Improved Visualization in Difficult-to-Image Stress Echocardiography Patients Using Real-Time Harmonic Spatial...

Area of Science:

• Medical Imaging
• Cardiovascular Ultrasound
• Diagnostic Echocardiography

Background:

• Stress echocardiography assesses cardiac function but is challenged by image clutter in obese patients.
• Left ventricular (LV) endocardial border visualization is crucial for detecting myocardial ischemia.
• Obesity rates have increased globally, exacerbating imaging difficulties in echocardiography.

Purpose of the Study:

• To evaluate the efficacy of harmonic spatial coherence imaging (HSCI) in improving LV visualization during stress echocardiography.
• To compare HSCI with conventional tissue harmonic imaging (THI) in difficult-to-image patients.

Main Methods:

• Implemented a real-time, efficient short-lag spatial coherence (SLSC) imaging formulation on a GPU-based beamformer.
• Conducted a comparative study using HSCI and THI on 15 patients undergoing stress echocardiography.
• Experienced readers assessed the visualization of 17 LV segments on a three-point scale.

Main Results:

• HSCI demonstrated clear superiority over THI in unadjusted symmetry tests.
• Per-patient median total scores significantly favored HSCI.
• When simplified to a two-level scale, HSCI showed overall superiority over THI, with statistical significance after adjustment for clustering.

Conclusions:

• HSCI significantly enhances LV visualization in stress echocardiography compared to THI.
• This improved imaging may reduce the need for contrast agents in challenging patient populations.
• HSCI represents a promising advancement for diagnosing myocardial ischemia, particularly in obese individuals.