Feature extraction to aid disease detection and assessment of disease progression in CT and MR colonography

Computed tomographic colonography (CTC) is a technique employed to examine the whole colon for cancers and premalignant adenomas (polyps). Oral preparation is taken to fully cleanse the colon, and gas insufflation maximises the attenuation contrast between the enoluminal colon surface and the lumen. The procedure is performed routinely with the patient both prone and supine to redistribute gas and residue. This helps to differentiate fixed colonic pathology from mobile faecal residue and also helps discover pathology occluded by retained fluid or luminal collapse. Matching corresponding endoluminal surface locations with the patient in the prone and supine positions is therefore an essential aspect of interpretation by radiologists; however, interpretation can be difficult and time consuming due to the considerable colonic deformations that occur during repositioning. Hence, a method for automated registration has the potential to improve efficiency and diagnostic accuracy. I propose a novel method to establish correspondence between prone and supine CT colonography acquisitions automatically. The problem is first simplified by detecting haustral folds which are elongated ridgelike endoluminal structures and can be identified by curvature based measurements. These are subsequently matched using appearance based features, and their relative geometric relationships. It is shown that these matches can be used to find correspondence along the full length of the colon, but may also be used in conjunction with other registration methods to achieve a more robust and accurate result, explicitly addressing the problem of colonic collapse. The potential clinical value of this method has been assessed in an external clinical validation, and the application to follow-up CTC surveillance has been investigated. MRI has recently been applied as a tool to quantitatively evaluate the therapeutic response to therapy in patients with Crohn's disease, and is the preferred choice for repeated imaging. A primary biomarker for this evaluation is the measurement of variations of bowel wall thickness on changing from the active phase of the disease to remission; however, a poor level of interobserver agreement of measured thickness is reported and therefore a system for accurate, robust and reproducible measurements is desirable. I propose a novel method which will automatically track sections of colon, by estimating the positions of elliptical cross sections. Subsequently, estimation of the positions of the inner and outer bowel walls are made based on image gradient information and therefore a thickness measurement value can be extracted

Automatic colonic polyp detection using curvature analysis for standard and low dose CT data

Colon cancer is the second leading cause of cancer related deaths in the developed nations. Early detection and removal of colorectal polyps via screening is the most effective way to reduce colorectal cancer (CRC) mortality. Computed Tomography Colonography (CTC) or Virtual Colonoscopy (VC) is a rapidly evolving non-invasive technique and the medical community view this medical procedure as an alternative to the standard colonoscopy for the detection of colonic polyps. In CTC the first step for automatic polyp detection for 3D visualization of the colon structure and automatic polyp detection addresses the segmentation of the colon lumen. The segmentation of colon lumen is far from a trivial task as in practice many datasets are collapsed due to incorrect patient preparation or blockages caused by residual water/materials left in the colon. In this thesis a robust multi-stage technique for automatic segmentation of the colon is proposed tha t maximally uses the anatomical model of a generic colon. In this regard, the colon is reconstructed using volume by length analysis, orientation, length, end points, geometrical position in the volumetric data, and gradient of the centreline of each candidate air region detected in the CT data. The proposed method was validated using a total of 151 standard dose (lOOmAs) and 13 low-dose (13mAs-40mAs) datasets and the collapsed colon surface detection was always higher than 95% with an average of 1.58% extra colonic surface inclusion. The second major step of automated CTC attempts the identification of colorectal polyps. In this thesis a robust method for polyp detection based on surface curvature analysis has been developed and evaluated. The convexity of the segmented colon surface is sampled using the surface normal intersection, Hough transform, 3D histogram, Gaussian distribution, convexity constraint and 3D region growing. For each polyp candidate surface the morphological and statistical features are extracted and the candidate surface is classified as a polyp/fold structure using a Feature Normalized Nearest Neighbourhood classifier. The devised polyp detection scheme entails a low computational overhead (typically takes 3.60 minute per dataset) and shows 100% sensitivity for polyps larger than 10mm, 92% sensitivity for polyps in the range 5 to 10mm and 64.28% sensitivity for polyp smaller than 5mm. The developed technique returns in average 4.01 false positives per dataset. The patient exposure to ionising radiation is the major concern in using CTC as a mass screening technique for colonic polyp detection. A reduction of the radiation dose will increase the level of noise during the acquisition process and as a result the quality of the CT d a ta is degraded. To fully investigate the effect of the low-dose radiation on the performance of automated polyp detection, a phantom has been developed and scanned using different radiation doses. The phantom polyps have realistic shapes (sessile, pedunculated, and flat) and sizes (3 to 20mm) and were designed to closely approximate the real polyps encountered in clinical CT data. Automatic polyp detection shows 100% sensitivity for polyps larger than 10mm and shows 95% sensitivity for polyps in the range 5 to 10mm. The developed method was applied to CT data acquired at radiation doses between 13 to 40mAs and the experimental results indicate th a t robust polyp detection can be obtained even at radiation doses as low as 13mAs

Geodesic tractography segmentation for directional medical image analysis

Acknowledgements page removed per author's request, 01/06/2014.Geodesic Tractography Segmentation is the two component approach presented in this thesis for the analysis of imagery in oriented domains, with emphasis on the application to diffusion-weighted magnetic resonance imagery (DW-MRI). The computeraided analysis of DW-MRI data presents a new set of problems and opportunities for the application of mathematical and computer vision techniques. The goal is to develop a set of tools that enable clinicians to better understand DW-MRI data and ultimately shed new light on biological processes. This thesis presents a few techniques and tools which may be used to automatically find and segment major neural fiber bundles from DW-MRI data. For each technique, we provide a brief overview of the advantages and limitations of our approach relative to other available approaches.Ph.D.Committee Chair: Tannenbaum, Allen; Committee Member: Barnes, Christopher F.; Committee Member: Niethammer, Marc; Committee Member: Shamma, Jeff; Committee Member: Vela, Patrici

Nonlinear effects in finite elements analysis of colorectal surgical clamping

Minimal Invasive Surgery (MIS) is a procedure that has increased its applications in past few years in different types of surgeries. As number of application fields are increasing day by day, new issues have been arising. In particular, instruments must be inserted through a trocar to access the abdominal cavity without capability of direct manipulation of tissues, so a loss of sensitivity occurs. Generally speaking, the student of medicine or junior surgeons need a lot of practice hours before starting any surgical procedure, since they have to difficulty in acquiring specific skills (hand–eye coordination among others) for this type of surgery. Here is what the surgical simulator present a promising training method using an approach based on Finite Element Method (FEM). The use of continuum mechanics, especially Finite Element Analysis (FEA) has gained an extensive application in medical field in order to simulate soft tissues. In particular, colorectal simulations can be used to understand the interaction between colon and the surrounding tissues and also between colon and instruments. Although several works have been introduced considering small displacements, FEA applied to colorectal surgical procedures with large displacements is a topic that asks for more investigations. This work aims to investigate how FEA can describe non-linear effects induced by material properties and different approximating geometries, focusing as test-case application colorectal surgery. More in detail, it shows a comparison between simulations that are performed using both linear and hyperelastic models. These different mechanical behaviours are applied on different geometrical models (planar, cylindrical, 3D-SS and a real model from digital acquisitions 3D-S) with the aim of evaluating the effects of geometric non-linearity. Final aim of the research is to provide a preliminary contribution to the simulation of the interaction between surgical instrument and colon tissues with multi-purpose FEA in order to help the preliminary set-up of different bioengineering tasks like force-contact evaluation or approximated modelling for virtual reality (surgical simulations). In particular, the contribution of this work is focused on the sensitivity analysis of the nonlinearities by FEA in the tissue-tool interaction through an explicit FEA solver. By doing in this way, we aim to demonstrate that the set-up of FEA computational surgical tools may be simplified in order to provide assistance to non-expert FEA engineers or medicians in more precise way of using FEA tools

Patient radiation dose issues resulting from the use of CT in the UK

In this report, COMARE presents a comprehensive review of the radiation dose issues associated with CT scans in the UK. The implications of the increase in the numbers of CT scans in the UK are considered in the report, with focus on the number of younger patients undergoing CT scans, who have greater sensitivity to x-rays. The report provides an update on the radiation protection aspects of justification (balancing risk and benefit) and optimisation (balancing the risk from the radiation dose with the quality of the image)

Characterization and modelling of complex motion patterns

Movement analysis is the principle of any interaction with the world and the survival of living beings completely depends on the effciency of such analysis. Visual systems have remarkably developed eficient mechanisms that analyze motion at different levels, allowing to recognize objects in dynamical and cluttered environments. In artificial vision, there exist a wide spectrum of applications for which the study of complex movements is crucial to recover salient information. Yet each domain may be different in terms of scenarios, complexity and relationships, a common denominator is that all of them require a dynamic understanding that captures the relevant information. Overall, current strategies are highly dependent on the appearance characterization and usually they are restricted to controlled scenarios. This thesis proposes a computational framework that is inspired in known motion perception mechanisms and structured as a set of modules. Each module is in due turn composed of a set of computational strategies that provide qualitative and quantitative descriptions of the dynamic associated to a particular movement. Diverse applications were herein considered and an extensive validation was performed for each of them. Each of the proposed strategies has shown to be reliable at capturing the dynamic patterns of different tasks, identifying, recognizing, tracking and even segmenting objects in sequences of video.Resumen. El análisis del movimiento es el principio de cualquier interacción con el mundo y la supervivencia de los seres vivos depende completamente de la eficiencia de este tipo de análisis. Los sistemas visuales notablemente han desarrollado mecanismos eficientes que analizan el movimiento en diferentes niveles, lo cual permite reconocer objetos en entornos dinámicos y saturados. En visión artificial existe un amplio espectro de aplicaciones para las cuales el estudio de los movimientos complejos es crucial para recuperar información saliente. A pesar de que cada dominio puede ser diferente en términos de los escenarios, la complejidad y las relaciones de los objetos en movimiento, un común denominador es que todos ellos requieren una comprensión dinámica para capturar información relevante. En general, las estrategias actuales son altamente dependientes de la caracterización de la apariencia y por lo general están restringidos a escenarios controlados. Esta tesis propone un marco computacional que se inspira en los mecanismos de percepción de movimiento conocidas y esta estructurado como un conjunto de módulos. Cada módulo esta a su vez compuesto por un conjunto de estrategias computacionales que proporcionan descripciones cualitativas y cuantitativas de la dinámica asociada a un movimiento particular. Diversas aplicaciones fueron consideradas en este trabajo y una extensa validación se llevó a cabo para cada uno de ellas. Cada una de las estrategias propuestas ha demostrado ser fiable en la captura de los patrones dinámicos de diferentes tareas identificando, reconociendo, siguiendo e incluso segmentando objetos en secuencias de video.Doctorad