Mapping testicular tumor microvasculature with super-resolution ultrasound imaging

Ultrasound (US) is the primary imaging modality for scrotal examinations, and with the use of contrast enhanced US (CEUS), the vascular abnormalities of testicular lesions can be analysed [1]. Dynamical behaviour of the contrast agent is used to provide investigative information about tissue vascularity, perfusion patterns, tumor margins and the presence of necrosis. However, this technique is fundamentally diffraction limited and therefore cannot produce detailed images of tumor vasculature. This work presents how CEUS images can be processed into super-resolution ultrasound (SRUS) images in order to map the microvasculature of a testicular tumor. In this work, we use a standard clinical US system to perform in vivo sub-diffraction imaging on a seminomatous germ cell tumor by localizing microbubbles flowing throughout the testicle. We present vessel localization and velocity maps of the tumor and compare them to the CEUS maximum intensity projection (MIP) images. The resultant SRUS images offer another potential tool for testicle tumor assessment and monitoring.