Volumetric MRI Reconstruction from 2D Slices in the Presence of Motion

Despite recent advances in acquisition techniques and reconstruction algorithms, magnetic resonance imaging (MRI) remains challenging in the presence of motion. To mitigate this, ultra-fast two-dimensional (2D) MRI sequences are often used in clinical practice to acquire thick, low-resolution (LR) 2D slices to reduce in-plane motion. The resulting stacks of thick 2D slices typically provide high-quality visualizations when viewed in the in-plane direction. However, the low spatial resolution in the through-plane direction in combination with motion commonly occurring between individual slice acquisitions gives rise to stacks with overall limited geometric integrity. In further consequence, an accurate and reliable diagnosis may be compromised when using such motion-corrupted, thick-slice MRI data. This thesis presents methods to volumetrically reconstruct geometrically consistent, high-resolution (HR) three-dimensional (3D) images from motion-corrupted, possibly sparse, low-resolution 2D MR slices. It focuses on volumetric reconstructions techniques using inverse problem formulations applicable to a broad field of clinical applications in which associated motion patterns are inherently different, but the use of thick-slice MR data is current clinical practice. In particular, volumetric reconstruction frameworks are developed based on slice-to-volume registration with inter-slice transformation regularization and robust, complete-outlier rejection for the reconstruction step that can either avoid or efficiently deal with potential slice-misregistrations. Additionally, this thesis describes efficient Forward-Backward Splitting schemes for image registration for any combination of differentiable (not necessarily convex) similarity measure and convex (not necessarily smooth) regularization with a tractable proximal operator. Experiments are performed on fetal and upper abdominal MRI, and on historical, printed brain MR films associated with a uniquely long-term study dating back to the 1980s. The results demonstrate the broad applicability of the presented frameworks to achieve robust reconstructions with the potential to improve disease diagnosis and patient management in clinical practice

Diffeomorphic image registration with applications to deformation modelling between multiple data sets

Over last years, the diffeomorphic image registration algorithms have been successfully introduced into the field of the medical image analysis. At the same time, the particular usability of these techniques, in majority derived from the solid mathematical background, has been only quantitatively explored for the limited applications such as longitudinal studies on treatment quality, or diseases progression. The thesis considers the deformable image registration algorithms, seeking out those that maintain the medical correctness of the estimated dense deformation fields in terms of the preservation of the object and its neighbourhood topology, offer the reasonable computational complexity to satisfy time restrictions coming from the potential applications, and are able to cope with low quality data typically encountered in Adaptive Radiotherapy (ART). The research has led to the main emphasis being laid on the diffeomorphic image registration to achieve one-to-one mapping between images. This involves introduction of the log-domain parameterisation of the deformation field by its approximation via a stationary velocity field. A quantitative and qualitative examination of existing and newly proposed algorithms for pairwise deformable image registration presented in this thesis, shows that the log-Euclidean parameterisation can be successfully utilised in the biomedical applications. Although algorithms utilising the log-domain parameterisation have theoretical justification for maintaining diffeomorphism, in general, the deformation fields produced by them have similar properties as these estimated by classical methods. Having this in mind, the best compromise in terms of the quality of the deformation fields has been found for the consistent image registration framework. The experimental results suggest also that the image registration with the symmetrical warping of the input images outperforms the classical approaches, and simultaneously can be easily introduced to most known algorithms. Furthermore, the log-domain implicit group-wise image registration is proposed. By linking the various sets of images related to the different subjects, the proposed image registration approach establishes a common subject space and between-subject correspondences therein. Although the correspondences between groups of images can be found by performing the classic image registration, the reference image selection (not required in the proposed implementation), may lead to a biased mean image being estimated and the corresponding common subject space not adequate to represent the general properties of the data sets. The approaches to diffeomorphic image registration have been also utilised as the principal elements for estimating the movements of the organs in the pelvic area based on the dense deformation field prediction system driven by the partial information coming from the specific type of the measurements parameterised using the implicit surface representation, and recognising facial expressions where the stationary velocity fields are used as the facial expression descriptors. Both applications have been extensively evaluated based on the real representative data sets of three-dimensional volumes and two-dimensional images, and the obtained results indicate the practical usability of the proposed techniques

Deep Learning with Limited Labels for Medical Imaging

Recent advancements in deep learning-based AI technologies provide an automatic tool to revolutionise medical image computing. Training a deep learning model requires a large amount of labelled data. Acquiring labels for medical images is extremely challenging due to the high cost in terms of both money and time, especially for the pixel-wise segmentation task of volumetric medical scans. However, obtaining unlabelled medical scans is relatively easier compared to acquiring labels for those images. This work addresses the pervasive issue of limited labels in training deep learning models for medical imaging. It begins by exploring different strategies of entropy regularisation in the joint training of labelled and unlabelled data to reduce the time and cost associated with manual labelling for medical image segmentation. Of particular interest are consistency regularisation and pseudo labelling. Specifically, this work proposes a well-calibrated semi-supervised segmentation framework that utilises consistency regularisation on different morphological feature perturbations, representing a significant step towards safer AI in medical imaging. Furthermore, it reformulates pseudo labelling in semi-supervised learning as an Expectation-Maximisation framework. Building upon this new formulation, the work explains the empirical successes of pseudo labelling and introduces a generalisation of the technique, accompanied by variational inference to learn its true posterior distribution. The applications of pseudo labelling in segmentation tasks are also presented. Lastly, this work explores unsupervised deep learning for parameter estimation of diffusion MRI signals, employing a hierarchical variational clustering framework and representation learning

Non-rigid medical image registration with extended free form deformations: modelling general tissue transitions

Image registration seeks pointwise correspondences between the same or analogous objects in different images. Conventional registration methods generally impose continuity and smoothness throughout the image. However, there are cases in which the deformations may involve discontinuities. In general, the discontinuities can be of different types, depending on the physical properties of the tissue transitions involved and boundary conditions. For instance, in the respiratory motion the lungs slide along the thoracic cage following the tangential direction of their interface. In the normal direction, however, the lungs and the thoracic cage are constrained to be always in contact but they have different material properties producing different compression or expansion rates. In the literature, there is no generic method, which handles different types of discontinuities and considers their directional dependence. The aim of this thesis is to develop a general registration framework that is able to correctly model different types of tissue transitions with a general formalism. This has led to the development of the eXtended Free Form Deformation (XFFD) registration method. XFFD borrows the concept of the interpolation method from the eXtended Finite Element method (XFEM) to incorporate discontinuities by enriching B-spline basis functions, coupled with extra degrees of freedom. XFFD can handle different types of discontinuities and encodes their directional-dependence without any additional constraints. XFFD has been evaluated on digital phantoms, publicly available 3D liver and lung CT images. The experiments show that XFFD improves on previous methods and that it is important to employ the correct model that corresponds to the discontinuity type involved at the tissue transition. The effect of using incorrect models is more evident in the strain, which measures mechanical properties of the tissues

Deep learning for fast and robust medical image reconstruction and analysis

Medical imaging is an indispensable component of modern medical research as well as clinical practice. Nevertheless, imaging techniques such as magnetic resonance imaging (MRI) and computational tomography (CT) are costly and are less accessible to the majority of the world. To make medical devices more accessible, affordable and efficient, it is crucial to re-calibrate our current imaging paradigm for smarter imaging. In particular, as medical imaging techniques have highly structured forms in the way they acquire data, they provide us with an opportunity to optimise the imaging techniques holistically by leveraging data. The central theme of this thesis is to explore different opportunities where we can exploit data and deep learning to improve the way we extract information for better, faster and smarter imaging. This thesis explores three distinct problems. The first problem is the time-consuming nature of dynamic MR data acquisition and reconstruction. We propose deep learning methods for accelerated dynamic MR image reconstruction, resulting in up to 10-fold reduction in imaging time. The second problem is the redundancy in our current imaging pipeline. Traditionally, imaging pipeline treated acquisition, reconstruction and analysis as separate steps. However, we argue that one can approach them holistically and optimise the entire pipeline jointly for a specific target goal. To this end, we propose deep learning approaches for obtaining high fidelity cardiac MR segmentation directly from significantly undersampled data, greatly exceeding the undersampling limit for image reconstruction. The final part of this thesis tackles the problem of interpretability of the deep learning algorithms. We propose attention-models that can implicitly focus on salient regions in an image to improve accuracy for ultrasound scan plane detection and CT segmentation. More crucially, these models can provide explainability, which is a crucial stepping stone for the harmonisation of smart imaging and current clinical practice.Open Acces

Computer-Assisted Electroanatomical Guidance for Cardiac Electrophysiology Procedures

Cardiac arrhythmias are serious life-threatening episodes affecting both the aging population and younger patients with pre-existing heart conditions. One of the most effective therapeutic procedures is the minimally-invasive catheter-driven endovascular electrophysiology study, whereby electrical potentials and activation patterns in the affected cardiac chambers are measured and subsequent ablation of arrhythmogenic tissue is performed. Despite emerging technologies such as electroanatomical mapping and remote intraoperative navigation systems for improved catheter manipulation and stability, successful ablation of arrhythmias is still highly-dependent on the operator’s skills and experience. This thesis proposes a framework towards standardisation in the electroanatomical mapping and ablation planning by merging knowledge transfer from previous cases and patient-specific data. In particular, contributions towards four different procedural aspects were made: optimal electroanatomical mapping, arrhythmia path computation, catheter tip stability analysis, and ablation simulation and optimisation. In order to improve the intraoperative electroanatomical map, anatomical areas of high mapping interest were proposed, as learned from previous electrophysiology studies. Subsequently, the arrhythmic wave propagation on the endocardial surface and potential ablation points were computed. The ablation planning is further enhanced, firstly by the analysis of the catheter tip stability and the probability of slippage at sparse locations on the endocardium and, secondly, by the simulation of the ablation result from the computation of convolutional matrices which model mathematically the ablation process. The methods proposed by this thesis were validated on data from patients with complex congenital heart disease, who present unusual cardiac anatomy and consequently atypical arrhythmias. The proposed methods also build a generic framework for computer guidance of electrophysiology, with results showing complementary information that can be easily integrated into the clinical workflow.Open Acces

Kernel-based modeling of pneumothorax deformation using intraoperative cone-beam CT images

Event: SPIE Medical Imaging, 2021, Online OnlyIn this study, we introduce statistical modeling methods for pneumothorax deformation using paired cone-beam computed tomography (CT) images. We designed a deformable mesh registration framework for shape changes involving non-linear deformation and rotation of the lungs. The registered meshes with local correspondences are available for both surgical guidance in thoracoscopic surgery and building statistical deformation models with inter-patient variations. In addition, a kernel-based deformation learning framework is proposed to reconstruct intraoperative dfl ated states of the lung from the preoperative CT models. This paper reports the findings of pneumothorax deformation and evaluation results of the kernel-based deformation framework