A demonstration of high field-of-view stability in hands-free echocardiography

Abstract

Background: Exercise stress echocardiography is clinically used to assess cardiovascular diseases. For accurate cardiac evaluation, a stable field-of-view is required. However, transducer orientation and position are difficult to preserve. Hands-free acquisitions might provide more consistent and reproducible results. In this study, the field-of-view stability and variability of hands-free acquisitions are objectively quantified in a comparison with manually obtained images, based on image structural and feature similarities. In addition, the feasibility and consistency of hands-free strain imaging is assessed. Methods: In twelve healthy males, apical and parasternal images were acquired hands-free, using a fixation device, and manually, during semi-supine exercise sessions. In the final ten seconds of every exercise period, the image structural similarity and cardiac feature consistency were computed using a steerable pyramid employing complex, oriented wavelets. An algorithm discarding images displaying lung artifacts was created. Hands-free strain consistency was analyzed. Results: Hands-free acquisitions were possible in 9 of the 12 subjects, whereas manually 10 out of 12 could be imaged. The image structural similarity was significantly improved in the hands-free apical window acquisitions (0.91 versus 0.82), and at least equally good in the parasternal window (0.90 versus 0.82). The change in curvature and orientation of the interventricular septum also appeared to be lower in the hands-free acquisitions. The variability in field-of-view was similar in both acquisitions. Longitudinal, septal strain was shown to be at least as consistent when obtained hands-free compared to manual acquisitions. Conclusions: The field-of-view was shown to be more or equally stable and consistent in the hands-free data in comparison to manually obtained images. The variability was similar, thus respiration-and exercise-induced motions were comparable for manual and hands-free acquisitions. Additionally, the feasibility of hands-free strain has been demonstrated. Furthermore, the results suggest the hands-free measurements to be more reproducible, though further analysis is required.

The Feasibility of Dynamic Musculoskeletal Function Analysis of the Vastus Lateralis in Endurance Runners Using Continuous, Hands-Free Ultrasound

“…The introduction of portable ultrasound systems and ultrasound transducer fixation devices has made dynamic evaluation of the skeletal muscles possible. The feasibility of short-term dynamic ultrasound acquisitions has already been demonstrated previously in cycling exercise in ultrasonography of skeletal muscles and in echocardiography [18,27]. In this study, the feasibility of long-term dynamic functional measurements has been investigated in ten endurance runners.…”

“…Fixation of the transducer enables dynamic imaging, and has been shown to overcome part of the limitations associated with manual acquisitions. Probe fixation has been shown to yield improved or similar field-of-view stability and repeatability of ultrasound acquisitions [18,26,27]. Additionally, probe fixation has shown to decline shoulder abduction and forearm muscle activation of sonographers without influencing the acquisition time in echocardiography [28].…”

POCUS in cardiac arrest and its therapeutic implications – a case report

“…Besides diagnosis, POCUS also plays a role in the prognostication of patients with cardiac arrest. Kedan and colleagues ( 4 ) have previously demonstrated a positive correlation between the presence of cardiac motion on ultrasonography during cardiac arrest and positive outcomes of cardiac resuscitation. Other authors ( 5 , 6 ) have proposed algorithms incorporating POCUS during cardiac arrest resuscitation.…”

Three-Dimensional Transesophageal Echocardiography as an Alternative to Multidetector Computed Tomography in Aortic Annular Diameter Measurements for Transcatheter Aortic Valve Implantation

“…Further research is required for the clinical usefulness of complementary 3D TEE measurements to MDCT in the sizing of prosthetic aortic valves used in TAVI and, therefore, in lowering the risk of paravalvular leakage. However, at the moment, there are several challenges facing 3D TEE, such as variability in measuring due to the experience of the operator or maintaining the position of the TEE probe transducer [31].…”