Fully automated segmentation and tracking of the intima media thickness in ultrasound video sequences of the common carotid artery

Abstract—The robust identification and measurement of the intima media thickness (IMT) has a high clinical relevance because it represents one of the most precise predictors used in the assessment of potential future cardiovascular events. To facilitate the analysis of arterial wall thickening in serial clinical investigations, in this paper we have developed a novel fully automatic algorithm for the segmentation, measurement, and tracking of the intima media complex (IMC) in B-mode ultrasound video sequences. The proposed algorithm entails a two-stage image analysis process that initially addresses the segmentation of the IMC in the first frame of the ultrasound video sequence using a model-based approach; in the second step, a novel customized tracking procedure is applied to robustly detect the IMC in the subsequent frames. For the video tracking procedure, we introduce a spatially coherent algorithm called adaptive normalized correlation that prevents the tracking process from converging to wrong arterial interfaces. This represents the main contribution of this paper and was developed to deal with inconsistencies in the appearance of the IMC over the cardiac cycle. The quantitative evaluation has been carried out on 40 ultrasound video sequences of the common carotid artery (CCA) by comparing the results returned by the developed algorithm with respect to ground truth data that has been manually annotated by clinical experts. The measured IMTmean ± standard deviation recorded by the proposed algorithm is 0.60 mm ± 0.10, with a mean coefficient of variation (CV) of 2.05%, whereas the corresponding result obtained for the manually annotated ground truth data is 0.60 mm ± 0.11 with a mean CV equal to 5.60%. The numerical results reported in this paper indicate that the proposed algorithm is able to correctly segment and track the IMC in ultrasound CCA video sequences, and we were encouraged by the stability of our technique when applied to data captured under different imaging conditions. Future clinical studies will focus on the evaluation of patients that are affected by advanced cardiovascular conditions such as focal thickening and arterial plaques

Statistical Region Based Segmentation of Ultrasound Images

Segmentation of ultrasound images is a challenging problem due to speckle, which corrupts the image and can result in weak or missing image boundaries, poor signal to noise ratio, and diminished contrast resolution. Speckle is a random interference pattern that is characterized by an asymmetric distribution as well as significant spatial correla- tion. These attributes of speckle are challenging to model in a segmentation approach, so many previous ultrasound segmentation methods simplify the problem by assuming that the speckle is white and/or Gaussian distributed. Unlike these methods, in this paper we present an ultrasound-specific segmentation approach that addresses both the spatial correlation of the data as well as its intensity distribution. We first decorrelate the image and then apply a region-based active contour whose motion is derived from an appropri- ate parametric distribution for maximum likelihood image segmentation. We consider zero-mean complex Gaussian, Rayleigh, and Fisher-Tippett flows, which are designed to model fully formed speckle in the in-phase/quadrature (IQ), envelope detected, and display (log compressed) images, respectively. We present experimental results demon- strating the effectiveness of our method, and compare the results to other parametric and non-parametric active contours

Intima-Media Thickness: Setting a Standard for a Completely Automated Method of Ultrasound Measurement

The intima - media thickness (IMT) of the common carotid artery is a widely used clinical marker of severe cardiovascular diseases. IMT is usually manually measured on longitudinal B-Mode ultrasound images. Many computer-based techniques for IMT measurement have been proposed to overcome the limits of manual segmentation. Most of these, however, require a certain degree of user interaction. In this paper we describe a new completely automated layers extraction (CALEXia) technique for the segmentation and IMT measurement of carotid wall in ultrasound images. CALEXia is based on an integrated approach consisting of feature extraction, line fitting, and classification that enables the automated tracing of the carotid adventitial walls. IMT is then measured by relying on a fuzzy K-means classifier. We tested CALEXia on a database of 200 images. We compared CALEXia performances to those of a previously developed methodology that was based on signal analysis (CULEXsa). Three trained operators manually segmented the images and the average profiles were considered as the ground truth. The average error from CALEXia for lumen - intima (LI) and media - adventitia (MA) interface tracings were 1.46 ± 1.51 pixel (0.091 ± 0.093 mm) and 0.40 ± 0.87 pixel (0.025 ± 0.055 mm), respectively. The corresponding errors for CULEXsa were 0.55 ± 0.51 pixels (0.035 ± 0.032 mm) and 0.59 ± 0.46 pixels (0.037 ± 0.029 mm). The IMT measurement error was equal to 0.87 ± 0.56 pixel (0.054 ± 0.035 mm) for CALEXia and 0.12 ± 0.14 pixel (0.01 ± 0.01 mm) for CULEXsa. Thus, CALEXia showed limited performance in segmenting the LI interface, but outperformed CULEXsa in the MA interface and in the number of images correctly processed (10 for CALEXia and 16 for CULEXsa). Based on two complementary strategies, we anticipate fusing them for further IMT improvement

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

Automating Carotid Intima-Media Thickness Video Interpretation with Convolutional Neural Networks

Cardiovascular disease (CVD) is the leading cause of mortality yet largely preventable, but the key to prevention is to identify at-risk individuals before adverse events. For predicting individual CVD risk, carotid intima-media thickness (CIMT), a noninvasive ultrasound method, has proven to be valuable, offering several advantages over CT coronary artery calcium score. However, each CIMT examination includes several ultrasound videos, and interpreting each of these CIMT videos involves three operations: (1) select three end-diastolic ultrasound frames (EUF) in the video, (2) localize a region of interest (ROI) in each selected frame, and (3) trace the lumen-intima interface and the media-adventitia interface in each ROI to measure CIMT. These operations are tedious, laborious, and time consuming, a serious limitation that hinders the widespread utilization of CIMT in clinical practice. To overcome this limitation, this paper presents a new system to automate CIMT video interpretation. Our extensive experiments demonstrate that the suggested system significantly outperforms the state-of-the-art methods. The superior performance is attributable to our unified framework based on convolutional neural networks (CNNs) coupled with our informative image representation and effective post-processing of the CNN outputs, which are uniquely designed for each of the above three operations.Comment: J. Y. Shin, N. Tajbakhsh, R. T. Hurst, C. B. Kendall, and J. Liang. Automating carotid intima-media thickness video interpretation with convolutional neural networks. CVPR 2016, pp 2526-2535; N. Tajbakhsh, J. Y. Shin, R. T. Hurst, C. B. Kendall, and J. Liang. Automatic interpretation of CIMT videos using convolutional neural networks. Deep Learning for Medical Image Analysis, Academic Press, 201

Multimodality carotid plaque tissue characterization and classification in the artificial intelligence paradigm: a narrative review for stroke application

Cardiovascular disease (CVD) is one of the leading causes of morbidity and mortality in the United States of America and globally. Carotid arterial plaque, a cause and also a marker of such CVD, can be detected by various non-invasive imaging modalities such as magnetic resonance imaging (MRI), computer tomography (CT), and ultrasound (US). Characterization and classification of carotid plaque-type in these imaging modalities, especially into symptomatic and asymptomatic plaque, helps in the planning of carotid endarterectomy or stenting. It can be challenging to characterize plaque components due to (I) partial volume effect in magnetic resonance imaging (MRI) or (II) varying Hausdorff values in plaque regions in CT, and (III) attenuation of echoes reflected by the plaque during US causing acoustic shadowing. Artificial intelligence (AI) methods have become an indispensable part of healthcare and their applications to the non-invasive imaging technologies such as MRI, CT, and the US. In this narrative review, three main types of AI models (machine learning, deep learning, and transfer learning) are analyzed when applied to MRI, CT, and the US. A link between carotid plaque characteristics and the risk of coronary artery disease is presented. With regard to characterization, we review tools and techniques that use AI models to distinguish carotid plaque types based on signal processing and feature strengths. We conclude that AI-based solutions offer an accurate and robust path for tissue characterization and classification for carotid artery plaque imaging in all three imaging modalities. Due to cost, user-friendliness, and clinical effectiveness, AI in the US has dominated the most

A study on industrial communication networking: ethernet based implementation

Recent enhancement of the industrial communication and networking has made it possible to apply Ethernet networks at all levels of industrial automation, especially at controller level where the data exchange in real-time communication is mandatory. This report presents a study on the development of industrial communication network based on the Ethernet and thus implementation towards Computer Integrated Manufacturing (CIM) system. The Ethernet module is installed onto supervisory OMRON PLC to integrate the various stations in the CIM-70A system which located at Robotic Laboratory in KUiTTHO. The workability of this communication technique was analyzed and compared with the conventional serial communication which widely used in automation networking systems. Through this approach, the communication and integration of CIM systems can be accessed easily and hence available to be upgraded to the management and enterprise levels of automation

Adjusting the input ultrasound image data and the atherosclerotic plaque detection in the carotid artery by the FOTOMNG system

Stroke is the third most frequent cause of death. Specifically, ischemic stroke accounts for the largest group of this kind of cases. Despite all the advances in medical therapeutic methods, no methods that would reliably reduce mortality from ischemic stroke have been found. Prevention is still the most significant way to combat stroke. When the frequent cause of ischemic stroke is atherosclerotic plaque in the carotid artery, its exploration can help to determine the development of the disease. These problems were very extensively discussed in October 2013 during the XVI International Neurosonology Congress in Sofia organized under the auspices of World Research Neurosonology Group, Bulgarian Neurosonology and Cerebral Hemodynamics Association. Our goal was to develop special modules for carotid artery picture processing (AVI file processing, reparation and reconstruction) and modules containing tools for automated carotid artery plaque detection; and to solve its measurement and three-dimensional modelling of the carotid artery and the plaque. New modules were implemented into the FOTOMNG system and tested on appropriate input data files, which verified their functionality and applicability.Web of Scienc