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Coronary artery lumen delineation, to localize and grade stenosis, is an important but tedious and challenging task for coronary heart disease evaluation. Deep learning has recently been successful applied to many applications, including medical imaging. However for small imaged objects such as coronary arteries and their segmentation, it remains a challenge. This paper investigates coronary artery lumen segmentation using 3D U-net convolutional neural networks, and tests its utility with multiple datasets on two settings. We adapted the computed tomography coronary angiography (CTCA) volumes into small patches for the networks and tuned the kernels, layers and the batch size for machine learning. Our experiment involves additional efforts to select and test various data transform, so as to reduce the problem of overfitting. Compared with traditional normalization of data, we showed that subject-specific normalization of dataset was superior to patch based normalization. The results also showed that the proposed deep learning approach outperformed other methods, evaluated by the Dice coefficients.

The CT angiography (CTA) is a clinically indicated test for the assessment of coronary luminal stenosis that requires centerline extractions. There is currently no centerline extraction algorithm that is automatic, real-time and very accurate. Therefore, we sought to (i) develop a hybrid approach by incorporating fast marching and Runge-Kutta based methods for the extraction of coronary artery centerlines from CTA; (ii) evaluate the accuracy of the present method compared to Van's method by using ground truth centerline as a reference; (iii) evaluate the coronary lumen area of our centerline method in comparison with the intravascular ultrasound (IVUS) as the standard of reference. The proposed method was found to be more computationally efficient, and performed better than the Van's method in terms of overlap measures (i.e., OV: [Formula: see text] vs. [Formula: see text]; OF: [Formula: see text] vs. [Formula: see text]; and OT: [Formula: see text] vs. [Formula: see text], all [Formula: see text]). In comparison with IVUS derived coronary lumen area, the proposed approach was more accurate than the Van's method. This hybrid approach by incorporating fast marching and Runge-Kutta based methods could offer fast and accurate extraction of centerline as well as the lumen area. This method may garner wider clinical potential as a real-time coronary stenosis assessment tool.

An interactive surgical simulation system needs to meet three main requirements, speed, accuracy, and stability. In this paper, we present a stable and accurate method for animating mass-spring systems in real time. An integration scheme derived from explicit integration is used to obtain interactive realistic animation for a multiobject environment. We explore a predictor-corrector approach by correcting the estimation of the explicit integration in a poststep process. We introduce novel constraints on positions into the mass-spring model (MSM) to model the nonlinearity and preserve volume for the realistic simulation of the incompressibility. We verify the proposed MSM by comparing its deformations with the reference deformations of the nonlinear finite-element method. Moreover, experiments on porcine organs are designed for the evaluation of the multiobject deformation. Using a pair of freshly harvested porcine liver and gallbladder, the real organ deformations are acquired by computed tomography and used as the reference ground truth. Compared to the porcine model, our model achieves a 1.502 mm mean absolute error measured at landmark locations for cases with small deformation (the largest deformation is 49.109 mm) and a 3.639 mm mean absolute error for cases with large deformation (the largest deformation is 83.137 mm). The changes of volume for the two deformations are limited to 0.030% and 0.057%, respectively. Finally, an implementation in a virtual reality environment for laparoscopic cholecystectomy demonstrates that our model is capable to simulate large deformation and preserve volume in real-time calculations.

We propose a new variant of the Mumford-Shah model for simultaneous bias correction and segmentation of images with intensity inhomogeneity. First, based on the model of images with intensity inhomogeneity, we introduce an L0 gradient regularizer to model the true intensity and a smooth regularizer to model the bias field. In addition, we derive a new data fidelity using the local intensity properties to allow the bias field to be influenced by its neighborhood. Second, we use a two-stage segmentation method, where the fast alternating direction method is implemented in the first stage for the recovery of true intensity and bias field and a simple thresholding is used in the second stage for segmentation. Different from most of the existing methods for simultaneous bias correction and segmentation, we estimate the bias field and true intensity without fixing either the number of the regions or their values in advance. Our method has been validated on medical images of various modalities with intensity inhomogeneity. Compared with the state-of-art approaches and the well-known brain software tools, our model is fast, accurate, and robust with initializations.

Information about abdominal wall can be used for many applications from organ segmentation, registration, and surgical simulation. The challenges exist in abdominal wall extraction due to its varieties in shapes, connection to the internal organs and anterior layer edge formed between the muscle and fascia/fatty layer, which may distract the shape model. In this paper we present an approach to the posterior abdominal wall extraction using the shape model and other abdominal context, particularly with the rib-spine bone information and the wall image features. The shape model is constructed based on the training abdominal walls that are delineated manually. After bone information being extracted, the wall shape deforms from the prior shape model using the snake, which is constrained by the bone context and guided by the processed image energy map with the aim of removing distracted image features of anterior abdominal wall and the outer region from the original map. Meanwhile, an overall convex shape is maintained by limiting the angles of the contour points. The proposed approach is tested on abdominal CT data which provides encouraging results.

Purpose: Characterization of focal liver lesions with various imaging modalities can be very challenging in the clinical practice and is experience-dependent. The authors' aim is to develop an automatic method to facilitate the characterization of focal liver lesions (FLLs) using multiphase computed tomography (CT) images by radiologists., Methods: A multiphase-image retrieval system is proposed to retrieve a preconstructed database of FLLs with confirmed diagnoses, which can assist radiologists' decision-making in FLL characterization. It first localizes the FLL on multiphase CT scans using a hybrid generative-discriminative FLL detection method and a nonrigid B-spline registration method. Then, it extracts the multiphase density and texture features to numerically represent the FLL. Next, it compares the query FLL with the model FLLs in the database in terms of the feature and measures their similarities using the L1-norm based similarity scores. The model FLLs are ranked by similarities and the top results are finally provided to the users for their evidence studies., Results: The system was tested on a database of 69 four-phase contrast-enhanced CT scans, consisting of six classes of liver lesions, and evaluated in terms of the precision-recall curve and the Bull's Eye Percentage Score (BEP). It obtained a BEP score of 78%. Compared with any single-phase based representation, the multiphase-based representation increased the BEP scores of the system, from 63%-65% to 78%. In a pilot study, two radiologists performed characterization of FLLs without and with the knowledge of the top five retrieved results. The results were evaluated in terms of the diagnostic accuracy, the receiver operating characteristic (ROC) curve and the mean diagnostic confidence. One radiologist's accuracy improved from 75% to 92%, the area under ROC curves (AUC) from 0.85 to 0.95 (p = 0.081), and the mean diagnostic confidence from 4.6 to 7.3 (p = 0.039). The second radiologist's accuracy did not change, at 75%, with AUC increasing from 0.72 to 0.75 (p = 0.709), and the mean confidence from 4.5 to 4.9 (p = 0.607)., Conclusions: Multiphase CT images can be used in content-based image retrieval for FLL's categorization and result in good performance in comparison with single-phase CT images. The proposed method has the potential to improve the radiologists' diagnostic accuracy and confidence by providing visually similar lesions with confirmed diagnoses for their interpretation of clinical studies.

This paper presents an approach to detection and segmentation of liver tumors in 3D computed tomography (CT) images. The automatic detection of tumor can be formulized as novelty detection or two-class classification issue. The method can also be used for tumor segmentation, where each voxel is to be assigned with a correct label, either a tumor class or nontumor class. A voxel is represented with a rich feature vector that distinguishes itself from voxels in different classes. A fast learning algorithm Extreme Learning Machine (ELM) is trained as a voxel classifier. In automatic liver tumor detection, we propose and show that ELM can be trained as a one-class classifier with only healthy liver samples in training. It results in a method of tumor detection based on novelty detection. We compare it with two-class ELM. To extract the boundary of a tumor, we adopt the semi-automatic approach by randomly selecting samples in 3D space within a limited region of interest (ROI) for classifier training. Our approach is validated on a group of patients' CT data and the experiment shows good detection and encouraging segmentation results.