GI-Perfusion

• To quantify blood perfusion in organs (non-cardiac indications)
  Provide a reliable method for quantifying organ perfusion, obtained from DCE-US examinations;

• With specific tools to follow-up perfusion of the same tissue or lesion over time
  Provide means for documenting and comparing analyses performed at different patient examinations (visits).

Liver DVP

• To highlight differences in contrast agent perfusion kinetics in focal liver lesions
  Provide tools to summarize the specificities of the difference signals signatures into a single, easy-to-read color-coded image.

Plaque package

• to detect vascularization and determine vascularized areas in atherosclerotic plaques

• specific vascularization parameters : plaque area, perfused area, relative perfused area, mean opacification.

In order to allow visual perception of all the useful information contained in the echo signal, the ultrasound system manufacturers amplify the echo signal in a non-linear manner, so as to enhance the lower amplitude echo signals. Particularly, the video signal is always zero for values of the echo signal below a minimum value. The desired result implies a loss of proportionally between the video signal and the echo signal. Furthermore, each manufacturer of medical ultrasound scanner has a peculiar approach to the implementation of this log-compression.

Linearization of the video signal is therefore important for deriving correct functional information relating to the blood perfusion in the body-part under analysis. The linearization indicates the processing that makes the amplitude of the video signal (i.e., the pixel values) directly proportional to the local concentration of the contrast agent in the corresponding pixel locations. This linearized signal provides a direct representation of the (relative) local blood volume in the respective portions of the body-part (since the contrast agent concentration is related, i.e., proportional, to the blood volume). As a consequence, the linearized signal allows a correct assessment of the blood perfusion in the body-part.

VueBox^® linearization has been validated with multiple ultrasound systems during dose ranging experiments to demonstrate the proportionality between signal measured in VueBox^® and contrast agent concentration.

Curve Fitting: BOLUS
 

• The Bracco patented models used in VueBox fit the experimental time-intensity curve in an optimal way
   

• Therefore the derived parameters (e.g. AUC, TTP, WiR, etc.) match the physiological reality in a better way

Curve Fitting: REPLENISHMENT
 

• Bracco has optimized curve fitting models for both bolus and replenishment kinetics

Perfusion Quantification: Parametric Imaging

• A parametric image is the synthetic representation of a parameter over time for each individual pixel in the ROI

Management of analysis results

Export of graphs and images (BMP, TIF, JPEG), data (Excel compatible) and clips (WMV)

• Customizable and easy-to-read
   
• Free selection of report contents
   
• Multiple-page print-ready formatting
   
• Export to PDF (non-modifiable file)

Dedicated to liver tissue analysis

The Dynamic Vascular Pattern (DVP) processing uses healthy tissue as reference and displays the hyper-enhanced and hypo-enhanced pixels over time by using warm and cold colour hues.

In addition to DVP, the Dynamic Vascular Pattern Parametric (DVPP) summarizes the specificities of the difference signals signatures into a single, easy-to-read color-coded image.

The final results are presented as parametric maps summarizing the dynamic vascular signature in a ROI in comparison with neighbouring parenchyma.

Dynamic Vascular Pattern Parametric (DVPP)

DVP signals, a classification is performed at the pixel level where each pixel is categorized into four classes according to the polarity of its difference signal over time.

A DVP image is then built as a color-coded map.

The objective of the Plaque package is to detect vascularisation and determine vascularized areas in atherosclerotic plaques.

The assessment of intra-plaque enhancement encounters several major challenges such as:
 

• risk of plaque signal contamination by contrast signals out of the vessel lumen
   
• dependence of measured intensity values from system settings
   
• very low signal to noise ratio in the plaque
   
• specific enhancement kinetics in the plaque vascularization

Parametric image of the perfused area of a carotid plaque and the respective numeric values.

The VueBox^® plaque package includes tools that overcome these issues. The detection of plaque enhancement relies on an automatic and adaptative threshold based on noise level making the measurements independent from settings and users. The analysis is performed on a subset of images taken from a recorded sequence within optimal time windows that help reduce contamination by the lumen.

The plaque package provides a MIP-based assessment of vascularised areas and specific quantitative perfusion parameters. Time intensity curves (TIC) from the lumen and plaque can be displayed simultaneously using different intensity scales, to allow the simultaneous representation of both curves in one graph.

Time windows selection on dual-scale graph, showing TIC from plaque and vascular lumen.

Key features:

• Specific vascularization parameters : plaque area, perfused area, relative perfused area, mean opacification
   
• Adaptative enhancement threshold based on noise level
   
• Analysis performed in optimal time windows (plateau of maximum plaque enhancement)
   
• Dual-scale display of time intensity curves of the lumen and plaque signals.