Enhancing sizing accuracy in ultrasound images with an alternative ADMIRE model and dynamic range considerations.

Ultrasound imaging can struggle with sizing accuracy, especially when the targets have a significantly different amplitude compared to the surrounding background. In this work, we consider the challenging task of accurately sizing hyperechoic structures, and specifically kidney stones, where accurate sizing is critical for determining medical intervention. AD-Ex, an extended alternative model of our aperture domain model image reconstruction (ADMIRE) pre-processing method, is introduced and is designed to improve clutter removal and improve sizing accuracy. We compare this method against other resolution enhancing methods such as minimum variance (MV) and generalized coherence factor (GCF), and against those methods using AD-Ex as a pre-processing tool. These methods are evaluated among patients with kidney stone disease, with the task of accurately sizing the stones against the gold standard, computed tomography (CT). Stone ROI's were selected using contour maps as reference from which the lateral stone size was estimated. Among the in vivo kidney stone cases we processed, AD-Ex+MV had the overall lowest sizing error among the methods, with an average error of 10.8% compared to the next best method AD-Ex which had an average error of 23.4%. For reference, DAS had an average error of 82.4%. Though dynamic range was evaluated to determine optimal thresholding for sizing applications, variability between stone cases was too high for any conclusions to be drawn at this time.