For assessment of coronary artery disease (CAD) and peripheral artery disease (PAD) the automatic extraction
of vessel centerlines is a crucial technology. In the most common approach two seed points have to be manually
placed in the vessel and the centerline is automatically computed between these points. This methodology is
appropriate for the quantitative analysis of single vessel segments. However, for an interactive and fast reading
of complete datasets a more interactive approach would be beneficial.
In this work we introduce an interactive vessel-tracking approach which eases the reading of cardiac and
vascular CTA datasets. Starting with a single seed point a local vessel-tracking is initialized and extended in
both directions while the user "walks" along the vessel centerline. For a robust tracking of a wide variety of vessel
diameters, from coronaries to the aorta, we combine a local A*-graph-search for tiny vessels and a model-based
tracking for larger vessels to an hybrid model-based and graph-based approach.
In order to further ease the reading of cardiac and vascular CTA datasets, we introduce a subdivision of the
interactively acquired centerline into segments that can be approximated by a single plane. This subdivision
allows the visualization of the vessel in optimally oriented multi-planar reformations (MPR). The proposed
visualization combines the advantage of a curved planar reformation (CPR), showing a large part of the vessel
in one view, with the benefits of a MPR, having a non distorted more trustable image.
Assessment of computed tomography coronary angiograms for diagnostic purposes is a mostly manual, timeconsuming
task demanding a high degree of clinical experience. In order to support diagnosis, a method for
reliable automatic detection of stenotic lesions in computed tomography angiograms is presented. Thereby,
lesions are detected by boosting-based classification. Hence, a strong classifier is trained using the AdaBoost
algorithm on annotated data. Subsequently, the resulting strong classification function is used in order to
detect different types of coronary lesions in previously unseen data. As pattern recognition algorithms require
a description of the objects to be classified, a novel approach for feature extraction in computed tomography
angiograms is introduced. By generation of cylinder segments that approximate the vessel shape at multiple
scales, feature values can be extracted that adequately describe the properties of stenotic lesions. As a result of
the multi-scale approach, the algorithm is capable of dealing with the variability of stenotic lesion configuration.
Evaluation of the algorithm was performed on a large database containing unseen segmented centerlines from
cardiac computed tomography images. Results showed that the method was able to detect stenotic cardiovascular
diseases with high sensitivity and specificity. Moreover, lesion based evaluation revealed that the majority of
stenosis can be reliable identified in terms of position, type and extent.
KEYWORDS: Heart, 3D modeling, Image segmentation, Statistical modeling, Data modeling, Process modeling, Systems modeling, Computed tomography, Databases, 3D image processing
Multi-chamber heart segmentation is a prerequisite for quantification of the cardiac function. In this paper, we propose an automatic heart chamber segmentation system. There are two closely related tasks to develop such a system: heart modeling and automatic model fitting to an unseen volume. The heart is a complicated non-rigid organ with four chambers and several major vessel trunks attached. A flexible and accurate model is necessary to capture the heart chamber shape at an appropriate level of details. In our four-chamber surface mesh model, the following two factors are considered and traded-off: 1) accuracy in anatomy and 2) easiness for both annotation and automatic detection. Important landmarks such as valves and cusp points on the interventricular septum are explicitly represented in our model. These landmarks can be detected reliably to guide the automatic model fitting process. We also propose two mechanisms, the rotation-axis based and parallel-slice based resampling methods, to establish mesh point correspondence, which is necessary to build a statistical shape model to enforce priori shape constraints in the model fitting procedure. Using this model, we develop an efficient and robust approach for automatic heart chamber segmentation in 3D computed tomography (CT) volumes. Our approach is based on recent advances in learning discriminative object models and we exploit a large database of annotated CT volumes. We formulate the segmentation as a two step learning problem: anatomical structure localization and boundary delineation. A novel algorithm, Marginal Space Learning (MSL), is introduced to solve the 9-dimensional similarity transformation search problem for localizing the heart chambers. After determining the pose of the heart chambers, we estimate the 3D shape through learning-based boundary delineation. Extensive experiments demonstrate the efficiency and robustness of the proposed approach, comparing favorably to the state-of-the-art. This is the first study reporting stable results on a large cardiac CT dataset with 323 volumes. In addition, we achieve a speed of less than eight seconds for automatic segmentation of all four chambers.
Coronary territory maps, which associate myocardial regions with the corresponding coronary artery that supply
them, are a common visualization technique to assist the physician in the diagnosis of coronary artery disease.
However, the commonly used visualization is based on the AHA-17-segment model, which is an empirical population
based model. Therefore, it does not necessarily cope with the often highly individual coronary anatomy
of a specific patient.
In this paper we introduce a novel fully automatic approach to compute the patient individual coronary
supply regions in CTA datasets. This approach is divided in three consecutive steps. First, the aorta is fully
automatically located in the dataset with a combination of a Hough transform and a cylindrical model matching
approach. Having the location of the aorta, a segmentation and skeletonization of the coronary tree is triggered.
In the next step, the three main branches (LAD, LCX and RCX) are automatically labeled, based on the
knowledge of the pose of the aorta and the left ventricle.
In the last step the labeled coronary tree is projected on the left ventricular surface, which can afterward be
subdivided into the coronary supply regions, based on a Voronoi transform. The resulting supply regions can be
either shown in 3D on the epicardiac surface of the left ventricle, or as a subdivision of a polarmap.
The manual segmentation and analysis of 4D high resolution multi slice cardiac CT datasets is both labor
intensive and time consuming. Therefore, it is necessary to supply the cardiologist with powerful software tools,
to segment the myocardium and the cardiac cavities in all cardiac phases and to compute the relevant diagnostic
parameters.
In recent years there have been several publications concerning the segmentation and analysis of the left
ventricle (LV) and myocardium for a single phase or for the diagnostically most relevant phases, the enddiastole
(ED) and the endsystole (ES). However, for a complete diagnosis and especially of wall motion abnormalities, it
is necessary to analyze not only the motion endpoints ED and ES, but also all phases in-between.
In this paper a novel approach for the 4D segmentation of the left ventricle in cardiac-CT-data is presented.
The segmentation of the 4D data is divided into a first part, which segments the motion endpoints of the cardiac
cycle ED and ES and a second part, which segments all phases in-between. The first part is based on a bi-temporal
statistical shape model of the left ventricle. The second part uses a novel approach based on the
individual volume curve for the interpolation between ED and ES and afterwards an active contour algorithm
for the final segmentation.
The volume curve based interpolation step allows the constraint of the subsequent segmentation of the phases
between ED and ES to very small search-intervals, hence makes the segmentation process faster and more robust.
The manual segmentation and analysis of high-resolution multislice cardiac CT datasets is both labor intensive and time consuming. Therefore it is necessary to supply the cardiologist with powerful software tools to segment the myocardium as well as the cardiac cavities and to compute the relevant diagnostic parameters. In this paper we present an automatic cardiac segmentation procedure with minimal user interaction. It is based on a combined bi-temporal statistical model of the left and right ventricle using the principal component analysis (PCA) as well as the independent component analysis (ICA) to model global and local shape variation. To train the model we used manually drawn end-diastolic as well as end-systolic contours of the right epi- and of the left and right endocardium to create triangular surfaces of training datasets. These surfaces were used to build a mean triangular surface model of the left and right ventricle for the end-diastolic and end-systolic heart phase and to compute the PCA and ICA decorrelation matrices which are used in a point distribution model (PDM) to model the global and local shape variations. In contrast to many previous attempts of model based cardiac segmentation we do not create separate models for the left and the right ventricle and for different heart phases, but instead create one single parameter vector containing the information of both ventricles and both heart phases. This enables us to use the correlation between the phases and between left and right side to create a model which is more robust and less sensitive e.g. to poor contrast at the right ventricle.
In the diagnosis of coronary artery disease, 3D-multi-slice
computed tomography (MSCT) has recently become more and more
important. In this work, an anatomical-based method for the
segmentation of atherosclerotic coronary arteries in MSCT is
presented. This technique is able to bridge severe stenosis, image
artifacts or even full vessel occlusions. Different anatomical
structures (aorta, blood-pool of the heart chambers, coronary
arteries and their orifices) are detected successively to
incorporate anatomical knowledge into the algorithm. The coronary
arteries are segmented by a simulated wave propagation method to
be able to extract anatomically spatial relations from the result.
In order to bridge segmentation breaks caused by stenosis or image
artifacts, the spatial location, its anatomical relation and
vessel curvature-propagation are taken into account to span a
dynamic search space for vessel bridging and gap closing. This
allows the prevention of vessel misidentifications and improves
segmentation results significantly. The robustness of this method
is proven on representative medical data sets.
Multi-slice computed tomography (MSCT) has developed strongly in the emerging field of cardiovascular imaging. The manual analysis of atherosclerotic plaques in coronary arteries is a very time consuming and labor intensive process and today only qualitative analysis is possible. In this paper we present a new shape-based segmentation and visualization technique for quantitative analysis of atherosclerotic plaques in coronary artery disease. The new technique takes into account several aspects of the vascular anatomy. It uses two surface representations, one for the contrast filled vessel lumen and also one for the vascular wall. The deviation between these two surfaces is defined as plaque volume. These surface representations can be edited by the user manually. With this kind of representation it is possible to calculate sub plaque volumes (such as: lipid rich core, fibrous tissue, calcified tissue) inside this suspicious area. Also a high quality 3D visualization, using Open Inventor is possible.
KEYWORDS: Image segmentation, Statistical modeling, Data modeling, Diagnostics, Visualization, Heart, Principal component analysis, Visual process modeling, 3D modeling, Mahalanobis distance
The manual segmentation and analysis of high-resolution multi-slice cardiac CT datasets is both labor intensive and time consuming. Therefore it is necessary to supply the cardiologist with powerful software tools to segment the myocardium and compute the relevant diagnostic parameters. In this work we present a semi-automatic cardiac segmentation approach with minimal user interaction. It is based on a combination of an adaptive slice-based regiongrowing and a modified Active Shape Model (ASM). Starting with a single manual click point in the ascending aorta, the aorta, the left atrium and the left ventricle get segmented with the slice-based adaptive regiongrowing. The approximate position of the aortic and mitral valve as well as the principal axes of the left ventricle (LV) are determined. To prevent the regiongrowing from draining into neighboring anatomical structures via CT artifacts, we implemented a draining control by examining a cubic region around the currently processed voxel. Additionally, we use moment-based parameters to integrate simple anatomical knowledge into the regiongrowing process.
Using the results of the preceding regiongrowing process, a ventricle-centric and normalized coordinate system is established
which is used to adapt a previously trained ASM to the image, using an iterative multi-resolution approach. After fitting the ASM to the image, we can use the generated model-points to create an exact surface model of the left ventricular myocardium for visualization and for computing the diagnostically relevant parameters, like the ventricular blood volume and the myocardial wall thickness.
Minimally invasive liver interventions demand a lot of experience
due to the limited access to the field of operation. In
particular, the correct placement of the trocar and the navigation
within the patient's body are hampered. In this work, we present
an intraoperative augmented reality system (IARS) that directly
projects preoperatively planned information and structures
extracted from CT data, onto the real laparoscopic video images.
Our system consists of a preoperative planning tool for liver
surgery and an intraoperative real time visualization component.
The planning software takes into account the individual anatomy of
the intrahepatic vessels and determines the vascular territories.
Methods for fast segmentation of the liver parenchyma, of the
intrahepatic vessels and of liver lesions are provided. In
addition, very efficient algorithms for skeletonization and
vascular analysis allowing the approximation of patient-individual
liver vascular territories are included. The intraoperative
visualization is based on a standard graphics adapter for hardware
accelerated high performance direct volume rendering. The
preoperative CT data is rigidly registered to the patient position
by the use of fiducials that are attached to the patient's body,
and anatomical landmarks in combination with an electro-magnetic
navigation system. Our system was evaluated in vivo during a
minimally invasive intervention simulation in a swine under
anesthesia.
Augmented reality systems (ARS) allow the transparent projection of preoperative CT images onto the physicians view. A significant problem in this context is the registration between the patient and the tomographic images, especially in the case of soft tissue deformation. The basis of our ARS is a volume rendering component on standard PC platform, which allows interactive volumetric deformation as a supplement to the 3D-texture based approaches. The volume is adaptively subdivided into a hierarchy of sub-cubes, each of which is deformed linearly. In order to approximate the Phong illumination model, our system allows pre-calculated gradients to be deformed efficiently. The registration is realized by the introduction of a two-stage procedure. Firstly, we compute a rigid pre-registration by the use of fiducial markers in combination with an electromagnetic navigation system. The second step accounts for the nonlinear deformation. For this purpose, several views of an object are captured and compared with its corresponding synthetic renderings in an optimization method using mutual information as metric. Throughout the experiments with our approach, several tests of the rigid registration has been carried out in a real laparoscopic intervention setup as a supplement to the actual clinical routine. In order to evaluate the nonlinear part of the registration, up until now several dummy objects (synthetically deformed datasets) have been successfully examined.
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