A Comprehensive Motion Compensation Method for In-Plane and Out-of-Plane Motion in Dynamic Contrast-Enhanced Ultrasound of Focal Liver Lesions.

Contrast-enhanced ultrasound (CEUS) acquisitions of focal liver lesions are affected by motion, which has an impact on contrast signal quantification. We therefore developed and tested, in a large patient cohort, a motion compensation algorithm called the Iterative Local Search Algorithm (ILSA), which can correct for both periodic and non-periodic in-plane motion and can reject frames with out-of-plane motion. CEUS cines of 183 focal liver lesions in 155 patients from three hospitals were used to develop and test ILSA. Performance was evaluated through quantitative metrics, including the root mean square error and R 2 in fitting time-intensity curves and standard deviation value of B-mode intensities, computed across cine frames), and qualitative evaluation, including B-mode mean intensity projection images and parametric perfusion imaging. The median root mean square error significantly decreased from 0.032 to 0.024 (p < 0.001). Median R 2 significantly increased from 0.88 to 0.93 (p < 0.001). The median standard deviation value of B-mode intensities significantly decreased from 6.2 to 5.0 (p < 0.001). B-Mode mean intensity projection images revealed improved spatial resolution. Parametric perfusion imaging also exhibited improved spatial detail and better differentiation between lesion and background liver parenchyma. ILSA can compensate for all types of motion encountered during liver CEUS, potentially improving contrast signal quantification of focal liver lesions.

Competing Interests: Conflict of interest disclosure J.R.E. received equipment support from Siemens; grant, equipment and drug support from GE Healthcare; equipment support from Canon Medical; and drug support and speaker fees from Lantheus Medical Imaging. C.E.W. does consulting with Bracco Diagnostics; and is on a speaking bureau for Canon Medical Systems. A.L. received research support from GE Healthcare, Bracco Diagnostics, Siemens Healthineers and Canon Medical Systems; is on the Advisory Board of Bracco Diagnostics; does consulting with GE Healthcare, Bracco Diagnostics, Bioclinica and WorldCare Clinical; is on a speaker panel for GE Healthcare; and has received book royalties from Elsevier. A.K. has received book royalties from Elsevier. The remaining authors declared no conflicts.

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