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Jorge Bernal, F. Javier Sanchez, Gloria Fernandez Esparrach, Debora Gil, Cristina Rodriguez de Miguel, & Fernando Vilariño. (2015). "WM-DOVA Maps for Accurate Polyp Highlighting in Colonoscopy: Validation vs. Saliency Maps from Physicians " . Computerized Medical Imaging and Graphics, 43, 99–111.
Abstract: We introduce in this paper a novel polyp localization method for colonoscopy videos. Our method is based on a model of appearance for polyps which defines polyp boundaries in terms of valley information. We propose the integration of valley information in a robust way fostering complete, concave and continuous boundaries typically associated to polyps. This integration is done by using a window of radial sectors which accumulate valley information to create WMDOVA1 energy maps related with the likelihood of polyp presence. We perform a double validation of our maps, which include the introduction of two new databases, including the first, up to our knowledge, fully annotated database with clinical metadata associated. First we assess that the highest value corresponds with the location of the polyp in the image. Second, we show that WM-DOVA energy maps can be comparable with saliency maps obtained from physicians' fixations obtained via an eye-tracker. Finally, we prove that our method outperforms state-of-the-art computational saliency results. Our method shows good performance, particularly for small polyps which are reported to be the main sources of polyp miss-rate, which indicates the potential applicability of our method in clinical practice.
Keywords: Polyp localization; Energy Maps; Colonoscopy; Saliency; Valley detection
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Carles Sanchez, Jorge Bernal, F. Javier Sanchez, Antoni Rosell, Marta Diez-Ferrer, & Debora Gil. (2015). "Towards On-line Quantification of Tracheal Stenosis from Videobronchoscopy " . International Journal of Computer Assisted Radiology and Surgery, 10(6), 935–945.
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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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Marta Diez-Ferrer, Debora Gil, Elena Carreño, Susana Padrones, & Samantha Aso. (2017). Positive Airway Pressure-Enhanced CT to Improve Virtual Bronchoscopic Navigation . 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 Fagertuna, Sergio Vera, Debora Gil, Miguel Angel Gonzalez Ballester, & Rasmus R. Paulsena. (2016). "Free-form image registration of human cochlear uCT data using skeleton similarity as anatomical prior " . Patter Recognition Letters, 76(1), 76–82.
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Marta Diez-Ferrer, Debora Gil, Elena Carreño, Susana Padrones, Samantha Aso, Vanesa Vicens, et al. (2017). "Positive Airway Pressure-Enhanced CT to Improve Virtual Bronchoscopic Navigation " . European Respiratory Journal, .
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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, Debora Gil, Elena Carreño, Susana Padrones, Samantha Aso, Vanesa Vicens, et al. (2016). Positive Airway Pressure-Enhanced CT to Improve Virtual Bronchoscopic Navigation . Chest Journal, 150(4), 1003A.
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Debora Gil, Ruth Aris, Agnes Borras, Esmitt Ramirez, Rafael Sebastian, & Mariano Vazquez. (2019). "Influence of fiber connectivity in simulations of cardiac biomechanics " . International Journal of Computer Assisted Radiology and Surgery, 14(1), 63–72.
Abstract: PURPOSE:
Personalized computational simulations of the heart could open up new improved approaches to diagnosis and surgery assistance systems. While it is fully recognized that myocardial fiber orientation is central for the construction of realistic computational models of cardiac electromechanics, the role of its overall architecture and connectivity remains unclear. Morphological studies show that the distribution of cardiac muscular fibers at the basal ring connects epicardium and endocardium. However, computational models simplify their distribution and disregard the basal loop. This work explores the influence in computational simulations of fiber distribution at different short-axis cuts.
METHODS:
We have used a highly parallelized computational solver to test different fiber models of ventricular muscular connectivity. We have considered two rule-based mathematical models and an own-designed method preserving basal connectivity as observed in experimental data. Simulated cardiac functional scores (rotation, torsion and longitudinal shortening) were compared to experimental healthy ranges using generalized models (rotation) and Mahalanobis distances (shortening, torsion).
RESULTS:
The probability of rotation was significantly lower for ruled-based models [95% CI (0.13, 0.20)] in comparison with experimental data [95% CI (0.23, 0.31)]. The Mahalanobis distance for experimental data was in the edge of the region enclosing 99% of the healthy population.
CONCLUSIONS:
Cardiac electromechanical simulations of the heart with fibers extracted from experimental data produce functional scores closer to healthy ranges than rule-based models disregarding architecture connectivity.
Keywords: Cardiac electromechanical simulations; Diffusion tensor imaging; Fiber connectivity
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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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