Construction of boundary element models in bioelectromagnetism

Multisensor electro- and magnetoencephalographic (EEG and MEG) as well as electro- and magnetocardiographic (ECG and MCG) recordings have been proved useful in noninvasively extracting information on bioelectric excitation. The anatomy of the patient needs to be taken into account, when excitation sites are localized by solving the inverse problem. In this work, a methodology has been developed to construct patient specific boundary element models for bioelectromagnetic inverse problems from magnetic resonance (MR) data volumes as well as from two orthogonal X-ray projections. The process consists of three main steps: reconstruction of 3-D geometry, triangulation of reconstructed geometry, and registration of the model with a bioelectromagnetic measurement system. The 3-D geometry is reconstructed from MR data by matching a 3-D deformable boundary element template to images. The deformation is accomplished as an energy minimization process consisting of image and model based terms. The robustness of the matching is improved by multi-resolution and global-to-local approaches as well as using oriented distance maps. A boundary element template is also used when 3-D geometry is reconstructed from X-ray projections. The deformation is first accomplished in 2-D for the contours of simulated, built from the template, and real X-ray projections. The produced 2-D vector field is back-projected and interpolated on the 3-D template surface. A marching cube triangulation is computed for the reconstructed 3-D geometry. Thereafter, a non-iterative mesh-simplification method is applied. The method is based on the Voronoi-Delaunay duality on a 3-D surface with discrete distance measures. Finally, the triangulated surfaces are registered with a bioelectromagnetic measurement utilizing markers. More than fifty boundary element models have been successfully constructed from MR images using the methods developed in this work. A simulation demonstrated the feasibility of X-ray reconstruction; some practical problems of X-ray imaging need to be solved to begin tests with real data.reviewe

Computerized Analysis of Magnetic Resonance Images to Study Cerebral Anatomy in Developing Neonates

The study of cerebral anatomy in developing neonates is of great importance for the understanding of brain development during the early period of life. This dissertation therefore focuses on three challenges in the modelling of cerebral anatomy in neonates during brain development. The methods that have been developed all use Magnetic Resonance Images (MRI) as source data. To facilitate study of vascular development in the neonatal period, a set of image analysis algorithms are developed to automatically extract and model cerebral vessel trees. The whole process consists of cerebral vessel tracking from automatically placed seed points, vessel tree generation, and vasculature registration and matching. These algorithms have been tested on clinical Time-of- Flight (TOF) MR angiographic datasets. To facilitate study of the neonatal cortex a complete cerebral cortex segmentation and reconstruction pipeline has been developed. Segmentation of the neonatal cortex is not effectively done by existing algorithms designed for the adult brain because the contrast between grey and white matter is reversed. This causes pixels containing tissue mixtures to be incorrectly labelled by conventional methods. The neonatal cortical segmentation method that has been developed is based on a novel expectation-maximization (EM) method with explicit correction for mislabelled partial volume voxels. Based on the resulting cortical segmentation, an implicit surface evolution technique is adopted for the reconstruction of the cortex in neonates. The performance of the method is investigated by performing a detailed landmark study. To facilitate study of cortical development, a cortical surface registration algorithm for aligning the cortical surface is developed. The method first inflates extracted cortical surfaces and then performs a non-rigid surface registration using free-form deformations (FFDs) to remove residual alignment. Validation experiments using data labelled by an expert observer demonstrate that the method can capture local changes and follow the growth of specific sulcus

A Multi-scale Learning of Data-driven and Anatomically Constrained Image Registration for Adult and Fetal Echo Images

Temporal echo image registration is a basis for clinical quantifications such as cardiac motion estimation, myocardial strain assessments, and stroke volume quantifications. Deep learning image registration (DLIR) is consistently accurate, requires less computing effort, and has shown encouraging results in earlier applications. However, we propose that a greater focus on the warped moving image's anatomic plausibility and image quality can support robust DLIR performance. Further, past implementations have focused on adult echo, and there is an absence of DLIR implementations for fetal echo. We propose a framework combining three strategies for DLIR for both fetal and adult echo: (1) an anatomic shape-encoded loss to preserve physiological myocardial and left ventricular anatomical topologies in warped images; (2) a data-driven loss that is trained adversarially to preserve good image texture features in warped images; and (3) a multi-scale training scheme of a data-driven and anatomically constrained algorithm to improve accuracy. Our experiments show that the shape-encoded loss and the data-driven adversarial loss are strongly correlated to good anatomical topology and image textures, respectively. They improve different aspects of registration performance in a non-overlapping way, justifying their combination. We show that these strategies can provide excellent registration results in both adult and fetal echo using the publicly available CAMUS adult echo dataset and our private multi-demographic fetal echo dataset, despite fundamental distinctions between adult and fetal echo images. Our approach also outperforms traditional non-DL gold standard registration approaches, including Optical Flow and Elastix. Registration improvements could also be translated to more accurate and precise clinical quantification of cardiac ejection fraction, demonstrating a potential for translation

Automated volume measurements in echocardiography by utilizing expert knowledge

Left ventricular (LV) volumes and ejection fraction (EF) are important parameters for diagnosis, prognosis, and treatment planning in patients with heart disease. These parameters are commonly measured by manual tracing in echocardiographic images, a procedure that is time consuming, prone to inter- and intra-observer variability, and require highly trained operators. This is particularly the case in three-dimensional (3D) echocardiography, where the increased amount of data makes manual tracing impractical. Automated methods for measuring LV volumes and EF can therefore improve efficiency and accuracy of echocardiographic examinations, giving better diagnosis at a lower cost. The main goal of this thesis was to improve the efficiency and quality of cardiac measurements. More specifically, the goal was to develop rapid and accurate methods that utilize expert knowledge for automated evaluation of cardiac function in echocardiography. The thesis presents several methods for automated volume and EF measurements in echocardiographic data. For two-dimensional (2D) echocardiography, an atlas based segmentation algorithm is presented in paper A. This method utilizes manually traced endocardial contours in a validated case database to control a snake optimized by dynamic programming. The challenge with this approach is to find the most optimal case in the database. More promising results are achieved in triplane echocardiography using a multiview and multi-frame extension to the active appearance model (AAM) framework, as demonstrated in paper B. The AAM generalizes better to new patient data and is based on more robust optimization schemes than the atlas-based method. In triplane images, the results of the AAM algorithm may be improved further by integrating a snake algorithm into the AAM framework and by constraining the AAM to manually defined landmarks, and this is shown in paper C. For 3D echocardiograms, a clinical semi-automated volume measurement tool with expert selected points is validated in paper D. This tool compares favorably to a reference measurement tool, with good agreement in measured volumes, and with a significantly lower analysis time. Finally, in paper E, fully automated real-time segmentation in 3D echocardiography is demonstrated using a 3D active shape model (ASM) of the left ventricle in a Kalman filter framework. The main advantage of this approach is its processing performance, allowing for real-time volume and EF estimates. Statistical models such as AAMs and ASMs provide elegant frameworks for incorporating expert knowledge into segmentation algorithms. Expert knowledge can also be utilized directly through manual input to semi-automated methods, allowing for manual initialization and correction of automatically determined volumes. The latter technique is particularly suitable for clinical routine examinations, while the fully automated 3D ASM method can extend the use of echocardiography to new clinical areas such as automated patient monitoring. In this thesis, different methods for utilizing expert knowledge in automated segmentation algorithms for echocardiography have been developed and evaluated. Particularly in 3D echocardiography, these contributions are expected to improve efficiency and quality of cardiac measurements

General Dynamic Surface Reconstruction: Application to the 3D Segmentation of the Left Ventricle

Aquesta tesi descriu la nostra contribució a la reconstrucció tridimensional de les superfícies interna i externa del ventricle esquerre humà. La reconstrucció és un primer procés dins d'una aplicació global de Realitat Virtual dissenyada com una important eina de diagnòstic per a hospitals. L'aplicació parteix de la reconstrucció de les superfícies i proveeix a l'expert de manipulació interactiva del model en temps real, a més de càlculs de volums i de altres paràmetres d'interès. El procés de recuperació de les superfícies es caracteritza per la seva velocitat de convergència, la suavitat a les malles finals i la precisió respecte de les dades recuperades. Donat que el diagnòstic de patologies cardíaques requereix d'experiència, temps i molt coneixement professional, la simulació és un procés clau que millora la eficiència.Els nostres algorismes i implementacions han estat aplicats a dades sintètiques i reals amb diferències relatives a la quantitat de dades inexistents, casuístiques presents a casos patològics i anormals. Els conjunts de dades inclouen adquisicions d'instants concrets i de cicles cardíacs complets. La bondat del sistema de reconstrucció ha estat avaluada mitjançant paràmetres mèdics per a poder comparar els nostres resultats finals amb aquells derivats a partir de programari típic utilitzat pels professionals de la medicina.A més de l'aplicació directa al diagnòstic mèdic, la nostra metodologia permet reconstruccions de tipus genèric en el camp dels Gràfics 3D per ordinador. Les nostres reconstruccions permeten generar models tridimensionals amb un baix cost en quant a la interacció manual necessària i a la càrrega computacional associada. Altrament, el nostre mètode pot entendre's com un robust algorisme de triangularització que construeix superfícies partint de núvols de punts que poden obtenir-se d'escàners làser o sensors magnètics, per exemple.Esta tesis describe nuestra contribución a la reconstrucción tridimensional de las superficies interna y externa del ventrículo izquierdo humano. La reconstrucción es un primer proceso que forma parte de una aplicación global de Realidad Virtual diseñada como una importante herramienta de diagnóstico para hospitales. La aplicación parte de la reconstrucción de las superficies y provee al experto de manipulación interactiva del modelo en tiempo real, además de cálculos de volúmenes y de otros parámetros de interés. El proceso de recuperación de las superficies se caracteriza por su velocidad de convergencia, la suavidad en las mallas finales y la precisión respecto de los datos recuperados. Dado que el diagnóstico de patologías cardíacas requiere experiencia, tiempo y mucho conocimiento profesional, la simulación es un proceso clave que mejora la eficiencia.Nuestros algoritmos e implementaciones han sido aplicados a datos sintéticos y reales con diferencias en cuanto a la cantidad de datos inexistentes, casuística presente en casos patológicos y anormales. Los conjuntos de datos incluyen adquisiciones de instantes concretos y de ciclos cardíacos completos. La bondad del sistema de reconstrucción ha sido evaluada mediante parámetros médicos para poder comparar nuestros resultados finales con aquellos derivados a partir de programario típico utilizado por los profesionales de la medicina.Además de la aplicación directa al diagnóstico médico, nuestra metodología permite reconstrucciones de tipo genérico en el campo de los Gráficos 3D por ordenador. Nuestras reconstrucciones permiten generar modelos tridimensionales con un bajo coste en cuanto a la interacción manual necesaria y a la carga computacional asociada. Por otra parte, nuestro método puede entenderse como un robusto algoritmo de triangularización que construye superficies a partir de nubes de puntos que pueden obtenerse a partir de escáneres láser o sensores magnéticos, por ejemplo.This thesis describes a contribution to the three-dimensional reconstruction of the internal and external surfaces of the human's left ventricle. The reconstruction is a first process fitting in a complete VR application that will serve as an important diagnosis tool for hospitals. Beginning with the surfaces reconstruction, the application will provide volume and interactive real-time manipulation to the model. We focus on speed, precision and smoothness for the final surfaces. As long as heart diseases diagnosis requires experience, time and professional knowledge, simulation is a key-process that enlarges efficiency.The algorithms and implementations have been applied to both synthetic and real datasets with differences regarding missing data, present in cases where pathologies and abnormalities arise. The datasets include single acquisitions and complete cardiac cycles. The goodness of the reconstructions has been evaluated with medical parameters in order to compare our results with those retrieved by typical software used by physicians.Besides the direct application to medicine diagnosis, our methodology is suitable for generic reconstructions in the field of computer graphics. Our reconstructions can serve for getting 3D models at low cost, in terms of manual interaction and CPU computation overhead. Furthermore, our method is a robust tessellation algorithm that builds surfaces from clouds of points that can be retrieved from laser scanners or magnetic sensors, among other available hardware

Developing advanced mathematical models for detecting abnormalities in 2D/3D medical structures.

Detecting abnormalities in two-dimensional (2D) and three-dimensional (3D) medical structures is among the most interesting and challenging research areas in the medical imaging field. Obtaining the desired accurate automated quantification of abnormalities in medical structures is still very challenging. This is due to a large and constantly growing number of different objects of interest and associated abnormalities, large variations of their appearances and shapes in images, different medical imaging modalities, and associated changes of signal homogeneity and noise for each object. The main objective of this dissertation is to address these problems and to provide proper mathematical models and techniques that are capable of analyzing low and high resolution medical data and providing an accurate, automated analysis of the abnormalities in medical structures in terms of their area/volume, shape, and associated abnormal functionality. This dissertation presents different preliminary mathematical models and techniques that are applied in three case studies: (i) detecting abnormal tissue in the left ventricle (LV) wall of the heart from delayed contrast-enhanced cardiac magnetic resonance images (MRI), (ii) detecting local cardiac diseases based on estimating the functional strain metric from cardiac cine MRI, and (iii) identifying the abnormalities in the corpus callosum (CC) brain structure—the largest fiber bundle that connects the two hemispheres in the brain—for subjects that suffer from developmental brain disorders. For detecting the abnormal tissue in the heart, a graph-cut mathematical optimization model with a cost function that accounts for the object’s visual appearance and shape is used to segment the the inner cavity. The model is further integrated with a geometric model (i.e., a fast marching level set model) to segment the outer border of the myocardial wall (the LV). Then the abnormal tissue in the myocardium wall (also called dead tissue, pathological tissue, or infarct area) is identified based on a joint Markov-Gibbs random field (MGRF) model of the image and its region (segmentation) map that accounts for the pixel intensities and the spatial interactions between the pixels. Experiments with real in-vivo data and comparative results with ground truth (identified by a radiologist) and other approaches showed that the proposed framework can accurately detect the pathological tissue and can provide useful metrics for radiologists and clinicians. To estimate the strain from cardiac cine MRI, a novel method based on tracking the LV wall geometry is proposed. To achieve this goal, a partial differential equation (PDE) method is applied to track the LV wall points by solving the Laplace equation between the LV contours of each two successive image frames over the cardiac cycle. The main advantage of the proposed tracking method over traditional texture-based methods is its ability to track the movement and rotation of the LV wall based on tracking the geometric features of the inner, mid-, and outer walls of the LV. This overcomes noise sources that come from scanner and heart motion. To identify the abnormalities in the CC from brain MRI, the CCs are aligned using a rigid registration model and are segmented using a shape-appearance model. Then, they are mapped to a simple unified space for analysis. This work introduces a novel cylindrical mapping model, which is conformal (i.e., one to one transformation and bijective), that enables accurate 3D shape analysis of the CC in the cylindrical domain. The framework can detect abnormalities in all divisions of the CC (i.e., splenium, rostrum, genu and body). In addition, it offers a whole 3D analysis of the CC abnormalities instead of only area-based analysis as done by previous groups. The initial classification results based on the centerline length and CC thickness suggest that the proposed CC shape analysis is a promising supplement to the current techniques for diagnosing dyslexia. The proposed techniques in this dissertation have been successfully tested on complex synthetic and MR images and can be used to advantage in many of today’s clinical applications of computer-assisted medical diagnostics and intervention