depth based on the effective attenuation estimation of ultrasound signal. For DR optimization, we introduce a novel cost function on the basis of the characteristics of ultrasound image, which provides the minimum value at the optimal DR. Experiments have been performed by applying the proposed algorithm to a real US imaging system. The results show that the algorithm automatically can determine the values of TGC and DR in realtime so that the subjective quality of the corresponding US image may be good enough for diagnosis.

• 정보처리학회논문지:소프트웨어 및 데이터공학
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• 제4권7호
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• pp.297-300
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• 2015

의료 진단 초음파영상에서 조영제의 전이시간과 확산패턴의 형태는 질환 및 병변을 분석하는 중요한 파라미터로 고려된다. 조영증강 초음파영상 분석과 관련한 기존의 대부분의 연구에서 대상 영역의 평균 명도 변화곡선을 기반으로 파라미터값을 추출한다. 그런데 이러한 명도 데이터는 조영제의 마이크로 버블 효과로 인하여 그 값이 왜곡될 수 있다. 이에 본 논문에서는 조영증강 초음파 진단 파라미터의 추출 과정에서 그 정확도를 개선하기 위하여 명도값의 변화뿐만 아니라, 조영제의 영향을 반영하는 픽셀에 대한 밀도 정보를 보완적으로 활용하는 방법을 제안한다. 제안된 기법은 간 질환 진단 과정에서 병변의 윤곽선 추출과 병변의 특성분석을 위하여 조영제의 확산시점과 속도를 보다 정확하게 판별할 수 있게 한다. 실제 임상 데이터를 사용한 실험결과를 통하여, 제안된 방법이 파라미터 영상 생성기법에서 개선된 결과를 생성할 수 있음을 보인다.

• Korean Journal of Radiology
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• 제22권5호
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• pp.801-810
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• 2021

Objective: To investigate imaging biomarkers of microperfusion in contrast-induced nephropathy (CIN) using contrast-enhanced ultrasound (CEUS). Materials and Methods: The CIN model was fabricated by administering indomethacin (10 mg/kg), L-NAME (15 mg/kg), and iopamidol (10 mL/kg) to Sprague-Dawley rats. After 24 hours, CEUS was performed on CIN (n = 6) and control (n = 6) rats with sulphur hexafluoride microbubbles (SonoVue). From time-intensity curves obtained from the kidney arriving time (AT), acceleration time (AC), time to peak (TTP), and peak enhancement (PE) were measured and compared between the groups. After CEUS, the rats were sacrificed, and cell apoptosis markers were evaluated to confirm the development of CIN. Results: Among CEUS parameters, AT (7.8 ± 1.6 vs. 4.2 ± 0.5 s, p = 0.002), AC (4.7 ± 1.4 vs. 2.0 ± 0.4 s, p = 0.002), and TTP (12.5 ± 2.9 vs. 6.2 ± 0.6 s, p = 0.002) were significantly prolonged in the CIN group compared to controls. PE was significantly higher in the control group than in the CIN group (17.1 ± 1.9 vs. 12.2 ± 2.0 dB, p = 0.004). In kidney tissue, mRNA and protein levels of the apoptotic makers were significantly higher in the CIN group than in the control group (p = 0.003 and p = 0.002). Conclusion: CEUS parameters can be used as imaging biomarkers for microperfusion in CIN. In rats with CIN, AT, AC, and TTP were significantly prolonged, while PE was significantly lower compared to controls.

• Korean Journal of Radiology
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• 제20권5호
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• pp.781-790
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• 2019

Objective: To assess the relationship between contrast-enhanced ultrasound (CEUS) parameters and perfusion CT (PCT) parameters of gastric cancers and their correlation with histologic features. Materials and Methods: This prospective study was approved by our Institutional Review Board. We included 43 patients with pathologically-proven gastric cancers undergoing CEUS using SonoVue^® (Bracco) and PCT on the same day. Correlation between the CEUS parameters (peak intensity [PI], area under the curve [AUC], rise time [RT] from 10% to 90% of PI, time to peak [TTP_US], and mean transit time [MTT_US]) and PCT parameters (blood flow, blood volume, TTP_CT, MTT_CT, and permeability surface product) of gastric cancers were analyzed using Spearman's rank correlation test. In cases of surgical resection, the CEUS and PCT parameters were compared according to histologic features using Mann-Whitney test. Results: CEUS studies were of diagnostic quality in 88.4% (38/43) of patients. Among the CEUS parameters of gastric cancers, RT and TTP_US showed significant positive correlations with TTP_CT (rho = 0.327 and 0.374, p = 0.045 and 0.021, respectively); PI and AUC were significantly higher in well-differentiated or moderately-differentiated tumors (n = 4) than poorly-differentiated tumors (n = 18) (p = 0.026 and 0.033, respectively), whereas MTT_CT showed significant differences according to histologic types (poorly cohesive carcinoma [PCC] vs. non-PCC), T-staging (≤ T2 vs. ≥ T3), N-staging (N0 vs. N-positive), and epidermal growth factor receptor expression (≤ faint vs. ≥ moderate staining) (p values < 0.05). Conclusion: In patients with gastric cancers, CEUS is technically feasible for the quantification of tumor perfusion and may provide correlative and complementary information to that of PCT, which may allow prediction of histologic features.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5799-5804
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• 2014

Background: Radiofrequency ablation (RFA) is the most widely used and studied method internationally for the local treatment of liver tumors. However, the extension of coagulation necrosis in one RFA procedure is limited and incomplete coverage of the damaged area can lead to a high local recurrence rate. Objective: In this study, we compared the effects of different solutions in enhancing hepatic radiofrequency by establishing a rabbit VX2 liver cancer model. We also determined the optimal solution to maximise effects on the extent of RFA-induced coagulation necrosis. Methods: Thirty VX2 tumor rabbits were randomly assigned to five groups: group A, RFA alone; group B, RFA with anhydrous ethanol injection; group C, RFA with 5% hypertonic saline injection; group D, RFA with lidocaine injection; and group E, RFA with a mixed solution. Routine ultrasound examinations and contrast-enhanced ultrasound (CEUS) of the ablation areas were performed after RFA. Then, we measured the major axis and transverse diameter and compared the areas of coagulation necrosis induced by RFA. Results: The mean ablation area range increased in groups B, C and especially E, and the scopes were greater compared with group A. Preoperative application of anhydrous ethanol, hypertonic saline, lidocaine and the mixed solution (groups B, C, D and E, respectively) resulted in larger coagulation necrosis areas than in group A (p<0.05). Among the groups, the coagulation necrosis areas in group E was largest, and the difference was statistically significant compared with other groups (p<0.05). Pathological findings were consistent with imaging results. Conclusions: A mixture of dehydrated alcohol, hypertonic saline and lidocaine injected with RFA increases the extent of coagulation necrosis in the liver with a single application, and the mixed solution is more effective than any other injection alone.

• 한국음향학회지
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• 제36권4호
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• pp.238-246
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• 2017

고주파수, 고해상도 초음파 영상을 획득하기 위해서는 고주파수 초음파 변환기가 가지는 작은 구경에 따른 낮은 민감도와 침투 깊이에 따른 높은 감쇠량을 극복하여야 한다. 이는 고주파수 초음파 변환기의 본질적인 한계점이므로 수신 시스템을 통하여 그 한계점을 극복하여야 한다. 본 논문은 고주파수, 고해상도 초음파 영상을 위하여 고주파수 초음파 변환기의 본질적인 한계인 낮은 민감도와 높은 감쇠량을 극복할 수 있는 저잡음 광대역 수신 시스템 개발과 특성 평가 결과에 관한 것이다. 개발한 저잡음 광대역 수신 시스템은 80 MHz 이상의 동작 주파수 대역에서 최대 73 dB의 증폭 이득과 48 dB의 가변 이득 범위를 만족하며 ${\pm}1dB$의 증폭 이득 평탄도 성능을 가진다. 또한 개발한 수신 시스템은 상용 리시버에 비하여 8.4 dB 이상의 신호대잡음비 성능과 3.7 dB 이상의 대조도 성능이 우수함을 확인하였다.

• 대한정형외과 초음파학회지
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• 제7권1호
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• pp.49-66
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• 2014

지금까지 경추부 중재술은 방사선 투시하에 하는 것이 표준화된 방법이었다. 그러나 방사선을 피폭해야 하는 문제가 있으며, 실시간으로 조영제를 이용하여 투시하거나 컴퓨터단층촬영 유도하 시술로써 안전하게 시행하려는 노력에도 불구하고, 특히 경추간공 차단술에서, 예기치 않은 주사제의 동맥내 주입이 발생하여 심각한 합병증인 척수 손상, 소뇌 및 뇌간 경색 등의 증례들이 방사선 투시하 시술에서 보고되는 것이 사실이다. 최근에는 그 대안으로서 경추부 초음파 유도하 중재술이 시행되고 있는데, 초음파는 주요 신경 및 혈관 구조물들의 위치를 관찰하면서 목표 부위 주위로 주사제가 퍼져나가는 양상을 파악할 수 있다는 장점이 있기 때문이다. 또한 초음파는 방사선이 없고 간편하며 주사하는 동안 실시간으로 계속 영상을 제공함으로써 시술의 정확도를 높일 수 있는 술기이다. 결국 초음파 유도하 시술은 주요 신경과 혈관의 위치를 확인하면서 그에 대한 손상 혹은 주사를 피할 수 있기 때문에 이러한 구조물들의 손상 위험이 높은 경추부에서 안전하게 시행할 수 있다는 중요한 장점이 있는 술기이다. 그리하여 저자는 실시간 초음파 유도하라는 술기가 경추부 중재술에서 얼마나 유용한가에 대해 분석하여 기술하였다.

• Journal of Korean Neurosurgical Society
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• 제66권2호
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• pp.172-182
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• 2023

Objective : The blood-brain barrier (BBB) is an obstacle for molecules to pass through from blood to the brain. Focused ultrasound is a new method which temporarily opens the BBB, which makes pharmaceutical delivery or removal of neurodegenerative proteins possible. This study was demonstrated to review our BBB opening procedure with magnetic resonance guided images and find specific patterns in the BBB opening. Methods : In this study, we reviewed the procedures and results of two clinical studies on BBB opening using focused ultrasound regarding its safety and clinical efficacy. Magnetic resonance images were also reviewed to discover any specific findings. Results : Two clinical trials showed clinical benefits. All clinical trials demonstrated safe BBB opening, with no specific side effects. Magnetic resonance imaging showed temporary T1 contrast enhancement in the sonication area, verifying the BBB opening. Several low-signal intensity spots were observed in the T2 susceptibility-weighted angiography images, which were also reversible and temporary. Although these spots can be considered as microbleeding, evidence suggests these are not ordinary microbleeding but an indicator for adequate BBB opening. Conclusion : Magnetic resonance images proved safe and efficient BBB opening in humans, using focused ultrasound.