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Patricia Marquez. (2015). A Confidence Framework for the Assessment of Optical Flow Performance (Debora Gil, & Aura Hernandez, Eds.). Ph.D. thesis, Ediciones Graficas Rey, .
Abstract: Optical Flow (OF) is the input of a wide range of decision support systems such as car driver assistance, UAV guiding or medical diagnose. In these real situations, the absence of ground truth forces to assess OF quality using quantities computed from either sequences or the computed optical flow itself. These quantities are generally known as Confidence Measures, CM. Even if we have a proper confidence measure we still need a way to evaluate its ability to discard pixels with an OF prone to have a large error. Current approaches only provide a descriptive evaluation of the CM performance but such approaches are not capable to fairly compare different confidence measures and optical flow algorithms. Thus, it is of prime importance to define a framework and a general road map for the evaluation of optical flow performance.
This thesis provides a framework able to decide which pairs “ optical flow – confidence measure” (OF-CM) are best suited for optical flow error bounding given a confidence level determined by a decision support system. To design this framework we cover the following points:
Descriptive scores. As a first step, we summarize and analyze the sources of inaccuracies in the output of optical flow algorithms. Second, we present several descriptive plots that visually assess CM capabilities for OF error bounding. In addition to the descriptive plots, given a plot representing OF-CM capabilities to bound the error, we provide a numeric score that categorizes the plot according to its decreasing profile, that is, a score assessing CM performance.
Statistical framework. We provide a comparison framework that assesses the best suited OF-CM pair for error bounding that uses a two stage cascade process. First of all we assess the predictive value of the confidence measures by means of a descriptive plot. Then, for a sample of descriptive plots computed over training frames, we obtain a generic curve that will be used for sequences with no ground truth. As a second step, we evaluate the obtained general curve and its capabilities to really reflect the predictive value of a confidence measure using the variability across train frames by means of ANOVA.
The presented framework has shown its potential in the application on clinical decision support systems. In particular, we have analyzed the impact of the different image artifacts such as noise and decay to the output of optical flow in a cardiac diagnose system and we have improved the navigation inside the bronchial tree on bronchoscopy.
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Sergio Vera. (2015). Anatomic Registration based on Medial Axis Parametrizations (Debora Gil, & Miguel Angel Gonzalez Ballester, Eds.). Ph.D. thesis, Ediciones Graficas Rey, .
Abstract: Image registration has been for many years the gold standard method to bring two images into correspondence. It has been used extensively in the eld of medical imaging in order to put images of dierent patients into a common overlapping spatial position. However, medical image registration is a slow, iterative optimization process, where many variables and prone to fall into the pit traps local minima.
A coordinate system parameterizing the interior of organs is a powerful tool for a systematic localization of injured tissue. If the same coordinate values are assigned to specic anatomical sites, parameterizations ensure integration of data across different medical image modalities. Harmonic mappings have been used to produce parametric meshes over the surface of anatomical shapes, given their ability to set values at specic locations through boundary conditions. However, most of the existing implementations in medical imaging restrict to either anatomical surfaces, or the depth coordinate with boundary conditions is given at discrete sites of limited geometric diversity.
The medial surface of the shape can be used to provide a continuous basis for the denition of a depth coordinate. However, given that dierent methods for generation of medial surfaces generate dierent manifolds, not all of them are equally suited to be the basis of radial coordinate for a parameterization. It would be desirable that the medial surface will be smooth, and robust to surface shape noise, with low number of spurious branches or surfaces.
In this thesis we present methods for computation of smooth medial manifolds and apply them to the generation of for anatomical volumetric parameterization that extends current harmonic parameterizations to the interior anatomy using information provided by the volume medial surface. This reference system sets a solid base for creating anatomical models of the anatomical shapes, and allows comparing several patients in a common framework of reference.
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Antonio Esteban Lansaque, Carles Sanchez, Agnes Borras, Marta Diez-Ferrer, Antoni Rosell, & Debora Gil. (2016). Stable Anatomical Structure Tracking for video-bronchoscopy Navigation. In 19th International Conference on Medical Image Computing and Computer Assisted Intervention Workshops.
Abstract: Bronchoscopy allows to examine the patient airways for detection of lesions and sampling of tissues without surgery. A main drawback in lung cancer diagnosis is the diculty to check whether the exploration is following the correct path to the nodule that has to be biopsied. The most extended guidance uses uoroscopy which implies repeated radiation of clinical sta and patients. Alternatives such as virtual bronchoscopy or electromagnetic navigation are very expensive and not completely robust to blood, mocus or deformations as to be extensively used. We propose a method that extracts and tracks stable lumen regions at dierent levels of the bronchial tree. The tracked regions are stored in a tree that encodes the anatomical structure of the scene which can be useful to retrieve the path to the lesion that the clinician should follow to do the biopsy. We present a multi-expert validation of our anatomical landmark extraction in 3 intra-operative ultrathin explorations.
Keywords: Lung cancer diagnosis; video-bronchoscopy; airway lumen detection; region tracking
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Debora Gil, Rosa Maria Ortiz, Carles Sanchez, & Antoni Rosell. (2018). Objective endoscopic measurements of central airway stenosis. A pilot study. RES - Respiration, 95, 63–69.
Abstract: Endoscopic estimation of the degree of stenosis in central airway obstruction is subjective and highly variable. Objective: To determine the benefits of using SENSA (System for Endoscopic Stenosis Assessment), an image-based computational software, for obtaining objective stenosis index (SI) measurements among a group of expert bronchoscopists and general pulmonologists. Methods: A total of 7 expert bronchoscopists and 7 general pulmonologists were enrolled to validate SENSA usage. The SI obtained by the physicians and by SENSA were compared with a reference SI to set their precision in SI computation. We used SENSA to efficiently obtain this reference SI in 11 selected cases of benign stenosis. A Web platform with three user-friendly microtasks was designed to gather the data. The users had to visually estimate the SI from videos with and without contours of the normal and the obstructed area provided by SENSA. The users were able to modify the SENSA contours to define the reference SI using morphometric bronchoscopy. Results: Visual SI estimation accuracy was associated with neither bronchoscopic experience (p = 0.71) nor the contours of the normal and the obstructed area provided by the system (p = 0.13). The precision of the SI by SENSA was 97.7% (95% CI: 92.4-103.7), which is significantly better than the precision of the SI by visual estimation (p < 0.001), with an improvement by at least 15%. Conclusion: SENSA provides objective SI measurements with a precision of up to 99.5%, which can be calculated from any bronchoscope using an affordable scalable interface. Providing normal and obstructed contours on bronchoscopic videos does not improve physicians' visual estimation of the SI.
Keywords: Bronchoscopy; Tracheal stenosis; Airway stenosis; Computer-assisted analysis
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Carles Sanchez, Oriol Ramos Terrades, Patricia Marquez, Enric Marti, Jaume Rocarias, & Debora Gil. (2014). Evaluación automática de prácticas en Moodle para el aprendizaje autónomo en Ingenierías.
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Debora Gil, Aura Hernandez-Sabate, David Castells, & Jordi Carrabina. (2017). CYBERH: Cyber-Physical Systems in Health for Personalized Assistance. In International Symposium on Symbolic and Numeric Algorithms for Scientific Computing.
Abstract: Assistance systems for e-Health applications have some specific requirements that demand of new methods for data gathering, analysis and modeling able to deal with SmallData:
1) systems should dynamically collect data from, both, the environment and the user to issue personalized recommendations; 2) data analysis should be able to tackle a limited number of samples prone to include non-informative data and possibly evolving in time due to changes in patient condition; 3) algorithms should run in real time with possibly limited computational resources and fluctuant internet access.
Electronic medical devices (and CyberPhysical devices in general) can enhance the process of data gathering and analysis in several ways: (i) acquiring simultaneously multiple sensors data instead of single magnitudes (ii) filtering data; (iii) providing real-time implementations condition by isolating tasks in individual processors of multiprocessors Systems-on-chip (MPSoC) platforms and (iv) combining information through sensor fusion
techniques.
Our approach focus on both aspects of the complementary role of CyberPhysical devices and analysis of SmallData in the process of personalized models building for e-Health applications. In particular, we will address the design of Cyber-Physical Systems in Health for Personalized Assistance (CyberHealth) in two specific application cases: 1) A Smart Assisted Driving System (SADs) for dynamical assessment of the driving capabilities of Mild Cognitive Impaired (MCI) people; 2) An Intelligent Operating Room (iOR) for improving the yield of bronchoscopic interventions for in-vivo lung cancer diagnosis.
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Marta Diez-Ferrer, Debora Gil, Elena Carreño, Susana Padrones, Samantha Aso, Vanesa Vicens, et al. (2016). Positive Airway Pressure-Enhanced CT to Improve Virtual Bronchoscopic Navigation. CHEST - Chest Journal, 150(4), 1003A.
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Marta Diez-Ferrer, Debora Gil, Elena Carreño, Susana Padrones, & Samantha Aso. (2017). Positive Airway Pressure-Enhanced CT to Improve Virtual Bronchoscopic Navigation. JTO - Journal of Thoracic Oncology, 12(1S), S596–S597.
Abstract: A main weakness of virtual bronchoscopic navigation (VBN) is unsuccessful segmentation of distal branches approaching peripheral pulmonary nodules (PPN). CT scan acquisition protocol is pivotal for segmentation covering the utmost periphery. We hypothesize that application of continuous positive airway pressure (CPAP) during CT acquisition could improve visualization and segmentation of peripheral bronchi. The purpose of the present pilot study is to compare quality of segmentations under 4 CT acquisition modes: inspiration (INSP), expiration (EXP) and both with CPAP (INSP-CPAP and EXP-CPAP).
Keywords: Thorax CT; diagnosis; Peripheral Pulmonary Nodule
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H. Martin Kjer, Jens Fagertun, Sergio Vera, & Debora Gil. (2017). Medial structure generation for registration of anatomical structures. In Skeletonization, Theory, Methods and Applications (Vol. 11).
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Carles Sanchez, Antonio Esteban Lansaque, Agnes Borras, Marta Diez-Ferrer, Antoni Rosell, & Debora Gil. (2017). Towards a Videobronchoscopy Localization System from Airway Centre Tracking. In 12th International Conference on Computer Vision Theory and Applications (pp. 352–359).
Abstract: Bronchoscopists use fluoroscopy to guide flexible bronchoscopy to the lesion to be biopsied without any kind of incision. Being fluoroscopy an imaging technique based on X-rays, the risk of developmental problems and cancer is increased in those subjects exposed to its application, so minimizing radiation is crucial. Alternative guiding systems such as electromagnetic navigation require specific equipment, increase the cost of the clinical procedure and still require fluoroscopy. In this paper we propose an image based guiding system based on the extraction of airway centres from intra-operative videos. Such anatomical landmarks are matched to the airway centreline extracted from a pre-planned CT to indicate the best path to the nodule. We present a
feasibility study of our navigation system using simulated bronchoscopic videos and a multi-expert validation of landmarks extraction in 3 intra-operative ultrathin explorations.
Keywords: Video-bronchoscopy; Lung cancer diagnosis; Airway lumen detection; Region tracking; Guided bronchoscopy navigation
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Debora Gil, Oriol Ramos Terrades, Elisa Minchole, Carles Sanchez, Noelia Cubero de Frutos, Marta Diez-Ferrer, et al. (2017). Classification of Confocal Endomicroscopy Patterns for Diagnosis of Lung Cancer. In 6th Workshop on Clinical Image-based Procedures: Translational Research in Medical Imaging (Vol. 10550, pp. 151–159). LNCS.
Abstract: Confocal Laser Endomicroscopy (CLE) is an emerging imaging technique that allows the in-vivo acquisition of cell patterns of potentially malignant lesions. Such patterns could discriminate between inflammatory and neoplastic lesions and, thus, serve as a first in-vivo biopsy to discard cases that do not actually require a cell biopsy.
The goal of this work is to explore whether CLE images obtained during videobronchoscopy contain enough visual information to discriminate between benign and malign peripheral lesions for lung cancer diagnosis. To do so, we have performed a pilot comparative study with 12 patients (6 adenocarcinoma and 6 benign-inflammatory) using 2 different methods for CLE pattern analysis: visual analysis by 3 experts and a novel methodology that uses graph methods to find patterns in pre-trained feature spaces. Our preliminary results indicate that although visual analysis can only achieve a 60.2% of accuracy, the accuracy of the proposed unsupervised image pattern classification raises to 84.6%.
We conclude that CLE images visual information allow in-vivo detection of neoplastic lesions and graph structural analysis applied to deep-learning feature spaces can achieve competitive results.
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Rosa Maria Ortiz, Debora Gil, Elisa Minchole, Marta Diez-Ferrer, & Noelia Cubero de Frutos. (2017). Classification of Confolcal Endomicroscopy Patterns for Diagnosis of Lung Cancer. In 18th World Conference on Lung Cancer.
Abstract: Confocal Laser Endomicroscopy (CLE) is an emerging imaging technique that allows the in-vivo acquisition of cell patterns of potentially malignant lesions. Such patterns could discriminate between inflammatory and neoplastic lesions and, thus, serve as a first in-vivo biopsy to discard cases that do not actually require a cell biopsy.
The goal of this work is to explore whether CLE images obtained during videobronchoscopy contain enough visual information to discriminate between benign and malign peripheral lesions for lung cancer diagnosis. To do so, we have performed a pilot comparative study with 12 patients (6 adenocarcinoma and 6 benign-inflammatory) using 2 different methods for CLE pattern analysis: visual analysis by 3 experts and a novel methodology that uses graph methods to find patterns in pre-trained feature spaces. Our preliminary results indicate that although visual analysis can only achieve a 60.2% of accuracy, the accuracy of the proposed unsupervised image pattern classification raises to 84.6%.
We conclude that CLE images visual information allow in-vivo detection of neoplastic lesions and graph structural analysis applied to deep-learning feature spaces can achieve competitive results.
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Esmitt Ramirez, Carles Sanchez, Agnes Borras, Marta Diez-Ferrer, Antoni Rosell, & Debora Gil. (2018). Image-Based Bronchial Anatomy Codification for Biopsy Guiding in Video Bronchoscopy. In OR 2.0 Context-Aware Operating Theaters, Computer Assisted Robotic Endoscopy, Clinical Image-Based Procedures, and Skin Image Analysis (Vol. 11041). LNCS.
Abstract: Bronchoscopy examinations allow biopsy of pulmonary nodules with minimum risk for the patient. Even for experienced bronchoscopists, it is difficult to guide the bronchoscope to most distal lesions and obtain an accurate diagnosis. This paper presents an image-based codification of the bronchial anatomy for bronchoscopy biopsy guiding. The 3D anatomy of each patient is codified as a binary tree with nodes representing bronchial levels and edges labeled using their position on images projecting the 3D anatomy from a set of branching points. The paths from the root to leaves provide a codification of navigation routes with spatially consistent labels according to the anatomy observes in video bronchoscopy explorations. We evaluate our labeling approach as a guiding system in terms of the number of bronchial levels correctly codified, also in the number of labels-based instructions correctly supplied, using generalized mixed models and computer-generated data. Results obtained for three independent observers prove the consistency and reproducibility of our guiding system. We trust that our codification based on viewer’s projection might be used as a foundation for the navigation process in Virtual Bronchoscopy systems.
Keywords: Biopsy guiding; Bronchoscopy; Lung biopsy; Intervention guiding; Airway codification
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Esmitt Ramirez, Carles Sanchez, Agnes Borras, Marta Diez-Ferrer, Antoni Rosell, & Debora Gil. (2018). BronchoX: bronchoscopy exploration software for biopsy intervention planning. HTL - Healthcare Technology Letters, 177–182.
Abstract: Virtual bronchoscopy (VB) is a non-invasive exploration tool for intervention planning and navigation of possible pulmonary lesions (PLs). A VB software involves the location of a PL and the calculation of a route, starting from the trachea, to reach it. The selection of a VB software might be a complex process, and there is no consensus in the community of medical software developers in which is the best-suited system to use or framework to choose. The authors present Bronchoscopy Exploration (BronchoX), a VB software to plan biopsy interventions that generate physician-readable instructions to reach the PLs. The authors’ solution is open source, multiplatform, and extensible for future functionalities, designed by their multidisciplinary research and development group. BronchoX is a compound of different algorithms for segmentation, visualisation, and navigation of the respiratory tract. Performed results are a focus on the test the effectiveness of their proposal as an exploration software, also to measure its accuracy as a guiding system to reach PLs. Then, 40 different virtual planning paths were created to guide physicians until distal bronchioles. These results provide a functional software for BronchoX and demonstrate how following simple instructions is possible to reach distal lesions from the trachea.
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Mireia Sole, Joan Blanco, Debora Gil, Oliver Valero, G. Fonseka, M. Lawrie, et al. (2017). Chromosome Territories in Mice Spermatogenesis: A new three-dimensional methodology of study. In 11th European CytoGenesis Conference.
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