2018 |
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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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2017 |
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Carles Sanchez, Antonio Esteban Lansaque, Agnes Borras, Marta Diez-Ferrer, Antoni Rosell, & Debora Gil. (2017). "Towards a Videobronchoscopy Localization System from Airway Centre Tracking " In 12th International Conference on Computer Vision Theory and Applications (pp. 352–359).
Abstract: Bronchoscopists use fluoroscopy to guide flexible bronchoscopy to the lesion to be biopsied without any kind of incision. Being fluoroscopy an imaging technique based on X-rays, the risk of developmental problems and cancer is increased in those subjects exposed to its application, so minimizing radiation is crucial. Alternative guiding systems such as electromagnetic navigation require specific equipment, increase the cost of the clinical procedure and still require fluoroscopy. In this paper we propose an image based guiding system based on the extraction of airway centres from intra-operative videos. Such anatomical landmarks are matched to the airway centreline extracted from a pre-planned CT to indicate the best path to the nodule. We present a
feasibility study of our navigation system using simulated bronchoscopic videos and a multi-expert validation of landmarks extraction in 3 intra-operative ultrathin explorations.
Keywords: Video-bronchoscopy; Lung cancer diagnosis; Airway lumen detection; Region tracking; Guided bronchoscopy navigation
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Debora Gil, Aura Hernandez-Sabate, David Castells, & Jordi Carrabina. (2017). "CYBERH: Cyber-Physical Systems in Health for Personalized Assistance " In International Symposium on Symbolic and Numeric Algorithms for Scientific Computing.
Abstract: Assistance systems for e-Health applications have some specific requirements that demand of new methods for data gathering, analysis and modeling able to deal with SmallData:
1) systems should dynamically collect data from, both, the environment and the user to issue personalized recommendations; 2) data analysis should be able to tackle a limited number of samples prone to include non-informative data and possibly evolving in time due to changes in patient condition; 3) algorithms should run in real time with possibly limited computational resources and fluctuant internet access.
Electronic medical devices (and CyberPhysical devices in general) can enhance the process of data gathering and analysis in several ways: (i) acquiring simultaneously multiple sensors data instead of single magnitudes (ii) filtering data; (iii) providing real-time implementations condition by isolating tasks in individual processors of multiprocessors Systems-on-chip (MPSoC) platforms and (iv) combining information through sensor fusion
techniques.
Our approach focus on both aspects of the complementary role of CyberPhysical devices and analysis of SmallData in the process of personalized models building for e-Health applications. In particular, we will address the design of Cyber-Physical Systems in Health for Personalized Assistance (CyberHealth) in two specific application cases: 1) A Smart Assisted Driving System (SADs) for dynamical assessment of the driving capabilities of Mild Cognitive Impaired (MCI) people; 2) An Intelligent Operating Room (iOR) for improving the yield of bronchoscopic interventions for in-vivo lung cancer diagnosis.
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Debora Gil, Oriol Ramos Terrades, Elisa Minchole, Carles Sanchez, Noelia Cubero de Frutos, Marta Diez-Ferrer, et al. (2017). "Classification of Confocal Endomicroscopy Patterns for Diagnosis of Lung Cancer " In 6th Workshop on Clinical Image-based Procedures: Translational Research in Medical Imaging (Vol. 10550, pp. 151–159).
Abstract: Confocal Laser Endomicroscopy (CLE) is an emerging imaging technique that allows the in-vivo acquisition of cell patterns of potentially malignant lesions. Such patterns could discriminate between inflammatory and neoplastic lesions and, thus, serve as a first in-vivo biopsy to discard cases that do not actually require a cell biopsy.
The goal of this work is to explore whether CLE images obtained during videobronchoscopy contain enough visual information to discriminate between benign and malign peripheral lesions for lung cancer diagnosis. To do so, we have performed a pilot comparative study with 12 patients (6 adenocarcinoma and 6 benign-inflammatory) using 2 different methods for CLE pattern analysis: visual analysis by 3 experts and a novel methodology that uses graph methods to find patterns in pre-trained feature spaces. Our preliminary results indicate that although visual analysis can only achieve a 60.2% of accuracy, the accuracy of the proposed unsupervised image pattern classification raises to 84.6%.
We conclude that CLE images visual information allow in-vivo detection of neoplastic lesions and graph structural analysis applied to deep-learning feature spaces can achieve competitive results.
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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 con dent 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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H. Martin, Jens Fagertun, Sergio Vera, & Debora Gil. (2017). "Medial structure generation for registration of anatomical structures " In Skeletonization, Theory, Methods and Applications (Vol. 11).
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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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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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Mireia Sole, Joan Blanco, Debora Gil, Oliver Valero, G. Fonseka, M. Lawrie, et al. (2017). "Chromosome Territories in Mice Spermatogenesis: A new three-dimensional methodology of study " In 11th European CytoGenesis Conference.
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Mireia Sole, Joan Blanco, Debora Gil, G. Fonseka, Richard Frodsham, Francesca Vidal, et al. (2017). "Noves perspectives en l estudi de la territorialitat cromosomica de cel·lules germinals masculines: estudis tridimensionals " . Biologia de la Reproduccio, 15, 73–78.
Abstract: In somatic cells, chromosomes occupy specific nuclear regions called chromosome territories which are involved in the
maintenance and regulation of the genome. Preliminary data in male germ cells also suggest the importance of chromosome
territoriality in cell functionality. Nevertheless, the specific characteristics of testicular tissue (presence of different
cell types with different morphological characteristics, in different stages of development and with different ploidy)
makes difficult to achieve conclusive results. In this study we have developed a methodology to approach the threedimensional
study of all chromosome territories in male germ cells from C57BL/6J mice (Mus musculus). The method
includes the following steps: i) Optimized cell fixation to obtain an optimal preservation of the three-dimensionality cell
morphology, ii) Chromosome identification by FISH (Chromoprobe Multiprobe® OctoChrome™ Murine System; Cytocell)
and confocal microscopy (TCS-SP5, Leica Microsystems), iii) Cell type identification by immunofluorescence
iv) Image analysis using Matlab scripts, v) Numerical data extraction related to chromosome features, chromosome
radial position and chromosome relative position. This methodology allows the unequivocally identification and the
analysis of the chromosome territories of all spermatogenic stages. Results will provide information about the features
that determine chromosomal position, preferred associations between chromosomes, and the relationship between chromosome
positioning and genome regulation.
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