Brachial artery vasomotion and transducer pressure effect on measurements by active contour segmentation on ultrasound

Cary, Theodore W.; Reamer, Courtney; Sultan, Laith R.; Mohler, Emile R.; Sehgal, Chandra M.

doi:10.1118/1.4862508

Cited by 17 publications

(19 citation statements)

References 31 publications

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“…At present, DUS is the first -line imaging modality to assess the VA. It is a cheap, easily available, non -invasive, non -ionizing imaging method that allows not only the hemodynamic investigation of the access but also the direct visualization of the VA morphology and its surrounding structures 27 . It also permits the investigation of other dysfunctions not related to stenosis and thrombosis, such as aneurysms or hematomas, and can be used in the pre -dialysis period 28 .…”

Section: Limitations and Pitfallsmentioning

confidence: 99%

Doppler Ultrasound in Vascular Access care: the pearls and pitfalls of flow volume measurement

Diniz¹,

Coentrão²

2020

pjnh

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Recently, the European Renal Best Practice (ERBP) clinical practice guidelines on hemodialysis VA stated that the evidence for surveillance in addition to clinical monitoring is inconclusive 11. Still, DUS Qa measurement is a very useful tool in vascular access care that is being increasingly adopted by nephrologists in their daily clinical practice. All the clinicians involved in VA care should be familiar with its advantages, disadvantages, and potential pitfalls, as well as its reliability and correlation with other methods in chronic kidney disease patients. DUPLEX ULTRASOUND-THEORY AND TECHNICAL CONSIDERATIONS Ultrasound is an imaging technique that allows the investigation of the VA through the use of a transducer capable of emitting and receiving ultrasounds and converting them to an electrical signal. This signal is analyzed by a processor and, based on the amplitude of the signal received, a gray-scale image is displayed on the screen of the ultrasound machine 12. The use of Doppler ultrasound for the detection of blood flow in the hemodialysis VA was reported for the first time in 1971, following the increasing use of the Doppler ultrasonic flowmeter as an adjuvant in the diagnosis and management of vascular disease at the time 13. The simplest and most widely available method

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Section: Limitations and Pitfallsmentioning

confidence: 99%

Doppler Ultrasound in Vascular Access care: the pearls and pitfalls of flow volume measurement

Diniz¹,

Coentrão²

2020

pjnh

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“…In fact, when comparing measurements of the same brachial artery in both planes, the equivalent-circle area calculated from the longitudinal diameter measurements was 27% lower than the cross-sectional area measured from transverse images. 10 The %FMD area should be twice that of %FMD diameter , but across all observers %FMD diameter underestimated the expected change in area by 10%. The observation that the %FMD area /%FMD diameter ratio is greater than the expected value of 2 indicates that the effect of compression by the transducer during longitudinal imaging could have played a role in the observed deviation.…”

Section: Transverse Vs Longitudinal Imagingmentioning

confidence: 99%

“…Compared to manual tracing, the FFAC algorithm and its automated contour tracking require, on average, 94 fewer minutes of manual intervention per case. 10 Given that one of the aims of this study was to try to develop an approach for evaluating %FMD that could be used in larger research and clinical populations, the time it takes to analyze each case will contribute significantly to its applicability.…”

Section: Coefficients Of Variationmentioning

confidence: 99%

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Feed-forward active contour analysis for improved brachial artery reactivity testing

et al. 2016

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Flow-mediated dilation (FMD) has emerged over the past 20 years as an important marker of vascular endothelial function that can be measured non-invasively. Celermajer et al. described its clinical utility in a study of children and adults who were at risk for developing atherosclerosis. 1 Endothelial dysfunction, as assessed by impaired brachial artery FMD, has been observed in almost every condition that predisposes to atherosclerosis and cardiovascular disease. 2 In addition, a recent meta-analysis indicates that impairment of brachial artery FMD is significantly associated with future cardiovascular events. 3 Unfortunately, evaluation of brachial artery FMD has not been adopted for more widespread clinical use primarily due to technical limitations that lead to poor inter-observer reproducibility of results. Multiple review papers have all noted that practical challenges, including significant test-to-test variability, have precluded widespread clinical use of this method. [4][5][6] Other than publication of guidelines to try to standardize brachial artery FMD measurement methodology, there has not been significant progress in improving the techniques for measuring brachial artery reactivity to minimize inter-observer variability. AbstractThe object of this study was to utilize a novel feed-forward active contour (FFAC) algorithm to find a reproducible technique for analysis of brachial artery reactivity. Flow-mediated dilation (FMD) is an important marker of vascular endothelial function but has not been adopted for widespread clinical use given its technical limitations, including interobserver variability and differences in technique across clinical sites. We developed a novel FFAC algorithm with the goal of validating a more reliable standard. Forty-six healthy volunteers underwent FMD measurement according to the standard technique. Ultrasound videos lasting 5-10 seconds each were obtained pre-cuff inflation and at minutes 1 through 5 post-cuff deflation in longitudinal and transverse views. Automated segmentation using the FFAC algorithm with initial boundary definition from three different observers was used to analyze the images to measure diameter/ cross-sectional area over the cardiac cycle. The %FMD was calculated for average, minimum, and maximum diameters/ areas. Using the FFAC algorithm, the population-specific coefficient of variation (CV) at end-diastole was 3.24% for transverse compared to 9.96% for longitudinal measurements; the subject-specific CV was 15.03% compared to 57.41%, respectively. For longitudinal measurements made via the conventional method, the population-specific CV was 4.77% and subject-specific CV was 117.79%. The intraclass correlation coefficient (ICC) for transverse measurements was 0.97 (95% CI: 0.95-0.98) compared to 0.90 (95% CI: 0.84-0.94) for longitudinal measurements with FFAC and 0.72 (95% CI: 0.51-0.84) for conventional measurements. In conclusion, transverse views using the novel FFAC method provide less inter-observer variability than traditional longitudinal...

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“…There have been efforts to extract the target vessel automatically with feed-forward active contour (snake) [7] or with a probabilistic approach to the computerized tracking of arterial walls [8] among others. However, those based on edge detection, are particularly vulnerable to speckle noise.…”

Section: Introductionmentioning

confidence: 99%

Automatic Segmentation of Brachial Artery based on Fuzzy C-Means Pixel Clustering from Ultrasound Images

Park¹,

Song²,

Nho³

et al. 2018

IJECE

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Automatic extraction of brachial artery and measuring associated indices such as flow-mediated dilatation and Intima-media thickness are important for early detection of cardiovascular disease and other vascular endothelial malfunctions. In this paper, we propose the basic but important component of such decision-assisting medical software development -noise tolerant fully automatic segmentation of brachial artery from ultrasound images. Pixel clustering with Fuzzy C-Means algorithm in the quantization process is the key component of that segmentation with various image processing algorithms involved. This algorithm could be an alternative choice of segmentation process that can replace speckle noise-suffering edge detection procedures in this application domain.

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Brachial artery vasomotion and transducer pressure effect on measurements by active contour segmentation on ultrasound

Cited by 17 publications

References 31 publications

Doppler Ultrasound in Vascular Access care: the pearls and pitfalls of flow volume measurement

Doppler Ultrasound in Vascular Access care: the pearls and pitfalls of flow volume measurement

Feed-forward active contour analysis for improved brachial artery reactivity testing

Automatic Segmentation of Brachial Artery based on Fuzzy C-Means Pixel Clustering from Ultrasound Images

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