Dilatation of Lateral Ventricles with Brain Volumes in Infants with 3D Transfontanelle US

Ultrasound (US) can be used to assess brain development in newborns, as MRI is challenging due to immobilization issues, and may require sedation. Dilatation of the lateral ventricles in the brain is a risk factor for poorer neurodevelopment outcomes in infants. Hence, 3D US has the ability to assess the volume of the lateral ventricles similar to clinically standard MRI, but manual segmentation is time consuming. The objective of this study is to develop an approach quantifying the ratio of lateral ventricular dilatation with respect to total brain volume using 3D US, which can assess the severity of macrocephaly. Automatic segmentation of the lateral ventricles is achieved with a multi-atlas deformable registration approach using locally linear correlation metrics for US-MRI fusion, followed by a refinement step using deformable mesh models. Total brain volume is estimated using a 3D ellipsoid modeling approach. Validation was performed on a cohort of 12 infants, ranging from 2 to 8.5 months old, where 3D US and MRI were used to compare brain volumes and segmented lateral ventricles. Automatically extracted volumes from 3D US show a high correlation and no statistically significant difference when compared to ground truth measurements. Differences in volume ratios was 6.0 +/- 4.8% compared to MRI, while lateral ventricular segmentation yielded a mean Dice coefficient of 70.8 +/- 3.6% and a mean absolute distance (MAD) of 0.88 +/- 0.2mm, demonstrating the clinical benefit of this tool in paediatric ultrasound

Neurosurgical Ultrasound Pose Estimation Using Image-Based Registration and Sensor Fusion - A Feasibility Study

Modern neurosurgical procedures often rely on computer-assisted real-time guidance using multiple medical imaging modalities. State-of-the-art commercial products enable the fusion of pre-operative with intra-operative images (e.g., magnetic resonance [MR] with ultrasound [US] images), as well as the on-screen visualization of procedures in progress. In so doing, US images can be employed as a template to which pre-operative images can be registered, to correct for anatomical changes, to provide live-image feedback, and consequently to improve confidence when making resection margin decisions near eloquent regions during tumour surgery. In spite of the potential for tracked ultrasound to improve many neurosurgical procedures, it is not widely used. State-of-the-art systems are handicapped by optical tracking’s need for consistent line-of-sight, keeping tracked rigid bodies clean and rigidly fixed, and requiring a calibration workflow. The goal of this work is to improve the value offered by co-registered ultrasound images without the workflow drawbacks of conventional systems. The novel work in this thesis includes: the exploration and development of a GPU-enabled 2D-3D multi-modal registration algorithm based on the existing LC2 metric; and the use of this registration algorithm in the context of a sensor and image-fusion algorithm. The work presented here is a motivating step in a vision towards a heterogeneous tracking framework for image-guided interventions where the knowledge from intraoperative imaging, pre-operative imaging, and (potentially disjoint) wireless sensors in the surgical field are seamlessly integrated for the benefit of the surgeon. The technology described in this thesis, inspired by advances in robot localization demonstrate how inaccurate pose data from disjoint sources can produce a localization system greater than the sum of its parts

iRegNet: Non-rigid Registration of MRI to Interventional US for Brain-Shift Compensation using Convolutional Neural Networks

Accurate and safe neurosurgical intervention can be affected by intra-operative tissue deformation, known as brain-shift. In this study, we propose an automatic, fast, and accurate deformable method, called iRegNet, for registering pre-operative magnetic resonance images to intra-operative ultrasound volumes to compensate for brain-shift. iRegNet is a robust end-to-end deep learning approach for the non-linear registration of MRI-iUS images in the context of image-guided neurosurgery. Pre-operative MRI (as moving image) and iUS (as fixed image) are first appended to our convolutional neural network, after which a non-rigid transformation field is estimated. The MRI image is then transformed using the output displacement field to the iUS coordinate system. Extensive experiments have been conducted on two multi-location databases, which are the BITE and the RESECT. Quantitatively, iRegNet reduced the mean landmark errors from pre-registration value of (4.18 ± 1.84 and 5.35 ± 4.19 mm) to the lowest value of (1.47 ± 0.61 and 0.84 ± 0.16 mm) for the BITE and RESECT datasets, respectively. Additional qualitative validation of this study was conducted by two expert neurosurgeons through overlaying MRI-iUS pairs before and after the deformable registration. Experimental findings show that our proposed iRegNet is fast and achieves state-of-the-art accuracies outperforming state-of-the-art approaches. Furthermore, the proposed iRegNet can deliver competitive results, even in the case of non-trained images as proof of its generality and can therefore be valuable in intra-operative neurosurgical guidance