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Professor Simon Meagher and Professor Ritsuko Pooh Performing Ultrasound Examinations Using the Voluson E22 System
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The emergence of diagnostic support software for Doppler ultrasound integrated with artificial intelligence (AI) has marked a major breakthrough, helping automate measurements, improve accuracy, and optimize workflow efficiency for physicians.
What Is Doppler Ultrasound and What Is It Used For?
Doppler ultrasound is an ultrasound technique that uses the Doppler effect to assess the movement of blood flow within the heart and vascular system. By analyzing changes in the frequency of ultrasound waves reflected from moving blood cells, the system can provide information about blood flow direction, velocity, and hemodynamic characteristics in the area being examined.
In clinical practice, Doppler ultrasound is widely used across multiple specialties:
- Cardiology: Evaluates blood flow through the heart valves, flow velocity, pressure gradients, and supports the detection of hemodynamic abnormalities associated with valvular heart disease.
- Vascular imaging: Examines arteries and veins, supporting the detection of vascular stenosis or occlusion, thrombosis, and the assessment of venous insufficiency.
- Obstetrics: Assesses maternal-fetal circulation through the uterine arteries, umbilical arteries, middle cerebral artery (MCA), and other vessels to support fetal health monitoring.
- Other organs: Doppler ultrasound can also be used to assess perfusion in the liver, kidneys, and other organs depending on clinical indications.
By providing information about hemodynamics in addition to anatomical imaging, Doppler has become an important component of many modern ultrasound workflows.
Limitations of Manual Doppler Measurements
Although Doppler ultrasound provides valuable clinical information, measurement quality may depend significantly on the skill and experience of the operator. In a traditional workflow, physicians or sonographers must perform multiple steps, such as identifying the vessel, adjusting the Doppler angle, positioning the sample volume, optimizing the spectral waveform, and selecting appropriate cardiac cycles for measurement.
After obtaining the Doppler spectrum, the operator may need to identify or trace the spectral envelope to calculate parameters such as PSV (Peak Systolic Velocity), EDV (End-Diastolic Velocity), RI (Resistance Index), PI (Pulsatility Index), and the S/D ratio.
This process has several limitations:
- It can be time-consuming when multiple measurements are required during a single examination.
- Results may vary between operators or between repeated measurements.
- Measurement quality can be affected by sample volume placement, Doppler angle, and signal quality.
- Manual tracing and data entry can increase workload, particularly in facilities with high patient volumes.
Automation and AI-based tools are therefore being developed to support recognition, measurement, and standardization of certain steps in the workflow, helping physicians reduce repetitive tasks and focus more on clinical interpretation.
What Is Doppler Ultrasound Diagnostic Support Software?
Doppler ultrasound diagnostic support software refers to software tools that apply AI and advanced medical image-processing algorithms and are either integrated directly into ultrasound systems or operated through PACS/EMR infrastructure.
Instead of requiring physicians to perform measurements and manually trace spectral waveforms, the software can automatically recognize vascular or cardiac structures, analyze waveform patterns, and instantly extract important hemodynamic parameters:
- RI (Resistance Index): An index reflecting vascular resistance.
- PI (Pulsatility Index): An index reflecting blood flow pulsatility.
- PSV (Peak Systolic Velocity): The maximum blood flow velocity during systole.
- EF (Ejection Fraction): The proportion of blood ejected from a cardiac chamber during contraction.
Types of Doppler Supported by Modern Ultrasound Systems
Depending on the system configuration and software, modern ultrasound systems may provide multiple Doppler modes for different clinical applications.
Color Doppler uses color coding to display blood flow information on a 2D ultrasound image, allowing physicians to quickly observe the direction and characteristics of blood flow within the region of interest. This technique is commonly used to identify blood vessels and detect areas of abnormal flow.
Pulsed Wave (PW) Doppler enables blood flow sampling at a specific location and displays a velocity waveform over time. It is an important mode for measuring parameters such as PSV, EDV, RI, PI, and the S/D ratio in vascular and obstetric examinations.
Continuous Wave (CW) Doppler can record high-velocity blood flow and is particularly useful in echocardiography, such as when assessing flow across heart valves or in cases where blood flow velocity exceeds the measurement limits of PW Doppler.
Power Doppler displays the strength of the Doppler signal rather than primarily representing flow direction. This technique offers good sensitivity to low-velocity blood flow and can support the assessment of perfusion in small vessels or areas with weak blood flow signals.
Tissue Doppler Imaging (TDI) is primarily used in echocardiography to measure myocardial motion velocity, supporting the assessment of systolic and diastolic cardiac function.
Integrating Doppler modes with automated measurement tools, image processing, and intelligent algorithms helps modern ultrasound systems optimize examination workflows. However, specific automation or AI capabilities vary depending on the ultrasound system, software version, and installed application package.
Core Features of Intelligent Doppler Software
1. Automated Hemodynamic Measurements
The software can automatically delineate spectral waveforms and rapidly calculate blood flow parameters from Doppler examinations:
- In Obstetrics: Automatically measures RI/PI of the uterine arteries, umbilical arteries, and middle cerebral artery, supporting the assessment of preeclampsia risk and fetal growth restriction (FGR).
- In Cardiology: Supports the analysis of regurgitant flow, automated cardiac measurements, and detailed assessment of systolic and ventricular function.
2. Lesion Detection and Classification
- Identifies abnormal color-flow regions and supports the detection of vascular stenosis or areas of turbulent blood flow.
- Supports the classification of venous insufficiency severity and real-time monitoring of cardiac chamber contraction.
3. Workflow Optimization and Reduced Examination Time
- Automatically extracts measurement results directly into standardized medical report forms.
- Integrates with PACS/EMR systems and stores Doppler images and videos, making it easier to retrieve and compare data across follow-up examinations.
- Reduces manual tasks, allowing physicians to devote more time to patient consultation.
The reliability of AI software depends significantly on the quality of data provided by the ultrasound hardware. TD TECH is proud to provide leading obstetric, gynecologic, and cardiovascular ultrasound solutions from GE HealthCare, featuring advanced intelligent Doppler technologies:
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Cardiac and Obstetric Ultrasound Systems
The application of AI-integrated Doppler ultrasound diagnostic support software represents a strategic step for healthcare facilities seeking to standardize clinical quality, reduce diagnostic variability, and enhance clinical performance.
Frequently Asked Questions
1. How does AI software support Doppler ultrasound?
AI software can assist with structure recognition, Doppler signal analysis, and automated measurement of parameters such as PSV, EDV, RI, and PI.
2. Can AI replace physicians in Doppler ultrasound?
No. AI supports measurement and analysis, while physicians remain responsible for clinical interpretation and diagnosis.
3. Which specialties can use AI-powered Doppler ultrasound?
It is commonly used in cardiology, obstetrics and gynecology, vascular imaging, and other diagnostic imaging fields.
4. Can AI software reduce Doppler ultrasound examination time?
Yes. Automated measurement and analysis can reduce repetitive manual tasks and help streamline clinical workflows.
5. What should healthcare facilities consider when choosing an AI-powered Doppler ultrasound system?
Key factors include Doppler image quality, AI capabilities, automated measurements, transducer options, PACS/EMR integration, and suitability for the intended specialty.
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