Learning Deep Similarity Metric for 3D MR-TRUS Registration

Purpose: The fusion of transrectal ultrasound (TRUS) and magnetic resonance (MR) images for guiding targeted prostate biopsy has significantly improved the biopsy yield of aggressive cancers. A key component of MR-TRUS fusion is image registration. However, it is very challenging to obtain a robust automatic MR-TRUS registration due to the large appearance difference between the two imaging modalities. The work presented in this paper aims to tackle this problem by addressing two challenges: (i) the definition of a suitable similarity metric and (ii) the determination of a suitable optimization strategy. Methods: This work proposes the use of a deep convolutional neural network to learn a similarity metric for MR-TRUS registration. We also use a composite optimization strategy that explores the solution space in order to search for a suitable initialization for the second-order optimization of the learned metric. Further, a multi-pass approach is used in order to smooth the metric for optimization. Results: The learned similarity metric outperforms the classical mutual information and also the state-of-the-art MIND feature based methods. The results indicate that the overall registration framework has a large capture range. The proposed deep similarity metric based approach obtained a mean TRE of 3.86mm (with an initial TRE of 16mm) for this challenging problem. Conclusion: A similarity metric that is learned using a deep neural network can be used to assess the quality of any given image registration and can be used in conjunction with the aforementioned optimization framework to perform automatic registration that is robust to poor initialization.Comment: To appear on IJCAR

MR to Ultrasound Registration for Image-Guided Prostate Biopsy

Transrectal ultrasound (TRUS) guided prostate biopsy is the standard approach for diagnosis of prostate cancer (PCa). However, due to the lack of image contrast of prostate tumors, it often results in false negatives. Magnetic Resonance Imaging (MRI) has been considered to be a promising imaging modality for noninvasive identification of PCa, since it can provide a high sensitivity and specificity for the detection of early stage PCa. Our main objective is to develop a registration method of 3D MR-TRUS images, allowing generation of volumetric 3D maps of targets identified in 3D MR images to be biopsied using 3D TRUS images. We proposed an image-based non-rigid registration approach which employs the modality independent neighborhood descriptor (MIND) as the local similarity feature. An efficient duality-based convex optimization-based algorithmic scheme was introduced to extract the deformations. The registration accuracy was evaluated using 20 patient images by calculating the target registration error (TRE) using manually identified corresponding intrinsic fiducials. Additional performance metrics (DSC, MAD, and MAXD) were also calculated by comparing the MR and TRUS manually segmented prostate surfaces in the registered images. Experimental results showed that the proposed method yielded an overall median TRE of 1.76 mm. In addition, we proposed a surface-based registration method, which first makes use of an initial rigid registration of 3D MR to TRUS using 6 manually placed corresponding landmarks in each image. Following the manual initialization, two prostate surfaces are segmented from 3D MR and TRUS images and then non-rigidly registered using a thin-plate spline algorithm. The registration accuracy was evaluated using 17 patient images by measuring TRE. Experimental results show that the proposed method yielded an overall mean TRE of 2.24 mm, which is favorably comparable to a clinical requirement for an error of less than 2.5 mm

Image-based registration methods for quantification and compensation of prostate motion during trans-rectal ultrasound (TRUS)-guided biopsy

Prostate biopsy is the clinical standard for cancer diagnosis and is typically performed under two-dimensional (2D) transrectal ultrasound (TRUS) for needle guidance. Unfortunately, most early stage prostate cancers are not visible on ultrasound and the procedure suffers from high false negative rates due to the lack of visible targets. Fusion of pre-biopsy MRI to 3D TRUS for targeted biopsy could improve cancer detection rates and volume of tumor sampled. In MRI-TRUS fusion biopsy systems, patient or prostate motion during the procedure causes misalignments in the MR targets mapped to the live 2D TRUS images, limiting the targeting accuracy of the biopsy system. In order to sample smallest clinically significant tumours of 0.5 cm3with 95% confidence, the root mean square (RMS) error of the biopsy system needs to be The target misalignments due to intermittent prostate motion during the procedure can be compensated by registering the live 2D TRUS images acquired during the biopsy procedure to the pre-acquired baseline 3D TRUS image. The registration must be performed both accurately and quickly in order to be useful during the clinical procedure. We developed an intensity-based 2D-3D rigid registration algorithm and validated it by calculating the target registration error (TRE) using manually identified fiducials within the prostate. We discuss two different approaches that can be used to improve the robustness of this registration to meet the clinical requirements. Firstly, we evaluated the impact of intra-procedural 3D TRUS imaging on motion compensation accuracy since the limited anatomical context available in live 2D TRUS images could limit the robustness of the 2D-3D registration. The results indicated that TRE improved when intra-procedural 3D TRUS images were used in registration, with larger improvements in the base and apex regions as compared with the mid-gland region. Secondly, we developed and evaluated a registration algorithm whose optimization is based on learned prostate motion characteristics. Compared to our initial approach, the updated optimization improved the robustness during 2D-3D registration by reducing the number of registrations with a TRE \u3e 5 mm from 9.2% to 1.2% with an overall RMS TRE of 2.3 mm. The methods developed in this work were intended to improve the needle targeting accuracy of 3D TRUS-guided biopsy systems. The successful integration of the techniques into current 3D TRUS-guided systems could improve the overall cancer detection rate during the biopsy and help to achieve earlier diagnosis and fewer repeat biopsy procedures in prostate cancer diagnosis

3D MR Ventricle Segmentation in Pre-term Infants with Post-Hemorrhagic Ventricle Dilation

Intraventricular hemorrhage (IVH) or bleed within the brain is a common condition among pre-term infants that occurs in very low birth weight preterm neonates. The prognosis is further worsened by the development of progressive ventricular dilatation, i.e., post-hemorrhagic ventricle dilation (PHVD), which occurs in 10-30% of IVH patients. In practice, predicting PHVD accurately and determining if that specific patient with ventricular dilatation requires the ability to measure accurately ventricular volume. While monitoring of PHVD in infants is typically done by repeated US and not MRI, once the patient has been treated, the follow-up over the lifetime of the patient is done by MRI. While manual segmentation is still seen as a gold standard, it is extremely time consuming, and therefore not feasible in a clinical context, and it also has a large inter-and intra-observer variability. This paper proposes an segmentation algorithm to extract the cerebral ventricles from 3D T1-weighted MR images of pre-term infants with PHVD. The proposed segmentation algorithm makes use of the convex optimization technique combined with the learned priors of image intensities and label probabilistic map, which is built from a multi-atlas registration scheme. The leave-one-out cross validation using 7 PHVD patient T1 weighted MR images showed that the proposed method yielded a mean DSC of 89.7% +/- 4.2%, a MAD of 2.6 +/- 1.1 mm, a MAXD of 17.8 +/- 6.2 mm, and a VD of 11.6% +/- 5.9%, suggesting a good agreement with manual segmentations

Rapid Segmentation Techniques for Cardiac and Neuroimage Analysis

Recent technological advances in medical imaging have allowed for the quick acquisition of highly resolved data to aid in diagnosis and characterization of diseases or to guide interventions. In order to to be integrated into a clinical work flow, accurate and robust methods of analysis must be developed which manage this increase in data. Recent improvements in in- expensive commercially available graphics hardware and General-Purpose Programming on Graphics Processing Units (GPGPU) have allowed for many large scale data analysis problems to be addressed in meaningful time and will continue to as parallel computing technology improves. In this thesis we propose methods to tackle two clinically relevant image segmentation problems: a user-guided segmentation of myocardial scar from Late-Enhancement Magnetic Resonance Images (LE-MRI) and a multi-atlas segmentation pipeline to automatically segment and partition brain tissue from multi-channel MRI. Both methods are based on recent advances in computer vision, in particular max-flow optimization that aims at solving the segmentation problem in continuous space. This allows for (approximately) globally optimal solvers to be employed in multi-region segmentation problems, without the particular drawbacks of their discrete counterparts, graph cuts, which typically present with metrication artefacts. Max-flow solvers are generally able to produce robust results, but are known for being computationally expensive, especially with large datasets, such as volume images. Additionally, we propose two new deformable registration methods based on Gauss-Newton optimization and smooth the resulting deformation fields via total-variation regularization to guarantee the problem is mathematically well-posed. We compare the performance of these two methods against four highly ranked and well-known deformable registration methods on four publicly available databases and are able to demonstrate a highly accurate performance with low run times. The best performing variant is subsequently used in a multi-atlas segmentation pipeline for the segmentation of brain tissue and facilitates fast run times for this computationally expensive approach. All proposed methods are implemented using GPGPU for a substantial increase in computational performance and so facilitate deployment into clinical work flows. We evaluate all proposed algorithms in terms of run times, accuracy, repeatability and errors arising from user interactions and we demonstrate that these methods are able to outperform established methods. The presented approaches demonstrate high performance in comparison with established methods in terms of accuracy and repeatability while largely reducing run times due to the employment of GPU hardware

Software and Hardware-based Tools for Improving Ultrasound Guided Prostate Brachytherapy

Minimally invasive procedures for prostate cancer diagnosis and treatment, including biopsy and brachytherapy, rely on medical imaging such as two-dimensional (2D) and three-dimensional (3D) transrectal ultrasound (TRUS) and magnetic resonance imaging (MRI) for critical tasks such as target definition and diagnosis, treatment guidance, and treatment planning. Use of these imaging modalities introduces challenges including time-consuming manual prostate segmentation, poor needle tip visualization, and variable MR-US cognitive fusion. The objective of this thesis was to develop, validate, and implement software- and hardware-based tools specifically designed for minimally invasive prostate cancer procedures to overcome these challenges. First, a deep learning-based automatic 3D TRUS prostate segmentation algorithm was developed and evaluated using a diverse dataset of clinical images acquired during prostate biopsy and brachytherapy procedures. The algorithm significantly outperformed state-of-the-art fully 3D CNNs trained using the same dataset while a segmentation time of 0.62 s demonstrated a significant reduction compared to manual segmentation. Next, the impact of dataset size, image quality, and image type on segmentation performance using this algorithm was examined. Using smaller training datasets, segmentation accuracy was shown to plateau with as little as 1000 training images, supporting the use of deep learning approaches even when data is scarce. The development of an image quality grading scale specific to 3D TRUS images will allow for easier comparison between algorithms trained using different datasets. Third, a power Doppler (PD) US-based needle tip localization method was developed and validated in both phantom and clinical cases, demonstrating reduced tip error and variation for obstructed needles compared to conventional US. Finally, a surface-based MRI-3D TRUS deformable image registration algorithm was developed and implemented clinically, demonstrating improved registration accuracy compared to manual rigid registration and reduced variation compared to the current clinical standard of physician cognitive fusion. These generalizable and easy-to-implement tools have the potential to improve workflow efficiency and accuracy for minimally invasive prostate procedures

Recalage déformable à base de graphes : mise en correspondance coupe-vers-volume et méthodes contextuelles

Image registration methods, which aim at aligning two or more images into one coordinate system, are among the oldest and most widely used algorithms in computer vision. Registration methods serve to establish correspondence relationships among images (captured at different times, from different sensors or from different viewpoints) which are not obvious for the human eye. A particular type of registration algorithm, known as graph-based deformable registration methods, has become popular during the last decade given its robustness, scalability, efficiency and theoretical simplicity. The range of problems to which it can be adapted is particularly broad. In this thesis, we propose several extensions to the graph-based deformable registration theory, by exploring new application scenarios and developing novel methodological contributions.Our first contribution is an extension of the graph-based deformable registration framework, dealing with the challenging slice-to-volume registration problem. Slice-to-volume registration aims at registering a 2D image within a 3D volume, i.e. we seek a mapping function which optimally maps a tomographic slice to the 3D coordinate space of a given volume. We introduce a scalable, modular and flexible formulation accommodating low-rank and high order terms, which simultaneously selects the plane and estimates the in-plane deformation through a single shot optimization approach. The proposed framework is instantiated into different variants based on different graph topology, label space definition and energy construction. Simulated and real-data in the context of ultrasound and magnetic resonance registration (where both framework instantiations as well as different optimization strategies are considered) demonstrate the potentials of our method.The other two contributions included in this thesis are related to how semantic information can be encompassed within the registration process (independently of the dimensionality of the images). Currently, most of the methods rely on a single metric function explaining the similarity between the source and target images. We argue that incorporating semantic information to guide the registration process will further improve the accuracy of the results, particularly in the presence of semantic labels making the registration a domain specific problem.We consider a first scenario where we are given a classifier inferring probability maps for different anatomical structures in the input images. Our method seeks to simultaneously register and segment a set of input images, incorporating this information within the energy formulation. The main idea is to use these estimated maps of semantic labels (provided by an arbitrary classifier) as a surrogate for unlabeled data, and combine them with population deformable registration to improve both alignment and segmentation.Our last contribution also aims at incorporating semantic information to the registration process, but in a different scenario. In this case, instead of supposing that we have pre-trained arbitrary classifiers at our disposal, we are given a set of accurate ground truth annotations for a variety of anatomical structures. We present a methodological contribution that aims at learning context specific matching criteria as an aggregation of standard similarity measures from the aforementioned annotated data, using an adapted version of the latent structured support vector machine (LSSVM) framework.Les méthodes de recalage d’images, qui ont pour but l’alignement de deux ou plusieurs images dans un même système de coordonnées, sont parmi les algorithmes les plus anciens et les plus utilisés en vision par ordinateur. Les méthodes de recalage servent à établir des correspondances entre des images (prises à des moments différents, par différents senseurs ou avec différentes perspectives), lesquelles ne sont pas évidentes pour l’œil humain. Un type particulier d’algorithme de recalage, connu comme « les méthodes de recalage déformables à l’aide de modèles graphiques » est devenu de plus en plus populaire ces dernières années, grâce à sa robustesse, sa scalabilité, son efficacité et sa simplicité théorique. La gamme des problèmes auxquels ce type d’algorithme peut être adapté est particulièrement vaste. Dans ce travail de thèse, nous proposons plusieurs extensions à la théorie de recalage déformable à l’aide de modèles graphiques, en explorant de nouvelles applications et en développant des contributions méthodologiques originales.Notre première contribution est une extension du cadre du recalage à l’aide de graphes, en abordant le problème très complexe du recalage d’une tranche avec un volume. Le recalage d’une tranche avec un volume est le recalage 2D dans un volume 3D, comme par exemple le mapping d’une tranche tomographique dans un système de coordonnées 3D d’un volume en particulier. Nos avons proposé une formulation scalable, modulaire et flexible pour accommoder des termes d'ordre élevé et de rang bas, qui peut sélectionner le plan et estimer la déformation dans le plan de manière simultanée par une seule approche d'optimisation. Le cadre proposé est instancié en différentes variantes, basés sur différentes topologies du graph, définitions de l'espace des étiquettes et constructions de l'énergie. Le potentiel de notre méthode a été démontré sur des données réelles ainsi que des données simulées dans le cadre d’une résonance magnétique d’ultrason (où le cadre d’installation et les stratégies d’optimisation ont été considérés).Les deux autres contributions inclues dans ce travail de thèse, sont liées au problème de l’intégration de l’information sémantique dans la procédure de recalage (indépendamment de la dimensionnalité des images). Actuellement, la plupart des méthodes comprennent une seule fonction métrique pour expliquer la similarité entre l’image source et l’image cible. Nous soutenons que l'intégration des informations sémantiques pour guider la procédure de recalage pourra encore améliorer la précision des résultats, en particulier en présence d'étiquettes sémantiques faisant du recalage un problème spécifique adapté à chaque domaine.Nous considérons un premier scénario en proposant un classificateur pour inférer des cartes de probabilité pour les différentes structures anatomiques dans les images d'entrée. Notre méthode vise à recaler et segmenter un ensemble d'images d'entrée simultanément, en intégrant cette information dans la formulation de l'énergie. L'idée principale est d'utiliser ces cartes estimées des étiquettes sémantiques (fournie par un classificateur arbitraire) comme un substitut pour les données non-étiquettées, et les combiner avec le recalage déformable pour améliorer l'alignement ainsi que la segmentation.Notre dernière contribution vise également à intégrer l'information sémantique pour la procédure de recalage, mais dans un scénario différent. Dans ce cas, au lieu de supposer que nous avons des classificateurs arbitraires pré-entraînés à notre disposition, nous considérons un ensemble d’annotations précis (vérité terrain) pour une variété de structures anatomiques. Nous présentons une contribution méthodologique qui vise à l'apprentissage des critères correspondants au contexte spécifique comme une agrégation des mesures de similarité standard à partir des données annotées, en utilisant une adaptation de l’algorithme « Latent Structured Support Vector Machine »