Landmark-based elastic registration using approximating thin-plate splines.

We consider elastic image registration based on a set of corresponding anatomical point landmarks and approximating thin-plate splines. This approach is an extension of the original interpolating thin-plate spline approach and allows to take into account landmark localization errors. The extension is important for clinical applications since landmark extraction is always prone to error. Our approach is based on a minimizing functional and can cope with isotropic as well as anisotropic landmark errors. In particular, in the latter case it is possible to include different types of landmarks, e.g., unique point landmarks as well as arbitrary edge points. Also, the scheme is general with respect to the image dimension and the order of smoothness of the underlying functional. Optimal affine transformations as well as interpolating thin-plate splines are special cases of this scheme. To localize landmarks we use a semi-automatic approach which is based on three-dimensional (3-D) differential operators. Experimental results are presented for two-dimensional as well as 3-D tomographic images of the human brain.

Three-dimensional reconstruction of high contrast objects using C-arm image intensifier projection data.

The reconstruction of three-dimensional (3D) objects from 2D X-ray cone-beam projections using a circular source path is most commonly done with an algorithm according to Feldkamp et al. [Feldkamp LA, Davis LC, Kress JW. Practical cone-beam algorithms. J Opt Soc Am A 1984;6:612-619]. An adaptation of this so-called Feldkamp method to cone-beam projections acquired with a C-arm system is presented here. In a phantom study, reconstruction results obtained along real source-detector trajectories of a C-arm system are compared to reconstruction results obtained from projections acquired from a full-circular trajectory and from one consisting of two full orthogonal circles, which fulfills Tuy's sufficiency condition. The straightforward application of Feldkamp's method adapted to projection data obtained with a C-arm system illustrates the 3D imaging potential of image intensifier based cone-beam computed tomography. Reconstruction results from projection data of different patients acquired with a motorized C-arm system such as vessel structures filled with contrast agent and bones are presented.

The EASI project--improving the effectiveness and quality of image-guided surgery.

In recent years, advances in computer technology and a significant increase in the accuracy of medical imaging have made it possible to develop systems that can assist the clinician in diagnosis, planning, and treatment. This paper deals with an area that is generally referred to as computer-assisted surgery, image-directed surgery, or image-guided surgery. We report the research, development, and clinical validation performed since January 1996 in the European Applications in Surgical Interventions (EASI) project, which is funded by the European Commission in their "4th Framework Telematics Applications for Health" program. The goal of this project is the improvement of the effectiveness and quality of image-guided neurosurgery of the brain and image-guided vascular surgery of abdominal aortic aneurysms, while at the same time reducing patient risks and overall cost. We have developed advanced prototype systems for preoperative surgical planning and intraoperative surgical navigation, and we have extensively clinically validated these systems. The prototype systems and the clinical validation results are described in this paper.

AIM Project A2003: COmputer VIsion in RAdiology (COVIRA).

This paper presents an overview of the COVIRA project, AIM Project No. 2003. The COVIRA consortium is performing research in the area of Multimodality Image Analysis, i.e., Registration and Segmentation. Together with results in the areas of Visualization, User Interface, Digital Anatomy Atlas, Conformal 3D Radiation Therapy Planning, and Cerebral Vessel Tree Reconstruction, clinical validation of initial results is under way at six clinical sites in five European countries. The main objective is to achieve an increase in efficiency and quality of healthcare in Neuro-radiological Diagnosis and Treatment Planning.

Multidisciplinary team counseling for fetal anomalies.

Prenatal management of fetal anomalies requires a cooperative effort of the family, obstetrician, ultrasonographer, neonatologist, pediatric subspecialists, nursing staff, geneticists, and social workers. Our approach to these patients is to convene all team members and the family shortly after an anomaly is identified to review the diagnosis, prognosis, plans, and alternatives. Team counseling offers a clear definition of the problem, avoids unnecessary confusion and anxiety for the family, and provides a supportive environment during this family crisis. Our experience with 28 families has been favorable and is described herein.

Real-time interactive NMR image synthesis.

A method is presented which allows us to synthesize NMR images for arbitrary pulse sequence timing parameters in real time after user input via trackball. The synthesis is based on calculated proton density and relaxation time images obtained from a special pulse sequence. Due to the real-time operation, the method can be used both as an educational tool and for diagnostic evaluation of images assuring optimum contrast. Details of the technical implementation are given and examples are presented for spin echo as well as inversion recovery images. Finally, alternative means of presenting the density and relaxation time data are discussed which do not relate to certain pulse sequences.

Aggressiveness of SJL/J lymphomas correlates with absence of H-2Ds antigens.

SJL/J lymphomas emerged as H-2Ds-negative variants upon transplantation of their respective H-2Ds-positive spontaneous tumors. Of nine spontaneous SJL/J lymphomas examined, only two contained detectable numbers of H-2Ds-negative tumor cells. Of seven successfully transplanted tumors, however, four emerged as predominantly H-2Ds-negative tumors by their second transplantation. Long term SJL/J lymphoma lines, RCS 5 and SJL/SJL, were also found to be H-2Ds-negative. The expression of H-2Ks and I-As were maintained on all tumor lines examined. H-2Ds-negative tumor cells were consistent stimulators of syngeneic lymphoproliferation, whereas tumors maintaining H-2Ds expression varied in their stimulatory capacity. Transplantation times required to achieve morbidity in syngeneic mice correlated with tumor cell expression of H-2Ds. Tumors maintaining H-2Ds expression were less aggressive and required 57 to 150 days to produce morbidity compared with highly aggressive H-2Ds-negative tumors that required only 7 to 10 days at one-quarter of the cell dose (10(7) cells). Growth curve analysis based on spleen weights (corrected for body weight) indicated that three types of SJL/J lymphomas could be identified based on their expression of H-2Ds and ability to stimulate syngeneic lymphoproliferation: 1) indolent, nonstimulatory H-2Ds-positive tumors; 2) indolent, stimulatory H-2Ds-positive tumors; and 3) highly aggressive, stimulatory H-2Ds-negative tumors.