This PDF file contains the front matter associated with SPIE Proceedings Volume 10133, including the Title Page, Copyright information, Table of Contents, and Conference Committee listing.

The fovea is an important clinical landmark that is used as a reference for assessing various quantitative measures, such as central retinal thickness or drusen count. In this paper we propose a novel method for automatic detection of the foveal center in Optical Coherence Tomography (OCT) scans. Although the clinician will generally aim to center the OCT scan on the fovea, post-acquisition image processing will give a more accurate estimate of the true location of the foveal center. A Convolutional Neural Network (CNN) was trained on a set of 781 OCT scans that classifies each pixel in the OCT B-scan with a probability of belonging to the fovea. Dilated convolutions were used to obtain a large receptive field, while maintaining pixel-level accuracy. In order to train the network more effectively, negative patches were sampled selectively after each epoch. After CNN classification of the entire OCT volume, the predicted foveal center was chosen as the voxel with maximum output probability, after applying an optimized three-dimensional Gaussian blurring. We evaluate the performance of our method on a data set of 99 OCT scans presenting different stages of Age-related Macular Degeneration (AMD). The fovea was correctly detected in 96:9% of the cases, with a mean distance error of 73 μm(±112 μm). This result was comparable to the performance of a second human observer who obtained a mean distance error of 69 μm (±94 μm). Experiments showed that the proposed method is accurate and robust even in retinas heavily affected by pathology.

Automatically detecting anatomy orientation is an important task in medical image analysis. Specifically, the ability to automatically detect coarse orientation of structures is useful to minimize the effort of fine/accurate orientation detection algorithms, to initialize non-rigid deformable registration algorithms or to align models to target structures in model-based segmentation algorithms. In this work, we present a deep convolution neural network (DCNN)-based method for fast and robust detection of the coarse structure orientation, i.e., the hemi-sphere where the principal axis of a structure lies. That is, our algorithm predicts whether the principal orientation of a structure is in the northern hemisphere or southern hemisphere, which we will refer to as UP and DOWN, respectively, in the remainder of this manuscript. The only assumption of our method is that the entire structure is located within the scan’s field-of-view (FOV). To efficiently solve the problem in 3D space, we formulated it as a multi-planar 2D deep learning problem. In the training stage, a large number coronal-sagittal slice pairs are constructed as 2-channel images to train a DCNN to classify whether a scan is UP or DOWN. During testing, we randomly sample a small number of coronal-sagittal 2-channel images and pass them through our trained network. Finally, coarse structure orientation is determined using majority voting. We tested our method on 114 Elbow MR Scans. Experimental results suggest that only five 2-channel images are sufficient to achieve a high success rate of 97.39%. Our method is also extremely fast and takes approximately 50 milliseconds per 3D MR scan. Our method is insensitive to the location of the structure in the FOV.

Representation learning through deep learning (DL) architecture has shown tremendous potential for identification, local- ization, and texture classification in various medical imaging modalities. However, DL applications to segmentation of objects especially to deformable objects are rather limited and mostly restricted to pixel classification. In this work, we propose marginal shape deep learning (MaShDL), a framework that extends the application of DL to deformable shape segmentation by using deep classifiers to estimate the shape parameters. MaShDL combines the strength of statistical shape models with the automated feature learning architecture of DL. Unlike the iterative shape parameters estimation approach of classical shape models that often leads to a local minima, the proposed framework is robust to local minima optimization and illumination changes. Furthermore, since the direct application of DL framework to a multi-parameter estimation problem results in a very high complexity, our framework provides an excellent run-time performance solution by independently learning shape parameter classifiers in marginal eigenspaces in the decreasing order of variation. We evaluated MaShDL for segmenting the lung field from 314 normal and abnormal pediatric chest radiographs and obtained a mean Dice similarity coefficient of 0:927 using only the four highest modes of variation (compared to 0:888 with classical ASM1 (p-value=0:01) using same configuration). To the best of our knowledge this is the first demonstration of using DL framework for parametrized shape learning for the delineation of deformable objects.

Accurate segmentation of lung fields on chest radiographs is the primary step for computer-aided detection of various conditions such as lung cancer and tuberculosis. The size, shape and texture of lung fields are key parameters for chest X-ray (CXR) based lung disease diagnosis in which the lung field segmentation is a significant primary step. Although many methods have been proposed for this problem, lung field segmentation remains as a challenge. In recent years, deep learning has shown state of the art performance in many visual tasks such as object detection, image classification and semantic image segmentation. In this study, we propose a deep convolutional neural network (CNN) framework for segmentation of lung fields. The algorithm was developed and tested on 167 clinical posterior-anterior (PA) CXR images collected retrospectively from picture archiving and communication system (PACS) of Geisinger Health System. The proposed multi-scale network is composed of five convolutional and two fully connected layers. The framework achieved IOU (intersection over union) of 0.96 on the testing dataset as compared to manual segmentation. The suggested framework outperforms state of the art registration-based segmentation by a significant margin. To our knowledge, this is the first deep learning based study of lung field segmentation on CXR images developed on a heterogeneous clinical dataset. The results suggest that convolutional neural networks could be employed reliably for lung field segmentation.

The vertebral column is a complex anatomical construct, composed of vertebrae and intervertebral discs (IVDs) supported by ligaments and muscles. During life, all components undergo degenerative changes, which may in some cases cause severe, chronic and debilitating low back pain. The main diagnostic challenge is to locate the pain generator, and degenerated IVDs have been identified to act as such. Accurate and robust segmentation of IVDs is therefore a prerequisite for computer-aided diagnosis and quantification of IVD degeneration, and can be also used for computer-assisted planning and simulation in spinal surgery. In this paper, we present a novel fully automated framework for supervised segmentation of IVDs from three-dimensional (3D) magnetic resonance (MR) spine images. By considering global intensity appearance and local shape information, a landmark-based approach is first used for the detection of IVDs in the observed image, which then initializes the segmentation of IVDs by coupling deformable models with convolutional networks (ConvNets). For this purpose, a 3D ConvNet architecture was designed that learns rich high-level appearance representations from a training repository of IVDs, and then generates spatial IVD probability maps that guide deformable models towards IVD boundaries. By applying the proposed framework to 15 3D MR spine images containing 105 IVDs, quantitative comparison of the obtained against reference IVD segmentations yielded an overall mean Dice coefficient of 92.8%, mean symmetric surface distance of 0.4 mm and Hausdorff surface distance of 3.7 mm.

The role of medical imaging in global health systems is literally fundamental. Like labs, medical images are used at one point or another in almost every high cost, high value episode of care. CT scans, mammograms, and x-rays, for example, “atlas” the body and help chart a course forward for a patient’s care team. Imaging precision has improved as a result of technological advancements and breakthroughs in related medical research. Those advancements also bring with them exponential growth in medical imaging data. As IBM trains Watson to "see" medical images, Ms. Le Grand will discuss recent advances made by Watson Health and explore the potential value of "augmented intelligence" to assist healthcare providers like radiologists and cardiologists, as well as the patients they serve.

There are growing applications of quantitative computed tomography for assessment of pulmonary diseases by characterizing lung parenchyma as well as the bronchial tree. Many large multi-center studies incorporating lung imaging as a study component are interested in phenotypes relating airway branching patterns, wall-thickness, and other morphological measures. To our knowledge, there are no fully automated airway tree segmentation methods, free of the need for user review. Even when there are failures in a small fraction of segmentation results, the airway tree masks must be manually reviewed for all results which is laborious considering that several thousands of image data sets are evaluated in large studies. In this paper, we present a CT-based novel airway tree segmentation algorithm using iterative multi-scale leakage detection, freezing, and active seed detection. The method is fully automated requiring no manual inputs or post-segmentation editing. It uses simple intensity based connectivity and a new leakage detection algorithm to iteratively grow an airway tree starting from an initial seed inside the trachea. It begins with a conservative threshold and then, iteratively shifts toward generous values. The method was applied on chest CT scans of ten non-smoking subjects at total lung capacity and ten at functional residual capacity. Airway segmentation results were compared to an expert’s manually edited segmentations. Branch level accuracy of the new segmentation method was examined along five standardized segmental airway paths (RB1, RB4, RB10, LB1, LB10) and two generations beyond these branches. The method successfully detected all branches up to two generations beyond these segmental bronchi with no visual leakages.

Automatic spleen segmentation on CT is challenging due to the complexity of abdominal structures. Multi-atlas segmentation (MAS) has shown to be a promising approach to conduct spleen segmentation. To deal with the substantial registration errors between the heterogeneous abdominal CT images, the context learning method for performance level estimation (CLSIMPLE) method was previously proposed. The context learning method generates a probability map for a target image using a Gaussian mixture model (GMM) as the prior in a Bayesian framework. However, the CLSSIMPLE typically trains a single GMM from the entire heterogeneous training atlas set. Therefore, the estimated spatial prior maps might not represent specific target images accurately. Rather than using all training atlases, we propose an adaptive GMM based context learning technique (AGMMCL) to train the GMM adaptively using subsets of the training data with the subsets tailored for different target images. Training sets are selected adaptively based on the similarity between atlases and the target images using cranio-caudal length, which is derived manually from the target image. To validate the proposed method, a heterogeneous dataset with a large variation of spleen sizes (100 cc to 9000 cc) is used. We designate a metric of size to differentiate each group of spleens, with 0 to 100 cc as small, 200 to 500cc as medium, 500 to 1000 cc as large, 1000 to 2000 cc as XL, and 2000 and above as XXL. From the results, AGMMCL leads to more accurate spleen segmentations by training GMMs adaptively for different target images.

Non-invasive spleen volume estimation is essential in detecting splenomegaly. Magnetic resonance imaging (MRI) has been used to facilitate splenomegaly diagnosis in vivo. However, achieving accurate spleen volume estimation from MR images is challenging given the great inter-subject variance of human abdomens and wide variety of clinical images/modalities. Multi-atlas segmentation has been shown to be a promising approach to handle heterogeneous data and difficult anatomical scenarios. In this paper, we propose to use multi-atlas segmentation frameworks for MRI spleen segmentation for splenomegaly. To the best of our knowledge, this is the first work that integrates multi-atlas segmentation for splenomegaly as seen on MRI. To address the particular concerns of spleen MRI, automated and novel semi-automated atlas selection approaches are introduced. The automated approach interactively selects a subset of atlases using selective and iterative method for performance level estimation (SIMPLE) approach. To further control the outliers, semi-automated craniocaudal length based SIMPLE atlas selection (L-SIMPLE) is proposed to introduce a spatial prior in a fashion to guide the iterative atlas selection. A dataset from a clinical trial containing 55 MRI volumes (28 T1 weighted and 27 T2 weighted) was used to evaluate different methods. Both automated and semi-automated methods achieved median DSC > 0.9. The outliers were alleviated by the L-SIMPLE (≈1 min manual efforts per scan), which achieved 0.9713 Pearson correlation compared with the manual segmentation. The results demonstrated that the multi-atlas segmentation is able to achieve accurate spleen segmentation from the multi-contrast splenomegaly MRI scans.

Shape from shading (SFS) has been studied for decades; nevertheless, its overly simple assumptions and its ill-conditioning have resulted in infrequent use in real applications. Price et al. recently developed an iterative scheme named shape from motion and shading (SFMS) that models both shape and reflectance of an unknown surface simultaneously. SFMS produces a fairly accurate, dense 3D reconstruction from each frame of a pharyngeal endoscopic video, albeit with inconsistency between the 3D reconstructions of different frames. We present a comprehensive study of the SFMS scheme and several improvements to it: (1) We integrate a deformable registration method into the iterative scheme and use the fusion of multiple surfaces as a reference surface to guide the next iteration’s reconstruction. This can be interpreted as incorporating regularity of a frame’s reconstruction with that of temporally nearby frames. (2) We show that the reflectance model estimation is crucial and very sensitive to noise in the data. Moreover, even when the surface reflection is not assumed to be Lambertian, the reflectance model estimation function in SFMS is still overly simple for endoscopy of human tissue. By removing outlier pixels, by preventing unrealistic BRDF estimation, and by reducing the falloff speed of illumination in SFS to account for the effect of multiple bouncing of the light, we improve the reconstruction accuracy.

Optical coherence tomography (OCT) yields high-resolution, three-dimensional images of the retina. A better understanding of retinal nerve fiber bundle (RNFB) trajectories in combination with visual field data may be used for future diagnosis and monitoring of glaucoma. However, manual tracing of these bundles is a tedious task. In this work, we present an automatic technique to estimate the orientation of RNFBs from volumetric OCT scans. Our method consists of several steps, starting from automatic segmentation of the RNFL. Then, a stack of en face images around the posterior nerve fiber layer interface was extracted. The image showing the best visibility of RNFB trajectories was selected for further processing. After denoising the selected en face image, a semblance structure-oriented filter was applied to probe the strength of local linear structure in a discrete set of orientations creating an orientation space. Gaussian filtering along the orientation axis in this space is used to find the dominant orientation. Next, a confidence map was created to supplement the estimated orientation. This confidence map was used as pixel weight in normalized convolution to regularize the semblance filter response after which a new orientation estimate can be obtained. Finally, after several iterations an orientation field corresponding to the strongest local orientation was obtained. The RNFB orientations of six macular scans from three subjects were estimated. For all scans, visual inspection shows a good agreement between the estimated orientation fields and the RNFB trajectories in the en face images. Additionally, a good correlation between the orientation fields of two scans of the same subject was observed. Our method was also applied to a larger field of view around the macula. Manual tracing of the RNFB trajectories shows a good agreement with the automatically obtained streamlines obtained by fiber tracking.

Fluorescence microscopy is used to image multiple subcellular structures in living cells which are not readily observed using conventional optical microscopy. Moreover, two-photon microscopy is widely used to image structures deeper in tissue. Recent advancement in fluorescence microscopy has enabled the generation of large data sets of images at different depths, times, and spectral channels. Thus, automatic object segmentation is necessary since manual segmentation would be inefficient and biased. However, automatic segmentation is still a challenging problem as regions of interest may not have well defined boundaries as well as non-uniform pixel intensities. This paper describes a method for segmenting tubular structures in fluorescence microscopy images of rat kidney and liver samples using adaptive histogram equalization, foreground/background segmentation, steerable filters to capture directional tendencies, and connected-component analysis. The results from several data sets demonstrate that our method can segment tubular boundaries successfully. Moreover, our method has better performance when compared to other popular image segmentation methods when using ground truth data obtained via manual segmentation.

Multiple sclerosis (MS) is a multi-factorial autoimmune disorder, characterized by spatial and temporal dissemination of brain lesions that are visible in T2-weighted and Proton Density (PD) MRI. Assessment of lesion burden and is useful for monitoring the course of the disease, and assessing correlates of clinical outcomes. Although there are established semi-automated methods to measure lesion volume, most of them require human interaction and editing, which are time consuming and limits the ability to analyze large sets of data with high accuracy. The primary objective of this work is to improve existing segmentation algorithms and accelerate the time consuming operation of identifying and validating MS lesions. In this paper, a Deep Neural Network for MS Lesion Segmentation is implemented. The MS lesion samples are extracted from the Partners Comprehensive Longitudinal Investigation of Multiple Sclerosis (CLIMB) study. A set of 900 subjects with T2, PD and a manually corrected label map images were used to train a Deep Neural Network and identify MS lesions. Initial tests using this network achieved a 90% accuracy rate. A secondary goal was to enable this data repository for big data analysis by using this algorithm to segment the remaining cases available in the CLIMB repository.

Manual segmentation of brain lesions from Magnetic Resonance Images (MRI) is cumbersome and introduces errors due to inter-rater variability. This paper introduces a semi-supervised technique for detection of brain lesion from MRI using Generative Adversarial Networks (GANs). GANs comprises of a Generator network and a Discriminator network which are trained simultaneously with the objective of one bettering the other. The networks were trained using non lesion patches (n=13,000) from 4 different MR sequences. The network was trained on BraTS dataset and patches were extracted from regions excluding tumor region. The Generator network generates data by modeling the underlying probability distribution of the training data, (PData). The Discriminator learns the posterior probability P (Label Data) by classifying training data and generated data as “Real” or “Fake” respectively. The Generator upon learning the joint distribution, produces images/patches such that the performance of the Discriminator on them are random, i.e. P (Label Data = GeneratedData) = 0.5. During testing, the Discriminator assigns posterior probability values close to 0.5 for patches from non lesion regions, while patches centered on lesion arise from a different distribution (PLesion) and hence are assigned lower posterior probability value by the Discriminator. On the test set (n=14), the proposed technique achieves whole tumor dice score of 0.69, sensitivity of 91% and specificity of 59%. Additionally the generator network was capable of generating non lesion patches from various MR sequences.

Automated and reliable segmentation of subcortical structures from human brain magnetic resonance images is of great importance for volumetric and shape analyses in quantitative neuroimaging studies. However, poor boundary contrast and variable shape of these structures make the automated segmentation a tough task. We propose a 3D graph-based machine learning method, called LOGISMOS-RF, to segment the caudate and the putamen from brain MRI scans in a robust and accurate way. An atlas-based tissue classification and bias-field correction method is applied to the images to generate an initial segmentation for each structure. Then a 3D graph framework is utilized to construct a geometric graph for each initial segmentation. A locally trained random forest classifier is used to assign a cost to each graph node. The max-flow algorithm is applied to solve the segmentation problem. Evaluation was performed on a dataset of T1-weighted MRI’s of 62 subjects, with 42 images used for training and 20 images for testing. For comparison, FreeSurfer, FSL and BRAINSCut approaches were also evaluated using the same dataset. Dice overlap coefficients and surface-to-surfaces distances between the automated segmentation and expert manual segmentations indicate the results of our method are statistically significantly more accurate than the three other methods, for both the caudate (Dice: 0.89 ± 0.03) and the putamen (0.89 ± 0.03).

Sulci are groove-like regions lying in the depth of the cerebral cortex between gyri, which together, form a folded appearance in human and mammalian brains. Sulci play an important role in the structural analysis of the brain, morphometry (i.e., the measurement of brain structures), anatomical labeling and landmark-based registration.1 Moreover, sulcal morphological changes are related to cortical thickness, whose measurement may provide useful information for studying variety of psychiatric disorders. Manually extracting sulci requires complying with complex protocols, which make the procedure both tedious and error prone.2 In this paper, we describe an automatic procedure, employing geometric active contours, which extract the sulci. Sulcal boundaries are obtained by minimizing a certain energy functional whose minimum is attained at the boundary of the given sulci.

The basal ganglia and limbic system, particularly the thalamus, putamen, internal and external globus pallidus, substantia nigra, and sub-thalamic nucleus, comprise a clinically relevant signal network for Parkinson’s disease. In order to manually trace these structures, a combination of high-resolution and specialized sequences at 7T are used, but it is not feasible to scan clinical patients in those scanners. Targeted imaging sequences at 3T such as F-GATIR, and other optimized inversion recovery sequences, have been presented which enhance contrast in a select group of these structures. In this work, we show that a series of atlases generated at 7T can be used to accurately segment these structures at 3T using a combination of standard and optimized imaging sequences, though no one approach provided the best result across all structures. In the thalamus and putamen, a median Dice coefficient over 0.88 and a mean surface distance less than 1.0mm was achieved using a combination of T1 and an optimized inversion recovery imaging sequences. In the internal and external globus pallidus a Dice over 0.75 and a mean surface distance less than 1.2mm was achieved using a combination of T1 and FGATIR imaging sequences. In the substantia nigra and sub-thalamic nucleus a Dice coefficient of over 0.6 and a mean surface distance of less than 1.0mm was achieved using the optimized inversion recovery imaging sequence. On average, using T1 and optimized inversion recovery together produced significantly improved segmentation results than any individual modality (p<0.05 wilcox sign-rank test).

Brain Extraction (classification of brain and non-brain tissue) of MRI brain images is a crucial pre-processing step necessary for imaging-based anatomical studies of the human brain. Several automated methods and software tools are available for performing this task, but differences in MR image parameters (pulse sequence, resolution) and instrumentand subject-dependent noise and artefacts affect the performance of these automated methods. We describe and evaluate a method that automatically adapts the default parameters of the Brain Surface Extraction (BSE) algorithm to optimize a cost function chosen to reflect accurate brain extraction. BSE uses a combination of anisotropic filtering, Marr-Hildreth edge detection, and binary morphology for brain extraction. Our algorithm automatically adapts four parameters associated with these steps to maximize the brain surface area to volume ratio. We evaluate the method on a total of 109 brain volumes with ground truth brain masks generated by an expert user. A quantitative evaluation of the performance of the proposed algorithm showed an improvement in the mean (s.d.) Dice coefficient from 0.8969 (0.0376) for default parameters to 0.9509 (0.0504) for the optimized case. These results indicate that automatic parameter optimization can result in significant improvements in definition of the brain mask.

Crossing fibers are prevalent in human brains and a subject of intense interest for neuroscience. Diffusion tensor imaging (DTI) can resolve tissue orientation but is blind to crossing fibers. Many advanced diffusion-weighted magnetic resolution imaging (MRI) approaches have been presented to extract crossing-fibers from high angular resolution diffusion imaging (HARDI), but the relative sensitivity and specificity of approaches remains unclear. Here, we examine two leading approaches (PAS and q-ball) in the context of a large-scale, single subject reproducibility study. A single healthy individual was scanned 11 times with 96 diffusion weighted directions and 10 reference volumes for each of five b-values (1000, 1500, 2000, 2500, 3000 s/mm2) for a total of 5830 volumes (over the course of three sessions). We examined the reproducibility of the number of fibers per voxel, volume fraction, and crossing-fiber angles. For each method, we determined the minimum resolvable angle for each acquisition. Reproducibility of fiber counts per voxel was generally high (~80% consensus for PAS and ~70% for q-ball), but there was substantial bias between individual repetitions and model estimated with all data (~10% lower consensus for PAS and ~15% lower for q-ball). Both PAS and q-ball predominantly discovered fibers crossing at near 90 degrees, but reproducibility was higher for PAS across most measures. Within voxels with low anisotropy, q-ball finds more intra-voxel structure; meanwhile, PAS resolves multiple fibers at greater than 75 degrees for more voxels. These results can inform researchers when deciding between HARDI approaches or interpreting findings across studies.

We investigate the applicability of large-scale Granger Causality (lsGC) for extracting a measure of multivariate information flow between pairs of regional brain activities from resting-state functional MRI (fMRI) and test the effectiveness of these measures for predicting a disease state. Such pairwise multivariate measures of interaction provide high-dimensional representations of connectivity profiles for each subject and are used in a machine learning task to distinguish between healthy controls and individuals presenting with symptoms of HIV Associated Neurocognitive Disorder (HAND). Cognitive impairment in several domains can occur as a result of HIV infection of the central nervous system. The current paradigm for assessing such impairment is through neuropsychological testing. With fMRI data analysis, we aim at non-invasively capturing differences in brain connectivity patterns between healthy subjects and subjects presenting with symptoms of HAND. To classify the extracted interaction patterns among brain regions, we use a prototype-based learning algorithm called Generalized Matrix Learning Vector Quantization (GMLVQ). Our approach to characterize connectivity using lsGC followed by GMLVQ for subsequent classification yields good prediction results with an accuracy of 87% and an area under the ROC curve (AUC) of up to 0.90. We obtain a statistically significant improvement (p<0.01) over a conventional Granger causality approach (accuracy = 0.76, AUC = 0.74). High accuracy and AUC values using our multivariate method to connectivity analysis suggests that our approach is able to better capture changes in interaction patterns between different brain regions when compared to conventional Granger causality analysis known from the literature.

High-angular-resolution diffusion-weighted imaging (HARDI) MRI acquisitions have become common for use with higher order models of diffusion. Despite successes in resolving complex fiber configurations and probing microstructural properties of brain tissue, there is no common consensus on the optimal b-value and number of diffusion directions to use for these HARDI methods. While this question has been addressed by analysis of the diffusion-weighted signal directly, it is unclear how this translates to the information and metrics derived from the HARDI models themselves. Using a high angular resolution data set acquired at a range of b-values, and repeated 11 times on a single subject, we study how the b-value and number of diffusion directions impacts the reproducibility and precision of metrics derived from Q-ball imaging, a popular HARDI technique. We find that Q-ball metrics associated with tissue microstructure and white matter fiber orientation are sensitive to both the number of diffusion directions and the spherical harmonic representation of the Q-ball, and often are biased when under sampled. These results can advise researchers on appropriate acquisition and processing schemes, particularly when it comes to optimizing the number of diffusion directions needed for metrics derived from Q-ball imaging.

The new hybrid-BCI-DNI atlas is a high-resolution MPRAGE, single-subject atlas, constructed using both anatomical and functional information to guide the parcellation of the cerebral cortex. Anatomical labeling was performed manually on coronal single-slice images guided by sulcal and gyral landmarks to generate the original (non-hybrid) BCI-DNI atlas. Functional sub-parcellations of the gyral ROIs were then generated from 40 minimally preprocessed resting fMRI datasets from the HCP database. Gyral ROIs were transferred from the BCI-DNI atlas to the 40 subjects using the HCP grayordinate space as a reference. For each subject, each gyral ROI was subdivided using the fMRI data by applying spectral clustering to a similarity matrix computed from the fMRI time-series correlations between each vertex pair. The sub-parcellations were then transferred back to the original cortical mesh to create the subparcellated hBCI-DNI atlas with a total of 67 cortical regions per hemisphere. To assess the stability of the gyral subdivisons, a separate set of 60 HCP datasets were processed as follows: 1) coregistration of the structural scans to the hBCI-DNI atlas; 2) coregistration of the anatomical BCI-DNI atlas without functional subdivisions, followed by sub-parcellation of each subject’s resting fMRI data as described above. We then computed consistency between the anatomically-driven delineation of each gyral subdivision and that obtained per subject using individual fMRI data. The gyral sub-parcellations generated by atlas-based registration show variable but generally good overlap of the confidence intervals with the resting fMRI-based subdivisions. These consistency measures will provide a quantitative measure of reliability of each subdivision to users of the atlas.

Purpose: To develop, test, evaluate and apply a novel tool for the white matter fiber-based analysis of T1w/T2w ratio maps quantifying myelin content. Background: The cerebral white matter in the human brain develops from a mostly non-myelinated state to a nearly fully mature white matter myelination within the first few years of life. High resolution T1w/T2w ratio maps are believed to be effective in quantitatively estimating myelin content on a voxel-wise basis. We propose the use of a fiber-tract-based analysis of such T1w/T2w ratio data, as it allows us to separate fiber bundles that a common regional analysis imprecisely groups together, and to associate effects to specific tracts rather than large, broad regions. Methods: We developed an intuitive, open source tool to facilitate such fiber-based studies of T1w/T2w ratio maps. Via its Graphical User Interface (GUI) the tool is accessible to non-technical users. The framework uses calibrated T1w/T2w ratio maps and a prior fiber atlas as an input to generate profiles of T1w/T2w values. The resulting fiber profiles are used in a statistical analysis that performs along-tract functional statistical analysis. We applied this approach to a preliminary study of early brain development in neonates. Results: We developed an open-source tool for the fiber based analysis of T1w/T2w ratio maps and tested it in a study of brain development.

CT and MR perfusion weighted imaging (PWI) enable quantification of perfusion parameters in stroke studies. These parameters are calculated from the residual impulse response function (IRF) based on a physiological model for tissue perfusion. The standard approach for estimating the IRF is deconvolution using oscillatory-limited singular value decomposition (oSVD) or Frequency Domain Deconvolution (FDD). FDD is widely recognized as the fastest approach currently available for deconvolution of CT Perfusion/MR PWI. In this work, three faster methods are proposed. The first is a direct (model based) crude approximation to the final perfusion quantities (Blood flow, Blood volume, Mean Transit Time and Delay) using the Welch-Satterthwaite approximation for gamma fitted concentration time curves (CTC). The second method is a fast accurate deconvolution method, we call Analytical Fourier Filtering (AFF). The third is another fast accurate deconvolution technique using Showalter’s method, we call Analytical Showalter’s Spectral Filtering (ASSF). Through systematic evaluation on phantom and clinical data, the proposed methods are shown to be computationally more than twice as fast as FDD. The two deconvolution based methods, AFF and ASSF, are also shown to be quantitatively accurate compared to FDD and oSVD.

Coronary artery calcification (CAC) is a strong and independent predictor of cardiovascular events (CVEs). CAC can be quantified in chest CT scans acquired in lung screening. However, in these images the reproducibility of CAC quantification is compromised by cardiac motion that occurs during scanning, thereby limiting the reproducibility of CVE risk assessment. We present a system for the identification of CACs strongly affected by cardiac motion artifacts by using a convolutional neural network (CNN). This study included 125 chest CT scans from the National Lung Screening Trial (NLST). Images were acquired with CT scanners from four different vendors (GE, Siemens, Philips, Toshiba) with varying tube voltage, image resolution settings, and without ECG synchronization. To define the reference standard, an observer manually identified CAC lesions and labeled each according to the presence of cardiac motion: strongly affected (positive), mildly affected/not affected (negative). A CNN was designed to automatically label the identified CAC lesions according to the presence of cardiac motion by analyzing a patch from the axial CT slice around each lesion. From 125 CT scans, 9201 CAC lesions were analyzed. 8001 lesions were used for training (19% positive) and the remaining 1200 (50% positive) were used for testing. The proposed CNN achieved a classification accuracy of 85% (86% sensitivity, 84% specificity). The obtained results demonstrate that the proposed algorithm can identify CAC lesions that are strongly affected by cardiac motion. This could facilitate further investigation into the relation of CAC scoring reproducibility and the presence of cardiac motion artifacts.

Echocardiography (echo) is the most common test for diagnosis and management of patients with cardiac condi- tions. While most medical imaging modalities benefit from a relatively automated procedure, this is not the case for echo and the quality of the final echo view depends on the competency and experience of the sonographer. It is not uncommon that the sonographer does not have adequate experience to adjust the transducer and acquire a high quality echo, which may further affect the clinical diagnosis. In this work, we aim to aid the operator during image acquisition by automatically assessing the quality of the echo and generating the Automatic Echo Score (AES). This quality assessment method is based on a deep convolutional neural network, trained in an end-to-end fashion on a large dataset of apical four-chamber (A4C) echo images. For this project, an expert car- diologist went through 2,904 A4C images obtained from independent studies and assessed their condition based on a 6-scale grading system. The scores assigned by the expert ranged from 0 to 5. The distribution of scores among the 6 levels were almost uniform. The network was then trained on 80% of the data (2,345 samples). The average absolute error of the trained model in calculating the AES was 0.8 ± 0:72. The computation time of the GPU implementation of the neural network was estimated at 5 ms per frame, which is sufficient for real-time deployment.

Cochlear implants (CIs) are neural prosthetics for treating severe-to-profound hearing loss. Our group has developed an image-guided cochlear implant programming (IGCIP) system that uses image analysis techniques to recommend patientspecific CI processor settings to improve hearing outcomes. One crucial step in IGCIP is the localization of CI electrodes in post-implantation CTs. Manual localization of electrodes requires time and expertise. To automate this process, our group has proposed automatic techniques that have been validated on CTs acquired with scanners that produce images with an extended range of intensity values. However, there are many clinical CTs acquired with a limited intensity range. This limitation complicates the electrode localization process. In this work, we present a pre-processing step for CTs with a limited intensity range and extend the methods we proposed for full intensity range CTs to localize CI electrodes in CTs with limited intensity range. We evaluate our method on CTs of 20 subjects implanted with CI arrays produced by different manufacturers. Our method achieves a mean localization error of 0.21mm. This indicates our method is robust for automatic localization of CI electrodes in different types of CTs, which represents a crucial step for translating IGCIP from research laboratory to clinical use.

Cystic Fibrosis (CF) results in severe bronchiectasis in nearly all cases. Bronchiectasis is a disease where parts of the airways are permanently dilated. The development and the progression of bronchiectasis is not evenly distributed over the entire lungs – rather, individual functional units are affected differently. We developed a fully automated method for the precise calculation of lobe-based airway taper indices. To calculate taper indices, some preparatory algorithms are needed. The airway tree is segmented, skeletonized and transformed to a rooted acyclic graph. This graph is used to label the airways. Then a modified version of the previously validated integral based method (IBM) for airway geometry determination is utilized. The rooted graph, the airway lumen and wall information are then used to calculate the airway taper indices. Using a computer-generated phantom simulating 10 cross sections of airways we present results showing a high accuracy of the modified IBM. The new taper index calculation method was applied to 144 volumetric inspiratory low-dose MDCT scans. The scans were acquired from 36 children with mild CF at 4 time-points (baseline, 3 month, 1 year, 2 years). We found a moderate correlation with the visual lobar Brody bronchiectasis scores by three raters (r2 = 0.36, p < .0001). The taper index has the potential to be a precise imaging biomarker but further improvements are needed. In combination with other imaging biomarkers, taper index calculation can be an important tool for monitoring the progression and the individual treatment of patients with bronchiectasis.

Analysis of retinal fundus images is essential for physicians, optometrists and ophthalmologists in the diagnosis, care and treatment of patients. The first step of almost all forms of automated fundus analysis begins with the segmentation and subtraction of the retinal vasculature, while analysis of that same structure can aid in the diagnosis of certain retinal and cardiovascular conditions, such as diabetes or stroke. This paper investigates the use of a Convolutional Neural Network as a multi-channel classifier of retinal vessels using DRIVE, a database of fundus images. The result of the network with the application of a confidence threshold was slightly below the 2nd observer and gold standard, with an accuracy of 0.9419 and ROC of 0.9707. The output of the network with on post-processing boasted the highest sensitivity found in the literature with a score of 0.9568 and a good ROC score of 0.9689. The high sensitivity of the system makes it suitable for longitudinal morphology assessments, disease detection and other similar tasks.

In this paper we propose a new strategy for the recovery of complex anatomical deformations that exhibit local discontinuities, such as the shearing found at the lung-ribcage interface, using multi-grid octree B-splines. B- spline based image registration is widely used in the recovery of respiration induced deformations between CT images. However, the continuity imposed upon the computed deformation field by the parametrizing cubic B- spline basis function results in an inability to correctly capture discontinuities such as the sliding motion at organ boundaries. The proposed technique efficiently captures deformation within and at organ boundaries without the need for prior knowledge, such as segmentation, by selectively increasing deformation freedom within image regions exhibiting poor local registration. Experimental results show that the proposed method achieves more physically plausible deformations than traditional global B-spline methods.

In this paper, we propose a 3D registration method for retinal optical coherence tomography (OCT) volumes. The proposed method consists of five main steps: First, a projection image of the 3D OCT scan is created. Second, the vessel enhancement filter is applied on the projection image to detect vessel shadow. Third, landmark points are extracted based on both vessel positions and layer information. Fourth, the coherent point drift method is used to align retinal OCT volumes. Finally, a nonrigid B-spline-based registration method is applied to find the optimal transform to match the data. We applied this registration method on 15 3D OCT scans of patients with Choroidal Neovascularization (CNV). The Dice coefficients (DSC) between layers are greatly improved after applying the nonrigid registration.

We present the Active Registration Model (ARM) that couples medical image registration with regularization using a statistical model of intensity. Inspired by Active Appearance Models (AAMs), the statistical model is embedded in the registration procedure as a regularization term that penalize differences between a target image and a synthesized model reconstruction of that image. We demonstrate that the method generalizes AAMs to 3D images, many different transformation models, and many different gradient descent optimization methods. The method is validated on magnetic resonance images of human brains.

Cochlear implant surgery is a hearing restoration procedure for patients with profound hearing loss. In this surgery, an electrode is inserted into the cochlea to stimulate the auditory nerve and restore the patient’s hearing. Clinical computed tomography (CT) images are used for planning and evaluation of electrode placement, but their low resolution limits the visualization of internal cochlear structures. Therefore, high resolution micro-CT images are used to develop atlas-based segmentation methods to extract these nonvisible anatomical features in clinical CT images. Accurate registration of the high and low resolution CT images is a prerequisite for reliable atlas-based segmentation. In this study, we evaluate and compare different non-rigid B-spline registration parameters using micro-CT and clinical CT images of five cadaveric human cochleae. The varying registration parameters are cost function (normalized correlation (NC), mutual information and mean square error), interpolation method (linear, windowed-sinc and B-spline) and sampling percentage (1%, 10% and 100%). We compare the registration results visually and quantitatively using the Dice similarity coefficient (DSC), Hausdorff distance (HD) and absolute percentage error in cochlear volume. Using MI or MSE cost functions and linear or windowed-sinc interpolation resulted in visually undesirable deformation of internal cochlear structures. Quantitatively, the transforms using 100% sampling percentage yielded the highest DSC and smallest HD (0.828±0.021 and 0.25±0.09mm respectively). Therefore, B-spline registration with cost function: NC, interpolation: B-spline and sampling percentage: moments 100% can be the foundation of developing an optimized atlas-based segmentation algorithm of intracochlear structures in clinical CT images.

Efficient Cochlear Implant (CI) surgery requires prior knowledge of the cochlea’s size and its characteristics. This information helps to select suitable implants for different patients. To get these measurements, a segmentation method of cochlea medical images is needed. An important pre-processing step for good cochlea segmentation involves efficient image registration. The cochlea’s small size and complex structure, in addition to the different resolutions and head positions during imaging, reveals a big challenge for the automated registration of the different image modalities. In this paper, an Automatic Cochlea Image Registration (ACIR) method for multi- modal human cochlea images is proposed. This method is based on using small areas that have clear structures from both input images instead of registering the complete image. It uses the Adaptive Stochastic Gradient Descent Optimizer (ASGD) and Mattes’s Mutual Information metric (MMI) to estimate 3D rigid transform parameters. The use of state of the art medical image registration optimizers published over the last two years are studied and compared quantitatively using the standard Dice Similarity Coefficient (DSC). ACIR requires only 4.86 seconds on average to align cochlea images automatically and to put all the modalities in the same spatial locations without human interference. The source code is based on the tool elastix and is provided for free as a 3D Slicer plugin. Another contribution of this work is a proposed public cochlea standard dataset which can be downloaded for free from a public XNAT server.

Whole-body diffusion-weighted (WB-DW) MRI in combination with anatomical MRI has shown a great poten- tial in bone and soft tissue tumour detection, evaluation of lymph nodes and treatment response assessment. Because of the vast body coverage, whole-body MRI is acquired in separate stations, which are subsequently combined into a whole-body image. However, inter-station and inter-modality image misalignments can occur due to image distortions and patient motion during acquisition, which may lead to inaccurate representations of patient anatomy and hinder visual assessment. Automated and accurate whole-body image formation and alignment of the multi-modal MRI images is therefore crucial. We investigated several registration approaches for the formation or stitching of the whole-body image stations, followed by a deformable alignment of the multi- modal whole-body images. We compared a pairwise approach, where diffusion-weighted (DW) image stations were sequentially aligned to a reference station (pelvis), to a groupwise approach, where all stations were simultaneously mapped to a common reference space while minimizing the overall transformation. For each, a choice of input images and corresponding metrics was investigated. Performance was evaluated by assessing the quality of the obtained whole-body images, and by verifying the accuracy of the alignment with whole-body anatomical sequences. The groupwise registration approach provided the best compromise between the formation of WB- DW images and multi-modal alignment. The fully automated method was found to be robust, making its use in the clinic feasible.

Taking a multi-objective optimization approach to deformable image registration has recently gained attention, because such an approach removes the requirement of manually tuning the weights of all the involved objectives. Especially for problems that require large complex deformations, this is a non-trivial task. From the resulting Pareto set of solutions one can then much more insightfully select a registration outcome that is most suitable for the problem at hand. To serve as an internal optimization engine, currently used multi-objective algorithms are competent, but rather inefficient. In this paper we largely improve upon this by introducing a multi-objective real-valued adaptation of the recently introduced Gene-pool Optimal Mixing Evolutionary Algorithm (GOMEA) for discrete optimization. In this work, GOMEA is tailored specifically to the problem of deformable image registration to obtain substantially improved efficiency. This improvement is achieved by exploiting a key strength of GOMEA: iteratively improving small parts of solutions, allowing to faster exploit the impact of such updates on the objectives at hand through partial evaluations. We performed experiments on three registration problems. In particular, an artificial problem containing a disappearing structure, a pair of pre- and post-operative breast CT scans, and a pair of breast MRI scans acquired in prone and supine position were considered. Results show that compared to the previously used evolutionary algorithm, GOMEA obtains a speed-up of up to a factor of ~1600 on the tested registration problems while achieving registration outcomes of similar quality.

Late Gadolinium-Enhanced Cardiac MRI (LGE CMRI) is a non-invasive technique, which has shown promise in detecting native and post-ablation atrial scarring. To visualize the scarring, a precise segmentation of the left atrium (LA) and pulmonary veins (PVs) anatomy is performed as a first step—usually from an ECG gated CMRI roadmap acquisition—and the enhanced scar regions from the LGE CMRI images are superimposed. The anatomy of the LA and PVs in particular is highly variable and manual segmentation is labor intensive and highly subjective. In this paper, we developed a multi-atlas propagation based whole heart segmentation (WHS) to delineate the LA and PVs from ECG gated CMRI roadmap scans. While this captures the anatomy of the atrium well, the PVs anatomy is less easily visualized. The process is therefore augmented by semi-automated manual strokes for PVs identification in the registered LGE CMRI data. This allows us to extract more accurate anatomy than the fully automated WHS. Both qualitative visualization and quantitative assessment with respect to manual segmented ground truth showed that our method is efficient and effective with an overall mean Dice score of 0.91.

Whole breast segmentation is the first step in quantitative analysis of breast MR images. This task is challenging due mainly to the chest-wall line’s (CWL) spatially varying appearance and nearby distracting structures, both being complex. In this paper, we propose an automatic three-dimensional (3-D) segmentation method of whole breast in sagittal MR images. This method distinguishes itself from others in two main aspects. First, it reformulates the challenging problem of CWL localization into an equivalence that searches for an optimal smooth depth field and so fully utilizes the 3-D continuity of the CWLs. Second, it employs a localized self- adapting algorithm to adjust to the CWL’s spatial variation. Experimental results on real patient data with expert-outlined ground truth show that the proposed method can segment breasts accurately and reliably, and that its segmentation is superior to that of previously established methods.

Magnetic Resonance Imaging (MRI) and Magnetic Resonance Spectroscopy (MRS) together have become the gold standard in the precise quantification of body fat. The study of the quantification of fat in the human body has matured in recent years from a simplistic interest in the whole-body fat content to detailing regional fat distributions. The realization that body-fat, or adipose tissue (AT) is far from being a mere aggregate mass or deposit but a biologically active organ in and of itself, may play a role in the association between obesity and the various pathologies that are the biggest health issues of our time. Furthermore, a major bottleneck in most medical image assessments of adipose tissue content and distribution is the lack of automated image analysis. This motivated us to develop a proper and at least partially automated methodology to accurately and reproducibly determine both body fat content and distribution in the human body, which is to be applied to cross-sectional and longitudinal studies. The AT considered here is located beneath the skin (subcutaneous) as well as around the internal organs and between muscles (visceral and inter-muscular). There are also special fat depots on and around the heart (pericardial) as well as around the aorta (peri-aortic). Our methods focus on measuring and classifying these various AT deposits in the human body in an intervention study that involves the acquisition of thoracic and abdominal MR images via a Dixon technique.

In this work, we present a formal definition and an efficient algorithm to compute the cores of Oriented Relative Fuzzy Connectedness (ORFC), a recent seed-based segmentation technique. The core is a region where the seed can be moved without altering the segmentation, an important aspect for robust techniques and reduction of user effort. We show how ORFC cores can be used to build a powerful hybrid image segmentation approach. We also provide some new theoretical relations between ORFC and Oriented Image Foresting Transform (OIFT), as well as their cores. Experimental results among several methods show that the hybrid approach conserves high accuracy, avoids the shrinking problem and provides robustness to seed placement inside the desired object due to the cores properties.

The segmentation of the thyroid in ultrasound images is a field of active research. The thyroid is a gland of the endocrine system and regulates several body functions. Measuring the volume of the thyroid is regular practice of diagnosing pathological changes. In this work, we compare three approaches for semi-automatic thyroid segmentation in freehand-tracked three-dimensional ultrasound images. The approaches are based on level set, graph cut and feature classification. For validation, sixteen 3D ultrasound records were created with ground truth segmentations, which we make publicly available. The properties analyzed are the Dice coefficient when compared against the ground truth reference and the effort of required interaction. Our results show that in terms of Dice coefficient, all algorithms perform similarly. For interaction, however, each algorithm has advantages over the other. The graph cut-based approach gives the practitioner direct influence on the final segmentation. Level set and feature classifier require less interaction, but offer less control over the result. All three compared methods show promising results for future work and provide several possible extensions.

Computerized assessments for diagnosis or malignancy grading of cyto-histopathological specimens have drawn increased attention in the field of digital pathology. Automatic segmentation of cell nuclei is a fundamental step in such automated systems. Despite considerable research, nuclei segmentation is still a challenging task due noise, nonuniform illumination, and most importantly, in 2D projection images, overlapping and touching nuclei. In most published approaches, nuclei refinement is a post-processing step after segmentation, which usually refers to the task of detaching the aggregated nuclei or merging the over-segmented nuclei. In this work, we present a novel segmentation technique which effectively addresses the problem of individually segmenting touching or overlapping cell nuclei during the segmentation process. The proposed framework is a region-based segmentation method, which consists of three major modules: i) the image is passed through a color deconvolution step to extract the desired stains; ii) then the generalized fast radial symmetry transform is applied to the image followed by non-maxima suppression to specify the initial seed points for nuclei, and their corresponding GFRS ellipses which are interpreted as the initial nuclei borders for segmentation; iii) finally, these nuclei border initial curves are evolved through the use of a statistical level-set approach along with topology preserving criteria for segmentation and separation of nuclei at the same time. The proposed method is evaluated using Hematoxylin and Eosin, and fluorescent stained images, performing qualitative and quantitative analysis, showing that the method outperforms thresholding and watershed segmentation approaches.

The identification of spondylolysis and spondylolisthesis is important in spinal diagnosis, rehabilitation, and surgery planning. Accurate and automatic detection of spinal portion with spondylolisthesis problem will significantly reduce the manual work of physician and provide a more robust evaluation for the spine condition. Most existing automatic identification methods adopted the indirect approach which used vertebrae locations to measure the spondylolisthesis. However, these methods relied heavily on automatic vertebra detection which often suffered from the pool spatial accuracy and the lack of validated pathological training samples. In this study, we present a novel spondylolisthesis detection method which can directly locate the irregular spine portion and output the corresponding grading. The detection is done by a set of learning-based detectors which are discriminatively trained by synthesized spondylolisthesis image samples. To provide sufficient pathological training samples, we used a parameterized spine model to synthesize different types of spondylolysis images from real MR/CT scans. The parameterized model can automatically locate the vertebrae in spine images and estimate their pose orientations, and can inversely alter the vertebrae locations and poses by changing the corresponding parameters. Various training samples can then be generated from only a few spine MR/CT images. The preliminary results suggest great potential for the fast and efficient spondylolisthesis identification and measurement in both MR and CT spine images.

Modeling subject-specific shape change is one of the most important challenges in longitudinal shape analysis of disease progression. Whereas anatomical change over time can be a function of normal aging, anatomy can also be impacted by disease related degeneration. Anatomical shape change may also be affected by structural changes from neighboring shapes, which may cause non-linear variations in pose. In this paper, we propose a framework to analyze disease related shape changes by coupling extrinsic modeling of the ambient anatomical space via spatiotemporal deformations with intrinsic shape properties from medial surface analysis. We compare intrinsic shape properties of a subject-specific shape trajectory to a normative 4D shape atlas representing normal aging to isolate shape changes related to disease. The spatiotemporal shape modeling establishes inter/intra subject anatomical correspondence, which in turn enables comparisons between subjects and the 4D shape atlas, and also quantitative analysis of disease related shape change. The medial surface analysis captures intrinsic shape properties related to local patterns of deformation. The proposed framework jointly models extrinsic longitudinal shape changes in the ambient anatomical space, as well as intrinsic shape properties to give localized measurements of degeneration. Six high risk subjects and six controls are randomly sampled from a Huntington’s disease image database for qualitative and quantitative comparison.

With the increasing amount of patient information that is being collected today, the idea of using this information to inform future patient care has gained momentum. In many cases, this information comes in the form of medical images. Several algorithms have been presented to automatically segment these images, and to extract structures relevant to different diagnostic or surgical procedures. Consequently, this allows us to obtain large data-sets of shapes, in the form of triangular meshes, segmented from these images. Given correspondences between these shapes, statistical shape models (SSMs) can be built using methods like Principal Component Analysis (PCA). Often, the initial correspondences between the shapes need to be improved, and SSMs can be used to improve these correspondences. However, just as often, initial segmentations also need to be improved. Unlike many correspondence improvement algorithms, which do not affect segmentation, many segmentation improvement algorithms negatively affect correspondences between shapes. We present a method that iteratively improves both segmentation as well as correspondence by using SSMs not only to improve correspondence, but also to constrain the movement of vertices during segmentation improvement. We show that our method is able to maintain correspondence while achieving as good or better segmentations than those produced by methods that improve segmentation without maintaining correspondence. We are additionally able to achieve segmentations with better triangle quality than segmentations produced without correspondence improvement.

The optic nerve (ON) is a vital structure in the human visual system and transports all visual information from the retina to the cortex for higher order processing. Due to the lack of redundancy in the visual pathway, measures of ON damage have been shown to correlate well with visual deficits. These measures are typically taken at an arbitrary anatomically defined point along the nerve and do not characterize changes along the length of the ON. We propose a fully automated, three-dimensionally consistent technique building upon a previous independent slice-wise technique to estimate the radius of the ON and surrounding cerebrospinal fluid (CSF) on high-resolution heavily T2-weighted isotropic MRI. We show that by constraining results to be three-dimensionally consistent this technique produces more anatomically viable results. We compare this technique with the previously published slice-wise technique using a short-term reproducibility data set, 10 subjects, follow-up <1 month, and show that the new method is more reproducible in the center of the ON. The center of the ON contains the most accurate imaging because it lacks confounders such as motion and frontal lobe interference. Long-term reproducibility, 5 subjects, follow-up of approximately 11 months, is also investigated with this new technique and shown to be similar to short-term reproducibility, indicating that the ON does not change substantially within 11 months. The increased accuracy of this new technique provides increased power when searching for anatomical changes in ON size amongst patient populations.

Freehand 3D ultrasound (US) consists in acquiring a US volume by moving a tracked conventional 2D probe over an area of interest. To maintain good acoustic coupling between the probe and the skin, the operator applies pressure on the skin with the probe. This pressure deforms the underlying tissues in a variable way across the excursion of the probe, which, in turn, leads to inconsistencies in the volume. To address this problem, this paper proposes a method to estimate the deformation field sustained by each image with respect to a reference deformation free image. The method is based on a 2D biomechanical model that takes into account the mechanical parameters of the tissues depicted in the image to predict a realistic deformation field. These parameters are estimated along with the deformation field such as to maximize the mutual information between the reference and the corrected images. The image is then corrected by applying the inverse deformation field. Preliminary validation was conducted with synthetic US images generated using a 3D biomechanical model. Results show that the proposed method improves image correction compared to a purely image-based method.

Segmentation is a key task in medical image analysis because its accuracy significantly affects successive steps. Automatic segmentation methods often produce inadequate segmentations, which require the user to manually edit the produced segmentation slice by slice. Because editing is time-consuming, an editing tool that enables the user to produce accurate segmentations by only drawing a sparse set of contours would be needed. This paper describes such a framework as applied to a single object. Constrained by the additional information enabled by the manually segmented contours, the proposed framework utilizes object shape statistics to transform the failed automatic segmentation to a more accurate version. Instead of modeling the object shape, the proposed framework utilizes shape change statistics that were generated to capture the object deformation from the failed automatic segmentation to its corresponding correct segmentation. An optimization procedure was used to minimize an energy function that consists of two terms, an external contour match term and an internal shape change regularity term. The high accuracy of the proposed segmentation editing approach was confirmed by testing it on a simulated data set based on 10 in-vivo infant magnetic resonance brain data sets using four similarity metrics. Segmentation results indicated that our method can provide efficient and adequately accurate segmentations (Dice segmentation accuracy increase of 10%), with very sparse contours (only 10%), which is promising in greatly decreasing the work expected from the user.

Eye diseases and visual impairment affect millions of Americans and induce billions of dollars in annual economic burdens. Expounding upon existing knowledge of eye diseases could lead to improved treatment and disease prevention. This research investigated the relationship between structural metrics of the eye orbit and visual function measurements in a cohort of 470 patients from a retrospective study of ophthalmology records for patients (with thyroid eye disease, orbital inflammation, optic nerve edema, glaucoma, intrinsic optic nerve disease), clinical imaging, and visual function assessments. Orbital magnetic resonance imaging (MRI) and computed tomography (CT) images were retrieved and labeled in 3D using multi-atlas label fusion. Based on the 3D structures, both traditional radiology measures (e.g., Barrett index, volumetric crowding index, optic nerve length) and novel volumetric metrics were computed. Using stepwise regression, the associations between structural metrics and visual field scores (visual acuity, functional acuity, visual field, functional field, and functional vision) were assessed. Across all models, the explained variance was reasonable (R2 ~ 0.1-0.2) but highly significant (p < 0.001). Instead of analyzing a specific pathology, this study aimed to analyze data across a variety of pathologies. This approach yielded a general model for the connection between orbital structural imaging biomarkers and visual function.

Tumor tracking and progression analysis using medical images is a crucial task for physicians to provide accurate and efficient treatment plans, and monitor treatment response. Tumor progression is tracked by manual measurement of tumor growth performed by radiologists. Several methods have been proposed to automate these measurements with segmentation, but many current algorithms are confounded by attached organs and vessels. To address this problem, we present a new generalized tumor propagation model considering time-series prior images and local anatomical features using a Hierarchical Hidden Markov model (HMM) for tumor tracking. First, we apply the multi-atlas segmentation technique to identify organs/sub-organs using pre-labeled atlases. Second, we apply a semi-automatic direct 3D segmentation method to label the initial boundary between the lesion and neighboring structures. Third, we detect vessels in the ROI surrounding the lesion. Finally, we apply the propagation model with the labeled organs and vessels to accurately segment and measure the target lesion. The algorithm has been designed in a general way to be applicable to various body parts and modalities. In this paper, we evaluate the proposed algorithm on lung and lung nodule segmentation and tracking. We report the algorithm’s performance by comparing the longest diameter and nodule volumes using the FDA lung Phantom data and a clinical dataset.

Representation of human tongue motion using three-dimensional vector fields over time can be used to better understand tongue function during speech, swallowing, and other lingual behaviors. To characterize the inter-subject variability of the tongue’s shape and motion of a population carrying out one of these functions it is desirable to build a statistical model of the four-dimensional (4D) tongue. In this paper, we propose a method to construct a spatio-temporal atlas of tongue motion using magnetic resonance (MR) images acquired from fourteen healthy human subjects. First, cine MR images revealing the anatomical features of the tongue are used to construct a 4D intensity image atlas. Second, tagged MR images acquired to capture internal motion are used to compute a dense motion field at each time frame using a phase-based motion tracking method. Third, motion fields from each subject are pulled back to the cine atlas space using the deformation fields computed during the cine atlas construction. Finally, a spatio-temporal motion field atlas is created to show a sequence of mean motion fields and their inter-subject variation. The quality of the atlas was evaluated by deforming cine images in the atlas space. Comparison between deformed and original cine images showed high correspondence. The proposed method provides a quantitative representation to observe the commonality and variability of the tongue motion field for the first time, and shows potential in evaluation of common properties such as strains and other tensors based on motion fields.

Accurate CT synthesis, sometimes called electron density estimation, from MRI is crucial for successful MRI-based radiotherapy planning and dose computation. Existing CT synthesis methods are able to synthesize normal tissues but are unable to accurately synthesize abnormal tissues (i.e., tumor), thus providing a suboptimal solution. We propose a multiatlas- based hybrid synthesis approach that combines multi-atlas registration and patch-based synthesis to accurately synthesize both normal and abnormal tissues. Multi-parametric atlas MR images are registered to the target MR images by multi-channel deformable registration, from which the atlas CT images are deformed and fused by locally-weighted averaging using a structural similarity measure (SSIM). Synthetic MR images are also computed from the registered atlas MRIs by using the same weights used for the CT synthesis; these are compared to the target patient MRIs allowing for the assessment of the CT synthesis fidelity. Poor synthesis regions are automatically detected based on the fidelity measure and refined by a patch-based synthesis. The proposed approach was tested on brain cancer patient data, and showed a noticeable improvement for the tumor region.

Purpose: To evaluate an efficient iterative deconvolution method (RSEMD) for improving the quantitative accuracy of previously reconstructed breast images by commercial positron emission mammography (PEM) scanner. Materials and Methods: The RSEMD method was tested on breast phantom data and clinical PEM imaging data. Data acquisition was performed on a commercial Naviscan Flex Solo II PEM camera. This method was applied to patient breast images previously reconstructed with Naviscan software (MLEM) to determine improvements in resolution, signal to noise ratio (SNR) and contrast to noise ratio (CNR.) Results: In all of the patients’ breast studies the post-processed images proved to have higher resolution and lower noise as compared with images reconstructed by conventional methods. In general, the values of SNR reached a plateau at around 6 iterations with an improvement factor of about 2 for post-processed Flex Solo II PEM images. Improvements in image resolution after the application of RSEMD have also been demonstrated. Conclusions: A rapidly converging, iterative deconvolution algorithm with a novel resolution subsets-based approach RSEMD that operates on patient DICOM images has been used for quantitative improvement in breast imaging. The RSEMD method can be applied to clinical PEM images to improve image quality to diagnostically acceptable levels and will be crucial in order to facilitate diagnosis of tumor progression at the earliest stages. The RSEMD method can be considered as an extended Richardson-Lucy algorithm with multiple resolution levels (resolution subsets).

In X-ray imaging, scatter can produce noise, artifacts, and decreased contrast. In practice, hardware such as anti-scatter grids are often used to reduce scatter. However, the remaining scatter can still be significant and additional software-based correction are desirable. Furthermore, good software solutions can potentially reduce the amount of needed anti-scatter hardware, thereby reducing cost. In this work, we developed a software correction algorithm by adapting a class of non-local image restoration techniques to scatter reduction. In this algorithm, scatter correction is formulated as a Bayesian MAP (maximum a posteriori) problem with a non-local prior, which leads to better textural detail preservation in scatter reduction. The efficacy of our algorithm is demonstrated through experimental and simulation results.

X-ray machines are widely used for medical imaging and their cost is highly dependent on their image resolution. Due to economic reasons, lower-resolution (lower-res) machines still have a lot of customers, especially in developing economies. Software based resolution enhancement can potentially enhance the capabilities of the lower-res machines without significantly increasing their cost hence, is highly desirable. In this work, we developed an algorithm for X-ray image resolution enhancement. In this algorithm, the fractal idea and cross-resolution patch matching are used to identify low-res patches that can be used as samples for high-res patch/pixel estimation. These samples are then used to generate a prior distribution and used in a Bayesian MAP (maximum a posteriori) optimization to produce the high-res image estimate. The efficacy