Echocardiography

The book "Echocardiography - New Techniques" brings worldwide contributions from highly acclaimed clinical and imaging science investigators, and representatives from academic medical centers. Each chapter is designed and written to be accessible to those with a basic knowledge of echocardiography. Additionally, the chapters are meant to be stimulating and educational to the experts and investigators in the field of echocardiography. This book is aimed primarily at cardiology fellows on their basic echocardiography rotation, fellows in general internal medicine, radiology and emergency medicine, and experts in the arena of echocardiography. Over the last few decades, the rate of technological advancements has developed dramatically, resulting in new techniques and improved echocardiographic imaging. The authors of this book focused on presenting the most advanced techniques useful in today's research and in daily clinical practice. These advanced techniques are utilized in the detection of different cardiac pathologies in patients, in contributing to their clinical decision, as well as follow-up and outcome predictions. In addition to the advanced techniques covered, this book expounds upon several special pathologies with respect to the functions of echocardiography

Speckle Noise Reduction in Medical Ultrasound Images

Ultrasound imaging is an incontestable vital tool for diagnosis, it provides in non-invasive manner the internal structure of the body to detect eventually diseases or abnormalities tissues. Unfortunately, the presence of speckle noise in these images affects edges and fine details which limit the contrast resolution and make diagnostic more difficult. In this paper, we propose a denoising approach which combines logarithmic transformation and a non linear diffusion tensor. Since speckle noise is multiplicative and nonwhite process, the logarithmic transformation is a reasonable choice to convert signaldependent or pure multiplicative noise to an additive one. The key idea from using diffusion tensor is to adapt the flow diffusion towards the local orientation by applying anisotropic diffusion along the coherent structure direction of interesting features in the image. To illustrate the effective performance of our algorithm, we present some experimental results on synthetically and real echographic images

Doctor of Philosophy

dissertationCongenital heart defects are classes of birth defects that affect the structure and function of the heart. These defects are attributed to the abnormal or incomplete development of a fetal heart during the first few weeks following conception. The overall detection rate of congenital heart defects during routine prenatal examination is low. This is attributed to the insufficient number of trained personnel in many local health centers where many cases of congenital heart defects go undetected. This dissertation presents a system to identify congenital heart defects to improve pregnancy outcomes and increase their detection rates. The system was developed and its performance assessed in identifying the presence of ventricular defects (congenital heart defects that affect the size of the ventricles) using four-dimensional fetal chocardiographic images. The designed system consists of three components: 1) a fetal heart location estimation component, 2) a fetal heart chamber segmentation component, and 3) a detection component that detects congenital heart defects from the segmented chambers. The location estimation component is used to isolate a fetal heart in any four-dimensional fetal echocardiographic image. It uses a hybrid region of interest extraction method that is robust to speckle noise degradation inherent in all ultrasound images. The location estimation method's performance was analyzed on 130 four-dimensional fetal echocardiographic images by comparison with manually identified fetal heart region of interest. The location estimation method showed good agreement with the manually identified standard using four quantitative indexes: Jaccard index, Sørenson-Dice index, Sensitivity index and Specificity index. The average values of these indexes were measured at 80.70%, 89.19%, 91.04%, and 99.17%, respectively. The fetal heart chamber segmentation component uses velocity vector field estimates computed on frames contained in a four-dimensional image to identify the fetal heart chambers. The velocity vector fields are computed using a histogram-based optical flow technique which is formulated on local image characteristics to reduces the effect of speckle noise and nonuniform echogenicity on the velocity vector field estimates. Features based on the velocity vector field estimates, voxel brightness/intensity values, and voxel Cartesian coordinate positions were extracted and used with kernel k-means algorithm to identify the individual chambers. The segmentation method's performance was evaluated on 130 images from 31 patients by comparing the segmentation results with manually identified fetal heart chambers. Evaluation was based on the Sørenson-Dice index, the absolute volume difference and the Hausdorff distance, with each resulting in per patient average values of 69.92%, 22.08%, and 2.82 mm, respectively. The detection component uses the volumes of the identified fetal heart chambers to flag the possible occurrence of hypoplastic left heart syndrome, a type of congenital heart defect. An empirical volume threshold defined on the relative ratio of adjacent fetal heart chamber volumes obtained manually is used in the detection process. The performance of the detection procedure was assessed by comparison with a set of images with confirmed diagnosis of hypoplastic left heart syndrome and a control group of normal fetal hearts. Of the 130 images considered 18 of 20 (90%) fetal hearts were correctly detected as having hypoplastic left heart syndrome and 84 of 110 (76.36%) fetal hearts were correctly detected as normal in the control group. The results show that the detection system performs better than the overall detection rate for congenital heart defect which is reported to be between 30% and 60%

Elevational Spatial Compounding for enhancing image quality in Echocardiography

INTRODUCTION: Echocardiography is commonly used in clinical practice for the real-time assessment of cardiac morphology and function. Nevertheless, due to the nature of the data acquisition, cardiac ultrasound images are often corrupted by a range of acoustic artefacts, including acoustic noise, speckle and shadowing. Spatial compounding techniques have long been recognised for their ability to suppress common ultrasound artefacts, enhancing the imaged cardiac structures. However, they require extended acquisition times as well as accurate spatio-temporal alignment of the compounded data. Elevational spatial compounding acquires and compounds adjacent partially decorrelated planes of the same cardiac structure. METHODS: This paper employs an anthropomorphic left ventricle phantom to examine the effect of acquisition parameters, such as inter-slice angular displacement and 3D sector angular range, on the elevational spatial compounding of cardiac ultrasound data. RESULTS AND CONCLUSION: Elevational spatial compounding can produce substantial noise and speckle suppression as well as visual enhancement of tissue structures even for small acquisition sector widths (2.5° to 6.5°). In addition, elevational spatial compounding eliminates the need for extended acquisition times as well as the need for temporal alignment of the compounded datasets. However, moderate spatial registration may still be required to reduce any tissue/chamber blurring side effects that may be introduced

A Fully Automatic Segmentation Method for Breast Ultrasound Images

Breast cancer is the second leading cause of death of women worldwide. Accurate lesion boundary detection is important for breast cancer diagnosis. Since many crucial features for discriminating benign and malignant lesions are based on the contour, shape, and texture of the lesion, an accurate segmentation method is essential for a successful diagnosis. Ultrasound is an effective screening tool and primarily useful for differentiating benign and malignant lesions. However, due to inherent speckle noise and low contrast of breast ultrasound imaging, automatic lesion segmentation is still a challenging task. This research focuses on developing a novel, effective, and fully automatic lesion segmentation method for breast ultrasound images. By incorporating empirical domain knowledge of breast structure, a region of interest is generated. Then, a novel enhancement algorithm (using a novel phase feature) and a newly developed neutrosophic clustering method are developed to detect the precise lesion boundary. Neutrosophy is a recently introduced branch of philosophy that deals with paradoxes, contradictions, antitheses, and antinomies. When neutrosophy is used to segment images with vague boundaries, its unique ability to deal with uncertainty is brought to bear. In this work, we apply neutrosophy to breast ultrasound image segmentation and propose a new clustering method named neutrosophic l-means. We compare the proposed method with traditional fuzzy c-means clustering and three other well-developed segmentation methods for breast ultrasound images, using the same database. Both accuracy and time complexity are analyzed. The proposed method achieves the best accuracy (TP rate is 94.36%, FP rate is 8.08%, and similarity rate is 87.39%) with a fairly rapid processing speed (about 20 seconds). Sensitivity analysis shows the robustness of the proposed method as well. Cases with multiple-lesions and severe shadowing effect (shadow areas having similar intensity values of the lesion and tightly connected with the lesion) are not included in this study