Abstract: Restoration of coronary flow after primary percutaneous coronary intervention in acute myocardial infarction does not always correlate with adequate myocardial perfusion. Recently, coronary angiography has been used to assess microcirculation integrity (Myocardial BlushAnalysis, MBA). Although MBA correlates with patient prognosis there are few image processing methods addressing objective perfusion quantification. The goal of this work is to develop statistical descriptors of the myocardial dyeing pattern allowing objective assessment of myocardial perfusion. Experiments on healthy right coronary arteries show that our approach allows reliable measurements without any specific image acquisition protocol.

Abstract: Any image filtering operator designed for automatic shape restoration should satisfy robustness (whatever the nature and degree of noise is) as well as non-trivial smooth asymptotic behavior. Moreover, a stopping criterion should be determined by characteristics of the evolved image rather than dependent on the number of iterations. Among the several PDE based techniques, curvature flows appear to be highly reliable for strongly noisy images compared to image diffusion processes.
In the present paper, we introduce a regularized curvature flow (RCF) that admits non-trivial steady states. It is based on a measure of the local curve smoothness that takes into account regularity of the curve curvature and serves as stopping term in the mean curvature flow. We prove that this measure decreases over the orbits of RCF, which endows the method with a natural stop criterion in terms of the magnitude of this measure. Further, in its discrete version it produces steady states consisting of piece-wise regular curves. Numerical experiments made on synthetic shapes corrupted with different kinds of noise show the abilities and limitations of each of the current geometric flows and the benefits of RCF. Finally, we present results on real images that illustrate the usefulness of the present approach in practical applications.

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.

Abstract: Cardiovascular diseases are a leading cause of death in developed countries. Most of them are caused by arterial (specially coronary) diseases, mainly caused by plaque accumulation. Such pathology narrows blood flow (stenosis) and affects artery bio- mechanical elastic properties (atherosclerosis). In the last decades, IntraVascular UltraSound (IVUS) has become a usual imaging technique for the diagnosis and follow up of arterial diseases. IVUS is a catheter-based imaging technique which shows a sequence of cross sections of the artery under study. Inspection of a single image gives information about the percentage of stenosis. Meanwhile, inspection of longitudinal views provides information about artery bio-mechanical properties, which can prevent a fatal outcome of the cardiovascular disease. On one hand, dynamics of arteries (due to heart pumping among others) is a major artifact for exploring tissue bio-mechanical properties. On the other one, manual stenosis measurements require a manual tracing of vessel borders, which is a time-consuming task and might suffer from inter-observer variations. This PhD thesis proposes several image processing tools for exploring vessel dy- namics and structures. We present a physics-based model to extract, analyze and correct vessel in-plane rigid dynamics and to retrieve cardiac phase. Furthermore, we introduce a deterministic-statistical method for automatic vessel borders detection. In particular, we address adventitia layer segmentation. An accurate validation pro- tocol to ensure reliable clinical applicability of the methods is a crucial step in any proposal of an algorithm. In this thesis we take special care in designing a valida- tion protocol for each approach proposed and we contribute to the in vivo dynamics validation with a quantitative and objective score to measure the amount of motion suppressed.

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.