Fahmi Khalifa

Models and methods for analyzing DCE‐MRI: A review

PURPOSE To present a review of most commonly used techniques to analyze dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), discusses their strengths and weaknesses, and outlines recent clinical applications of findings from these approaches. METHODS DCE-MRI allows for noninvasive quantitative analysis of contrast agent (CA) transient in soft tissues. Thus, it is an important and well-established tool to reveal microvasculature and perfusion in various clinical applications. In the last three decades, a host of nonparametric and parametric models and methods have been developed in order to quantify the CAs perfusion into tissue and estimate perfusion-related parameters (indexes) from signal- or concentration-time curves. These indexes are widely used in various clinical applications for the detection, characterization, and therapy monitoring of different diseases. RESULTS Promising theoretical findings and experimental results for the reviewed models and techniques in a variety of clinical applications suggest that DCE-MRI is a clinically relevant imaging modality, which can be used for early diagnosis of different diseases, such as breast and prostate cancer, renal rejection, and liver tumors. CONCLUSIONS Both nonparametric and parametric approaches for DCE-MRI analysis possess the ability to quantify tissue perfusion.

Focal cortical dysplasias in autism spectrum disorders

BackgroundPrevious reports indicate the presence of histological abnormalities in the brains of individuals with autism spectrum disorders (ASD) suggestive of a dysplastic process. In this study we identified areas of abnormal cortical thinning within the cerebral cortex of ASD individuals and examined the same for neuronal morphometric abnormalities by using computerized image analysis.ResultsThe study analyzed celloidin-embedded and Nissl-stained serial full coronal brain sections of 7 autistic (ADI-R diagnosed) and 7 age/sex-matched neurotypicals. Sections were scanned and manually segmented before implementing an algorithm using Laplace’s equation to measure cortical width. Identified areas were then subjected to analysis for neuronal morphometry. Results of our study indicate the presence within our ASD population of circumscribed foci of diminished cortical width that varied among affected individuals both in terms of location and overall size with the frontal lobes being particularly involved. Spatial statistic indicated a reduction in size of neurons within affected areas. Granulometry confirmed the presence of smaller pyramidal cells and suggested a concomitant reduction in the total number of interneurons.ConclusionsThe neuropathology is consistent with a diagnosis of focal cortical dysplasia (FCD). Results from the medical literature (e.g., heterotopias) and our own study suggest that the genesis of this cortical malformation seemingly resides in the heterochronic divisions of periventricular germinal cells. The end result is that during corticogenesis radially migrating neuroblasts (future pyramidal cells) are desynchronized in their development from those that follow a tangential route (interneurons). The possible presence of a pathological mechanism in common among different conditions expressing an autism-like phenotype argue in favor of considering ASD a “sequence” rather than a syndrome. Focal cortical dysplasias in ASD may serve to explain the high prevalence of seizures and sensory abnormalities in this patient population.

Precise Segmentation of 3-D Magnetic Resonance Angiography

Accurate automatic extraction of a 3-D cerebrovascular system from images obtained by time-of-flight (TOF) or phase contrast (PC) magnetic resonance angiography (MRA) is a challenging segmentation problem due to the small size objects of interest (blood vessels) in each 2-D MRA slice and complex surrounding anatomical structures (e.g., fat, bones, or gray and white brain matter). We show that due to the multimodal nature of MRA data, blood vessels can be accurately separated from the background in each slice using a voxel-wise classification based on precisely identified probability models of voxel intensities. To identify the models, an empirical marginal probability distribution of intensities is closely approximated with a linear combination of discrete Gaussians (LCDG) with alternate signs, using our previous EM-based techniques for precise linear combination of Gaussian-approximation adapted to deal with the LCDGs. The high accuracy of the proposed approach is experimentally validated on 85 real MRA datasets (50 TOF and 35 PC) as well as on synthetic MRA data for special 3-D geometrical phantoms of known shapes.

Accurate Automatic Analysis of Cardiac Cine Images

Acquisition of noncontrast agent cine cardiac magnetic resonance (CMR) gated images through the cardiac cycle is, at present, a well-established part of examining cardiac global function. However, regional quantification is less well established. We propose a new automated framework for analyzing the wall thickness and thickening function on these images that consists of three main steps. First, inner and outer wall borders are segmented from their surrounding tissues with a geometric deformable model guided by a special stochastic speed relationship. The latter accounts for Markov-Gibbs shape and appearance models of the object-of-interest and its background. In the second step, point-to-point correspondences between the inner and outer borders are found by solving the Laplace equation and provide initial estimates of the local wall thickness and the thickening function index. Finally, the effects of the segmentation error is reduced and a continuity analysis of the LV wall thickening is performed through iterative energy minimization using a generalized Gauss-Markov random field (GGMRF) image model. The framework was evaluated on 26 datasets from clinical cine CMR images that have been collected from patients with eleven independent studies, with chronic ischemic heart disease and heart damage. The performance evaluation of the proposed segmentation approach, based on the receiver operating characteristic (ROC) and Dice similarity coefficients (DSC) between manually drawn and automatically segmented contours, confirmed a high robustness and accuracy of the proposed segmentation approach. Furthermore, the Bland-Altman plot is used to assess the limit of agreement of our measurements of the global function parameters compared to the ground truth. Importantly, comparative results on the publicly available database (MICCAI 2009 Cardiac MR Left Ventricle Segmentation) demonstrated a superior performance of the proposed segmentation approach over published methods.

Non-invasive image-based approach for early detection of acute renal rejection

Abstract. A promising approach for the automatic classification of normal and acute rejection transplants from Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI) is proposed. The proposed approach consists of three main steps. The first step segments the kidney from the surrounding abdominal tissues by a level-set based deformable model with a speed function that accounts for a learned spatially variant statistical shape prior, 1st-order visual appearance descriptors of the contour interior and exterior (associated with the object and background, respectively), and a spatially invariant 2nd-order homogeneity descriptor. In the second step, to handle local object deformations due to kidney motion caused by patient breathing, we proposed a new nonrigid approach to align the object by solving Laplaces equation between closed equis-paced contours (iso-contours) of the reference and target objects. Finally, the perfusion curves that show the transportation of the contrast agent into the tissue are obtained from the segmented kidneys and used in the classification of normal and acute rejection transplants. Applications of the proposed approach yield promising results that would, in the near future, replace the use of current technologies such as nuclear imaging and ultrasonography, which are not specific enough to determine the type of kidney dysfunction.

3d kidney segmentation from CT images using a level set approach guided by a novel stochastic speed function

Kidney segmentation is a key step in developing any noninvasive computer-aided diagnosis (CAD) system for early detection of acute renal rejection. This paper describes a new 3-D segmentation approach for the kidney from computed tomography (CT) images. The kidney borders are segmented from the surrounding abdominal tissues with a geometric deformable model guided by a special stochastic speed relationship. The latter accounts for a shape prior and appearance features in terms of voxel-wise image intensities and their pair-wise spatial interactions integrated into a two-level joint Markov-Gibbs random field (MGRF) model of the kidney and its background. The segmentation approach was evaluated on 21 CT data sets with available manual expert segmentation. The performance evaluation based on the receiver operating characteristic (ROC) and Dice similarity coefficient (DSC) between manually drawn and automatically segmented contours confirm the robustness and accuracy of the proposed segmentation approach.

Dynamic Contrast-Enhanced MRI-Based Early Detection of Acute Renal Transplant Rejection

A novel framework for the classification of acute rejection versus nonrejection status of renal transplants from 2-D dynamic contrast-enhanced magnetic resonance imaging is proposed. The framework consists of four steps. First, kidney objects are segmented from adjacent structures with a level set deformable boundary guided by a stochastic speed function that accounts for a fourth-order Markov-Gibbs random field model of the kidney/background shape and appearance. Second, a Laplace-based nonrigid registration approach is used to account for local deformations caused by physiological effects. Namely, the target kidney object is deformed over closed, equispaced contours (iso-contours) to closely match the reference object. Next, the cortex is segmented as it is the functional kidney unit that is most affected by rejection. To characterize rejection, perfusion is estimated from contrast agent kinetics using empirical indexes, namely, the transient phase indexes (peak signal intensity, time-to-peak, and initial up-slope), and a steady-phase index defined as the average signal change during the slowly varying tissue phase of agent transit. We used a kn-nearest neighbor classifier to distinguish between acute rejection and nonrejection. Performance of our method was evaluated using the receiver operating characteristics (ROC). Experimental results in 50 subjects, using a combinatoric kn-classifier, correctly classified 92% of training subjects, 100% of the test subjects, and yielded an area under the ROC curve that approached the ideal value. Our proposed framework thus holds promise as a reliable noninvasive diagnostic tool.

A comprehensive non-invasive framework for automated evaluation of acute renal transplant rejection using DCE-MRI

The objective was to develop a novel and automated comprehensive framework for the non‐invasive identification and classification of kidney non‐rejection and acute rejection transplants using 2D dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI).

State-of-the-Art Medical Image Registration Methodologies: A Survey

Almost all computer vision applications, from remote sensing and cartography to medical imaging and biometrics, use image registration or alignment techniques that establish spatial correspondence (one-to-one mapping) between two or more images. These images depict either one planar (2-D) or volumetric (3-D) scene or several such scenes and can be taken at different times, from various viewpoints, and/or by multiple sensors. In medical image processing and analysis, the image registration is instrumental for clinical diagnosis and therapy planning, e.g., to follow disease progression and/or response to treatment, or integrate information from different sources/modalities to form more detailed descriptions of anatomical objects-of-interest. The unified registration goal – aligning a 2-D or 3-D target (sensed) image with a reference image – is reached by specifying a mathematical model of image transformations for and determining model parameters of the desired alignment. Frequently, the parameters provide an optimum of a goal function supported by the parameter space, so that the registration reduces to a certain optimization problem. This chapter overviews the 2-D and the 3-D medical image registration with special reference to the state-of-the-art robust techniques proposed for the last decade and discusses their advantages, drawbacks, and practical implementations.

Shape-Appearance Guided Level-Set Deformable Model for Image Segmentation

A new speed function to guide evolution of a level-set based active contour is proposed for segmenting an object from its background in a given image. The guidance accounts for a learned spatially variant statistical shape prior, 1st-order visual appearance descriptors of the contour interior and exterior (associated with the object and background, respectively), and a spatially invariant 2nd-order homogeneity descriptor. The shape prior is learned from a subset of co-aligned training images. The visual appearances are described with marginal gray level distributions obtained by separating their mixture over the image. The evolving contour interior is modeled by a 2nd-order translation and rotation invariant Markov-Gibbs random field of object/background labels with analytically estimated potentials. Experiments with kidney CT images confirm robustness and accuracy of the proposed approach.