Deformable Multisurface Segmentation of the Spine for Orthopedic Surgery Planning and Simulation

Purpose: We describe a shape-aware multisurface simplex deformable model for the segmentation of healthy as well as pathological lumbar spine in medical image data. Approach: This model provides an accurate and robust segmentation scheme for the identification of intervertebral disc pathologies to enable the minimally supervised planning and patient-specific simulation of spine surgery, in a manner that combines multisurface and shape statistics-based variants of the deformable simplex model. Statistical shape variation within the dataset has been captured by application of principal component analysis and incorporated during the segmentation process to refine results. In the case where shape statistics hinder detection of the pathological region, user assistance is allowed to disable the prior shape influence during deformation. Results: Results demonstrate validation against user-assisted expert segmentation, showing excellent boundary agreement and prevention of spatial overlap between neighboring surfaces. This section also plots the characteristics of the statistical shape model, such as compactness, generalizability and specificity, as a function of the number of modes used to represent the family of shapes. Final results demonstrate a proof-of-concept deformation application based on the open-source surgery simulation Simulation Open Framework Architecture toolkit. Conclusions: To summarize, we present a deformable multisurface model that embeds a shape statistics force, with applications to surgery planning and simulation

Modified mass-spring system for physically based deformation modeling

Mass-spring systems are considered the simplest and most intuitive of all deformable models. They are computationally efficient, and can handle large deformations with ease. But they suffer several intrinsic limitations. In this book a modified mass-spring system for physically based deformation modeling that addresses the limitations and solves them elegantly is presented. Several implementations in modeling breast mechanics, heart mechanics and for elastic images registration are presented

Modified mass-spring system for physically based deformation modeling

Mass-spring systems are considered the simplest and most intuitive of all deformable models. They are computationally efficient, and can handle large deformations with ease. But they suffer several intrinsic limitations. In this book a modified mass-spring system for physically based deformation modeling that addresses the limitations and solves them elegantly is presented. Several implementations in modeling breast mechanics, heart mechanics and for elastic images registration are presented

Analysis of contrast-enhanced medical images.

Early detection of human organ diseases is of great importance for the accurate diagnosis and institution of appropriate therapies. This can potentially prevent progression to end-stage disease by detecting precursors that evaluate organ functionality. In addition, it also assists the clinicians for therapy evaluation, tracking diseases progression, and surgery operations. Advances in functional and contrast-enhanced (CE) medical images enabled accurate noninvasive evaluation of organ functionality due to their ability to provide superior anatomical and functional information about the tissue-of-interest. The main objective of this dissertation is to develop a computer-aided diagnostic (CAD) system for analyzing complex data from CE magnetic resonance imaging (MRI). The developed CAD system has been tested in three case studies: (i) early detection of acute renal transplant rejection, (ii) evaluation of myocardial perfusion in patients with ischemic heart disease after heart attack; and (iii), early detection of prostate cancer. However, developing a noninvasive CAD system for the analysis of CE medical images is subject to multiple challenges, including, but are not limited to, image noise and inhomogeneity, nonlinear signal intensity changes of the images over the time course of data acquisition, appearances and shape changes (deformations) of the organ-of-interest during data acquisition, determination of the best features (indexes) that describe the perfusion of a contrast agent (CA) into the tissue. To address these challenges, this dissertation focuses on building new mathematical models and learning techniques that facilitate accurate analysis of CAs perfusion in living organs and include: (i) accurate mathematical models for the segmentation of the object-of-interest, which integrate object shape and appearance features in terms of pixel/voxel-wise image intensities and their spatial interactions; (ii) motion correction techniques that combine both global and local models, which exploit geometric features, rather than image intensities to avoid problems associated with nonlinear intensity variations of the CE images; (iii) fusion of multiple features using the genetic algorithm. The proposed techniques have been integrated into CAD systems that have been tested in, but not limited to, three clinical studies. First, a noninvasive CAD system is proposed for the early and accurate diagnosis of acute renal transplant rejection using dynamic contrast-enhanced MRI (DCE-MRI). Acute rejection–the immunological response of the human immune system to a foreign kidney–is the most sever cause of renal dysfunction among other diagnostic possibilities, including acute tubular necrosis and immune drug toxicity. In the U.S., approximately 17,736 renal transplants are performed annually, and given the limited number of donors, transplanted kidney salvage is an important medical concern. Thus far, biopsy remains the gold standard for the assessment of renal transplant dysfunction, but only as the last resort because of its invasive nature, high cost, and potential morbidity rates. The diagnostic results of the proposed CAD system, based on the analysis of 50 independent in-vivo cases were 96% with a 95% confidence interval. These results clearly demonstrate the promise of the proposed image-based diagnostic CAD system as a supplement to the current technologies, such as nuclear imaging and ultrasonography, to determine the type of kidney dysfunction. Second, a comprehensive CAD system is developed for the characterization of myocardial perfusion and clinical status in heart failure and novel myoregeneration therapy using cardiac first-pass MRI (FP-MRI). Heart failure is considered the most important cause of morbidity and mortality in cardiovascular disease, which affects approximately 6 million U.S. patients annually. Ischemic heart disease is considered the most common underlying cause of heart failure. Therefore, the detection of the heart failure in its earliest forms is essential to prevent its relentless progression to premature death. While current medical studies focus on detecting pathological tissue and assessing contractile function of the diseased heart, this dissertation address the key issue of the effects of the myoregeneration therapy on the associated blood nutrient supply. Quantitative and qualitative assessment in a cohort of 24 perfusion data sets demonstrated the ability of the proposed framework to reveal regional perfusion improvements with therapy, and transmural perfusion differences across the myocardial wall; thus, it can aid in follow-up on treatment for patients undergoing the myoregeneration therapy. Finally, an image-based CAD system for early detection of prostate cancer using DCE-MRI is introduced. Prostate cancer is the most frequently diagnosed malignancy among men and remains the second leading cause of cancer-related death in the USA with more than 238,000 new cases and a mortality rate of about 30,000 in 2013. Therefore, early diagnosis of prostate cancer can improve the effectiveness of treatment and increase the patient’s chance of survival. Currently, needle biopsy is the gold standard for the diagnosis of prostate cancer. However, it is an invasive procedure with high costs and potential morbidity rates. Additionally, it has a higher possibility of producing false positive diagnosis due to relatively small needle biopsy samples. Application of the proposed CAD yield promising results in a cohort of 30 patients that would, in the near future, represent a supplement of the current technologies to determine prostate cancer type. The developed techniques have been compared to the state-of-the-art methods and demonstrated higher accuracy as shown in this dissertation. The proposed models (higher-order spatial interaction models, shape models, motion correction models, and perfusion analysis models) can be used in many of today’s CAD applications for early detection of a variety of diseases and medical conditions, and are expected to notably amplify the accuracy of CAD decisions based on the automated analysis of CE images

Automated Knowledge Discovery from Functional Magnetic Resonance Images using Spatial Coherence

Functional Magnetic Resonance Imaging (fMRI) has the potential to unlock many of the mysteries of the brain. Although this imaging modality is popular for brain-mapping activities, clinical applications of this technique are relatively rare. For clinical applications, classification models are more useful than the current practice of reporting loci of neural activation associated with particular disorders. Also, since the methods used to account for anatomical variations between subjects are generally imprecise, the conventional voxel-by-voxel analysis limits the types of discoveries that are possible. This work presents a classification-based framework for knowledge discovery from fMRI data. Instead of voxel-centric knowledge discovery, this framework is segment-centric, where functional segments are clumps of voxels that represent a functional unit in the brain. With simulated activation images, it is shown that this segment-based approach can be more successful for knowledge discovery than conventional voxel-based approaches. The spatial coherence principle refers to the homogeneity of behavior of spatially contiguous voxels. Auto-threshold Contrast Enhancing Iterative Clustering (ACEIC) - a new algorithm based on the spatial coherence principle is presented here for functional segmentation. With benchmark data, it is shown that the ACEIC method can achieve higher segmentation accuracy than Probabilistic Independent Component Analysis - a popular method used for fMRI data analysis. The spatial coherence principle can also be exploited for voxel-centric image-classification problems. Spatially Coherent Voxels (SCV) is a new feature selection method that uses the spatial coherence principle to eliminate features that are unlikely to be useful for classification. For a Substance Use Disorder dataset, it is demonstrated that feature selection with SCV can achieve higher classification accuracies than conventional feature selection methods

Generative models for group fMRI data

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2011.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.Cataloged from student submitted PDF version of thesis.Includes bibliographical references (p. 151-174).In this thesis, we develop an exploratory framework for design and analysis of fMRI studies. In our framework, the experimenter presents subjects with a broad set of stimuli/tasks relevant to the domain under study. The analysis method then automatically searches for likely patterns of functional specificity in the resulting data. This is in contrast to the traditional confirmatory approaches that require the experimenter to specify a narrow hypothesis a priori and aims to localize areas of the brain whose activation pattern agrees with the hypothesized response. To validate the hypothesis, it is usually assumed that detected areas should appear in consistent anatomical locations across subjects. Our approach relaxes the conventional anatomical consistency constraint to discover networks of functionally homogeneous but anatomically variable areas. Our analysis method relies on generative models that explain fMRI data across the group as collections of brain locations with similar profiles of functional specificity. We refer to each such collection as a functional system and model it as a component of a mixture model for the data. The search for patterns of specificity corresponds to inference on the hidden variables of the model based on the observed fMRI data. We also develop a nonparametric hierarchical Bayesian model for group fMRI data that integrates the mixture model prior over activations with a model for fMRI signals. We apply the algorithms in a study of high level vision where we consider a large space of patterns of category selectivity over 69 distinct images. The analysis successfully discovers previously characterized face, scene, and body selective areas, among a few others, as the most dominant patterns in the data. This finding suggests that our approach can be employed to search for novel patterns of functional specificity in high level perception and cognition.by Danial Lashkari.Ph.D

The Piglet as Biomedical Model: Physiological Investigations, New Techniques and Future Applications

By the analysis of the literature, it looks like the strive for new piglets’ models of disease have prevaricated the necessity for a deeper knowledge of the physiology of the animal. It is well known how difficult it is to interpret obtained data when poor to none reference standards are provided and how hard it is to apply techniques borrowed from other models, no matter how similar they can look. The aim of the present work was to collect knowledge and information regarding the piglets by studying its physiology and to validating new techniques. The experiments can be divided into two categories: physiological investigations and new techniques and future applications. Blood and Cerebrospinal fluid were analyzed in a quali-quantitative manner in piglets. The studies, thanks to the extensive statistical analyses and the high number of sampled population, provide with important reference intervals that will allow for better understanding of several metabolic processes. For the second category, technical experiments aimed to find easier and relatively pain free procedures for the collection of Cerebrospinal fluid and intrathecal administration in piglets, were performed. Operators’ skills often are a limiting factor for the feasibility of experimental protocols, and easier techniques are the best way to break down these walls. Moreover, when leading to lower mortality and higher welfare, those techniques allow for better results and higher ethical standards. The last experiment aimed to create a comprehensive map of CNS transduction upon intrathecal administration of Adeno-Associated Viral vector in piglets, and to evaluate their potential toxicity. The obtained result will help choosing the right serotype depending on the targeted cell population, thus avoiding preliminary studies reducing the number of enrolled animals. In conclusion, this thesis represents an additional step toward the standardization of the physiological piglet model and its refinement and reduction in experimental protocols

Characterising pattern asymmetry in pigmented skin lesions

Abstract. In clinical diagnosis of pigmented skin lesions asymmetric pigmentation is often indicative of melanoma. This paper describes a method and measures for characterizing lesion symmetry. The estimate of mirror symmetry is computed first for a number of axes at different degrees of rotation with respect to the lesion centre. The statistics of these estimates are the used to assess the overall symmetry. The method is applied to three different lesion representations showing the overall pigmentation, the pigmentation pattern, and the pattern of dermal melanin. The best measure is a 100% sensitive and 96% specific indicator of melanoma on a test set of 33 lesions, with a separate training set consisting of 66 lesions

The Neural Development of Visuohaptic Object Processing

Thesis (Ph.D.) - Indiana University, Cognitive Science, 2015Object recognition is ubiquitous and essential for interacting with, as well as learning about, the surrounding multisensory environment. The inputs from multiple sensory modalities converge quickly and efficiently to guide this interaction. Vision and haptics are two modalities in particular that offer redundant and complementary information regarding the geometrical (i.e., shape) properties of objects for recognition and perception. While the systems supporting visuohaptic object recognition in the brain, including the lateral occipital complex (LOC) and the intraparietal sulcus (IPS), are well-studied in adults, there is currently a paucity of research surrounding the neural development of visuohaptic processing in children. Little is known about how and when vision converges with haptics for object recognition. In this dissertation, I investigate the development of neural mechanisms involved in multisensory processing. Using functional magnetic resonance imaging (fMRI) and general psychophysiological interaction (gPPI) methods of functional connectivity analysis in children (4 to 5.5 years, 7 to 8.5 years) and adults, I examine the developmental changes of the brain regions underlying the convergence of visual and haptic object perception, the neural substrates supporting crossmodal processing, and the interactions and functional connections between visuohaptic systems and other neural regions. Results suggest that the complexity of sensory inputs impacts the development of neural substrates. The more complicated forms of multisensory and crossmodal object processing show protracted developmental trajectories as compared to the processing of simple, unimodal shapes. Additionally, the functional connections between visuohaptic areas weaken over time, which may facilitate the fine-tuning of other perceptual systems that occur later in development. Overall, the findings indicate that multisensory object recognition cannot be described as a unitary process. Rather, it is comprised of several distinct sub-processes that follow different developmental timelines throughout childhood and into adulthood