Microbubble Contrast Agents Improve Detection of Active Hemorrhage
Assessment of trauma-induced hemorrhage with ultrasound is particularly challenging outside of the clinic, where its detection is crucial. The current clinical standard for hematoma detection – the focused assessment with sonography of trauma (FAST) exam – does not aim to detec...
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IEEE
2024-01-01
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| Series: | IEEE Open Journal of Engineering in Medicine and Biology |
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| Online Access: | https://ieeexplore.ieee.org/document/10561886/ |
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| author | Scott Schoen Jr Alexis Prasov Ion Candel Saaid Arshad Mark Ottensmeyer Theodore T. Pierce Laura J. Brattain Brian A. Telfer Anthony E. Samir |
| author_facet | Scott Schoen Jr Alexis Prasov Ion Candel Saaid Arshad Mark Ottensmeyer Theodore T. Pierce Laura J. Brattain Brian A. Telfer Anthony E. Samir |
| author_sort | Scott Schoen Jr |
| collection | DOAJ |
| description | Assessment of trauma-induced hemorrhage with ultrasound is particularly challenging outside of the clinic, where its detection is crucial. The current clinical standard for hematoma detection – the focused assessment with sonography of trauma (FAST) exam – does not aim to detect ongoing blood loss, and thus is unable to detect injuries of increasing severity. To enhance detection of active bleeding, we propose the use of ultrasound contrast agents (UCAs), together with a novel flow phantom and contrast-sensitive processing techniques, to facilitate efficient, practical characterization of internal bleeding. Within a the custom phantom, UCAs and processing techniques enabled a significant enhancement of the hemorrhage visualization (mean increase in generalized contrast-to-noise ratio of 17%) compared to the contrast-free case over a range of flow rates up to 40 ml/min. Moreover, we have shown that the use of UCAs improves the probability of detection: the area under the receiver operating characteristic curve for a flow rate of 40 ml/min was 0.99, compared to 0.72 without contrast. We also demonstrate how additional processing of the spatial and temporal information further localizes the bleeding site. UCAs also enhanced Doppler signals over the non-contrast case. These results show that specialized nonlinear processing (NLP) pipelines together with UCAs may offer an efficient means to improve substantially the detection of slower hemorrhages and increase survival rates for trauma-induced injury in pre-hospital settings. |
| format | Article |
| id | doaj-art-c97a5e2c01634b07bd18fb7099565fbf |
| institution | Kabale University |
| issn | 2644-1276 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | IEEE |
| record_format | Article |
| series | IEEE Open Journal of Engineering in Medicine and Biology |
| spelling | doaj-art-c97a5e2c01634b07bd18fb7099565fbf2025-08-20T03:32:54ZengIEEEIEEE Open Journal of Engineering in Medicine and Biology2644-12762024-01-01587788410.1109/OJEMB.2024.341497410561886Microbubble Contrast Agents Improve Detection of Active HemorrhageScott Schoen Jr0https://orcid.org/0000-0001-7195-2883Alexis Prasov1Ion Candel2Saaid Arshad3Mark Ottensmeyer4https://orcid.org/0000-0001-8886-4556Theodore T. Pierce5https://orcid.org/0000-0003-3244-0994Laura J. Brattain6Brian A. Telfer7https://orcid.org/0000-0002-3534-7149Anthony E. Samir8Center for Ultrasound Research and Translation, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USAMIT Lincoln Laboratory, Lexington, MA, USACenter for Ultrasound Research and Translation, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USAMIT Lincoln Laboratory, Lexington, MA, USACenter for Ultrasound Research and Translation, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USACenter for Ultrasound Research and Translation, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USAUniversity of Central Florida, Orlando, FL, USAMIT Lincoln Laboratory, Lexington, MA, USACenter for Ultrasound Research and Translation, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USAAssessment of trauma-induced hemorrhage with ultrasound is particularly challenging outside of the clinic, where its detection is crucial. The current clinical standard for hematoma detection – the focused assessment with sonography of trauma (FAST) exam – does not aim to detect ongoing blood loss, and thus is unable to detect injuries of increasing severity. To enhance detection of active bleeding, we propose the use of ultrasound contrast agents (UCAs), together with a novel flow phantom and contrast-sensitive processing techniques, to facilitate efficient, practical characterization of internal bleeding. Within a the custom phantom, UCAs and processing techniques enabled a significant enhancement of the hemorrhage visualization (mean increase in generalized contrast-to-noise ratio of 17%) compared to the contrast-free case over a range of flow rates up to 40 ml/min. Moreover, we have shown that the use of UCAs improves the probability of detection: the area under the receiver operating characteristic curve for a flow rate of 40 ml/min was 0.99, compared to 0.72 without contrast. We also demonstrate how additional processing of the spatial and temporal information further localizes the bleeding site. UCAs also enhanced Doppler signals over the non-contrast case. These results show that specialized nonlinear processing (NLP) pipelines together with UCAs may offer an efficient means to improve substantially the detection of slower hemorrhages and increase survival rates for trauma-induced injury in pre-hospital settings.https://ieeexplore.ieee.org/document/10561886/Traumahemorrhagecontrast agentsultrasounddoppler |
| spellingShingle | Scott Schoen Jr Alexis Prasov Ion Candel Saaid Arshad Mark Ottensmeyer Theodore T. Pierce Laura J. Brattain Brian A. Telfer Anthony E. Samir Microbubble Contrast Agents Improve Detection of Active Hemorrhage IEEE Open Journal of Engineering in Medicine and Biology Trauma hemorrhage contrast agents ultrasound doppler |
| title | Microbubble Contrast Agents Improve Detection of Active Hemorrhage |
| title_full | Microbubble Contrast Agents Improve Detection of Active Hemorrhage |
| title_fullStr | Microbubble Contrast Agents Improve Detection of Active Hemorrhage |
| title_full_unstemmed | Microbubble Contrast Agents Improve Detection of Active Hemorrhage |
| title_short | Microbubble Contrast Agents Improve Detection of Active Hemorrhage |
| title_sort | microbubble contrast agents improve detection of active hemorrhage |
| topic | Trauma hemorrhage contrast agents ultrasound doppler |
| url | https://ieeexplore.ieee.org/document/10561886/ |
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