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Simeon Petkov, Xavier Carrillo, Petia Radeva, & Carlo Gatta. (2014). Diaphragm border detection in coronary X-ray angiographies: New method and applications. CMIG - Computerized Medical Imaging and Graphics, 38(4), 296–305.
Abstract: X-ray angiography is widely used in cardiac disease diagnosis during or prior to intravascular interventions. The diaphragm motion and the heart beating induce gray-level changes, which are one of the main obstacles in quantitative analysis of myocardial perfusion. In this paper we focus on detecting the diaphragm border in both single images or whole X-ray angiography sequences. We show that the proposed method outperforms state of the art approaches. We extend a previous publicly available data set, adding new ground truth data. We also compose another set of more challenging images, thus having two separate data sets of increasing difficulty. Finally, we show three applications of our method: (1) a strategy to reduce false positives in vessel enhanced images; (2) a digital diaphragm removal algorithm; (3) an improvement in Myocardial Blush Grade semi-automatic estimation.
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Simone Balocco, Carlo Gatta, Francesco Ciompi, A. Wahle, Petia Radeva, S. Carlier, et al. (2014). Standardized evaluation methodology and reference database for evaluating IVUS image segmentation. CMIG - Computerized Medical Imaging and Graphics, 38(2), 70–90.
Abstract: This paper describes an evaluation framework that allows a standardized and quantitative comparison of IVUS lumen and media segmentation algorithms. This framework has been introduced at the MICCAI 2011 Computing and Visualization for (Intra)Vascular Imaging (CVII) workshop, comparing the results of eight teams that participated.
We describe the available data-base comprising of multi-center, multi-vendor and multi-frequency IVUS datasets, their acquisition, the creation of the reference standard and the evaluation measures. The approaches address segmentation of the lumen, the media, or both borders; semi- or fully-automatic operation; and 2-D vs. 3-D methodology. Three performance measures for quantitative analysis have
been proposed. The results of the evaluation indicate that segmentation of the vessel lumen and media is possible with an accuracy that is comparable to manual annotation when semi-automatic methods are used, as well as encouraging results can be obtained also in case of fully-automatic segmentation. The analysis performed in this paper also highlights the challenges in IVUS segmentation that remains to be
solved.
Keywords: IVUS (intravascular ultrasound); Evaluation framework; Algorithm comparison; Image segmentation
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Simone Balocco, Carlo Gatta, Marina Alberti, Xavier Carrillo, Juan Rigla, & Petia Radeva. (2012). Relation between plaque type, plaque thickness, blood shear stress and plaque stress in coronary arteries assessed by X-ray Angiography and Intravascular Ultrasound. MEDPHYS - Medical Physics, 39(12), 7430–7445.
Abstract: PMID 23231293
PURPOSE:
Atheromatic plaque progression is affected, among others phenomena, by biomechanical, biochemical, and physiological factors. In this paper, the authors introduce a novel framework able to provide both morphological (vessel radius, plaque thickness, and type) and biomechanical (wall shear stress and Von Mises stress) indices of coronary arteries.
METHODS:
First, the approach reconstructs the three-dimensional morphology of the vessel from intravascular ultrasound (IVUS) and Angiographic sequences, requiring minimal user interaction. Then, a computational pipeline allows to automatically assess fluid-dynamic and mechanical indices. Ten coronary arteries are analyzed illustrating the capabilities of the tool and confirming previous technical and clinical observations.
RESULTS:
The relations between the arterial indices obtained by IVUS measurement and simulations have been quantitatively analyzed along the whole surface of the artery, extending the analysis of the coronary arteries shown in previous state of the art studies. Additionally, for the first time in the literature, the framework allows the computation of the membrane stresses using a simplified mechanical model of the arterial wall.
CONCLUSIONS:
Circumferentially (within a given frame), statistical analysis shows an inverse relation between the wall shear stress and the plaque thickness. At the global level (comparing a frame within the entire vessel), it is observed that heavy plaque accumulations are in general calcified and are located in the areas of the vessel having high wall shear stress. Finally, in their experiments the inverse proportionality between fluid and structural stresses is observed.
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Simone Balocco, Carlo Gatta, Oriol Pujol, J. Mauri, & Petia Radeva. (2010). SRBF: Speckle Reducing Bilateral Filtering. UMB - Ultrasound in Medicine and Biology, 36(8), 1353–1363.
Abstract: Speckle noise negatively affects medical ultrasound image shape interpretation and boundary detection. Speckle removal filters are widely used to selectively remove speckle noise without destroying important image features to enhance object boundaries. In this article, a fully automatic bilateral filter tailored to ultrasound images is proposed. The edge preservation property is obtained by embedding noise statistics in the filter framework. Consequently, the filter is able to tackle the multiplicative behavior modulating the smoothing strength with respect to local statistics. The in silico experiments clearly showed that the speckle reducing bilateral filter (SRBF) has superior performances to most of the state of the art filtering methods. The filter is tested on 50 in vivo US images and its influence on a segmentation task is quantified. The results using SRBF filtered data sets show a superior performance to using oriented anisotropic diffusion filtered images. This improvement is due to the adaptive support of SRBF and the embedded noise statistics, yielding a more homogeneous smoothing. SRBF results in a fully automatic, fast and flexible algorithm potentially suitable in wide ranges of speckle noise sizes, for different medical applications (IVUS, B-mode, 3-D matrix array US).
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Simone Balocco, Francesco Ciompi, Juan Rigla, Xavier Carrillo, Josefina Mauri, & Petia Radeva. (2019). Assessment of intracoronary stent location and extension in intravascular ultrasound sequences. MEDPHYS - Medical Physics, 46(2), 484–493.
Abstract: PURPOSE:
An intraluminal coronary stent is a metal scaffold deployed in a stenotic artery during percutaneous coronary intervention (PCI). In order to have an effective deployment, a stent should be optimally placed with regard to anatomical structures such as bifurcations and stenoses. Intravascular ultrasound (IVUS) is a catheter-based imaging technique generally used for PCI guiding and assessing the correct placement of the stent. A novel approach that automatically detects the boundaries and the position of the stent along the IVUS pullback is presented. Such a technique aims at optimizing the stent deployment.
METHODS:
The method requires the identification of the stable frames of the sequence and the reliable detection of stent struts. Using these data, a measure of likelihood for a frame to contain a stent is computed. Then, a robust binary representation of the presence of the stent in the pullback is obtained applying an iterative and multiscale quantization of the signal to symbols using the Symbolic Aggregate approXimation algorithm.
RESULTS:
The technique was extensively validated on a set of 103 IVUS of sequences of in vivo coronary arteries containing metallic and bioabsorbable stents acquired through an international multicentric collaboration across five clinical centers. The method was able to detect the stent position with an overall F-measure of 86.4%, a Jaccard index score of 75% and a mean distance of 2.5 mm from manually annotated stent boundaries, and in bioabsorbable stents with an overall F-measure of 88.6%, a Jaccard score of 77.7 and a mean distance of 1.5 mm from manually annotated stent boundaries. Additionally, a map indicating the distance between the lumen and the stent along the pullback is created in order to show the angular sectors of the sequence in which the malapposition is present.
CONCLUSIONS:
Results obtained comparing the automatic results vs the manual annotation of two observers shows that the method approaches the interobserver variability. Similar performances are obtained on both metallic and bioabsorbable stents, showing the flexibility and robustness of the method.
Keywords: IVUS; malapposition; stent; ultrasound
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