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Jaume Garcia, Debora Gil, Luis Badiella, Aura Hernandez-Sabate, Francesc Carreras, Sandra Pujades, et al. (2010). "A Normalized Framework for the Design of Feature Spaces Assessing the Left Ventricular Function " . IEEE Transactions on Medical Imaging, 29(3), 733–745.
Abstract: A through description of the left ventricle functionality requires combining complementary regional scores. A main limitation is the lack of multiparametric normality models oriented to the assessment of regional wall motion abnormalities (RWMA). This paper covers two main topics involved in RWMA assessment. We propose a general framework allowing the fusion and comparison across subjects of different regional scores. Our framework is used to explore which combination of regional scores (including 2-D motion and strains) is better suited for RWMA detection. Our statistical analysis indicates that for a proper (within interobserver variability) identification of RWMA, models should consider motion and extreme strains.
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Aura Hernandez-Sabate, Debora Gil, Eduard Fernandez-Nofrerias, Petia Radeva, & Enric Marti. (2009). "Approaching Artery Rigid Dynamics in IVUS " . IEEE Transactions on Medical Imaging, 28(11), 1670–1680.
Abstract: Tissue biomechanical properties (like strain and stress) are playing an increasing role in diagnosis and long-term treatment of intravascular coronary diseases. Their assessment strongly relies on estimation of vessel wall deformation. Since intravascular ultrasound (IVUS) sequences allow visualizing vessel morphology and reflect its dynamics, this technique represents a useful tool for evaluation of tissue mechanical properties. Image misalignment introduced by vessel-catheter motion is a major artifact for a proper tracking of tissue deformation. In this work, we focus on compensating and assessing IVUS rigid in-plane motion due to heart beating. Motion parameters are computed by considering both the vessel geometry and its appearance in the image. Continuum mechanics laws serve to introduce a novel score measuring motion reduction in in vivo sequences. Synthetic experiments validate the proposed score as measure of motion parameters accuracy; whereas results in in vivo pullbacks show the reliability of the presented methodologies in clinical cases.
Keywords: Fourier analysis; intravascular ultrasound (IVUS) dynamics; longitudinal motion; quality measures; tissue deformation.
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Aura Hernandez-Sabate, Debora Gil, Jaume Garcia, & Enric Marti. (2011). "Image-based Cardiac Phase Retrieval in Intravascular Ultrasound Sequences " . IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control, 58(1), 60–72.
Abstract: Longitudinal motion during in vivo pullbacks acquisition of intravascular ultrasound (IVUS) sequences is a major artifact for 3-D exploring of coronary arteries. Most current techniques are based on the electrocardiogram (ECG) signal to obtain a gated pullback without longitudinal motion by using specific hardware or the ECG signal itself. We present an image-based approach for cardiac phase retrieval from coronary IVUS sequences without an ECG signal. A signal reflecting cardiac motion is computed by exploring the image intensity local mean evolution. The signal is filtered by a band-pass filter centered at the main cardiac frequency. Phase is retrieved by computing signal extrema. The average frame processing time using our setup is 36 ms. Comparison to manually sampled sequences encourages a deeper study comparing them to ECG signals.
Keywords: 3-D exploring; ECG; band-pass filter; cardiac motion; cardiac phase retrieval; coronary arteries; electrocardiogram signal; image intensity local mean evolution; image-based cardiac phase retrieval; in vivo pullbacks acquisition; intravascular ultrasound sequences; longitudinal motion; signal extrema; time 36 ms; band-pass filters; biomedical ultrasonics; cardiovascular system; electrocardiography; image motion analysis; image retrieval; image sequences; medical image processing; ultrasonic imaging
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Aura Hernandez-Sabate, Jose Elias Yauri, Pau Folch, Daniel Alvarez, & Debora Gil. (2024). EEG Dataset Collection for Mental Workload Predictions in Flight-Deck Environment . Sensors, 24(4), 1174.
Abstract: High mental workload reduces human performance and the ability to correctly carry out complex tasks. In particular, aircraft pilots enduring high mental workloads are at high risk of failure, even with catastrophic outcomes. Despite progress, there is still a lack of knowledge about the interrelationship between mental workload and brain functionality, and there is still limited data on flight-deck scenarios. Although recent emerging deep-learning (DL) methods using physiological data have presented new ways to find new physiological markers to detect and assess cognitive states, they demand large amounts of properly annotated datasets to achieve good performance. We present a new dataset of electroencephalogram (EEG) recordings specifically collected for the recognition of different levels of mental workload. The data were recorded from three experiments, where participants were induced to different levels of workload through tasks of increasing cognition demand. The first involved playing the N-back test, which combines memory recall with arithmetical skills. The second was playing Heat-the-Chair, a serious game specifically designed to emphasize and monitor subjects under controlled concurrent tasks. The third was flying in an Airbus320 simulator and solving several critical situations. The design of the dataset has been validated on three different levels: (1) correlation of the theoretical difficulty of each scenario to the self-perceived difficulty and performance of subjects; (2) significant difference in EEG temporal patterns across the theoretical difficulties and (3) usefulness for the training and evaluation of AI models.
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Debora Gil, Rosa Maria Ortiz, Carles Sanchez, & Antoni Rosell. (2018). "Objective endoscopic measurements of central airway stenosis. A pilot study " . 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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Marta Diez-Ferrer, Arturo Morales, Rosa Lopez Lisbona, Noelia Cubero, Cristian Tebe, Susana Padrones, et al. (2019). Ultrathin Bronchoscopy with and without Virtual Bronchoscopic Navigation: Influence of Segmentation on Diagnostic Yield . Respiration, 97(3), 252–258.
Abstract: Background: Bronchoscopy is a safe technique for diagnosing peripheral pulmonary lesions (PPLs), and virtual bronchoscopic navigation (VBN) helps guide the bronchoscope to PPLs. Objectives: We aimed to compare the diagnostic yield of VBN-guided and unguided ultrathin bronchoscopy (UTB) and explore clinical and technical factors associated with better results. We developed a diagnostic algorithm for deciding whether to use VBN to reach PPLs or choose an alternative diagnostic approach. Methods: We compared diagnostic yield between VBN-UTB (prospective cases) and unguided UTB (historical controls) and analyzed the VBN-UTB subgroup to identify clinical and technical variables that could predict the success of VBN-UTB. Results: Fifty-five cases and 110 controls were included. The overall diagnostic yield did not differ between the VBN-guided and unguided arms (47 and 40%, respectively; p = 0.354). Although the yield was slightly higher for PPLs ≤20 mm in the VBN-UTB arm, the difference was not significant (p = 0.069). No other clinical characteristics were associated with a higher yield in a subgroup analysis, but an 85% diagnostic yield was observed when segmentation was optimal and the PPL was endobronchial (vs. 30% when segmentation was suboptimal and 20% when segmentation was optimal but the PPL was extrabronchial). Conclusions: VBN-guided UTB is not superior to unguided UTB. A greater impact of VBN-guided over unguided UTB is highly dependent on both segmentation quality and an endobronchial location of the PPL. Segmentation quality should be considered before starting a procedure, when an alternative technique that may improve yield can be chosen, saving time and resources.
Keywords: Lung cancer; Peripheral lung lesion; Diagnosis; Bronchoscopy; Ultrathin bronchoscopy; Virtual bronchoscopic navigation
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Marta Diez-Ferrer, Debora Gil, Cristian Tebe, & Carles Sanchez. (2018). "Positive Airway Pressure to Enhance Computed Tomography Imaging for Airway Segmentation for Virtual Bronchoscopic Navigation " . Respiration, 96(6), 525–534.
Abstract: Abstract
RATIONALE:
Virtual bronchoscopic navigation (VBN) guidance to peripheral pulmonary lesions is often limited by insufficient segmentation of the peripheral airways.
OBJECTIVES:
To test the effect of applying positive airway pressure (PAP) during CT acquisition to improve segmentation, particularly at end-expiration.
METHODS:
CT acquisitions in inspiration and expiration with 4 PAP protocols were recorded prospectively and compared to baseline inspiratory acquisitions in 20 patients. The 4 protocols explored differences between devices (flow vs. turbine), exposures (within seconds vs. 15-min) and pressure levels (10 vs. 14 cmH2O). Segmentation quality was evaluated with the number of airways and number of endpoints reached. A generalized mixed-effects model explored the estimated effect of each protocol.
MEASUREMENTS AND MAIN RESULTS:
Patient characteristics and lung function did not significantly differ between protocols. Compared to baseline inspiratory acquisitions, expiratory acquisitions after 15 min of 14 cmH2O PAP segmented 1.63-fold more airways (95% CI 1.07-2.48; p = 0.018) and reached 1.34-fold more endpoints (95% CI 1.08-1.66; p = 0.004). Inspiratory acquisitions performed immediately under 10 cmH2O PAP reached 1.20-fold (95% CI 1.09-1.33; p < 0.001) more endpoints; after 15 min the increase was 1.14-fold (95% CI 1.05-1.24; p < 0.001).
CONCLUSIONS:
CT acquisitions with PAP segment more airways and reach more endpoints than baseline inspiratory acquisitions. The improvement is particularly evident at end-expiration after 15 min of 14 cmH2O PAP. Further studies must confirm that the improvement increases diagnostic yield when using VBN to evaluate peripheral pulmonary lesions.
Keywords: Multidetector computed tomography; Bronchoscopy; Continuous positive airway pressure; Image enhancement; Virtual bronchoscopic navigation
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Oriol Rodriguez-Leor, J. Mauri, Eduard Fernandez-Nofrerias, Antonio Tovar, Vicente del Valle, Aura Hernandez-Sabate, et al. (2004)." Utilizacion de la estructura de los campos vectoriales para la deteccion de la Adventicia en imagenes de Ecografia Intracoronaria" . Revista Española de Cardiología, 57(2), 100.
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Oriol Rodriguez-Leor, Debora Gil, & Eduard Fernandez-Nofrerias. (2006)." Analisis en los cambios en el nivel de gris en las secuencias angiograficas mediante descriptores estadisticos para determinar la perfusion miocardica" . Revista Española de Cardiología, 59 Supl 2-166(2), 128.
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Ferran Poveda, Debora Gil, Enric Marti, Albert Andaluz, Manel Ballester, & Francesc Carreras Costa. (2013). "Helical structure of the cardiac ventricular anatomy assessed by Diffusion Tensor Magnetic Resonance Imaging multi-resolution tractography " . Revista Española de Cardiología, 66(10), 782–790.
Abstract: Deep understanding of myocardial structure linking morphology and function of the heart would unravel crucial knowledge for medical and surgical clinical procedures and studies. Several conceptual models of myocardial fiber organization have been proposed but the lack of an automatic and objective methodology prevented an agreement. We sought to deepen in this knowledge through advanced computer graphic representations of the myocardial fiber architecture by diffusion tensor magnetic resonance imaging (DT-MRI).
We performed automatic tractography reconstruction of unsegmented DT-MRI canine heart datasets coming from the public database of the Johns Hopkins University. Full scale tractographies have been build with 200 seeds and are composed by streamlines computed on the vectorial field of primary eigenvectors given at the diffusion tensor volumes. Also, we introduced a novel multi-scale visualization technique in order to obtain a simplified tractography. This methodology allowed to keep the main geometric features of the fiber tracts, making easier to decipher the main properties of the architectural organization of the heart.
On the analysis of the output from our tractographic representations we found exact correlation with low-level details of myocardial architecture, but also with the more abstract conceptualization of a continuous helical ventricular myocardial fiber array.
Objective analysis of myocardial architecture by an automated method, including the entire myocardium and using several 3D levels of complexity, reveals a continuous helical myocardial fiber arrangement of both right and left ventricles, supporting the anatomical model of the helical ventricular myocardial band described by Torrent-Guasp.
Keywords: Heart;Diffusion magnetic resonance imaging;Diffusion tractography;Helical heart;Myocardial ventricular band.
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