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High performance ultrasound

simulation using Monte-Carlo
simulation: a GPU ray-tracing
implementation

Pérez Cambet, Tomás, Vitale, Santiago, Larrabide, Ignacio

Tomás Pérez Cambet, Santiago Vitale, Ignacio Larrabide, "High performance

ultrasound simulation using Monte-Carlo simulation: a GPU ray-tracing
implementation," Proc. SPIE 11583, 16th International Symposium on Medical
Information Processing and Analysis, 115830D (3 November 2020); doi:
10.1117/12.2576099

Event: The 16th International Symposium on Medical Information Processing

and Analysis, 2020, Lima, Peru

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 High performance ultrasound simulation using Monte-Carlo
simulation: a GPU ray-tracing implementation
Tomás Pérez Cambeta , Santiago Vitalea,b , and Ignacio Larrabidea,b
a
PLADEMA - UNICEN, Tandil, Argentina
b
CONICET, Tandil, Argentina

ABSTRACT
Medical ultrasound has gained relevance in medical diagnosis, procedure guidance and emergentology. It is a
low cost, safe and non-invasive practice, while obtaining real-time results. Limitations on working hours and
ultrasound equipment have made simulation the main alternative for training, since it eliminates the need for
a real ultrasound machine and allows the modeling of a large number of case studies. Patient 11 from the
3D-IRCADb-01 CT-scans data-set was used to generate corresponding OBJ mesh files. A JSON file carries
relevant information of the scene and tissues involved in it. Monte-Carlo simulation over GPU is used to improve
ray tracing performance on a deterministic surface model. An improvement in ray tracing performance and
throughput is achieved by the presented model. In execution cases presented, a minimum global acceleration
of 30% is reached, while reducing ray tracing times by at least 80%. Monte-Carlo simulation allows a more
realistic image generation than the previous deterministic model. Low memory usage gives room to implement
the remaining stages of the process on GPU. A correct parametrization of tissues is required in order to achieve
improved image quality.
Keywords: Ultrasound simulation, path tracing, medical training simulation, Monte-Carlo simulation

1. INTRODUCTION
Medical ultrasound (US) has become a common practice for medical diagnosis, as a diagnostic tool, for procedure
guidance (during drains and punctures, among others), and emergentology. This is because it is a low cost, safe,
non-invasive practice, as it does not require punctures nor irradiation, while being capable of obtaining real-time
results economically, without having to relocate the patient, and allowing repetition if needed.1
The main disadvantage of this method is its dependence on operator skills. Given that this is no simple
task, an under-trained operator might misunderstand the produced image or produce low quality images that
are useless for diagnosis. It is of vital importance that the US operator understands the relation between the
two-dimensional cut observed and the real three dimensional anatomy, as well as properly interprets artifacts
present in US images produced by speckle noise and acoustic shadows coming from different tissue properties
and US frequency. This requires intensive and extensive user training to acquire the proper visual and manual
skills in the operation of such devices.
Advances in educational technology have put medical simulation as a state-of-the-art methodology for health-
care professionals training, since various limitations to mandatory work hours and US equipment affect the cor-
rect learning of this technique. Its importance is also because during a real emergency no risks can be taken by
putting the life of patients in the hands of under-skilled students. More so, US equipment may not be available
for training purposes, and unfrequent or rare complex pathological cases may be difficult to come by in smaller,
less populated cities, extending and limiting the training process. This is where ultrasound simulators come in
handy, since such study cases can be generated digitally and effectively train students and residents.
For a simulator to be of any use, it must reproduce clinical scenarios as realistically as possible, providing a
controlled environment to train a student’s response during critical or abnormal situations. It is usually helpful
to supply a handful of performance metrics to correctly asset a residents level of skill.

16th International Symposium on Medical Information Processing and Analysis, edited by Eduardo Romero
Natasha Lepore, Jorge Brieva, Marius Linguraru, Proc. of SPIE Vol. SIP220, SIP22000
© 2020 SPIE · CCC code: 0277-786X/20/$21 · doi: 10.1117/12.2576099

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 1.1 Related Work
An ultrasound simulator can be based either on an interpolative or a generative approach. The first one refers to
the use of a set of real, pre-acquired, US studies as input. These studies are processed to generate new views and
cuts, from positions indicated by a false probe with movement sensors attached. These sensors provide position
and orientation angle, which are used to obtain the corresponding image at that position and orientation. This
approach can generate very realistic images if the requested view point is similar to those used to generate the
input US studies. On the other hand, since many artifacts are view-dependent, such as acoustic shadows, realism
is lost when the required cut is too far from the original acquisition position. Another constraint is that each
of the input images is generated with specific parameters, such as operation frequency, probe shape (curved or
flat), number of elements and elevation layers of that probe and, if the acquisition probe is curved, its amplitude
that cannot be altered at simulation time.
Generative approaches have been proposed in the literature where the input model is created from Com-
puterized Tomography (CT) images, such as2 and.3 This allows replicating the complete interaction between
ultrasound waves and tissue media, but at a high computational cost. As wave propagation is fully simulated,
most artifacts are automatically incorporated (acoustic shadows, reflections, refractions). Usually, a scattering
pattern is created using external software, such as Field II,4 which can generate static scattering patterns. It
takes around 20 minutes to generate between 200.000 and 1.000.000 scatterers with both, position and intensity,
for a single view. Because of this, scattering generation for multiple views may take several days. Further,
this approach can be problematic when modeling and adjusting parameters due to tissue heterogeneity or its
complex internal structure. If a scene is poorly modeled, this can result in simple images that look artificial when
compared to real ones. However, these models provide great versatility when simulating new scenes, along with
a lot of research being developed currently to look for new improvements in performance through paralelization
and mathematical approximation and incorporation of new artifacts.5, 6
Scattering noise is one of the most complex characteristics present in US images. This motivated that
different methods have been proposed to generate it, e.g. with Field II. Nevertheless, several other methods
are being objective of dedicated research in the scientific community. A relatively simple method is used in,6
where ray marching is applied to every segment found during ray tracing. The ray is followed along step by step
evaluating, based on an organ-specific set of properties, whether if a scatterer will make a contribution to the
final image or not. The authors also presented a new scatterer map generation algorithm7 named ScatRecN,
where the map was created based on various measurements of the same tissue with varying view parameters. In,8
CycleGANs are used to solve this scatterer map problem as an image translation task. To train this CycleGANs,
synthetically generated maps where used due to the lack of ground-through scatterer maps. The approach
presented by Rubi et al.9 is similar, since CT image volumes are used as input while applying ray casting to
simulate wave behaviour throughout the body, achieving reflections, shadows, attenuation and occlusion in real
time. The algorithm developed in10 is used when generating scatterers, since it presents a reduction in computing
time when compared to Field II. Further research in11 managed to develop a dynamic speckle-noise generation
algorithm, improving noise representation and realism while having a negligible loss of performance.
The model proposed in12 is based on a ray tracing algorithm, used to simulate ultrasound wave behaviour.
This rays are traced from the transducer towards the scene, where organs are modeled with meshes. Each one
of these is paired with a set of properties that describes its mechano-acoustic features (e.g. acoustic impedance),
used in the simulation of both the wave behaviour and dispersion. At every ray-organ interface, both a refraction
and a reflection rays are generated with their corresponding intensities. Considering that this two rays will be
created recursively, it is easy to notice that the amount of rays traced will increase exponentially with the depth
of recursion, largely increasing the computation l cost of the simulation.
Recently,13 proposed the training of two CycleGANs with different architectures for the generator with a set
of unpaired simulated and real US. Then, a GAN is used to translate simulated images into more realistic ones
showing a good performance and realism.
A new model is presented in5 and further improved on.6 The basis of this model is the use of Monte-Carlo
simulation to accurately represent interactions between rays and organs, through multiple sampling for each
traced ray. This allowed the incorporation of new parameters when characterizing the different tissues, such as

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 thickness and roughness. In addition to this, the model does not trace reflection and refraction rays, but only
one of them. To decide which one to follow, a weighting takes place depending on the energy carried by the ray.
Then, thanks to the Monte-Carlo sampling with an uniform distribution, the ray is selected according to the
corresponding threshold for each ray.
In this work, a performance comparison of available implementations of the volume model presented in,9
along with the deterministic surface model presented in12 is presented. Also, we include the comparison to an
implementation of the Monte-Carlo simulation model, in which the ray tracing segments of the pipeline are GPU
accelerated to achieve improved performance over the deterministic surface model without loss of realism.

2. MATERIALS AND METHODS

The 3D-IRCADb-01 data-set was used, which is composed of the 3D CT-scans of 10 men and 10 women with
hepatic tumours in 75% of cases. One data-set (man, no segmentation of the stomach and pancreas) without
tumor was selected from the data-set this 20 patient data-set one was selected. For the surface models, a set
OBJ files was created based on the CT-scans provided by IRCAD, with the triangle count shown by Table 1.
This adds up to a total of 196,626 triangles in this data-set. This OBJ files are accompanied by a JSON file,
where several parameters are specified, such as working directory, the origin of the scene, the starting material,
initial position and angles of the transducer, materials along with their variables, and the mesh files with its
associated material.

Table 1: Triangle count of every organ used in surface models.

Organ Triangle Count

Aorta 39,806 triangles
Bones 50,000 triangles
Cava 39,652 triangles
Gallbladder 5,000 triangles
Kidneys 10,000 triangles
Liver 7,996 triangles
Porta 29,968 triangles
Skin 10,204 triangles
Suprarenal glands 4,000 triangles

To produce a realistic output, tissue properties need to be correctly modeled. Among the parameters that
must be set, we can find the acoustic impedance and wave attenuation. Also, to generate speckle noise caused
by scatterers, a pair (µ, σ) that defines a normal distribution for scatterer amplitude, and a ρ parameter that
represents a tissue’s scatterer density, is needed. A sum of all parameters and their values for each material can
be found in table 2.
The volume model introduced in9 uses a CT volume image and simulates its interaction with acoustic waves
using a ray casting technique. This allows the representation of both reflections and wave attenuation to be
appreciated at every tissue interface. The former are produced when the involved materials have uneven acous-
tic impedance, and the strength of the reflection is given by Equation (1), where Z1,2 represent the acoustic
impedance of the current and collided tissues, respectively. The resulting transmitted energy (αT ) is calculated
as 1 − αR .

Z2 − Z1 2
αR = (1)
Z2 + Z1

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 Table 2: List of materials and corresponding parameters

Acoustic impedance Wave attenuation (µ, σ) ρ

Air 0.0004 1.64 (0.78, 0.1) 0.56
Blood 1.61 0.18 (0.001, 0.01) 0.0
Bone 7.8 5.0 (0.78, 0.1) 0.56
Fat 1.38 0.63 (0.5, 0.0) 0.5
Gallbladder 1.62 1.0 (0.4, 0.3) 0.6
−8
Gel 1.38 1 × 10 (0.0, 0.0) 0.0
Kidney 1.62 1.0 (0.4, 0.3) 0.6
Liver 1.65 0.7 (0.19, 0.24) 1.0
Skin 1.99 1.0 (0.4, 0.3) 0.6
Suprarenal glands 1.62 1.0 (0.4, 0.3) 0.6
Vessel 1.99 1.09 (0.2, 0.2) 0.1

This reflections are not specular, but behave differently depending to the angle between the incident wave
and the surface normal vector. Because of this, the signal received by the transducer is given by a Lambertian
scattering model. This causes the intensity to be dependent only on the incidence angle, and not the angle of
vision.
For a proper scattering emulation, a second image is generated from the CT volume using the real-time
speckle noise model presented in.11 In this way, view dependant scattering artifacts can be produced, being very
similar to those found in real ultrasound images. Both, the reflections and scattering images, are then combined
creating the final simulated image.
The deterministic surface model proposed in12 is based on a ray tracing algorithm, used to simulate ultrasound
wave behaviour. The model is implemented using C++, along with the Bullet3D14 library as a collision detector
between rays and meshes, and segment searching for further ray marching later on, and OpenCV15 for image
post-processing, which includes convolution, enveloping and scan conversion. This rays are traced from the
transducer to the scene, where organs are modeled with the meshes mentioned in Table 1. Each one of these
is paired with a set of properties that describe its mechano-acoustic features (Table 2), needed to simulate
both wave behaviour and dispersion. The refraction and reflection rays are generated according to Snell’s Law
equations, which states that the reflection ray will be given by

~vref lection = ~i + 2c~n (2)

while the refraction ray is defined by

p
~vref raction = r~i + (rc − 1 − r2 (1 − c2 )), (3)

where ~i is the incidence vector, r is the ratio between the refraction indexes of the involved tissues, and c is the
cosine of the incidence angle. The intensity that each ray will carry is given by the Fresnel equation presented
previously in Equation (1) and its complementary equation.
Considering that this two rays will be created recursively at every ray-organ interface, it is easy to notice that
the amount of rays traced will increase exponentially at a rhythm of 2d , where d denotes the depth of recursion.
Usually, the maximum depth of recursion for a scene will vary between 8 to 12, since rays generated from a
point onwards will make little to no contribution to the image. The echoes received at the probe are composed
by a reflection term, calculated when a collision is found, and a back-scatter term, calculated using the method
presented in16 using

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 Bi (l) = Ii (l) ∗ (P (l) ⊗ S(x, y, z)) (4)
where Ii (l) represents the intensity at a certain point along ray i, P (l) is a Point Spread Function (PSF),
and S(x, y, z) is a function describing the scatterers at point (x, y, z) in space for a given tissue. The PSF
is modeled as a 3D Gaussian modulated by a cosine function, where the parameters σx , σy and σz shape the
profile of the beam in axial, lateral and elevation directions, respectively. The S(x, y, z) function requires three
parameters to be defined for each tissue. In first place, the pair (µ, σ), which describes the normal distribution
of the scatterers amplitude. The remaining parameter, ρ, corresponds to the scatterer density, which provide a
probability threshold to determine if a said scatterer will contribute to the image or not.
To support mesh intersections (e.g., to model internal vessels), a tracking of actual and surrounding tissue is
considered. This is being done with a new set of variables. First, all meshes incorporate a parameter indicating
if it is a vessel or not. Second, rays must contain information about the mesh outside the one that is being
travelled. This is done with a pointer in the ray payload, which will only point to something different than null
if the ray is travelling inside a vessel. Additionally, a pointer to the parameters of the material outside is kept,
in order to retrieve them when the ray exits the vessel.
The implementation used here is based on Monte-Carlo simulation to accurately represent interactions be-
tween rays and organs, through multiple sampling for each traced ray. Unlike the deterministic one, it is imple-
mented using Nvidia OptiX,17 which is a GPU-accelerated library that offers a recursive single-ray programming
model that allows the abstraction of batching or reordering of rays, simplifying the programming process. This
allowed the incorporation of new parameters when characterizing the different tissues, such as thickness and
roughness. In addition to this, the model does not trace reflection and refraction rays, but only one of them.
To decide which one to trace, a weighting on the energy carried by each ray is considered. Then, thanks to the
Monte-Carlo sampling in an uniform distribution, the ray is selected according to the corresponding threshold
for each ray.
The modeling of surface roughness is done through a cosine distribution cosn , in which n refers to the
specularity of a surface. The random angle obtained from this distribution is then used to modify the original
normal vector of the surface that has been hit. By doing this, the reflection will not be perfectly symmetrical
as if it were specular, but more diffuse and realistic. Something similar happens with the bone penetration
simulation. To do this, a Gaussian distribution based in the thickness selected, is used. The random number
obtained from this distribution will modify the hit point of a ray, and the reflection ray will be traced from there.
Also, the correct attenuation must take place. This is solved using the Beer-Lambert Law, which points that
for a given travelled distance in a tissue with absorption coefficient α, the intensity after that distance will be
determined by Ie−xα . This allows a more precise approximation of the interaction between waves and tissues
according to sound wave physics. Nevertheless, a new problem arises in correctly setting parameters for each
tissue, since it is a manual, time-consuming task.
The echo received by the transducer from a point P is determined by eq. (5), where V~r and V~i represent the
~ is the distance between the collision point P and the
direction of the reflected and refracted rays, respectively. D
origin of the traced ray, and n is the specularity of the surface being hit. It must be taken into notice that in this
model, the refracted term is also noted, since usually only one of the terms will have a non-cero contribution.

Ir = max(cosn (∠(V~r , D)),

~ 0) + max(cosn (∠(V~i , D)),
~ 0). (5)

Unlike the work presented in,6 our implementation allows mesh intersection to model internal organ vessels.
This is done by using a stack with the material parameters. As the ray traverses the scene, the parameters of
the tissue assigned to each crossed mesh are stacked. The main caveat occurs when a ray is travelling inside
a vessel and hits a non-vascular organ. When this happens, the procedure follows depending on whether the
collided organ is the same as the next-to-the-top organ or not. If yes, this means that the ray is exiting that
organ while staying within the vessel, so we must remove the collided organ from the stack. Otherwise, a new
organ parameter must be stacked below the vessel, indicating that outside the vessel is within a new organ.

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 3. RESULTS
Both qualitative and quantitative results are presented below. First, a comparison between the output images
of the deterministic surface model and the Monte-Carlo simulation model with a varying number of Samples
Per Ray (SPR). This comparison will help analyzing the accuracy of the representation of various artifacts, such
as acoustic shadows and reflections. Second, images generated with the Monte-Carlo model will be compared,
according to different values for thickness and roughness parameters. Finally, a set of quantitative results will
be presented, showing the elapsed time in each stage of the simulation pipeline (ray tracing, ray marching and
post-processing), along with the amount of frames per second (FPS) and throughput, measured as rays traced
per second.
The image presented in Figure 1a is the output of the first model. In this case, it is possible to see a changing
noise, whose difference between tissues is not perceptible. As a result, it is difficult to notice variability between
organs, and internal organ vessels might be difficult to detect (blue circles). This occurs because, although the
interfaces between the different organs are well marked, their intensity decreases significantly when moving away
from the main axis of the transducer, causing the walls of internal vessels, such as the liver, to be lost in the
speckle noise of the image.
See Figures1b to 1d for the output of the surface model with Monte-Carlo simulation with different config-
urations of samples per beam. Here you can see how the edges of the organs stand out more strongly. Deep
reflections can be distinguished in the image. This indicates the detection of the present liver vessels as well
as the bottom wall of the liver. Also, the change in intensity of the noise generated by the scatterers between
different organs is more noticeable, allowing different types of tissues to be more easily differentiated, including
deeper organs (green circle). A detail to be taken into account is how, by increasing the number of samples per
beam, the bone located just above the liver (red circle) generates an increasingly faint glow and a somewhat
conical shape can be seen where part of the ultrasound waves are blocked. Something similar occurs with the
ribs in a real echography, where the bone obstructs the ultrasound and causes that the inferior wall of the liver
and part of the lateral wall of the kidney are not completely visible (yellow circle). However, a significant amount
of speckle noise can be seen below the bone. This is a problem because, although some noise can be seen under
a rib on an actual ultrasound, the acoustic shadow generated by that bone is more pronounced. Similarly, if the
overall speckle noise generation is improved, the amount of noise found under the rib would be more real.
In Figures 2a-2b it can be seen the effect of thickness parameter in the intensity at the interface, spreading
it through the bone sphere’s surface. This results in a more realistic interaction between ultrasound waves an a
bone in the simulation. Figures 2c-2d show the impact of the roughness variation in the simulation. The first
image shows a clearly unnatural brightness and thin organ walls, but as the roughness becomes higher, the edges
become fuzzier, giving a more authentic feel to the overall image.
As for quantitative results, it is necessary to highlight the fact that most of the work is centered around the first
stage of the pipeline, ray tracing. However, modifications to this stage can affect the performance of the following,
as seen in Table 3 where execution times at each stage, as well as the total time, FPS and throughput. Shown
values evidence that Monte-Carlo simulation and ray tracing over GPU provoke a considerable improvement in
the first stage where, depending on the amount of samples per ray (SPR from now on), performance increases
by a factor of 19 for 1SPR, 6 for 5SPR, and 3 for 10SPR over the deterministic model implemented over CPU.
Nevertheless, at the second stage the Monte-Carlo simulation model suffers considerably, specially when the
amount of samples per ray goes beyond 5SPR. The last stage, image post-processing, is virtually unaltered,
regardless of the model or the amount of samples per ray. The global acceleration obtained by the Monte-Carlo
simulation model is between a 342% and 30%, being the latter the 10SPR test.

4. DISCUSSION AND CONCLUSIONS

The Monte-Carlo model explored in this work strongly improves performance over the deterministic model, mostly
because of the use of Nvidia OptiX and a General-Purpose computing on Graphics Processing Units (GPGPU).
This comes along with a throughput improvement as the amount of samples per ray increase. However, only the
ray tracing stage is implemented on GPU, meaning that ray marching performance is heavily affected, since a
greater amount of ray segments are generated and must be traversed to create scattering noise. This generates a

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 (a) (b)

(c) (d)
Figure 1: Simulated output for each model. (a) corresponds to the deterministic model, whilst images (b) to
(d) are outputs for different amounts of samples per ray, going through 1 sample on the top left, to 5 and 10
samples on the second row.

great bottleneck in our pipeline, as for more than 5SPR the stage occupies more than 52% of the image generation
process. The post-processing stage is not affected by the greater amount of rays, since it only depends on image
resolution.
The latter two stages of the pipeline can be partially paralelized. However, Nvidia OptiX is not the best
selection for this. It is advisable to use other GPGPU libraries such as Nvidia CUDA or OpenCL, as the system
GPU would be idle otherwise. Even though this would carry an overhead provoked by data transfer from system
to GPU memory, it would be mitigated by the acceleration produced from GPU computing. RAM and VRAM
are no issue either, since all models consumed only up to 200MB of RAM and 330MB of VRAM, which negligible
in modern systems. This leaves a big room to use meshes with higher polygon count or to incorporate more
parameters to improve simulation quality.
Furthermore, Monte-Carlo allows a better modeling of tissue features. The previously mentioned roughness
aids when representing diffuse surfaces using a cosn distribution, being n the roughness of a given tissue. This
distribution will modify the real normal vector of the surface to simulate the micro-imperfections of the organ’s
wall, avoiding specular, unreal reflections at interfaces. Something similar happens with bone thickness. In this

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 (a) (b)

(c) (d)
Figure 2: Simulated output for each model. (a) corresponds to the deterministic model, whilst images (b) to
(d) are outputs for different amounts of samples per ray, going through 1 sample on the top left, to 5 and 10
samples on the second row.

case, when a ray collides with a bone, it will slightly penetrate it and strongly attenuate due to its high absorption
coefficient. This attenuation is calculated according to Ie−xα , where x is the distance the wave penetrated into
the bone, and α is its absorption coefficient. Even though this can produce more realistic images, a problem
arises when the corresponding values are assigned to each tissue, as it is a manual, time-consuming task.

ACKNOWLEDGMENTS
This project was partly funded by PICT 2016-0116 - FONCYT - ANPCYT of Argentina. The NVidia Quaddro
P6000 used for this research was donated by the NVIDIA Corporation. The financial support of these institutions
is greatly appreciated.

REFERENCES
[1] Pinzón Vargas, S. and Moreno Carrillo, A., “Uso y capacitación en ecografı́a en el departamento de emer-
gencias,” 54(3), 353–360 (2013).

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 Table 3: Execution time results for each simulation model. Values presented correspond to a time average over
10 consecutive frames.

Monte-Carlo
Deterministic
1SPR 5SPR 10SPR
Ray tracing 686.2ms 33.0ms 90.3ms 141.4ms
Ray marching 299.0ms 57.2ms 297.6ms 576.1ms
Post-processing 180.4ms 173.1ms 173.8ms 172.0ms
Total 1,165.6ms 263.3ms 561.7ms 889.5ms
FPS 0.86FPS 3.80FPS 1.78FPS 1.12FPS
Rays/second 67.5K 103K 188.3K 241.9K

[2] Shams, R., Hartley, R., and Navab, N., “Real-time simulation of medical ultrasound from ct images,” in
[Medical Image Computing and Computer-Assisted Intervention – MICCAI 2008], Metaxas, D., Axel, L.,
Fichtinger, G., and Székely, G., eds., 734–741 (2008).
[3] Kutter, O., Karamalis, A., Wein, W., and Navab, N., “A gpu-based framework for simulation of medical
ultrasound,” in [Medical Imaging 2009: Visualization, Image-Guided Procedures, and Modeling ], Miga, M. I.
and Wong, K. H., eds., 7261, 396–404, International Society for Optics and Photonics (2009).
[4] Jensen, J., “Field: A program for simulating ultrasound systems,” Medical and Biological Engineering and
Computing 34(1), 351–352 (1996).
[5] Mattausch, O. and Goksel, O., “Monte-carlo ray tracing for realistic ultrasound training simulation,” in
[Eurographics Workshop on Visual Computing for Biology and Medicine ], Springer (October 2016).
[6] Mattausch, O., Makhinya, M., and Goksel, O., “Realistic ultrasound simulation of complex surface models
using interactive monte-carlo path tracing,” Computer Graphics Forum 37(1), 202–213 (2018).
[7] Mattausch, O. and Goksel, O., “Image-based reconstruction of tissue scatterers using beam steering for
ultrasound simulation,” Transactions on Medical Imaging (2017).
[8] Bahou, A., Tanner, C., and Goksel, O., “Scatgan for reconstruction of ultrasound scatterers using generative
adversarial networks,” 1674–1677 (04 2019).
[9] Rubi, P., Vera, E. F., Larrabide, J., Calvo, M., D’Amato, J. P., and Larrabide, I., “Comparison of real-time
ultrasound simulation models using abdominal CT images,” in [12th International Symposium on Medical
Information Processing and Analysis], Romero, E., Lepore, N., Brieva, J., Brieva, J., and and, I. L., eds.,
10160, 55 – 63, International Society for Optics and Photonics, SPIE (2017).
[10] D’Amato, J., Lo Vercio, L., Rubi, P., Vera, E., Barbuzza, R., del Fresno, M., and Larrabide, I., “Efficient
scatter model for simulation of ultrasound images from computed tomography data,” (2015).
[11] Külsgaard, H. C., “Desarrollo de herramientas de procesamiento de imágenes para simulación de ultra-
sonido.,” (2017).
[12] Rubi, P., Manterola, H. L., Fernandez Vera, E., Dı́az, A., and Larrabide, I., “Modelling vascular structures
in real-time abdominal ultrasound simulation,” Trabajo sin publicar.
[13] Vitale, S., Orlando, J. I., Iarussi, E., and Larrabide, I., “Improving realism in patient-specific abdominal ul-
trasound simulation using cyclegans,” International Journal of Computer Assisted Radiology and Surgery 15,
183–192 (Feb 2020).
[14] Coumans, E., “Bullet physics sdk,” (2013).
[15] Bradski, G., “The OpenCV Library,” Dr. Dobb’s Journal of Software Tools (2000).
[16] Meunier, J. and Bertrand, M., “Ultrasonic texture motion analysis: Theory and simulation,” IEEE trans-
actions on medical imaging 14, 293–300 (1995).
[17] Parker, S. G., Bigler, J., Dietrich, A., Friedrich, H., Hoberock, J., Luebke, D., McAllister, D., McGuire, M.,
Morley, K., Robison, A., and et al., “Optix: A general purpose ray tracing engine,” 29(4) (2010).

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