Ultrasound-Augmented Laparoscopy

Laparoscopic surgery is perhaps the most common minimally invasive procedure for many diseases in the abdomen. Since the laparoscopic camera provides only the surface view of the internal organs, in many procedures, surgeons use laparoscopic ultrasound (LUS) to visualize deep-seated surgical targets. Conventionally, the 2D LUS image is visualized in a display spatially separate from that displays the laparoscopic video. Therefore, reasoning about the geometry of hidden targets requires mentally solving the spatial alignment, and resolving the modality differences, which is cognitively very challenging. Moreover, the mental representation of hidden targets in space acquired through such cognitive medication may be error prone, and cause incorrect actions to be performed. To remedy this, advanced visualization strategies are required where the US information is visualized in the context of the laparoscopic video. To this end, efficient computational methods are required to accurately align the US image coordinate system with that centred in the camera, and to render the registered image information in the context of the camera such that surgeons perceive the geometry of hidden targets accurately. In this thesis, such a visualization pipeline is described. A novel method to register US images with a camera centric coordinate system is detailed with an experimental investigation into its accuracy bounds. An improved method to blend US information with the surface view is also presented with an experimental investigation into the accuracy of perception of the target locations in space

A Survey on Deep Learning in Medical Image Registration: New Technologies, Uncertainty, Evaluation Metrics, and Beyond

Over the past decade, deep learning technologies have greatly advanced the field of medical image registration. The initial developments, such as ResNet-based and U-Net-based networks, laid the groundwork for deep learning-driven image registration. Subsequent progress has been made in various aspects of deep learning-based registration, including similarity measures, deformation regularizations, and uncertainty estimation. These advancements have not only enriched the field of deformable image registration but have also facilitated its application in a wide range of tasks, including atlas construction, multi-atlas segmentation, motion estimation, and 2D-3D registration. In this paper, we present a comprehensive overview of the most recent advancements in deep learning-based image registration. We begin with a concise introduction to the core concepts of deep learning-based image registration. Then, we delve into innovative network architectures, loss functions specific to registration, and methods for estimating registration uncertainty. Additionally, this paper explores appropriate evaluation metrics for assessing the performance of deep learning models in registration tasks. Finally, we highlight the practical applications of these novel techniques in medical imaging and discuss the future prospects of deep learning-based image registration

Mesh-to-raster based non-rigid registration of multi-modal images

Region of interest (ROI) alignment in medical images plays a crucial role in diagnostics, procedure planning, treatment, and follow-up. Frequently, a model is represented as triangulated mesh while the patient data is provided from CAT scanners as pixel or voxel data. Previously, we presented a 2D method for curve-to-pixel registration. This paper contributes (i) a general mesh-to-raster (M2R) framework to register ROIs in multi-modal images; (ii) a 3D surface-to-voxel application, and (iii) a comprehensive quantitative evaluation in 2D using ground truth provided by the simultaneous truth and performance level estimation (STAPLE) method. The registration is formulated as a minimization problem where the objective consists of a data term, which involves the signed distance function of the ROI from the reference image, and a higher order elastic regularizer for the deformation. The evaluation is based on quantitative light-induced fluoroscopy (QLF) and digital photography (DP) of decalcified teeth. STAPLE is computed on 150 image pairs from 32 subjects, each showing one corresponding tooth in both modalities. The ROI in each image is manually marked by three experts (900 curves in total). In the QLF-DP setting, our approach significantly outperforms the mutual information-based registration algorithm implemented with the Insight Segmentation and Registration Toolkit (ITK) and Elastix

Multi-atlas segmentation using clustering, local non-linear manifold embeddings and target-specific templates

Multi-atlas segmentation (MAS) has become an established technique for the automated delineation of anatomical structures. The often manually annotated labels from each of multiple pre-segmented images (atlases) are typically transferred to a target through the spatial mapping of corresponding structures of interest. The mapping can be estimated by pairwise registration between each atlas and the target or by creating an intermediate population template for spatial normalisation of atlases and targets. The former is done at runtime which is computationally expensive but provides high accuracy. In the latter approach the template can be constructed from the atlases offline requiring only one registration to the target at runtime. Although this is computationally more efficient, the composition of deformation fields can lead to decreased accuracy. Our goal was to develop a MAS method which was both efficient and accurate. In our approach we create a target-specific template (TST) which has a high similarity to the target and serves as intermediate step to increase registration accuracy. The TST is constructed from the atlas images that are most similar to the target. These images are determined in low-dimensional manifold spaces on the basis of deformation fields in local regions of interest. We also introduce a clustering approach to divide atlas labels into meaningful sub-regions of interest and increase local specificity for TST construction and label fusion. Our approach was tested on a variety of MR brain datasets and applied to an in-house dataset. We achieve state-of-the-art accuracy while being computationally much more efficient than competing methods. This efficiency opens the door to the use of larger sets of atlases which could lead to further improvement in segmentation accuracy

Multi-atlas segmentation using clustering, local non-linear manifold embeddings and target-specific templates

Multi-atlas segmentation (MAS) has become an established technique for the automated delineation of anatomical structures. The often manually annotated labels from each of multiple pre-segmented images (atlases) are typically transferred to a target through the spatial mapping of corresponding structures of interest. The mapping can be estimated by pairwise registration between each atlas and the target or by creating an intermediate population template for spatial normalisation of atlases and targets. The former is done at runtime which is computationally expensive but provides high accuracy. In the latter approach the template can be constructed from the atlases offline requiring only one registration to the target at runtime. Although this is computationally more efficient, the composition of deformation fields can lead to decreased accuracy. Our goal was to develop a MAS method which was both efficient and accurate. In our approach we create a target-specific template (TST) which has a high similarity to the target and serves as intermediate step to increase registration accuracy. The TST is constructed from the atlas images that are most similar to the target. These images are determined in low-dimensional manifold spaces on the basis of deformation fields in local regions of interest. We also introduce a clustering approach to divide atlas labels into meaningful sub-regions of interest and increase local specificity for TST construction and label fusion. Our approach was tested on a variety of MR brain datasets and applied to an in-house dataset. We achieve state-of-the-art accuracy while being computationally much more efficient than competing methods. This efficiency opens the door to the use of larger sets of atlases which could lead to further improvement in segmentation accuracy

Image-based registration methods for quantification and compensation of prostate motion during trans-rectal ultrasound (TRUS)-guided biopsy

Prostate biopsy is the clinical standard for cancer diagnosis and is typically performed under two-dimensional (2D) transrectal ultrasound (TRUS) for needle guidance. Unfortunately, most early stage prostate cancers are not visible on ultrasound and the procedure suffers from high false negative rates due to the lack of visible targets. Fusion of pre-biopsy MRI to 3D TRUS for targeted biopsy could improve cancer detection rates and volume of tumor sampled. In MRI-TRUS fusion biopsy systems, patient or prostate motion during the procedure causes misalignments in the MR targets mapped to the live 2D TRUS images, limiting the targeting accuracy of the biopsy system. In order to sample smallest clinically significant tumours of 0.5 cm3with 95% confidence, the root mean square (RMS) error of the biopsy system needs to be The target misalignments due to intermittent prostate motion during the procedure can be compensated by registering the live 2D TRUS images acquired during the biopsy procedure to the pre-acquired baseline 3D TRUS image. The registration must be performed both accurately and quickly in order to be useful during the clinical procedure. We developed an intensity-based 2D-3D rigid registration algorithm and validated it by calculating the target registration error (TRE) using manually identified fiducials within the prostate. We discuss two different approaches that can be used to improve the robustness of this registration to meet the clinical requirements. Firstly, we evaluated the impact of intra-procedural 3D TRUS imaging on motion compensation accuracy since the limited anatomical context available in live 2D TRUS images could limit the robustness of the 2D-3D registration. The results indicated that TRE improved when intra-procedural 3D TRUS images were used in registration, with larger improvements in the base and apex regions as compared with the mid-gland region. Secondly, we developed and evaluated a registration algorithm whose optimization is based on learned prostate motion characteristics. Compared to our initial approach, the updated optimization improved the robustness during 2D-3D registration by reducing the number of registrations with a TRE \u3e 5 mm from 9.2% to 1.2% with an overall RMS TRE of 2.3 mm. The methods developed in this work were intended to improve the needle targeting accuracy of 3D TRUS-guided biopsy systems. The successful integration of the techniques into current 3D TRUS-guided systems could improve the overall cancer detection rate during the biopsy and help to achieve earlier diagnosis and fewer repeat biopsy procedures in prostate cancer diagnosis

Fast 4D Ultrasound Registration for Image Guided Liver Interventions

Liver problems are a serious health issue. The common liver problems are hepatitis, fatty liver, liver cancer and liver damage caused by alcohol abuse. Continuous, long term disease may cause a condition of the liver known as the Liver Cirrhosis. Liver cirrhosis makes the liver scarred and hardened up causing portal hypertension. In such a situation the collateral vessels try to bypass the liver as blood cannot freely flow through the liver; causing internal bleeding. One of the treatments of portal hypertension is Transjugular intrahepatic portosystemic shunt (TIPS). In a TIPS procedure a tract in the liver is created that shortcuts two veins in the liver, reducing the portal hypertension. Radiofrequency ablation (RFA) is use for the treatment of liver cancer. In RFA, a needle electrode is placed through the skin into the liver tumor. High-frequency electrical currents are passed through the electrode, creating heat that destroys the cancer cells, without damaging the surrounding liver tissues. TIPS and RFA are minimally invasive procedures, where small incisions are made to perform the surgery and are alternative to open surgery. A minimally invasive alternative has large potential in reducing complication rates, minimizing surgical trauma and reducing hospital stay. However, in these procedures, due to lack of direct eyesight, three-dimensional imaging information about the anatomy and instruments during the intervention is required. The most difficult part of these procedures is the interpretation and selection of oblique views for needle/instrument insertion and target visualization. In our work we develop and evaluate techniques that enable the effective use of 3D ultrasound for image guided interventions. Ultrasound is low cost, mobile and unlike CT and X-rays does not use any harmful radiation in the imaging process. During these procedures, breathing shifts the region of interest and makes it difficult to constantly focus on a region of interest. We provide an approach to correct for the motion due to breathing. Additionally, we propose a method for image fusion of interventional ultrasound and preoperative imaging modalities such as CT for cases where the lesions are visible in CT but not visible in ultrasound. Incorporating CT data during intervention additionally adds greater definition and precision to the ultrasound based navigation system. Concluding, in this thesis, we presented methods and evaluated their accuracies that demonstrate the use of real-time 3D US and its fusion with CT in potentially improving image guidance in minimally invasive US guided liver interventions

Machine learning-based automated segmentation with a feedback loop for 3D synchrotron micro-CT

Die Entwicklung von Synchrotronlichtquellen der dritten Generation hat die Grundlage für die Untersuchung der 3D-Struktur opaker Proben mit einer Auflösung im Mikrometerbereich und höher geschaffen. Dies führte zur Entwicklung der Röntgen-Synchrotron-Mikro-Computertomographie, welche die Schaffung von Bildgebungseinrichtungen zur Untersuchung von Proben verschiedenster Art förderte, z.B. von Modellorganismen, um die Physiologie komplexer lebender Systeme besser zu verstehen. Die Entwicklung moderner Steuerungssysteme und Robotik ermöglichte die vollständige Automatisierung der Röntgenbildgebungsexperimente und die Kalibrierung der Parameter des Versuchsaufbaus während des Betriebs. Die Weiterentwicklung der digitalen Detektorsysteme führte zu Verbesserungen der Auflösung, des Dynamikbereichs, der Empfindlichkeit und anderer wesentlicher Eigenschaften. Diese Verbesserungen führten zu einer beträchtlichen Steigerung des Durchsatzes des Bildgebungsprozesses, aber auf der anderen Seite begannen die Experimente eine wesentlich größere Datenmenge von bis zu Dutzenden von Terabyte zu generieren, welche anschließend manuell verarbeitet wurden. Somit ebneten diese technischen Fortschritte den Weg für die Durchführung effizienterer Hochdurchsatzexperimente zur Untersuchung einer großen Anzahl von Proben, welche Datensätze von besserer Qualität produzierten. In der wissenschaftlichen Gemeinschaft besteht daher ein hoher Bedarf an einem effizienten, automatisierten Workflow für die Röntgendatenanalyse, welcher eine solche Datenlast bewältigen und wertvolle Erkenntnisse für die Fachexperten liefern kann. Die bestehenden Lösungen für einen solchen Workflow sind nicht direkt auf Hochdurchsatzexperimente anwendbar, da sie für Ad-hoc-Szenarien im Bereich der medizinischen Bildgebung entwickelt wurden. Daher sind sie nicht für Hochdurchsatzdatenströme optimiert und auch nicht in der Lage, die hierarchische Beschaffenheit von Proben zu nutzen. Die wichtigsten Beiträge der vorliegenden Arbeit sind ein neuer automatisierter Analyse-Workflow, der für die effiziente Verarbeitung heterogener Röntgendatensätze hierarchischer Natur geeignet ist. Der entwickelte Workflow basiert auf verbesserten Methoden zur Datenvorverarbeitung, Registrierung, Lokalisierung und Segmentierung. Jede Phase eines Arbeitsablaufs, die eine Trainingsphase beinhaltet, kann automatisch feinabgestimmt werden, um die besten Hyperparameter für den spezifischen Datensatz zu finden. Für die Analyse von Faserstrukturen in Proben wurde eine neue, hochgradig parallelisierbare 3D-Orientierungsanalysemethode entwickelt, die auf einem neuartigen Konzept der emittierenden Strahlen basiert und eine präzisere morphologische Analyse ermöglicht. Alle entwickelten Methoden wurden gründlich an synthetischen Datensätzen validiert, um ihre Anwendbarkeit unter verschiedenen Abbildungsbedingungen quantitativ zu bewerten. Es wurde gezeigt, dass der Workflow in der Lage ist, eine Reihe von Datensätzen ähnlicher Art zu verarbeiten. Darüber hinaus werden die effizienten CPU/GPU-Implementierungen des entwickelten Workflows und der Methoden vorgestellt und der Gemeinschaft als Module für die Sprache Python zur Verfügung gestellt. Der entwickelte automatisierte Analyse-Workflow wurde erfolgreich für Mikro-CT-Datensätze angewandt, die in Hochdurchsatzröntgenexperimenten im Bereich der Entwicklungsbiologie und Materialwissenschaft gewonnen wurden. Insbesondere wurde dieser Arbeitsablauf für die Analyse der Medaka-Fisch-Datensätze angewandt, was eine automatisierte Segmentierung und anschließende morphologische Analyse von Gehirn, Leber, Kopfnephronen und Herz ermöglichte. Darüber hinaus wurde die entwickelte Methode der 3D-Orientierungsanalyse bei der morphologischen Analyse von Polymergerüst-Datensätzen eingesetzt, um einen Herstellungsprozess in Richtung wünschenswerter Eigenschaften zu lenken

Políticas de Copyright de Publicações Científicas em Repositórios Institucionais: O Caso do INESC TEC

A progressiva transformação das práticas científicas, impulsionada pelo desenvolvimento das novas Tecnologias de Informação e Comunicação (TIC), têm possibilitado aumentar o acesso à informação, caminhando gradualmente para uma abertura do ciclo de pesquisa. Isto permitirá resolver a longo prazo uma adversidade que se tem colocado aos investigadores, que passa pela existência de barreiras que limitam as condições de acesso, sejam estas geográficas ou financeiras. Apesar da produção científica ser dominada, maioritariamente, por grandes editoras comerciais, estando sujeita às regras por estas impostas, o Movimento do Acesso Aberto cuja primeira declaração pública, a Declaração de Budapeste (BOAI), é de 2002, vem propor alterações significativas que beneficiam os autores e os leitores. Este Movimento vem a ganhar importância em Portugal desde 2003, com a constituição do primeiro repositório institucional a nível nacional. Os repositórios institucionais surgiram como uma ferramenta de divulgação da produção científica de uma instituição, com o intuito de permitir abrir aos resultados da investigação, quer antes da publicação e do próprio processo de arbitragem (preprint), quer depois (postprint), e, consequentemente, aumentar a visibilidade do trabalho desenvolvido por um investigador e a respetiva instituição. O estudo apresentado, que passou por uma análise das políticas de copyright das publicações científicas mais relevantes do INESC TEC, permitiu não só perceber que as editoras adotam cada vez mais políticas que possibilitam o auto-arquivo das publicações em repositórios institucionais, como também que existe todo um trabalho de sensibilização a percorrer, não só para os investigadores, como para a instituição e toda a sociedade. A produção de um conjunto de recomendações, que passam pela implementação de uma política institucional que incentive o auto-arquivo das publicações desenvolvidas no âmbito institucional no repositório, serve como mote para uma maior valorização da produção científica do INESC TEC.The progressive transformation of scientific practices, driven by the development of new Information and Communication Technologies (ICT), which made it possible to increase access to information, gradually moving towards an opening of the research cycle. This opening makes it possible to resolve, in the long term, the adversity that has been placed on researchers, which involves the existence of barriers that limit access conditions, whether geographical or financial. Although large commercial publishers predominantly dominate scientific production and subject it to the rules imposed by them, the Open Access movement whose first public declaration, the Budapest Declaration (BOAI), was in 2002, proposes significant changes that benefit the authors and the readers. This Movement has gained importance in Portugal since 2003, with the constitution of the first institutional repository at the national level. Institutional repositories have emerged as a tool for disseminating the scientific production of an institution to open the results of the research, both before publication and the preprint process and postprint, increase the visibility of work done by an investigator and his or her institution. The present study, which underwent an analysis of the copyright policies of INESC TEC most relevant scientific publications, allowed not only to realize that publishers are increasingly adopting policies that make it possible to self-archive publications in institutional repositories, all the work of raising awareness, not only for researchers but also for the institution and the whole society. The production of a set of recommendations, which go through the implementation of an institutional policy that encourages the self-archiving of the publications developed in the institutional scope in the repository, serves as a motto for a greater appreciation of the scientific production of INESC TEC