Biomedical subjects

Max A Viergever

Publications and source records attributed to Max A Viergever.

16 recordsLinked to original sources

PubMed2003

Measuring the arterial input function with gradient echo sequences.

The measurement of the arterial input function by use of gradient echo sequences was investigated by in vitro and in vivo experiments. First, calibration curves representing the influence of the concentration of Gd-DTPA on both the phase and the amplitude of the MR signal were measured in human blood by means of a slow-infusion experiment. The results showed a linear increase in the phase velocity and a quadratic increase in DeltaR(*) (2) as a function of the Gd-DTPA concentration. Next, the resultant calibration curves were incorporated in a partial volume correction algorithm for the arterial input function determination. The algorithm was tested in a phantom experiment and was found to substantially improve the accuracy of the concentration measurement. Finally, the reproducibility of the arterial input function measurement was estimated in 16 patients by considering the input function of the left and the right sides as replicate measurements. This in vivo study showed that the reproducibility of the arterial input function determination using gradient echo sequences is improved by employing a partial volume correction algorithm based on the calibration curve for the contrast agent used.

Algorithms↗

PubMed2003

On the artifact of a subvoxel susceptibility deviation in spoiled gradient-echo imaging.

In MRI, susceptibility-based negative contrast amplifies the effect of objects that are too small to be detected by water displacement or intrinsic contrast properties. In this work, a simplified description of the susceptibility artifact of a subvoxel object in spoiled gradient-echo imaging is presented that focuses on the elimination of signal in its vicinity: the dephased-volume. The size and position of the dephased-volume are investigated using 3D time-domain simulations and in vitro experiments in which scan parameters and object magnetic moment are systematically varied. Overall signal loss is found to be linearly related to a dephasing parameter that contains the susceptibility difference with tissue, object volume, and echo time (TE), and thus allows the magnetic moment of the object to be assessed. Gradient strength, in-plane resolution, fractional echo, and slice orientation have limited influence. For the settings used, the center of mass of the artifact was always within 0.5 mm of the object's in-plane position.

Artifacts↗

PubMed2003

Model of the human vasculature for studying the influence of contrast injection speed on cerebral perfusion MRI.

Simulations of dynamic susceptibility contrast (DSC) MRI are frequently performed by assuming a certain shape for the input function and the microvascular response function. However, to investigate the influence of parameters that will affect the shape of the input function, a more complex model of the human vasculature is required. In this study, a model of the human vasculature is proposed that consists of a network of vascular operators based on physiological data typical of a 35-year-old male subject. The simulated contrast passage curves were found to be within the range of observed contrast passage curves in a population of patients without vascular disease. The model was used to predict the effect of different injection speeds of the contrast agent on the accuracy of the perfusion experiment. It was found that injection speeds of <3 ml/s lead to an underestimation of the observed cerebral blood flow (CBF). Additionally, it was determined that decreasing the temporal resolution of the acquisition results in an underestimation of the CBF values, and an increase of the standard deviation (SD) of CBF measurements.

Adult↗

PubMed2003

Display of fused images: methods, interpretation, and diagnostic improvements.

The use of integrated visualization for medical images aims at assisting clinicians in the difficult task of mentally translating and integrating medical image data from multiple sources into a three-dimensional (3D) representation of the patient. This interpretation of the enormous amount and complexity of contemporary, multiparameter, and multimodal image data demands efficient methods for integrated presentation. This article reviews methods for fused display with the main focus on integration of functional with anatomical images. First, an overview of integrated two-dimensional (2D) and 3D medical image display techniques is presented, and topics related to the interpretation of the integrated images are discussed. Then we address the key issue for clinical acceptance, ie, whether these novel visualization techniques lead to diagnostic improvements. Methods for fused display appear to be powerful tools to assist the clinician in the retrieval of relevant information from multivariate medical image data. Evaluation of the different methods for fused display indicates that the diagnostic process improves, notably as concerns the anatomical localization (typically of functional processes), the registration procedure, enhancement of signal, and efficiency of information presentation (which increases speed of interpretation and comprehension). Consequently, fused display improves communication with referring specialists, increases confidence in the observations, and facilitates the intra- and intersubject comparison of a large part of the data from the different sources, thereby simplifying the extraction of additional, valuable information. In most diagnostic tasks the clinician is served best by providing several (interactive and flexible) 2D and 3D methods for fused display for a thorough assessment of the wealth of image information from multiple sources.

Anatomy, Cross-Sectional↗

PubMed2003

Localization and segmentation of aortic endografts using marker detection.

A method for localization and segmentation of bifurcated aortic endografts in computed tomographic angiography (CTA) images is presented. The graft position is determined by detecting radiopaque markers sewn on the outside of the graft. The user indicates the first and the last marker, whereupon the remaining markers are automatically detected. This is achieved by first detecting marker-like structures through second-order scaled derivative analysis, which is combined with prior knowledge of graft shape and marker configuration. The identified marker centers approximate the graft sides and, derived from these, the central axis. The graft boundary is determined by maximizing the local gradient in the radial direction along a deformable contour passing through both sides. Three segmentation methods were tested. The first performs graft contour detection in the initial CT-slices, the second in slices that were reformatted to be orthogonal to the approximated graft axis, and the third uses the segmentation from the second method to find a more reliable approximation of the axis and subsequently performs contour detection. The methods have been applied to ten CTA images and the results were compared to manual marker indication by one observer and region growing aided segmentation by three observers. Out of a total of 266 markers, 262 were detected. Adequate approximations of the graft sides were obtained in all cases. The best segmentation results were obtained using a second iteration orthogonal to the axis determined from the first segmentation, yielding an average relative volume of overlap with the expert segmentations of 92%, while the interexpert reproducibility is 95%. The averaged difference in volume measured by the automated method and by the experts equals the difference among the experts: 3.5%.

Anatomy, Cross-Sectional↗

PubMed2003

Blood pool contrast-enhanced MRA: improved arterial visualization in the steady state.

Blood pool agents (BPAs) for contrast-enhanced magnetic resonance angiography (CE-MRA) allow prolonged imaging during the steady state when the agent is distributed through the complete vascular system. This increases both the spatial resolution and the contrast resolution. However, simultaneous venous and arterial enhancement hampers interpretation. For the pelvic region of the vasculature, it is shown that arterial visualization in this equilibrium phase can be improved if the central arterial axis (CAA) is known. However, manually obtaining this axis is not feasible in clinical practice. Therefore, a method is presented that utilizes images acquired during the first pass of the contrast agent to find the CAA in the steady-state data with minimum user initialization. The accuracy of the resulting CAA is compared with tracings of three observers in six patient datasets. It was found that the mean difference between the semiautomatic method and the manual delineation is 1.32 mm in the steady-state data, and that the resulting CAA was always within the arterial lumen, which is an important prerequisite for both improved visualization and segmentation.

Algorithms↗

PubMed2003

Mutual-information-based registration of medical images: a survey.

An overview is presented of the medical image processing literature on mutual-information-based registration. The aim of the survey is threefold: an introduction for those new to the field, an overview for those working in the field, and a reference for those searching for literature on a specific application. Methods are classified according to the different aspects of mutual-information-based registration. The main division is in aspects of the methodology and of the application. The part on methodology describes choices made on facets such as preprocessing of images, gray value interpolation, optimization, adaptations to the mutual information measure, and different types of geometrical transformations. The part on applications is a reference of the literature available on different modalities, on interpatient registration and on different anatomical objects. Comparison studies including mutual information are also considered. The paper starts with a description of entropy and mutual information and it closes with a discussion on past achievements and some future challenges.

Algorithms↗

PubMed2003

Guide-wire tracking during endovascular interventions.

A method is presented to extract and track the position of a guide wire during endovascular interventions under X-ray fluoroscopy. The method can be used to improve guide-wire visualization in low-quality fluoroscopic images and to estimate the position of the guide wire in world coordinates. A two-step procedure is utilized to track the guide wire in subsequent frames. First, a rough estimate of the displacement is obtained using a template-matching procedure. Subsequently, the position of the guide wire is determined by fitting a spline to a feature image. The feature images that have been considered enhance line-like structures on: 1) the original images; 2) subtraction images; and 3) preprocessed images in which coherent structures are enhanced. In the optimization step, the influence of the scale at which the feature is calculated and the additional value of using directional information is investigated. The method is evaluated on 267 frames from ten clinical image sequences. Using the automatic method, the guide wire could be tracked in 96% of the frames, with a similar accuracy to three observers, although the position of the tip was estimated less accurately.

Algorithms↗

PubMed2002

Underestimation of access flow by ultrasound dilution flow measurements.

For hemodialysis access surveillance, flow measurements are increasingly considered important because they identify accesses at risk of thrombosis. Usually these flow measurements are performed with the ultrasound dilution technique. In a previous patient study it was observed that the resulting flow values were systematically low as compared to magnetic resonance flow measurements, but a satisfactory explanation was lacking. In the present study, we will demonstrate by hemodynamic calculations and in vitro experiments that this discrepancy can be explained by a temporary reduction of the access flow rate, caused by the reversed needle configuration during ultrasound dilution flow measurements. In this configuration. blood is injected retrogressively at one needle and flow between the needles is increased, causing an increased dissipation of energy. The proposed explanation is subsequently confirmed in a patient with a loop graft, by measuring the blood velocity by Doppler ultrasound as a function of reversed dialyzer flow rate. Apart from the ultrasound dilution technique, these findings are applicable to other recently proposed methods for measuring access flow that employ the reversed needle configuration.

Biophysics↗

PubMed2002

Improved lumen visualization in metallic vascular implants by reducing RF artifacts.

In this study, a method is proposed for MRI of the lumen of metallic vascular implants, like stents or vena cava filters. The method is based on the reduction of artifacts caused by flow, susceptibility, and RF eddy currents. Whereas both flow artifacts and susceptibility artifacts are well understood and documented, RF artifacts are not. Therefore, the present study comprises an in-depth theoretical explanation of the factors governing the severity of these RF artifacts. It is explained that the RF caging inside cage-like implants is caused by disturbances of the send and receive sensitivities due to coupling between the loops in the implant and the MR scanner's send and receive coils. A scaled excitation angle model describing the behavior of the signal intensity inside the implants as a function of the applied nominal excitation angle is introduced. This theoretical model was validated in phantom experiments. Reduced signal from within implants due to the caging problem could be restored by increasing the applied RF power in the excitation pulse, without exceeding the generally accepted SAR safety limits. The method was tested in vitro and in vivo in a pig model and allowed adequate depiction of the interior of a nitinol stent and that of a vena cava filter in contrast-enhanced MR angiograms. Magn Reson Med 47:171-180, 2002.

Alloys↗

PubMed2002

3D MRA coronary axis determination using a minimum cost path approach.

A method is introduced to automatically find the coronary axis based on two or more user-defined points, even in the presence of a severe stenosis. The coronary axis is determined by finding a minimum cost path (MCP) in a feature image in which the tubular-like structures are enhanced. The results of the proposed method were compared with manually drawn central axes to estimate the accuracy. In 32 3D TFE-EPI acquisitions of patients and volunteers, 14 right coronary arteries (RCAs), 15 left anterior descending arteries (LADs), and eight left circumflex arteries (LCXs) were manually tracked twice by two operators to determine a reference axis and to assess the inter- and intra-user variability. On average, the maximum distance to the reference axis, based on only two user-defined points, is less than 1.5 mm; the average distance is around 0.65 mm, which is less than the average in-plane resolution. The results of the method are comparable to those of the manual operators.

Coronary Stenosis↗

PubMed2002

Automatic detection of abnormalities in chest radiographs using local texture analysis.

A fully automatic method is presented to detect abnormalities in frontal chest radiographs which are aggregated into an overall abnormality score. The method is aimed at finding abnormal signs of a diffuse textural nature, such as they are encountered in mass chest screening against tuberculosis (TB). The scheme starts with automatic segmentation of the lung fields, using active shape models. The segmentation is used to subdivide the lung fields into overlapping regions of various sizes. Texture features are extracted from each region, using the moments of responses to a multiscale filter bank. Additional "difference features" are obtained by subtracting feature vectors from corresponding regions in the left and right lung fields. A separate training set is constructed for each region. All regions are classified by voting among the k nearest neighbors, with leave-one-out. Next, the classification results of each region are combined, using a weighted multiplier in which regions with higher classification reliability weigh more heavily. This produces an abnormality score for each image. The method is evaluated on two databases. The first database was collected from a TB mass chest screening program, from which 147 images with textural abnormalities and 241 normal images were selected. Although this database contains many subtle abnormalities, the classification has a sensitivity of 0.86 at a specificity of 0.50 and an area under the receiver operating characteristic (ROC) curve of 0.820. The second database consist of 100 normal images and 100 abnormal images with interstitial disease. For this database, the results were a sensitivity of 0.97 at a specificity of 0.90 and an area under the ROC curve of 0.986.

Algorithms↗

PubMed2002

Computation and visualization of three-dimensional soft tissue motion in the orbit.

This work presents a method to measure the soft tissue motion in three dimensions in the orbit during gaze. It has been shown that two-dimensional (2-D) quantification of soft tissue motion in the orbit is effective in the study of orbital anatomy and motion disorders. However, soft tissue motion is a three-dimensional (3-D) phenomenon and part of the kinematics is lost in any 2-D measurement. Therefore, T1-weighted magnetic resonance (MR) imaging volume sequences are acquired during gaze and soft tissue motion is quantified using a generalization of the Lucas and Kanade optical flow algorithm to three dimensions. New techniques have been developed for visualizing the 3-D flow field as a series of color-texture mapped 2-D slices or as a combination of volume rendering for display of the anatomy and scintillation rendering for the display of the motion field. We have studied the performance of the algorithm on four-dimensional volume sequences of synthetic motion, simulated motion of a static object imaged by MR, an MR-imaged rotating object and MR-imaged motion in the human orbit during gaze. The accuracy of the analysis is sufficient to characterize motion in the orbit and scintillation rendering is an effective visualization technique for 3-D motion in the orbit.

Algorithms↗

PubMed2002

Propagation of measurement noise through backprojection reconstruction in electrical impedance tomography.

A framework to analyze the propagation of measurement noise through backprojection reconstruction algorithms in electrical impedance tomography (EIT) is presented. Two measurement noise sources were considered: noise in the current drivers and in the voltage detectors. The influence of the acquisition system architecture (serial/semi-parallel) is also discussed. Three variants of backprojection reconstruction are studied: basic (unweighted), weighted and exponential backprojection. The results of error propagation theory have been compared with those obtained from simulated and experimental data. This comparison shows that the approach provides a good estimate of the reconstruction error variance. It is argued that the reconstruction error in EIT images obtained via backprojection can be approximately modeled as a spatially nonstationary Gaussian distribution. This methodology allows us to develop a spatial characterization of the reconstruction error in EIT images.

Algorithms↗

PubMed2002

Active shape model segmentation with optimal features.

An active shape model segmentation scheme is presented that is steered by optimal local features, contrary to normalized first order derivative profiles, as in the original formulation [Cootes and Taylor, 1995, 1999, and 2001]. A nonlinear kNN-classifier is used, instead of the linear Mahalanobis distance, to find optimal displacements for landmarks. For each of the landmarks that describe the shape, at each resolution level taken into account during the segmentation optimization procedure, a distinct set of optimal features is determined. The selection of features is automatic, using the training images and sequential feature forward and backward selection. The new approach is tested on synthetic data and in four medical segmentation tasks: segmenting the right and left lung fields in a database of 230 chest radiographs, and segmenting the cerebellum and corpus callosum in a database of 90 slices from MRI brain images. In all cases, the new method produces significantly better results in terms of an overlap error measure (p < 0.001 using a paired T-test) than the original active shape model scheme.

Adolescent↗

PubMed2002

Efficient simulation of SPECT down-scatter including photon interactions with crystal and lead.

A major image degrading factor in simultaneous Dual Isotope (DI) SPECT or simultaneous Emission-Transmission (ECT-TCT) imaging, is the detection of photons emitted by the higher energy isotope in the energy window used for imaging the lower energy isotope. In Tc-99m/Tl-201 DI-SPECT typically tens of percents of the total detected down-scatter is caused by lead x rays. In Tc-99m/Gd-153 ECT-TCT, a comparable fraction of the down-scatter originates from Tc-99m photons which only partly deposit their energy in the detector crystal (i.e., due to crystal interactions). Efficient simulation methods which model down-scatter can be used to optimize DI-SPECT or ECT-TCT imaging acquisition or reconstruction protocols. In this paper we adapt a previously proposed efficient down-scatter simulation method, to include the interactions of photons with the detector crystal and collimator lead. To this end, point spread function tables including crystal and lead interactions are precalculated. Subsequently, photons are traced through the patient body until their last scatter position, and the precalculated responses are used to project the photons onto the detector plane, while photon attenuation in the patient is taken into account. The approach is evaluated by comparing simulated Tc-99m down-scatter projections with measured projections. Incorporation of photon interaction with crystal and lead leads to significantly improved accuracy of the shape of down-scatter responses, while differences in total counts between simulated and measured projections typically decrease from tens of percents to a couple of percents. Calculating 60 down-scatter projections of an extended distribution on a 64 x 64 x 64 grid takes about three minutes on a PC with two 1.2 GHz processors. We conclude that accurate and efficient simulation of down-scatter is now possible including the major effects of the nonuniform mass density of the patient as well as photon interactions with the crystal and collimator lead.

Biophysical Phenomena↗