Functional ultrasound imaging (fUS or fUSI) is a medical ultrasound imaging technique for detecting or measuring changes in neural activities or metabolism, such as brain activity loci, typically through measuring hemodynamic (blood flow) changes. It is an extension of Doppler ultrasonography.
Background
Brain activation can be directly measured by imaging electrical activity of neurons using voltage-sensitive dyes, calcium imaging, electroencephalography, or magnetoencephalography. It can also be indirectly measured hemodynamically, that is, by detecting changes in blood flow in the neurovascular systems through functional magnetic resonance imaging (fMRI), positron emission tomography (PET), Functional near-infrared spectroscopy (fNIRS), or Doppler ultrasonography, etc. Optics-based methods generally provide the highest spatial and temporal resolutions; however, due to scattering, they are limited to measuring regions close to the surface. Thus, they are often used on animal models after partially removing or thinning the skull to allow light to penetrate into brain tissue. fMRI and PET, which measure the blood-oxygen level dependent (BOLD) signal, were the only techniques capable of imaging brain activation in depth. BOLD signal increases when neuronal activation exceeds oxygen consumption, where blood flow increases significantly, resulting in cerebral blood volume (CBV) changes. This relationship between neuronal activity and blood flow is called neurovascular coupling. In fact, in-depth imaging of cerebral hemodynamic responses by fMRI, being noninvasive, paved the way for major discoveries in neurosciences in the early stage, and is applicable on humans. However, fMRI also suffers limitations. First, the cost and size of MRI machines can be prohibitive. Second, for fMRI to achieve a high spatial resolution necessarily decreases its time resolution and/or signal-noise ratio. As a result, it is hard to image fine spatial details of transient events such as epilepsy. Finally, fMRI is not appropriate for all clinical applications. For example, fMRI is rarely performed on infants, because infants do not stay still inside MRI machines. Like fMRI, Doppler-based functional ultrasound is based on the neurovascular coupling and are thus limited by the spatiotemporal features of neurovascular coupling, specifically cerebral blood volume (CBV) changes. CBV is a pertinent parameter for functional imaging that is already used by other modalities such as intrinsic optical imaging or CBV-weighted fMRI. The spatiotemporal extent of CBV response was extensively studied. The spatial resolution of sensory-evoked CBV response can go down to cortical column (~100 μm). Temporally, the CBV impulse response function was measured to typically start at ~0.3 s and peak at ~1 s in response to ultrashort stimuli (300μs), which is much slower than the underlying electrical activity.
Conventional Doppler based approaches Hemodynamic changes in the brain are often used as a surrogate indicator of neuronal activity to map the loci of brain activity. Major part of the hemodynamic response occurs in small vessels; however, conventional Doppler ultrasound is not sensitive enough to detect the blood flow in such small vessels.
Functional transcranial Doppler (fTCD) Ultrasound Doppler imaging can be used to obtain basic functional measurements of brain activity using blood flow. In functional transcranial Doppler sonography, a low frequency (1-3 MHz) transducer is used through the temporal bone window with a conventional pulse Doppler mode to estimate blood flow at a single focal location. The temporal profile of blood velocity is usually acquired in main large arteries such as the middle cerebral artery (MCA). The peak velocity is compared between rest and task conditions or between right and left sides when studying lateralization. The temporal window is the thinnest lateral area of the skull, and it is mostly hairless. It is often used for fTCD.
Power Doppler Power Doppler is a Doppler sequence that measures the ultrasonic energy backscattered from red blood cells in each pixel of the image. It provides no information on blood velocity but is proportional to blood volume within the pixel. However, conventional power Doppler imaging lacks sensitivity to detect small arterioles/venules and thus is unable to provide local neurofunctional information through neurovascular coupling.
Ultrasensitive Doppler imaging Functional ultrasound imaging was pioneered at ESPCI by Mickael Tanter's team following work on ultrafast imaging and ultrafast Doppler.
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