Validation of a sensitivity performance index test protocol and evaluation of colour Doppler sensitivity for a range of ultrasound scanners.

The ability to detect flow is the most crucial aspect of an ultrasound (US) system because, if flow cannot be detected, no other aspect of performance matters. The objectives of this study were to validate a Doppler "sensitivity performance index," a figure of merit, and to determine if it could be used to differentiate colour Doppler sensitivity performance in scanners of varying complexity. The sensitivity performance index was developed to give a combined measure of related aspects of sensitivity, such as the lowest detectable velocity, the vessel size and the penetration depth. The colour Doppler sensitivity was evaluated objectively as the lowest detectable velocity signal from the deepest achievable point within the Doppler sensitivity phantom free from extraneous noise in a small diameter vessel (3.2 mm inner diameter). The effect of vessel size and mean velocity on the sensitivity performance index were investigated and it was found that the index was not proportional to vessel size, but this may be accounted for by considering the effect of the acoustic properties of the vessel material, the clutter filter and beam shape. The results obtained using flow phantoms with vessel sizes different from those used in this study are, therefore, not directly comparable to the results found in this study; however, a similar trend should be found in the results for the effect of control settings and a similar range of US scanners. It was found that the Doppler sensitivity performance index was a robust challenging test because none of the US scanners evaluated was capable of achieving the highest sensitivity performance index score, which would be limited by the lowest pump velocity and the deepest point of the vessel within the flow phantom. Therefore, this suggests that this method of determining Doppler sensitivity performance is valuable in the absence of other suitable methods, despite the fact that the relationship between the sensitivity performance index and vessel size is not proportional. Furthermore, use of the Doppler sensitivity performance index for the evaluation of a range of scanners demonstrated that curvilinear transducers have higher sensitivity performance indices than higher-frequency linear transducers, due to the higher achievable penetration depth. The effect of instrument settings was assessed for two transducers, the 4C3 curvilinear general-purpose transducer (Aspen) and the PVM375AT curvilinear general-purpose transducer (Nemio). The colour Doppler sensitivity performance was found to be significantly dependent on the clutter filter setting and the output power setting for both transducers tested. Users need to be aware of the effect of these settings on the colour Doppler sensitivity performance of their US scanner when interpreting the clinical significance of the colour Doppler information.