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

Endocardial Border Detection Using Radial Search and Domain Knowledge

The ejection fraction rate is a frequently used parameter when treating patients who suffered from heart disease. However, the measurement of this ejection rate depends on manual segmentation of left ventricle cavity in the end-systolic and end-diastolic phases. This paper proposes a semi-automatic algorithm for the detection of left ventricular border in two dimensional long axis ultrasound echocardiographic images. First, we apply a preprocessing filter to the ultrasound for the sake of speckle reduction. Then the knowledge of the anatomical structure of human heart and local homogeneity of blood pool is being used to detect the border of left ventricle. The proposed method evaluates 80 ultrasound images from four healthy volunteers and the generated contours are compared with contours manually drawn by an expert. The measured Dice Metric and Hausdorff Distance recorded by the proposed algorithm are 85.1% ± 0.4% and 3.25 ± 0.46 mm respectively. The numerical results reported in this paper indicate that the proposed algorithm is able to correctly segment the left ventricle cavity and can be used as an alternative to manual contouring of left ventricle cavity from ultrasound images

Delaunay triangulation based image enhancement for echocardiography images

A novel image enhancement approach for automatic echocardiography image processing is proposed. The main steps include undecimated wavelet based speckle noise reduction, edge detection, followed by a regional enhancement process that employs Delaunay triangulation based thresholding. The edge detection is performed using a fuzzy logic based center point detection and a subsequent radial search based fuzzy multiscale edge detection. The edges obtained are used as the vertices for Delaunay triangulation for enhancement purposes. This method enhances the heart wall region in the echo image. This technique is applied to both synthetic and real image sets that were obtained from a local hospital

LV Volume Quantification via Spatiotemporal Analysis of Real-Time 3-D Echocardiography

This paper presents a method of four-dimensional (4-D) (3-D+Time) space-frequency analysis for directional denoising and enhancement of real-time three-dimensional (RT3D) ultrasound and quantitative measures in diagnostic cardiac ultrasound. Expansion of echocardiographic volumes is performed with complex exponential wavelet-like basis functions called brushlets. These functions offer good localization in time and frequency and decompose a signal into distinct patterns of oriented harmonics, which are invariant to intensity and contrast range. Deformable-model segmentation is carried out on denoised data after thresholding of transform coefficients. This process attenuates speckle noise while preserving cardiac structure location. The superiority of 4-D over 3-D analysis for decorrelating additive white noise and multiplicative speckle noise on a 4-D phantom volume expanding in time is demonstrated. Quantitative validation, computed for contours and volumes, is performed on in vitro balloon phantoms. Clinical applications of this spatiotemporal analysis tool are reported for six patient cases providing measures of left ventricular volumes and ejection fraction

Lv volume quantification via spatiotemporal analysis of real-time 3-d echocardiography

Abstract—This paper presents a method of four-dimensional (4-D) (3-D + Time) space–frequency analysis for directional denoising and enhancement of real-time three-dimensional (RT3D) ultrasound and quantitative measures in diagnostic cardiac ultrasound. Expansion of echocardiographic volumes is performed with complex exponential wavelet-like basis functions called brushlets. These functions offer good localization in time and frequency and decompose a signal into distinct patterns of oriented harmonics, which are invariant to intensity and contrast range. Deformable-model segmentation is carried out on denoised data after thresholding of transform coefficients. This process attenuates speckle noise while preserving cardiac structure location. The superiority of 4-D over 3-D analysis for decorrelating additive white noise and multiplicative speckle noise on a 4-D phantom volume expanding in time is demonstrated. Quantitative validation, computed for contours and volumes, is performed on in vitro balloon phantoms. Clinical applications of this spaciotemporal analysis tool are reported for six patient cases providing measures of left ventricular volumes and ejection fraction. Index Terms—Echocardiography, LV volume, spaciotemporal analysis, speckle denoising. I

FETAL CARDIAC STRUCTURE DETECTION FROM ULTRASOUND SEQUENCES

Fetal heart abnormalities are the most common congenital anomalies and are also the leading cause of infant mortality related to birth defects. More than one-third of all malformations found after delivery are congenital heart defects. The prenatal detection of fetal cardiac structure is difficult because of its small size and rapid movements but is important for the early and effective diagnosis of congenital cardiac defects. A novel method is proposed for the detection of fetal cardiac structure from ultrasound sequences. An initial pre-processing is done to remove noise and enhance the images. An effective K means clustering algorithm is applied to the images to segment the region of interest. Finally an active appearance model is proposed to detect the structure of fetal heart

Echocardiography

The book "Echocardiography - New Techniques" brings worldwide contributions from highly acclaimed clinical and imaging science investigators, and representatives from academic medical centers. Each chapter is designed and written to be accessible to those with a basic knowledge of echocardiography. Additionally, the chapters are meant to be stimulating and educational to the experts and investigators in the field of echocardiography. This book is aimed primarily at cardiology fellows on their basic echocardiography rotation, fellows in general internal medicine, radiology and emergency medicine, and experts in the arena of echocardiography. Over the last few decades, the rate of technological advancements has developed dramatically, resulting in new techniques and improved echocardiographic imaging. The authors of this book focused on presenting the most advanced techniques useful in today's research and in daily clinical practice. These advanced techniques are utilized in the detection of different cardiac pathologies in patients, in contributing to their clinical decision, as well as follow-up and outcome predictions. In addition to the advanced techniques covered, this book expounds upon several special pathologies with respect to the functions of echocardiography

Automatic segmentation of the lumen of the carotid artery in ultrasound B-mode images

A new algorithm is proposed for the segmentation of the lumen and bifurcation boundaries of the carotid artery in B-mode ultrasound images. It uses the hipoechogenic characteristics of the lumen for the identification of the carotid boundaries and the echogenic characteristics for the identification of the bifurcation boundaries. The image to be segmented is processed with the application of an anisotropic diffusion filter for speckle removal and morphologic operators are employed in the detection of the artery. The obtained information is then used in the definition of two initial contours, one corresponding to the lumen and the other to the bifurcation boundaries, for the posterior application of the Chan-vese level set segmentation model. A set of longitudinal B-mode images of the common carotid artery (CCA) was acquired with a GE Healthcare Vivid-e ultrasound system (GE Healthcare, United Kingdom). All the acquired images include a part of the CCA and of the bifurcation that separates the CCA into the internal and external carotid arteries. In order to achieve the uppermost robustness in the imaging acquisition process, i.e., images with high contrast and low speckle noise, the scanner was adjusted differently for each acquisition and according to the medical exam. The obtained results prove that we were able to successfully apply a carotid segmentation technique based on cervical ultrasonography. The main advantage of the new segmentation method relies on the automatic identification of the carotid lumen, overcoming the limitations of the traditional methods