Region-based SVD processing of high-frequency ultrafast ultrasound to visualize cutaneous vascular networks.

Observing alterations in cutaneous vasculature in response to any disease or pathology is considered as a potential diagnostic marker in the progression and cure of a disease. To observe skin morphologies and tissue conditions, high-frequency ultrasound (HFUS) has been used in dermatology, although its ability to selectively visualize micro-vessels is limited due to insufficient Doppler sensitivity to peripheral slow-speed blood flow. In recent studies, this issue has been improved by increasing the sensitivity of Doppler imaging to slow flow, leveraging advanced cutter filtering approaches based on singular value decomposition (SVD) techniques that aid to effectively extract flow signals overlapped with tissue echo signals. Nevertheless, in skin imaging, variations in flow speed, diameter, and depth of the blood vessels at different skin layers can make clutter filtering challenging because these variations are problematic in selecting the optimal cut-off value for the SVD filtering. In this study, we aimed to devise a novel region-based SVD filtering approach for ultrafast HFUS data to visualize cutaneous vascular networks. The proposed method divides the acquired high-framerate data into two regions based on B-mode cutaneous morphological identification (dermis layer and subcutaneous tissue). Singular value decomposition processing was performed on each region to effectively extract the desired flow signal, and the processed regions were merged to generate a single power Doppler image, thereby highlighting the appearance of a complete cutaneous vascular network. Finally, top-hat transform was applied to the power Doppler image to further suppress the background noises and enhances the visibility of the micro-vessels. Experimental observations of the human cutaneous circulation showed that the image quality (contrast-to-noise ratio) through the region-based SVD filtering was measured to be 4.1 dB (before top-hat filtering) and 5.2 dB (after top-hat filtering), which were improved from 3.4 dB and 4.0 dB obtained using the global SVD approach with and without top-hat filtering, respectively. We envisioned that this approach would provide diverse applications in the diagnosis of cutaneous disorders.