Facial soft tissue segmentation

The importance of the face for socio-ecological interaction is the cause for a high demand on any surgical intervention on the facial musculo-skeletal system. Bones and soft-tissues are of major importance for any facial surgical treatment to guarantee an optimal, functional and aesthetical result. For this reason, surgeons want to pre-operatively plan, simulate and predict the outcome of the surgery allowing for shorter operation times and improved quality. Accurate simulation requires exact segmentation knowledge of the facial tissues. Thus semi-automatic segmentation techniques are required. This thesis proposes semi-automatic methods for segmentation of the facial soft-tissues, such as muscles, skin and fat, from CT and MRI datasets, using a Markov Random Fields (MRF) framework. Due to image noise, artifacts, weak edges and multiple objects of similar appearance in close proximity, it is difficult to segment the object of interest by using image information alone. Segmentations would leak at weak edges into neighboring structures that have a similar intensity profile. To overcome this problem, additional shape knowledge is incorporated in the energy function which can then be minimized using Graph-Cuts (GC). Incremental approaches by incorporating additional prior shape knowledge are presented. The proposed approaches are not object specific and can be applied to segment any class of objects be that anatomical or non-anatomical from medical or non-medical image datasets, whenever a statistical model is present. In the first approach a 3D mean shape template is used as shape prior, which is integrated into the MRF based energy function. Here, the shape knowledge is encoded into the data and the smoothness terms of the energy function that constrains the segmented parts to a reasonable shape. In the second approach, to improve handling of shape variations naturally found in the population, the fixed shape template is replaced by a more robust 3D statistical shape model based on Probabilistic Principal Component Analysis (PPCA). The advantages of using the Probabilistic PCA are that it allows reconstructing the optimal shape and computing the remaining variance of the statistical model from partial information. By using an iterative method, the statistical shape model is then refined using image based cues to get a better fitting of the statistical model to the patient's muscle anatomy. These image cues are based on the segmented muscle, edge information and intensity likelihood of the muscle. Here, a linear shape update mechanism is used to fit the statistical model to the image based cues. In the third approach, the shape refinement step is further improved by using a non-linear shape update mechanism where vertices of the 3D mesh of the statistical model incur the non-linear penalty depending on the remaining variability of the vertex. The non-linear shape update mechanism provides a more accurate shape update and helps in a finer shape fitting of the statistical model to the image based cues in areas where the shape variability is high. Finally, a unified approach is presented to segment the relevant facial muscles and the remaining facial soft-tissues (skin and fat). One soft-tissue layer is removed at a time such as the head and non-head regions followed by the skin. In the next step, bones are removed from the dataset, followed by the separation of the brain and non-brain regions as well as the removal of air cavities. Afterwards, facial fat is segmented using the standard Graph-Cuts approach. After separating the important anatomical structures, finally, a 3D fixed shape template mesh of the facial muscles is used to segment the relevant facial muscles. The proposed methods are tested on the challenging example of segmenting the masseter muscle. The datasets were noisy with almost all possessing mild to severe imaging artifacts such as high-density artifacts caused by e.g. dental fillings and dental implants. Qualitative and quantitative experimental results show that by incorporating prior shape knowledge leaking can be effectively constrained to obtain better segmentation results

Acquisition and Reconstruction Techniques for Fat Quantification Using Magnetic Resonance Imaging

Quantifying the tissue fat concentration is important for several diseases in various organs including liver, heart, skeletal muscle and kidney. Uniquely, MRI can separate the signal from water and fat in-vivo, rendering it the most suitable imaging modality for non-invasive fat quantification. Chemical-shift-encoded MRI is commonly used for quantitative fat measurement due to its unique ability to generate a separate image for water and fat. The tissue fat concentration can be consequently estimated from the two images. However, several confounding factors can hinder the water/fat separation process, leading to incorrect estimation of fat concentration. The inhomogeneities of the main magnetic field represent the main obstacle to water/fat separation. Most existing techniques rely mainly on imposing spatial smoothness constraints to address this problem; however, these often fail to resolve large and abrupt variations in the magnetic field. A novel convex relaxation approach to water/fat separation is proposed. The technique is compared to existing methods, demonstrating its robustness to resolve abrupt magnetic field inhomogeneities. Water/fat separation requires the acquisition of multiple images with different echo-times, which prolongs the acquisition time. Bipolar acquisitions can efficiently acquire the required data in shorter time. However, they induce phase errors that significantly distort the fat measurements. A new bipolar acquisition strategy that overcomes the phase errors and provides accurate fat measurements is proposed. The technique is compared to the current clinical sequence, demonstrating its efficiency in phantoms and in-vivo experiments. The proposed acquisition technique is also applied on animal models to achieve higher spatial resolution than the current sequence. In conclusion, this dissertation describes a complete framework for accurate and precise MRI fat quantification. Novel acquisitions and reconstruction techniques that address the current challenges for fat quantification are proposed

Computerized Analysis of Magnetic Resonance Images to Study Cerebral Anatomy in Developing Neonates

The study of cerebral anatomy in developing neonates is of great importance for the understanding of brain development during the early period of life. This dissertation therefore focuses on three challenges in the modelling of cerebral anatomy in neonates during brain development. The methods that have been developed all use Magnetic Resonance Images (MRI) as source data. To facilitate study of vascular development in the neonatal period, a set of image analysis algorithms are developed to automatically extract and model cerebral vessel trees. The whole process consists of cerebral vessel tracking from automatically placed seed points, vessel tree generation, and vasculature registration and matching. These algorithms have been tested on clinical Time-of- Flight (TOF) MR angiographic datasets. To facilitate study of the neonatal cortex a complete cerebral cortex segmentation and reconstruction pipeline has been developed. Segmentation of the neonatal cortex is not effectively done by existing algorithms designed for the adult brain because the contrast between grey and white matter is reversed. This causes pixels containing tissue mixtures to be incorrectly labelled by conventional methods. The neonatal cortical segmentation method that has been developed is based on a novel expectation-maximization (EM) method with explicit correction for mislabelled partial volume voxels. Based on the resulting cortical segmentation, an implicit surface evolution technique is adopted for the reconstruction of the cortex in neonates. The performance of the method is investigated by performing a detailed landmark study. To facilitate study of cortical development, a cortical surface registration algorithm for aligning the cortical surface is developed. The method first inflates extracted cortical surfaces and then performs a non-rigid surface registration using free-form deformations (FFDs) to remove residual alignment. Validation experiments using data labelled by an expert observer demonstrate that the method can capture local changes and follow the growth of specific sulcus

Efficient pre-segmentation filtering in MRCP

Magnetic Resonance Cholangiopancreatography (MRCP) is an evolving MRI technique designed for the imaging of the biliary tree, a system of narrow ducts that collect bile, produced within the liver, store it in the gall bladder, and deliver it into the small intestine as needed. Current MRCP protocols, used to diagnose problems in this ductal system, generate cluttered and noisy, low resolution, non-isometric volume data, often with significant intensity non-uniformities. This combination of undesirable characteristics presents particular challenges for the application of automated image analysis techniques. This thesis examines the development, characterisation, and testing of novel and efficient pre-segmentation filtering procedures designed to achieve increased robustness and precision in the subsequent segmentation and analysis of the biliary tree from MRCP data. A focused set of image preprocessing algorithms has been developed so as to facilitate the operation of non-complex segmentation and computer assisted diagnosis (CAD) procedures. Most notable in this regard are a number of novel techniques designed to address the key areas of this image processing task. These techniques consist of: • a new histogram preserving approach to inter-image and intervolume intensity non-uniformity correction, • a highly versatile adaptive smoothing filter, implemented as an oriented, scaled and shaped ellipsoid filter mask, • the downhill filter, an efficient new algorithm for morphological reconstruction by dilation, and • a novel approach to the reconstruction of fine branching structures in noisy volume data. Through this combination of flexible and efficient preprocessing algorithms, an effective route towards robust MRCP segmentation and analysis, and routine CAD in the assessment of the biliary tree from MRCP is presented

2D Phase Unwrapping via Graph Cuts

Phase imaging technologies such as interferometric synthetic aperture radar (InSAR), magnetic resonance imaging (MRI), or optical interferometry, are nowadays widespread and with an increasing usage. The so-called phase unwrapping, which consists in the in- ference of the absolute phase from the modulo-2π phase, is a critical step in many of their processing chains, yet still one of its most challenging problems. We introduce an en- ergy minimization based approach to 2D phase unwrapping. In this approach we address the problem by adopting a Bayesian point of view and a Markov random field (MRF) to model the phase. The maximum a posteriori estimation of the absolute phase gives rise to an integer optimization problem, for which we introduce a family of efficient algo- rithms based on existing graph cuts techniques. We term our approach and algorithms PUMA, for Phase Unwrapping MAx flow. As long as the prior potential of the MRF is convex, PUMA guarantees an exact global solution. In particular it solves exactly all the minimum L p norm (p ≥ 1) phase unwrapping problems, unifying in that sense, a set of existing independent algorithms. For non convex potentials we introduce a version of PUMA that, while yielding only approximate solutions, gives very useful phase unwrap- ping results. The main characteristic of the introduced solutions is the ability to blindly preserve discontinuities. Extending the previous versions of PUMA, we tackle denoising by exploiting a multi-precision idea, which allows us to use the same rationale both for phase unwrapping and denoising. Finally, the last presented version of PUMA uses a frequency diversity concept to unwrap phase images having large phase rates. A representative set of experiences illustrates the performance of PUMA

Automatic Segmentation of the Lumbar Spine from Medical Images

Segmentation of the lumbar spine in 3D is a necessary step in numerous medical applications, but remains a challenging problem for computational methods due to the complex and varied shape of the anatomy and the noise and other artefacts often present in the images. While manual annotation of anatomical objects such as vertebrae is often carried out with the aid of specialised software, obtaining even a single example can be extremely time-consuming. Automating the segmentation process is the only feasible way to obtain accurate and reliable segmentations on any large scale. This thesis describes an approach for automatic segmentation of the lumbar spine from medical images; specifically those acquired using magnetic resonance imaging (MRI) and computed tomography (CT). The segmentation problem is formulated as one of assigning class labels to local clustered regions of an image (called superpixels in 2D or supervoxels in 3D). Features are introduced in 2D and 3D which can be used to train a classifier for estimating the class labels of the superpixels or supervoxels. Spatial context is introduced by incorporating the class estimates into a conditional random field along with a learned pairwise metric. Inference over the resulting model can be carried out very efficiently, enabling an accurate pixel- or voxel-level segmentation to be recovered from the labelled regions. In contrast to most previous work in the literature, the approach does not rely on explicit prior shape information. It therefore avoids many of the problems associated with these methods, such as the need to construct a representative prior model of anatomical shape from training data and the approximate nature of the optimisation. The general-purpose nature of the proposed method means that it can be used to accurately segment both vertebrae and intervertebral discs from medical images without fundamental change to the model. Evaluation of the approach shows it to obtain accurate and robust performance in the presence of significant anatomical variation. The median average symmetric surface distances for 2D vertebra segmentation were 0.27mm on MRI data and 0.02mm on CT data. For 3D vertebra segmentation the median surface distances were 0.90mm on MRI data and 0.20mm on CT data. For 3D intervertebral disc segmentation a median surface distance of 0.54mm was obtained on MRI data

Segmentation of brain MRI during early childhood

The objective of this thesis is the development of automatic methods to measure the changes in volume and growth of brain structures in prematurely born infants. Automatic tools for accurate tissue quantification from magnetic resonance images can provide means for understanding how the neurodevelopmental effects of the premature birth, such as cognitive, neurological or behavioural impairment, are related to underlying changes in brain anatomy. Understanding these changes forms a basis for development of suitable treatments to improve the outcomes of premature birth. In this thesis we focus on the segmentation of brain structures from magnetic resonance images during early childhood. Most of the current brain segmentation techniques have been focused on the segmentation of adult or neonatal brains. As a result of rapid development, the brain anatomy during early childhood differs from anatomy of both adult and neonatal brains and therefore requires adaptations of available techniques to produce good results. To address the issue of anatomical differences of the brain during early childhood compared to other age-groups, population-specific deformable and probabilistic atlases are introduced. A method for generation of population-specific prior information in form of a probabilistic atlas is proposed and used to enhance existing segmentation algorithms. The evaluation of registration-based and intensity-based approaches shows the techniques to be complementary in the quality of automatic segmentation in different parts of the brain. We propose a novel robust segmentation method combining the advantages of both approaches. The method is based on multiple label propagation using B-spline non-rigid registration followed by EM segmentation. Intensity inhomogeneity is a shading artefact resulting from the acquisition process, which significantly affects modern high resolution MR data acquired at higher magnetic field strengths. A novel template based method focused on correcting the intensity inhomogeneity in data acquired at higher magnetic field strengths is therefore proposed. The proposed segmentation method combined with proposed intensity inhomogeneity correction method offers a robust tool for quantification of volumes and growth of brain structures during early childhood. The tool have been applied to 67 T1-weigted images of subject at one and two years of age

Multi-scale active shape description in medical imaging

Shape description in medical imaging has become an increasingly important research field in recent years. Fast and high-resolution image acquisition methods like Magnetic Resonance (MR) imaging produce very detailed cross-sectional images of the human body - shape description is then a post-processing operation which abstracts quantitative descriptions of anatomically relevant object shapes. This task is usually performed by clinicians and other experts by first segmenting the shapes of interest, and then making volumetric and other quantitative measurements. High demand on expert time and inter- and intra-observer variability impose a clinical need of automating this process. Furthermore, recent studies in clinical neurology on the correspondence between disease status and degree of shape deformations necessitate the use of more sophisticated, higher-level shape description techniques. In this work a new hierarchical tool for shape description has been developed, combining two recently developed and powerful techniques in image processing: differential invariants in scale-space, and active contour models. This tool enables quantitative and qualitative shape studies at multiple levels of image detail, exploring the extra image scale degree of freedom. Using scale-space continuity, the global object shape can be detected at a coarse level of image detail, and finer shape characteristics can be found at higher levels of detail or scales. New methods for active shape evolution and focusing have been developed for the extraction of shapes at a large set of scales using an active contour model whose energy function is regularized with respect to scale and geometric differential image invariants. The resulting set of shapes is formulated as a multiscale shape stack which is analysed and described for each scale level with a large set of shape descriptors to obtain and analyse shape changes across scales. This shape stack leads naturally to several questions in regard to variable sampling and appropriate levels of detail to investigate an image. The relationship between active contour sampling precision and scale-space is addressed. After a thorough review of modem shape description, multi-scale image processing and active contour model techniques, the novel framework for multi-scale active shape description is presented and tested on synthetic images and medical images. An interesting result is the recovery of the fractal dimension of a known fractal boundary using this framework. Medical applications addressed are grey-matter deformations occurring for patients with epilepsy, spinal cord atrophy for patients with Multiple Sclerosis, and cortical impairment for neonates. Extensions to non-linear scale-spaces, comparisons to binary curve and curvature evolution schemes as well as other hierarchical shape descriptors are discussed