Advancements and Breakthroughs in Ultrasound Imaging

Ultrasonic imaging is a powerful diagnostic tool available to medical practitioners, engineers and researchers today. Due to the relative safety, and the non-invasive nature, ultrasonic imaging has become one of the most rapidly advancing technologies. These rapid advances are directly related to the parallel advancements in electronics, computing, and transducer technology together with sophisticated signal processing techniques. This book focuses on state of the art developments in ultrasonic imaging applications and underlying technologies presented by leading practitioners and researchers from many parts of the world

Analysis and Detection of Ovarian Cyst Using Soft Computing Technique in MATLAB

Cyst and polycystic ovary syndrome is a disorder is a normal phenomenon that affect woman in the perlite age. The most important thing is that PCOS. PCOS syndrome is mainly found in women aging from 12 year to 60 year. In our project, we will be going to use more neighbour counter, water shade method, active counter models, Gaussian filtering and binary filtering method are going to be used in this paper to detect the size, shape and border of the ovarian cyst from echography images. In order to analyse the efficiency of segmentation and application developed in MATLAB software is proposed

PEMILIHAN METODE SEGMENTASI PADA CITRA ULTRASONOGRAFI OVARIUM

Penelitian ini membandingkan metode segmentasi untuk mengenali folikel pada citra ultrasonografi ovarium, metode segmentasi yang paling baik akan digunakan untuk proses perhitungan jumlah folikel. Penilaian kinerja metode segmentasi active contour dan active contour without edge dievaluasi menggunakan Probabilistic Rand Index (PRI) dan Global Consistency Error (GCE). Hasil penelitian ini menunjukkan metode segmentasi yang terbaikadalah active contour without edge karena memiliki nilai PRI lebih tinggi dan pada nilai GCE lebih rendah dari pada hasil metode segmentasi active contour

Segmentation of human ovarian follicles from ultrasound images acquired in vivo using geometric active contour models and a naïve Bayes classifier

Ovarian follicles are spherical structures inside the ovaries which contain developing eggs. Monitoring the development of follicles is necessary for both gynecological medicine (ovarian diseases diagnosis and infertility treatment), and veterinary medicine (determining when to introduce superstimulation in cattle, or dividing herds into different stages in the estrous cycle).Ultrasound imaging provides a non-invasive method for monitoring follicles. However, manually detecting follicles from ovarian ultrasound images is time consuming and sensitive to the observer's experience. Existing (semi-) automatic follicle segmentation techniques show the power of automation, but are not widely used due to their limited success.A new automated follicle segmentation method is introduced in this thesis. Human ovarian images acquired in vivo were smoothed using an adaptive neighbourhood median filter. Dark regions were initially segmented using geometric active contour models. Only part of these segmented dark regions were true follicles. A naïve Bayes classifier was applied to determine whether each segmented dark region was a true follicle or not. The Hausdorff distance between contours of the automatically segmented regions and the gold standard was 2.43 ± 1.46 mm per follicle, and the average root mean square distance per follicle was 0.86 ± 0.49 mm. Both the average Hausdorff distance and the root mean square distance were larger than those reported in other follicle segmentation algorithms. The mean absolute distance between contours of the automatically segmented regions and the gold standard was 0.75 ± 0.32 mm, which was below that reported in other follicle segmentation algorithms.The overall follicle recognition rate was 33% to 35%; and the overall image misidentification rate was 23% to 33%. If only follicles with diameter greater than or equal to 3 mm were considered, the follicle recognition rate increased to 60% to 63%, and the follicle misidentification rate increased slightly to 24% to 34%. The proposed follicle segmentation method is proved to be accurate in detecting a large number of follicles with diameter greater than or equal to 3 mm

Computational Approaches and Models for Ovarian Ageing: From 2D to 4D

The theme of the work presented in this multi-disciplinary PhD is the development of new computational tools and techniques to study and understand spatio-temporal follicle growth in neonatal mouse ovaries. The female ovary is endowed at birth with a finite, non-renewable supply of oocytes, each enclosed in a layer of supporting somatic (granulosa) cells to form a quiescent follicle. From birth, a steady trickle of follicles initiate growth to maintain a supply of mature oocytes for regular ovulation. Disruption in the regulation of initiation of follicle growth can result in various pathologies, such as premature ovarian failure and polycystic ovary syndrome. The mechanism of regulation of the initiation of follicle growth remains unclear, but may involve inter-follicle signaling via paracrine growth factors. To investigate this hypothesis, a new technique for quantifying and analyzing spatial distributions of quiescent and growing follicles in the adult human has been developed, as an extension of a novel technique previously developed in neonatal mice in our laboratory. As in the mouse study, we have found evidence that in the human ovary neighbouring quiescent follicles inhibit follicle growth, at a small range. This approach has been further extended to cultured neonatal mouse ovaries, which in vitro lack a systemic blood supply, to investigate the relative contributions of inter-follicle paracrine signaling and endocrine growth factor/nutrient signaling to the regulation of initiation of follicle growth. Accurate counts of the numbers of follicles in ovaries are important for a wide variety of studies of ovarian physiology, including investigating the effects of age, toxins, chemotherapeutics, endocrine disruptors and specific genes (knock out/transgenic studies) on follicle formation, endowment and development. Many published studies use frequent sampling of a small number of ovaries (often as few as three) to obtain estimates of the number of follicles. We have tested the validity of this approach by generating 3D spherical simulated ovaries which contain realistic numbers of follicles at different stages and which are realistically positioned within these ovaries. The number and position of follicles is based on real biological data. This model enables us to rapidly ‘virtually’ section the ovary in silico and obtain computer-generated counts of the numbers of follicles in sections at different frequencies, such as one every fifth section (1/5), 1/20 or 1/50. As we know precisely how many follicles each simulated ovary contains, we can compare the accuracy using different sampling frequencies of varying numbers of ovaries. This has enabled us to demonstrate that the error is smaller when infrequent sampling of a large number of ovaries (≥8) is carried out, and that this actually involves analyzing fewer sections overall. We have gone on to generate simulated ovaries from knockout mice, with more or fewer follicles, and can predict how many ovaries are required to make robust comparisons between knockout and control animals. This has shown that biological variability contributes more to counting error than the method of sampling. These simulated ovaries provide a unique resource to model large studies. Currently follicle counts are obtained by fixing and serially sectioning ovaries, and manually counting the follicles in sections. This is laborious and time-consuming. Faster methods of obtaining follicle estimates are required. With the use of confocal microscopy and immunohistochemistry for an oocyte-specific protein, we were able to establish a protocol that allows us to image and computationally reconstruct a whole neonatal mouse ovary in 3D. Follicle number can be estimated rapidly using a stereologic method. The stereologic technique error was estimated using the simulated ovary model, leading to the conclusion that the method can be safely used to obtain rapid estimates of follicle number. The time required can be further reduced by using image processing to detect the stained follicles on the sections. We have developed an algorithmic technique that can instantaneously identify stained oocytes, count them, and calculate their spatial distribution. A fundamental unanswered question is whether follicles move in the ovary, particularly as they grow. This question has arisen from the observation that small follicles tend to be situated close to the ovarian surface, while large ones are closer to the medulla. This question has implications for interfollicle signaling. We have developed a protocol to image the ovary while in culture using timelapse confocal and live lipid stains to visualize the follicles. Results show that small follicles are not moving significantly over a period of 12h. This project can be extended in the future with the use of transgenic mice for GFP tagging, to accurately monitor changes in structures of interest within cultured ovaries

Automated analysis of ultrasound imaging of muscle and tendon in the upper limb using artificial intelligence methods

Accurate estimation of geometric musculoskeletal parameters from medical imaging has a number of applications in healthcare analysis and modelling. In vivo measurement of key morphological parameters of an individual’s upper limb opens up a new era for the construction of subject-specific models of the shoulder and arm. These models could be used to aid diagnosis of musculoskeletal problems, predict the effects of interventions and assist in the design and development of medical devices. However, these parameters are difficult to evaluate in vivo due to the complicated and inaccessible nature of structures such as muscles and tendons. Ultrasound, as a non-invasive and low-cost imaging technique, has been used in the manual evaluation of parameters such as muscle fibre length, cross sectional area and tendon length. However, the evaluation of ultrasound images depends heavily on the expertise of the operator and is time-consuming. Basing parameter estimation on the properties of the image itself and reducing the reliance on the skill of the operator would allow for automation of the process, speeding up parameter estimation and reducing bias in the final outcome. Key barriers to automation are the presence of speckle noise in the images and low image contrast. This hinders the effectiveness of traditional edge detection and segmentation methods necessary for parameter estimation. Therefore, addressing these limitations is considered pivotal to progress in this area.The aims of this thesis were therefore to develop new methods for the automatic evaluation of these geometric parameters of the upper extremity, and to compare these with manual evaluations. This was done by addressing all stages of the image processing pipeline, and introducing new methods based on artificial intelligence.Speckle noise of musculoskeletal ultrasound images was reduced by successfully applying local adaptive median filtering and anisotropic diffusion filtering. Furthermore, low contrast of the ultrasound image and video was enhanced by developing a new method based on local fuzzy contrast enhancement. Both steps contributed to improving the quality of musculoskeletal ultrasound images to improve the effectiveness of edge detection methods.Subsequently, a new edge detection method based on the fuzzy inference system was developed to outline the necessary details of the musculoskeletal ultrasound images after image enhancement. This step allowed automated segmentation to be used to estimate the morphological parameters of muscles and tendons in the upper extremity.Finally, the automatically estimated geometric parameters, including the thickness and pennation angle of triceps muscle and the cross-sectional area and circumference of the flexor pollicis longus tendon were compared with manually taken measurements from the same ultrasound images.The results show successful performance of the novel methods in the sample population for the muscles and tendons chosen. A larger dataset would help to make the developed methods more robust and more widely applicable.Future work should concentrate on using the developed methods of this thesis to evaluate other geometric parameters of the upper and lower extremities such as automatic evaluation of the muscle fascicle length

Use of Software Tools to Implement Quality Control of Ultrasound Images in a Large Clinical Trial

Research Question This thesis aims to answer the question as to whether software tools might be developed for automating the analysis of images used to measure ovaries in transvaginal sonography (TVS) exams. Such tools would allow the routine collection of independent and objective metrics at low cost and might be used to drive a programme of continuous Quality Improvement (QI) in TVS scanning. The tools will be assessed by processing images from thousands of TVS exams performed by the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Background This research is important because TVS is core to any ovarian cancer (OC) screening strategy yet independent and objective quality control (QC) metrics for this procedure are not routinely obtained due to the high cost of manual image inspection. Improving the quality of TVS in the National Health Service (NHS) would assist in the early diagnosis of the disease and result in improved outcome for some women. Therefore, the research has clear translational potential for the >1.2 million scans performed annually by the NHS. Research Findings A study performed to process images from 1,000 TVS exams has shown the tool produces accurate and reliable QC metrics. A further study revealed that over half of these exams should have been classified as unsatisfactory as an expert review of the images showed that that the sonographer had mistakenly measured a structure that was not an ovary. It also reported a correlation between such ovary visualisation and a novel metric (DCR) measured by the tools from the examination images. Conclusion The research results suggest both a need to improve the quality of TVS scanning and the viability of achieving this objective by introducing a QI programme driven by metrics gathered by software tools able to analyze the images used to measure ovaries

Hypothyroidism

Hypothyroidism is an endocrine disorder commonly caused by Hashimoto’s disease. Nowadays, autoimmune diseases appear to be on the rise. As such, there is renewed interest in hypothyroidism. This book presents a comprehensive overview of the disorder with chapters on etiology and pathogenesis, precision medicine tools for detection, diagnosis and treatment, the morphology of the thyroid gland, the effect of hypothyroidism on various organ systems, and much more