Browsing by Author "Holland, Mark R."
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Item Assessing the performance of ultrasound imaging systems using images from relatively high‐density random spherical void phantoms: A simulation study(Wiley, 2022-02) Holland, Mark R.; Radiology & Imaging Sciences, School of MedicineBackground The development of clinically meaningful, objective, and quantitative methods for assessing the performance of ultrasound imaging systems represents a continuing area of interest. One approach has been to image phantoms with randomly distributed spherical voids. Purpose The objectives of this study were: (1) to explore the potential of using relatively high-volume fraction random spherical void (RSV) phantoms as an approach for quantitatively assessing the performance of ultrasound imaging systems; (2) to identify potential metrics that can be used to provide quantitative assessments of images obtained from relatively high-volume fraction RSV phantoms; and (3) to demonstrate changes in the quantitative metrics that can occur as image features are degraded. Methods A series (10 each) of computer-simulated RSV phantoms with a range of RSV volume fractions (0.05, 0.15, and 0.25) were generated. To determine the number of image planes necessary to provide robust measurements, a series of consecutive planes (ranging from 1 to 150) within each type of simulated phantom were analyzed. The observed circular cross-section radii histogram distributions (representing the intersection of each plane with the local distribution of spherical voids) were compared with the theoretical histogram distribution. Simulated phantom images were produced by adding speckle and degradation of imaging system performance was modeled by averaging 1 to 9 neighboring planes to represent increasing elevation plane thicknesses. Quantification of the performance of the imaging system was determined by measuring the: (1) mean number of circular cross-sections detected per image frame; (2) mean fractional area of circular cross-sections detected per image frame; (3) agreement of observed circular cross-section radii histogram distribution with the theoretical distribution (Chi-square statistic); and (4) contrast and contrast-to-noise ratio as a function of observed circular cross-section radius. Results Results suggest that analyses of a sufficient number of image planes (providing over approximately 3000 total circular cross-sectional areas) provides excellent agreement between the observed and theoretical histogram distributions (mean Chi-square < 0.004). For the 0.15 volume fraction series of simulated RSV phantoms, using 150 image plane analyses, phantom images show decreasing mean number of circle cross-sections detected per frame (31.5 ± 0.3, 28.4 ± 0.3, 28.2 ± 0.3, 26.3 ± 0.3, and 25.3 ± 0.3); decreasing mean fractional area of circle cross-sections per frame (0.157 ± 0.002, 0.133 ± 0.001, 0.133 ± 0.001, 0.111 ± 0.001, and 0.108 ± 0.001); and a decreasing agreement with the theoretical histogram distribution of radii (Chi-square values: 0.070 ± 0.004, 0.140 ± 0.005, 0.149 ± 0.007, 0.379 ± 0.011, and 0.518 ± 0.010) for 1, 3, 5, 7, and 9 plane averages, respectively. Contrast and contrast-to-noise measurements as a function of observed circular cross-section radius also demonstrate marked changes with simulated image degradation. Conclusions Results of this simulation study suggest that analyses of images obtained from relatively high-density RSV phantoms may offer a promising approach for assessing ultrasound imaging systems. The proposed measurements appear to provide reproducible, robust, quantitative metrics that can be compared with corresponding theoretical values to provide quantifiable, objective metrics of imaging system performance.Item FABRICA: A Bioreactor Platform for Printing, Perfusing, Observing, & Stimulating 3D Tissues(Nature Publishing Group, 2018-05-15) Smith, Lester J.; Li, Ping; Holland, Mark R.; Ekser, Burcin; Radiology and Imaging Sciences, School of MedicineWe are introducing the FABRICA, a bioprinter-agnostic 3D-printed bioreactor platform designed for 3D-bioprinted tissue construct culture, perfusion, observation, and analysis. The computer-designed FABRICA was 3D-printed with biocompatible material and used for two studies: (1) Flow Profile Study: perfused 5 different media through a synthetic 3D-bioprinted construct and ultrasonically analyzed the flow profile at increasing volumetric flow rates (VFR); (2) Construct Perfusion Study: perfused a 3D-bioprinted tissue construct for a week and compared histologically with a non-perfused control. For the flow profile study, construct VFR increased with increasing pump VFR. Water and other media increased VFR significantly while human and pig blood showed shallow increases. For the construct perfusion study, we confirmed more viable cells in perfused 3D-bioprinted tissue compared to control. The FABRICA can be used to visualize constructs during 3D-bioprinting, incubation, and to control and ultrasonically analyze perfusion, aseptically in real-time, making the FABRICA tunable for different tissues.Item Indiana Consortium for Innovation in Biomedical Imaging(Office of the Vice Chancellor for Research, 2016-04-08) Hutchins, Gary D.; Holland, Mark R.The Indiana Consortium for Innovation in Biomedical Imaging (Indiana-CIBI) has been established to leverage the biomedical imaging strengths of several major academic institutions throughout Indiana. This initiative provides the environment, infrastructure, and resources necessary for establishing one of the premier translational, research and educational imaging networks in the United States. The Indiana-CIBI will facilitate the identification of crucial clinical problems and unmet research needs; stimulate the development of innovative solutions; and help translate optimized patient care services into practice at partner health-care delivery facilities. The objectives of the Indiana-CIBI include: Providing national leadership in translation from concept to practice. Encouraging targeted problem-driven technology development. Nurturing innovation and progress through facile access to advanced resources. Focusing Indiana state-wide interdisciplinary partnerships in the development of new, innovative imaging technologies and the utilization of imaging resources. Cultivating investigator engagement and channeling intrinsic motivation. The stated objectives of the Indiana-CIBI define the operational model for the consortium. Key steps in the innovation-focused process include: 1) Identification of critical clinical or biomedical research needs by physician or biomedical investigator(s); 2) Creation of innovative solutions through innovation incubator teams, imaging innovation marathons, and crowdsourcing solicitations; 3) Translation to practice through a large medical physics/radiology network; and 4) Translation to advanced core services through the Indiana-CTSI core resource network. Critical success factors for the Indiana-CIBI include tight integration within academic health care facilities, consolidation of fragmented resources, and expansion of critical support resources, eliminating the need to duplicate some types of services across multiple sites in Indiana. For further information regarding the Indiana Consortium for Innovation in Biomedical Imaging and its programs please contact Mark Holland or Gary Hutchins at incibi@iupui.edu. The Indiana-CIBI is supported, in part, by contributions from the IUPUI Office of the Vice Chancellor for Research.Item Markers of Maternal and Infant Metabolism are Associated with Ventricular Dysfunction in Infants of Obese Women with Type 2 Diabetes(Nature Publishing group, 2017-11) Cade, W. Todd; Levy, Philip T.; Tinius, Rachel A.; Patel, Mehgna D.; Choudhry, Swati; Holland, Mark R.; Singh, Gautam K.; Cahill, Alison G.; Radiology and Imaging Sciences, School of MedicineBACKGROUND To test the hypothesis that infants born to obese women with pregestational type 2 diabetes mellitus (IBDM) have ventricular dysfunction at one month that is associated with markers of maternal lipid and glucose metabolism. METHODS In a prospective observational study of IBDM (OB+DM, n=25), echocardiography measures of septal, left (LV) and right ventricular (RV) function and structure were compared at one month of age to infants born to OB mothers without DM (OB, n=24), and non-OB without DM (Lean, n=23). Basal maternal lipid and glucose kinetics and maternal plasma and infant (cord) plasma were collected for hormone and cytokine analyses. RESULTS RV, LV, and septal strain measures were lower in the OB+DM infants vs. other groups, without evidence of septal hypertrophy. Maternal hepatic insulin sensitivity, maternal plasma free fatty acid concentration, and cord plasma insulin and leptin most strongly predicted decreased septal strain in the OB+DM infants. CONCLUSION IBDM’s have reduced septal function at one month in the absence of septal hypertrophy, which is associated with altered maternal and infant lipid and glucose metabolism. These findings suggest that maternal obesity and DM may have a prolonged impact on the cardiovascular health of their offspring, despite resolution of cardiac hypertrophy.Item Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle Tracking Echocardiography in Preterm Infants over the First Year of Age(Elsevier, 2017-07) Levy, Philip T.; EL-Khuffash, Afif; Patel, Meghna D.; Breatnach, Colm R.; James, Adam T.; Sanchez, Aura A.; Abuchabe, Cristina; Rogal, Sarah R.; Holland, Mark R.; McNamara, Patrick J.; Jain, Amish; Franklin, Orla; Mertens, Luc; Hamvas, Aaron; Singh, Gautam K.; Radiology and Imaging Sciences, School of MedicineBACKGROUND: The aim of this study was to determine the maturational changes in systolic ventricular strain mechanics by two-dimensional speckle-tracking echocardiography in extremely preterm neonates from birth to 1 year of age and discern the impact of common cardiopulmonary abnormalities on the deformation measures. METHODS: In a prospective multicenter study of 239 extremely preterm infants (<29 weeks gestation at birth), left ventricular (LV) global longitudinal strain (GLS) and global longitudinal systolic strain rate (GLSRs), interventricular septal wall (IVS) GLS and GLSRs, right ventricular (RV) free wall longitudinal strain and strain rate, and segmental longitudinal strain in the RV free wall, LV free wall, and IVS were serially measured on days 1, 2, and 5 to 7, at 32 and 36 weeks postmenstrual age, and at 1 year corrected age (CA). Premature infants who developed bronchopulmonary dysplasia or had echocardiographic findings of pulmonary hypertension were analyzed separately. RESULTS: In uncomplicated preterm infants (n = 103 [48%]), LV GLS and GLSRs remained unchanged from days 5 to 7 to 1 year CA (P = .60 and P = .59). RV free wall longitudinal strain, RV free wall longitudinal strain rate, and IVS GLS and GLSRs significantly increased over the same time period (P < .01 for all measures). A significant base-to-apex (highest to lowest) segmental longitudinal strain gradient (P < .01) was seen in the RV free wall and a reverse apex-to-base gradient (P < .01) in the LV free wall. In infants with bronchopulmonary dysplasia and/or pulmonary hypertension (n = 119 [51%]), RV free wall longitudinal strain and IVS GLS were significantly lower (P < .01), LV GLS and GLSRs were similar (P = .56), and IVS segmental longitudinal strain persisted as an RV-dominant base-to-apex gradient from 32 weeks postmenstrual age to 1 year CA. CONCLUSIONS: This study tracks the maturational patterns of global and regional deformation by two-dimensional speckle-tracking echocardiography in extremely preterm infants from birth to 1 year CA. The maturational patterns are ventricular specific. Bronchopulmonary dysplasia and pulmonary hypertension leave a negative impact on RV and IVS strain, while LV strain remains stable.Item Patients with Diabetes and Significant Epicardial Coronary Artery Disease have Increased Systolic Left Ventricular Apical Rotation and Rotation Rate at Rest(Wiley, 2016-04) Rasalingam, Ravi; Holland, Mark R.; Cooper, Daniel H.; Novak, Eric; Rich, Michael W.; Miller, James G.; Pérez, Julio E.; Department of Radiology and Imaging Sciences, IU School of MedicineObjective The purpose of this study was to determine whether resting myocardial deformation and rotation may be altered in diabetic patients with significant epicardial coronary artery disease (CAD) with normal left ventricular ejection fraction. Design A prospective observational study. Setting Diagnosis of epicardial CAD in patients with diabetes. Patients and Methods Eighty-four patients with diabetes suspected of epicardial CAD scheduled for cardiac catheterization had a resting echocardiogram performed prior to their procedure. Echocardiographic measurements were compared between patients with and without significant epicardial CAD as determined by cardiac catheterization. Main Outcome Measures Measurement of longitudinal strain, strain rate, apical rotation, and rotation rate, using speckle tracking echocardiography. Results Eighty-four patients were studied, 39 (46.4%) of whom had significant epicardial CAD. Global peak systolic apical rotation was significantly increased (14.9 ± 5.1 vs. 11.0 ± 4.8 degrees, P < 0.001) in patients with epicardial CAD along with faster peak systolic apical rotation rate (90.4 ± 29 vs. 68.1 ± 22.2 degrees/sec, P < 0.001). These findings were further confirmed through multivariate logistic regression analysis (global peak systolic apical rotation OR = 1.17, P = 0.004 and peak systolic apical rotation rate OR = 1.05, P < 0.001). Conclusions Patients with diabetes with significant epicardial CAD and normal LVEF exhibit an increase in peak systolic apical counterclockwise rotation and rotation rate detected by echocardiography, suggesting that significant epicardial CAD and its associated myocardial effects in patients with diabetes may be detected noninvasively at rest.Item Reference Ranges of Left Ventricular Strain Measures by Two-Dimensional Speckle-Tracking Echocardiography in Children: A Systematic Review and Meta-Analysis(Elsevier, 2016-03) Levy, Philip T.; Machefsky, Aliza; Sanchez, Aura A.; Patel, Meghna D.; Rogal, Sarah; Fowler, Susan; Yaeger, Lauren; Hardi, Angela; Holland, Mark R.; Hamvas, Aaron; Singh, Gautam K.; Department of Radiology and Imaging Sciences, IU School of MedicineBACKGROUND: Establishment of the range of reference values and associated variations of two-dimensional speckle-tracking echocardiography (2DSTE)-derived left ventricular (LV) strain is a prerequisite for its routine clinical adoption in pediatrics. The aims of this study were to perform a meta-analysis of normal ranges of LV global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) measurements derived by 2DSTE in children and to identify confounding factors that may contribute to variance in reported measures. METHODS: A systematic review was launched in MEDLINE, Embase, Scopus, the Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library. Search hedges were created to cover the concepts of pediatrics, STE, and left-heart ventricle. Two investigators independently identified and included studies if they reported 2DSTE-derived LV GLS, GCS, or GRS. The weighted mean was estimated by using random effects models with 95% CIs, heterogeneity was assessed using the Cochran Q statistic and the inconsistency index (I(2)), and publication bias was evaluated using the Egger test. Effects of demographic (age), clinical, and vendor variables were assessed in a metaregression. RESULTS: The search identified 2,325 children from 43 data sets. The reported normal mean values of GLS among the studies varied from -16.7% to -23.6% (mean, -20.2%; 95% CI, -19.5% to -20.8%), GCS varied from -12.9% to -31.4% (mean, -22.3%; 95% CI, -19.9% to -24.6%), and GRS varied from 33.9% to 54.5% (mean, 45.2%; 95% CI, 38.3% to 51.7%). Twenty-six studies reported longitudinal strain only from the apical four-chamber view, with a mean of -20.4% (95% CI, -19.8% to -21.7%). Twenty-three studies reported circumferential strain (mean, -20.3%; 95% CI, -19.4% to -21.2%) and radial strain (mean, 46.7%; 95% CI, 42.3% to 51.1%) from the short-axis view at the midventricular level. A significant apex-to-base segmental longitudinal strain gradient (P < .01) was observed in the LV free wall. There was significant between-study heterogeneity and inconsistency (I(2) > 94% and P < .001 for each strain measure), which was not explained by age, gender, body surface area, blood pressure, heart rate, frame rate, frame rate/heart rate ratio, tissue-tracking methodology, location of reported strain value along the strain curve, ultrasound equipment, or software. The metaregression showed that these effects were not significant determinants of variations among normal ranges of strain values. There was no evidence of publication bias (P = .40). CONCLUSIONS: This study defines reference values of 2DSTE-derived LV strain in children on the basis of a meta-analysis. In healthy children, mean LV GLS was -20.2% (95% CI, -19.5% to -20.8%), mean GCS was -22.3% (95% CI, -19.9% to -24.6%), and mean GRS was 45.2% (95% CI, 38.3% to 51.7%). LV segmental longitudinal strain has a stable apex-to-base gradient that is preserved throughout maturation. Although variations among different reference ranges in this meta-analysis were not dependent on differences in demographic, clinical, or vendor parameters, age- and vendor-specific referenced ranges were established as well.Item Research Center for Quantitative Renal Imaging(Office of the Vice Chancellor for Research, 2016-04-08) Molitoris, Bruce A.; Hutchins, Gary D.; Holland, Mark R.Mission: The mission of the Research Center for Quantitative Renal Imaging is to provide a focused research environment and resource for the development, implementation, and dissemination of innovative, quantitative imaging methods designed to assess the status of and mechanisms associated with acute and chronic kidney disease and evaluate efficacy of therapeutic interventions. Nature of the Center: This Research Center provides a formal mechanism to link research programs focused on understanding the fundamental mechanisms associated with kidney diseases with those associated with the development of advanced imaging methods and quantitative analyses into a focused effort dedicated toward the development and implementation of quantitative renal imaging methods. Goals of the IUPUI Research Center for Quantitative Renal Imaging: Identify, develop, and implement innovative imaging methods that provide quantitative imaging biomarkers for assessing and inter-relating renal structure, function, hemodynamics and underlying tissue micro-environmental factors contributing to kidney disease. Establish an environment that facilitates and encourages interdisciplinary collaborations among investigators and offers research support to investigators focused on developing and utilizing innovative quantitative imaging methods in support of kidney disease research. Provide a resource to inform the greater research and healthcare communities of advances in quantitative renal imaging and its potential for enhanced patient management and care. Offer an imaging research resource to companies engaged in product development associated with the diagnosis and treatment of kidney diseases. Further Information: For further information regarding the IUPUI Research Center for Quantitative RenalImaging and its funding programs please visit http://www.renalimaging.iupui.edu/ or contact the Center at renalimg@iupui.edu. Acknowledgments: The IUPUI Research Center for Quantitative Renal Imaging is supported by contributions from the IUPUI Signature Center Initiative, the Department of Radiology & Imaging Sciences; the Division of Nephrology, the IUPUI School of Science, the IUPUI School of Engineering & Technology, and the Indiana Clinical and Translational Sciences Institute (CTSI).Item Toward three-dimensional echocardiographic determination of regional myofiber structure(Elsevier, 2016-02) Milne, Michelle L.; Singh, Gautam K.; Miller, James G.; Wallace, Kirk D.; Holland, Mark R.; Department of Radiology and Imaging Sciences, IU School of MedicineAs a step toward the goal of relating changes in underlying myocardial structure to observed altered cardiac function in the hearts of individual patients, this study addresses the feasibility of creating echocardiography-derived maps of regional myocardial fiber structure for entire, intact, excised sheep hearts. Backscatter data were obtained from apical echocardiographic images acquired with a clinical ultrasonic imaging system and used to determine local fiber orientations in each of seven hearts. Systematic acquisition across the entire heart volume provided information sufficient to give a complete map for each heart. Results from the echocardiography-derived fiber maps compare favorably with corresponding results derived from diffusion tensor magnetic resonance imaging. The results of this study provide evidence of the feasibility of using echocardiographic methods to generate individualized whole heart fiber maps for patients.