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Biomedical subjects

A Fenster

Publications and source records attributed to A Fenster.

At least 37 records · Page 2Linked to original sources

Prostate boundary segmentation from 2D ultrasound images.

Outlining, or segmenting, the prostate is a very important task in the assignment of appropriate therapy and dose for cancer treatment; however, manual outlining is tedious and time-consuming. In this paper, an algorithm is described for semiautomatic segmentation of the prostate from 2D ultrasound images. The algorithm uses model-based initialization and the efficient discrete dynamic contour. Initialization requires the user to select only four points from which the outline of the prostate is estimated using cubic interpolation functions and shape information. The estimated contour is then deformed automatically to better fit the image. The algorithm can easily segment a wide range of prostate images, and contour editing tools are included to handle more difficult cases. The performance of the algorithm with a single user was compared to manual outlining by a single expert observer. The average distance between semiautomatically and manually outlined boundaries was found to be less than 5 pixels (0.63 mm), and the accuracy and sensitivity to area measurements were both over 90%.

Algorithms↗

Segmentation of carotid artery in ultrasound images: method development and evaluation technique.

Segmentation of carotid artery lumen in two-dimensional and three-dimensional ultrasonography is an important step in computerized evaluation of arterial disease severity and in finding vulnerable atherosclerotic plaques susceptible to rupture causing stroke. Because of the complexity of anatomical structures, noise as well as the requirement of accurate segmentation, interactions are necessary between observers and the computer segmentation process. In this paper a segmentation process is described based on the deformable model method with only one seed point to guide the initialization of the deformable model for each lumen cross section. With one seed, the initial contour of the deformable model is generated using the entropy map of the original image and mathematical morphology operations. The deformable model is driven to fit the lumen contour by an internal force and an external force that are calculated, respectively, with geometrical properties of deformed contour and with the image gray level features. The evaluation methodology using distance-based and area-based metrics is introduced in this paper. A contour probability distribution (CPD) method for calculating distance-based metrics is introduced. The CPD is obtained by generating contours of the lumen using a set of possible seed locations. The mean contour can be compared to a manual outlined contour to provide accuracy metrics. The variance computed from the CPD can provide metrics of local and global variability. These metrics provide a complete performance evaluation of an interactive segmentation algorithm and a means for comparing different algorithm settings.

Algorithms↗

An algorithm for automatic needle localization in ultrasound-guided breast biopsies.

An algorithm was developed in order to reduce operator dependence in ultrasound-guided breast biopsy, by automatically locating the needle in the ultrasound image, and displaying its location on the image for the user. Ultrasound images of a typical breast biopsy needle inserted in a tissue-mimicking agar were obtained to test the algorithm. The resulting images were examined by a group of observers who recorded the values of the angle, intercept and tip coordinates of the needle in the image, and inter- and intra-observer variability studies were performed on the results. The results of the algorithm segmentation were compared to the values recorded by the observers, and physical measurements recorded at the time the images were acquired. The algorithm segmentation was precise enough to successfully (when considering angle and tip segmentation) target 90% of tumors of 4.5 mm in diameter situated at the center of the image.

Algorithms↗

Variability and accuracy of measurements of prostate brachytherapy seed position in vitro using three-dimensional ultrasound: an intra- and inter-observer study.

This paper is a step in investigating whether three-dimensional (3D) ultrasound can be used intraoperatively to replace Computed Tomography (CT) for localization of brachytherapy seeds. In order to quantify the accuracy and variability of seed localization without introducing effects due to tissues, we first report our results with test phantoms. An inter- and intra-observer study was performed to assess the variability of 2 3D ultrasound scan acquisition methods: Tilt 3D scanning and pull-back 3D scanning. Seven observers measured the positions of gold seed markers in an agar phantom twice in each of the three orthogonal image planes. An analysis of variance (ANOVA) was performed to determine the intra- and inter-observer standard errors of measurement (SEM) and the minimum detectable changes in marker position (deltap). Average intra- and inter-observer SEMs for the tilt scan 3D image were 0.36 and 0.40 mm, respectively. Measurements of the pull-back scan 3D image yielded average intra- and inter-observer SEM of 0.46 and 0.49 mm, respectively. A paired difference analysis showed that the lower SEM for the tilt 3D scan image were statistically significant at a significance level of alpha= 0.05. The accuracy of the US measurements was tested by determining marker coordinates from CT images of the phantom in a stereotactic head frame. CT coordinates were matched to the ultrasound (US) coordinates by means of an affine transform. Average matching errors in x, y, and z were 0.02, 0.10, and -0.02 mm, respectively.

Agar↗

Intraoperative ultrasound for guidance and tissue shift correction in image-guided neurosurgery.

We present a surgical guidance system that incorporates pre-operative image information (e.g., MRI) with intraoperative ultrasound (US) imaging to detect and correct for brain tissue deformation during image-guided neurosurgery (IGNS). Many interactive IGNS implementations employ pre-operative images as a guide to the surgeons throughout the procedure. However, when a craniotomy is involved, tissue movement during a procedure can be a significant source of error in these systems. By incorporating intraoperative US imaging, the target volume can be scanned at any time, and two-dimensional US images may be compared directly to the corresponding slice from the pre-operative image. Homologous points may be mapped from the intraoperative to the pre-operative image space with an accuracy of better than 2 mm, enabling the surgeon to use this information to assess the accuracy of the guidance system along with the progress of the procedure (e.g., extent of lesion removal) at any time during the operation. Anatomical features may be identified on both the pre-operative and intraoperative images and used to generate a deformation map, which can be used to warp the pre-operative image to match the intraoperative US image. System validation is achieved using a deformable multi-modality imaging phantom, and preliminary clinical results are presented.

Brain↗

Accuracy and variability assessment of a semiautomatic technique for segmentation of the carotid arteries from three-dimensional ultrasound images.

In this paper, we report on a semiautomatic method for segmentation of three-dimensional (3D) carotid vascular ultrasound (US) images. Our method is based on a dynamic balloon model represented by a triangulated mesh. The mesh is manually placed within the interior of the carotid vessels, then is driven outward until it reaches the vessel wall by applying an inflation force to the mesh. Once the mesh is in close proximity to the vessel wall, it is further deformed using an image-based force, in order to better localize the boundary. Since the method requires manual initialization, there is inherent variability in the position and shape of the final segmented boundary. Using a 3D US image of a patient's carotids, we have examined the local variability in boundary position as the initialization position is varied throughout the interior of the carotid vessels in the 3D image. We have compared the semiautomatic segmentation method to a fully manual segmentation method, and found that the semiautomatic approach is less variable than the intraobserver variability for manual segmentation. We have furthermore examined the accuracy of the semiautomatic method by comparing the average surface to an "ideal" surface, determined by the average manually segmented surface. We have found, in general, good agreement between the semiautomatic and manual segmentation methods. For the 3D US image in question, the mean separation between the average segmented surface and the gold standard was found to be 0.35 mm. The two surfaces were determined to agree with each other, within uncertainty, at 65% of the mesh points comprising the two surfaces.

Biophysical Phenomena↗

Three-dimensional ultrasound imaging.

Two-dimensional viewing of three-dimensional anatomy by conventional ultrasound limits our ability to quantify and visualize a number of diseases and is partly responsible for the reported variability in diagnosis. Over the past two decades, many investigators have addressed this limitation by developing three-dimensional imaging techniques, including three-dimensional ultrasound imaging. In this paper we describe the development of a number of three-dimensional ultrasound imaging systems that make use of B mode, color Doppler, and power Doppler. In these systems, the conventional ultrasound transducer is scanned mechanically or by a freehand technique. The ultrasound images are digitized and then reconstructed into a three-dimensional volume, which can be viewed and manipulated interactively by the diagnostician with a variety of image-rendering techniques. These developments as well as future trends are discussed with regard to their applications and limitations.

Biomedical Engineering↗

Application of dynamic computed tomography for measurements of local aortic elastic modulus.

A novel computed tomographic (CT) technique used for the instantaneous measurement of the dynamic elastic modulus of intact excised porcine aortic vessels subjected to physiological pressure waveforms is described. This system was comprised of a high resolution X-ray image intensifier based computed tomographic system with limiting spatial resolution of 3.2 mm-1 (for a 40 mm field of view) and a computer-controlled flow simulator. Utilising cardiac gating and computer control, a time-resolved sequence of 1 mm thick axial tomographic slices was obtained for porcine aortic specimens during one simulated cardiac cycle. With an image acquisition sampling interval of 16.5 ms, the time sequences of CT slices were able to quantify the expansion and contraction of the aortic wall during each phase of the cardiac cycle. Through superficial tagging of the adventitial surface of the specimens with wire markers, measurement of wall strain in specific circumferential sectors and subsequent calculations of localised dynamic elastic modulus were possible. The precision of circumferential measurements made from the CT images utilising a cluster-growing segmentation technique was approximately +/- 0.25 mm and allowed determination of the dynamic elastic modulus E(dyn) with a precision of +/- 8 kPa. Dynamic elastic modulus was resolved as a function of the harmonics of the physiological pressure waveform and as a function of the angular position around the vessel circumference. Application of this dynamic CT (DCT) technique to seven porcine thoracic aortic specimens produced a circumferential average (over all frequency components) E(dyn) of 373 +/- 29 kPa. This value was not statistically different (p < 0.05) from the values of 430 +/- 77 and 390 +/- 47 kPa obtained by uniaxial tensile testing and volumetric measurements respectively.

Animals↗

Quantitative angiographic blood-flow measurement using pulsed intra-arterial injection.

A technique for quantitative blood-flow measurement using a novel pulsed injection of radiographic contrast agent is reported. A pressurized source of contrast agent is interrupted by a rotary valve at rates ranging from 1 to 30 Hz, producing well-defined boli at the end of a catheter. The position of these boli can be recorded by a digital radiographic system and analyzed by one of several previously reported techniques, to produce quantitative measurements of blood velocity and flow rate throughout the cardiac cycle. The contrast-agent flow wave form produced by the pulsed injector has been measured with an electromagnetic flow meter, for driving pressures ranging from 600 to 1500 kPa. Excellent modulation of the contrast agent is observed for injection frequencies up to 20 Hz, through catheters up to 100 cm in length. Preliminary in vitro angiographic flow measurements have been performed using an x-ray image intensifier, coupled to a linear photodiode array as the digital detector. Both constant flow and pulsatile human blood-flow wave forms were simulated within a 6.4-mm-diam straight tube and monitored with an electromagnetic flow meter. These experiments indicate that the pulsed injector can be used to provide estimates of arterial blood flow over the entire cardiac cycle (including reverse flow), to within about +/-11%, following injection of less than 10 ml of iodinated contrast agent.

Angiography, Digital Subtraction↗

A new flow model for Doppler ultrasound study of prosthetic heart valves.

BACKGROUND AND AIM OF THE STUDY: Steady and pulsatile flow models used to assess the hydrodynamic aspects of prosthetic heart valves are generally made of Plexiglas and Lucite tubing. They often allow continuous-wave and pulsed-wave Doppler ultrasound velocity measurements to be made parallel to the flow, but cannot be used as such for ultrasound scanning of valve inflow and outflow velocities because of ultrasonic reverberation and refraction by the tubing. The aim of the study was to develop a new flow model which allowed ultrasonic scanning of the prosthetic valve flow for three-dimensional (3D) reconstruction of color Doppler flow distributions. METHODS: The flow model, designed with left ventricular and aortic chambers composed of agar gel which mimics the ultrasound characteristics of biological tissues, was developed and tested for comparative in vitro hydrodynamic and Doppler ultrasonic studies of aortic prosthetic valves. An electromagnetic flowmeter and a pressure monitor provided the flow and pressure signals for the hydrodynamic tests. The Doppler ultrasonic evaluation was performed with an Ultramark 9 HDI ultrasound system and a 3D ultrasound imaging system. The model was designed to enable assessment of prosthetic valve performance by pulsed-wave and continuous-wave Doppler velocity measurements, as well as by 3D color Doppler velocity measurements obtained by ultrasonic scanning of the left ventricle or aortic chamber with an ultrasound probe mounted on a motorized translation assembly. RESULTS: The study results showed that this new flow model can provide 3D color Doppler velocity distributions as well as accurate comparisons of hydrodynamic parameters of mechanical and bioprosthetic heart valves derived from Doppler and catheter measurements, both under steady and pulsatile flow conditions. CONCLUSION: This new flow model can be used to evaluate the usefulness of hydrodynamic parameters for the assessment of prosthetic heart valves using both conventional Doppler echocardiography, as currently used in patients, and 3D color Doppler ultrasonic imaging.

Blood Flow Velocity↗

Three-dimensional ultrasound imaging of the vasculature.

With conventional ultrasonography, the diagnostician must view a series of two-dimensional images in order to form a mental impression of the three-dimensional anatomy, an efficient and time consuming practice prone to operator variability, which may cause variable or even incorrect diagnoses. Also, a conventional two-dimensional ultrasound image represents a thin slice of the patients anatomy at a single location and orientation, which is difficult to reproduce at a later time. These factors make conventional ultrasonography non-optimal for prospective or follow-up studies. Our efforts have focused on overcoming these deficiencies by developing three-dimensional ultrasound imaging techniques that are capable of acquiring B-mode, colour Doppler and power Doppler images of the vasculature, by using a conventional ultrasound system to acquire a series of two-dimensional images and then mathematically reconstructing them into a single three-dimensional image, which may then be viewed interactively on an inexpensive desktop computer. We report here on two approaches: (1) free-hand scanning, in which a magnetic positioning device is attached to the ultrasound transducer to record the position and orientation of each two-dimensional image needed for the three-dimensional image reconstruction; and (2) mechanical scanning, in which a motor-driven assembly is used to translate the transducer linearly across the neck, yielding a set of uniformly-spaced parallel two-dimensional images.

Algorithms↗

Analysis of linear, area and volume distortion in 3D ultrasound imaging.

We have developed a three-dimensional (3D) ultrasound imaging system that uses a side-firing probe, axially rotated under computer control, to acquire a series of 2D images, from which the 3D image is reconstructed. For an undistorted reconstruction, the inner radius R0 of the 2D images and the total scanning angle theta must be known accurately. Here, we describe (a) a theoretical analysis of the relative distortion in image shape, length, area, and volume due to an error delta R in R0 or delta theta in theta; (b) measurements of these in simulated and real 3D images; and (c) a method to calibrate R0, theta, and image scale accurately. Theoretically, all four relative distortions vary as P delta R/R + Q delta theta/theta, where magnitude of P < or = 1, magnitude of Q < or = 1, and R is the average distance of the object from the axis. In every case, the simple theoretical formulas for P and Q agree with image measurements to within the measurement uncertainty.

Algorithms↗

Intra- and inter-observer variability and reliability of prostate volume measurement via two-dimensional and three-dimensional ultrasound imaging.

We describe the results of a study to evaluate the intra- and inter-observer variability and reliability of prostate volume measurements made from transrectal ultrasound (TRUS) images, using either the (optimal) height-width-length (HWL) method (V = pi/6 HWL) with two-dimensional (2D) TRUS images (obtained as cross-sections of three-dimensional [3D] TRUS images) or manual planimetry of 3D TRUS images (the 3D US method). In this study, eight observers measured 15 prostate images, twice via each method, and an analysis of variance (ANOVA) was performed. This analysis shows that, with the 3D US method, intra-observer prostate volume estimates have 5.1% variability and 99% reliability, and inter-observer estimates have 11.4% variability and 96% reliability. With the HWL method, intra-observer estimates have 15.5% variability and 93% reliability, and inter-observer estimates have 21.9% variability and 87% reliability. Thus, in vivo prostate volume estimates from manual planimetry of 3D TRUS images have much lower variability and higher reliability than HWL estimates from 2D TRUS images.

Analysis of Variance↗

In vitro evaluation of multiple arterial stenoses using three-dimensional power Doppler angiography.

PURPOSE: The study was done to improve quantification of multiple arterial stenoses and to investigate a new imaging technique for lower limb arteries. Three-dimensional power Doppler angiography was used to quantify in vitro arterial stenoses. METHODS: We built two types of artery phantoms containing multiple stenoses. One used stenotic porcine arteries, and the other was designed to control the proximal and distal stenoses while we assessed central stenosis of a wall-less agar lumen. Three-dimensional power Doppler angiograms of the flow lumens were generated at different flow rates under steady and pulsatile flow conditions with a PowerPC 8500 computer-based three-dimensional ultrasound imaging system. This experimental system works off-line, performs three-dimensional acquisition, reconstruction, and display of ultrasound images. Images of flow lumens were compared with the measured B-mode images or the true geometry. RESULTS: This technique produces good three-dimensional angiographic images of the flow lumen, and multiple stenoses do not affect the diagnosis of arterial stenoses. With this technique, the average errors for estimating 80% and 50% area reduction stenoses were -10% and 4%, respectively. CONCLUSIONS: Three-dimensional power Doppler angiography has the potential to quantitatively grade multisegmental stenoses in lower limbs and generate a map for vasculature surgery planning.

Animals↗

Three-dimensional ophthalmic contact B-scan ultrasonography of the posterior segment.

PURPOSE: A system to produce three-dimensional computer reconstructions of ophthalmic contact B-scan ultrasound was developed and investigated. METHODS: Investigators used ocular phantoms to measure the accuracy and reproducibility of linear, area, and volume measurements. RESULTS: In vitro calibration tests of linear and area measurements demonstrate accurate and reproducible findings throughout the imaged space. Phantom volume tests also show reasonable accuracy and reproducibility. CONCLUSIONS: Three-dimensional ultrasonography is effective in measuring length, area, and volume in an experimental model. The in vitro accuracy and reproducibility of measurements warrants further investigation into the clinical utility of this method in posterior segment tumors and other posterior segment pathology.

Equipment Design↗

Three-dimensional transrectal ultrasound guided cryoablation for localized prostate cancer in nonsurgical candidates: a feasibility study and report of early results.

PURPOSE: A 3-dimensional (D) transrectal ultrasound imaging system was incorporated into the cryoablation routine for prostate cancer to assess its feasibility and use. The objective was to improve visibility for probe placement and for intraoperative monitoring. MATERIALS AND METHODS: A commercially available transrectal ultrasound unit was coupled with a custom designed software system to construct 3-dimensional prostate images. A total of 52 patients with clinically localized prostate cancer, in whom radiotherapy had failed (45) or who were otherwise judged to be nonsurgical candidates (7) were treated with cryoablation, using 3-D transrectal ultrasound for intraoperative guidance. RESULTS: In all cases the intraoperative 3-D transrectal ultrasound images provided a unique coronal view of the prostate, revealing useful information and facilitating more precise probe placement and treatment monitoring. Early postoperative histological and biochemical results and complication rates compare well with other contemporary series. CONCLUSIONS: Although the precise role of cryoablation in the management of prostate cancer remains unclear and long-term results are pending, incorporation of a 3-D transrectal ultrasound imaging system into the cryoablation routine proved to be feasible and appeared to be a worthwhile effort to facilitate the procedure, and deserves further evaluation.

Cryosurgery↗

X-ray imaging technique for in vitro tissue composition measurements using saline/iodine displacement: technique optimization.

An in vitro radiographic technique which uses saline/iodine displacement has been developed to study the thickness of bone-equivalent and soft-tissue-equivalent materials within atherosclerotic plaques in arterial specimens which have been cut open longitudinally and laid flat. Results concerning the optimization of the imaging parameters are presented and discussed. The technique consists of imaging arterial specimens under two different conditions: (1) when it is immersed in an isotonic saline solution, to estimate the calcium content, and (2) when it is immersed in a concentrated iodine solution, to estimate the total thickness of the specimen. Calibration step wedges made out of bone-mimicking and soft-tissue-mimicking materials are imaged simultaneously to generate calibration curves which are used to convert the radiographs into bone-equivalent and soft-tissue-equivalent thickness images. The optimal spectral parameters were determined to be 45 and 100 kVp for the saline and the iodine images, respectively, with a significant amount of added filtration for both images. Inherent systematic inaccuracies due to (1) the nonidealities due to linear attenuation coefficient mismatch between tissue and calibration materials and (2) beam hardening due to heel effect are determined theoretically, and can be used to correct a set of bone-equivalent and the soft-tissue-equivalent images to within +/- 6 microns with an ideal, noise-free imaging system.

Angiography↗

Tomographic imaging of the angular-dependent coherent-scatter cross section.

A new special-purpose computed tomographic (CT) imaging system is described which produces images based on measurements of the low-angle (0-10 degrees) x-ray diffraction properties of an object. Low-angle scatter in the diagnostic x-ray energy range is dominated by coherent scatter, and the system uses first-generation CT geometry to acquire a diffraction pattern for each pencil beam. The patterns are used to reconstruct a series of images which represent the coherent-scatter intensity at a series of scatter angles. To demonstrate the potential of coherent-scatter CT (CSCT), the scanner has been built and used to image a phantom consisting of a water-filled Lucite cylinder containing rods of polyethylene, Lucite, polycarbonate, and nylon. In this paper, the system is described and a sequence of CSCT images of this phantom is shown. Coherent-scatter cross sections of these materials are generated for each pixel from this sequence of images and compared with cross sections measured separately. The resulting excellent agreement shows that the angular-dependent coherent-scatter cross section can be accurately imaged in a tomographic slice through an object. These cross sections give material-specific information about the object. The long-term goal of this research is to make measurements of bone-mineral content for every pixel in a tomographic slice.

Bone Density↗