Automatic segmentation of the left ventricle cavity and myocardium in MRI data

A novel approach for the automatic segmentation has been developed to extract the epi-cardium and endo-cardium boundaries of the left ventricle (lv) of the heart. The developed segmentation scheme takes multi-slice and multi-phase magnetic resonance (MR) images of the heart, transversing the short-axis length from the base to the apex. Each image is taken at one instance in the heart's phase. The images are segmented using a diffusion-based filter followed by an unsupervised clustering technique and the resulting labels are checked to locate the (lv) cavity. From cardiac anatomy, the closest pool of blood to the lv cavity is the right ventricle cavity. The wall between these two blood-pools (interventricular septum) is measured to give an approximate thickness for the myocardium. This value is used when a radial search is performed on a gradient image to find appropriate robust segments of the epi-cardium boundary. The robust edge segments are then joined using a normal spline curve. Experimental results are presented with very encouraging qualitative and quantitative results and a comparison is made against the state-of-the art level-sets method

Use of Image Processing Techniques for the Analysis of Echocardiographic Images

Echocardiography is a medical imaging modality that uses ultrasound in order to obtain cross sectional views of the heart. The basic problem in the use of echocardiography is the ability to obtain a reliable set of physical parameters related to cardiac status, so that assessment of heart disease can be performed automatically. This work overviews different image processing techniques used in the analysis of two dimensional echocardiographic images. After reviewing how the echocardiographic image formation process works, an outline of the general processing steps from image acquisition to automatic detection of important features is presented. Special emphasis on cardiac image segmentation is presented. In particular, a relaxation algorithm for image segmentation is discussed. Also, echocardiographic image segmentation using temporal analysis and a new algorithm for boundary detection is described. Measurements of left ventricular area, wall thickness, and ejection fraction is also presented. Shape analysis is introduced as a tool for echocardiographic image analysis. A high level description of the left ventricular boundaries using curvature is proposed. Curvature analysis attempts to identify stable landmarks during the beating process, muscles. Tracking these landmarks aids in the detection of abnormal heart contractions. Finally the use of expert systems is proposed in the analysis of echocardiographic images

A New Feature Extraction Method for Classifying Heart Wall from Left Ventricle Cavity

Echocardiography is a method of examination with high-frequency sound waves to obtain images of heart organs. Examination of heart health conditions with echocardiography as an imaging method, serves to detect the potential for heart disease, thus that the right treatment from the evaluation results can be decided. Examination of the source of heart disease with echocardiography was performed using several views, namely the long axis, short axis, two-chamber, and four-chamber. However, the assessment of cardiac function is still carried out conventionally. Thus it is necessary to build a system that can assess cardiac function. This study proposes a feature extraction method for the classification of heart disease based on the left ventricular motion on the short-axis. In this method, feature extraction uses 24 good features for the process of tracking the movement of the left ventricle with optical flow. Each good feature produces four features, namely direction (negative direction and positive direction) and distance (negative distance and positive distance) from the results of left ventricular tracking and produces 96 attributes for the whole process. The features that have been obtained are then processed using several classification algorithms with validation techniques that are, k-folds, and leave one out. The result is a classification algorithm with a gradient boosting classifier method that has the best accuracy. Gradient boosting classifier produces accuracy values with validation techniques for k-folds 90.98%, and leave one out 93.23%. This shows that the gradient boosting classifier can be relied upon for the classification of heart disease using the proposed feature extraction method. In this study, we developed a new feature extraction method from the results of tracking the heart wall using optical flow. This algorithm can produce feature values from the tracking results that can be used to build a knowledge system for the classification of heart health conditions

Novel Techniques for Tissue Imaging and Characterization Using Biomedical Ultrasound

The use of ultrasound technology in the biomedical field has been widely increased in recent decades. Ultrasound modalities are considered more safe and cost effective than others that use ionizing radiation. Moreover, the use of high-frequency ultrasound provides means of high-resolution and precise tissue assessment. Consequently, ultrasound elastic waves have been widely used to develop non-invasive techniques for tissue assessment. In this work, ultrasound waves have been used to develop non-invasive techniques for tissue imaging and characterization in three different applications.;Currently, there is a lack of imaging modalities to accurately predict minute structures and defects in the jawbone. In particular, the inability of 2D radiographic images to detect bony periodontal defects resulted from infection of the periodontium. They also may carry known risks of cancer generation or may be limited in accurate diagnosis scope. Ultrasonic guided waves are sensitive to changes in microstructural properties, while high-frequency ultrasound has been used to reconstruct high-resolution images for tissue. The use of these ultrasound techniques may provide means for early diagnosis of marrow ischemic disorders via detecting focal osteoporotic marrow defect, chronic nonsuppurative osteomyelitis, and cavitations in the mandible (jawbone). The first part of this work investigates the feasibility of using guided waves and high frequency ultrasound for non-invasive human jawbone assessment. The experimental design and the signal/image processing procedures for each technique are developed, and multiple in vitro studies are carried out using dentate and non-dentate mandibles. Results from both the ultrasonic guided waves analysis and the high frequency 3D echodentographic imaging suggest that these techniques show great potential in providing non-invasive methods to characterize the jawbone and detect periodontal diseases at earlier stages.;The second part of this work describes indirect technique for characterization via reconstructing high-resolution microscopic images. The availability of well-defined genetic strains and the ability to create transgenic and knockout mice makes mouse models extremely significant tools in different kinds of research. For example, noninvasive measurement of cardiovascular function in mouse hearts has become a valuable need when studying the development or treatment of various diseases. This work describes the development and testing of a single-element ultrasound imaging system that can reconstruct high-resolution brightness mode (B-mode) images for mouse hearts and blood vessels that can be used for quantitative measurements in vitro. Signal processing algorithms are applied on the received ultrasound signals including filtering, focusing, and envelope detection prior to image reconstruction. Additionally, image enhancement techniques and speckle reduction are adopted to improve the image resolution and quality. The system performance is evaluated using both phantom and in vitro studies using isolated mouse hearts and blood vessels from APOE-KO and its wild type control. This imaging system shall provide a basis for early and accurate detection of different kinds of diseases such as atherosclerosis in mouse model.;The last part of this work is initialized by the increasing need for a non-invasive method to assess vascular wall mechanics. Endothelial dysfunction is considered a key factor in the development of atherosclerosis. Flow-mediated vasodilatation (FMD) measurement in brachial and other conduit arteries has become a common method to assess the endothelial function in vivo. In spite of the direct relationship that could be between the arterial wall multi-component strains and the FMD response, direct measurement of wall strain tensor due to FMD has not yet been reported in the literature. In this work, a noninvasive direct ultrasound-based strain tensor measuring (STM) technique is presented to assess changes in the mechanical parameters of the vascular wall during post-occlusion reactive hyperemia and/or FMD, including local velocities and displacements, diameter change, local strain tensor and strain rates. The STM technique utilizes sequences of B-mode ultrasound images as its input with no extra hardware requirement. The accuracy of the STM algorithm is assessed using phantom, and in vivo studies using human subjects during pre- and post-occlusion. Good correlations are found between the post-occlusion responses of diameter change and local wall strains. Results indicate the validity and versatility of the STM algorithm, and describe how parameters other than the diameter change are sensitive to reactive hyperemia following occlusion. This work suggests that parameters such as local strains and strain rates within the arterial wall are promising metrics for the assessment of endothelial function, which can then be used for accurate assessment of atherosclerosis

Doctor of Philosophy

dissertationCongenital heart defects are classes of birth defects that affect the structure and function of the heart. These defects are attributed to the abnormal or incomplete development of a fetal heart during the first few weeks following conception. The overall detection rate of congenital heart defects during routine prenatal examination is low. This is attributed to the insufficient number of trained personnel in many local health centers where many cases of congenital heart defects go undetected. This dissertation presents a system to identify congenital heart defects to improve pregnancy outcomes and increase their detection rates. The system was developed and its performance assessed in identifying the presence of ventricular defects (congenital heart defects that affect the size of the ventricles) using four-dimensional fetal chocardiographic images. The designed system consists of three components: 1) a fetal heart location estimation component, 2) a fetal heart chamber segmentation component, and 3) a detection component that detects congenital heart defects from the segmented chambers. The location estimation component is used to isolate a fetal heart in any four-dimensional fetal echocardiographic image. It uses a hybrid region of interest extraction method that is robust to speckle noise degradation inherent in all ultrasound images. The location estimation method's performance was analyzed on 130 four-dimensional fetal echocardiographic images by comparison with manually identified fetal heart region of interest. The location estimation method showed good agreement with the manually identified standard using four quantitative indexes: Jaccard index, Sørenson-Dice index, Sensitivity index and Specificity index. The average values of these indexes were measured at 80.70%, 89.19%, 91.04%, and 99.17%, respectively. The fetal heart chamber segmentation component uses velocity vector field estimates computed on frames contained in a four-dimensional image to identify the fetal heart chambers. The velocity vector fields are computed using a histogram-based optical flow technique which is formulated on local image characteristics to reduces the effect of speckle noise and nonuniform echogenicity on the velocity vector field estimates. Features based on the velocity vector field estimates, voxel brightness/intensity values, and voxel Cartesian coordinate positions were extracted and used with kernel k-means algorithm to identify the individual chambers. The segmentation method's performance was evaluated on 130 images from 31 patients by comparing the segmentation results with manually identified fetal heart chambers. Evaluation was based on the Sørenson-Dice index, the absolute volume difference and the Hausdorff distance, with each resulting in per patient average values of 69.92%, 22.08%, and 2.82 mm, respectively. The detection component uses the volumes of the identified fetal heart chambers to flag the possible occurrence of hypoplastic left heart syndrome, a type of congenital heart defect. An empirical volume threshold defined on the relative ratio of adjacent fetal heart chamber volumes obtained manually is used in the detection process. The performance of the detection procedure was assessed by comparison with a set of images with confirmed diagnosis of hypoplastic left heart syndrome and a control group of normal fetal hearts. Of the 130 images considered 18 of 20 (90%) fetal hearts were correctly detected as having hypoplastic left heart syndrome and 84 of 110 (76.36%) fetal hearts were correctly detected as normal in the control group. The results show that the detection system performs better than the overall detection rate for congenital heart defect which is reported to be between 30% and 60%

Improved echocardiography segmentation using active shape model and optical flow

Heart disease is one of the most dangerous diseases that threaten human life. The doctor uses echocardiography to analyze heart disease. The result of echocardiography test is a video that shows the movement of the heart rate. The result of echocardiography test indicates whether the patient’s heart is normal or not by identifying a heart cavity area. Commonly it is determined by a doctor based on his own accuracy and experience. Therefore, many methods to do heart segmentation is appearing. But, the methods are a bit slow and less precise. Thus, a system that can help the doctor to analyze it better is needed. This research will develop a system that can analyze the heart rate-motion and automatically measure heart cavity area better than the existing method. This paper proposes an improved system for cardiac segmentation using median high boost filter to increase image quality, followed by the use of an active shape model and optical flow. The segmentation of the heart rate-motion and auto measurement of the heart cavity area is expected to help the doctor to analyze the condition of the patient with better accuracy. Experimental result validated our approach

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

Automated boundary detection of echocardiograms

Two-dimensional echocardiograms of the left ventricle of the heart have been used to produce three-dimensional wire frame reconstructions of the inner wall of the left ventricle chamber. Currently, this process is accomplished by tracing the boundary of the images manually after applying simple image processing algorithms. This manual interaction is a very tedious and time consuming step in the three-dimensional and four-dimensional reconstruction process. It would be desirable to remove as much operator interaction as possible from the process to improve repeatability and decrease throughput time. This thesis investigated and implemented several basic and novel image processing algorithms which automatically preprocessed the echo images and extracted the boundary information necessary for a reconstruction process. Among the algorithms investigated are common spatial kernel operators such as the Gaussian Convolution Kernel and the Standard Deviation Kernel. Also implemented and discussed are the Robust Automatic Threshold Selector (RATS), a Contour Following Algorithm and a variation of a QUAD-TREE/Pyramid Resolution data structure. Morphological operations of erosion and dilation were applied to give the closing effect necessary in handling boundary dropouts found in some echo images. An effort has been made to utilize the Gould/Deanza image processing system to execute the algorithms in order to take advantage of its unique architecture. The accuracy of the final sequence of algorithms was tested on actual images and a comparison made between hand drawn borders and the computer generated borders traced on actual echo images

Lv volume quantification via spatiotemporal analysis of real-time 3-d echocardiography

Abstract—This paper presents a method of four-dimensional (4-D) (3-D + Time) space–frequency analysis for directional denoising and enhancement of real-time three-dimensional (RT3D) ultrasound and quantitative measures in diagnostic cardiac ultrasound. Expansion of echocardiographic volumes is performed with complex exponential wavelet-like basis functions called brushlets. These functions offer good localization in time and frequency and decompose a signal into distinct patterns of oriented harmonics, which are invariant to intensity and contrast range. Deformable-model segmentation is carried out on denoised data after thresholding of transform coefficients. This process attenuates speckle noise while preserving cardiac structure location. The superiority of 4-D over 3-D analysis for decorrelating additive white noise and multiplicative speckle noise on a 4-D phantom volume expanding in time is demonstrated. Quantitative validation, computed for contours and volumes, is performed on in vitro balloon phantoms. Clinical applications of this spaciotemporal analysis tool are reported for six patient cases providing measures of left ventricular volumes and ejection fraction. Index Terms—Echocardiography, LV volume, spaciotemporal analysis, speckle denoising. I