Contrast-Enhanced Ultrasound with Optimized Aperture Patterns and Bubble Segmentation Based on Echo Phase

Amplitude modulation (AM) suppresses tissue signals and detects microbubble signals in contrast-enhanced ultrasound (CEUS) and is often implemented with checkerboard apertures. However, possible crosstalk between transmitting and non-transmitting array elements may compromise tissue suppression in AM. Using AM aperture patterns other than the conventional checkerboard approach (one on, one off) may reduce the degree of crosstalk and increase the contrast-to-tissue-ratio (CTR) compared with conventional AM. Furthermore, previous studies have reported that the phase difference between the echoes in AM pulsing sequences may be used to segment tissue and microbubbles and improve tissue signal suppression and the CTR of CEUS images. However, the CTR of the image produced by alternative AM aperture patterns and the effect of segmentation approach on these alternative apertures have not been investigated. We evaluated a number of AM aperture patterns to find an optimal AM aperture pattern that provides the highest CTR. We found that the aperture that uses alternating groups of two elements, AM2, had the highest CTR for the probe evaluated. In addition, a segmentation technique based on echo phase differences (between the full and half-pulses, ΔΦ_AM, between the complementary half-pulses, ΔΦ_half, and the maximum of the two ΔΦ_max) was also considered in the AM aperture optimization process. The segmentation approach increases the CTR by about 25 dB for all apertures. Finally, AM2 segmented with ΔΦ_max had a 7-dB higher CTR in a flow phantom and a 6-dB higher contrast in a perfused pig liver than conventional AM segmented with ΔΦ_AM, and it is the optimal transmit aperture design.