Dynamic Volume Rendering of Functional Medical Data on Dissimilar Hardware Platforms

In the last 30 years, medical imaging has become one of the most used diagnostic tools in the medical profession. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) technologies have become widely adopted because of their ability to capture the human body in a non-invasive manner. A volumetric dataset is a series of orthogonal 2D slices captured at a regular interval, typically along the axis of the body from the head to the feet. Volume rendering is a computer graphics technique that allows volumetric data to be visualized and manipulated as a single 3D object. Iso-surface rendering, image splatting, shear warp, texture slicing, and raycasting are volume rendering methods, each with associated advantages and disadvantages. Raycasting is widely regarded as the highest quality renderer of these methods. Originally, CT and MRI hardware was limited to providing a single 3D scan of the human body. The technology has improved to allow a set of scans capable of capturing anatomical movements like a beating heart. The capturing of anatomical data over time is referred to as functional imaging. Functional MRI (fMRI) is used to capture changes in the human body over time. While fMRI’s can be used to capture any anatomical data over time, one of the more common uses of fMRI is to capture brain activity. The fMRI scanning process is typically broken up into a time consuming high resolution anatomical scan and a series of quick low resolution scans capturing activity. The low resolution activity data is mapped onto the high resolution anatomical data to show changes over time. Academic research has advanced volume rendering and specifically fMRI volume rendering. Unfortunately, academic research is typically a one-off solution to a singular medical case or set of data, causing any advances to be problem specific as opposed to a general capability. Additionally, academic volume renderers are often designed to work on a specific device and operating system under controlled conditions. This prevents volume rendering from being used across the ever expanding number of different computing devices, such as desktops, laptops, immersive virtual reality systems, and mobile computers like phones or tablets. This research will investigate the feasibility of creating a generic software capability to perform real-time 4D volume rendering, via raycasting, on desktop, mobile, and immersive virtual reality platforms. Implementing a GPU-based 4D volume raycasting method for mobile devices will harness the power of the increasing number of mobile computational devices being used by medical professionals. Developing support for immersive virtual reality can enhance medical professionals’ interpretation of 3D physiology with the additional depth information provided by stereoscopic 3D. The results of this research will help expand the use of 4D volume rendering beyond the traditional desktop computer in the medical field. Developing the same 4D volume rendering capabilities across dissimilar platforms has many challenges. Each platform relies on their own coding languages, libraries, and hardware support. There are tradeoffs between using languages and libraries native to each platform and using a generic cross-platform system, such as a game engine. Native libraries will generally be more efficient during application run-time, but they require different coding implementations for each platform. The decision was made to use platform native languages and libraries in this research, whenever practical, in an attempt to achieve the best possible frame rates. 4D volume raycasting provides unique challenges independent of the platform. Specifically, fMRI data loading, volume animation, and multiple volume rendering. Additionally, real-time raycasting has never been successfully performed on a mobile device. Previous research relied on less computationally expensive methods, such as orthogonal texture slicing, to achieve real-time frame rates. These challenges will be addressed as the contributions of this research. The first contribution was exploring the feasibility of generic functional data input across desktop, mobile, and immersive virtual reality. To visualize 4D fMRI data it was necessary to build in the capability to read Neuroimaging Informatics Technology Initiative (NIfTI) files. The NIfTI format was designed to overcome limitations of 3D file formats like DICOM and store functional imagery with a single high-resolution anatomical scan and a set of low-resolution anatomical scans. Allowing input of the NIfTI binary data required creating custom C++ routines, as no object oriented APIs freely available for use existed. The NIfTI input code was built using C++ and the C++ Standard Library to be both light weight and cross-platform. Multi-volume rendering is another challenge of fMRI data visualization and a contribution of this work. fMRI data is typically broken into a single high-resolution anatomical volume and a series of low-resolution volumes that capture anatomical changes. Visualizing two volumes at the same time is known as multi-volume visualization. Therefore, the ability to correctly align and scale the volumes relative to each other was necessary. It was also necessary to develop a compositing method to combine data from both volumes into a single cohesive representation. Three prototype applications were built for the different platforms to test the feasibility of 4D volume raycasting. One each for desktop, mobile, and virtual reality. Although the backend implementations were required to be different between the three platforms, the raycasting functionality and features were identical. Therefore, the same fMRI dataset resulted in the same 3D visualization independent of the platform itself. Each platform uses the same NIfTI data loader and provides support for dataset coloring and windowing (tissue density manipulation). The fMRI data can be viewed changing over time by either animation through the time steps, like a movie, or using an interface slider to “scrub” through the different time steps of the data. The prototype applications data load times and frame rates were tested to determine if they achieved the real-time interaction goal. Real-time interaction was defined by achieving 10 frames per second (fps) or better, based on the work of Miller [1]. The desktop version was evaluated on a 2013 MacBook Pro running OS X 10.12 with a 2.6 GHz Intel Core i7 processor, 16 GB of RAM, and a NVIDIA GeForce GT 750M graphics card. The immersive application was tested in the C6 CAVE™, a 96 graphics node computer cluster comprised of NVIDIA Quadro 6000 graphics cards running Red Hat Enterprise Linux. The mobile application was evaluated on a 2016 9.7” iPad Pro running iOS 9.3.4. The iPad had a 64-bit Apple A9X dual core processor with 2 GB of built in memory. Two different fMRI brain activity datasets with different voxel resolutions were used as test datasets. Datasets were tested using both the 3D structural data, the 4D functional data, and a combination of the two. Frame rates for the desktop implementation were consistently above 10 fps, indicating that real-time 4D volume raycasting is possible on desktop hardware. The mobile and virtual reality platforms were able to perform real-time 3D volume raycasting consistently. This is a marked improvement for 3D mobile volume raycasting that was previously only able to achieve under one frame per second [2]. Both VR and mobile platforms were able to raycast the 4D only data at real-time frame rates, but did not consistently meet 10 fps when rendering both the 3D structural and 4D functional data simultaneously. However, 7 frames per second was the lowest frame rate recorded, indicating that hardware advances will allow consistent real-time raycasting of 4D fMRI data in the near future

Developing a virtual reality environment for petrous bone surgery: a state-of-the-art review

The increasing power of computers has led to the development of sophisticated systems that aim to immerse the user in a virtual environment. The benefits of this type of approach to the training of physicians and surgeons are immediately apparent. Unfortunately the implementation of “virtual reality” (VR) surgical simulators has been restricted by both cost and technical limitations. The few successful systems use standardized scenarios, often derived from typical clinical data, to allow the rehearsal of procedures. In reality we would choose a system that allows us not only to practice typical cases but also to enter our own patient data and use it to define the virtual environment. In effect we want to re-write the scenario every time we use the environment and to ensure that its behavior exactly duplicates the behavior of the real tissue. If this can be achieved then VR systems can be used not only to train surgeons but also to rehearse individual procedures where variations in anatomy or pathology present specific surgical problems. The European Union has recently funded a multinational 3-year project (IERAPSI, Integrated Environment for Rehearsal and Planning of Surgical Interventions) to produce a virtual reality system for surgical training and for rehearsing individual procedures. Building the IERAPSI system will bring together a wide range of experts and combine the latest technologies to produce a true, patient specific virtual reality surgical simulator for petrous/temporal bone procedures. This article presents a review of the “state of the art” technologies currently available to construct a system of this type and an overview of the functionality and specifications such a system requires

Advanced Endoscopic Navigation:Surgical Big Data,Methodology,and Applications

随着科学技术的飞速发展，健康与环境问题日益成为人类面临的最重大问题之一。信息科学、计算机技术、电子工程与生物医学工程等学科的综合应用交叉前沿课题，研究现代工程技术方法，探索肿瘤癌症等疾病早期诊断、治疗和康复手段。本论文综述了计算机辅助微创外科手术导航、多模态医疗大数据、方法论及其临床应用：从引入微创外科手术导航概念出发，介绍了医疗大数据的术前与术中多模态医学成像方法、阐述了先进微创外科手术导航的核心流程包括计算解剖模型、术中实时导航方案、三维可视化方法及交互式软件技术，归纳了各类微创外科手术方法的临床应用。同时，重点讨论了全球各种手术导航技术在临床应用中的优缺点，分析了目前手术导航领域内的最新技术方法。在此基础上，提出了微创外科手术方法正向数字化、个性化、精准化、诊疗一体化、机器人化以及高度智能化的发展趋势。【Abstract】Interventional endoscopy (e.g., bronchoscopy, colonoscopy, laparoscopy, cystoscopy) is a widely performed procedure that involves either diagnosis of suspicious lesions or guidance for minimally invasive surgery in a variety of organs within the body cavity. Endoscopy may also be used to guide the introduction of certain items (e.g., stents) into the body. Endoscopic navigation systems seek to integrate big data with multimodal information (e.g., computed tomography, magnetic resonance images, endoscopic video sequences, ultrasound images, external trackers) relative to the patient's anatomy, control the movement of medical endoscopes and surgical tools, and guide the surgeon's actions during endoscopic interventions. Nevertheless, it remains challenging to realize the next generation of context-aware navigated endoscopy. This review presents a broad survey of various aspects of endoscopic navigation, particularly with respect to the development of endoscopic navigation techniques. First, we investigate big data with multimodal information involved in endoscopic navigation. Next, we focus on numerous methodologies used for endoscopic navigation. We then review different endoscopic procedures in clinical applications. Finally, we discuss novel techniques and promising directions for the development of endoscopic navigation.X.L. acknowledges funding from the Fundamental Research Funds for the Central Universities. T.M.P. acknowledges funding from the Canadian Foundation for Innovation, the Canadian Institutes for Health Research, the National Sciences and Engineering Research Council of Canada, and a grant from Intuitive Surgical Inc

Modeling and Simulation in Engineering

This book provides an open platform to establish and share knowledge developed by scholars, scientists, and engineers from all over the world, about various applications of the modeling and simulation in the design process of products, in various engineering fields. The book consists of 12 chapters arranged in two sections (3D Modeling and Virtual Prototyping), reflecting the multidimensionality of applications related to modeling and simulation. Some of the most recent modeling and simulation techniques, as well as some of the most accurate and sophisticated software in treating complex systems, are applied. All the original contributions in this book are jointed by the basic principle of a successful modeling and simulation process: as complex as necessary, and as simple as possible. The idea is to manipulate the simplifying assumptions in a way that reduces the complexity of the model (in order to make a real-time simulation), but without altering the precision of the results

Development of advanced 3D medical analysis tools for clinical training, diagnosis and treatment

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.The objective of this PhD research was the development of novel 3D interactive medical platforms for medical image analysis, simulation and visualisation, with a focus on oncology images to support clinicians in managing the increasing amount of data provided by several medical image modalities. DoctorEye and Automatic Tumour Detector platforms were developed through constant interaction and feedback from expert clinicians, integrating a number of innovations in algorithms and methods, concerning image handling, segmentation, annotation, visualisation and plug-in technologies. DoctorEye is already being used in a related tumour modelling EC project (ContraCancrum) and offers several robust algorithms and tools for fast annotation, 3D visualisation and measurements to assist the clinician in better understanding the pathology of the brain area and define the treatment. It is free to use upon request and offers a user friendly environment for clinicians as it simplifies the implementation of complex algorithms and methods. It integrates a sophisticated, simple-to-use plug-in technology allowing researchers to add algorithms and methods (e.g. tumour growth and simulation algorithms for improving therapy planning) and interactively check the results. Apart from diagnostic and research purposes, it supports clinical training as it allows an expert clinician to evaluate a clinical delineation by different clinical users. The Automatic Tumour Detector focuses on abdominal images, which are more complex than those of the brain. It supports full automatic 3D detection of kidney pathology in real-time as well as 3D advanced visualisation and measurements. This is achieved through an innovative method implementing Templates. They contain rules and parameters for the Automatic Recognition Framework defined interactively by engineers based on clinicians’ 3D Golden Standard models. The Templates enable the automatic detection of kidneys and their possible abnormalities (tumours, stones and cysts). The system also supports the transmission of these Templates to another expert for a second opinion. Future versions of the proposed platforms could integrate even more sophisticated algorithms and tools and offer fully computer-aided identification of a variety of other organs and their dysfunctions

NiftyNet: a deep-learning platform for medical imaging

Medical image analysis and computer-assisted intervention problems are increasingly being addressed with deep-learning-based solutions. Established deep-learning platforms are flexible but do not provide specific functionality for medical image analysis and adapting them for this application requires substantial implementation effort. Thus, there has been substantial duplication of effort and incompatible infrastructure developed across many research groups. This work presents the open-source NiftyNet platform for deep learning in medical imaging. The ambition of NiftyNet is to accelerate and simplify the development of these solutions, and to provide a common mechanism for disseminating research outputs for the community to use, adapt and build upon. NiftyNet provides a modular deep-learning pipeline for a range of medical imaging applications including segmentation, regression, image generation and representation learning applications. Components of the NiftyNet pipeline including data loading, data augmentation, network architectures, loss functions and evaluation metrics are tailored to, and take advantage of, the idiosyncracies of medical image analysis and computer-assisted intervention. NiftyNet is built on TensorFlow and supports TensorBoard visualization of 2D and 3D images and computational graphs by default. We present 3 illustrative medical image analysis applications built using NiftyNet: (1) segmentation of multiple abdominal organs from computed tomography; (2) image regression to predict computed tomography attenuation maps from brain magnetic resonance images; and (3) generation of simulated ultrasound images for specified anatomical poses. NiftyNet enables researchers to rapidly develop and distribute deep learning solutions for segmentation, regression, image generation and representation learning applications, or extend the platform to new applications.Comment: Wenqi Li and Eli Gibson contributed equally to this work. M. Jorge Cardoso and Tom Vercauteren contributed equally to this work. 26 pages, 6 figures; Update includes additional applications, updated author list and formatting for journal submissio

Development of a neurofeedback-based virtual reality environment

Recent technology has continuously expanded the reaching spectre of psychotherapy. In the latest years, the development of digital environments, coupled with the evolution of sensorial hardware, has demonstrated usefulness and effectiveness in some areas of psychotherapy such as phobia treatment and attention deficit hyperactivity disorder management through neurofeedback training. However, the generality of these equipments is very expensive. In this project, an audiovisual stimuli virtual reality environment was developed, capable of displaying signals provided by an electroencephalography-based brain-computer interface. This environment has the objective of providing its user with neurofeedback training and being suited for affordable hardware equipments. Development of the aforementioned environment took place in the Unity3D ® game engine version 5.3.0f4, using C# scripting developed in Microsoft ® Visual Studio 2015 TM. As for the virtual reality display, an Oculus Rift ® development kit 1 was used for testing, together with the Oculus runtime for Windows ®, version 0.8.0.0. The used brain-computer interface was Neurosky’s Mindband TM, a research tool with a single electroencephalography channel, mediated through the ThinkGear Connector, version 3.1.8.0. The creation of this environment as an application directed towards neurofeedback training and compatible with affordable equipments is a contribution towards a reality where virtual reality is more synchronized with our society

ATD: a multiplatform for semiautomatic 3-D detection of kidneys and their pathology in real time

This research presents a novel multi-functional system for medical Imaging-enabled Assistive Diagnosis (IAD). Although the IAD demonstrator has focused on abdominal images and supports the clinical diagnosis of kidneys using CT/MRI imaging, it can be adapted to work on image delineation, annotation and 3D real-size volumetric modelling of other organ structures such as the brain, spine, etc. The IAD provides advanced real-time 3D visualisation and measurements with fully automated functionalities as developed in two stages. In the first stage, via the clinically driven user interface, specialist clinicians use CT/MRI imaging datasets to accurately delineate and annotate the kidneys and their possible abnormalities, thus creating “3D Golden Standard Models”. Based on these models, in the second stage, clinical support staff i.e. medical technicians interactively define model-based rules and parameters for the integrated “Automatic Recognition Framework” to achieve results which are closest to that of the clinicians. These specific rules and parameters are stored in “Templates” and can later be used by any clinician to automatically identify organ structures i.e. kidneys and their possible abnormalities. The system also supports the transmission of these “Templates” to another expert for a second opinion. A 3D model of the body, the organs and their possible pathology with real metrics is also integrated. The automatic functionality was tested on eleven MRI datasets (comprising of 286 images) and the 3D models were validated by comparing them with the metrics from the corresponding “3D Golden Standard Models”. The system provides metrics for the evaluation of the results, in terms of Accuracy, Precision, Sensitivity, Specificity and Dice Similarity Coefficient (DSC) so as to enable benchmarking of its performance. The first IAD prototype has produced promising results as its performance accuracy based on the most widely deployed evaluation metric, DSC, yields 97% for the recognition of kidneys and 96% for their abnormalities; whilst across all the above evaluation metrics its performance ranges between 96% and 100%. Further development of the IAD system is in progress to extend and evaluate its clinical diagnostic support capability through development and integration of additional algorithms to offer fully computer-aided identification of other organs and their abnormalities based on CT/MRI/Ultra-sound Imaging