Abstract: Early diagnosis and accurate treatment of Left Ventricle (LV) dysfunction significantly increases the patient survival. Impairment of LV contractility due to cardiovascular diseases is reflected in its motion patterns. Recent advances in medical imaging, such as Magnetic Resonance (MR), have encouraged research on 3D simulation and modelling of the LV dynamics. Most of the existing 3D models consider just the gross anatomy of the LV and restore a truncated ellipse which deforms along the cardiac cycle. The contraction mechanics of any muscle strongly depends on the spatial orientation of its muscular fibers since the motion that the muscle undergoes mainly takes place along the fibers. It follows that such simplified models do not allow evaluation of the heart electro-mechanical function and coupling, which has recently risen as the key point for understanding the LV functionality . In order to thoroughly understand the LV mechanics it is necessary to consider the complete anatomy of the LV given by the orientation of the myocardial fibres in 3D space as described by Torrent Guasp. We propose developing a 3D patient-sensitive model of the LV integrating, for the first time, the ven- tricular band anatomy (fibers orientation), the LV gross anatomy and its functionality. Such model will represent the LV function as a natural consequence of its own ventricular band anatomy. This might be decisive in restoring a proper LV contraction in patients undergoing pace marker treatment. The LV function is defined as soon as the propagation of the contractile electromechanical pulse has been modelled. In our experiments we have used the wave equation for the propagation of the electric pulse. The electromechanical wave moves on the myocardial surface and should have a conductivity tensor oriented along the muscular fibers. Thus, whatever mathematical model for electric pulse propa- gation [4] we consider, the complete anatomy of the LV should be extracted. The LV gross anatomy is obtained by processing multi slice MR images recorded for each patient. Information about the myocardial fibers distribution can only be extracted by Diffusion Tensor Imag- ing (DTI), which can not provide in vivo information for each patient. As a first approach, we have computed an average model of fibers from several DTI studies of canine hearts. This rough anatomy is the input for our electro-mechanical propagation model simulating LV dynamics. The average fiber orientation is updated until the simulated LV motion agrees with the experimental evidence provided by the LV motion observed in tagged MR (TMR) sequences. Experimental LV motion is recovered by applying image processing, differential geometry and interpolation techniques to 2D TMR slices [5]. The pipeline in figure 1 outlines the interaction between simulations and experimental data leading to our patient-tailored model.

Abstract: Cardiac diseases are diagnosed and treated through a study of the morphology and dynamics of cardiac arteries. In- travascular Ultrasound (IVUS) imaging is of high interest to physicians since it provides both information. At the current state-of-the-art in image segmentation, a robust detection of the arterial lumen in IVUS demands manual intervention or ECG-gating. Manual intervention is a tedious and time consuming task that requires experienced observers, meanwhile ECG-gating is an acquisition technique not available in all clinical centers. We introduce a parametric algorithm that detects the arterial luminal border in in vivo sequences. The method consist in smoothing the sequences’ level surfaces under a regularized mean curvature flow that admits non-trivial steady states. The flow is based on a measure of the surface local smoothness that takes into account regularity of the surface curvature.

Abstract: Deep understanding of myocardial structure may help to link form and funcion of the heart unraveling crucial knowledge for medical and surgical clinical procedures and studies. In this work we introduce two visualization techniques based on DT-MRI streamlining able to decipher interesting properties of the architectural organization of the heart.

Abstract: Three-dimensional intravascular ultrasound (IVUS) allows to visualize and obtain volumetric measurements of coronary lesions through an exploration of the cross sections and longitudinal views of arteries. However, the visualization and subsequent morpho-geometric measurements in IVUS longitudinal cuts are subject to distortion caused by periodic image/vessel motion around the IVUS catheter. Usually, to overcome the image motion artifact ECG-gating and image-gated approaches are proposed, leading to slowing the pullback acquisition or disregarding part of IVUS data. In this paper, we argue that the image motion is due to 3-D vessel geometry as well as cardiac dynamics, and propose a dynamic model based on the tracking of an elliptical vessel approximation to recover the rigid transformation and align IVUS images without loosing any IVUS data. We report an extensive validation with synthetic simulated data and in vivo IVUS sequences of 30 patients achieving an average reduction of the image artifact of 97% in synthetic data and 79% in real-data. Our study shows that IVUS alignment improves longitudinal analysis of the IVUS data and is a necessary step towards accurate reconstruction and volumetric measurements of 3-D IVUS.

Abstract: Intravascular ultrasound images represent a unique tool to analyze the morphology of arteries and vessels (plaques, restenosis, etc). The poor quality of these images makes unsupervised segmentation based on traditional segmentation algorithms (such as edge or ridge/valley detection) fail to achieve the expected results. In this paper we present a probabilistic flexible template to separate different regions in the image. In particular, we use elliptic templates to model and detect the shape of the vessel inner wall in IVUS images. We present the results of successful segmentation obtained from patients undergoing stent treatment. A physician team has validated these results.