CORE-Deblur: Parallel MRI Reconstruction by Deblurring Using Compressed Sensing

In this work we introduce a new method that combines Parallel MRI and Compressed Sensing (CS) for accelerated image reconstruction from subsampled k-space data. The method first computes a convolved image, which gives the convolution between a user-defined kernel and the unknown MR image, and then reconstructs the image by CS-based image deblurring, in which CS is applied for removing the inherent blur stemming from the convolution process. This method is hence termed CORE-Deblur. Retrospective subsampling experiments with data from a numerical brain phantom and in-vivo 7T brain scans showed that CORE-Deblur produced high-quality reconstructions, comparable to those of a conventional CS method, while reducing the number of iterations by a factor of 10 or more. The average Normalized Root Mean Square Error (NRMSE) obtained by CORE-Deblur for the in-vivo datasets was 0.016. CORE-Deblur also exhibited robustness regarding the chosen kernel and compatibility with various k-space subsampling schemes, ranging from regular to random. In summary, CORE-Deblur enables high quality reconstructions and reduction of the CS iterations number by 10-fold.Comment: 11 pages, 6 figures, 1 tabl

Multimodal Imaging and Hybrid Scanners

10.1155/2007/45353International Journal of Biomedical Imaging20074535

Improved Image Fusion in PET/CT Using Hybrid Image Reconstruction and Super-Resolution

Purpose. To provide PET/CT image fusion with an improved PET resolution and better contrast ratios than standard reconstructions. Method. Using a super-resolution algorithm, several PET acquisitions were combined to improve the resolution. In addition, functional PET data was smoothed with a hybrid computed tomography algorithm (HCT), in which anatomical edge information taken from the CT was employed to retain sharper edges. The combined HCT and super-resolution technique were evaluated in phantom and patient studies using a clinical PET scanner. Results. In the phantom studies, 3 mm18F-FDG sources were resolved. PET contrast ratios improved (average: 54%, range: 45%–69%) relative to the standard reconstructions. In the patient study, target-to-background ratios also improved (average: 34%, range: 17%–47%). Given corresponding anatomical borders, sharper edges were depicted. Conclusion. A new method incorporating super-resolution and HCT for fusing PET and CT images has been developed and shown to provide higher-resolution metabolic images

Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry

Background: Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The ‘Atrial fibrillation Better Care’ (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients. Methods: From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses. Results: Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58–0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52–0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58–0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56–0.98) and composite outcome (aHR: 0.76, 95%CI 0.60–0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome. Conclusions: An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients

Impact of renal impairment on atrial fibrillation: ESC-EHRA EORP-AF Long-Term General Registry

Background: Atrial fibrillation (AF) and renal impairment share a bidirectional relationship with important pathophysiological interactions. We evaluated the impact of renal impairment in a contemporary cohort of patients with AF. Methods: We utilised the ESC-EHRA EORP-AF Long-Term General Registry. Outcomes were analysed according to renal function by CKD-EPI equation. The primary endpoint was a composite of thromboembolism, major bleeding, acute coronary syndrome and all-cause death. Secondary endpoints were each of these separately including ischaemic stroke, haemorrhagic event, intracranial haemorrhage, cardiovascular death and hospital admission. Results: A total of 9306 patients were included. The distribution of patients with no, mild, moderate and severe renal impairment at baseline were 16.9%, 49.3%, 30% and 3.8%, respectively. AF patients with impaired renal function were older, more likely to be females, had worse cardiac imaging parameters and multiple comorbidities. Among patients with an indication for anticoagulation, prescription of these agents was reduced in those with severe renal impairment, p <.001. Over 24 months, impaired renal function was associated with significantly greater incidence of the primary composite outcome and all secondary outcomes. Multivariable Cox regression analysis demonstrated an inverse relationship between eGFR and the primary outcome (HR 1.07 [95% CI, 1.01–1.14] per 10 ml/min/1.73 m2 decrease), that was most notable in patients with eGFR <30 ml/min/1.73 m2 (HR 2.21 [95% CI, 1.23–3.99] compared to eGFR ≥90 ml/min/1.73 m2). Conclusion: A significant proportion of patients with AF suffer from concomitant renal impairment which impacts their overall management. Furthermore, renal impairment is an independent predictor of major adverse events including thromboembolism, major bleeding, acute coronary syndrome and all-cause death in patients with AF

Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry

Background: Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients\u2019 clinical phenotypes and analyse the differential clinical course. Methods: We performed a hierarchical cluster analysis based on Ward\u2019s Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry. Results: A total of 9363 were available for this analysis. We identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients and prevalent non-cardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients with low prevalence of comorbidities; Cluster 3 (n = 2955;31.6%) characterized by patients\u2019 prevalent cardiovascular risk factors/comorbidities. Over a mean follow-up of 22.5 months, Cluster 3 had the highest rate of cardiovascular events, all-cause death, and the composite outcome (combining the previous two) compared to Cluster 1 and Cluster 2 (all P <.001). An adjusted Cox regression showed that compared to Cluster 2, Cluster 3 (hazard ratio (HR) 2.87, 95% confidence interval (CI) 2.27\u20133.62; HR 3.42, 95%CI 2.72\u20134.31; HR 2.79, 95%CI 2.32\u20133.35), and Cluster 1 (HR 1.88, 95%CI 1.48\u20132.38; HR 2.50, 95%CI 1.98\u20133.15; HR 2.09, 95%CI 1.74\u20132.51) reported a higher risk for the three outcomes respectively. Conclusions: In European AF patients, three main clusters were identified, differentiated by differential presence of comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of major adverse outcomes

Basics of biomedical ultrasound for engineers

"Basics of Biomedical Ultrasound for Engineers is a structured textbook for university engineering courses in biomedical ultrasound and for researchers in the field. This book offers a tool for building a solid understanding of biomedical ultrasound, and leads the novice through the field in a step-by-step manner. The book begins with the most basic definitions of waves, proceeds to ultrasounds in fluids, and then delves into solid ultrasounds, the most complicated kind of ultrasound. It encompasses a wide range of topics within biomedical ultrasound, from conceptual definitions of waves to the intricacies of focusing devices, transducers, and acoustic fields"--Provided by publisher

Image translation of Ultrasound to Pseudo Anatomical Display by CycleGAN

Ultrasound is the second most used modality in medical imaging. It is cost effective, hazardless, portable and implemented routinely in numerous clinical procedures. Nonetheless, image quality is characterized by granulated appearance, poor SNR and speckle noise. Specific for malignant tumors, the margins are blurred and indistinct. Thus, there is a great need for improving ultrasound image quality. We hypothesize that this can be achieved, using neural networks, by translation into a more realistic display which mimics an anatomical cut through the tissue. In order to achieve this goal, the preferable approach would be to use a set of paired images. However, this is practically impossible in our case. Therefore, Cycle Generative Adversarial Network (CycleGAN) was used, in order to learn each domain properties separately and enforce cross domain cycle consistency. The two datasets which were used for training the model were "Breast Ultrasound Images" (BUSI) and a set of optic images of poultry breast tissue samples acquired at our lab. The generated pseudo anatomical images provide improved visual discrimination of the lesions with clearer border definition and pronounced contrast. In order to evaluate the preservation of the anatomical features, the lesions in the ultrasonic images and the generated pseudo anatomical images were both automatically segmented and compared. This comparison yielded median dice score of 0.91 for the benign tumors and 0.70 for the malignant ones. The median lesion center error was 0.58% and 3.27% for the benign and malignancies respectively and the median area error index was 0.40% and 4.34% for the benign and malignancies respectively. In conclusion, these generated pseudo anatomical images, which are presented in a more intuitive way, enhance tissue anatomy and can potentially simplify the diagnosis and improve the clinical outcome.Comment: 9 pages, 5 figure