Virtual clinical trials in medical imaging: a review

The accelerating complexity and variety of medical imaging devices and methods have outpaced the ability to evaluate and optimize their design and clinical use. This is a significant and increasing challenge for both scientific investigations and clinical applications. Evaluations would ideally be done using clinical imaging trials. These experiments, however, are often not practical due to ethical limitations, expense, time requirements, or lack of ground truth. Virtual clinical trials (VCTs) (also known as in silico imaging trials or virtual imaging trials) offer an alternative means to efficiently evaluate medical imaging technologies virtually. They do so by simulating the patients, imaging systems, and interpreters. The field of VCTs has been constantly advanced over the past decades in multiple areas. We summarize the major developments and current status of the field of VCTs in medical imaging. We review the core components of a VCT: computational phantoms, simulators of different imaging modalities, and interpretation models. We also highlight some of the applications of VCTs across various imaging modalities

Simulation study on acousto-optics sensing of focused ultrasound

Abstract. The acousto-optics (AO) technique can provide a good contrast with high penetration depth (up to 5 cm) and can be potentially utilized in real time monitoring of the focused ultrasound (FUS) therapies. This work presents the AO simulation study on the interaction of light and FUS in the single-layer brain (SLB) medium and four-layer brain (FLB) medium. FUS pressure distribution at 0.5 MHz and 0.9 MHz frequency was simulated on k-Wave toolbox and the AO Monte Carlo (MC) algorithm was developed on MATLAB to simulate the AO effect in both mediums. The result for the SLB for both ultrasound (US) frequencies suggests that the modulation depth (MD) is high in the region of US focus with a magnitude of 2%-3% and <1% at 0.5 MHz and 0.9 MHz, respectively. Moreover, the MD decreases to 5 orders of magnitude at the source region. In the FLB, the MD decreased to 4–4.5 orders at the source and was present in the skull and US focus region with a magnitude of <1% at both US frequencies. These results suggest that AO can be utilized in sensing FUS effects on brain tissue and the AO signal-to-noise ratio (SNR) depends not only on the MD but also on the level of light intensity interacting with the US pressure

Performance Evaluation of Pseudospectral Ultrasound Simulations on a Cluster of Xeon Phi Accelerators

The rapid development of novel procedures in medical ultrasonics, including treatment planning in therapeutic ultrasound and image reconstruction in photoacoustic tomography, leads to increasing demand for large-scale ultrasound simulations. However, routine execution of such simulations using traditional methods, e.g., finite difference time domain, is expensive and often considered intractable due to the computational and memory requirements. The k-space corrected pseudospectral time domain method used by the k-Wave toolbox allows for significant reductions in spatial and temporal grid resolution. These improvements are achieved at the cost of all-to-all communication, which are inherent to the multi-dimensional fast Fourier transforms. To improve data locality, reduce communication and allow efficient use of accelerators, we recently implemented a domain decomposition technique based on a local Fourier basis. In this paper, we investigate whether it is feasible to run the distributed k-Wave implementation on the Salomon cluster equipped with 864 Intel Xeon Phi (Knight’s Corner) accelerators. The results show the immaturity of the KNC platform with issues ranging from limited support of Infiniband and LustreFS in Intel MPI on this platform to poor performance of 3D FFTs achieved by Intel MKL on the KNC architecture. Yet, we show that it is possible to achieve strong and weak scaling comparable to CPU-only platforms albeit with the runtime 1.8× to 4.3× longer. However, the accounting policy for Salomon’s accelerators is far more favorable and thus their employment reduces the computational cost significantly

High Resolution 3D Ultrasonic Breast Imaging by Time-Domain Full Waveform Inversion

Ultrasound tomography (UST) scanners allow quantitative images of the human breast's acoustic properties to be derived with potential applications in screening, diagnosis and therapy planning. Time domain full waveform inversion (TD-FWI) is a promising UST image formation technique that fits the parameter fields of a wave physics model by gradient-based optimization. For high resolution 3D UST, it holds three key challenges: Firstly, its central building block, the computation of the gradient for a single US measurement, has a restrictively large memory footprint. Secondly, this building block needs to be computed for each of the $10^3-10^4$ measurements, resulting in a massive parallel computation usually performed on large computational clusters for days. Lastly, the structure of the underlying optimization problem may result in slow progression of the solver and convergence to a local minimum. In this work, we design and evaluate a comprehensive computational strategy to overcome these challenges: Firstly, we introduce a novel gradient computation based on time reversal that dramatically reduces the memory footprint at the expense of one additional wave simulation per source. Secondly, we break the dependence on the number of measurements by using source encoding (SE) to compute stochastic gradient estimates. Also we describe a more accurate, TD-specific SE technique with a finer variance control and use a state-of-the-art stochastic LBFGS method. Lastly, we design an efficient TD multi-grid scheme together with preconditioning to speed up the convergence while avoiding local minima. All components are evaluated in extensive numerical proof-of-concept studies simulating a bowl-shaped 3D UST breast scanner prototype. Finally, we demonstrate that their combination allows us to obtain an accurate 442x442x222 voxel image with a resolution of 0.5mm using Matlab on a single GPU within 24h

The Essential Role of Open Data and Software for the Future of Ultrasound-Based Neuronavigation

With the recent developments in machine learning and modern graphics processing units (GPUs), there is a marked shift in the way intra-operative ultrasound (iUS) images can be processed and presented during surgery. Real-time processing of images to highlight important anatomical structures combined with in-situ display, has the potential to greatly facilitate the acquisition and interpretation of iUS images when guiding an operation. In order to take full advantage of the recent advances in machine learning, large amounts of high-quality annotated training data are necessary to develop and validate the algorithms. To ensure efficient collection of a sufficient number of patient images and external validity of the models, training data should be collected at several centers by different neurosurgeons, and stored in a standard format directly compatible with the most commonly used machine learning toolkits and libraries. In this paper, we argue that such effort to collect and organize large-scale multi-center datasets should be based on common open source software and databases. We first describe the development of existing open-source ultrasound based neuronavigation systems and how these systems have contributed to enhanced neurosurgical guidance over the last 15 years. We review the impact of the large number of projects worldwide that have benefited from the publicly available datasets “Brain Images of Tumors for Evaluation” (BITE) and “Retrospective evaluation of Cerebral Tumors” (RESECT) that include MR and US data from brain tumor cases. We also describe the need for continuous data collection and how this effort can be organized through the use of a well-adapted and user-friendly open-source software platform that integrates both continually improved guidance and automated data collection functionalities.publishedVersio

Digital Image Processing Applications

Digital image processing can refer to a wide variety of techniques, concepts, and applications of different types of processing for different purposes. This book provides examples of digital image processing applications and presents recent research on processing concepts and techniques. Chapters cover such topics as image processing in medical physics, binarization, video processing, and more