Estimation of Aneurysm Wall Motion from 4D Computerized Tomographic Angiography Images

It is widely accepted that wall shear stressis associated to aneurysm formation, growthand rupture. Early identification of potential risk factors may contribute to decide the treatment and improve patient care. Previous studies have shown associations between high aneurysm wall shear stress values and both elevated risk of rupture and localization of regions of aneurysm progression. Based on the assumption that damaged regions of the endothelium have different mechanical properties, regions with differentiated wall displacement amplitudes are expected. A previous approach based on the analysis ofbidimensional dynamic tomographic angiography images at a limited number of points during the cardiac cycle showed only small displacements in some patients using that simplified and semi-automatic low resolution methodology. The purpose of this work is to overcome some of those limitations. High time and spatial resolution four dimensional computerized tomographic angiography images of cerebral aneurysms were acquired and analyzed in order to identify and characterize wall motion. Images were filtered andsegmented at nineteentime points during the cardiac cycle.An average image was computed to generate the vascular model. Anunstructured mesh of tetrahedral elements was generated using an advancing front technique. A finite element blood flow simulationwas carried out under personalized pulsatile flow conditions. A fuzzy c-means clustering algorithm was used to estimate regions that exhibit wall motion within the aneurysm sac. A good correlation between localization of regions of elevated wall shear stress and regionsexhibiting wall motion was found.Fil: Castro, Marcelo Adrian. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ahumada Olivares, María C.. Universidad Favaloro; ArgentinaFil: Putman, Christopher M. . Inova Fairfax Hospital. Department of Interventional Neuroradiology; Estados UnidosFil: Cebral, Juan R.. George Mason University. Department of Computational and Data Sciences; Estados Unido

Accurate geometry reconstruction of vascular structures using implicit splines

3-D visualization of blood vessel from standard medical datasets (e.g. CT or MRI) play an important role in many clinical situations, including the diagnosis of vessel stenosis, virtual angioscopy, vascular surgery planning and computer aided vascular surgery. However, unlike other human organs, the vasculature system is a very complex network of vessel, which makes it a very challenging task to perform its 3-D visualization. Conventional techniques of medical volume data visualization are in general not well-suited for the above-mentioned tasks. This problem can be solved by reconstructing vascular geometry. Although various methods have been proposed for reconstructing vascular structures, most of these approaches are model-based, and are usually too ideal to correctly represent the actual variation presented by the cross-sections of a vascular structure. In addition, the underlying shape is usually expressed as polygonal meshes or in parametric forms, which is very inconvenient for implementing ramification of branching. As a result, the reconstructed geometries are not suitable for computer aided diagnosis and computer guided minimally invasive vascular surgery. In this research, we develop a set of techniques associated with the geometry reconstruction of vasculatures, including segmentation, modelling, reconstruction, exploration and rendering of vascular structures. The reconstructed geometry can not only help to greatly enhance the visual quality of 3-D vascular structures, but also provide an actual geometric representation of vasculatures, which can provide various benefits. The key findings of this research are as follows: 1. A localized hybrid level-set method of segmentation has been developed to extract the vascular structures from 3-D medical datasets. 2. A skeleton-based implicit modelling technique has been proposed and applied to the reconstruction of vasculatures, which can achieve an accurate geometric reconstruction of the vascular structures as implicit surfaces in an analytical form. 3. An accelerating technique using modern GPU (Graphics Processing Unit) is devised and applied to rendering the implicitly represented vasculatures. 4. The implicitly modelled vasculature is investigated for the application of virtual angioscopy

Real-time automated image segmentation technique for cerebral aneurysm on reconfigurable system-on-chip

Cerebral aneurysm is a weakness in a blood vessel that may enlarge and bleed into the surrounding area, which is a life-threatening condition. Therefore, early and accurate diagnosis of aneurysm is highly required to help doctors to decide the right treatment. This work aims to implement a real-time automated segmentation technique for cerebral aneurysm on the Zynq system-on-chip (SoC), and virtualize the results on a 3D plane, utilizing virtual reality (VR) facilities, such as Oculus Rift, to create an interactive environment for training purposes. The segmentation algorithm is designed based on hard thresholding and Haar wavelet transformation. The system is tested on six subjects, for each consists 512 × 512 DICOM slices, of 16 bits 3D rotational angiography. The quantitative and subjective evaluation show that the segmented masks and 3D generated volumes have admitted results. In addition, the hardware implement results show that the proposed implementation is capable to process an image using Zynq SoC in an average time of 5.2 ms

Computational study of pulmonary flow patterns after repair of transposition of great arteries

Patients that undergo the arterial switch operation (ASO) to repair transposition of great arteries (TGA) can develop abnormal pulmonary trunk morphology with significant long-term complications. In this study, cardiovascular magnetic resonance was combined with computational fluid dynamics to investigate the impact of the postoperative layout on the pulmonary flow patterns. Three ASO patients were analyzed and compared to a volunteer control. Results showed the presence of anomalous shear layer instabilities, vortical and helical structures, and turbulent-like states in all patients, particularly as a consequence of the unnatural curvature of the pulmonary bifurcation. Streamlined, mostly laminar flow was instead found in the healthy subject. These findings shed light on the correlation between the post-ASO anatomy and the presence of altered flow features, and may be useful to improve surgical planning as well as the long-term care of TGA patients.Postprint (author's final draft

Machine learning approaches for lung cancer diagnosis.

The enormity of changes and development in the field of medical imaging technology is hard to fathom, as it does not just represent the technique and process of constructing visual representations of the body from inside for medical analysis and to reveal the internal structure of different organs under the skin, but also it provides a noninvasive way for diagnosis of various disease and suggest an efficient ways to treat them. While data surrounding all of our lives are stored and collected to be ready for analysis by data scientists, medical images are considered a rich source that could provide us with a huge amount of data, that could not be read easily by physicians and radiologists, with valuable information that could be used in smart ways to discover new knowledge from these vast quantities of data. Therefore, the design of computer-aided diagnostic (CAD) system, that can be approved for use in clinical practice that aid radiologists in diagnosis and detecting potential abnormalities, is of a great importance. This dissertation deals with the development of a CAD system for lung cancer diagnosis, which is the second most common cancer in men after prostate cancer and in women after breast cancer. Moreover, lung cancer is considered the leading cause of cancer death among both genders in USA. Recently, the number of lung cancer patients has increased dramatically worldwide and its early detection doubles a patient’s chance of survival. Histological examination through biopsies is considered the gold standard for final diagnosis of pulmonary nodules. Even though resection of pulmonary nodules is the ideal and most reliable way for diagnosis, there is still a lot of different methods often used just to eliminate the risks associated with the surgical procedure. Lung nodules are approximately spherical regions of primarily high density tissue that are visible in computed tomography (CT) images of the lung. A pulmonary nodule is the first indication to start diagnosing lung cancer. Lung nodules can be benign (normal subjects) or malignant (cancerous subjects). Large (generally defined as greater than 2 cm in diameter) malignant nodules can be easily detected with traditional CT scanning techniques. However, the diagnostic options for small indeterminate nodules are limited due to problems associated with accessing small tumors. Therefore, additional diagnostic and imaging techniques which depends on the nodules’ shape and appearance are needed. The ultimate goal of this dissertation is to develop a fast noninvasive diagnostic system that can enhance the accuracy measures of early lung cancer diagnosis based on the well-known hypotheses that malignant nodules have different shape and appearance than benign nodules, because of the high growth rate of the malignant nodules. The proposed methodologies introduces new shape and appearance features which can distinguish between benign and malignant nodules. To achieve this goal a CAD system is implemented and validated using different datasets. This CAD system uses two different types of features integrated together to be able to give a full description to the pulmonary nodule. These two types are appearance features and shape features. For the appearance features different texture appearance descriptors are developed, namely the 3D histogram of oriented gradient, 3D spherical sector isosurface histogram of oriented gradient, 3D adjusted local binary pattern, 3D resolved ambiguity local binary pattern, multi-view analytical local binary pattern, and Markov Gibbs random field. Each one of these descriptors gives a good description for the nodule texture and the level of its signal homogeneity which is a distinguishable feature between benign and malignant nodules. For the shape features multi-view peripheral sum curvature scale space, spherical harmonics expansions, and different group of fundamental geometric features are utilized to describe the nodule shape complexity. Finally, the fusion of different combinations of these features, which is based on two stages is introduced. The first stage generates a primary estimation for every descriptor. Followed by the second stage that consists of an autoencoder with a single layer augmented with a softmax classifier to provide us with the ultimate classification of the nodule. These different combinations of descriptors are combined into different frameworks that are evaluated using different datasets. The first dataset is the Lung Image Database Consortium which is a benchmark publicly available dataset for lung nodule detection and diagnosis. The second dataset is our local acquired computed tomography imaging data that has been collected from the University of Louisville hospital and the research protocol was approved by the Institutional Review Board at the University of Louisville (IRB number 10.0642). These frameworks accuracy was about 94%, which make the proposed frameworks demonstrate promise to be valuable tool for the detection of lung cancer

Vascular Modeling from Volumetric Diagnostic Data: A Review

Reconstruction of vascular trees from digital diagnostic images is a challenging task in the development of tools for simulation and procedural planning for clinical use. Improvements in quality and resolution of acquisition modalities are constantly increasing the fields of application of computer assisted techniques for vascular modeling and a lot of Computer Vision and Computer Graphics research groups are currently active in the field, developing methodologies, algorithms and software prototypes able to recover models of branches of human vascular system from different kinds of input images. Reconstruction methods can be extremely different according to image type, accuracy requirements and level of automation. Some technologies have been validated and are available on medical workstation, others have still to be validated in clinical environments. It is difficult, therefore, to give a complete overview of the different approach used and results obtained, this paper just presents a short review including some examples of the principal reconstruction approaches proposed for vascular reconstruction, showing also the contribution given to the field by the Medical Application Area of CRS4, where methods to recover vascular models have been implemented and used for blood flow analysis, quantitative diagnosis and surgical planning tools based on Virtual Reality

Implicit deformable models for biomedical image segmentation.

In this thesis, new methods for the efficient segmentation of images are presented. The proposed methods are based on the deformable model approach, and can be used efficiently in the segmentation of complex geometries from various imaging modalities. A novel deformable model that is based on a geometrically induced external force field which can be conveniently generalized to arbitrary dimensions is presented. This external force field is based on hypothesized interactions between the relative geometries of the deformable model and the object boundary characterized by image gradient. The evolution of the deformable model is solved using the level set method so that topological changes are handled automatically. The relative geometrical configurations between the deformable model and the object boundaries contributes to a dynamic vector force field that changes accordingly as the deformable model evolves. The geometrically induced dynamic interaction force has been shown to greatly improve the deformable model performance in acquiring complex geometries and highly concave boundaries, and give the deformable model a high invariance in initialization configurations. The voxel interactions across the whole image domain provides a global view of the object boundary representation, giving the external force a long attraction range. The bidirectionality of the external force held allows the new deformable model to deal with arbitrary cross-boundary initializations, and facilitates the handling of weak edges and broken boundaries. In addition, it is shown that by enhancing the geometrical interaction field with a nonlocal edge-preserving algorithm, the new deformable model can effectively overcome image noise. A comparative study on the segmentation of various geometries with different topologies from both synthetic and real images is provided, and the proposed method is shown to achieve significant improvements against several existing techniques. A robust framework for the segmentation of vascular geometries is described. In particular, the framework consists of image denoising, optimal object edge representation, and segmentation using implicit deformable model. The image denoising is based on vessel enhancing diffusion which can be used to smooth out image noise and enhance the vessel structures. The image object boundaries are derived using an edge detection technique which can produce object edges of single pixel width. The image edge information is then used to derive the geometric interaction field for optimal object edge representation. The vascular geometries are segmented using an implict deformable model. A region constraint is added to the deformable model which allows it to easily get around calcified regions and propagate across the vessels to segment the structures efficiently. The presented framework is ai)plied in the accurate segmentation of carotid geometries from medical images. A new segmentation model with statistical shape prior using a variational approach is also presented in this thesis. The proposed model consists of an image attraction force that propagates contours towards image object boundaries, and a global shape force that attracts the model towards similar shapes in the statistical shape distribution. The image attraction force is derived from gradient vector interactions across the whole image domain, which makes the model more robust to image noise, weak edges and initializations. The statistical shape information is incorporated using kernel density estimation, which allows the shape prior model to handle arbitrary shape variations. It is shown that the proposed model with shape prior can be used to segment object shapes from images efficiently