PVR: Patch-to-Volume Reconstruction for Large Area Motion Correction of Fetal MRI

In this paper we present a novel method for the correction of motion artifacts that are present in fetal Magnetic Resonance Imaging (MRI) scans of the whole uterus. Contrary to current slice-to-volume registration (SVR) methods, requiring an inflexible anatomical enclosure of a single investigated organ, the proposed patch-to-volume reconstruction (PVR) approach is able to reconstruct a large field of view of non-rigidly deforming structures. It relaxes rigid motion assumptions by introducing a specific amount of redundant information that is exploited with parallelized patch-wise optimization, super-resolution, and automatic outlier rejection. We further describe and provide an efficient parallel implementation of PVR allowing its execution within reasonable time on commercially available graphics processing units (GPU), enabling its use in the clinical practice. We evaluate PVR's computational overhead compared to standard methods and observe improved reconstruction accuracy in presence of affine motion artifacts of approximately 30% compared to conventional SVR in synthetic experiments. Furthermore, we have evaluated our method qualitatively and quantitatively on real fetal MRI data subject to maternal breathing and sudden fetal movements. We evaluate peak-signal-to-noise ratio (PSNR), structural similarity index (SSIM), and cross correlation (CC) with respect to the originally acquired data and provide a method for visual inspection of reconstruction uncertainty. With these experiments we demonstrate successful application of PVR motion compensation to the whole uterus, the human fetus, and the human placenta.Comment: 10 pages, 13 figures, submitted to IEEE Transactions on Medical Imaging. v2: wadded funders acknowledgements to preprin

Deep Placental Vessel Segmentation for Fetoscopic Mosaicking

During fetoscopic laser photocoagulation, a treatment for twin-to-twin transfusion syndrome (TTTS), the clinician first identifies abnormal placental vascular connections and laser ablates them to regulate blood flow in both fetuses. The procedure is challenging due to the mobility of the environment, poor visibility in amniotic fluid, occasional bleeding, and limitations in the fetoscopic field-of-view and image quality. Ideally, anastomotic placental vessels would be automatically identified, segmented and registered to create expanded vessel maps to guide laser ablation, however, such methods have yet to be clinically adopted. We propose a solution utilising the U-Net architecture for performing placental vessel segmentation in fetoscopic videos. The obtained vessel probability maps provide sufficient cues for mosaicking alignment by registering consecutive vessel maps using the direct intensity-based technique. Experiments on 6 different in vivo fetoscopic videos demonstrate that the vessel intensity-based registration outperformed image intensity-based registration approaches showing better robustness in qualitative and quantitative comparison. We additionally reduce drift accumulation to negligible even for sequences with up to 400 frames and we incorporate a scheme for quantifying drift error in the absence of the ground-truth. Our paper provides a benchmark for fetoscopy placental vessel segmentation and registration by contributing the first in vivo vessel segmentation and fetoscopic videos dataset.Comment: Accepted at MICCAI 202

Vision based robot assistance in TTTS fetal surgery

© 2019 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes,creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works.This paper presents an accurate and robust tracking vision algorithm for Fetoscopic Laser Photo-coagulation (FLP) surgery for Twin-Twin Transfusion Syndrome (TTTS). The aim of the proposed method is to assist surgeons during anastomosis localization, coagulation and review using a tele-operated robotic system. The algorithm computes the relative position of the fetoscope tool tip with respect to the placenta, via local vascular structure registration.The algorithm uses image features (local superficial vascular structures of the placenta’s surface) to automatically match consecutive fetoscopic images. It is composed of three sequential steps: image processing (filtering, binarization and vascular structures segmentation); relevant Points Of Interest (POIs) seletion; and image registration between consecutive images.The algorithm has to deal with the low quality of fetoscopic images, the liquid and dirty environment inside the placenta jointly with the thin diameter of the fetoscope optics and low amount of environment light reduces the image quality. The obtained images are blurred, noisy and with very poor color components.The tracking system has been tested using real video sequences of FLP surgery for TTTS. The computational performance enables real time tracking, locally guiding the robot over the placenta’s surface with enough accuracy.Peer ReviewedPostprint (author's final draft

A SHAPE-CONTEXT MODEL FOR MATCHING PLACENTAL CHORIONIC SURFACE VASCULAR NETWORKS

Placental chorionic surface vascular networks (PCSVNs) are essential high-capacitance, low-resistance distribution and drainage networks, and are hence important to placental function and to fetal and newborn health. It was hypothesized that variations in the PCSVN structure may reflect both the overall effects of genetic and environmentally regulated variations in branching morphogenesis within the conceptus and the fetus’s vital organs. A critical step in PCSVN analysis is the extraction of blood vessel structure, which has only been done manually through a laborious process, making studies in large cohorts and applications in clinical settings nearly impossible. The large variation in the shape, color, and texture of the placenta presents significant challenges to both machine and human to accurately extract PCSVNs. To increase the visibility of the vessels, colored paint can be injected into the vascular networks of placentas, allowing PCSVNs to be manually traced with a high level of accuracy. This paper provides a proof-of-concept study to explain the geometric differences between manual tracings of paint-injected and un-manipulated PCSVNs under the framework of a shape-context model. Under this framework, paint-injected and un-manipulated tracings of PCSVNs can be matched with nearly 100% accuracy. The implication of our results is that the manual tracing protocol yields faithful PCSVN representations modulo a set of affine transformations, making manual tracing a reliable method for studying PCSVNs. Our work provides assurance to a new pre-processing approach for studying vascular networks by ways of dye-injection in medical imaging problems

Alcohol exposure impairs trophoblast survival and alters subtype-specific gene expression in vitro

Maternal alcohol consumption is common prior to pregnancy recognition and in the rat results in altered placental development and fetal growth restriction. To assess the effect of ethanol (EtOH) exposure on the differentiation of trophoblast stem (TS) cells, mouse TS lines were differentiated in vitro for 6 days in 0%, 0.2% or 1% EtOH. This reduced both trophoblast survival and expression of labyrinth and junctional zone trophoblast subtype-specific genes. This suggests that fetal growth restriction and altered placental development associated with maternal alcohol consumption in the periconceptional period could be mediated in part by direct effects on trophoblast development. (C) 2016 Elsevier Ltd. All rights reserved

RhoJ/TCL Regulates Endothelial Motility and Tube Formation and Modulates Actomyosin Contractility and Focal Adhesion Numbers

Objective—RhoJ/TCL was identified by our group as an endothelial-expressed Rho GTPase. The aim of this study was to determine its tissue distribution, subcellular localization, and function in endothelial migration and tube formation. Methods and Results—Using in situ hybridization, RhoJ was localized to endothelial cells in a set of normal and cancerous tissues and in the vasculature of mouse embryos; endogenous RhoJ was localized to focal adhesions by immunofluorescence. The proangiogenic factor vascular endothelial growth factor activated RhoJ in endothelial cells. Using either small interfering (si)RNA-mediated knockdown of RhoJ expression or overexpression of constitutively active RhoJ (daRhoJ), RhoJ was found to positively regulate endothelial motility and tubule formation. Downregulating RhoJ expression increased focal adhesions and stress fibers in migrating cells, whereas daRhoJ overexpression resulted in the converse. RhoJ downregulation resulted in increased contraction of a collagen gel and increased phospho–myosin light chain, indicative of increased actomyosin contractility. Pharmacological inhibition of Rho-kinase (which phosphorylates myosin light chain) or nonmuscle myosin II reversed the defective tube formation and migration of RhoJ knockdown cells. Conclusion—RhoJ is endothelial-expressed in vivo, activated by vascular endothelial growth factor, localizes to focal adhesions, regulates endothelial cell migration and tube formation, and modulates actomyosin contractility and focal adhesion numbers