Functional gut disorders or disordered gut function? Small bowel dysmotility evidenced by an original technique

BACKGROUND

This study aimed to determine the proportion of cases with abnormal intestinal motility among patients with functional bowel disorders. To this end, we applied an original method, previously developed in our laboratory, for analysis of endoluminal images obtained by capsule endoscopy. This novel technology is based on computer vision and machine learning techniques.

METHODS

The endoscopic capsule (Pillcam SB1; Given Imaging, Yokneam, Israel) was administered to 80 patients with functional bowel disorders and 70 healthy subjects. Endoluminal image analysis was performed with a computer vision program developed for the evaluation of contractile events (luminal occlusions and radial wrinkles), non-contractile patterns (open tunnel and smooth wall patterns), type of content (secretions, chyme) and motion of wall and contents. Normality range and discrimination of abnormal cases were established by a machine learning technique. Specifically, an iterative classifier (one-class support vector machine) was applied in a random population of 50 healthy subjects as a training set and the remaining subjects (20 healthy subjects and 80 patients) as a test set.

KEY RESULTS

The classifier identified as abnormal 29% of patients with functional diseases of the bowel (23 of 80), and as normal 97% of healthy subjects (68 of 70) (P < 0.05 by chi-squared test). Patients identified as abnormal clustered in two groups, which exhibited either a hyper- or a hypodynamic motility pattern. The motor behavior was unrelated to clinical features.

CONCLUSIONS & INFERENCES

With appropriate methodology, abnormal intestinal motility can be demonstrated in a significant proportion of patients with functional bowel disorders, implying a pathologic disturbance of gut physiology.

Myocardial perfusion characterization from contrast angiography spectral distribution

Despite recovering a normal coronary flow after acute myocardial infarction, percutaneous coronary intervention does not guarantee a proper perfusion (irrigation) of the infarcted area. This damage in microcirculation integrity may detrimentally affect the patient survival. Visual assessment of the myocardium opacification in contrast angiography serves to define a subjective score of the microcirculation integrity myocardial blush analysis (MBA). Although MBA correlates with patient prognosis its visual assessment is a very difficult task that requires of a highly expertise training in order to achieve a good intraobserver and interobserver agreement. In this paper, we provide objective descriptors of the myocardium staining pattern by analyzing the spectrum of the image local statistics. The descriptors proposed discriminate among the different phenomena observed in the angiographic sequence and allow defining an objective score of the myocardial perfusion.

Discriminant snakes for 3D reconstruction of anatomical organs

In this work a new statistic deformable model for 3D segmentation of anatomical organs in medical images is proposed. A statistic discriminant snake performs a supervised learning of the object boundary in an image slice to segment the next slice of the image sequence. Each part of the object boundary is projected in a feature space generated by a bank of Gaussian filters. Then, clusters corresponding to different boundary pieces are constructed by means of linear discriminant analysis. Finally, a parametric classifier is generated from each contour in the image slice and embodied into the snake energy-minimization process to guide the snake deformation in the next image slice. The discriminant snake selects and classifies image features by the parametric classifier and deforms to minimize the dissimilarity between the learned and found image features. The new approach is of particular interest for segmenting 3D images with anisotropic spatial resolution, and for tracking temporal image sequences. In particular, several anatomical organs from different imaging modalities are segmented and the results compared to expert tracings.

Tag surface reconstruction and tracking of myocardial beads from SPAMM-MRI with parametric B-spline surfaces

Magnetic resonance imaging (MRI) is unique in its ability to noninvasively and selectively alter tissue magnetization, and create tag planes intersecting image slices. The resulting grid of signal voids allows for tracking deformations of tissues in otherwise homogeneous-signal myocardial regions. In this paper, we propose a specific spatial modulation of magnetization (SPAMM) imaging protocol together with efficient techniques for measurement of three-dimensional (3-D) motion of material points of the human heart (referred to as myocardial beads) from images collected with the SPAMM method. The techniques make use of tagged images in orthogonal views by explicitly reconstructing 3-D B-spline surface representation of tag planes (tag planes in two orthogonal orientations intersecting the short-axis (SA) image slices and tag planes in an orientation orthogonal to the short-axis tag planes intersecting long-axis (LA) image slices). The developed methods allow for viewing deformations of 3-D tag surfaces, spatial correspondence of long-axis and short-axis image slice and tag positions, as well as nonrigid movement of myocardial beads as a function of time.

ECG recognition by Boolean decision rules

The classical pattern recognition problem is considered. A model of construction of Boolean decision rules is implemented. Computational procedures for construction of non-reducible descriptors is briefly discussed. Applications of Boolean decision rules to ECG analysis and ECG recognition are suggested.