Search Results (55)

A comprehensive framework for ultrasound imaging simulations is presented. Solutions to an inhomogeneous wave equation are provided, yielding a linear model for characterizing ultrasound propagation and scattering in soft tissue. This simulation approach, which is based upon the fast nearfield method, is implemented in the Fast Object-oriented C++ Ultrasound Simulator (FOCUS) and is extended to a range of imaging modalities, including synthetic aperture, B-mode, plane wave, and color Doppler imaging. The generation of radiofrequency (RF) data and the receive beamforming techniques employed for each imaging modality, along with background on color Doppler imaging, are described. Simulation results demonstrate rapid convergence and lower error rates compared to conventional spatial impulse response methods and Field II, resulting in substantial reductions in computation time. Notably, the framework effectively simulates hundreds of thousands of scatterers without the need for a full three-dimensional (3D) grid, and the inherent randomness in the scatterer distributions produces realistic speckle patterns. A plane wave imaging example, for instance, achieves high fidelity using 100,000 scatterers with five steering angles, and the simulation is completed on a personal computer in a few minutes. Furthermore, by modeling scatterers as moving particles, the simulation framework captures dynamic flow conditions in vascular phantoms for color Doppler imaging. These advances establish FOCUS as a robust, versatile tool for the rapid prototyping, validation, and optimization of both established and novel ultrasound imaging techniques. Full article

Nitric oxide (NO) is a well-known member of the reactive oxygen species (ROS) family. The extent of its concentration influences whether it produces beneficial physiological effects or harmful toxic reactions. In a blood system, NO is generally produced by nitric oxide synthase (NOS) in the endothelium. Then, it diffuses into the smooth muscle wall causing a vasodilatation, and it can also be diluted in a lumen blood stream. In the present study, we analyzed a convectional reaction–diffusion of NO in a 3D digital phantom of a short segment of small arteries. NO concentrations were analyzed by applying numerical solutions to the boundary problems, which included the Navier–Stokes equation, Darcy’s law, varying consumption of NO, and the dependence of NOS activity on shear stress. All the boundary problems were evaluated using COMSOL Multiphysics software ver. 5.5. The role of two diffusive barriers surrounding the endothelium producing NO was theoretically proven. When the eNOS rate remains unchanged, an increase in the fenestration of the internal elastic lamina (IEL) and a decrease in the diffusive permeability of a thin layer of endothelial surface glycocalyx (ESG) lead to a notable rise in the NO concentration in the vascular wall. The alterations in pore count in IEL and the viscosity of ESG are considered to be involved in the physiological and pathological regulation of NO concentrations. Full article

The paper presents the design, manufacturing, and evaluation of a 3D-printed pancreas phantom model used for preoperative surgical planning and surgical training. Several manufacturing and design alternatives have been explored, leading to the final solution, which consisted of a transparent 3D printed elastic shell of the pancreas, resulting in an empty volume that was filled with a custom hydrogel to ensure an anatomically realistic behaviour. Additionally, specific vascular structures were printed using elastic material and specific colours. The hollow shell of the pancreas and the vascular structures were manufactured using photopolymerisation technology. The hydrogel, which replicates the internal structure of the pancreas, was made from a custom proportion of gelatine, agar, and glycerol. The phantom model of the pancreas was assessed by the surgical team and tested using the PARA-SILSROB parallel robot designed for single-incision surgical procedures. Full article

With advancing age, blood vessels undergo deterioration that causes structural and functional changes, including a progressive increase in arterial wall stiffness. Since arterial stiffness is closely linked to the potential risks of cardiovascular diseases, which remains the leading cause of global mortality, it has become essential to develop effective techniques for early diagnosis and continuous monitoring over time. Photoplethysmography, a low-cost and non-invasive technology that measures blood volume changes, has gained increasing popularity in recent years and has proven to be a potential valuable tool for estimating arterial stiffness. This study employs an in vitro experimental setup designed to simulate the cardiovascular system performing under controlled velocity and pressure conditions, in which silicone phantom models with different geometric and mechanical properties were implemented to evaluate their stiffness using a pair of photoplethysmographic sensors. These were employed to measure the pulse wave velocity, currently considered the reference technique for estimating arterial stiffness, correlated through the well-known Moens–Korteweg equation. Photoplethysmographic sensors were placed at three specific distances to determine an optimal configuration for assessing arterial stiffness. Results showed the best performance for softer vascular models at a 15 cm sensor distance, with measurements demonstrating satisfactory accuracy. Variability and standard deviation values increased with model stiffness. The aim of this study is to improve the use of photoplethysmographic sensors for monitoring the mechanical properties of blood vessels and, therefore, to prevent potential cardiovascular diseases. Full article

Asymptomatic peripheral artery disease (PAD) poses a silent risk, potentially leading to severe conditions if undetected. Integrating new screening tools into routine general practitioner (GP) visits could enable early detection. This study investigates the feasibility of photoplethysmography (PPG) monitoring for assessing vascular health across different blood pressure (BP) conditions. Custom femoral artery phantoms representing healthy (0.82 MPa), intermediate (1.48 MPa), and atherosclerotic (2.06 MPa) vessels were tested under hypertensive, normotensive, and hypotensive conditions to evaluate PPG’s ability to distinguish between vascular states. Extracted features from the PPG signal, including amplitude, area under the curve (AUC), median upslope–downslope ratio, and median end datum difference, were analysed. Kruskal–Wallis tests revealed significant differences between healthy and unhealthy vessels across BP states, supporting PPG as a screening tool. The fiducial points from the second derivative of the photoplethysmography signal (SDPPG) were analysed. The ${\displaystyle \frac{b}{a}}$ ratio was most pronounced between healthy and unhealthy phantoms under hypertensive conditions (ranging from –2.13 to –2.06), suggesting a change in vascular wall distensibility. Under normotensive conditions, the difference in ${\displaystyle \frac{b}{a}}$ ratios between healthy and unhealthy phantoms was smaller (0.01), and no meaningful difference was observed under hypotensive conditions, suggesting the reduced sensitivity of this metric at lower perfusion pressures. Intermediate states were challenging to detect, particularly under hypotension, suggesting a need for further research. Nonetheless, this study highlights the promise of PPG monitoring in identifying vascular stiffness. Full article

We have designed and built an improved system for combined Time-Domain Near-Infrared Spectroscopy (TD NIRS) and Diffuse Correlation Spectroscopy (DCS) measurements. The system features two independent channels, enabling TD NIRS and DCS acquisition at short and long source-detector distances to enhance depth sensitivity in layered tissues. Moreover, the device can operate at fast acquisition rates (up to 50 Hz) to monitor hemodynamic oscillations in biological tissues. An OEM (Original Equipment Manufacturer) TD NIRS device enables stable and robust acquisition of photon distribution of time-of-flight. For the DCS signals, the use of a time tagger and a software correlator allows us flexibility in post-processing. A user-friendly GUI controls TD NIRS data acquisition and online data analysis. We present results for the system characterization on calibrated tissue phantoms according to standardized protocols for performance assessment of TD NIRS and DCS devices. In-vivo measurements during rest and during vascular occlusions are also reported to validate the system in real settings. Full article

Magnetic soft continuum robots (MSCRs) hold significant potential in fulfilling the requirements of vascular interventional robots, enabling safe access to difficult-to-reach areas with enhanced active maneuverability, shape morphing capabilities, and stiffness variability. Their primary advantage lies in their tether-less actuation mechanism that can safely adapt to complex vessel structures. Existing commercial MSCRs primarily employ a magnetic-pull strategy, which suffers from insufficient driving force and a single actuation strategy, limiting their clinical applicability. Inspired by the inchworm crawling locomotion gait, we herein present a novel MSCR that integrates a magnetic sinusoidal actuation mechanism with adjustable frequency and kirigami structures. The developed MSCRs consist of two permanent magnets connected by a micro-spring, which is coated with a silicone membrane featuring a specific notch array. This design enables bio-inspired crawling with controllable velocity and active maneuverability. An analytical model of the magnetic torque and finite element analysis (FEA) simulations of the MSCRs has been constructed. Additionally, the prototype has been validated through two-dimensional in-vitro tracking experiments with actuation frequencies ranging from 1 to 10 Hz. Its stride efficiency has also been verified in a three-dimensional (3D) coronary artery phantom. Diametrically magnetized spherical chain tip enhances active steerability. Kirigami skin is coated over the novel guidewire and catheter, not only providing proximal anchorage for improved stride efficiency but also serving similar function as a cutting balloon. Under the actuation of an external magnetic field, the proposed MSCRs demonstrate the ability to traverse bifurcations and tortuous paths, indicating their potential for dexterous flexibility in pathological vessels. Full article

Introduction: Image-guided invasive procedures on the liver require a steep learning curve to acquire the necessary skills. The best and safest way to achieve these skills is through hands-on courses that include simulations and phantoms of different complications, without any risks for patients. There are many liver phantoms on the market made of various materials; however, there are few multimodal liver phantoms, and only two are cast in a 3D-printed mold. Methods: We created a virtual liver and 3D-printed mold by segmenting a CT scan. The InVesalius and Autodesk Fusion 360 software packages were used for segmentation and 3D modeling. Using this modular mold, we cast and tested silicone- and gelatin-based liver phantoms with tumor and vascular formations inside. We tested the gelatin liver phantoms for several procedures, including ultrasound diagnosis, elastography, fibroscan, ultrasound-guided biopsy, ultrasound-guided drainage, ultrasound-guided radio-frequency ablation, CT scan diagnosis, CT–ultrasound fusion, CT-guided biopsy, and MRI diagnosis. The phantoms were also used in hands-on ultrasound courses at four international congresses. Results: We evaluated the feedback of 33 doctors regarding their experiences in using and learning on liver phantoms to validate our model for training in ultrasound procedures. Conclusions: We validated our liver phantom solution, demonstrating its positive impact on the education of young doctors who can safely learn new procedures thus improving the outcomes of patients with different liver pathologies. Full article

Cancers can manifest large variations in tumor phenotypes due to genetic and microenvironmental factors, which has motivated the development of quantitative radiomics-based image analysis with the aim to robustly classify tumor phenotypes in vivo. Positron emission tomography (PET) imaging can be particularly helpful in elucidating the metabolic profiles of tumors. However, the relatively low resolution, high noise, and limited PET data availability make it difficult to study the relationship between the microenvironment properties and metabolic tumor phenotype as seen on the images. Most of previously proposed digital PET phantoms of tumors are static, have an over-simplified morphology, and lack the link to cellular biology that ultimately governs the tumor evolution. In this work, we propose a novel method to investigate the relationship between microscopic tumor parameters and PET image characteristics based on the computational simulation of tumor growth. We use a hybrid, multiscale, stochastic mathematical model of cellular metabolism and proliferation to generate simulated cross-sections of tumors in vascularized normal tissue on a microscopic level. The generated longitudinal tumor growth sequences are converted to PET images with realistic resolution and noise. By changing the biological parameters of the model, such as the blood vessel density and conditions for necrosis, distinct tumor phenotypes can be obtained. The simulated cellular maps were compared to real histology slides of SiHa and WiDr xenografts imaged with Hoechst 33342 and pimonidazole. As an example application of the proposed method, we simulated six tumor phenotypes that contain various amounts of hypoxic and necrotic regions induced by a lack of oxygen and glucose, including phenotypes that are distinct on the microscopic level but visually similar in PET images. We computed 22 standardized Haralick texture features for each phenotype, and identified the features that could best discriminate the phenotypes with varying image noise levels. We demonstrated that “cluster shade” and “difference entropy” are the most effective and noise-resilient features for microscopic phenotype discrimination. Longitudinal analysis of the simulated tumor growth showed that radiomics analysis can be beneficial even in small lesions with a diameter of 3.5–4 resolution units, corresponding to 8.7–10.0 mm in modern PET scanners. Certain radiomics features were shown to change non-monotonically with tumor growth, which has implications for feature selection for tracking disease progression and therapy response. Full article

The objective of this study is to assess the ability of an Artificial Circulatory Phantom (ACP) to verify its accuracy in simulating the movement of artificial vessels vs. real vessels under changing cardiovascular parameters such as heartbeat, ejection fraction, and total peripheral resistance. The experiments were conducted with blood-like fluid that flows through two types of vessels: iliac arteries and different types of ePTFE vascular prostheses. Parameters such as diameter and tortuosity were measured and analyzed. The flow characteristics included a pulsating pattern with a frequency of 60–120 min⁻¹ and ejection volumes ranging from 70 to 115 mL. The results showed a predominantly positive correlation between wall displacement (W_d) and tortuosity index (T_i) for the iliac artery (R² = 0.981), as well as between Wd and mean tortuosity index (MT_i) (R² = 0.994). Similarly, positive correlations between Wd and T_i (R² = 0.942) and Wd and MT_i (R² = 0.922) were computed for the ePTFE vascular prosthesis. The ACP introduced in this study is a valuable tool for evaluating various vessel types and the spatial configurations of vascular prostheses under diverse hemodynamic conditions. These findings are promising for the advancement of novel approaches to the testing and design of vascular grafts, ultimately enhancing their patency rates in future applications. Full article

Age-related vessel deterioration leads to changes in the structure and function of the heart and blood vessels, notably stiffening of vessel walls, increasing the risk of developing cardiovascular disease (CVD), which accounts for 17.9 million global deaths annually. This study describes the fabrication of custom-made silicon vessels with varying mechanical properties (arterial stiffness). The primary objective of this study was to explore how changes in silicone formulations influenced vessel properties and their correlation with features extracted from signals obtained from photoplethysmography (PPG) reflectance sensors in an in vitro setting. Through alterations in the silicone formulations, it was found that it is possible to create elastomers exhibiting an elasticity range of 0.2 MPa to 1.22 MPa. It was observed that altering vessel elasticity significantly impacted PPG signal morphology, particularly reducing amplitude with increasing vessel stiffness (p < 0.001). A p-value of 5.176 × 10⁻¹⁵ and 1.831 × 10⁻¹⁴ was reported in the red and infrared signals, respectively. It has been concluded in this study that a femoral artery can be recreated using the silicone material, with the addition of a softener to achieve the required mechanical properties. This research lays the foundation for future studies to replicate healthy and unhealthy vascular systems. Additional pathologies can be introduced by carefully adjusting the elastomer materials or incorporating geometrical features consistent with various CVDs. Full article

The rate of parental consent for fetal and perinatal autopsy is decreasing, whereas parents are more likely to agree to virtual autopsy by non-invasive imaging methods. Fetal and perinatal virtual autopsy needs high-resolution and good soft-tissue contrast for investigation of the cause of death and underlying trauma or pathology in fetuses and stillborn infants. This is offered by micro-computed tomography (CT), as opposed to the limited resolution provided by clinical CT scanners, and this is one of the most promising tools for non-invasive perinatal postmortem imaging. We developed and optimized a micro-CT scanner with a dual-energy imaging option. It is dedicated to post-mortem CT angiography and virtual autopsy of fetuses and stillborn infants in that the chamber can be cooled down to around 5 °C; this increases tissue rigidity and slows decomposition of the native specimen. This, together with the dedicated gantry-based architecture, attempts to reduce potential motion artifacts. The developed methodology is based on prior endovascular injection of a BaSO₄-based contrast agent. We explain the design choices and considerations for this scanner prototype. We give details of the treatment of the optimization of the dual-energy and virtual mono-energetic imaging option that has been based on minimizing noise propagation and maximizing the contrast-to-noise ratio for vascular features. We demonstrate the scanner capabilities with proof-of-concept experiments on phantoms and stillborn piglets. Full article

Accurate geometric modeling of blood vessel lumen from 3D images is crucial for vessel quantification as part of the diagnosis, treatment, and monitoring of vascular diseases. Our method, unlike other approaches which assume a circular or elliptical vessel cross-section, employs parametric B-splines combined with image formation system equations to accurately localize the highly curved lumen boundaries. This approach avoids the need for image segmentation, which may reduce the localization accuracy due to spatial discretization. We demonstrate that the model parameters can be reliably identified by a feedforward neural network which, driven by the cross-section images, predicts the parameter values many times faster than a reference least-squares (LS) model fitting algorithm. We present and discuss two example applications, modeling the lower extremities of artery–vein complexes visualized in steady-state contrast-enhanced magnetic resonance images (MRI) and the coronary arteries pictured in computed tomography angiograms (CTA). Beyond applications in medical diagnosis, blood-flow simulation and vessel-phantom design, the method can serve as a tool for automated annotation of image datasets to train machine-learning algorithms. Full article

Cardiovascular disease in gout is a central issue, but the underlying mechanisms linking the two are unclear. The existence of monosodium (MSU) crystal deposition directly inflaming vessel walls has been recurrently suggested and challenged since the 1950s and is again a matter of active debate since recent studies using dual-energy computed tomography (DECT) suggested a higher prevalence of plaques considered to be containing MSU crystals in patients with gout. The objective of this review is to critically cover the evidence gathered on MSU crystal deposition in the cardiovascular system. In patients affected with gout, histological evidence of MSU crystals in arteries lacks a biochemical characterization supporting the observation in polarized light microscopy, while current knowledge on vascular lesions identified in DECT as containing MSU crystals suggests that they may be only artifacts, including in cadaveric and phantom studies. In individuals without gout, MSU crystal deposition in vessel walls have not been demonstrated, despite higher urate local plaque concentrations and increased xanthine oxidase activity. Gout is associated with increased arterial calcification and atherosclerosis, both being potential confounders of suspected MSU crystal deposition for the analysis of DECT scans and histopathology, respectively. In summary, the reality of the presence of MSU crystals in vascular plaques has not been demonstrated so far, and needs further investigation as it represents a potential outcome for cardiovascular complications of gout. Full article