Cube-Cut: Vertebral Body Segmentation in MRI-Data through Cubic-Shaped Divergences

In this article, we present a graph-based method using a cubic template for volumetric segmentation of vertebrae in magnetic resonance imaging (MRI) acquisitions. The user can define the degree of deviation from a regular cube via a smoothness value Delta. The Cube-Cut algorithm generates a directed graph with two terminal nodes (s-t-network), where the nodes of the graph correspond to a cubic-shaped subset of the image's voxels. The weightings of the graph's terminal edges, which connect every node with a virtual source s or a virtual sink t, represent the affinity of a voxel to the vertebra (source) and to the background (sink). Furthermore, a set of infinite weighted and non-terminal edges implements the smoothness term. After graph construction, a minimal s-t-cut is calculated within polynomial computation time, which splits the nodes into two disjoint units. Subsequently, the segmentation result is determined out of the source-set. A quantitative evaluation of a C++ implementation of the algorithm resulted in an average Dice Similarity Coefficient (DSC) of 81.33% and a running time of less than a minute.Comment: 23 figures, 2 tables, 43 references, PLoS ONE 9(4): e9338

Automated template-based brain localization and extraction for fetal brain MRI reconstruction.

Most fetal brain MRI reconstruction algorithms rely only on brain tissue-relevant voxels of low-resolution (LR) images to enhance the quality of inter-slice motion correction and image reconstruction. Consequently the fetal brain needs to be localized and extracted as a first step, which is usually a laborious and time consuming manual or semi-automatic task. We have proposed in this work to use age-matched template images as prior knowledge to automatize brain localization and extraction. This has been achieved through a novel automatic brain localization and extraction method based on robust template-to-slice block matching and deformable slice-to-template registration. Our template-based approach has also enabled the reconstruction of fetal brain images in standard radiological anatomical planes in a common coordinate space. We have integrated this approach into our new reconstruction pipeline that involves intensity normalization, inter-slice motion correction, and super-resolution (SR) reconstruction. To this end we have adopted a novel approach based on projection of every slice of the LR brain masks into the template space using a fusion strategy. This has enabled the refinement of brain masks in the LR images at each motion correction iteration. The overall brain localization and extraction algorithm has shown to produce brain masks that are very close to manually drawn brain masks, showing an average Dice overlap measure of 94.5%. We have also demonstrated that adopting a slice-to-template registration and propagation of the brain mask slice-by-slice leads to a significant improvement in brain extraction performance compared to global rigid brain extraction and consequently in the quality of the final reconstructed images. Ratings performed by two expert observers show that the proposed pipeline can achieve similar reconstruction quality to reference reconstruction based on manual slice-by-slice brain extraction. The proposed brain mask refinement and reconstruction method has shown to provide promising results in automatic fetal brain MRI segmentation and volumetry in 26 fetuses with gestational age range of 23 to 38 weeks

Computational methods for the analysis of functional 4D-CT chest images.

Medical imaging is an important emerging technology that has been intensively used in the last few decades for disease diagnosis and monitoring as well as for the assessment of treatment effectiveness. Medical images provide a very large amount of valuable information that is too huge to be exploited by radiologists and physicians. Therefore, the design of computer-aided diagnostic (CAD) system, which can be used as an assistive tool for the medical community, is of a great importance. This dissertation deals with the development of a complete CAD system for lung cancer patients, which remains the leading cause of cancer-related death in the USA. In 2014, there were approximately 224,210 new cases of lung cancer and 159,260 related deaths. The process begins with the detection of lung cancer which is detected through the diagnosis of lung nodules (a manifestation of lung cancer). These nodules are approximately spherical regions of primarily high density tissue that are visible in computed tomography (CT) images of the lung. The treatment of these lung cancer nodules is complex, nearly 70% of lung cancer patients require radiation therapy as part of their treatment. Radiation-induced lung injury is a limiting toxicity that may decrease cure rates and increase morbidity and mortality treatment. By finding ways to accurately detect, at early stage, and hence prevent lung injury, it will have significant positive consequences for lung cancer patients. The ultimate goal of this dissertation is to develop a clinically usable CAD system that can improve the sensitivity and specificity of early detection of radiation-induced lung injury based on the hypotheses that radiated lung tissues may get affected and suffer decrease of their functionality as a side effect of radiation therapy treatment. These hypotheses have been validated by demonstrating that automatic segmentation of the lung regions and registration of consecutive respiratory phases to estimate their elasticity, ventilation, and texture features to provide discriminatory descriptors that can be used for early detection of radiation-induced lung injury. The proposed methodologies will lead to novel indexes for distinguishing normal/healthy and injured lung tissues in clinical decision-making. To achieve this goal, a CAD system for accurate detection of radiation-induced lung injury that requires three basic components has been developed. These components are the lung fields segmentation, lung registration, and features extraction and tissue classification. This dissertation starts with an exploration of the available medical imaging modalities to present the importance of medical imaging in today’s clinical applications. Secondly, the methodologies, challenges, and limitations of recent CAD systems for lung cancer detection are covered. This is followed by introducing an accurate segmentation methodology of the lung parenchyma with the focus of pathological lungs to extract the volume of interest (VOI) to be analyzed for potential existence of lung injuries stemmed from the radiation therapy. After the segmentation of the VOI, a lung registration framework is introduced to perform a crucial and important step that ensures the co-alignment of the intra-patient scans. This step eliminates the effects of orientation differences, motion, breathing, heart beats, and differences in scanning parameters to be able to accurately extract the functionality features for the lung fields. The developed registration framework also helps in the evaluation and gated control of the radiotherapy through the motion estimation analysis before and after the therapy dose. Finally, the radiation-induced lung injury is introduced, which combines the previous two medical image processing and analysis steps with the features estimation and classification step. This framework estimates and combines both texture and functional features. The texture features are modeled using the novel 7th-order Markov Gibbs random field (MGRF) model that has the ability to accurately models the texture of healthy and injured lung tissues through simultaneously accounting for both vertical and horizontal relative dependencies between voxel-wise signals. While the functionality features calculations are based on the calculated deformation fields, obtained from the 4D-CT lung registration, that maps lung voxels between successive CT scans in the respiratory cycle. These functionality features describe the ventilation, the air flow rate, of the lung tissues using the Jacobian of the deformation field and the tissues’ elasticity using the strain components calculated from the gradient of the deformation field. Finally, these features are combined in the classification model to detect the injured parts of the lung at an early stage and enables an earlier intervention

The anthropometric, environmental and genetic determinants of right ventricular structure and function

BACKGROUND Measures of right ventricular (RV) structure and function have significant prognostic value. The right ventricle is currently assessed by global measures, or point surrogates, which are insensitive to regional and directional changes. We aim to create a high-resolution three-dimensional RV model to improve understanding of its structural and functional determinants. These may be particularly of interest in pulmonary hypertension (PH), a condition in which RV function and outcome are strongly linked. PURPOSE To investigate the feasibility and additional benefit of applying three-dimensional phenotyping and contemporary statistical and genetic approaches to large patient populations. METHODS Healthy subjects and incident PH patients were prospectively recruited. Using a semi-automated atlas-based segmentation algorithm, 3D models characterising RV wall position and displacement were developed, validated and compared with anthropometric, physiological and genetic influences. Statistical techniques were adapted from other high-dimensional approaches to deal with the problems of multiple testing, contiguity, sparsity and computational burden. RESULTS 1527 healthy subjects successfully completed high-resolution 3D CMR and automated segmentation. Of these, 927 subjects underwent next-generation sequencing of the sarcomeric gene titin and 947 subjects completed genotyping of common variants for genome-wide association study. 405 incident PH patients were recruited, of whom 256 completed phenotyping. 3D modelling demonstrated significant reductions in sample size compared to two-dimensional approaches. 3D analysis demonstrated that RV basal-freewall function reflects global functional changes most accurately and that a similar region in PH patients provides stronger survival prediction than all anthropometric, haemodynamic and functional markers. Vascular stiffness, titin truncating variants and common variants may also contribute to changes in RV structure and function. CONCLUSIONS High-resolution phenotyping coupled with computational analysis methods can improve insights into the determinants of RV structure and function in both healthy subjects and PH patients. Large, population-based approaches offer physiological insights relevant to clinical care in selected patient groups.Open Acces

Development and application of a human cortical brain atlas on MRI considering phylogeny = Développement et emploi d’un atlas du cortex cérébral humain réalisé sur IRM et tenant compte de la phylogénie

Le cortex cérébral est une structure en couches complexe qui remplit différents types de fonctions. Au cours de l’histoire des neurosciences, plusieurs atlas corticaux ont été développés pour classifier différentes régions du cortex en tant que zones aux caractéristiques structurelles ou fonctionnelles communes, afin d'étudier et de quantifier les changements aux états sain et pathologique. Cependant, il n'existe pas d'atlas suivant une approche phylogénétique, c'est-à-dire, basée sur les critères d'évolution communs. Ce mémoire présente les étapes de création d'un nouvel atlas dans un modèle d’imagerie par résonance magnétique (IRM) en espace standard (pseudo-Talairach) : le PAN-Atlas, basé sur l'origine phylogénétique commune de chaque zone corticale, et son application sur des scans d’IRM de dix individus pour évaluer sa performance. D’abord, nous avons regroupé les différentes régions corticales en cinq régions d'intérêt (RdI) d'origine phylogénétique connue (archicortex, paléocortex, périarchicortex, proïsocortex, isocortex ou néocortex) sur la base de protocoles de segmentation validés histologiquement par d'autres groupes de chercheurs. Puis, nous avons segmenté ces régions manuellement sur le modèle d’IRM cérébrale moyen MNI-ICBM 2009c, en formant des masques. Par la suite, on a utilisé un pipeline multi-étapes de traitement des images pour réaliser le recalage des masques de notre atlas aux scans pondérés T1 de dix participants sains, en obtenant ainsi des masques automatiques pour chaque RdI. Les masques automatiques ont été évalués après une correction manuelle par le biais de l’indice Dice-kappa, qui quantifie la colocalisation des voxels de chaque masque automatique vs. le masque corrigé manuellement. L’indice a montré une très bonne à excellente performance de notre atlas. Cela a permis l’évaluation et comparaison des volumes corticales de chaque région et la quantification des valeurs de transfert de magnétisation (ITM), qui sont sensibles à la quantité de myéline présente dans le tissu. Ce travail montre que la division régionale du cortex en IRM avec une approche phylogénétique est réalisable à l'aide de notre PAN-Atlas en espace standard et que les masques peuvent être utilisés pour différents types de quantifications, comme les volumes corticaux, ou l’estimation des valeurs de ITM. Notre atlas pourrait éventuellement servir à évaluer les différences entre personnes saines et celles atteintes par des maladies neurodégénératives ou d’autres maladies neurologiques.The cerebral cortex is a complex layered structure that performs different types of functions. Throughout the history of neuroscience, several cortical atlases have been developed to classify/divide different regions of the cortex into areas with common structural or functional characteristics, to then study and quantify changes in healthy and pathological states. However, to date, there is no atlas following a phylogenetic approach, i.e. based on the common evolution criteria. This thesis presents the steps of creation of a new atlas corresponding to a standard MRI template: the PAN-Atlas, based on the common phylogenetic origin of each cortical zone, and its application on MRI scans of ten healthy participants to assess its performance. First, we grouped the different cortical regions into five regions of interest (ROI) of known phylogenetic origin (archicortex, paleocortex, periarchicortex, proisocortex, isocortex or neocortex) based on MRI protocols previously validated through histology by other groups of researchers. Then, we manually segmented these ROIs on the MNI-ICBM 2009c average brain MRI template, creating corresponding masks. We then used a multi-step image processing pipeline to register the atlas’ masks to T1 weighted images of ten healthy participants, generating automatic masks for each scan. The accuracy of these automatic atlas’ masks was assessed after manual correction using Dice-kappa similarity index, to quantify the colocalization of the automatic vs. the manually corrected masks. The Dice-kappa values showed a very good to excellent performance of the automatic atlas’ masks. This allowed the evaluation and comparison of cortical volumes of each ROI, as well as the quantification of magnetization transfer ratio (MTR) values, which are sensitive to myelin content. This work shows that the division of the cortex on MRI following a phylogenetic approach is feasible using our PAN Atlas, and that the masks of the atlas can be used to perform different types of quantifications, such as the ones presented here (cortical volume and MTR per ROI). Our atlas could similarly be used to assess differences between the cortex of healthy individuals and people affected by neurodegenerative diseases and other neurological disorders