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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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Jaume Garcia, Petia Radeva, & Francesc Carreras. (2004). "Combining Spectral and Active Shape methods to Track Tagged MRI " In Recent Advances in Artificial Intelligence Research and Development (pp. 37–44). IOS Press.
Abstract: Tagged magnetic resonance is a very usefull and unique tool that provides a complete local and global knowledge of the left ventricle (LV) motion. In this article we introduce a method capable of tracking and segmenting the LV. Spectral methods are applied in order to obtain the so called HARP images which encode information about movement and are the base for LV point-tracking. For segmentation we use Active Shapes (ASM) that model LV shape variation in order to overcome possible local misplacements of the boundary. We finally show experiments on both synthetic and real data which appear to be very promising.
Keywords: MR; tagged MR; ASM; LV segmentation; motion estimation.
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Debora Gil, Agnes Borras, Sergio Vera, & Miguel Angel Gonzalez Ballester. (2013). "A Validation Benchmark for Assessment of Medial Surface Quality for Medical Applications " In 9th International Conference on Computer Vision Systems (Vol. 7963, pp. 334–343). Springer Berlin Heidelberg.
Abstract: Confident use of medial surfaces in medical decision support systems requires evaluating their quality for detecting pathological deformations and describing anatomical volumes. Validation in the medical imaging field is a challenging task mainly due to the difficulties for getting consensual ground truth. In this paper we propose a validation benchmark for assessing medial surfaces in the context of medical applications. Our benchmark includes a home-made database of synthetic medial surfaces and volumes and specific scores for evaluating surface accuracy, its stability against volume deformations and its capabilities for accurate reconstruction of anatomical volumes.
Keywords: Medial Surfaces; Shape Representation; Medical Applications; Performance Evaluation
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Sergio Vera, Miguel Angel Gonzalez Ballester, & Debora Gil. (2012). "Optimal Medial Surface Generation for Anatomical Volume Representations " In MichaelW. David and Vannier H. and H. Yoshida (Ed.), Abdominal Imaging. Computational and Clinical Applications (Vol. 7601, pp. 265–273). Lecture Notes in Computer Science. Springer Berlin Heidelberg.
Abstract: Medial representations are a widely used technique in abdominal organ shape representation and parametrization. Those methods require good medial manifolds as a starting point. Any medial
surface used to parametrize a volume should be simple enough to allow an easy manipulation and complete enough to allow an accurate reconstruction of the volume. Obtaining good quality medial
surfaces is still a problem with current iterative thinning methods. This forces the usage of generic, pre-calculated medial templates that are adapted to the final shape at the cost of a drop in volume reconstruction.
This paper describes an operator for generation of medial structures that generates clean and complete manifolds well suited for their further use in medial representations of abdominal organ volumes. While being simpler than thinning surfaces, experiments show its high performance in volume reconstruction and preservation of medial surface main branching topology.
Keywords: Medial surface representation; volume reconstruction
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Sergio Vera, Miguel Angel Gonzalez Ballester, & Debora Gil. (2012). "A medial map capturing the essential geometry of organs " In ISBI Workshop on Open Source Medical Image Analysis software (1691 - 1694). IEEE.
Abstract: Medial representations are powerful tools for describing and parameterizing the volumetric shape of anatomical structures. Accurate computation of one pixel wide medial surfaces is mandatory. Those surfaces must represent faithfully the geometry of the volume. Although morphological methods produce excellent results in 2D, their complexity and quality drops across dimensions, due to a more complex description of pixel neighborhoods. This paper introduces a continuous operator for accurate and efficient computation of medial structures of arbitrary dimension. Our experiments show its higher performance for medical imaging applications in terms of simplicity of medial structures and capability for reconstructing the anatomical volume
Keywords: Medial Surface Representation, Volume Reconstruction,Geometry , Image reconstruction , Liver , Manifolds , Shape , Surface morphology , Surface reconstruction
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Debora Gil, Sergio Vera, Agnes Borras, Albert Andaluz, & Miguel Angel Gonzalez Ballester. (2017). "Anatomical Medial Surfaces with Efficient Resolution of Branches Singularities " . Medical Image Analysis, 35, 390–402.
Abstract: Medial surfaces are powerful tools for shape description, but their use has been limited due to the sensibility existing methods to branching artifacts. Medial branching artifacts are associated to perturbations of the object boundary rather than to geometric features. Such instability is a main obstacle for a condent application in shape recognition and description. Medial branches correspond to singularities of the medial surface and, thus, they are problematic for existing morphological and energy-based algorithms. In this paper, we use algebraic geometry concepts in an energy-based approach to compute a medial surface presenting a stable branching topology. We also present an ecient GPU-CPU implementation using standard image processing tools. We show the method computational eciency and quality on a custom made synthetic database. Finally, we present some results on a medical imaging application for localization of abdominal pathologies.
Keywords: Medial Representations; Shape Recognition; Medial Branching Stability ; Singular Points
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Sergio Vera, Debora Gil, Agnes Borras, Marius George Linguraru, & Miguel Angel Gonzalez Ballester. (2013). "Geometric Steerable Medial Maps " . Machine Vision and Applications, 24(6), 1255–1266.
Abstract: In order to provide more intuitive and easily interpretable representations of complex shapes/organs, medial manifolds should reach a compromise between simplicity in geometry and capability for restoring the anatomy/shape of the organ/volume. Existing morphological methods show excellent results when applied to 2D objects, but their quality drops across dimensions.
This paper contributes to the computation of medial manifolds in two aspects. First, we provide a standard scheme for the computation of medial manifolds that avoids degenerated medial axis segments. Second, we introduce a continuous operator for accurate and efficient computation of medial structures of arbitrary dimension. We evaluate quantitatively the performance of our method with respect to existing approaches, by applying them to syn- thetic shapes of known medial geometry. We also show its higher performance for medical imaging applications in terms of simplicity of medial structures and capability for reconstructing the anatomical volume.
Keywords: Medial Representations ,Medial Manifolds Comparation , Surface , Reconstruction
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Sergio Vera, Debora Gil, Agnes Borras, F. Javier Sanchez, Frederic Perez, Marius G. Linguraru, et al. (2012). "Computation and Evaluation of Medial Surfaces for Shape Representation of Abdominal Organs " In H. Yoshida et al (Ed.), Workshop on Computational and Clinical Applications in Abdominal Imaging (Vol. 7029, 223–230). Lecture Notes in Computer Science. Berlin: Springer Link.
Abstract: Medial representations are powerful tools for describing and parameterizing the volumetric shape of anatomical structures. Existing methods show excellent results when applied to 2D
objects, but their quality drops across dimensions. This paper contributes to the computation of medial manifolds in two aspects. First, we provide a standard scheme for the computation of medial
manifolds that avoid degenerated medial axis segments; second, we introduce an energy based method which performs independently of the dimension. We evaluate quantitatively the performance of our
method with respect to existing approaches, by applying them to synthetic shapes of known medial geometry. Finally, we show results on shape representation of multiple abdominal organs,
exploring the use of medial manifolds for the representation of multi-organ relations.
Keywords: medial manifolds, abdomen.
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Francesc Carreras, Jaume Garcia, Debora Gil, Sandra Pujadas, Chi ho Lion, R.Suarez-Arias, et al. (2012). "Left ventricular torsion and longitudinal shortening: two fundamental components of myocardial mechanics assessed by tagged cine-MRI in normal subjects " . International Journal of Cardiovascular Imaging, 28(2), 273–284.
Abstract: Cardiac magnetic resonance imaging (Cardiac MRI) has become a gold standard diagnostic technique for the assessment of cardiac mechanics, allowing the non-invasive calculation of left ventric- ular long axis longitudinal shortening (LVLS) and absolute myocardial torsion (AMT) between basal and apical left ventricular slices, a movement directly related to the helicoidal anatomic disposition of the myocardial fibers. The aim of this study is to determine AMT and LVLS behaviour and normal values from a group of healthy subjects. A group of 21 healthy volunteers (15 males) (age: 23–55 y.o., mean:30.7 ± 7.5) were prospectively included in an obser- vational study by Cardiac MRI. Left ventricular rotation (degrees) was calculated by custom-made software (Harmonic Phase Flow) in consecutive LV short axis planes tagged cine-MRI sequences. AMT was determined from the difference between basal and apical planes LV rotations. LVLS (%) was determined from the LV longitudinal and horizontal axis cine-MRI images. All the 21 cases studied were interpretable, although in three cases the value of the LV apical rotation could not be determined. The mean rotation of the basal and apical planes at end-systole were -3.71° ± 0.84° and 6.73° ± 1.69° (n:18) respectively, resulting in a LV mean AMT of 10.48° ± 1.63° (n:18). End-systolic mean LVLS was 19.07 ± 2.71%. Cardiac MRI allows for the calculation of AMT and LVLS, fundamental functional components of the ventricular twist mechanics conditioned, in turn, by the anatomical helical layout of the myocardial fibers. These values provide complementary information about systolic ventricular function in relation to the traditional parameters used in daily practice.
Keywords: Magnetic resonance imaging (MRI); Tagging MRI; Cardiac mechanics; Ventricular torsion
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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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