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

Medical image analysis methods for anatomical surface reconstruction using tracked 3D ultrasound

The thesis focuses on a study of techniques for acquisition and reconstruction of surface data from anatomical objects by means of tracked 3D ultrasound. In the context of the work two experimental scanning systems are developed and tested on both artificial objects and biological tissues. The first system is based on the freehand ultrasound principle and utilizes a conventional 2D ultrasound transducer coupled with an electromechanical 3D position tracker. The main properties and the basic features of this system are discussed. A number of experiments show that its accuracy in the close to ideal conditions reaches 1.2 mm RMS. The second proposed system implements the sequential triggered scanning approach. The system consists of an ultrasound machine, a workstation and a scanning body (a moving tank filled with liquid and a transducer fixation block) that performs transducer positioning and tracking functions. The system is tested on artificial and real bones. The performed experiments illustrate that it provides significantly better accuracy than the freehand ultrasound (about 0.2 mm RMS) and allows acquiring regular data with a good precision. This makes such a system a promising tool for orthopaedic and trauma surgeons during contactless X-ray-free examinations of injured extremities. The second major subject of the thesis concerns development of medical image analysis methods for 3D surface reconstruction and 2D object detection. We introduce a method based on mesh-growing surface reconstruction that is designed for noisy and sparse data received from 3D tracked ultrasound scanners. A series of experiments on synthetic and ultrasound data show an appropriate reconstruction accuracy. The reconstruction error is measured as the averaged distance between the faces of the mesh and the points from the cloud. Dependently on the initial settings of the method the error varies in range 0.04 - 0.2% for artificial data and 0.3 - 0.7 mm for ultrasound bone data. The reconstructed surfaces correctly interpolate the original point clouds and demonstrate proper smoothness. The next significant problem considered in the work is 2D object detection. Although medical object detection is not integrated into the developed scanning systems, it can be used as a possible further extension of the systems for automatic detection of specific anatomical structures. We analyse the existent object detection methods and introduce a modification of the one based on the popular Generalized Hough Transform (GHT). Unlike the original GHT, the developed method is invariant to rotation and uniform scaling, and uses an intuitive two-point parametrization. We propose several implementations of the feature-to-vote conversion function with the corresponding vote analysis principles. Special attention is devoted to a study of the hierarchical vote analysis and its probabilistic properties. We introduce a parameter space subdivision strategy that reduces the probability of vote peak omission, and show that it can be efficiently implemented in practice using the Gumbel probability distribution

Characterising pattern asymmetry in pigmented skin lesions

Abstract. In clinical diagnosis of pigmented skin lesions asymmetric pigmentation is often indicative of melanoma. This paper describes a method and measures for characterizing lesion symmetry. The estimate of mirror symmetry is computed first for a number of axes at different degrees of rotation with respect to the lesion centre. The statistics of these estimates are the used to assess the overall symmetry. The method is applied to three different lesion representations showing the overall pigmentation, the pigmentation pattern, and the pattern of dermal melanin. The best measure is a 100% sensitive and 96% specific indicator of melanoma on a test set of 33 lesions, with a separate training set consisting of 66 lesions

Combinatorial optimisation for arterial image segmentation.

Cardiovascular disease is one of the leading causes of the mortality in the western world. Many imaging modalities have been used to diagnose cardiovascular diseases. However, each has different forms of noise and artifacts that make the medical image analysis field important and challenging. This thesis is concerned with developing fully automatic segmentation methods for cross-sectional coronary arterial imaging in particular, intra-vascular ultrasound and optical coherence tomography, by incorporating prior and tracking information without any user intervention, to effectively overcome various image artifacts and occlusions. Combinatorial optimisation methods are proposed to solve the segmentation problem in polynomial time. A node-weighted directed graph is constructed so that the vessel border delineation is considered as computing a minimum closed set. A set of complementary edge and texture features is extracted. Single and double interface segmentation methods are introduced. Novel optimisation of the boundary energy function is proposed based on a supervised classification method. Shape prior model is incorporated into the segmentation framework based on global and local information through the energy function design and graph construction. A combination of cross-sectional segmentation and longitudinal tracking is proposed using the Kalman filter and the hidden Markov model. The border is parameterised using the radial basis functions. The Kalman filter is used to adapt the inter-frame constraints between every two consecutive frames to obtain coherent temporal segmentation. An HMM-based border tracking method is also proposed in which the emission probability is derived from both the classification-based cost function and the shape prior model. The optimal sequence of the hidden states is computed using the Viterbi algorithm. Both qualitative and quantitative results on thousands of images show superior performance of the proposed methods compared to a number of state-of-the-art segmentation methods

Multi-scale active shape description in medical imaging

Shape description in medical imaging has become an increasingly important research field in recent years. Fast and high-resolution image acquisition methods like Magnetic Resonance (MR) imaging produce very detailed cross-sectional images of the human body - shape description is then a post-processing operation which abstracts quantitative descriptions of anatomically relevant object shapes. This task is usually performed by clinicians and other experts by first segmenting the shapes of interest, and then making volumetric and other quantitative measurements. High demand on expert time and inter- and intra-observer variability impose a clinical need of automating this process. Furthermore, recent studies in clinical neurology on the correspondence between disease status and degree of shape deformations necessitate the use of more sophisticated, higher-level shape description techniques. In this work a new hierarchical tool for shape description has been developed, combining two recently developed and powerful techniques in image processing: differential invariants in scale-space, and active contour models. This tool enables quantitative and qualitative shape studies at multiple levels of image detail, exploring the extra image scale degree of freedom. Using scale-space continuity, the global object shape can be detected at a coarse level of image detail, and finer shape characteristics can be found at higher levels of detail or scales. New methods for active shape evolution and focusing have been developed for the extraction of shapes at a large set of scales using an active contour model whose energy function is regularized with respect to scale and geometric differential image invariants. The resulting set of shapes is formulated as a multiscale shape stack which is analysed and described for each scale level with a large set of shape descriptors to obtain and analyse shape changes across scales. This shape stack leads naturally to several questions in regard to variable sampling and appropriate levels of detail to investigate an image. The relationship between active contour sampling precision and scale-space is addressed. After a thorough review of modem shape description, multi-scale image processing and active contour model techniques, the novel framework for multi-scale active shape description is presented and tested on synthetic images and medical images. An interesting result is the recovery of the fractal dimension of a known fractal boundary using this framework. Medical applications addressed are grey-matter deformations occurring for patients with epilepsy, spinal cord atrophy for patients with Multiple Sclerosis, and cortical impairment for neonates. Extensions to non-linear scale-spaces, comparisons to binary curve and curvature evolution schemes as well as other hierarchical shape descriptors are discussed