Echocardiography

The book "Echocardiography - New Techniques" brings worldwide contributions from highly acclaimed clinical and imaging science investigators, and representatives from academic medical centers. Each chapter is designed and written to be accessible to those with a basic knowledge of echocardiography. Additionally, the chapters are meant to be stimulating and educational to the experts and investigators in the field of echocardiography. This book is aimed primarily at cardiology fellows on their basic echocardiography rotation, fellows in general internal medicine, radiology and emergency medicine, and experts in the arena of echocardiography. Over the last few decades, the rate of technological advancements has developed dramatically, resulting in new techniques and improved echocardiographic imaging. The authors of this book focused on presenting the most advanced techniques useful in today's research and in daily clinical practice. These advanced techniques are utilized in the detection of different cardiac pathologies in patients, in contributing to their clinical decision, as well as follow-up and outcome predictions. In addition to the advanced techniques covered, this book expounds upon several special pathologies with respect to the functions of echocardiography

AUTOMATED MIDLINE SHIFT DETECTION ON BRAIN CT IMAGES FOR COMPUTER-AIDED CLINICAL DECISION SUPPORT

Midline shift (MLS), the amount of displacement of the brain’s midline from its normal symmetric position due to illness or injury, is an important index for clinicians to assess the severity of traumatic brain injury (TBI). In this dissertation, an automated computer-aided midline shift estimation system is proposed. First, a CT slice selection algorithm (SSA) is designed to automatically select a subset of appropriate CT slices from a large number of raw images for MLS detection. Next, ideal midline detection is implemented based on skull bone anatomical features and global rotation assumptions. For the actual midline detection algorithm, a window selection algorithm (WSA) is applied first to confine the region of interest, then the variational level set method is used to segment the image and extract the ventricle contours. With a ventricle identification algorithm (VIA), the position of actual midline is detected based on the identified right and left lateral ventricle contours. Finally, the brain midline shift is calculated using the positions of detected ideal midline and actual midline. One of the important applications of midline shift in clinical medical decision making is to estimate the intracranial pressure (ICP). ICP monitoring is a standard procedure in the care of severe traumatic brain injury (TBI) patients. An automated ICP level prediction model based on machine learning method is proposed in this work. Multiple features, including midline shift, intracranial air cavities, ventricle size, texture patterns, and blood amount, are used in the ICP level prediction. Finally, the results are evaluated to assess the effectiveness of the proposed method in ICP level prediction

Foetal echocardiographic segmentation

Congenital heart disease affects just under one percentage of all live births [1]. Those defects that manifest themselves as changes to the cardiac chamber volumes are the motivation for the research presented in this thesis. Blood volume measurements in vivo require delineation of the cardiac chambers and manual tracing of foetal cardiac chambers is very time consuming and operator dependent. This thesis presents a multi region based level set snake deformable model applied in both 2D and 3D which can automatically adapt to some extent towards ultrasound noise such as attenuation, speckle and partial occlusion artefacts. The algorithm presented is named Mumford Shah Sarti Collision Detection (MSSCD). The level set methods presented in this thesis have an optional shape prior term for constraining the segmentation by a template registered to the image in the presence of shadowing and heavy noise. When applied to real data in the absence of the template the MSSCD algorithm is initialised from seed primitives placed at the centre of each cardiac chamber. The voxel statistics inside the chamber is determined before evolution. The MSSCD stops at open boundaries between two chambers as the two approaching level set fronts meet. This has significance when determining volumes for all cardiac compartments since cardiac indices assume that each chamber is treated in isolation. Comparison of the segmentation results from the implemented snakes including a previous level set method in the foetal cardiac literature show that in both 2D and 3D on both real and synthetic data, the MSSCD formulation is better suited to these types of data. All the algorithms tested in this thesis are within 2mm error to manually traced segmentation of the foetal cardiac datasets. This corresponds to less than 10% of the length of a foetal heart. In addition to comparison with manual tracings all the amorphous deformable model segmentations in this thesis are validated using a physical phantom. The volume estimation of the phantom by the MSSCD segmentation is to within 13% of the physically determined volume

A review of algorithms for medical image segmentation and their applications to the female pelvic cavity

This paper aims to make a review on the current segmentation algorithms used for medical images. Algorithms are classified according to their principal methodologies, namely the ones based on thresholds, the ones based on clustering techniques and the ones based on deformable models. The last type is focused on due to the intensive investigations into the deformable models that have been done in the last few decades. Typical algorithms of each type are discussed and the main ideas, application fields, advantages and disadvantages of each type are summarised. Experiments that apply these algorithms to segment the organs and tissues of the female pelvic cavity are presented to further illustrate their distinct characteristics. In the end, the main guidelines that should be considered for designing the segmentation algorithms of the pelvic cavity are proposed

Detection and diagnosis of dilated cardiomyopathy and hypertrophic cardiomyopathy using image processing techniques

AbstractMajor heart diseases like heart muscle damage and valvular problems are diagnosed using echocardiogram. Since the echocardiogram is an image or sequence of images with less information the cardiologist spends more time to predict or to make decision. Automating the detection and diagnosis of dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) is a key enabling technology in computer aided diagnosis systems. In this paper, a system is proposed to automatically detect and diagnose dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM). This system performs denoising, enhancement, before left ventricular segmentation is carried out in the individual frames. Using the segmented left ventricle, the LV parameters like volume and ejection fraction (EF) are calculated and also the end-diastolic LV is extracted. The PCA and DCT features are obtained from the extracted end-diastolic LV and the classifiers BPNN, SVM and combined K-NN are used to classify the normal hearts, hearts affected with DCM and hearts affected with HCM. The PCA feature with BPNN classifier gives a highest overall accuracy of 92.04% in classifying normal and abnormal hearts. Experiments over 60 echocardiogram videos expose that the proposed system can be effectively utilized to detect and diagnose DCM and HCM

Doctor of Philosophy

dissertationCongenital heart defects are classes of birth defects that affect the structure and function of the heart. These defects are attributed to the abnormal or incomplete development of a fetal heart during the first few weeks following conception. The overall detection rate of congenital heart defects during routine prenatal examination is low. This is attributed to the insufficient number of trained personnel in many local health centers where many cases of congenital heart defects go undetected. This dissertation presents a system to identify congenital heart defects to improve pregnancy outcomes and increase their detection rates. The system was developed and its performance assessed in identifying the presence of ventricular defects (congenital heart defects that affect the size of the ventricles) using four-dimensional fetal chocardiographic images. The designed system consists of three components: 1) a fetal heart location estimation component, 2) a fetal heart chamber segmentation component, and 3) a detection component that detects congenital heart defects from the segmented chambers. The location estimation component is used to isolate a fetal heart in any four-dimensional fetal echocardiographic image. It uses a hybrid region of interest extraction method that is robust to speckle noise degradation inherent in all ultrasound images. The location estimation method's performance was analyzed on 130 four-dimensional fetal echocardiographic images by comparison with manually identified fetal heart region of interest. The location estimation method showed good agreement with the manually identified standard using four quantitative indexes: Jaccard index, Sørenson-Dice index, Sensitivity index and Specificity index. The average values of these indexes were measured at 80.70%, 89.19%, 91.04%, and 99.17%, respectively. The fetal heart chamber segmentation component uses velocity vector field estimates computed on frames contained in a four-dimensional image to identify the fetal heart chambers. The velocity vector fields are computed using a histogram-based optical flow technique which is formulated on local image characteristics to reduces the effect of speckle noise and nonuniform echogenicity on the velocity vector field estimates. Features based on the velocity vector field estimates, voxel brightness/intensity values, and voxel Cartesian coordinate positions were extracted and used with kernel k-means algorithm to identify the individual chambers. The segmentation method's performance was evaluated on 130 images from 31 patients by comparing the segmentation results with manually identified fetal heart chambers. Evaluation was based on the Sørenson-Dice index, the absolute volume difference and the Hausdorff distance, with each resulting in per patient average values of 69.92%, 22.08%, and 2.82 mm, respectively. The detection component uses the volumes of the identified fetal heart chambers to flag the possible occurrence of hypoplastic left heart syndrome, a type of congenital heart defect. An empirical volume threshold defined on the relative ratio of adjacent fetal heart chamber volumes obtained manually is used in the detection process. The performance of the detection procedure was assessed by comparison with a set of images with confirmed diagnosis of hypoplastic left heart syndrome and a control group of normal fetal hearts. Of the 130 images considered 18 of 20 (90%) fetal hearts were correctly detected as having hypoplastic left heart syndrome and 84 of 110 (76.36%) fetal hearts were correctly detected as normal in the control group. The results show that the detection system performs better than the overall detection rate for congenital heart defect which is reported to be between 30% and 60%