Coronary Artery Centerline Extraction in Cardiac CT Angiography Using a CNN-Based Orientation Classifier

Coronary artery centerline extraction in cardiac CT angiography (CCTA) images is a prerequisite for evaluation of stenoses and atherosclerotic plaque. We propose an algorithm that extracts coronary artery centerlines in CCTA using a convolutional neural network (CNN). A 3D dilated CNN is trained to predict the most likely direction and radius of an artery at any given point in a CCTA image based on a local image patch. Starting from a single seed point placed manually or automatically anywhere in a coronary artery, a tracker follows the vessel centerline in two directions using the predictions of the CNN. Tracking is terminated when no direction can be identified with high certainty. The CNN was trained using 32 manually annotated centerlines in a training set consisting of 8 CCTA images provided in the MICCAI 2008 Coronary Artery Tracking Challenge (CAT08). Evaluation using 24 test images of the CAT08 challenge showed that extracted centerlines had an average overlap of 93.7% with 96 manually annotated reference centerlines. Extracted centerline points were highly accurate, with an average distance of 0.21 mm to reference centerline points. In a second test set consisting of 50 CCTA scans, 5,448 markers in the coronary arteries were used as seed points to extract single centerlines. This showed strong correspondence between extracted centerlines and manually placed markers. In a third test set containing 36 CCTA scans, fully automatic seeding and centerline extraction led to extraction of on average 92% of clinically relevant coronary artery segments. The proposed method is able to accurately and efficiently determine the direction and radius of coronary arteries. The method can be trained with limited training data, and once trained allows fast automatic or interactive extraction of coronary artery trees from CCTA images.Comment: Accepted in Medical Image Analysi

Contrast-enhanced micro-computed tomography and image processing integrated approach for microstructural analysis of biological soft fibrous tissues

Nel sistema muscolo-scheletrico, tendini e legamenti svolgono un ruolo importante al fine di garantire mobilità e stabilità. Questi tessuti sono composti principalmente da collagene e presentano una struttura altamente fibrosa. Evidenziare i componenti della microstruttura di legamenti e tendini in immagini tridimensionali (3D) è di fondamentale importanza per estrarre informazioni significative che posso anvere ripercussioni sulla scienza di base e sulle applicazioni ortopediche. In particolare, le proprietà meccaniche delle microstrutture fibrose sono fortemente influenzate da alcune caratteristiche geometriche, come la volume fraction, l’orientamento e il diametro; tuttavia, determinare l'orientamento e il diametro della fibra 3D è impegnativo. In questa prospettiva, questa tesi mirava ad unire tomografia microcomputerizzata (microCT) ed elaborazione delle immagini in un approccio integrato al fine di identificare e migliorare le informazioni microstrutturali sui tessuti biologici fibrosi, includendo i dati di volume e orientamento. La procedura complessiva è stata applicata per la prima volta su campioni di tendine del ginocchio umano e su legamento collaterale bovino. In una prima fase, sono state testate preparazioni specifiche del campione, inclusa una disidratazione chimica o soluzioni di acido fosfotungstico (PTA) al 2 % in acqua (H2O) o in soluzione di etanolo al 70% (EtOH), così da migliorare il contrasto dell'immagine di questi specifici tessuti. Inoltre, utilizzando i dati scansionati, è stata sviluppata una nuova tecnica di elaborazione delle immagini basata sul filtro 3D hessiano multiscala per evidenziare le strutture fibrose ed ottenere informazioni quantitative sulle fibre. È interessante notare che, per qualsiasi strategia di preparazione del campione di tendini/legamenti, l'approccio proposto è risultato adeguato per rilevare e caratterizzare le proprietà del fascicolo. I risultati del test hanno mostrato che la disposizione delle fibre è fortemente allineata lungo la direzione longitudinale principale nel tendine del tendine, più delle fibre del legamento collaterale bovino. Inoltre, questa tecnica è stata ulteriormente applicata al fine di determinare come il Legamento Crociato Anteriore (LCA) umano risponda a carichi uniassiali rispetto a valori crescenti di deformazione, considerando sia un tessuto sano che uno in condizioni patologiche, cioè acquisito da un paziente con l'artrosi. Anche in questi casi, l'approccio integrato si è rivelato valido ed affidabile nell'individuare orientamento e dimensione dei fascicoli presenti e, quindi, attraverso un modello meccanico strutturale - basato su specifiche leggi costitutive - nello stimare il modulo elastico di questi tessuti. Sono state infatti stimate le curve sforzo-deformazione, ottenendo un valore di modulo elastico di 60.8 MPa e 7.7 MPa rispettivamente per il LCA sano e patologico. In conclusione, è stato progettato e validato in via preliminare un nuovo protocollo microCT per il miglioramento del contrasto dedicato all'analisi microstrutturale dei tessuti molli biologici con caratteristiche fibrose. In una peculiare applicazione al LCA, le informazioni ottenute con il protocollo sono state utilizzate per implementare un modello meccanico dei tessuti fibrosi, stimando così il comportamento biomeccanico dei tessuti sani e patologici.ABSTRACT In the musculoskeletal system, tendons and ligaments play an important role in ensuring mobility and stability. These tissues are primarily composed of collagen and present a highly fibrous structure. Highlighting the microstructure components of ligaments and tendons in three-dimensional (3D) images is crucial for extracting meaningful information impacting basic science and orthopaedic applications. In particular, the mechanical properties of the fibrous microstructures are strongly influenced by their volume fraction, orientation, and diameter. However, determining the 3D fibre orientation and diameter is challenging. In this picture, this thesis aimed at integrating microcomputed tomography (microCT) and image processing approach to identify and enhance microstructural information about biological soft fibrous tissues, including volume and orientation. The overall procedure was first applied on human hamstring tendon and bovine collateral ligament samples. In a first phase specific sample preparations – including either a chemical dehydration, or by 2% of phosphotungstic acid (PTA) in water (H2O) or in 70% ethanol (EtOH) solution – were tested to enhance image contrast of these specific soft tissues. Further, using the scanned data, a novel image processing technique based on 3D Hessian multiscale filter for highlighting fibrous structures was developed to obtain quantitative fibre information. Interestingly, for any strategy of tendon/ligament sample preparation, the proposed approach was adequate for detecting and characterizing fascicle features. The test results showed the fibre arrangement strongly aligned along the main longitudinal direction in the human hamstring tendon more than fibres on the bovine collateral ligament. Moreover, this technique was further applied in order to determine how the human Anterior Cruciate Ligament (ACL) responds to uniaxial loads with respect to increasing values of strain, considering both a healthy tissue and a one under pathological conditions, i.e., acquired from a patient with osteoarthritis. Also in these cases, the integrated approach was valuable and reliable in identifying orientation and size of present fascicles and, thus, through a structural mechanical model - based on specific constitutive law - to estimate the elastic modulus of these tissues. In fact, stress-strain curves were estimated, obtaining a value of elastic modulus of 60.8 MPa and 7.7 MPa for the healthy and pathological ACLs, respectively. In conclusion, a novel contrast enhancement microCT protocol was designed and preliminarily validated for the microstructural analysis of biological soft fibrous tissues. In a peculiar application to ACL, the information obtained with the protocol was used to implement a mechanical model of fibrous tissues, thus estimating the biomechanical behaviour of the healthy and pathological tissues

Comparing algorithms for automated vessel segmentation in computed tomography scans of the lung: the VESSEL12 study

The VESSEL12 (VESsel SEgmentation in the Lung) challenge objectively compares the performance of different algorithms to identify vessels in thoracic computed tomography (CT) scans. Vessel segmentation is fundamental in computer aided processing of data generated by 3D imaging modalities. As manual vessel segmentation is prohibitively time consuming, any real world application requires some form of automation. Several approaches exist for automated vessel segmentation, but judging their relative merits is difficult due to a lack of standardized evaluation. We present an annotated reference dataset containing 20 CT scans and propose nine categories to perform a comprehensive evaluation of vessel segmentation algorithms from both academia and industry. Twenty algorithms participated in the VESSEL12 challenge, held at International Symposium on Biomedical Imaging (ISBI) 2012. All results have been published at the VESSEL12 website http://vessel12.grand-challenge.org. The challenge remains ongoing and open to new participants. Our three contributions are: (1) an annotated reference dataset available online for evaluation of new algorithms; (2) a quantitative scoring system for objective comparison of algorithms; and (3) performance analysis of the strengths and weaknesses of the various vessel segmentation methods in the presence of various lung diseases.Rudyanto, RD.; Kerkstra, S.; Van Rikxoort, EM.; Fetita, C.; Brillet, P.; Lefevre, C.; Xue, W.... (2014). Comparing algorithms for automated vessel segmentation in computed tomography scans of the lung: the VESSEL12 study. Medical Image Analysis. 18(7):1217-1232. doi:10.1016/j.media.2014.07.003S1217123218

Coronary Artery Segmentation and Motion Modelling

Conventional coronary artery bypass surgery requires invasive sternotomy and the use of a cardiopulmonary bypass, which leads to long recovery period and has high infectious potential. Totally endoscopic coronary artery bypass (TECAB) surgery based on image guided robotic surgical approaches have been developed to allow the clinicians to conduct the bypass surgery off-pump with only three pin holes incisions in the chest cavity, through which two robotic arms and one stereo endoscopic camera are inserted. However, the restricted field of view of the stereo endoscopic images leads to possible vessel misidentification and coronary artery mis-localization. This results in 20-30% conversion rates from TECAB surgery to the conventional approach. We have constructed patient-specific 3D + time coronary artery and left ventricle motion models from preoperative 4D Computed Tomography Angiography (CTA) scans. Through temporally and spatially aligning this model with the intraoperative endoscopic views of the patient's beating heart, this work assists the surgeon to identify and locate the correct coronaries during the TECAB precedures. Thus this work has the prospect of reducing the conversion rate from TECAB to conventional coronary bypass procedures. This thesis mainly focus on designing segmentation and motion tracking methods of the coronary arteries in order to build pre-operative patient-specific motion models. Various vessel centreline extraction and lumen segmentation algorithms are presented, including intensity based approaches, geometric model matching method and morphology-based method. A probabilistic atlas of the coronary arteries is formed from a group of subjects to facilitate the vascular segmentation and registration procedures. Non-rigid registration framework based on a free-form deformation model and multi-level multi-channel large deformation diffeomorphic metric mapping are proposed to track the coronary motion. The methods are applied to 4D CTA images acquired from various groups of patients and quantitatively evaluated

Data driven and physics based methods to assess the mechanical response of advanced materials: from experiments to efficient predictions

L'abstract è presente nell'allegato / the abstract is in the attachmen