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Polish Academy of Sciences

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P. Tortoli


Recent publications
1.  Secomski W., Nowicki A., Tortoli P., Olszewski R., Multigate Doppler measurements of ultrasonic attenuation and blood hematocrit in human arteries, ULTRASOUND IN MEDICINE AND BIOLOGY, ISSN: 0301-5629, DOI: 10.1016/j.ultrasmedbio.2008.08.009, Vol.35, No.2, pp.230-236, 2009

Abstract:
A clinically applicable method for noninvasive measurement of hematocrit based on 20 MHz multigate Doppler ultrasound was developed. The ultrasound attenuation coefficient in blood is obtained by measuring the power of the signal coming from gates at different depths. A robust averaging method is introduced, which provides stable and repeatable results by using the echo signals from all depths inside the vessel. In vitro measurements have been done on porcine blood with hematocrit ranging from 3.0% to 65.0%. Steady and pulsatile flow conditions have been simulated using a peristaltic pump. The attenuation coefficient indicated the linear relation to hematocrit. The resulting correlation coefficient was R=0.999 for the continuous blood flow and R=0.992 for pulsatile flow. In vivo measurements have been performed in the brachial artery in 43 patients with hematocrit in the range of 32.0% to 49.3%. The mean absolute error has been 3.24% with a standard deviation of 3.72%.

Keywords:
blood, hematocrit, Doppler, ultrasonic attenuation

Affiliations:
Secomski W. - IPPT PAN
Nowicki A. - IPPT PAN
Tortoli P. - other affiliation
Olszewski R. - other affiliation
2.  Secomski W., Nowicki A., Guidi F., Tortoli P., Lewin P.A., Non-invasive measurement of blood hematocrit in artery, BULLETIN OF THE POLISH ACADEMY OF SCIENCES: TECHNICAL SCIENCES, ISSN: 0239-7528, Vol.53, No.3, pp.245-250, 2005

Abstract:
Objective:
The goal of this work was to develop a clinically applicable method for non-invasive acoustic determination of hematocrit in vivo.

Methods:
The value of hematocrit (HCT) was determined initially in vitro from the pulse-echo measurements of acoustic attenuation. The testing was carried out using a laboratory setup with ultrasound transducer operating at 20 MHz and employing human blood samples at the temperature of 37C. The attenuation coefficient measurements in blood in vitro and in vivo were implemented using multi-gated (128-gates), 20 MHz pulse Doppler flow meter. The Doppler signal was recorded in the brachial artery. Both in vitro and in vivo HCT data were compared with those obtained using widely accepted, conventional centrifuge method.

Results:
The attenuation coefficient in vitro was determined from the measurements of 168 samples with hematocrit varying between 23.9 and 51.6%. Those experiments indicated that the coefficient increased linearly with hematocrit. The HCT value was obtained from the 20 MHz data using regression analysis. The attenuation (() was determined as a 42.14 + 1.02*HCT (Np/m). The corresponding standard deviation (SD), and the correlation coefficient were calculated as SD = 2.4 Np/m, and R = 0.9, (p<0.001), respectively The absolute accuracy of in vivo measurements in the brachial artery was determined to be within 5% HCT.

Conclusions:
The method proposed appears to be promising for in vivo determination of hematocrit as 5% error is adequate to monitor changes in patients in shock or during dialysis. It was found that the multigate system largely simplified the placement of an ultrasonic probing beam in the center of the blood vessel. Current work focuses on enhancing the method’s applicability to arbitrary selected vessels and reducing the HCT measurement error to well below 5%.

Keywords:
hematocrit, blood, Doppler, power Doppler, multigate Doppler

Affiliations:
Secomski W. - IPPT PAN
Nowicki A. - IPPT PAN
Guidi F. - other affiliation
Tortoli P. - other affiliation
Lewin P.A. - Drexel University (US)

List of chapters in recent monographs
1. 
Secomski W., Nowicki A., Tortoli P., Blood flow modelling and diagnostics, ABIOMED Lecture Notes 6, rozdział: Ultrasonic Doppler measurement of the attenuation, scattering and blood hematocrit in the human artery, IPPT PAN, ABIOMED (Warszawa), Kowalewski T.A. (Ed.), pp.427-438, 2005

Conference papers
1.  Lewandowski M., Klimonda Z., Karwat P., Sęklewski M., Nowicki A., Bassi L., Tortoli P., Comparison of different schemes of synthetic transmit aperture using an ultrasound advanced open platform (ULA-OP), IUS 2010, IEEE International Ultrasonics Symposium, 2010-10-11/10-14, San Diego (US), DOI: 10.1109/ULTSYM.2010.5935656, Vol.1, pp.1988-1991, 2010

Abstract:
Increasing efforts are currently dedicated to incorporate the Synthetic Transmit Aperture (STA) method in ultrasound imaging systems. The STA technique can provide a pixel-like focusing (dynamic focusing at both transmit and receive) without impairment of the frame rate. This goal can only be achieved by a careful design of the transmission and reception schemes. In this paper, the preliminary results of resolution, Signal to Noise Ratio (SNR) and Contrast to Noise Ratio (CNR) measurements for a specific SA scheme with different transmit apertures are presented. The measurements were made using a novel ultrasound advanced open platform (ULA-OP) developed at the University of Florence. The ULA-OP is fully programmable and enables access to the RF echo-data from each transducer element.

Keywords:
synthetic aperture, ultrasound open platform

Affiliations:
Lewandowski M. - IPPT PAN
Klimonda Z. - IPPT PAN
Karwat P. - IPPT PAN
Sęklewski M. - IPPT PAN
Nowicki A. - IPPT PAN
Bassi L. - other affiliation
Tortoli P. - other affiliation

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