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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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Enric Marti. (2008)." Aplicació de la metodología d’Aprenentatge basat en Proyectes en l’assignatura de Gràfics per Computador d’enginyeria Informàtica. Balanç de Quatre anys d’experiència" (Vol. 6).
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Mireia Sole, Joan Blanco, Debora Gil, G. Fonseka, Richard Frodsham, Oliver Valero, et al. (2017)." Análisis 3d de la territorialidad cromosómica en células espermatogénicas: explorando la infertilidad desde un nuevo prisma" . Revista Asociación para el Estudio de la Biología de la Reproducción, 22(2), 105.
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Oriol Rodriguez-Leon.A.Carol, H.Tizon, Eduard Fernandez-Nofrerias, Josefina Mauri, Vicente del Valle, Debora Gil, et al. (2005)." Model estadístic-determinístic per la segmentació de l adventicia en imatges d ecografía intracoronaria" . Rev Societat Catalana Cardiologia, 5, 41.
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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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Josep Llados, Ernest Valveny, & Enric Marti. (2000)." Symbol Recognition in Document Image Analysis: Methods and Challenges" . Recent Research Developments in Pattern Recognition, Transworld Research Network,, 1, 151–178.
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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, & Petia Radeva. (2004). "Inhibition of False Landmarks " In J. V. et al (Ed.), Recent Advances in Artificial Intelligence Research and Development (pp. 233–244). Barcelona (Spain): IOS Press.
Abstract: We argue that a corner detector should be based on the degree of continuity of the tangent vector to the image level sets, work on the image domain and need no assumptions on neither the image local structure nor the particular geometry of the corner/junction. An operator measuring the degree of differentiability of the projection matrix on the image gradient fulfills the above requirements. Its high sensitivity to changes in vector directions makes it suitable for landmark location in real images prone to need smoothing to reduce the impact of noise. Because using smoothing kernels leads to corner misplacement, we suggest an alternative fake response remover based on the receptive field inhibition of spurious details. The combination of both orientation discontinuity detection and noise inhibition produce our Inhibition Orientation Energy (IOE) landmark locator.
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