Human treelike tubular structure segmentation: A comprehensive review and future perspectives

Various structures in human physiology follow a treelike morphology, which often expresses complexity at very fine scales. Examples of such structures are intrathoracic airways, retinal blood vessels, and hepatic blood vessels. Large collections of 2D and 3D images have been made available by medical imaging modalities such as magnetic resonance imaging (MRI), computed tomography (CT), Optical coherence tomography (OCT) and ultrasound in which the spatial arrangement can be observed. Segmentation of these structures in medical imaging is of great importance since the analysis of the structure provides insights into disease diagnosis, treatment planning, and prognosis. Manually labelling extensive data by radiologists is often time-consuming and error-prone. As a result, automated or semi-automated computational models have become a popular research field of medical imaging in the past two decades, and many have been developed to date. In this survey, we aim to provide a comprehensive review of currently publicly available datasets, segmentation algorithms, and evaluation metrics. In addition, current challenges and future research directions are discussed

직접 볼륨 렌더링의 전이 함수 설계에 관한 연구

학위논문 (박사)-- 서울대학교 대학원 : 전기·컴퓨터공학부, 2017. 2. 신영길.Although direct volume rendering (DVR) has become a commodity, the design of transfer functions still a challenge. Transfer functions which map data values to optical properties (i.e., colors and opacities) highlight features of interests as well as hide unimportant regions, dramatically impacting on the quality of the visualization. Therefore, for the effective rendering of interesting features, the design of transfer functions is very important and challenging task. Furthermore, manipulation of these transfer functions is tedious and time-consuming task. In this paper, we propose a 3D spatial field for accurately identifying and visually distinguishing interesting features as well as a mechanism for data exploration using multi-dimensional transfer function. First, we introduce a 3D spatial field for the effective visualization of constricted tubular structures, called as a stenosis map which stores the degree of constriction at each voxel. Constrictions within tubular structures are quantified by using newly proposed measures (i.e., line similarity measure and constriction measure) based on the localized structure analysis, and classified with a proposed transfer function mapping the degree of constriction to color and opacity. We show the application results of our method to the visualization of coronary artery stenoses. We present performance evaluations using twenty-eight clinical datasets, demonstrating high accuracy and efficacy of our proposed method. Second, we propose a new multi-dimensional transfer function which incorporates texture features calculated from statistically homogeneous regions. This approach employs parallel coordinates to provide an intuitive interface for exploring a new multi-dimensional transfer function space. Three specific ways to use a new transfer function based on parallel coordinates enables the effective exploration of large and complex datasets. We present a mechanism for data exploration with a new transfer function space, demonstrating the practical efficacy of our proposed method. Through a study on transfer function design for DVR, we propose two useful approaches. First method to saliently visualize the constrictions within tubular structures and interactively adjust the visual appearance of the constrictions delivers a substantial aid in radiologic practice. Furthermore, second method to classify objects with our intuitive interface utilizing parallel coordinates proves to be a powerful tool for complex data exploration.Chapter 1 Introduction 1 1.1 Background 1 1.1.1 Volume rendering 1 1.1.2 Computer-aided diagnosis 3 1.1.3 Parallel coordinates 5 1.2 Problem statement 8 1.3 Main contribution 12 1.4 Organization of dissertation 16 Chapter 2 Related Work 17 2.1 Transfer function 17 2.1.1 Transfer functions based on spatial characteristics 17 2.1.2 Opacity modulation techniques 20 2.1.3 Multi-dimensional transfer functions 22 2.1.4 Manipulation mechanism for transfer functions 25 2.2 Coronary artery stenosis 28 2.3 Parallel coordinates 32 Chapter 3 Volume Visualization of Constricted Tubular Structures 36 3.1 Overview 36 3.2 Localized structure analysis 37 3.3 Stenosis map 39 3.3.1 Overview 39 3.3.2 Detection of tubular structures 40 3.3.3 Stenosis map computation 49 3.4 Stenosis-based classification 52 3.4.1 Overview 52 3.4.2 Constriction-encoded volume rendering 52 3.4.3 Opacity modulation based on constriction 54 3.5 GPU implementation 57 3.6 Experimental results 59 3.6.1 Clinical data preparation 59 3.6.2 Qualitative evaluation 60 3.6.3 Quantitative evaluation 63 3.6.4 Comparison with previous methods 66 3.6.5 Parameter study 69 Chapter 4 Interactive Multi-Dimensional Transfer Function Using Adaptive Block Based Feature Analysis 73 4.1 Overview 73 4.2 Extraction of statistical features 74 4.3 Extraction of texture features 78 4.4 Multi-dimensional transfer function design using parallel coordinates 81 4.5 Experimental results 86 Chapter 5 Conclusion 90 Bibliography 92 초 록 107Docto

Open-source virtual bronchoscopy for image guided navigation

This thesis describes the development of an open-source system for virtual bronchoscopy used in combination with electromagnetic instrument tracking. The end application is virtual navigation of the lung for biopsy of early stage cancer nodules. The open-source platform 3D Slicer was used for creating freely available algorithms for virtual bronchscopy. Firstly, the development of an open-source semi-automatic algorithm for prediction of solitary pulmonary nodule malignancy is presented. This approach may help the physician decide whether to proceed with biopsy of the nodule. The user-selected nodule is segmented in order to extract radiological characteristics (i.e., size, location, edge smoothness, calcification presence, cavity wall thickness) which are combined with patient information to calculate likelihood of malignancy. The overall accuracy of the algorithm is shown to be high compared to independent experts' assessment of malignancy. The algorithm is also compared with two different predictors, and our approach is shown to provide the best overall prediction accuracy. The development of an airway segmentation algorithm which extracts the airway tree from surrounding structures on chest Computed Tomography (CT) images is then described. This represents the first fundamental step toward the creation of a virtual bronchoscopy system. Clinical and ex-vivo images are used to evaluate performance of the algorithm. Different CT scan parameters are investigated and parameters for successful airway segmentation are optimized. Slice thickness is the most affecting parameter, while variation of reconstruction kernel and radiation dose is shown to be less critical. Airway segmentation is used to create a 3D rendered model of the airway tree for virtual navigation. Finally, the first open-source virtual bronchoscopy system was combined with electromagnetic tracking of the bronchoscope for the development of a GPS-like system for navigating within the lungs. Tools for pre-procedural planning and for helping with navigation are provided. Registration between the lungs of the patient and the virtually reconstructed airway tree is achieved using a landmark-based approach. In an attempt to reduce difficulties with registration errors, we also implemented a landmark-free registration method based on a balanced airway survey. In-vitro and in-vivo testing showed good accuracy for this registration approach. The centreline of the 3D airway model is extracted and used to compensate for possible registration errors. Tools are provided to select a target for biopsy on the patient CT image, and pathways from the trachea towards the selected targets are automatically created. The pathways guide the physician during navigation, while distance to target information is updated in real-time and presented to the user. During navigation, video from the bronchoscope is streamed and presented to the physician next to the 3D rendered image. The electromagnetic tracking is implemented with 5 DOF sensing that does not provide roll rotation information. An intensity-based image registration approach is implemented to rotate the virtual image according to the bronchoscope's rotations. The virtual bronchoscopy system is shown to be easy to use and accurate in replicating the clinical setting, as demonstrated in the pre-clinical environment of a breathing lung method. Animal studies were performed to evaluate the overall system performance

Machine Learning/Deep Learning in Medical Image Processing

Many recent studies on medical image processing have involved the use of machine learning (ML) and deep learning (DL). This special issue, “Machine Learning/Deep Learning in Medical Image Processing”, has been launched to provide an opportunity for researchers in the area of medical image processing to highlight recent developments made in their fields with ML/DL. Seven excellent papers that cover a wide variety of medical/clinical aspects are selected in this special issue

Upper airways segmentation using principal curvatures

Esta tesis propone una nueva técnica para segmentar las vías aéreas superiores. Esta propuesta permite la extracción de estructuras curvilíneas usando curvaturas principales. La propuesta permite la extracción de éstas estructuras en imágenes 2D y 3D. Entre las principales novedades se encuentra la propuesta de un nuevo criterio de parada en la propagación del algoritmo de realce de contraste (operador multi-escala de tipo sombrero alto). De la misma forma, el criterio de parada propuesto es usado para detener los algoritmos de difusión anisotrópica. Además, un nuevo criterio es propuesto para seleccionar las curvaturas principales que conforman las estructuras curvilíneas, que se basa en los criterios propuestos por Steger, Deng et. al. y Armande et. al. Además, se propone un nuevo algoritmo para realizar la supresión de nomáximos que permite reducir la presencia de discontinuidades en el borde de las estructuras curvilíneas. Para extraer los bordes de las estructuras curvilíneas, se utiliza un algoritmo de enlace que incluye un nuevo criterio de distancia para reducir la aparición de agujeros en la estructura final. Finalmente, con base en los resultados obtenidos, se utiliza un algoritmo morfológico para cerrar los agujeros y se aplica un algoritmo de crecimiento de regiones para obtener la segmentación final de las vías respiratorias superiores.This dissertation proposes a new approach to segment the upper airways. This proposal allows the extraction of curvilinear structures based on the principal curvatures. The proposal allows extracting these structures from 2D and 3D images. Among the main novelties is the proposal of a new stopping criterion to stop the propagation of the contrast enhancement algorithm (multiscale top-hat morphological operator). In the same way, the proposed stopping criterion is used to stop the anisotropic diffusion algorithms. In addition, a new criterion is proposed to select the principal curvatures that make up the curvilinear structures, which is based on the criteria proposed by Steger, Deng et. al. and Armande et. al. Furthermore, a new algorithm to perform the non-maximum suppression that allows reducing the presence of discontinuities in the border of curvilinear structures is proposed. To extract the edges of the curvilinear structures, a linking algorithm is used that includes a new distance criterion to reduce the appearance of gaps in the final structure. Finally, based on the obtained results, a morphological algorithm is used to close the gaps and a region growing algorithm to obtain the final upper airways segmentation is applied.Doctor en IngenieríaDoctorad

Pattern recognition methods applied to medical imaging: lung nodule detection in computed tomography images

Lung cancer is one of the main public health issues in developed countries. The overall 5-year survival rate is only 10−16%, although the mortality rate among men in the United States has started to decrease by about 1.5% per year since 1991 and a similar trend for the male population has been observed in most European countries. By contrast, in the case of the female population, the survival rate is still decreasing, despite a decline in the mortality of young women has been ob- served over the last decade. Approximately 70% of lung cancers are diagnosed at too advanced stages for the treatments to be effective. The five-year survival rate for early-stage lung cancers (stage I), which can reach 70%, is sensibly higher than for cancers diagnosed at more advanced stages. Lung cancer most commonly manifests itself as non-calcified pulmonary nodules. The CT has been shown as the most sensitive imaging modality for the detection of small pulmonary nodules, particularly since the introduction of the multi-detector-row and helical CT technologies. Screening programs based on Low Dose Computed Tomography (LDCT) may be regarded as a promising technique for detecting small, early-stage lung cancers. The efficacy of screening programs based on CT in reducing the mortality rate for lung cancer has not been fully demonstrated yet, and different and opposing opinions are being pointed out on this topic by many experts. However, the recent results obtained by the National Lung Screening Trial (NLST), involving 53454 high risk patients, show a 20% reduction of mortality when the screening program was carried out with the helical CT, rather than with a conventional chest X-ray. LDCT settings are currently recommended by the screening trial protocols. However, it is not trivial in this case to identify small pulmonary nodules,due to the noisier appearance of the images in low-dose CT with respect to the standard-dose CT. Moreover, thin slices are generally used in screening programs, thus originating datasets of about 300 − 400 slices per study. De- pending on the screening trial protocol they joined, radiologists can be asked to identify even very small lung nodules, which is a very difficult and time- consuming task. Lung nodules are rather spherical objects, characterized by very low CT values and/or low contrast. Nodules may have CT values in the same range of those of blood vessels, airway walls, pleura and may be strongly connected to them. It has been demonstrated, that a large percent- age of nodules (20 − 35%) is actually missed in screening diagnoses. To support radiologists in the identification of early-stage pathological objects, about one decade ago, researchers started to develop CAD methods to be applied to CT examinations. Within this framework, two CAD sub-systems are proposed: CAD for internal nodules (CADI), devoted to the identification of small nodules embedded in the lung parenchyma, i.e. Internal Nodules (INs) and CADJP, devoted the identification of nodules originating on the pleura surface, i.e. Juxta-Pleural Nodules (JPNs) respectively. As the training and validation sets may drastically influence the performance of a CAD system, the presented approaches have been trained, developed and tested on different datasets of CT scans (Lung Image Database Consortium (LIDC), ITALUNG − CT) and finally blindly validated on the ANODE09 dataset. The two CAD sub-systems are implemented in the ITK framework, an open source C++ framework for segmentation and registration of medical im- ages, and the rendering of the obtained results are achieved using VTK, a freely available software system for 3D computer graphics, image processing and visualization. The Support Vector Machines (SVMs) are implemented in SVMLight. The two proposed approaches have been developed to detect solid nodules, since the number of Ground Glass Opacity (GGO) contained in the available datasets has been considered too low. This thesis is structured as follows: in the first chapter the basic concepts about CT and lung anatomy are explained. The second chapter deals with CAD systems and their evaluation methods. In the third chapter the datasets used for this work are described. In chapter 4 the lung segmentation algorithm is explained in details, and in chapter 5 and 6 the algorithms to detect internal and juxta-pleural candidates are discussed. In chapter 7 the reduction of false positives findings is explained. In chapter 8 results of the train and validation sessions are shown. Finally in the last chapter the conclusions are drawn