3D approximation of scapula bone shape from 2D X-ray images using landmark-constrained statistical shape model fitting

Two-dimensional X-ray imaging is the dominant imaging modality in low-resource countries despite the existence of three-dimensional (3D) imaging modalities. This is because fewer hospitals in low-resource countries can afford the 3D imaging systems as their acquisition and operation costs are higher. However, 3D images are desirable in a range of clinical applications, for example surgical planning. The aim of this research was to develop a tool for 3D approximation of scapula bone from 2D X-ray images using landmark-constrained statistical shape model fitting. First, X-ray stereophotogrammetry was used to reconstruct the 3D coordinates of points located on 2D X-ray images of the scapula, acquired from two perspectives. A suitable calibration frame was used to map the image coordinates to their corresponding 3D realworld coordinates. The 3D point localization yielded average errors of (0.14, 0.07, 0.04) mm in the X, Y and Z coordinates respectively, and an absolute reconstruction error of 0.19 mm. The second phase assessed the reproducibility of the scapula landmarks reported by Ohl et al. (2010) and Borotikar et al. (2015). Only three (the inferior angle, acromion and the coracoid process) of the eight reproducible landmarks considered were selected as these were identifiable from the two different perspectives required for X-ray stereophotogrammetry in this project. For the last phase, an approximation of a scapula was produced with the aid of a statistical shape model (SSM) built from a training dataset of 84 CT scapulae. This involved constraining an SSM to the 3D reconstructed coordinates of the selected reproducible landmarks from 2D X-ray images. Comparison of the approximate model with a CT-derived ground truth 3D segmented volume resulted in surface-to-surface average distances of 4.28 mm and 3.20 mm, using three and sixteen landmarks respectively. Hence, increasing the number of landmarks produces a posterior model that makes better predictions of patientspecific reconstructions. An average Euclidean distance of 1.35 mm was obtained between the three selected landmarks on the approximation and the corresponding landmarks on the CT image. Conversely, a Euclidean distance of 5.99 mm was obtained between the three selected landmarks on the original SSM and corresponding landmarks on the CT image. The Euclidean distances confirm that a posterior model moves closer to the CT image, hence it reduces the search space for a more exact patient-specific 3D reconstruction by other fitting algorithms

Une approche logicielle du traitement de la dyslexie : étude de modèles et applications

Neuropsychological disorders are widespread and generate real public health problems. In particular in our modern society, where written communication is ubiquitous, dyslexia can be extremely disabling. Nevertheless we can note that the diagnosis and remediation of this pathology are fastidious and lack of standardization. Unfortunately it seems inherent to the clinical characterization of dyslexia by exclusion, to the multitude of different practitioners involved in such treatment and to the lack of objectivity of some existing methods. In this respect, we decided to investigate the possibilities offered by modern computing to overcome these barriers. Indeed we have assumed that the democratization of computer systems and their computing power could make of them a perfect tool to alleviate the difficulties encountered in the treatment of dyslexia. This research has led us to study the techniques software as well as hardware, which can conduct to the development of an inexpensive and scalable system able to attend a beneficial and progressive changing of practices in this pathology field. With this project we put ourselves definitely in an innovative stream serving quality of care and aid provided to people with disabilities. Our work has been identifying different improvement areas that the use of computers enables. Then each of these areas could then be the subject of extensive research, modeling and prototype developments. We also considered the methodology for designing this kind of system as a whole. In particular our thoughts and these accomplishments have allowed us to define a software framework suitable for implementing a software platform that we called the PAMMA. This platform should theoretically have access to all the tools required for the flexible and efficient development of medical applications integrating business processes. In this way it is expected that this system allows the development of applications for caring dyslexic patients thus leading to a faster and more accurate diagnosis and a more appropriate and effective remediation. Of our innovation efforts emerge encouraging perspectives. However such initiatives can only be achieved within multidisciplinary collaborations with many functional, technical and financial means. Creating such a consortium seems to be the next required step to get a funding necessary for realizing a first functional prototype of the PAMMA, as well as its first applications. Some clinical studies may be conducted to prove undoubtedly the effectiveness of such an approach for treating dyslexia and eventually other neuropsychological disorders.Les troubles neuropsychologiques sont très répandus et posent de réels problèmes de santé publique. En particulier, dans notre société moderne où la communication écrite est omniprésente, la dyslexie peut s’avérer excessivement handicapante. On remarque néanmoins que le diagnostic et la remédiation de cette pathologie restent délicats et manquent d’uniformisation. Ceci semble malheureusement inhérent à la caractérisation clinique par exclusion de la dyslexie, à la multitude de praticiens différents impliqués dans une telle prise en charge ainsi qu’au manque d’objectivité de certaines méthodes existantes. A ce titre, nous avons décidé d’investiguer les possibilités offertes par l’informatique actuelle pour surmonter ces barrières. Effectivement, nous avons supposé que la démocratisation des systèmes informatiques et leur puissance de calcul pourraient en faire un outil de choix pour pallier les difficultés rencontrées lors de la prise en charge de la dyslexie. Cette recherche nous a ainsi mené à étudier les techniques, aussi bien logicielles que matérielles, pouvant conduire au développement d’un système bon marché et évolutif qui serait capable d’assister un changement bénéfique et progressif des pratiques qui entourent cette pathologie. Avec ce projet, nous nous plaçons définitivement dans un courant innovant au service de la qualité des soins et des aides apportées aux personnes souffrant d’un handicap. Notre travail a ainsi consisté à identifier différents axes d’amélioration que l’utilisation de l’outil informatique rend possible. Chacun de ces axes a alors pu faire l’objet de recherches exhaustives, de modélisations et de développements de prototypes. Nous avons également réfléchi à la méthodologie à mettre en œuvre pour concevoir un tel système dans sa globalité. En particulier, nos réflexions et ces différents accomplissements nous ont permis de définir un framework logiciel propice à l’implémentation d’une plate-forme logicielle que nous avons appelée la PAMMA. Cette plate-forme devrait théoriquement pouvoir disposer de tous les outils permettant le développement souple et efficace d’applications médicales intégrant des processus métiers. Il est ainsi attendu de ce système qu’il permette le développement d’applications, pour la prise en charges des patients dyslexiques, conduisant à un diagnostic plus rapide et plus précis ainsi qu’à une remédiation plus adaptée et plus efficace. De notre effort d’innovation ressortent des perspectives encourageantes. Cependant, ce type d’initiative ne peut se concrétiser qu’autour de collaborations pluridisciplinaires disposant de nombreux moyens fonctionnels, techniques et financiers. La constitution d’un tel consortium semble donc être la prochaine étape nécessaire à l’obtention des financements pour réaliser un premier prototype fonctionnel de la PAMMA, ainsi que de premières applications. Des études cliniques pourront être alors menées pour prouver indubitablement l’efficacité d’une telle approche dans le cadre de la prise en charge de la dyslexie, ainsi qu’éventuellement d’autres troubles neuropsychologiques