Foetal echocardiographic segmentation

Congenital heart disease affects just under one percentage of all live births [1]. Those defects that manifest themselves as changes to the cardiac chamber volumes are the motivation for the research presented in this thesis. Blood volume measurements in vivo require delineation of the cardiac chambers and manual tracing of foetal cardiac chambers is very time consuming and operator dependent. This thesis presents a multi region based level set snake deformable model applied in both 2D and 3D which can automatically adapt to some extent towards ultrasound noise such as attenuation, speckle and partial occlusion artefacts. The algorithm presented is named Mumford Shah Sarti Collision Detection (MSSCD). The level set methods presented in this thesis have an optional shape prior term for constraining the segmentation by a template registered to the image in the presence of shadowing and heavy noise. When applied to real data in the absence of the template the MSSCD algorithm is initialised from seed primitives placed at the centre of each cardiac chamber. The voxel statistics inside the chamber is determined before evolution. The MSSCD stops at open boundaries between two chambers as the two approaching level set fronts meet. This has significance when determining volumes for all cardiac compartments since cardiac indices assume that each chamber is treated in isolation. Comparison of the segmentation results from the implemented snakes including a previous level set method in the foetal cardiac literature show that in both 2D and 3D on both real and synthetic data, the MSSCD formulation is better suited to these types of data. All the algorithms tested in this thesis are within 2mm error to manually traced segmentation of the foetal cardiac datasets. This corresponds to less than 10% of the length of a foetal heart. In addition to comparison with manual tracings all the amorphous deformable model segmentations in this thesis are validated using a physical phantom. The volume estimation of the phantom by the MSSCD segmentation is to within 13% of the physically determined volume

Left-ventricular epi- and endocardium extraction from 3D ultrasound images using an automatically constructed 3D ASM

© 2014 Taylor & Francis.In this paper, we propose an automatic method for constructing an active shape model (ASM) to segment the complete cardiac left ventricle in 3D ultrasound (3DUS) images, which avoids costly manual landmarking. The automatic construction of the ASM has already been addressed in the literature; however, the direct application of these methods to 3DUS is hampered by a high level of noise and artefacts. Therefore, we propose to construct the ASM by fusing the multidetector computed tomography data, to learn the shape, with the artificially generated 3DUS, in order to learn the neighbourhood of the boundaries. Our artificial images were generated by two approaches: a faster one that does not take into account the geometry of the transducer, and a more comprehensive one, implemented in Field II toolbox. The segmentation accuracy of our ASM was evaluated on 20 patients with left-ventricular asynchrony, demonstrating plausibility of the approach

Augmenting CT cardiac roadmaps with segmented streaming ultrasound

Static X-ray computed tomography (CT) volumes are often used as anatomic roadmaps during catheter-based cardiac interventions performed under X-ray fluoroscopy guidance. These CT volumes provide a high-resolution depiction of soft-tissue structures, but at only a single point within the cardiac and respiratory cycles. Augmenting these static CT roadmaps with segmented myocardial borders extracted from live ultrasound (US) provides intra-operative access to real-time dynamic information about the cardiac anatomy. In this work, using a customized segmentation method based on a 3D active mesh, endocardial borders of the left ventricle were extracted from US image streams (4D data sets) at a frame rate of approximately 5 frames per second. The coordinate systems for CT and US modalities were registered using rigid body registration based on manually selected landmarks, and the segmented endocardial surfaces were overlaid onto the CT volume. The root-mean squared fiducial registration error was 3.80 mm. The accuracy of the segmentation was quantitatively evaluated in phantom and human volunteer studies via comparison with manual tracings on 9 randomly selected frames using a finite-element model (the US image resolutions of the phantom and volunteer data were 1.3 x 1.1 x 1.3 mm and 0.70 x 0.82 x 0.77 mm, respectively). This comparison yielded 3.70±2.5 mm (approximately 3 pixels) root-mean squared error (RMSE) in a phantom study and 2.58±1.58 mm (approximately 3 pixels) RMSE in a clinical study. The combination of static anatomical roadmap volumes and dynamic intra-operative anatomic information will enable better guidance and feedback for image-guided minimally invasive cardiac interventions

Image based approach for early assessment of heart failure.

In diagnosing heart diseases, the estimation of cardiac performance indices requires accurate segmentation of the left ventricle (LV) wall from cine cardiac magnetic resonance (CMR) images. MR imaging is noninvasive and generates clear images; however, it is impractical to manually process the huge number of images generated to calculate the performance indices. In this dissertation, we introduce a novel, fast, robust, bi-directional coupled parametric deformable models that are capable of segmenting the LV wall borders using first- and second-order visual appearance features. These features are embedded in a new stochastic external force that preserves the topology of the LV wall to track the evolution of the parametric deformable models control points. We tested the proposed segmentation approach on 15 data sets in 6 infarction patients using the Dice similarity coefficient (DSC) and the average distance (AD) between the ground truth and automated segmentation contours. Our approach achieves a mean DSC value of 0.926±0.022 and mean AD value of 2.16±0.60 mm compared to two other level set methods that achieve mean DSC values of 0.904±0.033 and 0.885±0.02; and mean AD values of 2.86±1.35 mm and 5.72±4.70 mm, respectively. Also, a novel framework for assessing both 3D functional strain and wall thickening from 4D cine cardiac magnetic resonance imaging (CCMR) is introduced. The introduced approach is primarily based on using geometrical features to track the LV wall during the cardiac cycle. The 4D tracking approach consists of the following two main steps: (i) Initially, the surface points on the LV wall are tracked by solving a 3D Laplace equation between two subsequent LV surfaces; and (ii) Secondly, the locations of the tracked LV surface points are iteratively adjusted through an energy minimization cost function using a generalized Gauss-Markov random field (GGMRF) image model in order to remove inconsistencies and preserve the anatomy of the heart wall during the tracking process. Then the circumferential strains are straight forward calculated from the location of the tracked LV surface points. In addition, myocardial wall thickening is estimated by co-allocation of the corresponding points, or matches between the endocardium and epicardium surfaces of the LV wall using the solution of the 3D laplace equation. Experimental results on in vivo data confirm the accuracy and robustness of our method. Moreover, the comparison results demonstrate that our approach outperforms 2D wall thickening estimation approaches

A novel myocardium segmentation approach based on neutrosophic active contour model

Automatic delineation of the myocardium in echocardiography can assist ra- diologists to diagnosis heart problems. However, it is still challenging to distinguish myocardium from other tissue due to a low signal-to-noise ratio, low contrast, vague boundary, and speckle noise

Cardiac Motion Analysis Based on Optical Flow on Real-Time Three-Dimensional Ultrasound Data

With relatively high frame rates and the ability to acquire volume data sets with a stationary transducer, 3D ultrasound systems, based on matrix phased array transducers, provide valuable three-dimensional information, from which quantitative measures of cardiac function can be extracted. Such analyses require segmentation and visual tracking of the left ventricular endocardial border. Due to the large size of the volumetric data sets, manual tracing of the endocardial border is tedious and impractical for clinical applications. Therefore the development of automatic methods for tracking three-dimensional endocardial motion is essential. In this study, we evaluate a four-dimensional optical flow motion tracking algorithm to determine its capability to follow the endocardial border in three dimensional ultrasound data through time. The four-dimensional optical flow method was implemented using three-dimensional correlation. We tested the algorithm on an experimental open-chest dog data set and a clinical data set acquired with a Philips' iE33 three-dimensional ultrasound machine. Initialized with left ventricular endocardial data points obtained from manual tracing at end-diastole, the algorithm automatically tracked these points frame by frame through the whole cardiac cycle. Finite element surfaces were fitted through the data points obtained by both optical flow tracking and manual tracing by an experienced observer for quantitative comparison of the results. Parameterization of the finite element surfaces was performed and maps displaying relative differences between the manual and semi-automatic methods were compared. The results showed good consistency with less than 10% difference between manual tracing and optical flow estimation on 73% of the entire surface. In addition, the optical flow motion tracking algorithm greatly reduced processing time (about 94% reduction compared to human involvement per cardiac cycle) for analyzing cardiac function in three-dimensional ultrasound data sets. A displacement field was computed from the optical flow output, and a framework for computation of dynamic cardiac information is introduced. The method was applied to a clinical data set from a heart transplant patient and dynamic measurements agreed with known physiology as well as experimental results

State of the Art of Level Set Methods in Segmentation and Registration of Medical Imaging Modalities

Segmentation of medical images is an important step in various applications such as visualization, quantitative analysis and image-guided surgery. Numerous segmentation methods have been developed in the past two decades for extraction of organ contours on medical images. Low-level segmentation methods, such as pixel-based clustering, region growing, and filter-based edge detection, require additional pre-processing and post-processing as well as considerable amounts of expert intervention or information of the objects of interest. Furthermore the subsequent analysis of segmented objects is hampered by the primitive, pixel or voxel level representations from those region-based segmentation. Deformable models, on the other hand, provide an explicit representation of the boundary and the shape of the object. They combine several desirable features such as inherent connectivity and smoothness, which counteract noise and boundary irregularities, as well as the ability to incorporate knowledge about the object of interest. However, parametric deformable models have two main limitations. First, in situations where the initial model and desired object boundary differ greatly in size and shape, the model must be re-parameterized dynamically to faithfully recover the object boundary. The second limitation is that it has difficulty dealing with topological adaptation such as splitting or merging model parts, a useful property for recovering either multiple objects or objects with unknown topology. This difficulty is caused by the fact that a new parameterization must be constructed whenever topology change occurs, which requires sophisticated schemes. Level set deformable models, also referred to as geometric deformable models, provide an elegant solution to address the primary limitations of parametric deformable models. These methods have drawn a great deal of attention since their introduction in 1988. Advantages of the contour implicit formulation of the deformable model over parametric formulation include: (1) no parameterization of the contour, (2) topological flexibility, (3) good numerical stability, (4) straightforward extension of the 2D formulation to n-D. Recent reviews on the subject include papers from Suri. In this chapter we give a general overview of the level set segmentation methods with emphasize on new frameworks recently introduced in the context of medical imaging problems. We then introduce novel approaches that aim at combining segmentation and registration in a level set formulation. Finally we review a selective set of clinical works with detailed validation of the level set methods for several clinical applications