Improved robustness of multi-component analysis in amplitude envelope statistics using plane waves

We compared the evaluation accuracy of amplitude envelope statistics under the transmission and reception conditions of compounded plane wave imaging (CPWI) and focused beam imaging (FBI). In a basic study using a homogeneous phantom, we found that the amplitude gradient in the depth direction and the point spread function in the lateral direction spread in the FBI reduced the accuracy of evaluation in amplitude envelope statistics. On the other hand, CPWI showed a more stable evaluation than FBI because of the elimination of sound field characteristics. In CPWI, the multi-Rayleigh model discriminated signals from two types of scatterer with high accuracy in the evaluation using phantoms mimicking fatty liver. It was confirmed that the combination of CPWI and the multi-Rayleigh model is effective for detecting early fatty liver disease. The results show that CPWI is effective for improving the robustness of amplitude envelope statistics.

Efficient Johnson-SB Mixture Model for Segmentation of CT Liver Image

To overcome the problem that the traditional Gaussian mixture model (GMM) cannot well describe the skewness distribution of the gray-level histogram of a liver CT slice, we propose a novel segmentation method for liver CT images by introducing the Johnson-SB mixture model (J_SBMM). The Johnson-SB model not only has a flexible asymmetrical distribution but also covers a variety of other distributions as well. In this article, the parameter optimization formulas for J_SBMM were derived by employing the expectation-maximization (EM) algorithm and maximum likelihood. The implementation process of the J_SBMM-based segmentation algorithm is provided in detail. To make better use of the skewness of Johnson-SB and improve the segmentation accuracy, we devise an idea to divide the histogram into two parts and calculate the segmentation threshold for each part, respectively, which is called J_SBMM-TDH. By analyzing and comparing the segmentation thresholds with different cluster numbers, it is illustrated that the segmentation threshold of J_SBMM-TDH will tend to be stable with the increasing of cluster number, while that of GMM is sensitive to different cluster numbers. The proposed J_SBMM-TDH is applied to segment four randomly obtained abdominal CT image sequences, and the segmentation results and robustness have been compared between J_SBMM-TDH and GMM. It is verified that J_SBMM-TDH has preferable segmentation results and better robustness than GMM for the segmentation of liver CT images.

Ten Fast Transfer Learning Models for Carotid Ultrasound Plaque Tissue Characterization in Augmentation Framework Embedded with Heatmaps for Stroke Risk Stratification

Background and Purpose: Only 1-2% of the internal carotid artery asymptomatic plaques are unstable as a result of >80% stenosis. Thus, unnecessary efforts can be saved if these plaques can be characterized and classified into symptomatic and asymptomatic using non-invasive B-mode ultrasound. Earlier plaque tissue characterization (PTC) methods were machine learning (ML)-based, which used hand-crafted features that yielded lower accuracy and unreliability. The proposed study shows the role of transfer learning (TL)-based deep learning models for PTC. Methods: As pertained weights were used in the supercomputer framework, we hypothesize that transfer learning (TL) provides improved performance compared with deep learning. We applied 11 kinds of artificial intelligence (AI) models, 10 of them were augmented and optimized using TL approaches-a class of Atheromatic™ 2.0 TL (AtheroPoint™, Roseville, CA, USA) that consisted of (i-ii) Visual Geometric Group-16, 19 (VGG16, 19); (iii) Inception V3 (IV3); (iv-v) DenseNet121, 169; (vi) XceptionNet; (vii) ResNet50; (viii) MobileNet; (ix) AlexNet; (x) SqueezeNet; and one DL-based (xi) SuriNet-derived from UNet. We benchmark 11 AI models against our earlier deep convolutional neural network (DCNN) model. Results: The best performing TL was MobileNet, with accuracy and area-under-the-curve (AUC) pairs of 96.10 ± 3% and 0.961 (p < 0.0001), respectively. In DL, DCNN was comparable to SuriNet, with an accuracy of 95.66% and 92.7 ± 5.66%, and an AUC of 0.956 (p < 0.0001) and 0.927 (p < 0.0001), respectively. We validated the performance of the AI architectures with established biomarkers such as greyscale median (GSM), fractal dimension (FD), higher-order spectra (HOS), and visual heatmaps. We benchmarked against previously developed Atheromatic™ 1.0 ML and showed an improvement of 12.9%. Conclusions: TL is a powerful AI tool for PTC into symptomatic and asymptomatic plaques.

Fast Approximations of the Jeffreys Divergence between Univariate Gaussian Mixtures via Mixture Conversions to Exponential-Polynomial Distributions

The Jeffreys divergence is a renown arithmetic symmetrization of the oriented Kullback–Leibler divergence broadly used in information sciences. Since the Jeffreys divergence between Gaussian mixture models is not available in closed-form, various techniques with advantages and disadvantages have been proposed in the literature to either estimate, approximate, or lower and upper bound this divergence. In this paper, we propose a simple yet fast heuristic to approximate the Jeffreys divergence between two univariate Gaussian mixtures with arbitrary number of components. Our heuristic relies on converting the mixtures into pairs of dually parameterized probability densities belonging to an exponential-polynomial family. To measure with a closed-form formula the goodness of fit between a Gaussian mixture and an exponential-polynomial density approximating it, we generalize the Hyvärinen divergence to α-Hyvärinen divergences. In particular, the 2-Hyvärinen divergence allows us to perform model selection by choosing the order of the exponential-polynomial densities used to approximate the mixtures. We experimentally demonstrate that our heuristic to approximate the Jeffreys divergence between mixtures improves over the computational time of stochastic Monte Carlo estimations by several orders of magnitude while approximating the Jeffreys divergence reasonably well, especially when the mixtures have a very small number of modes.

Motion blur invariant for estimating motion parameters of medical ultrasound images

High-quality medical ultrasound imaging is definitely concerning motion blur, while medical image analysis requires motionless and accurate data acquired by sonographers. The main idea of this paper is to establish some motion blur invariant in both frequency and moment domain to estimate the motion parameters of ultrasound images. We propose a discrete model of point spread function of motion blur convolution based on the Dirac delta function to simplify the analysis of motion invariant in frequency and moment domain. This model paves the way for estimating the motion angle and length in terms of the proposed invariant features. In this research, the performance of the proposed schemes is compared with other state-of-the-art existing methods of image deblurring. The experimental study performs using fetal phantom images and clinical fetal ultrasound images as well as breast scans. Moreover, to validate the accuracy of the proposed experimental framework, we apply two image quality assessment methods as no-reference and full-reference to show the robustness of the proposed algorithms compared to the well-known approaches.

Multimodality carotid plaque tissue characterization and classification in the artificial intelligence paradigm: a narrative review for stroke application

Cardiovascular disease (CVD) is one of the leading causes of morbidity and mortality in the United States of America and globally. Carotid arterial plaque, a cause and also a marker of such CVD, can be detected by various non-invasive imaging modalities such as magnetic resonance imaging (MRI), computer tomography (CT), and ultrasound (US). Characterization and classification of carotid plaque-type in these imaging modalities, especially into symptomatic and asymptomatic plaque, helps in the planning of carotid endarterectomy or stenting. It can be challenging to characterize plaque components due to (I) partial volume effect in magnetic resonance imaging (MRI) or (II) varying Hausdorff values in plaque regions in CT, and (III) attenuation of echoes reflected by the plaque during US causing acoustic shadowing. Artificial intelligence (AI) methods have become an indispensable part of healthcare and their applications to the non-invasive imaging technologies such as MRI, CT, and the US. In this narrative review, three main types of AI models (machine learning, deep learning, and transfer learning) are analyzed when applied to MRI, CT, and the US. A link between carotid plaque characteristics and the risk of coronary artery disease is presented. With regard to characterization, we review tools and techniques that use AI models to distinguish carotid plaque types based on signal processing and feature strengths. We conclude that AI-based solutions offer an accurate and robust path for tissue characterization and classification for carotid artery plaque imaging in all three imaging modalities. Due to cost, user-friendliness, and clinical effectiveness, AI in the US has dominated the most.

Fast and accurate segmentation method of active shape model with Rayleigh mixture model clustering for prostate ultrasound images

BACKGROUND AND OBJECTIVE

The prostate cancer interventions, which need an accurate prostate segmentation, are performed under ultrasound imaging guidance. However, prostate ultrasound segmentation is facing two challenges. The first is the low signal-to-noise ratio and inhomogeneity of the ultrasound image. The second is the non-standardized shape and size of the prostate.

METHODS

For prostate ultrasound image segmentation, this paper proposed an accurate and efficient method of Active shape model (ASM) with Rayleigh mixture model Clustering (ASM-RMMC). Firstly, Rayleigh mixture model (RMM) is adopted for clustering the image regions which present similar speckle distributions. These content-based clustered images are then used to initialize and guide the deformation of an ASM model.

RESULTS

The performance of the proposed method is assessed on 30 prostate ultrasound images using four metrics as Mean Average Distance (MAD), Dice Similarity Coefficient (DSC), False Positive Error (FPE) and False Negative Error (FNE). The proposed ASM-RMMC reaches high segmentation accuracy with 95% ± 0.81% for DSC, 1.86 ± 0.02 pixels for MAD, 2.10% ± 0.36% for FPE and 2.78% ± 0.71% for FNE, respectively. Moreover, the average segmentation time is less than 8 s when treating a single prostate ultrasound image through ASM-RMMC.

CONCLUSIONS

This paper presents a method for prostate ultrasound image segmentation, which achieves high accuracy with less computational complexity and meets the clinical requirements.

Semi-Automatic Algorithms for Estimation and Tracking of AP-Diameter of the IVC in Ultrasound Images

Acutely ill patients presenting with conditions such as sepsis, trauma, and congestive heart failure require judicious resuscitation in order to achieve and maintain optimal circulating blood volume. Increasingly, emergency and critical care physicians are using portable ultrasound to approximate the temporal changes of the anterior–posterior (AP)-diameter of the inferior vena cava (IVC) in order to guide fluid administration or removal. This paper proposes semi-automatic active ellipse and rectangle algorithms capable of improved and quantified measurement of the AP-diameter. The proposed algorithms are compared to manual measurement and a previously published active circle model. Results demonstrate that the rectangle model outperforms both active circle and ellipse irrespective of IVC shape and closely approximates tedious expert assessment.

[A probability model for analyzing speckles in intravascular ultrasound images to facilitate image segmentation]

Ultrasonic image speckles result from the interference of the reflected signals by the scatters in the detected tissue. The physical characteristics of the speckles are closely correlated with the structures of the biological tissues, and the probability distribution of these speckles differs across different tissues. Based on the probability characteristics of intravascular ultrasound (IVUS) speckles, a Gamma mixture model and Gaussian mixture model are proposed to describe the calcified plaque, soft plaque and normal vascular regions on IVUS images. Using KS test, KL divergence and correlation coefficient analysis, we found that the probability distributions of the speckles generated by calcified plaques and normal blood vessels were better described by the Gaussian mixture model, while the speckles caused by soft plaques were described better by the Gamma mixture model. Based on this finding, we propose a probability mixture model combining neighborhood information for plaque segmentation on IVUS images. Compared with the existing probabilistic mixture model, the segmentation accuracy was greatly improved with a reduced noise.

A Review on Atherosclerotic Biology, Wall Stiffness, Physics of Elasticity, and Its Ultrasound-Based Measurement

Functional and structural changes in the common carotid artery are biomarkers for cardiovascular risk. Current methods for measuring functional changes include pulse wave velocity, compliance, distensibility, strain, stress, stiffness, and elasticity derived from arterial waveforms. The review is focused on the ultrasound-based carotid artery elasticity and stiffness measurements covering the physics of elasticity and linking it to biological evolution of arterial stiffness. The paper also presents evolution of plaque with a focus on the pathophysiologic cascade leading to arterial hardening. Using the concept of strain, and image-based elasticity, the paper then reviews the lumen diameter and carotid intima-media thickness measurements in combined temporal and spatial domains. Finally, the review presents the factors which influence the understanding of atherosclerotic disease formation and cardiovascular risk including arterial stiffness, tissue morphological characteristics, and image-based elasticity measurement.

Nakagami-m Parametric Imaging for Atherosclerotic Plaque Characterization Using the Coarse-to-Fine Method

The Nakagami model was used to analyze the statistical differences in ultrasound backscattered signals between different plaque types. To improve image resolution, Nakagami-m parametric imaging using the coarse-to-fine method based on the maximum likelihood estimation (CTF-BOW) was proposed for atherosclerotic plaque characterization. Simulation results confirmed that the CTF-BOW method significantly outperforms the sliding window method in precision, smoothness and resolution. Preliminary in vivo results (n = 45) indicated that the ranges of the m parameters for calcified, mixed and echolucent plaques are, respectively, 0.2852-0.5225, 0.6532-0.8784 and 0.8908-1.4011, with no overlap. Results revealed that the CTF-BOW method significantly improves image resolution without sacrificing accuracy and can distinguish between calcified, mixed and echolucent plaques. Moreover, it was found that the parameter m is related to the composition of the plaque, indicating that Nakagami-m parametric imaging has the potential to characterize plaques.

Fast retrieval of calcification from sequential intravascular ultrasound gray-scale images

Intravascular ultrasound (IVUS)-based tissue characterization is invaluable for the computer-aided diagnosis and interventional treatment of cardiac vessel diseases. Although the analysis of raw backscattered signals allows more accurate plaque characterization than gray-scale images, its applications are limited due to its nature of electrocardiogram-gated acquisition. Images acquired by IVUS devices that do not allow the acquisition of raw signals cannot be characterized. To address these limitations, we developed a method for fast frame-by-frame retrieval and location of calcification according to the jump features of radial gray-level variation curves from sequential IVUS gray-scale images. The proposed method consists of three main steps: (1) radial gray-level variation curves are extracted from each filtered polar view, (2) sequential images are preliminarily queried according to the maximal slopes of radial gray-level variation curves, and finally, (3) key frames that include calcification are selected through checking the gray-level features of successive pixel columns in the preliminary results. Experimental results with clinically acquired in vivo data sets indicate key frames that include calcification can be retrieved with the advantages of simplicity, high efficiency, and accuracy. Recognition results correlate well with manual characterization results obtained by experienced physicians and through virtual histology.

Gendist: An R Package for Generated Probability Distribution Models

In this paper, we introduce the R package gendist that computes the probability density function, the cumulative distribution function, the quantile function and generates random values for several generated probability distribution models including the mixture model, the composite model, the folded model, the skewed symmetric model and the arc tan model. These models are extensively used in the literature and the R functions provided here are flexible enough to accommodate various univariate distributions found in other R packages. We also show its applications in graphing, estimation, simulation and risk measurements.

Unifying Concepts of Statistical and Spectral Quantitative Ultrasound Techniques

Quantitative ultrasound (QUS) techniques using radiofrequency (RF) backscattered signals have been used for tissue characterization of numerous organ systems. One approach is to use the magnitude and frequency dependence of backscatter echoes to quantify tissue structures. Another approach is to use first-order statistical properties of the echo envelope as a signature of the tissue microstructure. We propose a unification of these QUS concepts. For this purpose, a mixture of homodyned K-distributions is introduced to model the echo envelope, together with an estimation method and a physical interpretation of its parameters based on the echo signal spectrum. In particular, the total, coherent and diffuse signal powers related to the proposed mixture model are expressed explicitly in terms of the structure factor previously studied to describe the backscatter coefficient (BSC). Then, this approach is illustrated in the context of red blood cell (RBC) aggregation. It is experimentally shown that the total, coherent and diffuse signal powers are determined by a structural parameter of the spectral Structure Factor Size and Attenuation Estimator. A two-way repeated measures ANOVA test showed that attenuation (p-value of 0.077) and attenuation compensation (p-value of 0.527) had no significant effect on the diffuse to total power ratio. These results constitute a further step in understanding the physical meaning of first-order statistics of ultrasound images and their relations to QUS techniques. The proposed unifying concepts should be applicable to other biological tissues than blood considering that the structure factor can theoretically model any spatial distribution of scatterers.

Smartphone based monitoring system for long-term sleep assessment

The diagnosis of sleep disorders, highly prevalent in Western countries, typically involves sophisticated procedures and equipment that are highly intrusive to the patient. The high processing capabilities and storage capacity of current portable devices, together with a big range of available sensors, many of them with wireless capabilities, create new opportunities and change the paradigms in sleep studies. In this work, a smartphone based sleep monitoring system is presented along with the details of the hardware, software and algorithm implementation. The aim of this system is to provide a way for subjects, with no pre-diagnosed sleep disorders, to monitor their sleep habits, and on the initial screening of abnormal sleep patterns.

Statistics of boundaries in ultrasonic B-scan images

The existence of edges and boundaries in regions of interest (ROIs) in B-scan images alters the statistics of the backscattered echo from the ROI. Boundaries are the result of at least two different types of scattering scenarios in tissue, and the Nakagami model, which is being used extensively in ultrasound, is unlikely to fit the statistics of the backscattered echo under these conditions. Furthermore, there are very few other statistical models exist that describe the statistics of the backscattered echo from regions containing boundaries. In this work, the gamma mixture density and the recently proposed McKay density are explored as two viable models to fill this void. Justifications of these models are presented along with methods for estimating their parameters. Random number simulations and studies on tissue-mimicking phantoms indicate that the McKay and gamma mixture densities are the best for the modeling of the backscattered echo intensity when boundaries are present in the regions of interest.

Anisotropic diffusion filter with memory based on speckle statistics for ultrasound images

Ultrasound (US) imaging exhibits considerable difficulties for medical visual inspection and for development of automatic analysis methods due to speckle, which negatively affects the perception of tissue boundaries and the performance of automatic segmentation methods. With the aim of alleviating the effect of speckle, many filtering techniques are usually considered as a preprocessing step prior to automatic analysis methods or visual inspection. Most of the state-of-the-art filters try to reduce the speckle effect without considering its relevance for the characterization of tissue nature. However, the speckle phenomenon is the inherent response of echo signals in tissues and can provide important features for clinical purposes. This loss of information is even magnified due to the iterative process of some speckle filters, e.g., diffusion filters, which tend to produce over-filtering because of the progressive loss of relevant information for diagnostic purposes during the diffusion process. In this paper, we propose an anisotropic diffusion filter with a probabilistic-driven memory mechanism to overcome the over-filtering problem by following a tissue selective philosophy. In particular, we formulate the memory mechanism as a delay differential equation for the diffusion tensor whose behavior depends on the statistics of the tissues, by accelerating the diffusion process in meaningless regions and including the memory effect in regions where relevant details should be preserved. Results both in synthetic and real US images support the inclusion of the probabilistic memory mechanism for maintaining clinical relevant structures, which are removed by the state-of-the-art filters.

Automated detection framework of the calcified plaque with acoustic shadowing in IVUS images

Intravascular Ultrasound (IVUS) is one ultrasonic imaging technology to acquire vascular cross-sectional images for the visualization of the inner vessel structure. This technique has been widely used for the diagnosis and treatment of coronary artery diseases. The detection of the calcified plaque with acoustic shadowing in IVUS images plays a vital role in the quantitative analysis of atheromatous plaques. The conventional method of the calcium detection is manual drawing by the doctors. However, it is very time-consuming, and with high inter-observer and intra-observer variability between different doctors. Therefore, the computer-aided detection of the calcified plaque is highly desired. In this paper, an automated method is proposed to detect the calcified plaque with acoustic shadowing in IVUS images by the Rayleigh mixture model, the Markov random field, the graph searching method and the prior knowledge about the calcified plaque. The performance of our method was evaluated over 996 in-vivo IVUS images acquired from eight patients, and the detected calcified plaques are compared with manually detected calcified plaques by one cardiology doctor. The experimental results are quantitatively analyzed separately by three evaluation methods, the test of the sensitivity and specificity, the linear regression and the Bland-Altman analysis. The first method is used to evaluate the ability to distinguish between IVUS images with and without the calcified plaque, and the latter two methods can respectively measure the correlation and the agreement between our results and manual drawing results for locating the calcified plaque in the IVUS image. High sensitivity (94.68%) and specificity (95.82%), good correlation and agreement (>96.82% results fall within the 95% confidence interval in the Student t-test) demonstrate the effectiveness of the proposed method in the detection of the calcified plaque with acoustic shadowing in IVUS images.

Region and boundary feature estimation on ultrasound images using moment invariants

In ultrasound images, tissues are characterized by their speckle texture. Moment-based techniques have proven their ability to capture texture features. However, in ultrasound images, the speckle size increases with the distance from the probe and in some cases the speckle has a concentric texture arrangement. We propose to use moment invariants with respect to image scale and rotation to capture the texture in such cases. Results on synthetic data show that moment invariants are able to characterize the texture but also that some moment orders are sensitive to regions and, moreover, some are sensitive to the boundaries between two different textures. This behavior seems to be very interesting to be used within some segmentation scheme dealing with a combination of regional and boundary information. In this paper we will try to prove the usability of this complementary information in a min-cut/max-flow graph cut scheme.

Gamma mixture classifier for plaque detection in intravascular ultrasonic images

Carotid and coronary vascular incidents are mostly caused by vulnerable plaques. Detection and characterization of vulnerable plaques are important for early disease diagnosis and treatment. For this purpose, the echomorphology and composition have been studied. Several distributions have been used to describe ultrasonic data depending on tissues, acquisition conditions, and equipment. Among them, the Rayleigh distribution is a one-parameter model used to describe the raw envelope RF ultrasound signal for its simplicity, whereas the Nakagami distribution (a generalization of the Rayleigh distribution) is the two-parameter model which is commonly accepted. However, it fails to describe B-mode images or Cartesian interpolated or subsampled RF images because linear filtering changes the statistics of the signal. In this work, a gamma mixture model (GMM) is proposed to describe the subsampled/interpolated RF images and it is shown that the parameters and coefficients of the mixture are useful descriptors of speckle pattern for different types of plaque tissues. This new model outperforms recently proposed probabilistic and textural methods with respect to plaque description and characterization of echogenic contents. Classification results provide an overall accuracy of 86.56% for four classes and 95.16% for three classes. These results evidence the classifier usefulness for plaque characterization. Additionally, the classifier provides probability maps according to each tissue type, which can be displayed for inspecting local tissue composition, or used for automatic filtering and segmentation.

Joint learning of ultrasonic backscattering statistical physics and signal confidence primal for characterizing atherosclerotic plaques using intravascular ultrasound

Intravascular Ultrasound (IVUS) is a predominant imaging modality in interventional cardiology. It provides real-time cross-sectional images of arteries and assists clinicians to infer about atherosclerotic plaques composition. These plaques are heterogeneous in nature and constitute fibrous tissue, lipid deposits and calcifications. Each of these tissues backscatter ultrasonic pulses and are associated with a characteristic intensity in B-mode IVUS image. However, clinicians are challenged when colocated heterogeneous tissue backscatter mixed signals appearing as non-unique intensity patterns in B-mode IVUS image. Tissue characterization algorithms have been developed to assist clinicians to identify such heterogeneous tissues and assess plaque vulnerability. In this paper, we propose a novel technique coined as Stochastic Driven Histology (SDH) that is able to provide information about co-located heterogeneous tissues. It employs learning of tissue specific ultrasonic backscattering statistical physics and signal confidence primal from labeled data for predicting heterogeneous tissue composition in plaques. We employ a random forest for the purpose of learning such a primal using sparsely labeled and noisy samples. In clinical deployment, the posterior prediction of different lesions constituting the plaque is estimated. Folded cross-validation experiments have been performed with 53 plaques indicating high concurrence with traditional tissue histology. On the wider horizon, this framework enables learning of tissue-energy interaction statistical physics and can be leveraged for promising clinical applications requiring tissue characterization beyond the application demonstrated in this paper.

Asymptomatic carotid disease--a new tool for assessing neurological risk

Active carotid plaques are associated with atheroembolism and neurological events; its identification is crucial for stroke prevention. High-definition ultrasound (HDU) can be used to recognize plaque structure in carotid bifurcation stenosis associated with plaque vulnerability and occurrence of brain ischemic events. A new computer-assisted HDU method to study the echomorphology of the carotid plaque and to determine a risk score for developing appropriate symptoms is proposed in this study. Plaque echomorphology characteristics such as presence of ulceration at the plaque surface, juxta-luminal location of echolucent areas, echoheterogeneity were obtained from B-mode ultrasound scans using several image processing algorithms and were combined with measurement of severity of stenosis to obtain a clinical score--enhanced activity index (EAI)--which was correlated with the presence or absence of ipsilateral appropriate ischemic symptoms. An optimal cutoff value of EAI was determined to obtain the best separation between symptomatic (active) from asymptomatic (inactive) plaques and its diagnostic yield was compared to other 2 reference methods by means of receiver-operating characteristic (ROC) analysis. Classification performance was evaluated by leave-one-patient-out cross-validation applied to a cohort of 146 carotid plaques from 99 patients. The proposed method was benchmarked against (a) degree of stenosis criteria and (b) earlier proposed activity index (AI) and demonstrated that EAI yielded the highest accuracy up to an accuracy of 77% to predict asymptomatic plaques that developed symptoms in a prospective cross-sectional study. Enhanced activity index is a noninvasive, easy to obtain parameter, which provided accurate estimation of neurological risk of carotid plaques.

An IVUS image-based approach for improvement of coronary plaque characterization

Virtual Histology-Intravascular Ultrasound (VH-IVUS) is widely used for studying atherosclerosis plaque composition. However, one of the main limitations of the VH-IVUS relates to its dependence to the Electrocardiogram (ECG)-gated acquisition. To overcome this limitation, this paper proposes a robust image-based approach for characterization of the plaques using IVUS images. The proposed method consists of three main steps of (1) shadow detection: as an efficient preprocessing step to identify and remove acoustic shadow regions; (2) feature extraction: a combination of gray-scale based features and textural descriptors; and (3) classification: to classify each pixel into one of the three classes (calcium, necrotic core and fibro-fatty). In order to evaluate the efficiency of the proposed algorithm two in-vivo and ex-vivo data sets are considered. The kappa values of 0.639 on in-vivo and 0.628 on ex-vivo tests with VH-IVUS and the histology images labeled by the experts respectively indicate the effectiveness of the proposed algorithm.

Image-based modeling and precision medicine: patient-specific carotid and coronary plaque assessment and predictions

Atherosclerotic plaques may rupture without warning and cause acute cardiovascular events such as heart attack and stroke. Current clinical screening tools are insufficient to identify those patients with risks early and prevent the adverse events from happening. Medical imaging and image-based modeling have made considerable progress in recent years in identifying plaque morphological and mechanical risk factors which may be used in developing improved patient screening strategies. The key steps and factors in image-based models for human carotid and coronary plaques were illustrated, as well as grand challenges facing the researchers in the field to develop more accurate screening tools.

A generalized gamma mixture model for ultrasonic tissue characterization

Several statistical models have been proposed in the literature to describe the behavior of speckles. Among them, the Nakagami distribution has proven to very accurately characterize the speckle behavior in tissues. However, it fails when describing the heavier tails caused by the impulsive response of a speckle. The Generalized Gamma (GG) distribution (which also generalizes the Nakagami distribution) was proposed to overcome these limitations. Despite the advantages of the distribution in terms of goodness of fitting, its main drawback is the lack of a closed-form maximum likelihood (ML) estimates. Thus, the calculation of its parameters becomes difficult and not attractive. In this work, we propose (1) a simple but robust methodology to estimate the ML parameters of GG distributions and (2) a Generalized Gama Mixture Model (GGMM). These mixture models are of great value in ultrasound imaging when the received signal is characterized by a different nature of tissues. We show that a better speckle characterization is achieved when using GG and GGMM rather than other state-of-the-art distributions and mixture models. Results showed the better performance of the GG distribution in characterizing the speckle of blood and myocardial tissue in ultrasonic images.