Ultrasound IMT measurement on a multi-ethnic and multi-institutional database: Our review and experience using four fully automated and one semi-automated methods

Automated and high performance carotid intima-media thickness (IMT) measurement is gaining increasing importance in clinical practice to assess the cardiovascular risk of patients. In this paper, we compare four fully automated IMT measurement techniques (CALEX, CAMES, CARES and CAUDLES) and one semi-automated technique (FOAM). We present our experience using these algorithms, whose lumen-intima and media-adventitia border estimation use different methods that can be: (a) edge-based; (b) training-based; (c) feature-based; or (d) directional Edge-Flow based. Our database (DB) consisted of 665 images that represented a multi-ethnic group and was acquired using four OEM scanners. The performance evaluation protocol adopted error measures, reproducibility measures, and Figure of Merit (FoM). FOAM showed the best performance, with an IMT bias equal to 0.025 ± 0.225 mm, and a FoM equal to 96.6%. Among the four automated methods, CARES showed the best results with a bias of 0.032 ± 0.279 mm, and a FoM to 95.6%, which was statistically comparable to that of FOAM performance in terms of accuracy and reproducibility. This is the first time that completely automated and user-driven techniques have been compared on a multi-ethnic dataset, acquired using multiple original equipment manufacturer (OEM) machines with different gain settings, representing normal and pathologic case

Improvements In computed tomography perfusion output using complex singular value decomposition and the maximum slope algorithm

OBJECTIVE: Determine if complex singular value decomposition (cSVD) used as preprocessing in the maximum slope algorithm reduces image noise of resultant physiologic parametric images. Noise will be decreased in the parametric maps of cerebral blood flow (CBF), cerebral blood volume (CBV) as compared to the same algorithm and data set with no cSVD applied. MATERIALS AND METHODS: A set of 10 patients (n=15) underwent a total combined 15 CT perfusion studies upon presenting with stroke symptoms. It was determined these patients suffered from occlusions resulting in a prolonged arrival time of blood to the brain. DICOM data files of these patients scans were selected based on this increased arrival delay. We compared the output of estimation calculations for cerebral blood flow (CBF), and cerebral blood volume (CBV), using preprocessing cSVD against the same scan data with no preprocessing cSVD. Image noise was assessed through the calculation of the standard deviation within specific regions of interest copied to specific areas of grey and white matter as well as CSF space. A decrease in the standard deviation values will indicate improvement in the noise level of the resultant images.. Results for the mean value within the regions of interest are expected to be similar between the groups calculated using cSVD and those calculated under the standard method. This will indicate the presence of minimal bias. RESULTS: Between groups of the standard processing method and the cSVD method standard deviation (SD) reductions were seen in both CBF and CBV values across all three ROIs. In grey matter measures of CBV, SD was reduced an average of 0.0034 mL/100g while measures of CBF saw SD reduced by an average of 0.073 mL/100g/min. In samples of white matter, standard deviations of CBV values were reduced on average by 0.0041mL/100g while CBF SD's were reduced by 0.073 mL/100g/min. CSF ROIs in CBV calculations saw SD reductions averaging 0.0047 mL/100g and reductions of 0.074 mL/100g/min in measures of CBF. Bias within CBV calculations was at most minimal as determined by no significant changes in mean calculated values. Calculations of CBF saw large downward bias in the mean values. CONCLUSIONS: The application of the cSVD method to preprocessing of CT perfusion imaging studies produces an effective method of noise reduction. In calculations of CBV, cSVD noise reduction results in overall improvement. In calculations of CBF, cSVD, while effective in noise reduction, caused mean values to be statistically lower than the standard method. It should be noted that there is currently no evaluation of which values can be considered more accurate physiologically. Simulations of the effect of noise on CBF showed a positive correlation suggesting that the CBF algorithm itself is sensitive to the level of noise

Design and analysis of a novel long-distance double tendon-sheath transmission device for breast intervention robots under MRI field

Cancer represents a major threat to human health. Magnetic resonance imaging (MRI) provides superior performance to other imaging-based examination methods in the detection of tumors and offers distinct advantages in biopsy and seed implantation. However, because of the MRI environment, the material requirements for actuating devices for the medical robots used in MRI are incredibly demanding. This paper describes a novel double tendon-sheath transmission device for use in MRI applications. LeBus grooves are used in the original transmission wheels, thus enabling the system to realize long-distance and large-stroke transmission with improved accuracy. The friction model of the transmission system and the transmission characteristics model of the novel tendon-sheath structure are then established. To address the problem that tension sensors cannot be installed in large-stroke transmission systems, a three-point force measurement method is used to measure and set an appropriate preload in the novel tendon-sheath transmission system. Additionally, experiments are conducted to verify the accuracy of the theoretical model and multiple groups of tests are performed to explore the transmission characteristics. Finally, the novel tendon-sheath transmission system is compensated to improve its accuracy and the experimental results acquired after compensation show that the system satisfies the design requirements

Optimization in Differentiable Manifolds in Order to Determine the Method of Construction of Prehistoric Wall-Paintings

In this paper a general methodology is introduced for the determination of potential prototype curves used for the drawing of prehistoric wall-paintings. The approach includes a) preprocessing of the wall-paintings contours to properly partition them, according to their curvature, b) choice of prototype curves families, c) analysis and optimization in 4-manifold for a first estimation of the form of these prototypes, d) clustering of the contour parts and the prototypes, to determine a minimal number of potential guides, e) further optimization in 4-manifold, applied to each cluster separately, in order to determine the exact functional form of the potential guides, together with the corresponding drawn contour parts. The introduced methodology simultaneously deals with two problems: a) the arbitrariness in data-points orientation and b) the determination of one proper form for a prototype curve that optimally fits the corresponding contour data. Arbitrariness in orientation has been dealt with a novel curvature based error, while the proper forms of curve prototypes have been exhaustively determined by embedding curvature deformations of the prototypes into 4-manifolds. Application of this methodology to celebrated wall-paintings excavated at Tyrins, Greece and the Greek island of Thera, manifests it is highly probable that these wall-paintings had been drawn by means of geometric guides that correspond to linear spirals and hyperbolae. These geometric forms fit the drawings' lines with an exceptionally low average error, less than 0.39mm. Hence, the approach suggests the existence of accurate realizations of complicated geometric entities, more than 1000 years before their axiomatic formulation in Classical Ages

Detection of Inferior Myocardial Infarction using Shallow Convolutional Neural Networks

Myocardial Infarction is one of the leading causes of death worldwide. This paper presents a Convolutional Neural Network (CNN) architecture which takes raw Electrocardiography (ECG) signal from lead II, III and AVF and differentiates between inferior myocardial infarction (IMI) and healthy signals. The performance of the model is evaluated on IMI and healthy signals obtained from Physikalisch-Technische Bundesanstalt (PTB) database. A subject-oriented approach is taken to comprehend the generalization capability of the model and compared with the current state of the art. In a subject-oriented approach, the network is tested on one patient and trained on rest of the patients. Our model achieved a superior metrics scores (accuracy= 84.54%, sensitivity= 85.33% and specificity= 84.09%) when compared to the benchmark. We also analyzed the discriminating strength of the features extracted by the convolutional layers by means of geometric separability index and euclidean distance and compared it with the benchmark model

Which spring is the best? Comparison of methods for virtual stenting.

This paper presents a methodology for modeling the deployment of implantable devices used in minimally invasive vascular interventions. Motivated by the clinical need to perform preinterventional rehearsals of a stent deployment, we have developed methods enabling virtual device placement inside arteries, under the constraint of real-time application. This requirement of rapid execution narrowed down the search for a suitable method to the concept of a dynamic mesh. Inspired by the idea of a mesh of springs, we have found a novel way to apply it to stent modeling. The experiments conducted in this paper investigate properties of the stent models based on three different spring types: lineal, semitorsional, and torsional springs. Furthermore, this paper compares the results of various deployment scenarios for two different classes of devices: a stent graft and a flow diverter. The presented results can be of a high-potential clinical value, enabling the predictive evaluation of the outcome of a stent deployment treatment