Clinical evaluation of Synthetic Aperture Sequential Beamforming and Tissue Harmonic Imaging

This study determines if the data reduction achieved by the combination Synthetic Aperture Sequential Beamforming (SASB) and Tissue Harmonic Imaging (THI) affects image quality. SASB-THI was evaluated against the combination of Dynamic Received Focusing and Tissue Harmonic Imaging (DRF-THI). A BK medical UltraView 800 ultrasound scanner equipped with a research interface and an abdominal 3.5 MHz 3.5CL192-3ML convex array transducer was used and connected to a stand alone PC. SASB-THI and DRF-THI scan sequences were recorded interleaved and processed offline. Nineteen patients diagnosed with focal liver pathology were scanned to set a clinical condition, where ultrasonography is often performed. A total of 114 sequences were recorded and evaluated by five radiologists. The evaluators were blinded to the imaging technique, and each sequence was shown twice with different left-right positioning, resulting in 1140 evaluations. The program Image Quality Assessment Program (IQap) and a Visual Analog Scale (VAS) were applied for the evaluation. The scale ranged from -50 to 50, where positive values favored SASB-THI. SASB-THI and DRF-THI were evaluated alike in 49% of the evaluations, 28% favored SASB-THI and 23% favored DRF-THI. The average rating was 0.70 (Cl: -0.80 to 2.19). The statistical analysis, where the hypothesis of no differences between the techniques was tested, yielded a p-value of p=0.64, indicating no preference to any technique. This study demonstrates that SASB-THI and DRF-THI have equally good image quality although a data reduction of 64 times is achieved with SASB-THI.