Image Registration to Map Endoscopic Video to Computed Tomography for Head and Neck Radiotherapy Patients

The purpose of this work was to explore the feasibility of registering endoscopic video to radiotherapy treatment plans for patients with head and neck cancer without physical tracking of the endoscope during the examination. Endoscopy-CT registration would provide a clinical tool that could be used to enhance the treatment planning process and would allow for new methods to study the incidence of radiation-related toxicity. Endoscopic video frames were registered to CT by optimizing virtual endoscope placement to maximize the similarity between the frame and the virtual image. Virtual endoscopic images were rendered using a polygonal mesh created by segmenting the airways of the head and neck with a density threshold. The optical properties of the virtual endoscope were matched to a calibrated model of the real endoscope. A novel registration algorithm was developed that takes advantage of physical constraints on the endoscope to effectively search the airways of the head and neck for the desired virtual endoscope coordinates. This algorithm was tested on rigid phantoms with embedded point markers and protruding bolus material. In these tests, the median registration accuracy was 3.0 mm for point measurements and 3.5 mm for surface measurements. The algorithm was also tested on four endoscopic examinations of three patients, in which it achieved a median registration accuracy of 9.9 mm. The uncertainties caused by the non-rigid anatomy of the head and neck and differences in patient positioning between endoscopic examinations and CT scans were examined by taking repeated measurements after placing the virtual endoscope in surface meshes created from different CT scans. Non-rigid anatomy introduced errors on the order of 1-3 mm. Patient positioning had a larger impact, introducing errors on the order of 3.5-4.5 mm. Endoscopy-CT registration in the head and neck is possible, but large registration errors were found in patients. The uncertainty analyses suggest a lower limit of 3-5 mm. Further development is required to achieve an accuracy suitable for clinical use

Accurate geometry reconstruction of vascular structures using implicit splines

3-D visualization of blood vessel from standard medical datasets (e.g. CT or MRI) play an important role in many clinical situations, including the diagnosis of vessel stenosis, virtual angioscopy, vascular surgery planning and computer aided vascular surgery. However, unlike other human organs, the vasculature system is a very complex network of vessel, which makes it a very challenging task to perform its 3-D visualization. Conventional techniques of medical volume data visualization are in general not well-suited for the above-mentioned tasks. This problem can be solved by reconstructing vascular geometry. Although various methods have been proposed for reconstructing vascular structures, most of these approaches are model-based, and are usually too ideal to correctly represent the actual variation presented by the cross-sections of a vascular structure. In addition, the underlying shape is usually expressed as polygonal meshes or in parametric forms, which is very inconvenient for implementing ramification of branching. As a result, the reconstructed geometries are not suitable for computer aided diagnosis and computer guided minimally invasive vascular surgery. In this research, we develop a set of techniques associated with the geometry reconstruction of vasculatures, including segmentation, modelling, reconstruction, exploration and rendering of vascular structures. The reconstructed geometry can not only help to greatly enhance the visual quality of 3-D vascular structures, but also provide an actual geometric representation of vasculatures, which can provide various benefits. The key findings of this research are as follows: 1. A localized hybrid level-set method of segmentation has been developed to extract the vascular structures from 3-D medical datasets. 2. A skeleton-based implicit modelling technique has been proposed and applied to the reconstruction of vasculatures, which can achieve an accurate geometric reconstruction of the vascular structures as implicit surfaces in an analytical form. 3. An accelerating technique using modern GPU (Graphics Processing Unit) is devised and applied to rendering the implicitly represented vasculatures. 4. The implicitly modelled vasculature is investigated for the application of virtual angioscopy

Optical techniques for 3D surface reconstruction in computer-assisted laparoscopic surgery

One of the main challenges for computer-assisted surgery (CAS) is to determine the intra-opera- tive morphology and motion of soft-tissues. This information is prerequisite to the registration of multi-modal patient-specific data for enhancing the surgeon’s navigation capabilites by observ- ing beyond exposed tissue surfaces and for providing intelligent control of robotic-assisted in- struments. In minimally invasive surgery (MIS), optical techniques are an increasingly attractive approach for in vivo 3D reconstruction of the soft-tissue surface geometry. This paper reviews the state-of-the-art methods for optical intra-operative 3D reconstruction in laparoscopic surgery and discusses the technical challenges and future perspectives towards clinical translation. With the recent paradigm shift of surgical practice towards MIS and new developments in 3D opti- cal imaging, this is a timely discussion about technologies that could facilitate complex CAS procedures in dynamic and deformable anatomical regions

Wireless capsule gastrointestinal endoscopy: direction of arrival estimation based localization survey

One of the significant challenges in Capsule Endoscopy (CE) is to precisely determine the pathologies location. The localization process is primarily estimated using the received signal strength from sensors in the capsule system through its movement in the gastrointestinal (GI) tract. Consequently, the wireless capsule endoscope (WCE) system requires improvement to handle the lack of the capsule instantaneous localization information and to solve the relatively low transmission data rate challenges. Furthermore, the association between the capsule’s transmitter position, capsule location, signal reduction and the capsule direction should be assessed. These measurements deliver significant information for the instantaneous capsule localization systems based on TOA (time of arrival) approach, PDOA (phase difference of arrival), RSS (received signal strength), electromagnetic, DOA (direction of arrival) and video tracking approaches are developed to locate the WCE precisely. The current article introduces the acquisition concept of the GI medical images using the endoscopy with a comprehensive description of the endoscopy system components. Capsule localization and tracking are considered to be the most important features of the WCE system, thus the current article emphasizes the most common localization systems generally, highlighting the DOA-based localization systems and discusses the required significant research challenges to be addressed

Vision-based retargeting for endoscopic navigation

Endoscopy is a standard procedure for visualising the human gastrointestinal tract. With the advances in biophotonics, imaging techniques such as narrow band imaging, confocal laser endomicroscopy, and optical coherence tomography can be combined with normal endoscopy for assisting the early diagnosis of diseases, such as cancer. In the past decade, optical biopsy has emerged to be an effective tool for tissue analysis, allowing in vivo and in situ assessment of pathological sites with real-time feature-enhanced microscopic images. However, the non-invasive nature of optical biopsy leads to an intra-examination retargeting problem, which is associated with the difficulty of re-localising a biopsied site consistently throughout the whole examination. In addition to intra-examination retargeting, retargeting of a pathological site is even more challenging across examinations, due to tissue deformation and changing tissue morphologies and appearances. The purpose of this thesis is to address both the intra- and inter-examination retargeting problems associated with optical biopsy. We propose a novel vision-based framework for intra-examination retargeting. The proposed framework is based on combining visual tracking and detection with online learning of the appearance of the biopsied site. Furthermore, a novel cascaded detection approach based on random forests and structured support vector machines is developed to achieve efficient retargeting. To cater for reliable inter-examination retargeting, the solution provided in this thesis is achieved by solving an image retrieval problem, for which an online scene association approach is proposed to summarise an endoscopic video collected in the first examination into distinctive scenes. A hashing-based approach is then used to learn the intrinsic representations of these scenes, such that retargeting can be achieved in subsequent examinations by retrieving the relevant images using the learnt representations. For performance evaluation of the proposed frameworks, extensive phantom, ex vivo and in vivo experiments have been conducted, with results demonstrating the robustness and potential clinical values of the methods proposed.Open Acces

On Simultaneous Localization and Mapping inside the Human Body (Body-SLAM)

Wireless capsule endoscopy (WCE) offers a patient-friendly, non-invasive and painless investigation of the entire small intestine, where other conventional wired endoscopic instruments can barely reach. As a critical component of the capsule endoscopic examination, physicians need to know the precise position of the endoscopic capsule in order to identify the position of intestinal disease after it is detected by the video source. To define the position of the endoscopic capsule, we need to have a map of inside the human body. However, since the shape of the small intestine is extremely complex and the RF signal propagates differently in the non-homogeneous body tissues, accurate mapping and localization inside small intestine is very challenging. In this dissertation, we present an in-body simultaneous localization and mapping technique (Body-SLAM) to enhance the positioning accuracy of the WCE inside the small intestine and reconstruct the trajectory the capsule has traveled. In this way, the positions of the intestinal diseases can be accurately located on the map of inside human body, therefore, facilitates the following up therapeutic operations. The proposed approach takes advantage of data fusion from two sources that come with the WCE: image sequences captured by the WCE\u27s embedded camera and the RF signal emitted by the capsule. This approach estimates the speed and orientation of the endoscopic capsule by analyzing displacements of feature points between consecutive images. Then, it integrates this motion information with the RF measurements by employing a Kalman filter to smooth the localization results and generate the route that the WCE has traveled. The performance of the proposed motion tracking algorithm is validated using empirical data from the patients and this motion model is later imported into a virtual testbed to test the performance of the alternative Body-SLAM algorithms. Experimental results show that the proposed Body-SLAM technique is able to provide accurate tracking of the WCE with average error of less than 2.3cm

Large Model Visualization : Techniques and Applications

The size of datasets in scientific computing is rapidly increasing. This increase is caused by a boost of processing power in the past years, which in turn was invested in an increase of the accuracy and the size of the models. A similar trend enabled a significant improvement of medical scanners; more than 1000 slices of a resolution of 512x512 can be generated by modern scanners in daily practice. Even in computer-aided engineering typical models eas-ily contain several million polygons. Unfortunately, the data complexity is growing faster than the rendering performance of modern computer systems. This is not only due to the slower growing graphics performance of the graphics subsystems, but in particular because of the significantly slower growing memory bandwidth for the transfer of the geometry and image data from the main memory to the graphics accelerator. Large model visualization addresses this growing divide between data complexity and rendering performance. Most methods focus on the reduction of the geometric or pixel complexity, and hence also the memory bandwidth requirements are reduced. In this dissertation, we discuss new approaches from three different research areas. All approaches target at the reduction of the processing complexity to achieve an interactive visualization of large datasets. In the second part, we introduce applications of the presented ap-proaches. Specifically, we introduce the new VIVENDI system for the interactive virtual endoscopy and other applications from mechanical engineering, scientific computing, and architecture.The size of datasets in scientific computing is rapidly increasing. This increase is caused by a boost of processing power in the past years, which in turn was invested in an increase of the accuracy and the size of the models. A similar trend enabled a significant improvement of medical scanners; more than 1000 slices of a resolution of 512x512 can be generated by modern scanners in daily practice. Even in computer-aided engineering typical models eas-ily contain several million polygons. Unfortunately, the data complexity is growing faster than the rendering performance of modern computer systems. This is not only due to the slower growing graphics performance of the graphics subsystems, but in particular because of the significantly slower growing memory bandwidth for the transfer of the geometry and image data from the main memory to the graphics accelerator. Large model visualization addresses this growing divide between data complexity and rendering performance. Most methods focus on the reduction of the geometric or pixel complexity, and hence also the memory bandwidth requirements are reduced. In this dissertation, we discuss new approaches from three different research areas. All approaches target at the reduction of the processing complexity to achieve an interactive visualization of large datasets. In the second part, we introduce applications of the presented ap-proaches. Specifically, we introduce the new VIVENDI system for the interactive virtual endoscopy and other applications from mechanical engineering, scientific computing, and architecture