Patient-specific in silico 3D coronary model in cardiac catheterisation laboratories

Coronary artery disease is caused by the buildup of atherosclerotic plaque in the coronary arteries, affecting the blood supply to the heart, one of the leading causes of death around the world. X-ray coronary angiography is the most common procedure for diagnosing coronary artery disease, which uses contrast material and x-rays to observe vascular lesions. With this type of procedure, blood flow in coronary arteries is viewed in real-time, making it possible to detect stenoses precisely and control percutaneous coronary interventions and stent insertions. Angiograms of coronary arteries are used to plan the necessary revascularisation procedures based on the calculation of occlusions and the affected segments. However, their interpretation in cardiac catheterisation laboratories presently relies on sequentially evaluating multiple 2D image projections, which limits measuring lesion severity, identifying the true shape of vessels, and analysing quantitative data. In silico modelling, which involves computational simulations of patient-specific data, can revolutionise interventional cardiology by providing valuable insights and optimising treatment methods. This paper explores the challenges and future directions associated with applying patient-specific in silico models in catheterisation laboratories. We discuss the implications of the lack of patient-specific in silico models and how their absence hinders the ability to accurately predict and assess the behaviour of individual patients during interventional procedures. Then, we introduce the different components of a typical patient-specific in silico model and explore the potential future directions to bridge this gap and promote the development and utilisation of patient-specific in silico models in the catheterisation laboratories.

Enhancing fine retinal vessel segmentation: Morphological reconstruction and double thresholds filtering strategy

Eye diseases such as diabetic retinopathy are progressive with various changes in the retinal vessels, and it is difficult to analyze the disease for future treatment. There are many computerized algorithms implemented for retinal vessel segmentation, but the tiny vessels drop off, impacting the performance of the overall algorithms. This research work contains the new image processing techniques such as enhancement filters, coherence filters and binary thresholding techniques to handle the different color retinal fundus image problems to achieve a vessel image that is well-segmented, and the proposed algorithm has improved performance over existing work. Our developed technique incorporates morphological techniques to address the center light reflex issue. Additionally, to effectively resolve the problem of insufficient and varying contrast, our developed technique employs homomorphic methods and Wiener filtering. Coherent filters are used to address the coherence issue of the retina vessels, and then a double thresholding technique is applied with image reconstruction to achieve a correctly segmented vessel image. The results of our developed technique were evaluated using the STARE and DRIVE datasets and it achieves an accuracy of about 0.96 and a sensitivity of 0.81. The performance obtained from our proposed method proved the capability of the method which can be used by ophthalmology experts to diagnose ocular abnormalities and recommended for further treatment.

Inter/intra-frame constrained vascular segmentation in X-ray angiographic image sequence

Background

Automatic vascular segmentation in X-ray angiographic image sequence is of crucial interest, for instance, for better quantifying coronary arteries in diagnostic and interventional procedures.

Methods

A novel inter/intra-frame constrained vascular segmentation method is proposed to automatically segment vessels in coronary X-ray angiographic image sequence. First, a morphological filter operator is applied to remove structures undergoing the respiratory motion from the original image sequence. Second, an inter-frame constrained robust principal component analysis (RPCA) is utilized to remove the quasi-static structures from the image sequence. Third, an intra-frame constrained RPCA is employed to smooth the final extracted vascular sequence. Fourth, a multi-feature fusion is designed to improve the vascular contrast and the final vascular segmentation is realized by thresholding-based method.

Results

Experiments are conducted on 22 clinical X-ray angiographic image sequences. The global and local contrast-to-noise ratio of the proposed method are 6.6344 and 4.2882, respectively. And the precision, sensitivity and F1 value are 0.7378, 0.7960 and 0.7658, respectively. It demonstrates that our method is effective and robust for vascular segmentation from image sequence.

Conclusions

The proposed method is effective to remove non-vascular structures, reduce motion artefacts and other non-uniform illumination caused noises. Also, the proposed method is online which can just process one image per time without re-optimizing the model.

Automated identification and grading of coronary artery stenoses with X-ray angiography

BACKGROUND AND OBJECTIVE

X-ray coronary angiography (XCA) remains the gold standard imaging technique for the diagnosis and treatment of cardiovascular disease. Automatic detection and grading of coronary stenoses in XCA are challenging problems due to the complex overlap of different background structures with intensity inhomogeneities. We present a new computerized image based method to accurately identify and quantify the stenosis severity on XCA.

METHODS

A unified framework, consisting of Hessian-based vessel enhancement, level-set skeletonization, improved measure of match measurement, and local extremum identification, is developed to distinctly reveal the vessel structures and accurately determine the stenosis grades. The methodology was validated on 143 consecutive patients who underwent diagnostic XCA through both qualitative and quantitative evaluations.

RESULTS

The presented algorithm was tested on a set of 267 vessel segments annotated by two expert cardiologists. The experimental results show that the method can effectively localize and quantify the vessel stenoses, achieving average detection accuracy, sensitivity, specificity, and F-score of 93.93%, 91.03%, 93.83%, 89.18%, respectively.

CONCLUSIONS

A fully automatic coronary analysis method is devised for vessel stenosis detection and grading in XCA. The presented approach can potentially serve as a generalized framework to handle different image modalities.

Accurate liver vessel segmentation via active contour model with dense vessel candidates

BACKGROUND AND OBJECTIVE

The purpose of this paper is to propose a fully automated liver vessel segmentation algorithm including portal vein and hepatic vein on contrast enhanced CTA images.

METHODS

First, points of a vessel candidate region are extracted from 3-dimensional (3D) CTA image. To generate accurate points, we reduce 3D segmentation problem to 2D problem by generating multiple maximum intensity (MI) images. After the segmentation of MI images, we back-project pixels to the original 3D domain. We call these voxels as vessel candidates (VCs). A large set of MI images can produce very dense and accurate VCs. Finally, for the accurate segmentation of a vessel region, we propose a newly designed active contour model (ACM) that uses the original image, vessel probability map from dense VCs, and the good prior of an initial contour.

RESULTS

We used 55 abdominal CTAs for a parameter study and a quantitative evaluation. We evaluated the performance of the proposed method comparing with other state-of-the-art ACMs for vascular images applied directly to the original data. The result showed that our method successfully segmented vascular structure 25%-122% more accurately than other methods without any extra false positive detection.

CONCLUSION

Our model can generate a smooth and accurate boundary of the vessel object and easily extract thin and weak peripheral branch vessels. The proposed approach can automatically segment a liver vessel without any manual interaction. The detailed result can aid further anatomical studies.

A robust statistics driven volume-scalable active contour for segmenting anatomical structures in volumetric medical images with complex conditions

BACKGROUND

Accurate segmentation of anatomical structures in medical images is a critical step in the development of computer assisted intervention systems. However, complex image conditions, such as intensity inhomogeneity, noise and weak object boundary, often cause considerable difficulties in medical image segmentation. To cope with these difficulties, we propose a novel robust statistics driven volume-scalable active contour framework, to extract desired object boundary from magnetic resonance (MR) and computed tomography (CT) imagery in 3D.

METHODS

We define an energy functional in terms of the initial seeded labels and two fitting functions that are derived from object local robust statistics features. This energy is then incorporated into a level set scheme which drives the active contour evolving and converging at the desired position of the object boundary. Due to the local robust statistics and the volume scaling function in the energy fitting term, the object features in local volumes are learned adaptively to guide the motion of the contours, which thereby guarantees the capability of our method to cope with intensity inhomogeneity, noise and weak boundary. In addition, the initialization of active contour is simplified by select several seeds in the object and/or background to eliminate the sensitivity to initialization.

RESULTS

The proposed method was applied to extensive public available volumetric medical images with challenging image conditions. The segmentation results of various anatomical structures, such as white matter (WM), atrium, caudate nucleus and brain tumor, were evaluated quantitatively by comparing with the corresponding ground truths. It was found that the proposed method achieves consistent and coherent segmentation accuracy of 0.9246 ± 0.0068 for WM, 0.9043 ± 0.0131 for liver tumors, 0.8725 ± 0.0374 for caudate nucleus, 0.8802 ± 0.0595 for brain tumors, etc., measured by Dice similarity coefficients value for the overlap between the algorithm one and the ground truth. Further comparative experimental results showed desirable performances of the proposed method over several well-known segmentation methods in terms of accuracy and robustness.

CONCLUSION

We proposed an approach to accurate segment volumetric medical images with complex conditions. The accuracy of segmentation, robustness to noise and contour initialization were validated on the basis of extensive MR and CT volumes.

Automated Vessel Segmentation Using Infinite Perimeter Active Contour Model with Hybrid Region Information with Application to Retinal Images

Automated detection of blood vessel structures is becoming of crucial interest for better management of vascular disease. In this paper, we propose a new infinite active contour model that uses hybrid region information of the image to approach this problem. More specifically, an infinite perimeter regularizer, provided by using L(2) Lebesgue measure of the γ -neighborhood of boundaries, allows for better detection of small oscillatory (branching) structures than the traditional models based on the length of a feature's boundaries (i.e., H(1) Hausdorff measure). Moreover, for better general segmentation performance, the proposed model takes the advantage of using different types of region information, such as the combination of intensity information and local phase based enhancement map. The local phase based enhancement map is used for its superiority in preserving vessel edges while the given image intensity information will guarantee a correct feature's segmentation. We evaluate the performance of the proposed model by applying it to three public retinal image datasets (two datasets of color fundus photography and one fluorescein angiography dataset). The proposed model outperforms its competitors when compared with other widely used unsupervised and supervised methods. For example, the sensitivity (0.742), specificity (0.982) and accuracy (0.954) achieved on the DRIVE dataset are very close to those of the second observer's annotations.

Retinal vessel segmentation: an efficient graph cut approach with retinex and local phase

Our application concerns the automated detection of vessels in retinal images to improve understanding of the disease mechanism, diagnosis and treatment of retinal and a number of systemic diseases. We propose a new framework for segmenting retinal vasculatures with much improved accuracy and efficiency. The proposed framework consists of three technical components: Retinex-based image inhomogeneity correction, local phase-based vessel enhancement and graph cut-based active contour segmentation. These procedures are applied in the following order. Underpinned by the Retinex theory, the inhomogeneity correction step aims to address challenges presented by the image intensity inhomogeneities, and the relatively low contrast of thin vessels compared to the background. The local phase enhancement technique is employed to enhance vessels for its superiority in preserving the vessel edges. The graph cut-based active contour method is used for its efficiency and effectiveness in segmenting the vessels from the enhanced images using the local phase filter. We have demonstrated its performance by applying it to four public retinal image datasets (3 datasets of color fundus photography and 1 of fluorescein angiography). Statistical analysis demonstrates that each component of the framework can provide the level of performance expected. The proposed framework is compared with widely used unsupervised and supervised methods, showing that the overall framework outperforms its competitors. For example, the achieved sensitivity (0:744), specificity (0:978) and accuracy (0:953) for the DRIVE dataset are very close to those of the manual annotations obtained by the second observer.

A vessel active contour model for vascular segmentation

This paper proposes a vessel active contour model based on local intensity weighting and a vessel vector field. Firstly, the energy function we define is evaluated along the evolving curve instead of all image points, and the function value at each point on the curve is based on the interior and exterior weighted means in a local neighborhood of the point, which is good for dealing with the intensity inhomogeneity. Secondly, a vascular vector field derived from a vesselness measure is employed to guide the contour to evolve along the vessel central skeleton into thin and weak vessels. Thirdly, an automatic initialization method that makes the model converge rapidly is developed, and it avoids repeated trails in conventional local region active contour models. Finally, a speed-up strategy is implemented by labeling the steadily evolved points, and it avoids the repeated computation of these points in the subsequent iterations. Experiments using synthetic and real vessel images validate the proposed model. Comparisons with the localized active contour model, local binary fitting model, and vascular active contour model show that the proposed model is more accurate, efficient, and suitable for extraction of the vessel tree from different medical images.

Automated analysis of diabetic retinopathy images: principles, recent developments, and emerging trends

Diabetic retinopathy (DR) is a vision-threatening complication of diabetes. Timely diagnosis and intervention are essential for treatment that reduces the risk of vision loss. A good color retinal (fundus) photograph can be used as a surrogate for face-to-face evaluation of DR. The use of computers to assist or fully automate DR evaluation from retinal images has been studied for many years. Early work showed promising results for algorithms in detecting and classifying DR pathology. Newer techniques include those that adapt machine learning technology to DR image analysis. Challenges remain, however, that must be overcome before fully automatic DR detection and analysis systems become practical clinical tools.

Bayesian method with spatial constraint for retinal vessel segmentation

A Bayesian method with spatial constraint is proposed for vessel segmentation in retinal images. The proposed model makes the assumption that the posterior probability of each pixel is dependent on posterior probabilities of their neighboring pixels. An energy function is defined for the proposed model. By applying the modified level set approach to minimize the proposed energy function, we can identify blood vessels in the retinal image. Evaluation of the developed method is done on real retinal images which are from the DRIVE database and the STARE database. The performance is analyzed and compared to other published methods using a number of measures which include accuracy, sensitivity, and specificity. The proposed approach is proved to be effective on these two databases. The average accuracy, sensitivity, and specificity on the DRIVE database are 0.9529, 0.7513, and 0.9792, respectively, and for the STARE database 0.9476, 0.7147, and 0.9735, respectively. The performance is better than that of other vessel segmentation methods.