A methodology for peripheral nerve segmentation using a multiple annotators approach based on Centered Kernel Alignment

Peripheral Nerve Blocking (PNB) is a technique commonly used to perform regional anesthesia and for pain management. The success of PNB procedures depends on the accurate location of the target nerve. Recently, ultrasound imaging has been widely used to locate nerve structures to carry out PNB, due to it enables a non-invasive visualization of the target nerve and the anatomical structures around it. However, the ultrasound images are affected by several artifacts making difficult the accurate delimitation of nerves. In the literature, several approaches have been proposed to carry out automatic or semi-automatic segmentation. Nevertheless, these methods are designed assuming that the gold standard is available, and for this segmentation problem this gold standard can not be obtained considering that it corresponds to subjective interpretation. In this sense, for building those segmentation models, we do not have access to the actual label but an amount of subjective annotations provided by multiple experts. To deal with this drawback we use the concepts of a relatively new area of machine learning known as “Learning from crowds”, this area deals with supervised learning problems considering the case when the gold standard is not available. In this project, we develop a nerve segmentation system that includes: a preprocessing stage, feature extraction methodology based on adaptive methods, and a Centered Kernel Alignment (CKA) based representation to measure the annotators performance for building a classifier with multiple annotators in order to support peripheral nerve segmentation. Our approach to classification with multiple annotators based on CKA is tested on both simulated data and real data; similarly, the methodology of automatic segmentation proposed in this work was tested over ultrasound images labeled by a set of specialists who give their opinion about the location of nerve structures. According to the results, we conclude that our methodology can be used to locate nerve structures in ultrasound images even if the gold standard (the actual location of nerve structures) is not available in the training stage. Moreover, we determine that the approach proposed in this work could be implemented as a guiding tool for the anesthesiologist to carry out PNB procedures assisted by ultrasound imaging

Enhancement of nerve structure segmentation by a correntropy-based pre-image approach

El bloqueo de nervios periféricos (PNB) es una técnica ampliamente usada para llevar a cabo anestesia regional en el manejo del dolor. El PNB aplica una sustancia anestésica en el área que rodea el nervio que se quiere intervenir, y su éxito depende de la localización exacta del mismo. Recientemente, las imágenes de ultrasonido (UI) se han utilizado para la localización de nervios periféricos en PNB ya que permiten una visualización no invasiva y directa del nervio y de las estructuras anatómicas alrededor de él; sin embargo, este tipo de imágenes están afectadas por ruido speckle, dificultando su delimitación exacta. De esta manera, es pertinente una etapa de filtrado para atenuar el ruido sin remover información anatómica importante para la segmentación. En este artículo se propone una estrategia para el mejoramiento de UI usando filtrado basado en pre-imágenes. En particular, las imágenes se mapean a un espacio de alta dimensionalidad a través de una función kernel. Específicamente, se emplea un mapeo basado en Correntropía con el fin de codificar estadísticos de orden superior de las imágenes bajo condiciones no-lineales y no-Gaussianas. El enfoque propuesto se valida en la segmentación de nervios para PNB. El enfoque de filtrado basado en pre-imágenes con Correntropía (CPIF) es usado como pre-procesamiento en tareas de segmentación de nervios sobre UI. El rendimiento de la segmentación es medida en términos del coeficiente Dice. De acuerdo con los resultados, CPIF encuentra una aproximación adecuada para las UI al asegurar la identificación de patrones discriminativos de estructuras nerviosas.Peripheral Nerve Blocking (PNB) is a commonly used technique for performing regional anesthesia and managing pain. PNB comprises the administration of anesthetics in the proximity of a nerve. In this sense, the success of PNB procedures depends on an accurate location of the target nerve. Recently, ultrasound images (UI) have been widely used to locate nerve structures for PNB, since they enable a non-invasive visualization of the target nerve and the anatomical structures around it. However, UI are affected by speckle noise, which makes it difficult to accurately locate a given nerve. Thus, it is necessary to perform a filtering step to attenuate the speckle noise without eliminating relevant anatomical details that are required for high-level tasks, such as segmentation of nerve structures. In this paper, we propose an UI improvement strategy with the use of a pre-image-based filter. In particular, we map the input images by a nonlinear function (kernel). Specifically, we employ a correntropy-based mapping as kernel functional to code higher-order statistics of the input data under both nonlinear and non-Gaussian conditions. We validate our approach against an UI dataset focused on nerve segmentation for PNB. Likewise, our Correntropy-based Pre-Image Filtering (CPIF) is applied as a pre-processing stage to segment nerve structures in a UI. The segmentation performance is measured in terms of the Dice coefficient. According to the results, we observe that CPIF finds a suitable approximation for UI by highlighting discriminative nerve patterns

Segmentation of pelvic structures from preoperative images for surgical planning and guidance

Prostate cancer is one of the most frequently diagnosed malignancies globally and the second leading cause of cancer-related mortality in males in the developed world. In recent decades, many techniques have been proposed for prostate cancer diagnosis and treatment. With the development of imaging technologies such as CT and MRI, image-guided procedures have become increasingly important as a means to improve clinical outcomes. Analysis of the preoperative images and construction of 3D models prior to treatment would help doctors to better localize and visualize the structures of interest, plan the procedure, diagnose disease and guide the surgery or therapy. This requires efficient and robust medical image analysis and segmentation technologies to be developed. The thesis mainly focuses on the development of segmentation techniques in pelvic MRI for image-guided robotic-assisted laparoscopic radical prostatectomy and external-beam radiation therapy. A fully automated multi-atlas framework is proposed for bony pelvis segmentation in MRI, using the guidance of MRI AE-SDM. With the guidance of the AE-SDM, a multi-atlas segmentation algorithm is used to delineate the bony pelvis in a new \ac{MRI} where there is no CT available. The proposed technique outperforms state-of-the-art algorithms for MRI bony pelvis segmentation. With the SDM of pelvis and its segmented surface, an accurate 3D pelvimetry system is designed and implemented to measure a comprehensive set of pelvic geometric parameters for the examination of the relationship between these parameters and the difficulty of robotic-assisted laparoscopic radical prostatectomy. This system can be used in both manual and automated manner with a user-friendly interface. A fully automated and robust multi-atlas based segmentation has also been developed to delineate the prostate in diagnostic MR scans, which have large variation in both intensity and shape of prostate. Two image analysis techniques are proposed, including patch-based label fusion with local appearance-specific atlases and multi-atlas propagation via a manifold graph on a database of both labeled and unlabeled images when limited labeled atlases are available. The proposed techniques can achieve more robust and accurate segmentation results than other multi-atlas based methods. The seminal vesicles are also an interesting structure for therapy planning, particularly for external-beam radiation therapy. As existing methods fail for the very onerous task of segmenting the seminal vesicles, a multi-atlas learning framework via random decision forests with graph cuts refinement has further been proposed to solve this difficult problem. Motivated by the performance of this technique, I further extend the multi-atlas learning to segment the prostate fully automatically using multispectral (T1 and T2-weighted) MR images via hybrid \ac{RF} classifiers and a multi-image graph cuts technique. The proposed method compares favorably to the previously proposed multi-atlas based prostate segmentation. The work in this thesis covers different techniques for pelvic image segmentation in MRI. These techniques have been continually developed and refined, and their application to different specific problems shows ever more promising results.Open Acces

Gaze-Based Human-Robot Interaction by the Brunswick Model

We present a new paradigm for human-robot interaction based on social signal processing, and in particular on the Brunswick model. Originally, the Brunswick model copes with face-to-face dyadic interaction, assuming that the interactants are communicating through a continuous exchange of non verbal social signals, in addition to the spoken messages. Social signals have to be interpreted, thanks to a proper recognition phase that considers visual and audio information. The Brunswick model allows to quantitatively evaluate the quality of the interaction using statistical tools which measure how effective is the recognition phase. In this paper we cast this theory when one of the interactants is a robot; in this case, the recognition phase performed by the robot and the human have to be revised w.r.t. the original model. The model is applied to Berrick, a recent open-source low-cost robotic head platform, where the gazing is the social signal to be considered