Clifford wavelets for fetal ECG extraction

Analysis of the fetal heart rate during pregnancy is essential for monitoring the proper development of the fetus. Current fetal heart monitoring techniques lack the accuracy in fetal heart rate monitoring and features acquisition, resulting in diagnostic medical issues. The challenge lies in the extraction of the fetal ECG from the mother's ECG during pregnancy. This approach has the advantage of being a reliable and non-invasive technique. For this aim, we propose in this paper a wavelet/multi-wavelet method allowing to extract perfectly the feta ECG parameters from the abdominal mother ECG. The method is essentially due to the exploitation of Clifford wavelets as recent variants in the field. We prove that these wavelets are more efficient and performing against classical ones. The experimental results are therefore due to two basic classes of wavelets and multi-wavelets. A first-class is the classical Haar Schauder, and a second one is due to Clifford valued wavelets and multi-wavelets. These results showed that wavelets/multiwavelets are already good bases for the FECG processing, provided that Clifford ones are the best.Comment: 21 pages, 8 figures, 1 tabl

In Vivo Human Right Ventricle Shape and Kinematic Analysis with and without Pulmonary Hypertension

Pulmonary hypertension (PH) is a severe cardio-pulmonary illness which has been commonly observed to induce substantial and ultimately deleterious changes to the human right ventricle (RV) shape and function. As such, the functional state of the RV is thought to be a major determinant of symptoms and survival rates for PH. However, there has been little success to-date to identify clinically obtainable metrics of RV shape and deformation as a means to detect the onset and progression of PH. This difficulty is largely the result of the absence of a proven approach that is generally applicable for consistent and reliable quantitative analysis of anatomical shapes, particularly the RV, between patients and over time. Therefore, a computational framework which can quantitatively analyze RV shape and deformation could be a key to assist in clinically detecting the onset and progression of PH. Statistical shape analysis techniques were developed, implemented, and assessed to analyze variations in human RV endocardial surface (RVES) shapes and kinematics from noninvasive clinical medical imaging data with respect to a spectrum of hemodynamic states. A computational framework for the quantitative analysis and statistical decomposition of sets of 3D genus-0 shapes that combines a modified harmonic mapping approach directly with proper orthogonal decomposition (DM-POD) is presented. The DM-POD approach is shown to be a robust technique for recovering inherent shape-related features through the analysis of sets of artificially generated shapes. The DM-POD approach is then applied to obtain kinematic features of the human RV based on the relative change in shape of the endocardial surface using cardiac computed tomography images. In addition, the kinematic features of the RVES obtained by the DM-POD approach are shown to be consistent and associated with intrinsically physiological components of the heart, and thus may potentially provide a more accurate means for classifying the progressive change in RV function caused by PH, in comparison to traditional clinical hemodynamic and volume-based metrics. Statistical shape analysis for the human RV is further evaluated through analysis of alternate components of the DM-POD approach, as well as through comparison of the DM-POD workflow with an alternate spherical harmonic function-based workflow (SPHARM), with respect to the aspects of surface representation, alignment, and decomposition. Additionally, different ways of utilizing the available imaging data with respect to the classification potential are investigated by considering analysis results when applying both the various DM-POD and SPHARM approaches with several different combinations of the phases captured throughout a single cardiac cycle for the patient set. Lastly, a novel statistical decomposition technique known as independent component analysis (ICA) was incorporated into the statistical shape analysis framework (i.e., DM-POD) to produce an alternative workflow (DM-ICA). Both the DM-POD and DM-ICA approaches are applied to analyze sets of artificially generated data and the human RVES datasets, and the respective results are compared. The DM-POD and DM-ICA workflows are shown to produce consistent, but substantially different results due to the various principles and views of each of the two statistical decomposition algorithms (i.e., POD and ICA). Most importantly, the results from the DM-POD and DM-ICA workflows appear to relate to RV function in unique ways, with respect to both traditional clinical metrics and each other, and have the potential to provide new metrics for better understanding of the human RV and its relationship to PH

Three-dimensional model-based analysis of vascular and cardiac images

This thesis is concerned with the geometrical modeling of organs to perform medical image analysis tasks. The thesis is divided in two main parts devoted to model linear vessel segments and the left ventricle of the heart, respectively. Chapters 2 to 4 present different aspects of a model-based technique for semi-automated quantification of linear vessel segments from 3-D Magnetic Resonance Angiography (MRA). Chapter 2 is concerned with a multiscale filter for the enhancement of vessels in 2-D and 3-D angiograms. Chapter 3 applies the filter developed in Chapter 2 to determine the central vessel axis in 3-D MRA images. This procedure is initialized using an efficient user interaction technique that naturally incorporates the knowledge of the operator about the vessel of interest. Also in this chapter, a linear vessel model is used to recover the position of the vessel wall in order to carry out an accurate quantitative analysis of vascular morphology. Prior knowledge is provided in two main forms: a cylindrical model introduces a shape prior while prior knowledge on the image acquisition (type of MRA technique) is used to define an appropriate vessel boundary criterion. In Chapter 4 an extensive in vitro and in vivo evaluation of the algorithm introduced in Chapter 3 is described. Chapters 5 to 7 change the focus to 3D cardiac image analysis from Magnetic Resonance Imaging. Chapter 5 presents an extensive survey, a categorization and a critical review of the field of cardiac modeling. Chapter 6 and Chapter 7 present successive refinements of a method for building statistical models of shape variability with particular emphasis on cardiac modeling. The method is based on an elastic registration method using hierarchical free-form deformations. A 3D shape model of the left and right ventricles of the heart was constructed. This model contains both the average shape of these organs as well as their shape variability. The methodology presented in the last two chapters could also be applied to other anatomical structures. This has been illustrated in Chapter 6 with examples of geometrical models of the nucleus caudate and the radius

Characterising Shape Variation in the Human Right Ventricle Using Statistical Shape Analysis: Preliminary Outcomes and Potential for Predicting Hypertension in a Clinical Setting

Variations in the shape of the human right ventricle (RV) have previously been shown to be predictive of heart function and long term prognosis in Pulmonary Hypertension (PH), a deadly disease characterised by high blood pressure in the pulmonary arteries. The extent to which ventricular shape is also affected by non-pathological features such as sex, body mass index (BMI) and age is explored in this thesis. If fundamental differences in the shape of a structurally normal RV exist, these might also impact the success of a predictive model. This thesis evaluates the extent to which non-pathological features affect the shape of the RV and determines the best ways, in terms of procedure and analysis, to adapt the model to consistently predict PH. It also identifies areas where the statistical shape analysis procedure is robust, and considers the extent to which specific, non-pathological, characteristics impact the diagnostic potential of the statistical shape model. Finally, recommendations are made on next steps in the development of a classification procedure for PH. The dataset was composed of clinically-obtained, cardiovascular magnetic resonance images (CMR) from two independent sources; The University of Pittsburgh Medical Center and Newcastle University. Shape change is assessed using a 3D statistical shape analysis technique, which topologically maps heart meshes through an harmonic mapping approach to create a unique shape function for each shape. Proper Orthogonal Decomposition (POD) was applied to the complete set of shape functions in order to determine and rank a set of shape features (i.e. modes and corresponding coefficients from the decomposition). MRI scanning protocol produced the most significant difference in shape; a shape mode associated with detail at the RV apex and ventricular length from apex to base strongly correlated with the MRI sequence used to record each subject. Qualitatively, a protocol which skipped slices produced a shorter RV with less detail at the apex. Decomposition of sex, age and BMI also derives unique RV shape descriptors which correspond to anatomically meaningful features. The shape features are shown to be able to predict presence of PH. The predictive model can be improved by including BMI as a factor, but these improvements are mainly concentrated in identification of healthy subjects

Analysis of cardiac motion using MRI and nonrigid image registration

Imperial Users onl

Reconstruction and analysis of 4D heart motion from tagged MR images.

Luo Guo.Thesis (M.Phil.)--Chinese University of Hong Kong, 2003.Includes bibliographical references (leaves 97-109).Abstracts in English and Chinese.Abstract --- p.iAcknowledgement --- p.iiiChapter 1 --- Introduction --- p.1Chapter 1.1 --- Motivation --- p.2Chapter 1.2 --- Basics --- p.3Chapter 1.2.1 --- Anatomy of Human Heart --- p.3Chapter 1.2.2 --- The Philosophy of MRI --- p.5Chapter 1.2.3 --- MRI in Practice --- p.7Chapter 1.3 --- Cardiac MR Images Analysis --- p.7Chapter 1.3.1 --- Heart Boundary Segmentation --- p.7Chapter 1.3.2 --- Motion Reconstruction --- p.13Chapter 1.4 --- Summary and Thesis Overview --- p.17Chapter 2 --- Tracking Tags in SPAMM Images --- p.21Chapter 2.1 --- Introduction --- p.21Chapter 2.2 --- The Snake Model --- p.28Chapter 2.3 --- The Improved Snake Model: Tracking Tags Using Snakes --- p.30Chapter 2.3.1 --- Imaging Protocol --- p.30Chapter 2.3.2 --- Model Formulation --- p.31Chapter 2.3.3 --- Numerical Solution --- p.39Chapter 2.4 --- Experimental Results --- p.44Chapter 3 --- B-Spline Based LV Motion Reconstruction --- p.52Chapter 3.1 --- Introduction --- p.52Chapter 3.2 --- LV Shape: Generalized Deformable Ellipsoid --- p.56Chapter 3.3 --- The New Geometric Model: Generalized Prolate Spheroid --- p.58Chapter 3.3.1 --- Generalized Prolate Spheroid --- p.58Chapter 3.3.2 --- Initial Geometric Fitting --- p.59Chapter 3.4 --- Fast Motion Reconstruction: The Enhanced Hi- erarchical Motion Decomposition --- p.65Chapter 3.4.1 --- Hierarchical Motion Decomposition --- p.65Chapter 3.4.2 --- Motion Reconstruction --- p.68Chapter 3.4.3 --- Implementation --- p.76Chapter 3.4.4 --- Time Smoothing --- p.77Chapter 3.5 --- Experimental Results --- p.79Chapter 3.5.1 --- Geometric Fitting --- p.79Chapter 3.5.2 --- Motion Reconstruction --- p.79Chapter 4 --- Conclusion --- p.93Bibliography --- p.10

Foetal echocardiographic segmentation

Congenital heart disease affects just under one percentage of all live births [1]. Those defects that manifest themselves as changes to the cardiac chamber volumes are the motivation for the research presented in this thesis. Blood volume measurements in vivo require delineation of the cardiac chambers and manual tracing of foetal cardiac chambers is very time consuming and operator dependent. This thesis presents a multi region based level set snake deformable model applied in both 2D and 3D which can automatically adapt to some extent towards ultrasound noise such as attenuation, speckle and partial occlusion artefacts. The algorithm presented is named Mumford Shah Sarti Collision Detection (MSSCD). The level set methods presented in this thesis have an optional shape prior term for constraining the segmentation by a template registered to the image in the presence of shadowing and heavy noise. When applied to real data in the absence of the template the MSSCD algorithm is initialised from seed primitives placed at the centre of each cardiac chamber. The voxel statistics inside the chamber is determined before evolution. The MSSCD stops at open boundaries between two chambers as the two approaching level set fronts meet. This has significance when determining volumes for all cardiac compartments since cardiac indices assume that each chamber is treated in isolation. Comparison of the segmentation results from the implemented snakes including a previous level set method in the foetal cardiac literature show that in both 2D and 3D on both real and synthetic data, the MSSCD formulation is better suited to these types of data. All the algorithms tested in this thesis are within 2mm error to manually traced segmentation of the foetal cardiac datasets. This corresponds to less than 10% of the length of a foetal heart. In addition to comparison with manual tracings all the amorphous deformable model segmentations in this thesis are validated using a physical phantom. The volume estimation of the phantom by the MSSCD segmentation is to within 13% of the physically determined volume

Statistical shape analysis of neuroanatomical structures based on spherical wavelet transformation

Thesis (Ph. D.)--Harvard-MIT Division of Health Sciences and Technology, 2008.Includes bibliographical references.Evidence suggests that morphological changes of neuroanatomical structures may reflect abnormalities in neurodevelopment, or relate to a variety of disorders, such as schizophrenia and Alzheimer's disease (AD). Advances in high-resolution Magnetic Resonance Imaging (MRI) techniques allow us to study these alterations of brain structures in vivo. Previous work in studying the shape variations of brain structures has provided additional localized information compared with traditional volume-based study. However, challenges remain in finding an accurate shape presentation and conducting shape analysis with sound statistical principles. In this work, we develop methods for automatically extracting localized and multi-scale shape features and conducting statistical shape analysis of neuroanatomical structures obtained from MR images. We first develop a procedure to extract multi-scale shape features of brain structures using biorthogonal spherical wavelets. Using this wavelet-based shape representation, we build multi-scale shape models and study the localized cortical folding variations in a normal population using Principal Component Analysis (PCA). We then build a shape-based classification framework for detecting pathological changes of cortical surfaces using advanced classification methods, such as predictive Automatic Relevance Determination (pred-ARD), and demonstrate promising results in patient/control group comparison studies. Thirdly, we develop a nonlinear temporal model for studying the temporal order and regional difference of cortical folding development based on this shape representation. Furthermore, we develop a shape-guided segmentation method to improve the segmentation of sub-cortical structures, such as hippocampus, by using shape constraints obtained in the wavelet domain.(cont.) Finally, we improve upon the proposed wavelet-based shape representation by adopting a newly developed over-complete spherical wavelet transformation and demonstrate its utility in improving the accuracy and stability of shape representations. By using these shape representations and statistical analysis methods, we have demonstrated promising results in localizing shape changes of neuroanatomical structures related to aging, neurological diseases, and neurodevelopment at multiple spatial scales. Identification of these shape changes could potentially lead to more accurate diagnoses and improved understanding of neurodevelopment and neurological diseases.by Peng Yu.Ph.D

Role of machine learning in early diagnosis of kidney diseases.

Machine learning (ML) and deep learning (DL) approaches have been used as indispensable tools in modern artificial intelligence-based computer-aided diagnostic (AIbased CAD) systems that can provide non-invasive, early, and accurate diagnosis of a given medical condition. These AI-based CAD systems have proven themselves to be reproducible and have the generalization ability to diagnose new unseen cases with several diseases and medical conditions in different organs (e.g., kidneys, prostate, brain, liver, lung, breast, and bladder). In this dissertation, we will focus on the role of such AI-based CAD systems in early diagnosis of two kidney diseases, namely: acute rejection (AR) post kidney transplantation and renal cancer (RC). A new renal computer-assisted diagnostic (Renal-CAD) system was developed to precisely diagnose AR post kidney transplantation at an early stage. The developed Renal-CAD system perform the following main steps: (1) auto-segmentation of the renal allograft from surrounding tissues from diffusion weighted magnetic resonance imaging (DW-MRI) and blood oxygen level-dependent MRI (BOLD-MRI), (2) extraction of image markers, namely: voxel-wise apparent diffusion coefficients (ADCs) are calculated from DW-MRI scans at 11 different low and high b-values and then represented as cumulative distribution functions (CDFs) and extraction of the transverse relaxation rate (R2*) values from the segmented kidneys using BOLD-MRI scans at different echotimes, (3) integration of multimodal image markers with the associated clinical biomarkers, serum creatinine (SCr) and creatinine clearance (CrCl), and (4) diagnosing renal allograft status as nonrejection (NR) or AR by utilizing these integrated biomarkers and the developed deep learning classification model built on stacked auto-encoders (SAEs). Using a leaveone- subject-out cross-validation approach along with SAEs on a total of 30 patients with transplanted kidney (AR = 10 and NR = 20), the Renal-CAD system demonstrated 93.3% accuracy, 90.0% sensitivity, and 95.0% specificity in differentiating AR from NR. Robustness of the Renal-CAD system was also confirmed by the area under the curve value of 0.92. Using a stratified 10-fold cross-validation approach, the Renal-CAD system demonstrated its reproduciblity and robustness with a diagnostic accuracy of 86.7%, sensitivity of 80.0%, specificity of 90.0%, and AUC of 0.88. In addition, a new renal cancer CAD (RC-CAD) system for precise diagnosis of RC at an early stage was developed, which incorporates the following main steps: (1) estimating the morphological features by applying a new parametric spherical harmonic technique, (2) extracting appearance-based features, namely: first order textural features are calculated and second order textural features are extracted after constructing the graylevel co-occurrence matrix (GLCM), (3) estimating the functional features by constructing wash-in/wash-out slopes to quantify the enhancement variations across different contrast enhanced computed tomography (CE-CT) phases, (4) integrating all the aforementioned features and modeling a two-stage multilayer perceptron artificial neural network (MLPANN) classifier to classify the renal tumor as benign or malignant and identify the malignancy subtype. On a total of 140 RC patients (malignant = 70 patients (ccRCC = 40 and nccRCC = 30) and benign angiomyolipoma tumors = 70), the developed RC-CAD system was validated using a leave-one-subject-out cross-validation approach. The developed RC-CAD system achieved a sensitivity of 95.3% ± 2.0%, a specificity of 99.9% ± 0.4%, and Dice similarity coefficient of 0.98 ± 0.01 in differentiating malignant from benign renal tumors, as well as an overall accuracy of 89.6% ± 5.0% in the sub-typing of RCC. The diagnostic abilities of the developed RC-CAD system were further validated using a randomly stratified 10-fold cross-validation approach. The results obtained using the proposed MLP-ANN classification model outperformed other machine learning classifiers (e.g., support vector machine, random forests, and relational functional gradient boosting) as well as other different approaches from the literature. In summary, machine and deep learning approaches have shown potential abilities to be utilized to build AI-based CAD systems. This is evidenced by the promising diagnostic performance obtained by both Renal-CAD and RC-CAD systems. For the Renal- CAD, the integration of functional markers extracted from multimodal MRIs with clinical biomarkers using SAEs classification model, potentially improved the final diagnostic results evidenced by high accuracy, sensitivity, and specificity. The developed Renal-CAD demonstrated high feasibility and efficacy for early, accurate, and non-invasive identification of AR. For the RC-CAD, integrating morphological, textural, and functional features extracted from CE-CT images using a MLP-ANN classification model eventually enhanced the final results in terms of accuracy, sensitivity, and specificity, making the proposed RC-CAD a reliable noninvasive diagnostic tool for RC. The early and accurate diagnosis of AR or RC will help physicians to provide early intervention with the appropriate treatment plan to prolong the life span of the diseased kidney, increase the survival chance of the patient, and thus improve the healthcare outcome in the U.S. and worldwide

CAD system for early diagnosis of diabetic retinopathy based on 3D extracted imaging markers.

This dissertation makes significant contributions to the field of ophthalmology, addressing the segmentation of retinal layers and the diagnosis of diabetic retinopathy (DR). The first contribution is a novel 3D segmentation approach that leverages the patientspecific anatomy of retinal layers. This approach demonstrates superior accuracy in segmenting all retinal layers from a 3D retinal image compared to current state-of-the-art methods. It also offers enhanced speed, enabling potential clinical applications. The proposed segmentation approach holds great potential for supporting surgical planning and guidance in retinal procedures such as retinal detachment repair or macular hole closure. Surgeons can benefit from the accurate delineation of retinal layers, enabling better understanding of the anatomical structure and more effective surgical interventions. Moreover, real-time guidance systems can be developed to assist surgeons during procedures, improving overall patient outcomes. The second contribution of this dissertation is the introduction of a novel computeraided diagnosis (CAD) system for precise identification of diabetic retinopathy. The CAD system utilizes 3D-OCT imaging and employs an innovative approach that extracts two distinct features: first-order reflectivity and 3D thickness. These features are then fused and used to train and test a neural network classifier. The proposed CAD system exhibits promising results, surpassing other machine learning and deep learning algorithms commonly employed in DR detection. This demonstrates the effectiveness of the comprehensive analysis approach employed by the CAD system, which considers both low-level and high-level data from the 3D retinal layers. The CAD system presents a groundbreaking contribution to the field, as it goes beyond conventional methods, optimizing backpropagated neural networks to integrate multiple levels of information effectively. By achieving superior performance, the proposed CAD system showcases its potential in accurately diagnosing DR and aiding in the prevention of vision loss. In conclusion, this dissertation presents novel approaches for the segmentation of retinal layers and the diagnosis of diabetic retinopathy. The proposed methods exhibit significant improvements in accuracy, speed, and performance compared to existing techniques, opening new avenues for clinical applications and advancements in the field of ophthalmology. By addressing future research directions, such as testing on larger datasets, exploring alternative algorithms, and incorporating user feedback, the proposed methods can be further refined and developed into robust, accurate, and clinically valuable tools for diagnosing and monitoring retinal diseases