Publications by Year: 2006

Scarless surgery is a new and very promising technique that can mark a new era in surgical procedures. We have created and validated a navigation system for endoscopic and transgastric access interventions in in vivo pilot studies. The system provides augmented visual feedback and additional contextual information by establishing a correspondence between the real time endoscopic ultrasound image and a preoperative CT volume using rigid registration. The system enhances the operator’s ability to interpret the ultrasound image reducing the mental burden used in probe placement. Our analysis shows that rigid registration is accurate enough to help physicians in endoscopic abdominal surgery where, by using preoperative data for context and real-time imaging for targeting, distortions that limit the use of only preoperative data can be overcome.

Lung cancer remains an ongoing problem resulting in substantial deaths in the United States and the world. Within the United states, cancer of the lung and bronchus are the leading causes of fatal malignancy and make up 32% of the cancer deaths among men and 25% of the cancer deaths among women. Five year survival is low, (14%), but recent studies are beginning to provide some hope that we can increase survivability of lung cancer provided that the cancer is caught and treated in early stages. These results motivate revisiting the concept of lung cancer screening using thin slice multidetector computed tomography (MDCT) protocols and automated detection algorithms to facilitate early detection. In this environment, resources to aid Computer Aided Detection (CAD) researchers to rapidly develop and harden detection and diagnostic algorithms may have a significant impact on world health. The National Cancer Institute (NCI) formed the Lung Imaging Database Consortium (LIDC) to establish a resource for detecting, sizing, and characterizing lung nodules. This resource consists of multiple CT chest exams containing lung nodules that seveal radiologists manually countoured and characterized. Consensus on the location of the nodule boundaries, or even on the existence of a nodule at a particular location in the lung was not enforced, and each contour is considered a possible nodule. The researcher is encouraged to develop measures of ground truth to reconcile the multiple radiologist marks. This paper analyzes these marks to determine radiologist agreement and to apply statistical tools to the generation of a nodule ground truth. Features of the resulting consensus and individual markings are analyzed.

Volume imaging, defibrillation electrode models, and finite element modeling are employed in patient-specific procedural modeling in pediatric patients with cardiac arrhythmias. Due to variable size and anatomy, these patients may not be well-served by devices designed for adult defibrillation. A pipeline for rapid creation of image based models that can be interactively interrogated to determine optimal defibrillation scenarios and preliminary proof-of-concept work are presented. This approach has potential clinical applications for therapy planning and broad applications for finite element modeling in anatomical models. Clinical studies investigating the effects of body size, habitus, and anatomical variation on myocardial voltage gradients are planned.

Quantitative analysis of computed tomographic (CT) images of the lungs is becoming increasingly useful in the medical and surgical management of subjects with Chronic Obstructive Pulmonary Disease (COPD). Current methods for the assessment of airway wall work well in idealized models of the airway. We propose a new method for airway wall detection based on phase congruency. This method does not rely on either a specific model of the airway or the point spread function of the scanner. Our results show that our method gives a better localization of the airway wall than "full width at a half max" and is less sensitive to different reconstruction kernels and radiation doses.

Studying the intersection of brain structure and function is an important aspect of modern neuroscience. The development of magnetic resonance imaging (MRI) over the last 25 years has provided new and powerful tools for the study of brain structure and function. Two tools in particular, diffusion imaging and functional MRI (fMRI), are playing increasingly important roles in elucidating the complementary aspects of brain structure and function. In this work, we review basic technical features of diffusion imaging and fMRI for studying the integrity of white matter structural components and for determining the location and extent of cortical activation in gray matter, respectively. We then review a growing body of literature in which the complementary aspects of diffusion imaging and fMRI, applied as separate examinations but analyzed in tandem, have been exploited to enhance our knowledge of brain structure and function.

In thorax and abdomen imaging, image quality may be affected by breathing motion. Cardiac MR images are typically obtained while the patient holds his or her breath, to avoid respiration-related artifacts. Although useful, breath-holding imposes constraints on scan duration, which in turn limits the achievable resolution and SNR. Longer scan times would be required to improve image quality, and effective strategies are needed to compensate for respiratory motion. A novel approach at respiratory compensation, targeted toward 3D free-breathing cardiac MRI, is presented here. The method aims at suppressing the negative effects of respiratory-induced cardiac motion while capturing the heart’s beating motion. The method is designed so that the acquired data can be reconstructed in two different ways: First, a time series of images is reconstructed to quantify and correct for respiratory motion. Then, the corrected data are reconstructed a final time into a cardiac-phase series of images to capture the heart’s beating motion. The method was implemented, and initial results are presented. A cardiac-phase series of 3D images, covering the entire heart, was obtained for two free-breathing volunteers. The present method may prove especially useful in situations where breath-holding is not an option, for example, for very sick, mentally impaired or infant patients.

Recent work shows that diffusion tensor imaging (DTI) can help resolving thalamic nuclei based on the characteristic fiber orientation of the corticothalamic/thalamocortical striations within each nucleus. In this paper we describe a novel segmentation method based on spectral clustering. We use Markovian relaxation to handle spatial information in a natural way, and we explicitly minimize the normalized cut criteria of the spectral clustering for a better optimization. Using this modified spectral clustering algorithm, we can resolve the organization of the thalamic nuclei into groups and subgroups solely based on the voxel affinity matrix, avoiding the need for explicitly defined cluster centers. The identification of nuclear subdivisions can facilitate localization of functional activation and pathology to individual nuclear subgroups.

White matter fiber bundles in the human brain can be located by tracing the local water diffusion in diffusion weighted magnetic resonance imaging (MRI) images. In this paper, a novel Bayesian modeling approach for white matter tractography is presented. The uncertainty associated with estimated white matter fiber paths is investigated, and a method for calculating the probability of a connection between two areas in the brain is introduced. The main merits of the presented methodology are its simple implementation and its ability to handle noise in a theoretically justified way. Theory for estimating global connectivity is also presented, as well as a theorem that facilitates the estimation of the parameters in a constrained tensor model of the local water diffusion profile.

A reoccurring theme in the diffusion tensor imaging literature is the per-voxel estimation of a symmetric 3 x 3 tensor describing the measured diffusion. In this work we attempt to generalize this approach by calculating 2 or 3 or up to k diffusion tensors for each voxel. We show that our procedure can more accurately describe the diffusion particularly when crossing fibers or fiber-bundles are present in the datasets.

A common goal of multivariate visualization is to enable data inspection at discrete points, while also illustrating larger-scale continuous structures. In diffusion tensor visualization, glyphs are typically used to meet the first goal, and methods such as texture synthesis or fiber tractography can address the second. We adapt particle systems originally developed for surface modeling and anisotropic mesh generation to enhance the utility of glyph-based tensor visualizations. By carefully distributing glyphs throughout the field (either on a slice, or in the volume) into a dense packing, using potential energy profiles shaped by the local tensor value, we remove undue visual emphasis of the regular sampling grid of the data, and the underlying continuous features become more apparent. The method is demonstrated on a DT-MRI scan of a patient with a brain tumor.