Simulation Method for the Physical Deformation of a Three-Dimensional Soft Body in Augmented Reality-Based External Ventricular Drainage.

OBJECTIVES: Intraoperative navigation reduces the risk of major complications and increases the likelihood of optimal surgical outcomes. This paper presents an augmented reality (AR)-based simulation technique for ventriculostomy that visualizes brain deformations caused by the movements of a surgical instrument in a three-dimensional brain model. This is achieved by utilizing a position-based dynamics (PBD) physical deformation method on a preoperative brain image. METHODS: An infrared camera-based AR surgical environment aligns the real-world space with a virtual space and tracks the surgical instruments. For a realistic representation and reduced simulation computation load, a hybrid geometric model is employed, which combines a high-resolution mesh model and a multiresolution tetrahedron model. Collision handling is executed when a collision between the brain and surgical instrument is detected. Constraints are used to preserve the properties of the soft body and ensure stable deformation. RESULTS: The experiment was conducted once in a phantom environment and once in an actual surgical environment. The tasks of inserting the surgical instrument into the ventricle using only the navigation information presented through the smart glasses and verifying the drainage of cerebrospinal fluid were evaluated. These tasks were successfully completed, as indicated by the drainage, and the deformation simulation speed averaged 18.78 fps. CONCLUSIONS: This experiment confirmed that the AR-based method for external ventricular drain surgery was beneficial to clinicians.

Non-rigid registration based on hierarchical deformation of coronary arteries in CCTA images.

In this paper, we propose an accurate and rapid non-rigid registration method between blood vessels in temporal 3D cardiac computed tomography angiography images of the same patient. This method provides auxiliary information that can be utilized in the diagnosis and treatment of coronary artery diseases. The proposed method consists of the following four steps. First, global registration is conducted through rigid registration between the 3D vessel centerlines obtained from temporal 3D cardiac CT angiography images. Second, point matching between the 3D vessel centerlines in the rigid registration results is performed, and the corresponding points are defined. Third, the outliers in the matched corresponding points are removed by using various information such as thickness and gradient of the vessels. Finally, non-rigid registration is conducted for hierarchical local transformation using an energy function. The experiment results show that the average registration error of the proposed method is 0.987 mm, and the average execution time is 2.137 s, indicating that the registration is accurate and rapid. The proposed method that enables rapid and accurate registration by using the information on blood vessel characteristics in temporal CTA images of the same patient.

Deep Learning Segmentation in 2D X-ray Images and Non-Rigid Registration in Multi-Modality Images of Coronary Arteries.

X-ray angiography is commonly used in the diagnosis and treatment of coronary artery disease with the advantage of visualization of the inside of blood vessels in real-time. However, it has several disadvantages that occur in the acquisition process, which causes inconvenience and difficulty. Here, we propose a novel segmentation and nonrigid registration method to provide useful real-time assistive images and information. A convolutional neural network is used for the segmentation of coronary arteries in 2D X-ray angiography acquired from various angles in real-time. To compensate for errors that occur during the 2D X-ray angiography acquisition process, 3D CT angiography is used to analyze the topological structure. A novel energy function-based 3D deformation and optimization is utilized to implement real-time registration. We evaluated the proposed method for 50 series from 38 patients by comparing the ground truth. The proposed segmentation method showed that Precision, Recall, and F1 score were 0.7563, 0.6922, and 0.7176 for all vessels, 0.8542, 0.6003, and 0.7035 for markers, and 0.8897, 0.6389, and 0.7386 for bifurcation points, respectively. In the nonrigid registration method, the average distance of 0.8705, 1.06, and 1. 5706 mm for all vessels, markers, and bifurcation points was achieved. The overall process execution time was 0.179 s.

Rapid and Accurate Registration Method between Intraoperative 2D XA and Preoperative 3D CTA Images for Guidance of Percutaneous Coronary Intervention.

In this paper, we propose a rapid rigid registration method for the fusion visualization of intraoperative 2D X-ray angiogram (XA) and preoperative 3D computed tomography angiography (CTA) images. First, we perform the cardiac cycle alignment of a patient's 2D XA and 3D CTA images obtained from a different apparatus. Subsequently, we perform the initial registration through alignment of the registration space and optimal boundary box. Finally, the two images are registered where the distance between two vascular structures is minimized by using the local distance map, selective distance measure, and optimization of transformation function. To improve the accuracy and robustness of the registration process, the normalized importance value based on the anatomical information of the coronary arteries is utilized. The experimental results showed fast, robust, and accurate registration using 10 cases, each of the left coronary artery (LCA) and right coronary artery (RCA). Our method can be used as a computer-aided technology for percutaneous coronary intervention (PCI). Our method can be applied to the study of other types of vessels.

Efficient blood flow visualization using flowline extraction and opacity modulation based on vascular structure analysis.

With the recent advances regarding the acquisition and simulation of blood flow data, blood flow visualization has been widely used in medical imaging for the diagnosis and treatment of pathological vessels. In this paper, we present a novel method for the visualization of the blood flow in vascular structures. The vessel inlet or outlet is first identified using the orthogonality metric between the normal vectors of the flow velocity and vessel surface. Then, seed points are generated on the identified inlet or outlet by Poisson disk sampling. Therefore, it is possible to achieve the automatic seeding that leads to a consistent and faster flow depiction by skipping the manual location of a seeding plane for the initiation of the line integration. In addition, the early terminated line integration in the thin curved vessels is resolved through the adaptive application of the tracing direction that is based on the flow direction at each seed point. Based on the observation that blood flow usually follows the vessel track, the representative flowline for each branch is defined by the vessel centerline. Then, the flowlines are rendered through an opacity assignment according to the similarity between their shape and the vessel centerline. Therefore, the flowlines that are similar to the vessel centerline are shown transparently, while the different ones are shown opaquely. Accordingly, the opacity modulation method enables the flowlines with an unusual flow pattern to appear more noticeable, while the visual clutter and line occlusion are minimized. Finally, Hue-Saturation-Value color coding is employed for the simultaneous exhibition of flow attributes such as local speed and residence time. The experiment results show that the proposed technique is suitable for the depiction of the blood flow in vascular structures. The proposed approach is applicable to many kinds of tubular structures with embedded flow information.

Interactive registration between supine and prone scans in computed tomography colonography using band-height images.

In computed tomographic colonography (CTC), a patient is commonly scanned twice including supine and prone scans to improve the sensitivity of polyp detection. Typically, a radiologist must manually match the corresponding areas in the supine and prone CT scans, which is a difficult and time-consuming task, even for experienced scan readers. In this paper, we propose a method of supine-prone registration utilizing band-height images, which are directly constructed from the CT scans using a ray-casting algorithm containing neighboring shape information. In our method, we first identify anatomical feature points and establish initial correspondences using local extreme points on centerlines. We then correct correspondences using band-height images that contain neighboring shape information. We use geometrical and image-based information to match positions between the supine and prone centerlines. Finally, our algorithm searches the correspondence of user input points using the matched anatomical feature point pairs as key points and band-height images. The proposed method achieved accurate matching and relatively faster processing time than other previously proposed methods. The mean error of the matching between the supine and prone points for uniformly sampled positions was 18.41±22.07mm in 20 CTC datasets. The average pre-processing time was 62.9±8.6s, and the interactive matching was performed in nearly real-time. Our supine-prone registration method is expected to be helpful for the accurate and fast diagnosis of polyps.

Automatic Four-Chamber Segmentation Using Level-Set Method and Split Energy Function.

OBJECTIVES: In this paper, we present an automatic method to segment four chambers by extracting a whole heart, separating the left and right sides of the heart, and spliting the atrium and ventricle regions from each heart in cardiac computed tomography angiography (CTA) efficiently. METHODS: We smooth the images by applying filters to remove noise. Next, the volume of interest is detected by using k-means clustering. In this step, the whole heart is coarsely extracted, and it is used for seed volumes in the next step. Then, we detect seed volumes using a geometric analysis based on anatomical information and separate the left and right heart regions with the power watershed algorithm. Finally, we refine the left and right sides of the heart using the level-set method, and extract the atrium and ventricle from the left and right heart regions using the split energy function. RESULTS: We tested the proposed heart segmentation method using 20 clinical scan datasets which were acquired from various patients. To validate the proposed heart segmentation method, we evaluated its accuracy in segmenting four chambers based on four error evaluation metrics. The average values of differences between the manual and automatic segmentations were less than 3.3%, approximately. CONCLUSIONS: The proposed method extracts the four chambers of the heart accurately, demonstrating that this approach can assist the cardiologist.

High-quality slab-based intermixing method for fusion rendering of multiple medical objects.

The visualization of multiple 3D objects has been increasingly required for recent applications in medical fields. Due to the heterogeneity in data representation or data configuration, it is difficult to efficiently render multiple medical objects in high quality. In this paper, we present a novel intermixing scheme for fusion rendering of multiple medical objects while preserving the real-time performance. First, we present an in-slab visibility interpolation method for the representation of subdivided slabs. Second, we introduce virtual zSlab, which extends an infinitely thin boundary (such as polygonal objects) into a slab with a finite thickness. Finally, based on virtual zSlab and in-slab visibility interpolation, we propose a slab-based visibility intermixing method with the newly proposed rendering pipeline. Experimental results demonstrate that the proposed method delivers more effective multiple-object renderings in terms of rendering quality, compared to conventional approaches. And proposed intermixing scheme provides high-quality intermixing results for the visualization of intersecting and overlapping surfaces by resolving aliasing and z-fighting problems. Moreover, two case studies are presented that apply the proposed method to the real clinical applications. These case studies manifest that the proposed method has the outstanding advantages of the rendering independency and reusability.

Automatic detection method of hepatocellular carcinomas using the non-rigid registration method of multi-phase liver CT images.

BACKGROUND: Multi-phase CT images are obtained sequentially after the injection of contrast agents so that there is a large amount of local deformation between images due to the respiratory and heart motion. Therefore, a non-rigid registration technique is required in order to establish the anatomical correspondence between the multi-phase CT images for liver CAD (computer-aided diagnosis). OBJECTIVE: In this paper, we propose the automatic detection method of hepatocellular carcinomas using the non-rigid registration method of multi-phase CT images. METHODS: Global movements between multi-phase CT images are aligned by rigid registration based on normalized mutual information. Local deformations between multi-phase CT images are modeled by non-rigid registration based on B-spline deformable model. After the registration of multi-phase CT images, hepatocellular carcinomas are automatically detected by analyzing the original and subtraction information of the registered multi-phase CT images. RESULTS: We applied our method to twenty five multi-phase CT datasets. Experimental results showed that the multi-phase CT images were accurately aligned. All of the hepatocellular carcinomas including small size ones in our 25 subjects were accurately detected using our method. CONCLUSION: We conclude that our method is useful for detecting hepatocellular carcinomas.

Fast and Accurate Semiautomatic Segmentation of Individual Teeth from Dental CT Images.

In this paper, we propose a fast and accurate semiautomatic method to effectively distinguish individual teeth from the sockets of teeth in dental CT images. Parameter values of thresholding and shapes of the teeth are propagated to the neighboring slice, based on the separated teeth from reference images. After the propagation of threshold values and shapes of the teeth, the histogram of the current slice was analyzed. The individual teeth are automatically separated and segmented by using seeded region growing. Then, the newly generated separation information is iteratively propagated to the neighboring slice. Our method was validated by ten sets of dental CT scans, and the results were compared with the manually segmented result and conventional methods. The average error of absolute value of volume measurement was 2.29 ± 0.56%, which was more accurate than conventional methods. Boosting up the speed with the multicore processors was shown to be 2.4 times faster than a single core processor. The proposed method identified the individual teeth accurately, demonstrating that it can give dentists substantial assistance during dental surgery.

An enhanced method for registration of dental surfaces partially scanned by a 3D dental laser scanning.

In this paper, we propose the fast and accurate registration method of partially scanned dental surfaces in a 3D dental laser scanning. To overcome the multiple point correspondence problems of conventional surface registration methods, we propose the novel depth map-based registration method to register 3D surface models. First, we convert a partially scanned 3D dental surface into a 2D image by generating the 2D depth map image of the surface model by applying a 3D rigid transformation into this model. Then, the image-based registration method using 2D depth map images accurately estimates the initial transformation between two consequently acquired surface models. To further increase the computational efficiency, we decompose the 3D rigid transformation into out-of-plane (i.e. x-, y-rotation, and z-translation) and in-plane (i.e. x-, y-translation, and z-rotation) transformations. For the in-plane transformation, we accelerate the transformation process by transforming the 2D depth map image instead of transforming the 3D surface model. For the more accurate registration of 3D surface models, we enhance iterative closest point (ICP) method for the subsequent fine registration. Our initial depth map-based registration well aligns each surface model. Therefore, our subsequent ICP method can accurately register two surface models since it is highly probable that the closest point pairs are the exact corresponding point pairs. The experimental results demonstrated that our method accurately registered partially scanned dental surfaces. Regarding the computational performance, our method delivered about 1.5 times faster registration than the conventional method. Our method can be successfully applied to the accurate reconstruction of 3D dental objects for orthodontic and prosthodontic treatment.

Parallelized seeded region growing using CUDA.

This paper presents a novel method for parallelizing the seeded region growing (SRG) algorithm using Compute Unified Device Architecture (CUDA) technology, with intention to overcome the theoretical weakness of SRG algorithm of its computation time being directly proportional to the size of a segmented region. The segmentation performance of the proposed CUDA-based SRG is compared with SRG implementations on single-core CPUs, quad-core CPUs, and shader language programming, using synthetic datasets and 20 body CT scans. Based on the experimental results, the CUDA-based SRG outperforms the other three implementations, advocating that it can substantially assist the segmentation during massive CT screening tests.