Mobile tele-echography: user interface design.

Ultrasound imaging allows the evaluation of the degree of emergency of a patient. However, in some instances, a well-trained sonographer is unavailable to perform such echography. To cope with this issue, the Mobile Tele-Echography Using an Ultralight Robot (OTELO) project aims to develop a fully integrated end-to-end mobile tele-echography system using an ultralight remote-controlled robot for population groups that are not served locally by medical experts. This paper focuses on the user interface of the OTELO system, consisting of the following parts: an ultrasound video transmission system providing real-time images of the scanned area, an audio/video conference to communicate with the paramedical assistant and with the patient, and a virtual-reality environment, providing visual and haptic feedback to the expert, while capturing the expert's hand movements. These movements are reproduced by the robot at the patient site while holding the ultrasound probe against the patient skin. In addition, the user interface includes an image processing facility for enhancing the received images and the possibility to include them into a database.

Predictive (un)distortion model and 3-D reconstruction by biplane snakes.

This paper is concerned with the three-dimensional (3-D) reconstruction of coronary vessel centerlines and with how distortion of X-ray angiographic images affects it. Angiographies suffer from pincushion and other geometrical distortions, caused by the peripheral concavity of the image intensifier (II) and the nonlinearity of electronic acquisition devices. In routine clinical practice, where a field-of-view (FOV) of 17-23 cm is commonly used for the acquisition of coronary vessels, this distortion introduces a positional error of up to 7 pixels for an image matrix size of 512 x 512 and an FOV of 17 cm. This error increases with the size of the FOV. Geometrical distortions have a significant effect on the validity of the 3-D reconstruction of vessels from these images. We show how this effect can be reduced by integrating a predictive model of (un)distortion into the biplane snakes formulation for 3-D reconstruction. First, we prove that the distortion can be accurately modeled using a polynomial for each view. Also, we show that the estimated polynomial is independent of focal length, but not of changes in anatomical angles, as the II is influenced by the earth's magnetic field. Thus, we decompose the polynomial into two components: the steady and the orientation-dependent component. We determine the optimal polynomial degree for each component, which is empirically determined to be five for the steady component and three for the orientation-dependent component. This fact simplifies the prediction of the orientation-dependent polynomial, since the number of polynomial coefficients to be predicted is lower. The integration of this model into the biplane snakes formulation enables us to avoid image unwarping, which deteriorates image quality and therefore complicates vessel centerline feature extraction. Moreover, we improve the biplane snake behavior when dealing with wavy vessels, by means of using generalized gradient vector flow. Our experiments show that the proposed methods in this paper decrease up to 88% the reconstruction error obtained when geometrical distortion effects are ignored. Tests on imaged phantoms and real cardiac images are presented as well.