4D-UNet improves clutter rejection in human transcranial contrast enhanced ultrasound

Transcranial ultrasound imaging is limited by high skull absorption, limiting vascular imaging to only the largest vessels. Traditional clutter filters struggle with low signal-to-noise ratio (SNR) ultrasound datasets, where blood and tissue signals cannot be easily separated, even when the echogenicity of the blood is improved with contrast agents. Here, we present a novel 4D U-Net approach for clutter filtering in transcranial 3D Contrast Enhanced Ultrasound (CEUS) exploiting spatial and temporal information via a 4D-UNet implementation to enhance microbubble detection in transcranial data acquired in human adults. Our results show that the 4D-UNet improves temporal clutter filters. By integrating deep learning into CEUS, this study advances neurovascular imaging, offering improved clutter rejection and visualization. The findings underscore the potential of AI-driven approaches to enhance ultrasound-based medical imaging, paving the way for more accurate diagnostics and broader clinical applications.