The ultrasound image quality is of utmost importance for a clinician to reach the correct diagnosis. Conventionally, image quality is evaluated using metrics to evaluate the contrast and resolution. These metrics requires localization of specific regions and targets in the image such as a region of interest (ROI), a background region and or a point scatter. Such objects can all be difficult to identify in in-vivo images, especially for automatic evaluation of image quality in large amounts of data. Using a matrix array probe, we have recorded a Very Large cardiac Channel data Database (VLCD) to evaluate coherence as an in-vivo image quality metric.  The VLCD consists of 33 280 individual image frames from 538 recordings of 106 patients. We also introduce a Global Image Coherence (GIC), an in-vivo image quality metric that does not require any identified ROI since it is defined as an average coherence value calculated from all the data pixels used to form the image. The GIC is shown to be a quantitative metric for in-vivo image quality when applied to the VLCD. There exists multiple methods to estimate the coherence of the received signal across the ultrasound array. We further demonstrate that all coherence measures investigated in this study is highly correlated (R>0.9, p<0.001) when applied to the VLCD. Thus, even though there are differences in the implementation of coherence measures, they all measure the similarity of the signal across the array and can be averaged into a GIC to evaluate the image quality automatically and quantitatively.

An aberration correction algorithm has been implemented and demonstrated in an echocardiographic clinical trial using 2D imaging. The method estimates and compensates arrival time errors between different sub- aperture processor signals in a matrix array probe in post processing. Five standard views of channel data cineloops were recorded from 22 patients. Using a coherence metric, the aberration correction algorithm was shown to improve image quality in all 7380 processed frames. In a blinded and left-right-randomized side-by-side evaluation, four cardiologists (two experienced and two in training) preferred the aberration corrected image in 97% of the cases. The feedback from the clinicians was that the images appeared sharper with better contrast and less noise. Many structures like valve leaflets, chordae, endocardium, and endocardial borders appeared narrower and more clearly defined in the aberration corrected images. An important finding is that aberration correction improves contrast between the endocardium and ventricle cavities for all processed images. This was confirmed by the cardiologists in their feedback, and quantified with a median global gain difference estimate between the aberration-corrected and non- corrected images of 1.2 dB.