Miguel Ángel González Ballester

Optimisation of orthopaedic implant design using statistical shape space analysis based on level sets.

Statistical shape analysis techniques have shown to be efficient tools to build population specific models of anatomical variability. Their use is commonplace as prior models for segmentation, in which case the instance from the shape model that best fits the image data is sought. In certain cases, however, it is not just the most likely instance that must be searched, but rather the whole set of shape instances that meet certain criterion. In this paper we develop a method for the assessment of specific anatomical/morphological criteria across the shape variability found in a population. The method is based on a level set segmentation approach, and used on the parametric space of the statistical shape model of the target population, solved via a multi-level narrow-band approach for computational efficiency. Based on this technique, we develop a framework for evidence-based orthopaedic implant design. To date, implants are commonly designed and validated by evaluating implant bone fitting on a limited set of cadaver bones, which not necessarily span the whole variability in the population. Based on our framework, we can virtually fit a proposed implant design to samples drawn from the statistical model, and assess which range of the population is suitable for the implant. The method highlights which patterns of bone variability are more important for implant fitting, allowing and easing implant design improvements, as to fit a maximum of the target population. Results are presented for the optimisation of implant design of proximal human tibia, used for internal fracture fixation.

Accurate and robust reconstruction of proximal femur from sparse intraoperative data and dense point distribution model for surgical navigation

Constructing a 3D surface model from sparse-point data is a nontrivial task. Here, we report an accurate and robust approach for reconstructing a surface model of the proximal femur from sparse-point data and a dense-point distribution model (DPDM). The problem is formulated as a three-stage optimal estimation process. The first stage, affine registration, is to iteratively estimate a scale and a rigid transformation between the mean surface model of the DPDM and the sparse input points. The estimation results of the first stage are used to establish point correspondences for the second stage, statistical instantiation, which stably instantiates a surface model from the DPDM using a statistical approach. This surface model is then fed to the third stage, kernel-based deformation, which further refines the surface model. Handling outliers is achieved by consistently employing the least trimmed squares (LTS) approach with a roughly estimated outlier rate in all three stages. If an optimal value of the outlier rate is preferred, we propose a hypothesis testing procedure to automatically estimate it. We present here our validations using four experiments, which include 1 leave-one-out experiment, 2 experiment on evaluating the present approach for handling pathology, 3 experiment on evaluating the present approach for handling outliers, and 4 experiment on reconstructing surface models of seven dry cadaver femurs using clinically relevant data without noise and with noise added. Our validation results demonstrate the robust performance of the present approach in handling outliers, pathology, and noise. An average 95-percentile error of 1.7-2.3 mm was found when the present approach was used to reconstruct surface models of the cadaver femurs from sparse-point data with noise added.

Patient-Specific Simulation of Implant Placement and Function for Cochlear Implantation Surgery Planning

We present a framework for patient specific electrical stimulation of the cochlea, that allows to perform in-silico analysis of implant placement and function before surgery. A Statistical Shape Model (SSM) is created from high-resolution human μCT data to capture important anatomical details. A Finite Element Model (FEM) is built and adapted to the patient using the results of the SSM. Electrical simulations based on Maxwells equations for the electromagnetic field are performed on this personalized model. The model includes implanted electrodes and nerve fibers. We present the results for the bipolar stimulation protocol and predict the voltage spread and the locations of nerve excitation.

Anatomical variability of organs via principal factor analysis from the construction of an abdominal probabilistic atlas

Extensive recent work has taken place on the construction of probabilistic atlases of anatomical organ. We propose a probabilistic atlas of ten major abdominal organs which retains structural variability by using a size-preserving affine registration, and normalizes the physical organ locations to an anatomical landmark. Restricting the degrees of freedom in the transformation, the bias from the reference data is minimized, in terms of organ shape, size and position. Additionally, we present a scheme for the study of anatomical variability within the abdomen, including the clusterization of the modes of variation. The analysis of deformation fields showed a strong correlation with anatomical landmarks and known mechanical deformations in the abdomen. The atlas and its dependencies represent a potentially important research tool for abdominal diagnosis, modeling and soft tissue interventions.

Computational Models for Predicting Outcomes of Neuroprosthesis Implantation: the Case of Cochlear Implants

Electrical stimulation of the brain has resulted in the most successful neuroprosthetic techniques to date: deep brain stimulation (DBS) and cochlear implants (CI). In both cases, there is a lack of pre-operative measures to predict the outcomes after implantation. We argue that highly detailed computational models that are specifically tailored for a patient can provide useful information to improve the precision of the nervous system electrode interface. We apply our framework to the case of CI, showing how we can predict nerve response for patients with both intact and degenerated nerve fibers. Then, using the predicted response, we calculate a metric for the usefulness of the stimulation protocol and use this information to rerun the simulations with better parameters.

STATISTICAL SHAPE ANALYSIS VIA PRINCIPAL FACTOR ANALYSIS

Statistical shape analysis techniques commonly employed in the medical imaging community, such as active shape models or active appearance models, rely on principal component analysis (PCA) to decompose shape variability into a reduced set of interpretable components. In this paper we propose principal factor analysis (PFA) as an alternative and complementary tool to PCA providing a decomposition into modes of variation that can be more easily interpretable, while still being a linear efficient technique that performs dimensionality reduction (as opposed to independent component analysis, ICA). The key difference between PFA and PCA is that PFA models covariance between variables, rather than the total variance in the data. The added value of PFA is illustrated on 2D landmark data of corpora callosa outlines. Then, a study of the 3D shape variability of the human left femur is performed. Finally, we report results on vector-valued 3D deformation fields resulting from non-rigid registration of ventricles in MRI of the brain.

Evaluation of state-of-the-art segmentation algorithms for left ventricle infarct from late Gadolinium enhancement MR images

Studies have demonstrated the feasibility of late Gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging for guiding the management of patients with sequelae to myocardial infarction, such as ventricular tachycardia and heart failure. Clinical implementation of these developments necessitates a reproducible and reliable segmentation of the infarcted regions. It is challenging to compare new algorithms for infarct segmentation in the left ventricle (LV) with existing algorithms. Benchmarking datasets with evaluation strategies are much needed to facilitate comparison. This manuscript presents a benchmarking evaluation framework for future algorithms that segment infarct from LGE CMR of the LV. The image database consists of 30 LGE CMR images of both humans and pigs that were acquired from two separate imaging centres. A consensus ground truth was obtained for all data using maximum likelihood estimation. Six widely-used fixed-thresholding methods and five recently developed algorithms are tested on the benchmarking framework. Results demonstrate that the algorithms have better overlap with the consensus ground truth than most of the n-SD fixed-thresholding methods, with the exception of the Full-Width-at-Half-Maximum (FWHM) fixed-thresholding method. Some of the pitfalls of fixed thresholding methods are demonstrated in this work. The benchmarking evaluation framework, which is a contribution of this work, can be used to test and benchmark future algorithms that detect and quantify infarct in LGE CMR images of the LV. The datasets, ground truth and evaluation code have been made publicly available through the website: https://www.cardiacatlas.org/web/guest/challenges.

Building an Ensemble of Complementary Segmentation Methods by Exploiting Probabilistic Estimates

Two common ways of approaching atlas-based segmentation of brain MRI are (1) intensity-based modelling and (2) multi-atlas label fusion. Intensity-based methods are robust to registration errors but need distinctive image appearances. Multi-atlas label fusion can identify anatomical correspondences with faint appearance cues, but needs a reasonable registration. We propose an ensemble segmentation method that combines the complementary features of both types of approaches. Our method uses the probabilistic estimates of the base methods to compute their optimal combination weights in a spatially varying way. We also propose an intensity-based method (to be used as base method) that offers a trade-off between invariance to registration errors and dependence on distinct appearances. Results show that sacrificing invariance to registration errors (up to a certain degree) improves the performance of our intensity-based method. Our proposed ensemble method outperforms the rest of participating methods in most of the structures of the NeoBrainS12 Challenge on neonatal brain segmentation. We achieve up to \(\sim \)10 % of improvement in some structures.

Differentiation of sCJD and vCJD forms by automated analysis of basal ganglia intensity distribution in multisequence MRI of the brain-definition and evaluation of new MRI-based ratios

We present a method for the analysis of basal ganglia (including the thalamus) for accurate detection of human spongiform encephalopathy in multisequence magnetic resonance imaging (MRI) of the brain. One common feature of most forms of prion protein diseases is the appearance of hyperintensities in the deep grey matter area of the brain in T2-weighted magnetic resonance (MR) images. We employ T1, T2, and Flair-T2 MR sequences for the detection of intensity deviations in the internal nuclei. First, the MR data are registered to a probabilistic atlas and normalized in intensity. Then smoothing is applied with edge enhancement. The segmentation of hyperintensities is performed using a model of the human visual system. For more accurate results, a priori anatomical data from a segmented atlas are employed to refine the registration and remove false positives. The results are robust over the patient data and in accordance with the clinical ground truth. Our method further allows the quantification of intensity distributions in basal ganglia. The caudate nuclei are highlighted as main areas of diagnosis of sporadic Creutzfeldt-Jakob Disease (sCJD), in agreement with the histological data. The algorithm permitted the classification of the intensities of abnormal signals in sCJD patient FLAIR images with a higher hypersignal in caudate nuclei (10/10) and putamen (6/10) than in thalami. Defining normalized MRI measures of the intensity relations between the internal grey nuclei of patients, we robustly differentiate sCJD and variant CJD (vCJD) patients, in an attempt to create an automatic classification tool of human spongiform encephalopathies

Free-form image registration of human cochlear µCT data using skeleton similarity as anatomical prior

We create simple parametric centerline descriptions for human µCT cochlears.We regularize intensity-based image registration with centerline correspondences.We show that a skeleton can act as an useful global anatomical registration prior. Better understanding of the anatomical variability of the human cochlear is important for the design and function of Cochlear Implants. Proper non-rigid alignment of high-resolution cochlear µCT data is a challenge for the typical cubic B-spline registration model. In this paper we study one way of incorporating skeleton-based similarity as an anatomical registration prior. We extract a centerline skeleton of the cochlear spiral, and generate corresponding parametric pseudo-landmarks between samples. These correspondences are included in the cost function of a typical cubic B-spline registration model to provide a more global guidance of the alignment. The resulting registrations are evaluated using different metrics for accuracy and model behavior, and compared to the results of a registration without the prior.