Synthetic transmit beams with multi-line and
diverging wave transmission for real-time, high
frame rate, low-artefact tissue Doppler imaging
Alessandro Ramalli, Alessandro Dallai, Francesco Guidi, Valentino Meacci, and Piero Tortoli
Department of Information Engineering, University of Florence, 50139 Florence, Italy
Abstract— The use of wide beams in transmission and
parallel beamforming in reception allows increasing the frame
rate of ultrasound images. Any misalignment between the
transmitted beams and the received lines determines spatial
discontinuities that appear as strip-like imaging artifacts. The
use of synthetic transmit beams (STB) has been shown effective
to reduce these artifacts, although with an increased
computational burden that might compromise its real-time
implementation.
This paper shows how STB was implemented on the
ULA-OP 256 research scanner in combination with both
multiline and diverging wave transmissions. The system
performance is demonstrated in cardiac tissue Doppler imaging
2021 IEEE International Ultrasonics Symposium (IUS) | 978-1-6654-0355-9/21/$31.00 ©2021 IEEE | DOI: 10.1109/IUS52206.2021.9593699
applications, showing that strip-like artifacts can be attenuated
and, at the same time, real-time B-mode images can be obtained
at a rate of 688 frames/s, which is high enough to process tissue
Doppler images up to 230 frame/s, depending on the ensemble
length.
Keywords— Multiline transmission, diverging waves,
synthetic transmit beams, tissue Doppler imaging, real-time,
cardiac imaging, high frame rate imaging, multiline acquisition,
Doppler artifacts.
I. INTRODUCTION
Cardiovascular diseases remain the leading cause of death
in the western developed countries [1], [2]. Since major
diseases are associated with (regional) dysfunction of the left
ventricle [3], the accurate assessment of ventricular function
during all phases of the heart cycle is fundamental. Although
the myocardial function is still often assessed through visual
wall motion scoring, quantitative techniques can also be used
[4]–[6]. Myocardial strain and strain rate values can be
obtained by either color tissue Doppler imaging (TDI) [7] or
speckle tracking echocardiography (STE) [8]. TDI operates on
relatively high frame rates but compromises the field of view.
On the other hand, STE does not limit the field of view, but
operates at low frame rates and cannot describe short-lived
cardiac events.
Lately, advanced imaging techniques have been developed
to achieve high frame rates (HFR) and have enabled STE to
track rapid cardiac events [9]–[11] and TDI to work on
extended fields of view [12], [13]. In cardiac imaging, the
most used HFR approaches exploit either the simultaneous
transmission of multiple focused beams into different
directions [14]–[17] or the transmission of defocused waves
[18]–[21]. However, strip-like artifacts typically appear due to
unavoidable misalignments between adjacent transmission
beams and reconstructed lines. The use of synthetic transmit
beams (STB [22], [23]) has been shown effective to reduce
This work is part of the Moore4Medical project funded by the ECSEL
Joint Undertaking under grant number H2020-ECSEL-2019-IA-876190.
978-0-7381-1209-1/21/$31.00 ©2021 IEEE
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these artifacts on both morphological and Doppler images.
STB can be seen as a particular compounding algorithm,
which transmits partially overlapping wide beams. In
reception, several lines are parallel beamformed, and an
interpolation algorithm on overlapping lines must be
implemented. Hence, STB involves an increased
computational burden that might compromise its real-time
implementation.
This work shows how STB was implemented on the
ultrasound advanced open platform ULA-OP 256, [24]
together with both multiline (MLT) and diverging wave (DW)
transmission for TDI application. The obtained performance
is demonstrated in terms of processing capabilities and
artifacts reduction.
II. METHODS
The ULA-OP 256 is based on a modular architecture that
integrates the electronics needed to store huge amount of raw
data and to perform computationally intensive processing
algorithms. Up to 8 front-end (FE) boards, managing 32
channels each, are connected in a ring architecture through a
high-speed link running on a backplane. A master control
(MC) board oversees all FE operations and communicates
with a host personal computer (PC) through a universal serial
bus (USB 3.0).
Each channel can transmit an arbitrary waveform with a
maximum amplitude of 90 V. In reception (see Fig. 1), the
ultrasound echoes are band-pass filtered, amplified, and
converted to digital by analog FE (AFE) dedicated devices.
The FE field programmable gate arrays (FPGAs) implement
parallel beamforming by six independent delay and sum
(DAS) units working in parallel, which are re-configurable to
beamform more lines within the pulse repetition interval (PRI)
at a maximum output data rate of 500 mega samples per
second (MSPS) [24]. This feature is essential to implement the
multiline acquisition (MLA) technique, i.e., the simultaneous
beamforming of nMLA adjacent lines, which allows reducing
the number of transmission events needed to reconstruct a full
frame. Beamformed data are in-phase quadrature (IQ)
demodulated, low-pass filtered, and downsampled by multi-
core digital signal processors (DSPs). The DSP on the MC
board collects the 32-channel beamformed data from the FE
boards and performs the processing needed to create STB B-
Mode and TDI images. These are finally shown on the host
PC display through a graphical interface running in real-time.
For the application presented in this paper, the ULA-OP
256 was connected to the phased array probe PA230 (Esaote
S.p.A., Florence, Italy) consisting of 128 elements. A 128-line
(nLines), 90°-wide (2 ) sector was scanned over the range
from 1 to 12 cm, and the transmitted signal was a two-cycle
Fig. 1 Main blocks involved during the reception processeing on the ULA-OP 256.
sine burst at 2 MHz, weighted with a Hann’s window, with a
peak amplitude of 60 V.
The next paragraphs detail how the features of the
ULA-OP 256 were exploited to implement high frame rate
imaging sequences, the STB technique, and tissue Doppler
processing.
A. Scan sequences
1) Multiline transmission
The multiline transmission (MLT) technique allows
increasing the imaging frame rate by concurrently insonifying
the tissue with nMLT beams spatially distributed over the
region of interest. By exploiting the superimposition principle,
the simultaneous transmission of multiple beams needs a
different transmission (TX) signal for each active element of
the probe. On the ULA-OP 256, the probe elements are driven
by independent arbitrary waveform generators implemented
on the FE boards. Signal synthesis is obtained through sigma-
delta modulators running at 468Mbit/s, in the charge of the
FPGAs, connected to linear high-voltage amplifiers [25].
On the reception (RX) side, the number of lines
reconstructed per PRI is increased by MLA. Since the lines
are collected in an order different than the one required to form
the frame, a sorting algorithm is correspondingly required.
This task is implemented in the DSP of the MC board as a
separate processing module.
2) Diverging waves transmission
Diverging waves requires nDW transmission events to
reconstruct one frame, which is divided in sub-sectors. For
each sub-sector several lines are reconstructed in parallel by
exploiting MLA. The transmission sequences and the
beamforming patterns are pre-calculated based on the
processing strategy and parameters, and stored in the
memories of the FE boards, from which are retrieved during
the real-time acquisition.
B. Synthtetic transmit beams
In the STB [22], [23] technique, partially overlapped
neighboring TX beams involves doubling the number of lines
reconstructed in the overlapping regions, which are then
interpolated.
On the ULA-OP 256, the overlap factor OL ranges
between 0% (no overlap) and 50%. As for MLT and MLA, in
RX, STB exploits the parallel beamformer. Line interpolation
is handled in real‑time by retrieving quadrature demodulated
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samples from a circular buffer. The DSP of the MC board
selects two lines, reconstructed in different PRIs along the
same direction, multiplies them by a pair of weights, and sums
the product to output one line. The specific weights are pre-
calculated by the PC and depend on the angular distance
between the transmitted beam and the reconstructed line: the
farther the line, the lower the weight. These operations are
repeated according to the scan sequence to form a whole
frame, rearranging the lines likewise they are represented in
the display.
C. Tissue Doppler Processing
TDI typically measures the velocity of the myocardium by
estimating the phase shift between consecutive frames. On the
ULA-OP 256, pixels on consecutive IQ frames are processed
by an autocorrelation method, whose ensemble length is
programmable in the range 3-64 samples to allow finding the
best compromise between estimation quality and frame rate.
Then, the complex autocorrelation output is low-pass filtered
in space and slow-time by a 3×3 Gaussian filter and a first-
order infinite impulse response (IIR) filter, respectively.
Next, the slow-time phase shifts are calculated from the
filtered autocorrelation values - by means of a look-up table
containing the values of the four-quadrant arctangent function
and color-coded in a red-blue palette. The results are finally
multiplied by a 2-D binary mask obtained by comparing the
signal power and the autocorrelation standard deviation to
programmable thresholds. This is done to enhance the high
scattering heart walls and remove noise and the low-coherent
signals, typical of the blood flow inside the heart chambers.
The resulting color-coded TDI and the B-mode images are
transferred together to the host PC for real-time display.
D. Experiments
As summarized in TABLE I, four different HFR scan
sequences, each characterized by the same number of
transmission events (nTX), were tested with and without the
use of the STB technique. For the MLT sequences, 4 beams,
with an interbeam angle of 22.5°, were transmitted
simultaneously, all with 7 cm focal depth. Apodization
through a 128-element Hamming window was implemented
to widen the transmitted beams and suppress sidelobes and,
thereby, limit the cross-talk between MLT beams. For the DW
sequences, the virtual source was set at 9.45 cm behind the
probe surface and the aperture size was adapted to vary the
 TABLE I
EXPERIMENTAL MODES SETTINGS AND SPEED PERFORMANCE
Mode
name
MLT4 None w/o - 4 16 5500 Hz 688 Hz 43
MLT4+STB 50% w/ - 4 32 5500 Hz 688 Hz 43
128 90° 8
DW8 None w/o 10.6° - 16 5500 Hz 688 Hz 43
DW8+STB 50% w/ 19.1° - 28 5500 Hz 688 Hz 43

aperture angle (2 ) of the diverging wave between 10.6° and
19.1°.
It is worth highlighting that, in transmission, for the
sequences implementing the STB technique, the -6dB width
of the transmitted beams was designed so that neighboring
beams overlap by 50%. In reception, depending on the
requirements of the implemented scan sequence, the system
was set to beamform nMLA lines in parallel per transmission
event. The ensemble length of TDI processing was always set
to 16.
1) Speed performance tests
The processing speed of the whole system was tested by
assessing the maximum achievable pulse repetition frequency
(PRFMax) and frame rate during continuous real-time B-mode
(FRBM) and tissue Doppler (FRTD) imaging.
2) In-vivo tests
The ULA-OP 256 was programmed to implement two
DW8 scan sequences, with and without STB compounding,
respectively. To acquire at least one cardiac cycle per
sequence, the ULA-OP 256 was set to consecutively process
the echo data for 1.4 s for each case, with a PRF of 5000 Hz.
III. RESULTS AND DISCUSSION
A. Speed performance
The three rightmost columns of TABLE I show the
measured speed performance of the system for the different
implemented scan sequences. It is worth highlighting that,
although the maximum PRF for a non-ambiguous range of 12
cm, i.e., the maximum depth of interest set for the
experimental tests, is 6250 Hz, PRFMax was found equal to
5500 Hz. Indeed, the performance was restricted by the
overhead required by the system to complete the operations of
beamforming, data transferring, and memory access during
the PRI. The most demanding sequence was MLT4+STB,
which required the multiline acquisition of 32 lines in parallel,
thus increasing the computational burden of the beamformer,
which reached a maximum output rate of 493 MSPS. All
sequences allowed achieving a real-time output frame rate of
688 Hz, which is high enough to detect velocities up to 12
cm/s without aliasing, i.e., high enough to follow the
myocardial velocities in resting condition. Moreover, with the
set ensemble length (16), at least 43 frames per second could
be obtained in tissue Doppler, which enables quite a high
temporal resolution for a quantitative evaluation of clinical
markers.
B. In-vivo real-time images
The example in Fig. 2 shows the apical 4-chamber view of
a volunteer’s heart in DW8. Tissue Doppler images (ensemble
length = 16) overlay the B-mode images, while local velocity
curves of the septum and the lateral wall are displayed on the
bottom. When STB processing was not used (left), strip-like
artifacts across adjacent beams are visible especially on the
right ventricle and on the lateral wall (see the white arrows).
On the other hand, the adoption of STB attenuates those
artifacts, and the tissue Doppler images appear smoother.
Similar results were obtained for MLT4, showing that the
combination of MLT/DW TX with STB is effective to remove
strip-like artifacts while sustaining high TDI frame rates.
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