124 research outputs found
Unveiling healthcare data archiving: Exploring the role of artificial intelligence in medical image analysis
Gli archivi sanitari digitali possono essere considerati dei moderni database progettati per immagazzinare e gestire ingenti quantitaÌ di informazioni mediche, dalle cartelle cliniche dei pazienti, a studi clinici fino alle immagini mediche e a dati genomici. I dati strutturati e non strutturati che compongono gli archivi sanitari sono oggetto di scrupolose e rigorose procedure di validazione per garantire accuratezza, affidabilitaÌ e standardizzazione a fini clinici e di ricerca.
Nel contesto di un settore sanitario in continua e rapida evoluzione, lâintelligenza artificiale (IA) si propone come una forza trasformativa, capace di riformare gli archivi sanitari digitali migliorando la gestione, lâanalisi e il recupero di vasti set di dati clinici, al fine di ottenere decisioni cliniche piuÌ informate e ripetibili, interventi tempestivi e risultati migliorati per i pazienti.
Tra i diversi dati archiviati, la gestione e lâanalisi delle immagini mediche in archivi digitali presentano numerose sfide dovute allâeterogeneitaÌ dei dati, alla variabilitaÌ della qualitaÌ delle immagini, noncheÌ alla mancanza di annotazioni. Lâimpiego di soluzioni basate sullâIA puoÌ aiutare a risolvere efficacemente queste problematiche, migliorando lâaccuratezza dellâanalisi delle immagini, standardizzando la qualitaÌ dei dati e facilitando la generazione di annotazioni dettagliate.
Questa tesi ha lo scopo di utilizzare algoritmi di IA per lâanalisi di immagini mediche depositate in archivi sanitari digitali. Il presente lavoro propone di indagare varie tecniche di imaging medico, ognuna delle quali eÌ caratterizzata da uno specifico dominio di applicazione e presenta quindi un insieme unico di sfide, requisiti e potenziali esiti. In particolare, in questo lavoro di tesi saraÌ oggetto di approfondimento lâassistenza diagnostica degli algoritmi di IA per tre diverse tecniche di imaging, in specifici scenari clinici:
i) Immagini endoscopiche ottenute durante esami di laringoscopia; cioÌ include unâesplorazione approfondita di tecniche come la detection di keypoints per la stima della motilitaÌ delle corde vocali e la segmentazione di tumori del tratto aerodigestivo superiore;
ii) Immagini di risonanza magnetica per la segmentazione dei dischi intervertebrali, per la diagnosi e il trattamento di malattie spinali, cosiÌ come per lo svolgimento di interventi chirurgici guidati da immagini;
iii) Immagini ecografiche in ambito reumatologico, per la valutazione della sindrome del tunnel carpale attraverso la segmentazione del nervo mediano.
Le metodologie esposte in questo lavoro evidenziano lâefficacia degli algoritmi di IA nellâanalizzare immagini mediche archiviate. I progressi metodologici ottenuti sottolineano il notevole potenziale dellâIA nel rivelare informazioni implicitamente presenti negli archivi sanitari digitali
Algorithm for Video Summarization of Bronchoscopy Procedures
<p>Abstract</p> <p>Background</p> <p>The duration of bronchoscopy examinations varies considerably depending on the diagnostic and therapeutic procedures used. It can last more than 20 minutes if a complex diagnostic work-up is included. With wide access to videobronchoscopy, the whole procedure can be recorded as a video sequence. Common practice relies on an active attitude of the bronchoscopist who initiates the recording process and usually chooses to archive only selected views and sequences. However, it may be important to record the full bronchoscopy procedure as documentation when liability issues are at stake. Furthermore, an automatic recording of the whole procedure enables the bronchoscopist to focus solely on the performed procedures. Video recordings registered during bronchoscopies include a considerable number of frames of poor quality due to blurry or unfocused images. It seems that such frames are unavoidable due to the relatively tight endobronchial space, rapid movements of the respiratory tract due to breathing or coughing, and secretions which occur commonly in the bronchi, especially in patients suffering from pulmonary disorders.</p> <p>Methods</p> <p>The use of recorded bronchoscopy video sequences for diagnostic, reference and educational purposes could be considerably extended with efficient, flexible summarization algorithms. Thus, the authors developed a prototype system to create shortcuts (called summaries or abstracts) of bronchoscopy video recordings. Such a system, based on models described in previously published papers, employs image analysis methods to exclude frames or sequences of limited diagnostic or education value.</p> <p>Results</p> <p>The algorithm for the selection or exclusion of specific frames or shots from video sequences recorded during bronchoscopy procedures is based on several criteria, including automatic detection of "non-informative", frames showing the branching of the airways and frames including pathological lesions.</p> <p>Conclusions</p> <p>The paper focuses on the challenge of generating summaries of bronchoscopy video recordings.</p
Surgical Data Science - from Concepts toward Clinical Translation
Recent developments in data science in general and machine learning in particular have transformed the way experts envision the future of surgery. Surgical Data Science (SDS) is a new research field that aims to improve the quality of interventional healthcare through the capture, organization, analysis and modeling of data. While an increasing number of data-driven approaches and clinical applications have been studied in the fields of radiological and clinical data science, translational success stories are still lacking in surgery. In this publication, we shed light on the underlying reasons and provide a roadmap for future advances in the field. Based on an international workshop involving leading researchers in the field of SDS, we review current practice, key achievements and initiatives as well as available standards and tools for a number of topics relevant to the field, namely (1) infrastructure for data acquisition, storage and access in the presence of regulatory constraints, (2) data annotation and sharing and (3) data analytics. We further complement this technical perspective with (4) a review of currently available SDS products and the translational progress from academia and (5) a roadmap for faster clinical translation and exploitation of the full potential of SDS, based on an international multi-round Delphi process
Interfaces for Modular Surgical Planning and Assistance Systems
Modern surgery of the 21st century relies in many aspects on computers or, in a wider sense, digital data processing. Department administration, OR scheduling, billing, and - with increasing pervasion - patient data management are performed with the aid of so called Surgical Information Systems (SIS) or, more general, Hospital Information Systems (HIS).
Computer Assisted Surgery (CAS) summarizes techniques which assist a surgeon in the preparation and conduction of surgical interventions. Today still predominantly based on radiology images, these techniques include the preoperative determination of an optimal surgical strategy and intraoperative systems which aim at increasing the accuracy of surgical manipulations.
CAS is a relatively young field of computer science. One of the unsolved "teething troubles" of CAS is the absence of technical standards for the interconnectivity of CAS system. Current CAS systems are usually "islands of information" with no connection to other devices within the operating room or hospital-wide information systems. Several workshop reports and individual publications point out that this situation leads to ergonomic, logistic, and economic limitations in hospital work. Perioperative processes are prolonged by the manual installation and configuration of an increasing amount of technical devices. Intraoperatively, a large amount of the surgeons'' attention is absorbed by the requirement to monitor and operate systems. The need for open infrastructures which enable the integration of CAS devices from different vendors in order to exchange information as well as commands among these devices through a network has been identified by numerous experts with backgrounds in medicine as well as engineering.
This thesis contains two approaches to the integration of CAS systems:
- For perioperative data exchange, the specification of new data structures as an amendment to the existing DICOM standard for radiology image management is presented. The extension of DICOM towards surgical application allows for the seamless integration of surgical planning and reporting systems into DICOM-based Picture Archiving and Communication Systems (PACS) as they are installed in most hospitals for the exchange and long-term archival of patient images and image-related patient data.
- For the integration of intraoperatively used CAS devices, such as, e.g., navigation systems, video image sources, or biosensors, the concept of a surgical middleware is presented. A c++ class library, the TiCoLi, is presented which facilitates the configuration of ad-hoc networks among the modules of a distributed CAS system as well as the exchange of data streams, singular data objects, and commands between these modules. The TiCoLi is the first software library for a surgical field of application to implement all of these services.
To demonstrate the suitability of the presented specifications and their implementation, two modular CAS applications are presented which utilize the proposed DICOM extensions for perioperative exchange of surgical planning data as well as the TiCoLi for establishing an intraoperative network of autonomous, yet not independent, CAS modules.Die moderne Hochleistungschirurgie des 21. Jahrhunderts ist auf vielerlei Weise abhĂ€ngig von Computern oder, im weiteren Sinne, der digitalen Datenverarbeitung. Administrative AblĂ€ufe, wie die Erstellung von NutzungsplĂ€nen fĂŒr die verfĂŒgbaren technischen, rĂ€umlichen und personellen Ressourcen, die Rechnungsstellung und - in zunehmendem MaĂe - die Verwaltung und Archivierung von Patientendaten werden mit Hilfe von digitalen Informationssystemen rationell und effizient durchgefĂŒhrt. Innerhalb der Krankenhausinformationssysteme (KIS, oder englisch HIS) stehen fĂŒr die speziellen BedĂŒrfnisse der einzelnen Fachabteilungen oft spezifische Informationssysteme zur VerfĂŒgung. Chirurgieinformationssysteme (CIS, oder englisch SIS) decken hierbei vor allen Dingen die Bereiche Operationsplanung sowie Materialwirtschaft fĂŒr spezifisch chirurgische Verbrauchsmaterialien ab.
WĂ€hrend die genannten HIS und SIS vornehmlich der Optimierung administrativer Aufgaben dienen, stehen die Systeme der Computerassistierten Chirugie (CAS) wesentlich direkter im Dienste der eigentlichen chirugischen Behandlungsplanung und Therapie. Die CAS verwendet Methoden der Robotik, digitalen Bild- und Signalverarbeitung, kĂŒnstlichen Intelligenz, numerischen Simulation, um nur einige zu nennen, zur patientenspezifischen Behandlungsplanung und zur intraoperativen UnterstĂŒtzung des OP-Teams, allen voran des Chirurgen. Vor allen Dingen Fortschritte in der rĂ€umlichen Verfolgung von Werkzeugen und Patienten ("Tracking"), die VerfĂŒgbarkeit dreidimensionaler radiologischer Aufnahmen (CT, MRT, ...) und der Einsatz verschiedener Robotersysteme haben in den vergangenen Jahrzehnten den Einzug des Computers in den Operationssaal - medienwirksam - ermöglicht. Weniger prominent, jedoch keinesfalls von untergeordnetem praktischen Nutzen, sind Beispiele zur automatisierten Ăberwachung klinischer Messwerte, wie etwa Blutdruck oder SauerstoffsĂ€ttigung.
Im Gegensatz zu den meist hochgradig verteilten und gut miteinander verwobenen Informationssystemen fĂŒr die Krankenhausadministration und Patientendatenverwaltung, sind die Systeme der CAS heutzutage meist wenig oder ĂŒberhaupt nicht miteinander und mit Hintergrundsdatenspeichern vernetzt. Eine Reihe wissenschaftlicher Publikationen und interdisziplinĂ€rer Workshops hat sich in den vergangen ein bis zwei Jahrzehnten mit den Problemen des Alltagseinsatzes von CAS Systemen befasst. Mit steigender IntensitĂ€t wurde hierbei auf den Mangel an infrastrukturiellen Grundlagen fĂŒr die Vernetzung intraoperativ eingesetzter CAS Systeme miteinander und mit den perioperativ eingesetzten Planungs-, Dokumentations- und Archivierungssystemen hingewiesen. Die sich daraus ergebenden negativen EinflĂŒsse auf die Effizienz perioperativer AblĂ€ufe - jedes GerĂ€t muss manuell in Betrieb genommen und mit den spezifischen Daten des nĂ€chsten Patienten gefĂŒttert werden - sowie die zunehmende Aufmerksamkeit, welche der Operateur und sein Team auf die Ăberwachung und dem Betrieb der einzelnen GerĂ€te verwenden muss, werden als eine der "Kinderkrankheiten" dieser relativ jungen Technologie betrachtet und stehen einer Verbreitung ĂŒber die Grenzen einer engagierten technophilen Nutzergruppe hinaus im Wege.
Die vorliegende Arbeit zeigt zwei parallel von einander (jedoch, im Sinne der SchnittstellenkompatibilitÀt, nicht gÀnzlich unabhÀngig voneinander) zu betreibende AnsÀtze zur Integration von CAS Systemen.
- FĂŒr den perioperativen Datenaustausch wird die Spezifikation zusĂ€tzlicher Datenstrukturen zum Transfer chirurgischer Planungsdaten im Rahmen des in radiologischen Bildverarbeitungssystemen weit verbreiteten DICOM Standards vorgeschlagen und an zwei Beispielen vorgefĂŒhrt. Die Erweiterung des DICOM Standards fĂŒr den perioperativen Einsatz ermöglicht hierbei die nahtlose Integration chirurgischer Planungssysteme in existierende "Picture Archiving and Communication Systems" (PACS), welche in den meisten FĂ€llen auf dem DICOM Standard basieren oder zumindest damit kompatibel sind. Dadurch ist einerseits der Tatsache Rechnung getragen, dass die patientenspezifische OP-Planung in hohem Masse auf radiologischen Bildern basiert und andererseits sicher gestellt, dass die Planungsergebnisse entsprechend der geltenden Bestimmungen langfristig archiviert und gegen unbefugten Zugriff geschĂŒtzt sind - PACS Server liefern hier bereits wohlerprobte Lösungen.
- FĂŒr die integration intraoperativer CAS Systeme, wie etwa Navigationssysteme, Videobildquellen oder Sensoren zur Ăberwachung der Vitalparameter, wird das Konzept einer "chirurgischen Middleware" vorgestellt. Unter dem Namen TiCoLi wurde eine c++ Klassenbibliothek entwickelt, auf deren Grundlage die Konfiguration von ad-hoc Netzwerken wĂ€hrend der OP-Vorbereitung mittels plug-and-play Mechanismen erleichtert wird. Nach erfolgter Konfiguration ermöglicht die TiCoLi den Austausch kontinuierlicher Datenströme sowie einzelner Datenpakete und Kommandos zwischen den Modulen einer verteilten CAS Anwendung durch ein Ethernet-basiertes Netzwerk. Die TiCoLi ist die erste frei verfĂŒgbare Klassenbibliothek welche diese FunktionalitĂ€ten dediziert fĂŒr einen Einsatz im chirurgischen Umfeld vereinigt.
Zum Nachweis der Tauglichkeit der gezeigten Spezifikationen und deren Implementierungen, werden zwei modulare CAS Anwendungen prÀsentiert, welche die vorgeschlagenen DICOM Erweiterungen zum perioperativen Austausch von Planungsergebnissen sowie die TiCoLi zum intraoperativen Datenaustausch von Messdaten unter echzeitnahen Anforderungen verwenden
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Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.
BackgroundInjuries are quickly becoming a leading cause of death globally, disproportionately affecting sub-Saharan Africa, where reports on the epidemiology of injuries are extremely limited. Reports on the patterns and frequency of injuries are available from Cameroon are also scarce. This study explores the patterns of trauma seen at the emergency ward of the busiest trauma center in Cameroon's capital city.Materials and methodsAdministrative records from January 1, 2007, through December 31, 2007, were retrospectively reviewed; information on age, gender, mechanism of injury, and outcome was abstracted for all trauma patients presenting to the emergency ward. Univariate analysis was performed to assess patterns of injuries in terms of mechanism, date, age, and gender. Bivariate analysis was used to explore potential relationships between demographic variables and mechanism of injury.ResultsA total of 6,234 injured people were seen at the Central Hospital of Yaoundé's emergency ward during the year 2007. Males comprised 71% of those injured, and the mean age of injured patients was 29 years (SD = 14.9). Nearly 60% of the injuries were due to road traffic accidents, 46% of which involved a pedestrian. Intentional injuries were the second most common mechanism of injury (22.5%), 55% of which involved unarmed assault. Patients injured in falls were more likely to be admitted to the hospital (p < 0.001), whereas patients suffering intentional injuries and bites were less likely to be hospitalized (p < 0.001). Males were significantly more likely to be admitted than females (p < 0.001)DiscussionPatterns in terms of age, gender, and mechanism of injury are similar to reports from other countries from the same geographic region, but the magnitude of cases reported is high for a single institution in an African city the size of Yaoundé. As the burden of disease is predicted to increase dramatically in sub-Saharan Africa, immediate efforts in prevention and treatment in Cameroon are strongly warranted
Semi-automated parallel programming in heterogeneous intelligent reconfigurable environments (SAPPHIRE)
In recent years, as we come closer to approaching physical limits in making smaller (and faster) computer processors, focus has instead been turned toward including multiple processor cores in each device. While this technically allows for more computational power as compared with only one traditional processor core, conventional software can typically only make use of a single processor. Furthermore, we see an increasing number of stream programs that process streams of data such as a stream of images or audio. For stream programs to effectively utilize multi-core processors, multithreading is the key, but it may be difficult to implement in practice depending on the complexity of the programs.
We present SAPPHIRE: Semi-Automated Parallel Programming in Heterogeneous Intelligent Reconfigurable Environment, a middleware and SDK for developing multithreaded stream programs. In this middleware, we implement our semi-automated program construction technique which is designed to aid in writing multithreaded software by reducing needed complexity and lines of code written by software developers.
We also present a novel static task-scheduling algorithm for stream programs with heterogeneous implementation choices. Our algorithm is capable of scheduling stream programs with provably near-optimal results given a specific set of assumptions, without requiring the unrolling of the task graph. Unrolling the task graph greatly increases the size of the input to the NP-Complete part of the task-scheduling problem as in related work.
Finally, we present two case study programs implemented using SAPPHIRE. One case study, EM-Capture, has analyzed over 50 billion frames of endoscopy video in real-time in a real hospital, discerning over 71,000 unique endoscopy procedures. The other case study, EM-Feedback-RT, is a collaborative extension to EM-Capture, and is an attempt to provide real-time quality analysis feedback to physicians during a colonoscopy exam
Laparoscopic Image Recovery and Stereo Matching
Laparoscopic imaging can play a significant role in the minimally invasive surgical procedure. However, laparoscopic images often suffer from insufficient and irregular light sources, specular highlight surfaces, and a lack of depth information. These problems can negatively influence the surgeons during surgery, and lead to erroneous visual tracking and potential surgical risks. Thus, developing effective image-processing algorithms for laparoscopic vision recovery and stereo matching is of significant importance. Most related algorithms are effective on nature images, but less effective on laparoscopic images.
The first purpose of this thesis is to restore low-light laparoscopic vision, where an effective image enhancement method is proposed by identifying different illumination regions and designing the enhancement criteria for desired image quality. This method can enhance the low-light region by reducing noise amplification during the enhancement process. In addition, this thesis also proposes a simplified Retinex optimization method for non-uniform illumination enhancement. By integrating the prior information of the illumination and reflectance into the optimization process, this method can significantly enhance the dark region while preserving naturalness, texture details, and image structures. Moreover, due to the replacement of the total variation term with two -norm terms, the proposed algorithm has a significant computational advantage.
Second, a global optimization method for specular highlight removal from a single laparoscopic image is proposed. This method consists of a modified dichromatic reflection model and a novel diffuse chromaticity estimation technique. Due to utilizing the limited color variation of the laparoscopic image, the estimated diffuse chromaticity can approximate the true diffuse chromaticity, which allows us to effectively remove the specular highlight with texture detail preservation.
Third, a robust edge-preserving stereo matching method is proposed, based on sparse feature matching, left and right illumination equalization, and refined disparity optimization processes. The sparse feature matching and illumination equalization techniques can provide a good disparity map initialization so that our refined disparity optimization can quickly obtain an accurate disparity map. This approach is particularly promising on surgical tool edges, smooth soft tissues, and surfaces with strong specular highlight
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