Learning the dynamics and time-recursive boundary detection of deformable objects

We propose a principled framework for recursively segmenting deformable objects across a sequence of frames. We demonstrate the usefulness of this method on left ventricular segmentation across a cardiac cycle. The approach involves a technique for learning the system dynamics together with methods of particle-based smoothing as well as non-parametric belief propagation on a loopy graphical model capturing the temporal periodicity of the heart. The dynamic system state is a low-dimensional representation of the boundary, and the boundary estimation involves incorporating curve evolution into recursive state estimation. By formulating the problem as one of state estimation, the segmentation at each particular time is based not only on the data observed at that instant, but also on predictions based on past and future boundary estimates. Although the paper focuses on left ventricle segmentation, the method generalizes to temporally segmenting any deformable object

Computational Methods for Segmentation of Multi-Modal Multi-Dimensional Cardiac Images

Segmentation of the heart structures helps compute the cardiac contractile function quantified via the systolic and diastolic volumes, ejection fraction, and myocardial mass, representing a reliable diagnostic value. Similarly, quantification of the myocardial mechanics throughout the cardiac cycle, analysis of the activation patterns in the heart via electrocardiography (ECG) signals, serve as good cardiac diagnosis indicators. Furthermore, high quality anatomical models of the heart can be used in planning and guidance of minimally invasive interventions under the assistance of image guidance. The most crucial step for the above mentioned applications is to segment the ventricles and myocardium from the acquired cardiac image data. Although the manual delineation of the heart structures is deemed as the gold-standard approach, it requires significant time and effort, and is highly susceptible to inter- and intra-observer variability. These limitations suggest a need for fast, robust, and accurate semi- or fully-automatic segmentation algorithms. However, the complex motion and anatomy of the heart, indistinct borders due to blood flow, the presence of trabeculations, intensity inhomogeneity, and various other imaging artifacts, makes the segmentation task challenging. In this work, we present and evaluate segmentation algorithms for multi-modal, multi-dimensional cardiac image datasets. Firstly, we segment the left ventricle (LV) blood-pool from a tri-plane 2D+time trans-esophageal (TEE) ultrasound acquisition using local phase based filtering and graph-cut technique, propagate the segmentation throughout the cardiac cycle using non-rigid registration-based motion extraction, and reconstruct the 3D LV geometry. Secondly, we segment the LV blood-pool and myocardium from an open-source 4D cardiac cine Magnetic Resonance Imaging (MRI) dataset by incorporating average atlas based shape constraint into the graph-cut framework and iterative segmentation refinement. The developed fast and robust framework is further extended to perform right ventricle (RV) blood-pool segmentation from a different open-source 4D cardiac cine MRI dataset. Next, we employ convolutional neural network based multi-task learning framework to segment the myocardium and regress its area, simultaneously, and show that segmentation based computation of the myocardial area is significantly better than that regressed directly from the network, while also being more interpretable. Finally, we impose a weak shape constraint via multi-task learning framework in a fully convolutional network and show improved segmentation performance for LV, RV and myocardium across healthy and pathological cases, as well as, in the challenging apical and basal slices in two open-source 4D cardiac cine MRI datasets. We demonstrate the accuracy and robustness of the proposed segmentation methods by comparing the obtained results against the provided gold-standard manual segmentations, as well as with other competing segmentation methods

Contrast echocardiography for cardiac quantifications

The indicator-dilution-theory for cardiac quantifications has always been limited in practice by the invasiveness of the available techniques. However, the recent introduction of stable ultrasound contrast agents opens new possibilities for indicator dilution measurements. This study describes a new and successful approach to overcome this invasiveness issue. We show a novel approach for minimally invasive quantification of several cardiac parameters based on the dilution of ultrasound contrast agents. A single peripheral injection of an ultrasound contrast agent bolus can result in the simultaneous assessment of cardiac output, pulmonary blood volume, and left and right ventricular ejection fraction. The bolus passage in different sites of the central circulation is detected by an ultrasound transducer. The detected acoustic (or video) intensities are processed and several indicator dilution curves are measured simultaneously. To this end, we exploit that for low concentrations the relation between contrast concentration and acoustic backscatter is approximately linear. The Local Density Random Walk Model is used to fit and interpret the indicator dilution curves for cardiac output, pulmonary blood volume, and ejection fraction measurements. Two fitting algorithms based either on a multiple linear regression in the logarithmic domain or on the solution of the moment equations are developed. The indicator dilution system can be also interpreted as a linear system and, therefore, characterized by an impulse response function. An adaptive Wiener deconvolution filter is implemented for robust dilution system identification. For ejection fraction measurements, the atrial and ventricular indicator dilution curves are measured and processed by the deconvolution filter, resulting in the estimate of the left ventricle dilution-system impulse response. This curve can be fitted and interpreted by a mono-compartment exponential model for the ejection fraction assessment. The proposed deconvolution filter is also used for the identification of the dilution system between right ventricle and left atrium. The Local Density Random Walk Model fit of the estimated impulse response allows the pulmonary blood volume assessment. Both cardiac output and pulmonary blood volume measurements are validated in vitro with accurate results (correlation coefficients larger than 0.99). The Pulmonary blood volume measurement feasibility is also tested in humans with promising results. The ejection fraction measurement is validated in-vivo. The impulse response approach allows accurate left ventricle ejection fraction estimates. Comparison with echocardiographic bi-plane measurements shows a correlation coefficient equal to 0.93. A dedicated image segmentation algorithm for videodensitometry has also been developed for automating the determination of regions of interest. The resulting algorithm has been integrated with the indicator dilution analysis system. The automatic determination of the measurement region results in improved dilution-curve signal-to-noise ratios. In conclusion, this study proves that quantification of cardiac output, pulmonary blood volume, and left and right ventricular ejection fraction by dilution of ultrasound contrast agents is feasible and accurate. Moreover, the proposed methods are applicable in different contexts (e.g., magnetic resonance imaging) and for different types of measurements, leading to a broad range of applications

A Survey on Deep Learning in Medical Image Registration: New Technologies, Uncertainty, Evaluation Metrics, and Beyond

Over the past decade, deep learning technologies have greatly advanced the field of medical image registration. The initial developments, such as ResNet-based and U-Net-based networks, laid the groundwork for deep learning-driven image registration. Subsequent progress has been made in various aspects of deep learning-based registration, including similarity measures, deformation regularizations, and uncertainty estimation. These advancements have not only enriched the field of deformable image registration but have also facilitated its application in a wide range of tasks, including atlas construction, multi-atlas segmentation, motion estimation, and 2D-3D registration. In this paper, we present a comprehensive overview of the most recent advancements in deep learning-based image registration. We begin with a concise introduction to the core concepts of deep learning-based image registration. Then, we delve into innovative network architectures, loss functions specific to registration, and methods for estimating registration uncertainty. Additionally, this paper explores appropriate evaluation metrics for assessing the performance of deep learning models in registration tasks. Finally, we highlight the practical applications of these novel techniques in medical imaging and discuss the future prospects of deep learning-based image registration

A Markov Random Field Based Approach to 3D Mosaicing and Registration Applied to Ultrasound Simulation

A novel Markov Random Field (MRF) based method for the mosaicing of 3D ultrasound volumes is presented in this dissertation. The motivation for this work is the production of training volumes for an affordable ultrasound simulator, which offers a low-cost/portable training solution for new users of diagnostic ultrasound, by providing the scanning experience essential for developing the necessary psycho-motor skills. It also has the potential for introducing ultrasound instruction into medical education curriculums. The interest in ultrasound training stems in part from the widespread adoption of point-of-care scanners, i.e. low cost portable ultrasound scanning systems in the medical community. This work develops a novel approach for producing 3D composite image volumes and validates the approach using clinically acquired fetal images from the obstetrics department at the University of Massachusetts Medical School (UMMS). Results using the Visible Human Female dataset as well as an abdominal trauma phantom are also presented. The process is broken down into five distinct steps, which include individual 3D volume acquisition, rigid registration, calculation of a mosaicing function, group-wise non-rigid registration, and finally blending. Each of these steps, common in medical image processing, has been investigated in the context of ultrasound mosaicing and has resulted in improved algorithms. Rigid and non-rigid registration methods are analyzed in a probabilistic framework and their sensitivity to ultrasound shadowing artifacts is studied. The group-wise non-rigid registration problem is initially formulated as a maximum likelihood estimation, where the joint probability density function is comprised of the partially overlapping ultrasound image volumes. This expression is simplified using a block-matching methodology and the resulting discrete registration energy is shown to be equivalent to a Markov Random Field. Graph based methods common in computer vision are then used for optimization, resulting in a set of transformations that bring the overlapping volumes into alignment. This optimization is parallelized using a fusion approach, where the registration problem is divided into 8 independent sub-problems whose solutions are fused together at the end of each iteration. This method provided a speedup factor of 3.91 over the single threaded approach with no noticeable reduction in accuracy during our simulations. Furthermore, the registration problem is simplified by introducing a mosaicing function, which partitions the composite volume into regions filled with data from unique partially overlapping source volumes. This mosaicing functions attempts to minimize intensity and gradient differences between adjacent sources in the composite volume. Experimental results to demonstrate the performance of the group-wise registration algorithm are also presented. This algorithm is initially tested on deformed abdominal image volumes generated using a finite element model of the Visible Human Female to show the accuracy of its calculated displacement fields. In addition, the algorithm is evaluated using real ultrasound data from an abdominal phantom. Finally, composite obstetrics image volumes are constructed using clinical scans of pregnant subjects, where fetal movement makes registration/mosaicing especially difficult. Our solution to blending, which is the final step of the mosaicing process, is also discussed. The trainee will have a better experience if the volume boundaries are visually seamless, and this usually requires some blending prior to stitching. Also, regions of the volume where no data was collected during scanning should have an ultrasound-like appearance before being displayed in the simulator. This ensures the trainee\u27s visual experience isn\u27t degraded by unrealistic images. A discrete Poisson approach has been adapted to accomplish these tasks. Following this, we will describe how a 4D fetal heart image volume can be constructed from swept 2D ultrasound. A 4D probe, such as the Philips X6-1 xMATRIX Array, would make this task simpler as it can acquire 3D ultrasound volumes of the fetal heart in real-time; However, probes such as these aren\u27t widespread yet. Once the theory has been introduced, we will describe the clinical component of this dissertation. For the purpose of acquiring actual clinical ultrasound data, from which training datasets were produced, 11 pregnant subjects were scanned by experienced sonographers at the UMMS following an approved IRB protocol. First, we will discuss the software/hardware configuration that was used to conduct these scans, which included some custom mechanical design. With the data collected using this arrangement we generated seamless 3D fetal mosaics, that is, the training datasets, loaded them into our ultrasound training simulator, and then subsequently had them evaluated by the sonographers at the UMMS for accuracy. These mosaics were constructed from the raw scan data using the techniques previously introduced. Specific training objectives were established based on the input from our collaborators in the obstetrics sonography group. Important fetal measurements are reviewed, which form the basis for training in obstetrics ultrasound. Finally clinical images demonstrating the sonographer making fetal measurements in practice, which were acquired directly by the Philips iU22 ultrasound machine from one of our 11 subjects, are compared with screenshots of corresponding images produced by our simulator