19 research outputs found
The optimisation of deep neural networks for segmenting multiple knee joint tissues from MRIs.
Automated semantic segmentation of multiple knee joint tissues is desirable to allow faster and more reliable analysis of large datasets and to enable further downstream processing e.g. automated diagnosis. In this work, we evaluate the use of conditional Generative Adversarial Networks (cGANs) as a robust and potentially improved method for semantic segmentation compared to other extensively used convolutional neural network, such as the U-Net. As cGANs have not yet been widely explored for semantic medical image segmentation, we analysed the effect of training with different objective functions and discriminator receptive field sizes on the segmentation performance of the cGAN. Additionally, we evaluated the possibility of using transfer learning to improve the segmentation accuracy. The networks were trained on i) the SKI10 dataset which comes from the MICCAI grand challenge "Segmentation of Knee Images 2010″, ii) the OAI ZIB dataset containing femoral and tibial bone and cartilage segmentations of the Osteoarthritis Initiative cohort and iii) a small locally acquired dataset (Advanced MRI of Osteoarthritis (AMROA) study) consisting of 3D fat-saturated spoiled gradient recalled-echo knee MRIs with manual segmentations of the femoral, tibial and patellar bone and cartilage, as well as the cruciate ligaments and selected peri-articular muscles. The Sørensen-Dice Similarity Coefficient (DSC), volumetric overlap error (VOE) and average surface distance (ASD) were calculated for segmentation performance evaluation. DSC ≥ 0.95 were achieved for all segmented bone structures, DSC ≥ 0.83 for cartilage and muscle tissues and DSC of ≈0.66 were achieved for cruciate ligament segmentations with both cGAN and U-Net on the in-house AMROA dataset. Reducing the receptive field size of the cGAN discriminator network improved the networks segmentation performance and resulted in segmentation accuracies equivalent to those of the U-Net. Pretraining not only increased segmentation accuracy of a few knee joint tissues of the fine-tuned dataset, but also increased the network's capacity to preserve segmentation capabilities for the pretrained dataset. cGAN machine learning can generate automated semantic maps of multiple tissues within the knee joint which could increase the accuracy and efficiency for evaluating joint health.European Union's Horizon 2020 Framework Programme [grant number 761214]
Addenbrooke’s Charitable Trust (ACT)
National Institute of Health Research (NIHR) Cambridge Biomedical Research Centre
University of Cambridge
Cambridge University Hospitals NHS Foundation Trust
GSK VARSITY: PHD STUDENTSHIP Funder reference: 300003198
Automatic knee joint space measurement from plain radiographs
Abstract. Knee osteoarthritis is a common joint disease and one of the leading causes of disability. The disease is characterized by loss of articular cartilage and bone remodeling. Tissue deformations eventually lead to joint space narrowing which can be detected from plain radiographs. Joint space narrowing is typically measured by an experienced radiologist manually, which can be time consuming and error prone process. The aim of this study was to develop and evaluate a fully automatic joint space width measurement method for bilateral knee radiographs.
The knee joint was localized from the x-ray images using template matching and the joint space was delineated using active shape model (ASM). Two different automatic joint space measurement methods were tested and the results were validated against manual measurements performed by an experienced researcher. The first joint space width measurements were done by binarizing the joint space and measuring the local thickness of the binary mask using disk fitting. The second method classified bone pixels to tibia and femur. Classification was based on the ASM delineation. Nearest neighbors between femur and tibia were then used to find the joint space width. An automatic method for tibial region of interest (ROI) selection was also implemented. The algorithms used in this thesis were also made publicly available online.
The automatically obtained joint space widths were in line with manual measurements. Higher accuracy was obtained using the disk fitting algorithm. Automatic Tibial ROI selection was accurate, although the orientation of the joint was ignored in this study. An open source software with a simple graphical user interface and visualization tools was also developed. Computationally efficient and easily explainable methods were utilized in order to improve accessibility and transparency of computer assisted diagnosis of knee osteoarthritis.Tiivistelmä. Polvinivelrikko on eräs yleisimpiä niveltauteja sekä yksi merkittävimmistä liikuntavammojen aiheuttajista. Nivelrikolle ominaisia piirteitä ovat nivelruston vaurioituminen ja muutokset nivelrustonalaisessa luussa. Kudosten muutokset ja vauriot johtavat lopulta niveltilan kaventumiseen, mikä voidaan havaita röntgenkuvista. Tavallisesti kokenut radiologi tekee niveltilan mittaukset manuaalisesti, mikä vaatii usein paljon aikaa ja on lisäksi virhealtis prosessi. Tämän tutkielman tavoitteena oli kehittää täysin automaattinen niveltilan mittausmenetelmä bilateraalisille polven röntgenkuville.
Polvinivel paikallistettiin röntgenkuvista muotoon perustuvalla hahmontunnistuksella ja nivelväli rajattiin käyttämällä aktiivista muodon sovitusta (active shape model, ASM). Nivelvälin mittaukseen käytettiin kahta eri menetelmää, joita verrattiin kokeneen tutkijan tekemiin manuaalisiin mittauksiin. Ensimmäinen nivelvälin mittausmenetelmä sovitti ympyränmuotoisia maskeja niveltilasta tehtyyn binäärimaskiin. Toinen mittausmenetelmä luokitteli luuhun kuuluvat pikselit sääri- ja reisiluuhun. Luokittelu perustui aikaisemmin tehtyyn automaattiseen nivelvälin rajaukseen. Nivelvälin mittaukseen käytettiin lähimpiä naapuripikseleitä sääri- ja reisiluusta. Työssä kehitettiin myös menetelmä automaattiseen sääriluun mielenkiintoalueiden (region of interest, ROI) valintaan. Käytetyt algoritmit ovat julkisesti saatavilla verkossa.
Automaattiset nivelväli mittaukset vastasivat manuaalisia mittauksia hyvin. Parempi tarkkuus saatiin käyttämällä ympyrän sovitusta hyödyntävää algoritmia nivelvälin mittaukseen. Sääriluun mielenkiintoalueet onnistuttiin määrittämään automaattisesti, tosin nivelen orientaatiota ei huomioitu tässä työssä. Lisäksi kehitettiin avoimen lähdekoodin ohjelmisto yksinkertaisella graafisella käyttöliittymällä ja visualisointityökaluilla. Työssä käytettiin laskennallisesti tehokkaita ja helposti selitettäviä menetelmiä, mikä edesauttaa tietokoneavusteisen menetelmien käyttöä polvinivelrikon tutkimuksessa
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Quantitative Magnetic Resonance Imaging and Analysis of Articular Cartilage and Osteoarthritis
MRI plays an important role in the continuing search for a sensitive osteoarthritis (OA) imaging biomarker able to detect early, pre-morphological alterations in cartilage composition. Determining the compositional recovery pattern of cartilage following acute joint loading could potentially present a more sensitive biomarker for defining cartilage health [1]. However, only a limited amount of studies have assessed both the immediate effect of joint loading on cartilage, as well as its post-loading recovery. In addition, when assessing the compositional responses of cartilage to joint loading, previous studies usually did not incorporate the measurement error of the used quantitative MRI technique into their analysis. Therefore, an uncertainty persists whether or not compositional MRI techniques are sensitive enough to measure changes in water and macromolecular content of cartilage, or if previous studies were merely measuring noise. Consequently, an objective of this thesis is to increase our understanding of and reliability in quantitative T2 and T1ρ relaxation time mapping to detect compositional responses of cartilage following a joint loading activity.
Furthermore, to obtain the quantitative morphological and compositional measures of cartilage, detailed region-specific delineation of cartilage is required. This delineation (or segmentation) of cartilage is laborious and time-consuming as it is usually performed manually by an expert observer. Many new advances in image analysis, particularly those in convolutional neural networks (CNNs) and deep learning, have enabled a time-efficient semi- or fully-automated alternative to this process [2, 3]. This thesis explores the utility of deep CNNs generated segmentations for accurate surface-based analysis of cartilage morphology and composition from knee MRIs as well as of cortical bone thickness from knee CTs.
Chapter 1 will provide an introduction into the structure and biomechanics of articular cartilage and the role of MRI in imaging the degenerative joint disorder, osteoarthritis as well as the effects of different joint loading activities on cartilage morphology and composition.
Chapter 2 explains the principle of MRI and the pulse sequences used in the following chapter for the morphometric and compositional assessment of articular cartilage.
Chapter 3 describes the use of 3D Cartilage Surface Mapping (3D-CaSM) [3] to assess variations in cartilage T1ρ and T2 relaxation times of young, healthy participants following a mild, unilateral stepping activity. By evaluating and incorporating the intrasessional repeatability of the T1ρ and T2 mapping techniques, I aim to highlight those cartilage areas experiencing exercise-induced compositional changes greater than measurement error.
A significant amount of time is needed to manually segment the regions-of-interest required to perform the 3D-CaSM used in Chapter 3. Therefore, in Chapter 4, I assessed the use of deep convolutional neural networks for automating the segmentation process for multiple knee joint tissues simultaneous and increase the time-efficiency for evaluating knee MR datasets. I evaluated the use of a conditional Generative Adversarial Network (cGAN) as a potentially improved method for automated segmentation compared to the widely used convolutional neural network, U-Net.
In Chapter 5 I combined the 3D-CaSM and automated segmentation methods presented in Chapters 3 and 4, respectively to assess the use of fully automatic segmentations of femoral and tibial bone-cartilage structures for accurate surface-based analysis of cartilage morphology and composition on knee MR images. This was performed on publicly available data from the Osteoarthritis Initiative, a multicentre observational study with expert manual segmentations provided by the Zuse Institute in Berlin.
Chapter 6 describes an automated pipeline for subchondral cortical bone thickness mapping from knee CT data. I developed a method of using automated segmentations of articular cartilage and bone from knee MRI data to determine the periarticular bone surface which is covered by cartilage. This surface was then used to perform cortical bone thickness measurements on corresponding CT data. I validated this pipeline using data from the EU-funded, multi-centre observational study called Applied Private-Public partneRship enabling OsteoArthritis Clinical Headway (APPROACH).
Chapter 7 summarises the main conclusions and contributions of the works presented in this thesis as well as providing directions for future work.PhD Studentship funded by GlaxoSmithKlin
Development of a finite element model of the knee using patient specific magnetic resonance imaging data and biomechanical testing of soft tissues
This thesis presents the findings of investigations carried out relating to the creation of full joint contact patient specific finite element models for correlation with biological studies in the study of Osteoarthritis (OA) development. To understand the relationship between altered loading and biological changes in articular cartilage (AC), a method for predicting stresses and strains experienced inside the tissues is required.
An in-vitro study was conducted to explore the possibility of correlating finite element (FE) and gene expression study results. FE models were used to predict the stresses and strains inside the AC for explants subjected to different loading conditions. The study demonstrated that the accurate representation of AC surface geometry is crucial and current flat surface axisymmetric cylinder representations used in AC explant modelling introduces significant error in the prediction of tissue mechanical behaviour. Cutting of the AC explant to achieve a flat surface can affect the biological, mechanical and tribology behaviour of the tissue. Thus, a method for creating explant specific finite element models with the use of digital image correlation (DIC) was developed and is presented, allowing for surface layer preservation in AC explants for correlated gene expression and inverse FE.
Reconstruction of tissue geometries from magnetic resonance (MR) imaging scan data of the knee was explored. It was possible to segment both hard and soft tissues from the same set of MR imaging scan data. Meshing of the geometries using a fundamentally voxel based algorithm proved to cause significant error in the segmented volume. An alternative contour based algorithm needs to be explored.
Uncertainties concerning the presence and modelling of meniscotibial ligaments (MTLs) in full joint contact FE models found in literature were addressed. An anatomy study revealed that the MTLs are found in both the medial and lateral side of the joint around the periphery of the anterior, middle and posterior portion of the menisci. With the use of cross polarised light microscopy, it was established
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that MTLs consist of Type I collagen orientated in the circumferential direction around the menisci. As a result, the MTLs were modelled as an anisotropic membrane. Using the full joint contact finite element model, the influence of MTLs on knee joint kinematics was investigated. It was found that the MTLs reinforce the function of the meniscal horns and circumferential fibres in the meniscus and help constrain the meniscus. Therefore, it was concluded that the MTLs are mechanically significant in the stabilisation of knee joints and should be included in knee models for accurate prediction of knee joint behaviour
A novel method of cadaveric data acquisition from a dissection of the male lower limb using the Perceptron ScanWorks® V5 scanner
Introduction: Under the current pressures of an expanding medical curriculum, the time allocated to anatomical training in medical education has been greatly reduced, resulting in an increasing number of doctors qualifying from medical school with an inadequate, and arguably unsafe level of anatomical understanding. Given the limited time now available for cadaveric dissection in medical training, future rectification of these deficits is becoming heavily dependent on supplementation from virtual anatomical training tools. In light of this, many attempts have been made to acquire cadaveric data for the creation of realistic virtual specimens. Until now however, the educational value of these training tools has been heavily scrutinised, with many sharing the view that they are over simplified and anatomically inaccurate.
The main problems associated with the usability of pre-existing datasets arise primarily as a result of the methodology used to acquire their cadaveric data. Projects in this field have previously approached the task of cadaveric data acquisition by creating comprehensive libraries of anatomical cross-sections, from which three-dimensional processing can be technically difficult and not always successful for the reconstruction of fine or complex anatomical structures.
Aim: The aim of this study therefore was to approach cadaveric data acquisition, for the purpose of creating a digital cadaveric specimen, in an unconventional manner, by obtaining three-dimensional data directly from cadaveric tissues with a Perceptron ScanWorksV5 non-contact laser scanner.
Methods: To do this, a carefully planned dissection of the lower limb was performed on a 68 year old male cadaver, and laser scanning of all clinically relevant structures was undertaken at sequential stages throughout. In addition to this, colour and texture information was collected from the cadaveric tissues by high-resolution digital photography.
Results: A comprehensive three-dimensional dataset was acquired from all clinically relevant anatomy of the lower limb as a result of the methodology used in this study. Data was obtained at extremely high point to point resolutions, with a measurement accuracy of 24μm, 2σ.
Discussion: By obtaining cadaveric data in this way, the problems associated with the three-dimensional processing of conventional cross-sectional data, such as image segmentation, are largely overcome and fine anatomical details can be accurately documented with high precision. This data can be processed further to create an accurate and realistic virtual reconstruction of the lower limb for both three-dimensional anatomical training and surgical rehearsal in the future.
Conclusion: Whilst the value of cross-sectional datasets in their own right should not be disputed, the methodology used for cadaveric data acquisition in this study has proved a very successful in collecting three-dimensional data directly form the specimen, and could be used to acquire detailed datasets for the reconstruction of other complex body regions for virtual anatomical training in the future
Book of Abstracts 15th International Symposium on Computer Methods in Biomechanics and Biomedical Engineering and 3rd Conference on Imaging and Visualization
In this edition, the two events will run together as a single conference, highlighting the strong connection with the Taylor & Francis journals: Computer Methods in Biomechanics and Biomedical Engineering (John Middleton and Christopher Jacobs, Eds.) and Computer Methods in Biomechanics and Biomedical Engineering: Imaging and Visualization (JoãoManuel R.S. Tavares, Ed.).
The conference has become a major international meeting on computational biomechanics, imaging andvisualization. In this edition, the main program includes 212 presentations. In addition, sixteen renowned researchers will give plenary keynotes, addressing current challenges in computational biomechanics and biomedical imaging.
In Lisbon, for the first time, a session dedicated to award the winner of the Best Paper in CMBBE Journal will take place.
We believe that CMBBE2018 will have a strong impact on the development of computational biomechanics and biomedical imaging and visualization, identifying emerging areas of research and promoting the collaboration and networking between participants. This impact is evidenced through the well-known research groups, commercial companies and scientific organizations, who continue to support and sponsor the CMBBE meeting
series. In fact, the conference is enriched with five workshops on specific scientific topics and commercial software.info:eu-repo/semantics/draf
Robust Magnetic Resonance Imaging of Short T2 Tissues
Tissues with short transverse relaxation times are defined as ‘short T2 tissues’, and short T2 tissues often appear dark on images generated by conventional magnetic resonance imaging techniques. Common short T2 tissues include tendons, meniscus, and cortical bone. Ultrashort Echo Time (UTE) pulse sequences can provide morphologic contrasts and quantitative maps for short T2 tissues by reducing time-of-echo to the system minimum (e.g., less than 100 us). Therefore, UTE sequences have become a powerful imaging tool for visualizing and quantifying short T2 tissues in many applications. In this work, we developed a new Flexible Ultra Short time Echo (FUSE) pulse sequence employing a total of thirteen acquisition features with adjustable parameters, including optimized radiofrequency pulses, trajectories, choice of two or three dimensions, and multiple long-T2 suppression techniques. Together with the FUSE sequence, an improved analytical density correction and an auto-deblurring algorithm were incorporated as part of a novel reconstruction pipeline for reducing imaging artifacts. Firstly, we evaluated the FUSE sequence using a phantom containing short T2 components. The results demonstrated that differing UTE acquisition methods, improving the density correction functions and improving the deblurring algorithm could reduce the various artifacts, improve the overall signal, and enhance short T2 contrast. Secondly, we applied the FUSE sequence in bovine stifle joints (similar to the human knee) for morphologic imaging and quantitative assessment. The results showed that it was feasible to use the FUSE sequence to create morphologic images that isolate signals from the various knee joint tissues and carry out comprehensive quantitative assessments, using the meniscus as a model, including the mappings of longitudinal relaxation (T1) times, quantitative magnetization transfer parameters, and effective transverse relaxation (T2*) times. Lastly, we utilized the FUSE sequence to image the human skull for evaluating its feasibility in synthetic computed tomography (CT) generation and radiation treatment planning. The results demonstrated that the radiation treatment plans created using the FUSE-based synthetic CT and traditional CT data were able to present comparable dose calculations with the dose difference of mean less than a percent. In summary, this thesis clearly demonstrated the need for the FUSE sequence and its potential for robustly imaging short T2 tissues in various applications