Speckle noise filtering has been investigated since at least fifty years, this multiplicative and granular interference may be found in any image, i.e, Synthetic Aperture Radar (SAR), optical coherence tomography, and of course, medical ultrasound imaging. Speckle noise is produced by structural characteristics of materials, in case of the ultrasound imaging case, by small structural irregularities. This work proposes a novel speckle noise filtering strategy using a bank of morphological multi-scale filters that captures anisotropic information and additionally preserves cardiac structures. This method is compared against commonly used filters, namely: Anisotropic Diffusion Filter (ADMSS), Non-Local Means Filter (NLMF) and Detail Preserving Anisotropic Diffusion Filter (DPAD).
Nowadays magnetic resonance images (MRI) are being used to calculate important clinical parameters such as ejection fraction (EF), left ventricle myocardium mass (MM), and stroke volume (SV) which are crucial to estimate the cardiac function, surgical planning and create patient-specific heart models, therefore for quantifying accurately these parameters it is also necessary a good delimitation of cardiac structures. The proposed approach presents an automatic segmentation of the left ventricle (LV) and basically is composed by three steps: first, heart structure localization with template matching technique in coronal and sagittal view that is used to restrict axial analysis. Second, ellipsoidal approximation using the axial projection of previous coarse segmentation. Third, a conventional snake algorithm is performed to refine external myocardium boundaries in axial view. The strategy was evaluated using 100 cardiac MRI volumes provided by the ACDC 2017 MICCAI challenge which is composed of 4 different heart diseases, the strategy had an average Dice Score of 0.79.
Accurate volume quantification in magnetic resonance imaging (MRI) provides an important cardiac indicator in congenital heart diseases and furthermore, it is crucial for any surgical planning of congenital surgery. This paper presents an automatic segmentation of the left ventricle (LV) in congenital heart diseases. The proposed approach is basically the suite of three steps: first, a radial saliency analysis coarsely approximates the myocardium boundary. Second, this boundary is refined by choosing, among the candidate points, those ones that follow the most ellipsoidal closed curve. Third, these points serve as the external energy of a conventional snake that is evolved to approximate the inner myocardium boundary. This method requires a minimum parameterization and demands low computational power, in fact, a whole case is segmented in 80 s. The strategy was evaluated using 10 cardiac MRI volumes of actual congenital diseases provided by the HVSMR 2016 challenges, achieving an average Dice of 0.77.
Cerebral palsy (CP) is a large group of motion and posture disorders caused during the fetal or infant brain development. Sensorial impairment is commonly found in children with CP, i.e., between 40-75 percent presents some form of vision problems or disabilities. An automatic characterization of the cerebral palsy is herein presented by estimating the ocular motion during a gaze pursuing task. Specifically, After automatically detecting the eye location, an optical flow algorithm tracks the eye motion following a pre-established visual assignment. Subsequently, the optical flow trajectories are characterized in the velocity-acceleration phase plane. Differences are quantified in a small set of patients between four to ten years.
External auditory cues stimulate motor related areas of the brain, activating motor ways parallel to the basal ganglia circuits and providing a temporary pattern for gait. In effect, patients may re-learn motor skills mediated by compensatory neuroplasticity mechanisms. However, long term functional gains are dependent on the nature of the pathology, follow-up is usually limited and reinforcement by healthcare professionals is crucial. Aiming to cope with these challenges, several researches and device implementations provide auditory or visual stimulation to improve Parkinsonian gait pattern, inside and outside clinical scenarios. The current work presents a semiautomated strategy for spatio-temporal feature extraction to study the relations between auditory temporal stimulation and spatiotemporal gait response. A protocol for auditory stimulation was built to evaluate the integrability of the strategy in the clinic practice. The method was evaluated in transversal measurement with an exploratory group of people with Parkinson’s (n = 12 in stage 1, 2 and 3) and control subjects (n =6). The result showed a strong linear relation between auditory stimulation and cadence response in control subjects (R=0.98 ±0.008) and PD subject in stage 2 (R=0.95 ±0.03) and stage 3 (R=0.89 ±0.05). Normalized step length showed a variable response between low and high gait velocity (0.2> R >0.97). The correlation between normalized mean velocity and stimulus was strong in all PD stage 2 (R>0.96) PD stage 3 (R>0.84) and controls (R>0.91) for all experimental conditions. Among participants, the largest variation from baseline was found in PD subject in stage 3 (53.61 ±39.2 step/min, 0.12 ± 0.06 in step length and 0.33 ± 0.16 in mean velocity). In this group these values were higher than the own baseline. These variations are related with direct effect of metronome frequency on cadence and velocity. The variation of step length involves different regulation strategies and could need others specific external cues. In conclusion the current protocol (and their selected parameters, kind of sound time for training, step of variation, range of variation) provide a suitable gait facilitation method specially for patients with the highest gait disturbance (stage 2 and 3). The method should be adjusted for initial stages and evaluated in a rehabilitation program.
Parkinson’s disease (PD) is constituted by a set of motor symptoms, namely tremor, rigidity, and bradykinesia, which are usually described but not quantified. This work proposes an objective characterization of PD gait patterns by approximating the single stance phase a single grounded pendulum. This model estimates the force generated by the gait during the single support from gait data. This force describes the motion pattern for different stages of the disease. The model was validated using recorded videos of 8 young control subjects, 10 old control subjects and 10 subjects with Parkinson’s disease in different stages. The estimated force showed differences among stages of Parkinson disease, observing a decrease of the estimated force for the advanced stages of this illness.
An accurate left (LV) and right ventricular (RV) function quantification is important to support evaluation, diagnosis and prognosis of cardiac pathologies such as the cardiomyopathies. Currently, diagnosis by ultrasound is the most cost-effective examination. However, this modality is highly noisy and operator dependent, hence prone to errors. Therefore, fusion with other cardiac modalities may provide complementary information and improve the analysis of the specific pathologies like cardiomyopathies. This paper proposes an automatic registration between two complementary modalities, 4D echocardiography and Magnetic resonance images, by mapping both modalities to a common space of salience where an optimal registration between them is estimated. The obtained matrix transformation is then applied to the MRI volume which is superimposed to the 4D echocardiography. Manually selected marks in both modalities are used to evaluate the precision of the superimposition. Preliminary results, in three evaluation cases, show the distance between these marked points and the estimated with the transformation is about 2 mm.
Several approaches using auditory feedback have been proposed to improve gait rehabilitation in Parkinson Disease. Despite auditory cues have shown to be useful, there are still unanswered questions about their optimal usage regarding parameters like frequency, number of beats and their integration with rehabilitation protocols, among others. Most approaches have attempted to resolve these questions by measuring their direct effect on spatiotemporal gait variables. However, few studies have assessed how synchronized the auditory feedback and the gait pattern are. The main goal was to quantify synchronization between the gait temporal patterns and the auditory stimuli. The group of participants consisted of seven (7) healthy subjects, aged between 50-70 years (average 57.28, ± 5.87 years), with average height of 1.64±0.09m and independent community ambulation. Each candidate was asked to sign an informed consent, given their good cognitive conditions for understanding the nature and purpose of the study. Participants were instructed to follow the sounds provided by a metronome. Feet tracking yielded the temporal gait pattern. The temporal coherence metric was developed to evaluate synchronization between audio signal and subject motion, in terms of phase shift (π radian). Results show a good fit to auditory stimulus in metronome rates between 140-150 and 60-80 beats/min (bpm) for the selected participants. A lower temporal coherence was observed at the beginning and the end of the test. The proposed metric allows quantification of the temporal coherence between gait and auditory cues in healthy elder subjects. Other exploratory trials should be directed to evaluate the temporal coherence between auditory stimuli and generated movements in population with Parkinson Disease.
An accurate ventricular function quantification is important to support evaluation, diagnosis and prognosis of several cardiac pathologies. However, expert heart delineation, specifically for the right ventricle, is a time consuming task with high inter-and-intra observer variability. A fully automatic 3D+time heart segmentation framework is herein proposed for short-axis-cardiac MRI sequences. This approach estimates the heart using exclusively information from the sequence itself without tuning any parameters. The proposed framework uses a coarse-to-fine approach, which starts by localizing the heart via spatio-temporal analysis, followed by a segmentation of the basal heart that is then propagated to the apex by using a non-rigid-registration strategy. The obtained volume is then refined by estimating the ventricular muscle by locally searching a prior endocardium- pericardium intensity pattern. The proposed framework was applied to 48 patients datasets supplied by the organizers of the MICCAI 2012 Right Ventricle segmentation challenge. Results show the robustness, efficiency and competitiveness of the proposed method both in terms of accuracy and computational load.
An accurate right ventricular (RV) function quantification is important to support the evaluation, diagnosis and
prognosis of several cardiac pathologies and to complement the left ventricular function assessment. However,
expert RV delineation is a time consuming task with high inter-and-intra observer variability. In this paper
we present an automatic segmentation method of the RV in MR-cardiac sequences. Unlike atlas or multi-atlas
methods, this approach estimates the RV using exclusively information from the sequence itself. For so doing,
a spatio-temporal analysis segments the heart at the basal slice, segmentation that is then propagated to the
apex by using a non-rigid-registration strategy. The proposed approach achieves an average Dice Score of 0:79
evaluated with a set of 48 patients.
A reliable diagnosis of the Parkinson Disease lies on the objective evaluation of different motor sub-systems. Discovering specific motor patterns associated to the disease is fundamental for the development of unbiased assessments that facilitate the disease characterization, independently of the particular examiner. This paper proposes a new objective screening of patients with Parkinson, an approach that optimally combines ipsilateral global descriptors. These ipsilateral gait features are simple upper-lower limb relationships in frequency and relative phase spaces. These low level characteristics feed a simple SVM classifier with a polynomial kernel function. The strategy was assessed in a binary classification task, normal against Parkinson, under a leave-one-out scheme in a population of 16 Parkinson patients and 7 healthy control subjects. Results showed an accuracy of 94;6% using relative phase spaces and 82;1% with simple frequency relations.
An early diagnosis of Parkinson’s Disease (PD) is crucial towards devising successful rehabilitation programs. Typically, the PD diagnosis is performed by characterizing typical symptoms, namely bradykinesia, rigidity, tremor, postural instability or freezing gait. However, traditional examination tests are usually incapable of detecting slight motor changes, specially for early stages of the pathology. Recently, eye movement abnormalities have correlated with early onset of some neurodegenerative disorders. This work introduces a new characterization of the Parkinson disease by describing the ocular motion during a common daily activity as the gait. This paper proposes a fully automatic eye motion analysis using a dense optical flow that tracks the ocular direction. The eye motion is then summarized using orientation histograms constructed during a whole gait cycle. The proposed approach was evaluated by measuring the χ2 distance between the orientation histograms, showing substantial differences between control and PD patients.
Modern rehabilitation protocols of most neurodegenerative diseases, in particular the Parkinson Disease, rely on a clinical analysis of gait patterns. Currently, such analysis is highly dependent on both the examiner expertise and the type of evaluation. Development of evaluation methods with objective measures is then crucial. Physical models arise as a powerful alternative to quantify movement patterns and to emulate the progression and performance of specific treatments. This work introduces a novel quantification of the Parkinson disease progression using a physical model that accurately represents the main gait biomarker, the body Center of Gravity (CoG). The model tracks the whole gait cycle by a coupled double inverted pendulum that emulates the leg swinging for the single support phase and by a damper-spring System (SDP) that recreates both legs in contact with the ground for the double phase. The patterns generated by the proposed model are compared with actual ones learned from 24 subjects in stages 2,3, and 4. The evaluation performed demonstrates a better performance of the proposed model when compared with a baseline model(SP) composed of a coupled double pendulum and a mass-spring system. The Frechet distance measured differences between model estimations and real trajectories, showing for stages 2, 3 and 4 distances of 0.137, 0.155, 0.38 for the baseline and 0.07, 0.09, 0.29 for the proposed method.
Reconstruction of the heartbeat is an useful tool to detect and diagnose some pathologies. However, this process represents a challenge because the heart is a moving organ inside a moving body, so that, either similar regions are hard to identify or some regions appear and disappear constantly. This article presents a reconstruction method of the right ventricle using SURF points in irregular regions. The SURF points, invariant to image scale and rotation, provide robust features of a right ventricle slice that can then be traced to the other slices. By using such points and then, using a nonrigid registration, it possible to perform a volumetrical reconstruction of these images.
In this work is presented a novel strategy that tracks the right ventricle (RV) shape during a whole cardiac cycle in magnetic resonance sequences (MRC). The proposed approach obtains a set of spatio-temporal observations from a bidirectional per pixel motion descriptor which are each time fused with prior learned edges. A main advantage of the proposed approach is a robust MRI heart characterization that is regularized by a prior information, obtaining in each cardiac state coherent results. The proposed approach achieves a Dice Score of 0.64 evaluated over 16 patients.
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