Ultrasound tissue perfusion imaging

Enhanced blood perfusion in a tissue mass is an indication of neo-vascularity and potential malignancy. Ultrasonic pulsed Doppler imaging is a safe and economical modality for noninvasive monitoring of blood flow. However, weak blood echoes make it difficult to detect perfusion using standard methods without the expense of contrast enhancement. Additionally, imaging requires high sensitivity to slow, disorganized blood-flow patterns while simultaneously rejecting clutter and noise. An approach to address these challenges involves arranging acquisition data in a multi-dimensional structure to facilitate the characterization and separation of independent scattering sources. The resulting data array involves a linear combination of spatial, slow-time (kHz-order sampling), and frame-time (Hz-order sampling) coordinates. Applying an eigenfilter that exploits higher-order singular value decomposition (HOSVD) can technically transform the array and reduce the dimensions to yield power estimates for blood flow and perfusion that are well isolated from tissue clutter. Studies using microcirculation-mimicking simulations and phantoms enable the optimization of the filtering algorithm to maximize estimation efficiency. These techniques are applied to murine models of ischemia and melanoma at 24 MHz to form perfusion images. The results show enhancements of tissue perfusion maps, which help researchers access lesions without contrast enhancement. In a study aimed at peripheral artery disease (PAD), the enhanced sensitivity and specificity of ultrasonic-pulsed-Doppler imaging enable differentiation of perfusion between healthy and ischemic states. In addition, the use of the new ultrasound imaging coupled with other imaging modalities helps to illuminate the complex mechanism that mediates neovascularization in response to vascular occlusion. Consequently, these techniques have the potential to increase the effectiveness of existing medical imaging technologies in safe, cost-effective ways that promote sustainable medicine

Dynamic Thermal Imaging for Intraoperative Monitoring of Neuronal Activity and Cortical Perfusion

Neurosurgery is a demanding medical discipline that requires a complex interplay of several neuroimaging techniques. This allows structural as well as functional information to be recovered and then visualized to the surgeon. In the case of tumor resections this approach allows more fine-grained differentiation of healthy and pathological tissue which positively influences the postoperative outcome as well as the patient's quality of life. In this work, we will discuss several approaches to establish thermal imaging as a novel neuroimaging technique to primarily visualize neural activity and perfusion state in case of ischaemic stroke. Both applications require novel methods for data-preprocessing, visualization, pattern recognition as well as regression analysis of intraoperative thermal imaging. Online multimodal integration of preoperative and intraoperative data is accomplished by a 2D-3D image registration and image fusion framework with an average accuracy of 2.46 mm. In navigated surgeries, the proposed framework generally provides all necessary tools to project intraoperative 2D imaging data onto preoperative 3D volumetric datasets like 3D MR or CT imaging. Additionally, a fast machine learning framework for the recognition of cortical NaCl rinsings will be discussed throughout this thesis. Hereby, the standardized quantification of tissue perfusion by means of an approximated heating model can be achieved. Classifying the parameters of these models yields a map of connected areas, for which we have shown that these areas correlate with the demarcation caused by an ischaemic stroke segmented in postoperative CT datasets. Finally, a semiparametric regression model has been developed for intraoperative neural activity monitoring of the somatosensory cortex by somatosensory evoked potentials. These results were correlated with neural activity of optical imaging. We found that thermal imaging yields comparable results, yet doesn't share the limitations of optical imaging. In this thesis we would like to emphasize that thermal imaging depicts a novel and valid tool for both intraoperative functional and structural neuroimaging

Developing Ultrasound-Based Computer-Aided Diagnostic Systems Through Statistical Pattern Recognition

Computer-aided diagnosis (CAD) is the use of a computer software to help physicians having a better interpretation of medical images. CAD systems can be viewed as pattern recognition algorithms that identify suspicious signs on a medical image and complement physicians' judgments, by reducing inter-/intra-observer variability and subjectivity. The proposed CAD systems in this thesis have been designed based on the statistical approach to pattern recognition as the most successfully used technique in practice. The main focus of this thesis has been on designing (new) feature extraction and classification algorithms for ultrasound-based CAD purposes. Ultrasound imaging has a broad range of usage in medical applications because it is a safe device which does not use harmful ionizing radiations, it provides clinicians with real-time images, it is portable and relatively cheap. The thesis was concerned with developing new ultrasound-based systems for the diagnosis of prostate cancer (PCa) and myocardial infarction (MI) where these issues have been addressed in two separate parts. In the first part, 1) a new CAD system was designed for prostate cancer biopsy by focusing on handling uncertainties in labels of the ground truth data, 2) the appropriateness of the independent component analysis (ICA) method for learning features from radiofrequency (RF) signals, backscattered from prostate tissues, was examined and, 3) a new ensemble scheme for learning ICA dictionaries from RF signals, backscattered from a tissue mimicking phantom, was proposed. In the second part, 1) principal component analysis (PCA) was used for the statistical modeling of the temporal deformation patterns of the left ventricle (LV) to detect abnormalities in its regional function, 2) a spatio-temporal representation of LV function based on PCA parameters was proposed to detect MI and, 3) a local-to-global statistical shape model based on PCA was presented to detect MI

A novel diffusion tensor imaging-based computer-aided diagnostic system for early diagnosis of autism.

Autism spectrum disorders (ASDs) denote a significant growing public health concern. Currently, one in 68 children has been diagnosed with ASDs in the United States, and most children are diagnosed after the age of four, despite the fact that ASDs can be identified as early as age two. The ultimate goal of this thesis is to develop a computer-aided diagnosis (CAD) system for the accurate and early diagnosis of ASDs using diffusion tensor imaging (DTI). This CAD system consists of three main steps. First, the brain tissues are segmented based on three image descriptors: a visual appearance model that has the ability to model a large dimensional feature space, a shape model that is adapted during the segmentation process using first- and second-order visual appearance features, and a spatially invariant second-order homogeneity descriptor. Secondly, discriminatory features are extracted from the segmented brains. Cortex shape variability is assessed using shape construction methods, and white matter integrity is further examined through connectivity analysis. Finally, the diagnostic capabilities of these extracted features are investigated. The accuracy of the presented CAD system has been tested on 25 infants with a high risk of developing ASDs. The preliminary diagnostic results are promising in identifying autistic from control patients

An image processing decisional system for the Achilles tendon using ultrasound images

The Achilles Tendon (AT) is described as the largest and strongest tendon in the human body. As for any other organs in the human body, the AT is associated with some medical problems that include Achilles rupture and Achilles tendonitis. AT rupture affects about 1 in 5,000 people worldwide. Additionally, AT is seen in about 10 percent of the patients involved in sports activities. Today, ultrasound imaging plays a crucial role in medical imaging technologies. It is portable, non-invasive, free of radiation risks, relatively inexpensive and capable of taking real-time images. There is a lack of research that looks into the early detection and diagnosis of AT abnormalities from ultrasound images. This motivated the researcher to build a complete system which enables one to crop, denoise, enhance, extract the important features and classify AT ultrasound images. The proposed application focuses on developing an automated system platform. Generally, systems for analysing ultrasound images involve four stages, pre-processing, segmentation, feature extraction and classification. To produce the best results for classifying the AT, SRAD, CLAHE, GLCM, GLRLM, KPCA algorithms have been used. This was followed by the use of different standard and ensemble classifiers trained and tested using the dataset samples and reduced features to categorize the AT images into normal or abnormal. Various classifiers have been adopted in this research to improve the classification accuracy. To build an image decisional system, a 57 AT ultrasound images has been collected. These images were used in three different approaches where the Region of Interest (ROI) position and size are located differently. To avoid the imbalanced misleading metrics, different evaluation metrics have been adapted to compare different classifiers and evaluate the whole classification accuracy. The classification outcomes are evaluated using different metrics in order to estimate the decisional system performance. A high accuracy of 83% was achieved during the classification process. Most of the ensemble classifies worked better than the standard classifiers in all the three ROI approaches. The research aim was achieved and accomplished by building an image processing decisional system for the AT ultrasound images. This system can distinguish between normal and abnormal AT ultrasound images. In this decisional system, AT images were improved and enhanced to achieve a high accuracy of classification without any user intervention

Automatic BIRAD scoring of breast cancer mammograms

A computer aided diagnosis system (CAD) is developed to fully characterize and classify mass to benign and malignancy and to predict BIRAD (Breast Imaging Reporting and Data system) scores using mammographic image data. The CAD includes a preprocessing step to de-noise mammograms. This is followed by an active counter segmentation to deforms an initial curve, annotated by a radiologist, to separate and define the boundary of a mass from background. A feature extraction scheme wasthen used to fully characterize a mass by extraction of the most relevant features that have a large impact on the outcome of a patient biopsy. For this thirty-five medical and mathematical features based on intensity, shape and texture associated to the mass were extracted. Several feature selection schemes were then applied to select the most dominant features for use in next step, classification. Finally, a hierarchical classification schemes were applied on those subset of features to firstly classify mass to benign (mass with BIRAD score 2) and malignant mass (mass with BIRAD score over 4), and secondly to sub classify mass with BIRAD score over 4 to three classes (BIRAD with score 4a,4b,4c). Accuracy of segmentation performance were evaluated by calculating the degree of overlapping between the active counter segmentation and the manual segmentation, and the result was 98.5%. Also reproducibility of active counter 3 using different manual initialization of algorithm by three radiologists were assessed and result was 99.5%. Classification performance was evaluated using one hundred sixty masses (80 masses with BRAD score 2 and 80 mass with BIRAD score over4). The best result for classification of data to benign and malignance was found using a combination of sequential forward floating feature (SFFS) selection and a boosted tree hybrid classifier with Ada boost ensemble method, decision tree learner type and 100 learners’ regression tree classifier, achieving 100% sensitivity and specificity in hold out method, 99.4% in cross validation method and 98.62 % average accuracy in cross validation method. For further sub classification of eighty malignance data with BIRAD score of over 4 (30 mass with BIRAD score 4a,30 masses with BIRAD score 4b and 20 masses with BIRAD score 4c), the best result achieved using the boosted tree with ensemble method bag, decision tree learner type with 200 learners Classification, achieving 100% sensitivity and specificity in hold out method, 98.8% accuracy and 98.41% average accuracy for ten times run in cross validation method. Beside those 160 masses (BIRAD score 2 and over 4) 13 masses with BIRAD score 3 were gathered. Which means patient is recommended to be tested in another medical imaging technique and also is recommended to do follow-up in six months. The CAD system was trained with mass with BIRAD score 2 and over 4 also 4 it was further tested using 13 masses with a BIRAD score of 3 and the CAD results are shown to agree with the radiologist’s classification after confirming in six months follow up. The present results demonstrate high sensitivity and specificity of the proposed CAD system compared to prior research. The present research is therefore intended to make contributions to the field by proposing a novel CAD system, consists of series of well-selected image processing algorithms, to firstly classify mass to benign or malignancy, secondly sub classify BIRAD 4 to three groups and finally to interpret BIRAD 3 to BIRAD 2 without a need of follow up study