Development, Implementation and Pre-clinical Evaluation of Medical Image Computing Tools in Support of Computer-aided Diagnosis: Respiratory, Orthopedic and Cardiac Applications

Over the last decade, image processing tools have become crucial components of all clinical and research efforts involving medical imaging and associated applications. The imaging data available to the radiologists continue to increase their workload, raising the need for efficient identification and visualization of the required image data necessary for clinical assessment. Computer-aided diagnosis (CAD) in medical imaging has evolved in response to the need for techniques that can assist the radiologists to increase throughput while reducing human error and bias without compromising the outcome of the screening, diagnosis or disease assessment. More intelligent, but simple, consistent and less time-consuming methods will become more widespread, reducing user variability, while also revealing information in a more clear, visual way. Several routine image processing approaches, including localization, segmentation, registration, and fusion, are critical for enhancing and enabling the development of CAD techniques. However, changes in clinical workflow require significant adjustments and re-training and, despite the efforts of the academic research community to develop state-of-the-art algorithms and high-performance techniques, their footprint often hampers their clinical use. Currently, the main challenge seems to not be the lack of tools and techniques for medical image processing, analysis, and computing, but rather the lack of clinically feasible solutions that leverage the already developed and existing tools and techniques, as well as a demonstration of the potential clinical impact of such tools. Recently, more and more efforts have been dedicated to devising new algorithms for localization, segmentation or registration, while their potential and much intended clinical use and their actual utility is dwarfed by the scientific, algorithmic and developmental novelty that only result in incremental improvements over already algorithms. In this thesis, we propose and demonstrate the implementation and evaluation of several different methodological guidelines that ensure the development of image processing tools --- localization, segmentation and registration --- and illustrate their use across several medical imaging modalities --- X-ray, computed tomography, ultrasound and magnetic resonance imaging --- and several clinical applications: Lung CT image registration in support for assessment of pulmonary nodule growth rate and disease progression from thoracic CT images. Automated reconstruction of standing X-ray panoramas from multi-sector X-ray images for assessment of long limb mechanical axis and knee misalignment. Left and right ventricle localization, segmentation, reconstruction, ejection fraction measurement from cine cardiac MRI or multi-plane trans-esophageal ultrasound images for cardiac function assessment. When devising and evaluating our developed tools, we use clinical patient data to illustrate the inherent clinical challenges associated with highly variable imaging data that need to be addressed before potential pre-clinical validation and implementation. In an effort to provide plausible solutions to the selected applications, the proposed methodological guidelines ensure the development of image processing tools that help achieve sufficiently reliable solutions that not only have the potential to address the clinical needs, but are sufficiently streamlined to be potentially translated into eventual clinical tools provided proper implementation. G1: Reducing the number of degrees of freedom (DOF) of the designed tool, with a plausible example being avoiding the use of inefficient non-rigid image registration methods. This guideline addresses the risk of artificial deformation during registration and it clearly aims at reducing complexity and the number of degrees of freedom. G2: The use of shape-based features to most efficiently represent the image content, either by using edges instead of or in addition to intensities and motion, where useful. Edges capture the most useful information in the image and can be used to identify the most important image features. As a result, this guideline ensures a more robust performance when key image information is missing. G3: Efficient method of implementation. This guideline focuses on efficiency in terms of the minimum number of steps required and avoiding the recalculation of terms that only need to be calculated once in an iterative process. An efficient implementation leads to reduced computational effort and improved performance. G4: Commence the workflow by establishing an optimized initialization and gradually converge toward the final acceptable result. This guideline aims to ensure reasonable outcomes in consistent ways and it avoids convergence to local minima, while gradually ensuring convergence to the global minimum solution. These guidelines lead to the development of interactive, semi-automated or fully-automated approaches that still enable the clinicians to perform final refinements, while they reduce the overall inter- and intra-observer variability, reduce ambiguity, increase accuracy and precision, and have the potential to yield mechanisms that will aid with providing an overall more consistent diagnosis in a timely fashion

Modeling and Simulation in Engineering

This book provides an open platform to establish and share knowledge developed by scholars, scientists, and engineers from all over the world, about various applications of the modeling and simulation in the design process of products, in various engineering fields. The book consists of 12 chapters arranged in two sections (3D Modeling and Virtual Prototyping), reflecting the multidimensionality of applications related to modeling and simulation. Some of the most recent modeling and simulation techniques, as well as some of the most accurate and sophisticated software in treating complex systems, are applied. All the original contributions in this book are jointed by the basic principle of a successful modeling and simulation process: as complex as necessary, and as simple as possible. The idea is to manipulate the simplifying assumptions in a way that reduces the complexity of the model (in order to make a real-time simulation), but without altering the precision of the results

Research and Technology Objectives and Plans Summary (RTOPS)

This publication represents the NASA research and technology program for FY89. It is a compilation of the Summary portions of each of the RTOPs (Research and Technology Objectives and Plans) used for management review and control of research currently in progress throughout NASA. The RTOP Summary is designed to facilitate communication and coordination among concerned technical personnel in government, in industry, and in universities. The first section containing citations and abstracts of the RTOPs is followed by four indexes: Subject, Technical Monitor, Responsible NASA Organization, and RTOP Number

EVOLUTION OF THE SUBCONTINENTAL LITHOSPHERE DURING MESOZOIC TETHYAN RIFTING: CONSTRAINTS FROM THE EXTERNAL LIGURIAN MANTLE SECTION (NORTHERN APENNINE, ITALY)

Our study is focussed on mantle bodies from the External Ligurian ophiolites, within the Monte Gavi and Monte Sant'Agostino areas. Here, two distinct pyroxenite-bearing mantle sections were recognized, mainly based on their plagioclase-facies evolution. The Monte Gavi mantle section is nearly undeformed and records reactive melt infiltration under plagioclase-facies conditions. This process involved both peridotites (clinopyroxene-poor lherzolites) and enclosed spinel pyroxenite layers, and occurred at 0.7–0.8 GPa. In the Monte Gavi peridotites and pyroxenites, the spinel-facies clinopyroxene was replaced by Ca-rich plagioclase and new orthopyroxene, typically associated with secondary clinopyroxene. The reactive melt migration caused increase of TiO2 contents in relict clinopyroxene and spinel, with the latter also recording a Cr2O3 increase. In the Monte Gavi peridotites and pyroxenites, geothermometers based on slowly diffusing elements (REE and Y) record high temperature conditions (1200-1250 °C) related to the melt infiltration event, followed by subsolidus cooling until ca. 900°C. The Monte Sant'Agostino mantle section is characterized by widespread ductile shearing with no evidence of melt infiltration. The deformation recorded by the Monte Sant'Agostino peridotites (clinopyroxene-rich lherzolites) occurred at 750–800 °C and 0.3–0.6 GPa, leading to protomylonitic to ultramylonitic textures with extreme grain size reduction (10–50 μm). Compared to the peridotites, the enclosed pyroxenite layers gave higher temperature-pressure estimates for the plagioclase-facies re-equilibration (870–930 °C and 0.8–0.9 GPa). We propose that the earlier plagioclase crystallization in the pyroxenites enhanced strain localization and formation of mylonite shear zones in the entire mantle section. We subdivide the subcontinental mantle section from the External Ligurian ophiolites into three distinct domains, developed in response to the rifting evolution that ultimately formed a Middle Jurassic ocean-continent transition: (1) a spinel tectonite domain, characterized by subsolidus static formation of plagioclase, i.e. the Suvero mantle section (Hidas et al., 2020), (2) a plagioclase mylonite domain experiencing melt-absent deformation and (3) a nearly undeformed domain that underwent reactive melt infiltration under plagioclase-facies conditions, exemplified by the the Monte Sant'Agostino and the Monte Gavi mantle sections, respectively. We relate mantle domains (1) and (2) to a rifting-driven uplift in the late Triassic accommodated by large-scale shear zones consisting of anhydrous plagioclase mylonites. Hidas K., Borghini G., Tommasi A., Zanetti A. & Rampone E. 2021. Interplay between melt infiltration and deformation in the deep lithospheric mantle (External Liguride ophiolite, North Italy). Lithos 380-381, 105855

Impact of geogenic degassing on C-isotopic composition of dissolved carbon in karst systems of Greece

The Earth C-cycle is complex, where endogenic and exogenic sources are interconnected, operating in a multiple spatial and temporal scale (Lee et al., 2019). Non-volcanic CO2 degassing from active tectonic structures is one of the less defined components of this cycle (Frondini et al., 2019). Carbon mass-balance (Chiodini et al., 2000) is a useful tool to quantify the geogenic carbon output from regional karst hydrosystems. This approach has been demonstrated for central Italy and may be valid also for Greece, due to the similar geodynamic settings. Deep degassing in Greece has been ascertained mainly at hydrothermal and volcanic areas, but the impact of geogenic CO2 released by active tectonic areas has not yet been quantified. The main aim of this research is to investigate the possible deep degassing through the big karst aquifers of Greece. Since 2016, 156 karst springs were sampled along most of the Greek territory. To discriminate the sources of carbon, the analysis of the isotopic composition of carbon was carried out. δ13CTDIC values vary from -16.61 to -0.91‰ and can be subdivided into two groups characterized by (a) low δ13CTDIC, and (b) intermediate to high δ13CTDIC with a threshold value of -6.55‰. The composition of the first group can be related to the mixing of organic-derived CO2 and the dissolution of marine carbonates. Springs of the second group, mostly located close to Quaternary volcanic areas, are linked to possible carbon input from deep sources

Impact of Etna’s volcanic emission on major ions and trace elements composition of the atmospheric deposition

Mt. Etna, on the eastern coast of Sicily (Italy), is one of the most active volcanoes on the planet and it is widely recognized as a big source of volcanic gases (e.g., CO2 and SO2), halogens, and a lot of trace elements, to the atmosphere in the Mediterranean region. Especially during eruptive periods, Etna’s emissions can be dispersed over long distances and cover wide areas. A group of trace elements has been recently brought to attention for their possible environmental and human health impacts, the Technology-critical elements. The current knowledge about their geochemical cycles is still scarce, nevertheless, recent studies (Brugnone et al., 2020) evidenced a contribution from the volcanic activity for some of them (Te, Tl, and REE). In 2021, in the framework of the research project “Pianeta Dinamico”, by INGV, a network of 10 bulk collectors was implemented to collect, monthly, atmospheric deposition samples. Four of these collectors are located on the flanks of Mt. Etna, other two are in the urban area of Catania and three are in the industrial area of Priolo, all most of the time downwind of the main craters. The last one, close to Cesarò (Nebrodi Regional Park), represents the regional background. The research aims to produce a database on major ions and trace element compositions of the bulk deposition and here we report the values of the main physical-chemical parameters and the deposition fluxes of major ions and trace elements from the first year of research. The pH ranged from 3.1 to 7.7, with a mean value of 5.6, in samples from the Etna area, while it ranged between 5.2 and 7.6, with a mean value of 6.4, in samples from the other study areas. The EC showed values ranging from 5 to 1032 μS cm-1, with a mean value of 65 μS cm-1. The most abundant ions were Cl- and SO42- for anions, Na+ and Ca+ for cations, whose mean deposition fluxes, considering all sampling sites, were 16.6, 6.8, 8.4, and 6.0 mg m-2 d, respectively. The highest deposition fluxes of volcanic refractory elements, such as Al, Fe, and Ti, were measured in the Etna’s sites, with mean values of 948, 464, and 34.3 μg m-2 d-1, respectively, higher than those detected in the other sampling sites, further away from the volcanic source (26.2, 12.4, 0.5 μg m-2 d-1, respectively). The same trend was also observed for volatile elements of prevailing volcanic origin, such as Tl (0.49 μg m-2 d-1), Te (0.07 μg m-2 d-1), As (0.95 μg m-2 d-1), Se (1.92 μg m-2 d-1), and Cd (0.39 μg m-2 d-1). Our preliminary results show that, close to a volcanic area, volcanic emissions must be considered among the major contributors of ions and trace elements to the atmosphere. Their deposition may significantly impact the pedosphere, hydrosphere, and biosphere and directly or indirectly human health