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Register a new userPatient Specific Biomechanics Are Clinically Significant In Accurate Computer Aided Surgical Image Guidance
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Augmented Reality is used in Image Guided surgery (AR IG) to fuse surgical landmarks from preoperative images into a video overlay. Physical simulation is essential to maintaining accurate position of the landmarks as surgery progresses and ensuring patient safety by avoiding accidental damage to vessels etc. In liver procedures, AR IG simulation accuracy is hampered by an inability to model stiffness variations unique to the patients disease. We introduce a novel method to account for patient specific stiffness variation based on Magnetic Resonance Elastography (MRE) data. To the best of our knowledge we are the first to demonstrate the use of in-vivo biomechanical data for AR IG landmark placement. In this early work, a comparative evaluation of our MRE data driven simulation and the traditional method shows clinically significant differences in accuracy during landmark placement and motivates further animal model trials.
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Invasive intracranial electroencephalography (iEEG) or electrocorticography (ECoG) measures electrical potential directly on the surface of the brain, and, combined with numerical modeling, can be used to inform treatment planning for epilepsy surgery. Accurate solution of the iEEG or ECoG forward problem, which is a crucial prerequisite for solving the inverse problem in epilepsy seizure onset localization, requires accurate representation of the patients brain geometry and tissue electrical conductivity after implantation of electrodes. However, implantation of subdural grid electrodes causes the brain to deform, which invalidates preoperatively acquired image data. Moreover, postoperative MRI is incompatible with implanted electrodes and CT has insufficient range of soft tissue contrast, which precludes both MRI and CT from being used to obtain the deformed postoperative geometry. In this paper, we present a biomechanics-based image warping procedure using preoperative MRI for tissue classification and postoperative CT for locating implanted electrodes to perform non-rigid registration of the preoperative image data to the postoperative configuration. We solve the iEEG forward problem on the predicted postoperative geometry using the finite element method (FEM) which accounts for patient-specific inhomogeneity and anisotropy of tissue conductivity. Results for the simulation of a current source in the brain show large differences in electrical potential predicted by the models based on the original images and the deformed images corresponding to the brain geometry deformed by placement of invasive electrodes. Computation of the leadfield matrix also showed significant differences between the different models. The results suggest that significant improvements in source localization accuracy may be realized by the application of the proposed modeling methodology.
Current Computer-Aided Diagnosis (CAD) methods mainly depend on medical images. The clinical information, which usually needs to be considered in practical clinical diagnosis, has not been fully employed in CAD. In this paper, we propose a novel deep learning-based method for fusing Magnetic Resonance Imaging (MRI)/Computed Tomography (CT) images and clinical information for diagnostic tasks. Two paths of neural layers are performed to extract image features and clinical features, respectively, and at the same time clinical features are employed as the attention to guide the extraction of image features. Finally, these two modalities of features are concatenated to make decisions. We evaluate the proposed method on its applications to Alzheimers disease diagnosis, mild cognitive impairment converter prediction and hepatic microvascular invasion diagnosis. The encouraging experimental results prove the values of the image feature extraction guided by clinical features and the concatenation of two modalities of features for classification, which improve the performance of diagnosis effectively and stably.
Rationale: Computer aided detection (CAD) algorithms for Pulmonary Embolism (PE) algorithms have been shown to increase radiologists sensitivity with a small increase in specificity. However, CAD for PE has not been adopted into clinical practice, likely because of the high number of false positives current CAD software produces. Objective: To generate a database of annotated computed tomography pulmonary angiographies, use it to compare the sensitivity and false positive rate of current algorithms and to develop new methods that improve such metrics. Methods: 91 Computed tomography pulmonary angiography scans were annotated by at least one radiologist by segmenting all pulmonary emboli visible on the study. 20 annotated CTPAs were open to the public in the form of a medical image analysis challenge. 20 more were kept for evaluation purposes. 51 were made available post-challenge. 8 submissions, 6 of them novel, were evaluated on the 20 evaluation CTPAs. Performance was measured as per embolus sensitivity vs. false positives per scan curve. Results: The best algorithms achieved a per-embolus sensitivity of 75% at 2 false positives per scan (fps) or of 70% at 1 fps, outperforming the state of the art. Deep learning approaches outperformed traditional machine learning ones, and their performance improved with the number of training cases. Significance: Through this work and challenge we have improved the state-of-the art of computer aided detection algorithms for pulmonary embolism. An open database and an evaluation benchmark for such algorithms have been generated, easing the development of further improvements. Implications on clinical practice will need further research.
Low grade endometrial stromal sarcoma (LGESS) is rare form of cancer, accounting for about 0.2% of all uterine cancer cases. Approximately 75% of LGESS patients are initially misdiagnosed with leiomyoma, which is a type of benign tumor, also known as fibroids. In this research, uterine tissue biopsy images of potential LGESS patients are preprocessed using segmentation and staining normalization algorithms. A variety of classic machine learning and leading deep learning models are then applied to classify tissue images as either benign or cancerous. For the classic techniques considered, the highest classification accuracy we attain is about 0.85, while our best deep learning model achieves an accuracy of approximately 0.87. These results indicate that properly trained learning algorithms can play a useful role in the diagnosis of LGESS.
Pulmonary embolism (PE) represents a thrombus (blood clot), usually originating from a lower extremity vein, that travels to the blood vessels in the lung, causing vascular obstruction and in some patients, death. This disorder is commonly diagnosed using CT pulmonary angiography (CTPA). Deep learning holds great promise for the computer-aided CTPA diagnosis (CAD) of PE. However, numerous competing methods for a given task in the deep learning literature exist, causing great confusion regarding the development of a CAD PE system. To address this confusion, we present a comprehensive analysis of competing deep learning methods applicable to PE diagnosis using CTPA at the both image and exam levels. At the image level, we compare convolutional neural networks (CNNs) with vision transformers, and contrast self-supervised learning (SSL) with supervised learning, followed by an evaluation of transfer learning compared with training from scratch. At the exam level, we focus on comparing conventional classification (CC) with multiple instance learning (MIL). Our extensive experiments consistently show: (1) transfer learning consistently boosts performance despite differences between natural images and CT scans, (2) transfer learning with SSL surpasses its supervised counterparts; (3) CNNs outperform vision transformers, which otherwise show satisfactory performance; and (4) CC is, surprisingly, superior to MIL. Compared with the state of the art, our optimal approach provides an AUC gain of 0.2% and 1.05% for image-level and exam-level, respectively.
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