Infrared dermal thermography on diabetic feet soles to predict ulcerations: a case study

Diabetic foot ulceration is a major complication for patients with diabetes mellitus. If not adequately treated, these ulcers may lead to foot infection, and ultimately to lower extremity amputation, which imposes a major burden to society and great loss in health-related quality of life for patients. Early identification and subsequent preventive treatment have proven useful to limit the incidence of foot ulcers and lower extremity amputation. Thus, the development of new diagnosis tools has become an attractive option. The ultimate objective of our project is to develop an intelligent telemedicine monitoring system for frequent examination on patients’ feet, to timely detect pre-signs of ulceration. Inflammation in diabetic feet can be an early and predictive warning sign for ulceration, and temperature has been proven to be a vicarious marker for inflammation. Studies have indicated that infrared dermal thermography of foot soles can be one of the important parameters for assessing the risk of diabetic foot ulceration. This paper covers the feasibility study of using an infrared camera, FLIR SC305, in our setup, to acquire the spatial thermal distribution on the feet soles. With the obtained thermal images, automated detection through image analysis was performed to identify the abnormal increased/decreased temperature and assess the risk for ulceration. The thermography for feet soles of patients with diagnosed diabetic foot complications were acquired before the ordinary foot examinations. Assessment from clinicians and thermography were compared and follow-up measurements were performed to investigate the prediction. A preliminary case study will be presented, indicating that dermal thermography in our proposed setup can be a screening modality to timely detect pre-signs of ulceration

Motion Calculations on Stent Grafts in AAA

Endovascular aortic repair (EVAR) is a technique which uses stent grafts to treat aortic aneurysms in patients at risk of aneurysm rupture. Although this technique has been shown to be very successful on the short term, the long term results are less optimistic due to failure of the stent graft. The pulsating blood flow applies stresses and forces to the stent graft, which can cause problems such as breakage, leakage, and migration. Therefore it is of importance to gain more insight into the in vivo motion behavior of these devices. If we know more about the motion patterns in well-behaved stent graft as well as ill-behaving devices, we shall be better able to distinguish between these type of behaviors These insights will enable us to detect stent-related problems and might even be used to predict problems beforehand. Further, these insights will help in designing the next generation stent grafts. Firstly, this work discusses the applicability of ECG-gated CT for measuring the motions of stent grafts in AAA. Secondly, multiple methods to segment the stent graft from these data are discussed. Thirdly, this work proposes a method that uses image registration to apply motion to the segmented stent mode

Towards Robust and Accurate Image Registration by Incorporating Anatomical and Appearance Priors

Ph.DDOCTOR OF PHILOSOPH

Development of Efficient Intensity Based Registration Techniques for Multi-modal Brain Images

Recent advances in medical imaging have resulted in the development of many imaging techniques that capture various aspects of the patients anatomy and metabolism. These are accomplished with image registration: the task of transforming images on a common anatomical coordinate space. Image registration is one of the important task for multi-modal brain images, which has paramount importance in clinical diagnosis, leads to treatment of brain diseases. In many other applications, image registration characterizes anatomical variability, to detect changes in disease state over time, and by mapping functional information into anatomical space. This thesis is focused to explore intensity-based registration techniques to accomplish precise information with accurate transformation for multi-modal brain images. In this view, we addressed mainly three important issues of image registration both in the rigid and non-rigid framework, i.e. i) information theoretic based similarity measure for alignment measurement, ii) free form deformation (FFD) based transformation, and iii) evolutionary technique based optimization of the cost function. Mutual information (MI) is a widely used information theoretic similarity measure criterion for multi-modal brain image registration. MI only dense the quantitative aspects of information based on the probability of events. For rustication of the information of events, qualitative aspect i.e. utility or saliency is a necessitate factor for consideration. In this work, a novel similarity measure is proposed, which incorporates the utility information into mutual Information, known as Enhanced Mutual Information(EMI).It is found that the maximum information gain using EMI is higher as compared to that of other state of arts. The utility or saliency employed in EMI is a scale invariant parameter, and hence it may fail to register in case of projective and perspective transformations. To overcome this bottleneck, salient region (SR) based Enhance Mutual Information (SR-EMI)is proposed, a new similarity measure for robust and accurate registration. The proposed SR-EMI based registration technique is robust to register the multi-modal brain images at a faster rate with better alignment

Information theoretic regularization in diffuse optical tomography

Diffuse optical tomography (DOT) retrieves the spatially distributed optical characteristics of a medium from external measurements. Recovering these parameters of interest involves solving a non-linear and severely ill-posed inverse problem. In this thesis we propose methods towards the regularization of DOT via the introduction of spatially unregistered, a priori information from alternative high resolution anatomical modalities, using the information theory concepts of joint entropy (JE) and mutual information (MI). Such functionals evaluate the similarity between the reconstructed optical image and the prior image, while bypassing the multi-modality barrier manifested as the incommensurate relation between the gray value representations of corresponding anatomical features in the modalities involved. By introducing structural a priori information in the image reconstruction process, we aim to improve the spatial resolution and quantitative accuracy of the solution. A further condition for the accurate incorporation of a priori information is the establishment of correct alignment between the prior image and the probed anatomy in a common coordinate system. However, limited information regarding the probed anatomy is known prior to the reconstruction process. In this work we explore the potentiality of spatially registering the prior image simultaneously with the solution of the reconstruction process. We provide a thorough explanation of the theory from an imaging perspective, accompanied by preliminary results obtained by numerical simulations as well as experimental data. In addition we compare the performance of MI and JE. Finally, we propose a method for fast joint entropy evaluation and optimization, which we later employ for the information theoretic regularization of DOT. The main areas involved in this thesis are: inverse problems, image reconstruction & regularization, diffuse optical tomography and medical image registration

Statistical models in medical image analysis

Thesis (Ph.D.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2000.Includes bibliographical references (leaves 149-156).Computational tools for medical image analysis help clinicians diagnose, treat, monitor changes, and plan and execute procedures more safely and effectively. Two fundamental problems in analyzing medical imagery are registration, which brings two or more datasets into correspondence, and segmentation, which localizes the anatomical structures in an image. The noise and artifacts present in the scans, combined with the complexity and variability of patient anatomy, limit the effectiveness of simple image processing routines. Statistical models provide application-specific context to the problem by incorporating information derived from a training set consisting of instances of the problem along with the solution. In this thesis, we explore the benefits of statistical models for medical image registration and segmentation. We present a technique for computing the rigid registration of pairs of medical images of the same patient. The method models the expected joint intensity distribution of two images when correctly aligned. The registration of a novel set of images is performed by maximizing the log likelihood of the transformation, given the joint intensity model. Results aligning SPGR and dual-echo magnetic resonance scans demonstrate sub-voxel accuracy and large region of convergence. A novel segmentation method is presented that incorporates prior statistical models of intensity, local curvature, and global shape to direct the segmentation toward a likely outcome. Existing segmentation algorithms generally fit into one of the following three categories: boundary localization, voxel classification, and atlas matching, each with different strengths and weaknesses. Our algorithm unifies these approaches. A higher dimensional surface is evolved based on local and global priors such that the zero level set converges on the object boundary. Results segmenting images of the corpus callosum, knee, and spine illustrate the strength and diversity of this approach.by Michael Emmanuel Leventon.Ph.D