A needle is enhanced in a medical diagnostic ultrasound image. The image intensities associated with a needle in an image are adaptively increased and/or enhanced by compounding from a plurality of ultrasound images. Filtering methods and probabilistic methods are used to locate possible needle locations. In one approach, possible needles are found in component frames that are acquired at the same time but at different beam orientations. The possible needles are associated with each other across the component frames and false detections are removed based on the associations. In one embodiment of needle detection in an ultrasound component frame, lines are found first. The lines are then searched to find possible needle segments. In another embodiment, data from different times may be used to find needle motion and differences from a reference, providing the features in additional to features from a single component frame for needle detection.
