Automatic detection of larynx cancer from contrast-enhanced magnetic resonance images

Detection of larynx cancer from medical imaging is important for the quantification and for the definition of target volumes in radiotherapy treatment planning (RTP). Magnetic resonance imaging (MRI) is being increasingly used in RTP due to its high resolution and excellent soft tissue contrast. Manually detecting larynx cancer from sequential MRI is time consuming and subjective. The large diversity of cancer in terms of geometry, non-distinct boundaries combined with the presence of normal anatomical regions close to the cancer regions necessitates the development of automatic and robust algorithms for this task. A new automatic algorithm for the detection of larynx cancer from 2D gadoliniumenhanced T1-weighted (T1+Gd) MRI to assist clinicians in RTP is presented. The algorithm employs edge detection using spatial neighborhood information of pixels and incorporates this information in a fuzzy c-means clustering process to robustly separate different tissues types. Furthermore, it utilizes the information of the expected cancerous location for cancer regions labeling. Comparison of this automatic detection system with manual clinical detection on real T1+Gd axial MRI slices of 2 patients (24 MRI slices) with visible larynx cancer yields an average dice similarity coefficient of 0.78±0.04 and average root mean square error of 1.82±0.28 mm. Preliminary results show that this fully automatic system can assist clinicians in RTP by obtaining quantifiable and non-subjective repeatable detection results in a particular time-efficient and unbiased fashion

MRI-only based radiotherapy treatment planning for the rat brain on a Small Animal Radiation Research Platform (SARRP)

Computed tomography (CT) is the standard imaging modality in radiation therapy treatment planning (RTP). However, magnetic resonance (MR) imaging provides superior soft tissue contrast, increasing the precision of target volume selection. We present MR-only based RTP for a rat brain on a small animal radiation research platform (SARRP) using probabilistic voxel classification with multiple MR sequences. Six rat heads were imaged, each with one CT and five MR sequences. The MR sequences were: T1-weighted, T2-weighted, zero-echo time (ZTE), and two ultra-short echo time sequences with 20 mu s (UTE1) and 2 ms (UTE2) echo times. CT data were manually segmented into air, soft tissue, and bone to obtain the RTP reference. Bias field corrected MR images were automatically segmented into the same tissue classes using a fuzzy c-means segmentation algorithm with multiple images as input. Similarities between segmented CT and automatic segmented MR (ASMR) images were evaluated using Dice coefficient. Three ASMR images with high similarity index were used for further RTP. Three beam arrangements were investigated. Dose distributions were compared by analysing dose volume histograms. The highest Dice coefficients were obtained for the ZTE-UTE2 combination and for the T1-UTE1-T2 combination when ZTE was unavailable. Both combinations, along with UTE1-UTE2, often used to generate ASMR images, were used for further RTP. Using 1 beam, MR based RTP underestimated the dose to be delivered to the target (range: 1.4%-7.6%). When more complex beam configurations were used, the calculated dose using the ZTE-UTE2 combination was the most accurate, with 0.7% deviation from CT, compared to 0.8% for T1-UTE1-T2 and 1.7% for UTE1-UTE2. The presented MR-only based workflow for RTP on a SARRP enables both accurate organ delineation and dose calculations using multiple MR sequences. This method can be useful in longitudinal studies where CT's cumulative radiation dose might contribute to the total dose

Advanced Brain Tumour Segmentation from MRI Images

Magnetic resonance imaging (MRI) is widely used medical technology for diagnosis of various tissue abnormalities, detection of tumors. The active development in the computerized medical image segmentation has played a vital role in scientific research. This helps the doctors to take necessary treatment in an easy manner with fast decision making. Brain tumor segmentation is a hot point in the research field of Information technology with biomedical engineering. The brain tumor segmentation is motivated by assessing tumor growth, treatment responses, computer-based surgery, treatment of radiation therapy, and developing tumor growth models. Therefore, computer-aided diagnostic system is meaningful in medical treatments to reducing the workload of doctors and giving the accurate results. This chapter explains the causes, awareness of brain tumor segmentation and its classification, MRI scanning process and its operation, brain tumor classifications, and different segmentation methodologies

Karakterizacija predkliničnega tumorskega ksenograftnega modela z uporabo multiparametrične MR

Introduction: In small animal studies multiple imaging modalities can be combined to complement each other in providing information on anatomical structure and function. Non-invasive imaging studies on animal models are used to monitor progressive tumor development. This helps to better understand the efficacy of new medicines and prediction of the clinical outcome. The aim was to construct a framework based on longitudinal multi-modal parametric in vivo imaging approach to perform tumor tissue characterization in mice. Materials and Methods: Multi-parametric in vivo MRI dataset consisted of T1-, T2-, diffusion and perfusion weighted images. Image set of mice (n=3) imaged weekly for 6 weeks was used. Multimodal image registration was performed based on maximizing mutual information. Tumor region of interested was delineated in weeks 2 to 6. These regions were stacked together, and all modalities combined were used in unsupervised segmentation. Clustering methods, such as K-means and Fuzzy C-means together with blind source separation technique of non-negative matrix factorization were tested. Results were visually compared with histopathological findings. Results: Clusters obtained with K-means and Fuzzy C-means algorithm coincided with T2 and ADC maps per levels of intensity observed. Fuzzy C-means clusters and NMF abundance maps reported most promising results compared to histological findings and seem as a complementary way to asses tumor microenvironment. Conclusions: A workflow for multimodal MR parametric map generation, image registration and unsupervised tumor segmentation was constructed. Good segmentation results were achieved, but need further extensive histological validation.Uvod Eden izmed pomembnih stebrov znanstvenih raziskav v medicinski diagnostiki predstavljajo eksperimenti na živalih v sklopu predkliničnih študij. V teh študijah so eksperimenti izvedeni za namene odkrivanja in preskušanja novih terapevtskih metod za zdravljenje človeških bolezni. Rak jajčnikov je eden izmed glavnih vzrokov smrti kot posledica rakavih obolenj. Potreben je razvoj novih, učinkovitejših metod, da bi lahko uspešneje kljubovali tej bolezni. Časovno okno aplikacije novih terapevtikov je ključni dejavnik uspeha raziskovane terapije. Tumorska fiziologija se namreč razvija med napredovanjem bolezni. Eden izmed ciljev predkliničnih študij je spremljanje razvoja tumorskega mikro-okolja in tako določiti optimalno časovno okno za apliciranje razvitega terapevtika z namenom doseganja maksimalne učinkovitosti. Slikovne modalitete so kot raziskovalno orodje postale izjemno popularne v biomedicinskih in farmakoloških raziskavah zaradi svoje neinvazivne narave. Predklinične slikovne modalitete imajo nemalo prednosti pred tradicionalnim pristopom. Skladno z raziskovalno regulativo, tako za spremljanje razvoja tumorja skozi daljši čas ni potrebno žrtvovati živali v vmesnih časovnih točkah. Sočasno lahko namreč s svojim nedestruktivnim in neinvazivnim pristopom poleg anatomskih informacij podajo tudi molekularni in funkcionalni opis preučevanega subjekta. Za dosego slednjega so običajno uporabljene različne slikovne modalitete. Pogosto se uporablja kombinacija več slikovnih modalitet, saj so medsebojno komplementarne v podajanju željenih informacij. V sklopu te naloge je predstavljeno ogrodje za procesiranje različnih modalitet magnetno resonančnih predkliničnih modelov z namenom karakterizacije tumorskega tkiva. Metodologija V študiji Belderbos, Govaerts, Croitor Sava in sod. [1] so z uporabo magnetne resonance preučevali določitev optimalnega časovnega okna za uspešno aplikacijo novo razvitega terapevtika. Poleg konvencionalnih magnetno resonančnih slikovnih metod (T1 in T2 uteženo slikanje) sta bili uporabljeni tudi perfuzijsko in difuzijsko uteženi tehniki. Zajem slik je potekal tedensko v obdobju šest tednov. Podatkovni seti, uporabljeni v predstavljenem delu, so bili pridobljeni v sklopu omenjene raziskave. Ogrodje za procesiranje je narejeno v okolju Matlab (MathWorks, verzija R2019b) in omogoča tako samodejno kot ročno procesiranje slikovnih podatkov. V prvem koraku je pred generiranjem parametričnih map uporabljenih modalitet, potrebno izluščiti parametre uporabljenih protokolov iz priloženih tekstovnih datotek in zajete slike pravilno razvrstiti glede na podano anatomijo. Na tem mestu so slike tudi filtrirane in maskirane. Filtriranje je koristno za izboljšanje razmerja med koristnim signalom (slikanim živalskim modelom) in ozadjem, saj je skener za zajem slik navadno podvržen različnim izvorom slikovnega šuma. Uporabljen je bil filter ne-lokalnih povprečij Matlab knjižnice za procesiranje slik. Prednost maskiranja se potrdi v naslednjem koraku pri generiranju parametričnih map, saj se ob primerno maskiranem subjektu postopek bistveno pospeši z mapiranjem le na želenem področju. Za izdelavo parametričnih map je uporabljena metoda nelinearnih najmanjših kvadratov. Z modeliranjem fizikalnih pojavov uporabljenih modalitet tako predstavimo preiskovan živalski model z biološkimi parametri. Le-ti se komplementarno dopolnjujejo v opisu fizioloških lastnosti preučevanega modela na ravni posameznih slikovnih elementov. Ključen gradnik v uspešnem dopolnjevanju informacij posameznih modalitet je ustrezna poravnava parametričnih map. Posamezne modalitete so zajete zaporedno, ob različnih časih. Skeniranje vseh modalitet posamezne živali skupno traja več kot eno uro. Med zajemom slik tako navkljub uporabi anestetikov prihaja do majhnih premikov živali. V kolikor ti premiki niso pravilno upoštevani, prihaja do napačnih interpretacij skupnih informacij večih modalitet. Premiki živali znotraj modalitet so bili modelirani kot toge, med različnimi modalitetami pa kot afine preslikave. Poravnava slik je izvedena z lastnimi Matlab funkcijami ali z uporabo funkcij iz odprtokodnega ogrodja za procesiranje slik Elastix. Z namenom karakterizacije tumorskega tkiva so bile uporabljene metode nenadzorovanega razčlenjevanja. Bistvo razčlenjevanja je v združevanju posameznih slikovnih elementov v segmente. Elementi si morajo biti po izbranem kriteriju dovolj medsebojno podobni in se hkrati razlikovati od elementov drugih segmentov. Za razgradnjo so bile izbrane tri metode: metoda K-tih povprečij, kot ena izmed enostavnejšihmetoda mehkih C-tih povprečij, s prednostjo mehke razčlenitvein kot zadnja, nenegativna matrična faktorizacija. Slednja ponuja pogled na razčlenitev tkiva kot produkt tipičnih več-modalnih značilk in njihove obilice za vsak posamezni slikovni element. Za potrditev izvedenega razčlenjevanja z omenjenimi metodami je bila izvedena vizualna primerjava z rezultati histopatološke analize. Rezultati Na ustvarjene parametrične mape je imela poravnava slik znotraj posameznih modalitet velik vpliv. Zaradi dolgotrajnega zajema T1 uteženih slik nemalokrat prihaja do premikov živali, kar brez pravilne poravnave slik negativno vpliva na mapiranje modalitet in kasnejšo segmentacijo slik. Generirane mape imajo majhno odstopanje od tistih, narejenih s standardno uporabljenimi odprtokodnimi programi. Klastri pridobljeni z metodama K-tih in mehkih C-tih povprečij dobro sovpadajo z razčlenbami glede na njihovo inteziteto pri T2 in ADC mapah. Najobetavnejše rezultate po primerjavi s histološkimi izsledki podajata metoda mehkih C-povprečij in nenegativna matrična faktorizacija. Njuni segmentaciji se dopolnjujeta v razlagi tumorskega mikro-okolja. Zaključek Z izgradnjo ogrodja za procesiranje slik magnetne resonance in segmentacijo tumorskega tkiva je bil cilj magistrske naloge dosežen. Zasnova ogrodja omogoča poljubno dodajanje drugih modalitet in uporabo drugih živalskih modelov. Rezultati razčlenitve tumorskega tkiva so obetavni, vendar je potrebna nadaljna primerjava z rezultati histopatološke analize. Možna nadgradnja je izboljšanje robustnosti poravnave slik z uporabo modela netoge (elastične) preslikave. Prav tako je smiselno preizkusiti dodatne metode nenadzorovane segmentacije in dobljene rezultate primerjati s tukaj predstavljenimi

Combining global and local information for the segmentation of MR images of the brain

Magnetic resonance imaging can provide high resolution volumetric images of the brain with exceptional soft tissue contrast. These factors allow the complex structure of the brain to be clearly visualised. This has lead to the development of quantitative methods to analyse neuroanatomical structures. In turn, this has promoted the use of computational methods to automate and improve these techniques. This thesis investigates methods to accurately segment MRI images of the brain. The use of global and local image information is considered, where global information includes image intensity distributions, means and variances and local information is based on the relationship between spatially neighbouring voxels. Methods are explored that aim to improve the classification and segmentation of MR images of the brain by combining these elements. Some common artefacts exist in MR brain images that can be seriously detrimental to image analysis methods. Methods to correct for these artifacts are assessed by exploring their effect, first with some well established classification methods and then with methods that combine global information with local information in the form of a Markov random field model. Another characteristic of MR images is the partial volume effect that occurs where signals from different tissues become mixed over the finite volume of a voxel. This effect is demonstrated and quantified using a simulation. Analysis methods that address these issues are tested on simulated and real MR images. They are also applied to study the structure of the temporal lobes in a group of patients with temporal lobe epilepsy. The results emphasise the benefits and limitations of applying these methods to a problem of this nature. The work in this thesis demonstrates the advantages of using global and local information together in the segmentation of MR brain images and proposes a generalised framework that allows this information to be combined in a flexible way

FCM Clustering Algorithms for Segmentation of Brain MR Images

The study of brain disorders requires accurate tissue segmentation of magnetic resonance (MR) brain images which is very important for detecting tumors, edema, and necrotic tissues. Segmentation of brain images, especially into three main tissue types: Cerebrospinal Fluid (CSF), Gray Matter (GM), and White Matter (WM), has important role in computer aided neurosurgery and diagnosis. Brain images mostly contain noise, intensity inhomogeneity, and weak boundaries. Therefore, accurate segmentation of brain images is still a challenging area of research. This paper presents a review of fuzzy c-means (FCM) clustering algorithms for the segmentation of brain MR images. The review covers the detailed analysis of FCM based algorithms with intensity inhomogeneity correction and noise robustness. Different methods for the modification of standard fuzzy objective function with updating of membership and cluster centroid are also discussed

Multimodal image analysis of the human brain

Gedurende de laatste decennia heeft de snelle ontwikkeling van multi-modale en niet-invasieve hersenbeeldvorming technologieën een revolutie teweeg gebracht in de mogelijkheid om de structuur en functionaliteit van de hersens te bestuderen. Er is grote vooruitgang geboekt in het beoordelen van hersenschade door gebruik te maken van Magnetic Reconance Imaging (MRI), terwijl Elektroencefalografie (EEG) beschouwd wordt als de gouden standaard voor diagnose van neurologische afwijkingen. In deze thesis focussen we op de ontwikkeling van nieuwe technieken voor multi-modale beeldanalyse van het menselijke brein, waaronder MRI segmentatie en EEG bronlokalisatie. Hierdoor voegen we theorie en praktijk samen waarbij we focussen op twee medische applicaties: (1) automatische 3D MRI segmentatie van de volwassen hersens en (2) multi-modale EEG-MRI data analyse van de hersens van een pasgeborene met perinatale hersenschade. We besteden veel aandacht aan de verbetering en ontwikkeling van nieuwe methoden voor accurate en ruisrobuuste beeldsegmentatie, dewelke daarna succesvol gebruikt worden voor de segmentatie van hersens in MRI van zowel volwassen als pasgeborenen. Daarenboven ontwikkelden we een geïntegreerd multi-modaal methode voor de EEG bronlokalisatie in de hersenen van een pasgeborene. Deze lokalisatie wordt gebruikt voor de vergelijkende studie tussen een EEG aanval bij pasgeborenen en acute perinatale hersenletsels zichtbaar in MRI