Abstract: Human arteries affected by atherosclerosis are characterized by altered wall viscoelastic properties. The possibility of noninvasively assessing arterial viscoelasticity in vivo would significantly contribute to the early diagnosis and prevention of this disease. This paper presents a noniterative technique to estimate the viscoelastic parameters of a vascular wall Zener model. The approach requires the simultaneous measurement of flow variations and wall displacements, which can be provided by suitable ultrasound Doppler instruments. Viscoelastic parameters are estimated by fitting the theoretical constitutive equations to the experimental measurements using an ARMA parameter approach. The accuracy and sensitivity of the proposed method are tested using reference data generated by numerical simulations of arterial pulsation in which the physiological conditions and the viscoelastic parameters of the model can be suitably varied. The estimated values quantitatively agree with the reference values, showing that the only parameter affected by changing the physiological conditions is viscosity, whose relative error was about 27% even when a poor signal-to-noise ratio is simulated. Finally, the feasibility of the method is illustrated through three measurements made at different flow regimes on a cylindrical vessel phantom, yielding a parameter mean estimation error of 25%.

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.

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).

Abstract: The assessment of arterial luminal area, performed by IVUS analysis, is a clinical index used to evaluate the degree of coronary artery disease. In this paper we propose a novel approach to automatically segment the vessel lumen, which combines model-based temporal information extracted from successive frames of the sequence, with spatial classification using the Growcut algorithm. The performance of the method is evaluated by an in vivo experiment on 300 IVUS frames. The automatic and manual segmentation performances in general vessel and stent frames are comparable. The average segmentation error in vessel, stent and bifurcation frames are 0.17±0.08 mm, 0.18±0.07 mm and 0.31±0.12 mm respectively.

Abstract: State-of-the-art approaches for semantic image segmentation are built on Convolutional Neural Networks (CNNs). The typical segmentation architecture is composed of (a) a downsampling path responsible for extracting coarse semantic features, followed by (b) an upsampling path trained to recover the input image resolution at the output of the model and, optionally, (c) a post-processing module (e.g. Conditional Random Fields) to refine the model predictions.
Recently, a new CNN architecture, Densely Connected Convolutional Networks (DenseNets), has shown excellent results on image classification tasks. The idea of DenseNets is based on the observation that if each layer is directly connected to every other layer in a feed-forward fashion then the network will be more accurate and easier to train.
In this paper, we extend DenseNets to deal with the problem of semantic segmentation. We achieve state-of-the-art results on urban scene benchmark datasets such as CamVid and Gatech, without any further post-processing module nor pretraining. Moreover, due to smart construction of the model, our approach has much less parameters than currently published best entries for these datasets.

Abstract: Workshop STACOM, dins del MICCAI
X-ray angiography is the most common imaging modality employed in the diagnosis of coronary diseases prior to or during a catheter-based intervention. The analysis of the patient X-Ray sequence can provide useful information about the degree of arterial stenosis, the myocardial perfusion and other clinical parameters. If the sequence has been acquired to evaluate the perfusion grade, the opacity due to the diaphragm could potentially hinder any kind of visual inspection and make more difficult a computer aided measurements. In this paper we propose an accurate and robust method to automatically identify the diaphragm border in each frame. Quantitative evaluation on a set of 11 sequences shows that the proposed algorithm outperforms previous methods.