Non-Contrast Power Doppler Imaging With Multidimensional Clutter Filtering For Assessment Of Trans-Arterial Chemoembolization For Hepatic Malignancy

Immediate postoperative assessment of trans-arterial chemoembolization (TACE) using gold standard modalities, MRI and CT, is unreliable due to confounding interactions with lipiodol and post-embolization inflammatory changes. We previously demonstrated that recent advancements in power Doppler ultrasound processing enables changes in slow blood flow to be detected immediately following TACE. Recently, we have developed a filtering method that employs a higher-order singular value decomposition (HOSVD) applied to aperture data to mitigate thermal noise and acoustic clutter. Here, we investigate HOSVD as a tool to improve non-contrast ultrasound evaluation of TACE. Preliminary feasibility is demonstrated in a small pilot study. Treatment-induced changes in perfusion are visualized most readily using the HOSVD filter in comparison to conventional filtering methods. The HOSVD filter produced the greatest change in contrast between pre-TACE and post-TACE power Doppler images.