Cardiac motion assessement from echocardiographic image sequences by means of the structure multivector

International audienceWe recently contributed an algorithm for the estimation of cardiac deformation from echocardiographic image sequences based on the monogenic signal. By exploiting the phase information instead of the pixel intensity, the algorithm was robust to the temporal contrast variations normally encountered in cardiac ultrasound. In this paper we propose an improvement of that framework making use of an extension of the monogenic signal formalism, called structure multivector. The structure multivector models the image as the superposition of two perpendicular waves with associated amplitude, phase and orientation. Such a model is well adapted to describe the granular pattern of the characteristic speckle noise. The displacement is computed by solving the optical flow equation jointly for the two image phases. A local affine model accounts for typical cardiac motions as contraction/expansion and shearing; a coarse-to-fine B-spline scheme allows for a robust and effective computation of the model parameters and a pyramidal refinement scheme helps deal with large motions. Performance was evaluated on realistic simulated cardiac ultrasound sequences and compared to our previous monogenic-based algorithm and classical speckle tracking. Endpoint-error was used as accuracy metric. With respect to them we achieved error reductions of 13% and 30% respectively

An Automatic Framework for the Non-rigid Alignment of Electroanatomical Maps and Preoperative Anatomical Scans in Atrial Fibrillation

In atrial fibrillation, electro-anatomical maps (EAM) are used for ablation guidance. Yet, the anatomy reconstructed by the navigation system is known to be poorly accurate. This makes catheter navigation challenging and, as such, might affects ablation’s outcome. To ease navigation, existing systems allow co-registering EAMs with pre-operative MR scans by rigidly matching a set of manual landmarks. Nevertheless, the deformation between the two datasets is highly non-rigid. The aim of this work was therefore to develop a framework for the non-rigid alignment of EAMs and anatomical scans to improve ablation guidance

The role of the image phase in cardiac strain imaging

International audienceThis paper reviews our most recent contributions in the field of cardiac deformation imaging, which includes a motion estimation framework based on the conservation of the image phase over time and an open pipeline to benchmark algorithms for cardiac strain imaging in 2D and 3D ultrasound. The paper also shows an original evaluation of the proposed motion estimation technique based on the new benchmarking pipeline

T-wave axis deviation, metabolic syndrome and estimated cardiovascular risk in men and women of the MOLI-SANI Study

Aim: We aimed at investigating the association between T-wave axis deviation, metabolic syndrome (MetS), its components and estimated risk of cardiovascular disease (CVD) at 10 years in a adult Italian population. Methods: 11,143 women (54±11 years) and 9,742 men (55±11 years) were analysed from the Molisani cohort, randomly recruited from the general population. MetS was defined using the ATPIII criteria. T-wave axis deviation was measured from the standard 12-lead resting electrocardiogram. CVD risk in ten years was estimated by the CUORE score. Results: 29% of men and 27% of women with MetS showed borderline or abnormal T-wave as compared to 24% and 17% without MetS (p<0.0001 for both genders). Among components of MetS, elevated waist and blood pressure were strongly associated with Twave axis deviation, whereas glucose, HDL and triglycerides were only marginally. The odds of having borderline or abnormal T-wave axis deviation in multivariable regression analysis, was 1.38 (95% CI:1.25-1.53) in MetS men and 1.68 (95% CI:1.51-1.87) in MetS women compared to those without. Further adjustment for MetS components completely abolished the associations. Abnormal T-wave axis deviation was associated with an increased risk of CVD in 10 years in men (OR=4.4; 95% CI:1.10-17.9). Conclusion: T-wave axis deviation is strongly associated with components of the MetS, in particular high waist circumference and blood pressure and with an increased CVD risk, particularly in men. ECG monitoring to identify T-wave axis deviation in obese, hypertensive or MetS subjects can be an early indicator of vascular disease and help in reducing cardiac events

A Computational Framework to Benchmark Basket Catheter Guided Ablation in Atrial Fibrillation

Catheter ablation is a curative therapeutic approach for atrial fibrillation (AF). Ablation of rotational sources based on basket catheter measurements has been proposed as a promising approach in patients with persistent AF to complement pulmonary vein isolation. However, clinically reported success rates are equivocal calling for a mechanistic investigation under controlled conditions. We present a computational framework to benchmark ablation strategies considering the whole cycle from excitation propagation to electrogram acquisition and processing to virtual therapy. Fibrillation was induced in a patient-specific 3D volumetric model of the left atrium, which was homogeneously remodeled to sustain reentry. The resulting extracellular potential field was sampled using models of grid catheters as well as realistically deformed basket catheters considering the specific atrial anatomy. The virtual electrograms were processed to compute phase singularity density maps to target rotor tips with up to three circular ablations. Stable rotors were successfully induced in different regions of the homogeneously remodeled atrium showing that rotors are not constrained to unique anatomical structures or locations. Density maps of rotor tip trajectories correctly identified and located the rotors (deviation &lt; 10 mm) based on catheter recordings only for sufficient resolution (inter-electrode distance ≤3 mm) and proximity to the wall (≤10 mm). Targeting rotor sites with ablation did not stop reentries in the homogeneously remodeled atria independent from lesion size (1–7 mm radius), from linearly connecting lesions with anatomical obstacles, and from the number of rotors targeted sequentially (≤3). Our results show that phase maps derived from intracardiac electrograms can be a powerful tool to map atrial activation patterns, yet they can also be misleading due to inaccurate localization of the rotor tip depending on electrode resolution and distance to the wall. This should be considered to avoid ablating regions that are in fact free of rotor sources of AF. In our experience, ablation of rotor sites was not successful to stop fibrillation. Our comprehensive simulation framework provides the means to holistically benchmark ablation strategies in silico under consideration of all steps involved in electrogram-based therapy and, in future, could be used to study more heterogeneously remodeled disease states as well

A virtual imaging platform for multi-modality medical image simulation.

International audienceThis paper presents the Virtual Imaging Platform (VIP), a platform accessible at http://vip.creatis.insa-lyon.fr to facilitate the sharing of object models and medical image simulators, and to provide access to distributed computing and storage resources. A complete overview is presented, describing the ontologies designed to share models in a common repository, the workflow template used to integrate simulators, and the tools and strategies used to exploit computing and storage resources. Simulation results obtained in four image modalities and with different models show that VIP is versatile and robust enough to support large simulations. The platform currently has 200 registered users who consumed 33 years of CPU time in 2011

Preliminary checklist of the Italian gypsophilous flora

The richness and uniqueness of the flora growing on gypsum substrates in Italy is known since the XIX century (Macchiati, 1888). Furthermore, the concept of plant gypsophily can be defined as the exclusiveness (or virtually exclusiveness) for living in gypsum outcropping rocks. Thus only those plant species, which show preference – or even exclusivity - for gypsum substrates, would be classified as gipsophilous (Mota et al., 2011). The main aim of this research has been the elaboration of a checklist of the Italian gypsophilous flora. The study was made possible through international collaboration between the "Mediterranea" University of Reggio Calabria (Italy) and the University of Almería (Spain). During the first step, an extensive literature review has been carried out in order to collect all available information about gypsophilous flora and to compile a preliminary list. Afterwards 18 regional botanists experts on Italian gypsum flora have been asked to rank the preference of these species for gypsum soils. Following the methodology proposed by Mota et al. (2009), the gypsophilous character of more than 100 plant species has been thus ranked on a scale ranging from 1 to 5 (with 5 representing for a total dependence on gypsum substrates). According to the obtained values, all the plant species, ranking between absolute or preferent gypsophytes, will figure in the final checklist of the gypsophytes of the whole Italian territory

Statistical shape modeling of the left ventricle: myocardial infarct classification challenge

Statistical shape modeling is a powerful tool for visualizing and quantifying geometric and functional patterns of the heart. After myocardial infarction (MI), the left ventricle typically remodels in response to physiological challenges. Several methods have been proposed in the literature to describe statistical shape changes. Which method best characterizes left ventricular remodeling after MI is an open research question. A better descriptor of remodeling is expected to provide a more accurate evaluation of disease status in MI patients. We therefore designed a challenge to test shape characterization in MI given a set of three-dimensional left ventricular surface points. The training set comprised 100 MI patients, and 100 asymptomatic volunteers (AV). The challenge was initiated in 2015 at the Statistical Atlases and Computational Models of the Heart workshop, in conjunction with the MICCAI conference. The training set with labels was provided to participants, who were asked to submit the likelihood of MI from a different (validation) set of 200 cases (100 AV and 100 MI). Sensitivity, specificity, accuracy and area under the receiver operating characteristic curve were used as the outcome measures. The goals of this challenge were to (1) establish a common dataset for evaluating statistical shape modeling algorithms in MI, and (2) test whether statistical shape modeling provides additional information characterizing MI patients over standard clinical measures. Eleven groups with a wide variety of classification and feature extraction approaches participated in this challenge. All methods achieved excellent classification results with accuracy ranges from 0.83 to 0.98. The areas under the receiver operating characteristic curves were all above 0.90. Four methods showed significantly higher performance than standard clinical measures. The dataset and software for evaluation are available from the Cardiac Atlas Project website1

Notulae to the Italian native vascular flora: 3.

In this contribution new data concerning the distribution of native vascular flora in Italy are presented. It includes new records, exclusions, and confirmations to the Italian administrative regions for taxa in the genera Asplenium, Bolboschoenus, Botrychium, Chamaerops, Crocus, Galeopsis, Grafia, Helosciadium, Hieracium, Juniperus, Leucanthemum, Lolium, Medicago, Phalaris, Piptatherum, Potamogeton, Salicornia, Salvia, Seseli, Silene, Spiraea, Torilis and Vicia. Rhaponticoides calabrica is proposed as synonym novum of R. centaurium. Furthermore, new combinations in the genera Galatella and Lactuca are proposed