A novel sonification approach to support the diagnosis of Alzheimer's dementia

Alzheimer’s disease is the most common neurodegenerative form of dementia that steadily worsens and eventually leads to death. Its set of symptoms include loss of cognitive function and memory decline. Structural and functional imaging methods such as CT, MRI, and PET scans play an essential role in the diagnosis process, being able to identify specific areas of cerebral damages. While the accuracy of these imaging techniques increases over time, the severity assessment of dementia remains challenging and susceptible to cognitive and perceptual errors due to intra-reader variability among physicians. Doctors have not agreed upon standardized measurement of cell loss used to specifically diagnose dementia among individuals. These limitations have led researchers to look for supportive diagnosis tools to enhance the spectrum of diseases characteristics and peculiarities. Here is presented a supportive auditory tool to aid in diagnosing patients with different levels of Alzheimer’s. This tool introduces an audible parameter mapped upon three different brain’s lobes. The motivating force behind this supportive auditory technique arise from the fact that AD is distinguished by a decrease of the metabolic activity (hypometabolism) in the parietal and temporal lobes of the brain. The diagnosis is then performed by comparing metabolic activity of the affected lobes to the metabolic activity of other lobes that are not generally affected by AD (i.e., sensorimotor cortex). Results from the diagnosis process compared with the ground truth show that physicians were able to categorize different levels of AD using the sonification generated in this study with higher accuracy than using a standard diagnosis procedure, based on the visualization alone

Inviwo -- A Visualization System with Usage Abstraction Levels

The complexity of today's visualization applications demands specific visualization systems tailored for the development of these applications. Frequently, such systems utilize levels of abstraction to improve the application development process, for instance by providing a data flow network editor. Unfortunately, these abstractions result in several issues, which need to be circumvented through an abstraction-centered system design. Often, a high level of abstraction hides low level details, which makes it difficult to directly access the underlying computing platform, which would be important to achieve an optimal performance. Therefore, we propose a layer structure developed for modern and sustainable visualization systems allowing developers to interact with all contained abstraction levels. We refer to this interaction capabilities as usage abstraction levels, since we target application developers with various levels of experience. We formulate the requirements for such a system, derive the desired architecture, and present how the concepts have been exemplary realized within the Inviwo visualization system. Furthermore, we address several specific challenges that arise during the realization of such a layered architecture, such as communication between different computing platforms, performance centered encapsulation, as well as layer-independent development by supporting cross layer documentation and debugging capabilities

Unified Medical Image Pre-training in Language-Guided Common Semantic Space

Vision-Language Pre-training (VLP) has shown the merits of analysing medical images, by leveraging the semantic congruence between medical images and their corresponding reports. It efficiently learns visual representations, which in turn facilitates enhanced analysis and interpretation of intricate imaging data. However, such observation is predominantly justified on single-modality data (mostly 2D images like X-rays), adapting VLP to learning unified representations for medical images in real scenario remains an open challenge. This arises from medical images often encompass a variety of modalities, especially modalities with different various number of dimensions (e.g., 3D images like Computed Tomography). To overcome the aforementioned challenges, we propose an Unified Medical Image Pre-training framework, namely UniMedI, which utilizes diagnostic reports as common semantic space to create unified representations for diverse modalities of medical images (especially for 2D and 3D images). Under the text's guidance, we effectively uncover visual modality information, identifying the affected areas in 2D X-rays and slices containing lesion in sophisticated 3D CT scans, ultimately enhancing the consistency across various medical imaging modalities. To demonstrate the effectiveness and versatility of UniMedI, we evaluate its performance on both 2D and 3D images across 10 different datasets, covering a wide range of medical image tasks such as classification, segmentation, and retrieval. UniMedI has demonstrated superior performance in downstream tasks, showcasing its effectiveness in establishing a universal medical visual representation

Occlusion and Slice-Based Volume Rendering Augmentation for PET-CT

Dual-modality positron emission tomography and computed tomography (PET-CT) depicts pathophysiological function with PET in an anatomical context provided by CT. Three-dimensional volume rendering approaches enable visualization of a two-dimensional slice of interest (SOI) from PET combined with direct volume rendering (DVR) from CT. However, because DVR depicts the whole volume, it may occlude a region of interest, such as a tumor in the SOI. Volume clipping can eliminate this occlusion by cutting away parts of the volume, but it requires intensive user involvement in deciding on the appropriate depth to clip. Transfer functions that are currently available can make the regions of interest visible, but this often requires complex parameter tuning and coupled pre-processing of the data to define the regions. Hence, we propose a new visualization algorithm where a SOI from PET is augmented by volumetric contextual information from a DVR of the counterpart CT so that the obtrusiveness from the CT in the SOI is minimized. Our approach automatically calculates an augmentation depth parameter by considering the occlusion information derived from the voxels of the CT in front of the PET SOI. The depth parameter is then used to generate an opacity weight function that controls the amount of contextual information visible from the DVR. We outline the improvements with our visualization approach compared to other slice-based and our previous approaches. We present the preliminary clinical evaluation of our visualization in a series of PET-CT studies from patients with non-small cell lung cancer

Feature-driven Volume Visualization of Medical Imaging Data

Direct volume rendering (DVR) is a volume visualization technique that has been proved to be a very powerful tool in many scientific visualization domains. Diagnostic medical imaging is one such domain in which DVR provides new capabilities for the analysis of complex cases and improves the efficiency of image interpretation workflows. However, the full potential of DVR in the medical domain has not yet been realized. A major obstacle for a better integration of DVR in the medical domain is the time-consuming process to optimize the rendering parameters that are needed to generate diagnostically relevant visualizations in which the important features that are hidden in image volumes are clearly displayed, such as shape and spatial localization of tumors, its relationship with adjacent structures, and temporal changes in the tumors. In current workflows, clinicians must manually specify the transfer function (TF), view-point (camera), clipping planes, and other visual parameters. Another obstacle for the adoption of DVR to the medical domain is the ever increasing volume of imaging data. The advancement of imaging acquisition techniques has led to a rapid expansion in the size of the data, in the forms of higher resolutions, temporal imaging acquisition to track treatment responses over time, and an increase in the number of imaging modalities that are used for a single procedure. The manual specification of the rendering parameters under these circumstances is very challenging. This thesis proposes a set of innovative methods that visualize important features in multi-dimensional and multi-modality medical images by automatically or semi-automatically optimizing the rendering parameters. Our methods enable visualizations necessary for the diagnostic procedure in which 2D slice of interest (SOI) can be augmented with 3D anatomical contextual information to provide accurate spatial localization of 2D features in the SOI; the rendering parameters are automatically computed to guarantee the visibility of 3D features; and changes in 3D features can be tracked in temporal data under the constraint of consistent contextual information. We also present a method for the efficient computation of visibility histograms (VHs) using adaptive binning, which allows our optimal DVR to be automated and visualized in real-time. We evaluated our methods by producing visualizations for a variety of clinically relevant scenarios and imaging data sets. We also examined the computational performance of our methods for these scenarios

VRContour: Bringing Contour Delineations of Medical Structures Into Virtual Reality

Contouring is an indispensable step in Radiotherapy (RT) treatment planning. However, today's contouring software is constrained to only work with a 2D display, which is less intuitive and requires high task loads. Virtual Reality (VR) has shown great potential in various specialties of healthcare and health sciences education due to the unique advantages of intuitive and natural interactions in immersive spaces. VR-based radiation oncology integration has also been advocated as a target healthcare application, allowing providers to directly interact with 3D medical structures. We present VRContour and investigate how to effectively bring contouring for radiation oncology into VR. Through an autobiographical iterative design, we defined three design spaces focused on contouring in VR with the support of a tracked tablet and VR stylus, and investigating dimensionality for information consumption and input (either 2D or 2D + 3D). Through a within-subject study (n = 8), we found that visualizations of 3D medical structures significantly increase precision, and reduce mental load, frustration, as well as overall contouring effort. Participants also agreed with the benefits of using such metaphors for learning purposes.Comment: C. Chen, M. Yarmand, V. Singh, M.V. Sherer, J.D. Murphy, Y. Zhang and N. Weibel, "VRContour: Bringing Contour Delineations of Medical Structures Into Virtual Reality", 2022 IEEE International Symposium on Mixed and Augmented Reality (ISMAR), 2022, pp. 1-10, doi: 10.1109/ISMAR55827.2022.0002

Feature-driven Volume Visualization of Medical Imaging Data

Direct volume rendering (DVR) is a volume visualization technique that has been proved to be a very powerful tool in many scientific visualization domains. Diagnostic medical imaging is one such domain in which DVR provides new capabilities for the analysis of complex cases and improves the efficiency of image interpretation workflows. However, the full potential of DVR in the medical domain has not yet been realized. A major obstacle for a better integration of DVR in the medical domain is the time-consuming process to optimize the rendering parameters that are needed to generate diagnostically relevant visualizations in which the important features that are hidden in image volumes are clearly displayed, such as shape and spatial localization of tumors, its relationship with adjacent structures, and temporal changes in the tumors. In current workflows, clinicians must manually specify the transfer function (TF), view-point (camera), clipping planes, and other visual parameters. Another obstacle for the adoption of DVR to the medical domain is the ever increasing volume of imaging data. The advancement of imaging acquisition techniques has led to a rapid expansion in the size of the data, in the forms of higher resolutions, temporal imaging acquisition to track treatment responses over time, and an increase in the number of imaging modalities that are used for a single procedure. The manual specification of the rendering parameters under these circumstances is very challenging. This thesis proposes a set of innovative methods that visualize important features in multi-dimensional and multi-modality medical images by automatically or semi-automatically optimizing the rendering parameters. Our methods enable visualizations necessary for the diagnostic procedure in which 2D slice of interest (SOI) can be augmented with 3D anatomical contextual information to provide accurate spatial localization of 2D features in the SOI; the rendering parameters are automatically computed to guarantee the visibility of 3D features; and changes in 3D features can be tracked in temporal data under the constraint of consistent contextual information. We also present a method for the efficient computation of visibility histograms (VHs) using adaptive binning, which allows our optimal DVR to be automated and visualized in real-time. We evaluated our methods by producing visualizations for a variety of clinically relevant scenarios and imaging data sets. We also examined the computational performance of our methods for these scenarios

Enhanced perception in volume visualization

Due to the nature of scientic data sets, the generation of convenient visualizations may be a difficult task, but crucial to correctly convey the relevant information of the data. When working with complex volume models, such as the anatomical ones, it is important to provide accurate representations, since a misinterpretation can lead to serious mistakes while diagnosing a disease or planning surgery. In these cases, enhancing the perception of the features of interest usually helps to properly understand the data. Throughout years, researchers have focused on different methods to improve the visualization of volume data sets. For instance, the definition of good transfer functions is a key issue in Volume Visualization, since transfer functions determine how materials are classified. Other approaches are based on simulating realistic illumination models to enhance the spatial perception, or using illustrative effects to provide the level of abstraction needed to correctly interpret the data. This thesis contributes with new approaches to enhance the visual and spatial perception in Volume Visualization. Thanks to the new computing capabilities of modern graphics hardware, the proposed algorithms are capable of modifying the illumination model and simulating illustrative motifs in real time. In order to enhance local details, which are useful to better perceive the shape and the surfaces of the volume, our first contribution is an algorithm that employs a common sharpening operator to modify the lighting applied. As a result, the overall contrast of the visualization is enhanced by brightening the salient features and darkening the deeper regions of the volume model. The enhancement of depth perception in Direct Volume Rendering is also covered in the thesis. To do this, we propose two algorithms to simulate ambient occlusion: a screen-space technique based on using depth information to estimate the amount of light occluded, and a view-independent method that uses the density values of the data set to estimate the occlusion. Additionally, depth perception is also enhanced by adding halos around the structures of interest. Maximum Intensity Projection images provide a good understanding of the high intensity features of the data, but lack any contextual information. In order to enhance the depth perception in such a case, we present a novel technique based on changing how intensity is accumulated. Furthermore, the perception of the spatial arrangement of the displayed structures is also enhanced by adding certain colour cues. The last contribution is a new manipulation tool designed for adding contextual information when cutting the volume. Based on traditional illustrative effects, this method allows the user to directly extrude structures from the cross-section of the cut. As a result, the clipped structures are displayed at different heights, preserving the information needed to correctly perceive them.Debido a la naturaleza de los datos científicos, visualizarlos correctamente puede ser una tarea complicada, pero crucial para interpretarlos de forma adecuada. Cuando se trabaja con modelos de volumen complejos, como es el caso de los modelos anatómicos, es importante generar imágenes precisas, ya que una mala interpretación de las mismas puede producir errores graves en el diagnóstico de enfermedades o en la planificación de operaciones quirúrgicas. En estos casos, mejorar la percepción de las zonas de interés, facilita la comprensión de la información inherente a los datos. Durante décadas, los investigadores se han centrado en el desarrollo de técnicas para mejorar la visualización de datos volumétricos. Por ejemplo, los métodos que permiten definir buenas funciones de transferencia son clave, ya que éstas determinan cómo se clasifican los materiales. Otros ejemplos son las técnicas que simulan modelos de iluminación realista, que permiten percibir mejor la distribución espacial de los elementos del volumen, o bien los que imitan efectos ilustrativos, que proporcionan el nivel de abstracción necesario para interpretar correctamente los datos. El trabajo presentado en esta tesis se centra en mejorar la percepción de los elementos del volumen, ya sea modificando el modelo de iluminación aplicado en la visualización, o simulando efectos ilustrativos. Aprovechando la capacidad de cálculo de los nuevos procesadores gráficos, se describen un conjunto de algoritmos que permiten obtener los resultados en tiempo real. Para mejorar la percepción de detalles locales, proponemos modificar el modelo de iluminación utilizando una conocida herramienta de procesado de imágenes (unsharp masking). Iluminando aquellos detalles que sobresalen de las superficies y oscureciendo las zonas profundas, se mejora el contraste local de la imagen, con lo que se consigue realzar los detalles de superficie. También se presentan diferentes técnicas para mejorar la percepción de la profundidad en Direct Volume Rendering. Concretamente, se propone modificar la iluminación teniendo en cuenta la oclusión ambiente de dos maneras diferentes: la primera utiliza los valores de profundidad en espacio imagen para calcular el factor de oclusión del entorno de cada pixel, mientras que la segunda utiliza los valores de densidad del volumen para aproximar dicha oclusión en cada vóxel. Además de estas dos técnicas, también se propone mejorar la percepción espacial y de la profundidad de ciertas estructuras mediante la generación de halos. La técnica conocida como Maximum Intensity Projection (MIP) permite visualizar los elementos de mayor intensidad del volumen, pero no aporta ningún tipo de información contextual. Para mejorar la percepción de la profundidad, proponemos una nueva técnica basada en cambiar la forma en la que se acumula la intensidad en MIP. También se describe un esquema de color para mejorar la percepción espacial de los elementos visualizados. La última contribución de la tesis es una herramienta de manipulación directa de los datos, que permite preservar la información contextual cuando se realizan cortes en el modelo de volumen. Basada en técnicas ilustrativas tradicionales, esta técnica permite al usuario estirar las estructuras visibles en las secciones de los cortes. Como resultado, las estructuras de interés se visualizan a diferentes alturas sobre la sección, lo que permite al observador percibirlas correctamente