EchoFusion: Tracking and Reconstruction of Objects in 4D Freehand Ultrasound Imaging without External Trackers

Ultrasound (US) is the most widely used fetal imaging technique. However, US images have limited capture range, and suffer from view dependent artefacts such as acoustic shadows. Compounding of overlapping 3D US acquisitions into a high-resolution volume can extend the field of view and remove image artefacts, which is useful for retrospective analysis including population based studies. However, such volume reconstructions require information about relative transformations between probe positions from which the individual volumes were acquired. In prenatal US scans, the fetus can move independently from the mother, making external trackers such as electromagnetic or optical tracking unable to track the motion between probe position and the moving fetus. We provide a novel methodology for image-based tracking and volume reconstruction by combining recent advances in deep learning and simultaneous localisation and mapping (SLAM). Tracking semantics are established through the use of a Residual 3D U-Net and the output is fed to the SLAM algorithm. As a proof of concept, experiments are conducted on US volumes taken from a whole body fetal phantom, and from the heads of real fetuses. For the fetal head segmentation, we also introduce a novel weak annotation approach to minimise the required manual effort for ground truth annotation. We evaluate our method qualitatively, and quantitatively with respect to tissue discrimination accuracy and tracking robustness.Comment: MICCAI Workshop on Perinatal, Preterm and Paediatric Image analysis (PIPPI), 201

Learning ultrasound plane pose regression: assessing generalized pose coordinates in the fetal brain

In obstetric ultrasound (US) scanning, the learner's ability to mentally build a three-dimensional (3D) map of the fetus from a two-dimensional (2D) US image represents a significant challenge in skill acquisition. We aim to build a US plane localization system for 3D visualization, training, and guidance without integrating additional sensors. This work builds on top of our previous work, which predicts the six-dimensional (6D) pose of arbitrarily-oriented US planes slicing the fetal brain with respect to a normalized reference frame using a convolutional neural network (CNN) regression network. Here, we analyze in detail the assumptions of the normalized fetal brain reference frame and quantify its accuracy with respect to the acquisition of transventricular (TV) standard plane (SP) for fetal biometry. We investigate the impact of registration quality in the training and testing data and its subsequent effect on trained models. Finally, we introduce data augmentations and larger training sets that improve the results of our previous work, achieving median errors of 3.53 mm and 6.42 degrees for translation and rotation, respectively.Comment: 12 pages, 9 figures, 2 tables. This work has been submitted to the IEEE for possible publication (IEEE TMRB). Copyright may be transferred without notice, after which this version may no longer be accessibl

A Markov Random Field Based Approach to 3D Mosaicing and Registration Applied to Ultrasound Simulation

A novel Markov Random Field (MRF) based method for the mosaicing of 3D ultrasound volumes is presented in this dissertation. The motivation for this work is the production of training volumes for an affordable ultrasound simulator, which offers a low-cost/portable training solution for new users of diagnostic ultrasound, by providing the scanning experience essential for developing the necessary psycho-motor skills. It also has the potential for introducing ultrasound instruction into medical education curriculums. The interest in ultrasound training stems in part from the widespread adoption of point-of-care scanners, i.e. low cost portable ultrasound scanning systems in the medical community. This work develops a novel approach for producing 3D composite image volumes and validates the approach using clinically acquired fetal images from the obstetrics department at the University of Massachusetts Medical School (UMMS). Results using the Visible Human Female dataset as well as an abdominal trauma phantom are also presented. The process is broken down into five distinct steps, which include individual 3D volume acquisition, rigid registration, calculation of a mosaicing function, group-wise non-rigid registration, and finally blending. Each of these steps, common in medical image processing, has been investigated in the context of ultrasound mosaicing and has resulted in improved algorithms. Rigid and non-rigid registration methods are analyzed in a probabilistic framework and their sensitivity to ultrasound shadowing artifacts is studied. The group-wise non-rigid registration problem is initially formulated as a maximum likelihood estimation, where the joint probability density function is comprised of the partially overlapping ultrasound image volumes. This expression is simplified using a block-matching methodology and the resulting discrete registration energy is shown to be equivalent to a Markov Random Field. Graph based methods common in computer vision are then used for optimization, resulting in a set of transformations that bring the overlapping volumes into alignment. This optimization is parallelized using a fusion approach, where the registration problem is divided into 8 independent sub-problems whose solutions are fused together at the end of each iteration. This method provided a speedup factor of 3.91 over the single threaded approach with no noticeable reduction in accuracy during our simulations. Furthermore, the registration problem is simplified by introducing a mosaicing function, which partitions the composite volume into regions filled with data from unique partially overlapping source volumes. This mosaicing functions attempts to minimize intensity and gradient differences between adjacent sources in the composite volume. Experimental results to demonstrate the performance of the group-wise registration algorithm are also presented. This algorithm is initially tested on deformed abdominal image volumes generated using a finite element model of the Visible Human Female to show the accuracy of its calculated displacement fields. In addition, the algorithm is evaluated using real ultrasound data from an abdominal phantom. Finally, composite obstetrics image volumes are constructed using clinical scans of pregnant subjects, where fetal movement makes registration/mosaicing especially difficult. Our solution to blending, which is the final step of the mosaicing process, is also discussed. The trainee will have a better experience if the volume boundaries are visually seamless, and this usually requires some blending prior to stitching. Also, regions of the volume where no data was collected during scanning should have an ultrasound-like appearance before being displayed in the simulator. This ensures the trainee\u27s visual experience isn\u27t degraded by unrealistic images. A discrete Poisson approach has been adapted to accomplish these tasks. Following this, we will describe how a 4D fetal heart image volume can be constructed from swept 2D ultrasound. A 4D probe, such as the Philips X6-1 xMATRIX Array, would make this task simpler as it can acquire 3D ultrasound volumes of the fetal heart in real-time; However, probes such as these aren\u27t widespread yet. Once the theory has been introduced, we will describe the clinical component of this dissertation. For the purpose of acquiring actual clinical ultrasound data, from which training datasets were produced, 11 pregnant subjects were scanned by experienced sonographers at the UMMS following an approved IRB protocol. First, we will discuss the software/hardware configuration that was used to conduct these scans, which included some custom mechanical design. With the data collected using this arrangement we generated seamless 3D fetal mosaics, that is, the training datasets, loaded them into our ultrasound training simulator, and then subsequently had them evaluated by the sonographers at the UMMS for accuracy. These mosaics were constructed from the raw scan data using the techniques previously introduced. Specific training objectives were established based on the input from our collaborators in the obstetrics sonography group. Important fetal measurements are reviewed, which form the basis for training in obstetrics ultrasound. Finally clinical images demonstrating the sonographer making fetal measurements in practice, which were acquired directly by the Philips iU22 ultrasound machine from one of our 11 subjects, are compared with screenshots of corresponding images produced by our simulator

A Markov Random Field Based Approach to 3D Mosaicing and Registration Applied to Ultrasound Simulation

A novel Markov Random Field (MRF) based method for the mosaicing of 3D ultrasound volumes is presented in this dissertation. The motivation for this work is the production of training volumes for an affordable ultrasound simulator, which offers a low-cost/portable training solution for new users of diagnostic ultrasound, by providing the scanning experience essential for developing the necessary psycho-motor skills. It also has the potential for introducing ultrasound instruction into medical education curriculums. The interest in ultrasound training stems in part from the widespread adoption of point-of-care scanners, i.e. low cost portable ultrasound scanning systems in the medical community. This work develops a novel approach for producing 3D composite image volumes and validates the approach using clinically acquired fetal images from the obstetrics department at the University of Massachusetts Medical School (UMMS). Results using the Visible Human Female dataset as well as an abdominal trauma phantom are also presented. The process is broken down into five distinct steps, which include individual 3D volume acquisition, rigid registration, calculation of a mosaicing function, group-wise non-rigid registration, and finally blending. Each of these steps, common in medical image processing, has been investigated in the context of ultrasound mosaicing and has resulted in improved algorithms. Rigid and non-rigid registration methods are analyzed in a probabilistic framework and their sensitivity to ultrasound shadowing artifacts is studied. The group-wise non-rigid registration problem is initially formulated as a maximum likelihood estimation, where the joint probability density function is comprised of the partially overlapping ultrasound image volumes. This expression is simplified using a block-matching methodology and the resulting discrete registration energy is shown to be equivalent to a Markov Random Field. Graph based methods common in computer vision are then used for optimization, resulting in a set of transformations that bring the overlapping volumes into alignment. This optimization is parallelized using a fusion approach, where the registration problem is divided into 8 independent sub-problems whose solutions are fused together at the end of each iteration. This method provided a speedup factor of 3.91 over the single threaded approach with no noticeable reduction in accuracy during our simulations. Furthermore, the registration problem is simplified by introducing a mosaicing function, which partitions the composite volume into regions filled with data from unique partially overlapping source volumes. This mosaicing functions attempts to minimize intensity and gradient differences between adjacent sources in the composite volume. Experimental results to demonstrate the performance of the group-wise registration algorithm are also presented. This algorithm is initially tested on deformed abdominal image volumes generated using a finite element model of the Visible Human Female to show the accuracy of its calculated displacement fields. In addition, the algorithm is evaluated using real ultrasound data from an abdominal phantom. Finally, composite obstetrics image volumes are constructed using clinical scans of pregnant subjects, where fetal movement makes registration/mosaicing especially difficult. Our solution to blending, which is the final step of the mosaicing process, is also discussed. The trainee will have a better experience if the volume boundaries are visually seamless, and this usually requires some blending prior to stitching. Also, regions of the volume where no data was collected during scanning should have an ultrasound-like appearance before being displayed in the simulator. This ensures the trainee\u27s visual experience isn\u27t degraded by unrealistic images. A discrete Poisson approach has been adapted to accomplish these tasks. Following this, we will describe how a 4D fetal heart image volume can be constructed from swept 2D ultrasound. A 4D probe, such as the Philips X6-1 xMATRIX Array, would make this task simpler as it can acquire 3D ultrasound volumes of the fetal heart in real-time; However, probes such as these aren\u27t widespread yet. Once the theory has been introduced, we will describe the clinical component of this dissertation. For the purpose of acquiring actual clinical ultrasound data, from which training datasets were produced, 11 pregnant subjects were scanned by experienced sonographers at the UMMS following an approved IRB protocol. First, we will discuss the software/hardware configuration that was used to conduct these scans, which included some custom mechanical design. With the data collected using this arrangement we generated seamless 3D fetal mosaics, that is, the training datasets, loaded them into our ultrasound training simulator, and then subsequently had them evaluated by the sonographers at the UMMS for accuracy. These mosaics were constructed from the raw scan data using the techniques previously introduced. Specific training objectives were established based on the input from our collaborators in the obstetrics sonography group. Important fetal measurements are reviewed, which form the basis for training in obstetrics ultrasound. Finally clinical images demonstrating the sonographer making fetal measurements in practice, which were acquired directly by the Philips iU22 ultrasound machine from one of our 11 subjects, are compared with screenshots of corresponding images produced by our simulator

Recent Advances in Artificial Intelligence-Assisted Ultrasound Scanning

Funded by the Spanish Ministry of Economic Affairs and Digital Transformation (Project MIA.2021.M02.0005 TARTAGLIA, from the Recovery, Resilience, and Transformation Plan financed by the European Union through Next Generation EU funds). TARTAGLIA takes place under the R&D Missions in Artificial Intelligence program, which is part of the Spain Digital 2025 Agenda and the Spanish National Artificial Intelligence Strategy.Ultrasound (US) is a flexible imaging modality used globally as a first-line medical exam procedure in many different clinical cases. It benefits from the continued evolution of ultrasonic technologies and a well-established US-based digital health system. Nevertheless, its diagnostic performance still presents challenges due to the inherent characteristics of US imaging, such as manual operation and significant operator dependence. Artificial intelligence (AI) has proven to recognize complicated scan patterns and provide quantitative assessments for imaging data. Therefore, AI technology has the potential to help physicians get more accurate and repeatable outcomes in the US. In this article, we review the recent advances in AI-assisted US scanning. We have identified the main areas where AI is being used to facilitate US scanning, such as standard plane recognition and organ identification, the extraction of standard clinical planes from 3D US volumes, and the scanning guidance of US acquisitions performed by humans or robots. In general, the lack of standardization and reference datasets in this field makes it difficult to perform comparative studies among the different proposed methods. More open-access repositories of large US datasets with detailed information about the acquisition are needed to facilitate the development of this very active research field, which is expected to have a very positive impact on US imaging.Depto. de Estructura de la Materia, Física Térmica y ElectrónicaFac. de Ciencias FísicasTRUEMinistry of Economic Affairs and Digital Transformation from the Recovery, Resilience, and Transformation PlanNext Generation EU fundspu

Towards Computer Aided Management of Kidney Disease

Autosomal dominant polycystic kidney disease (ADPKD) is the fourth most common cause of kidney transplant worldwide accounting for 7-10% of all cases. Although ADPKD usually progresses over many decades, accurate risk prediction is an important task. Identifying patients with progressive disease is vital to providing new treatments being developed and enable them to enter clinical trials for new therapy. Among other factors, total kidney volume (TKV) is a major biomarker predicting the progression of ADPKD. Consortium for Radiologic Imaging Studies in Polycystic Kidney Disease (CRISP) have shown that TKV is an early, and accurate measure of cystic burden and likely growth rate. It is strongly associated with loss of renal function. While ultrasound (US) has proven as an excellent tool for diagnosing the disease; monitoring short-term changes using ultrasound has been shown to not be accurate. This is attributed to high operator variability and reproducibility as compared to tomographic modalities such as CT and MR (Gold standard). Ultrasound has emerged as one of the standout modalities for intra-procedural imaging and with methods for spatial localization has afforded us the ability to track 2D ultrasound in the physical space in which it is being used. In addition to this, the vast amount of recorded tomographic data can be used to generate statistical shape models that allow us to extract clinical value from archived image sets. Renal volumetry is of great interest in the management of chronic kidney diseases (CKD). In this work, we have implemented a tracked ultrasound system and developed a statistical shape model of the kidney. We utilize the tracked ultrasound to acquire a stack of slices that are able to capture the region of interest, in our case kidney phantoms, and reconstruct 3D volume from spatially localized 2D slices. Approximate shape data is then extracted from this 3D volume using manual segmentation of the organ and a shape model is fit to this data. This generates an instance from the shape model that best represents the scanned phantom and volume calculation is done on this instance. We observe that we can calculate the volume to within 10% error in estimation when compared to the gold standard volume of the phantom