Mohamed Abou El-Ghar

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.

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.

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.

Appearance models for robust segmentation of pulmonary nodules in 3d LDCT chest images

To more accurately separate each pulmonary nodule from its background in a low dose computer tomography (LDCT) chest image, two new adaptive probability models of visual appearance of small 2D and large 3D pulmonary nodules are used to control evolution of deformable boundaries. The appearance prior is modeled with a translation and rotation invariant Markov-Gibbs random field of voxel intensities with pairwise interaction analytically identified from a set of training nodules. Appearance of the nodules and their background in a current multi-modal chest image is also represented with a marginal probability distribution of voxel intensities. The nodule appearance model is isolated from the mixed distribution using its close approximation with a linear combination of discrete Gaussians. Experiments with real LDCT chest images confirm high accuracy of the proposed approach.

Quantitative nodule detection in low dose chest CT scans: new template modeling and evaluation for CAD system design

Automatic diagnosis of lung nodules for early detection of lung cancer is the goal of a number of screening studies worldwide. With the improvements in resolution and scanning time of low dose chest CT scanners, nodule detection and identification is continuously improving. In this paper we describe the latest improvements introduced by our group in automatic detection of lung nodules. We introduce a new template for nodule detection using level sets which describes various physical nodules irrespective of shape, size and distribution of gray levels. The template parameters are estimated automatically from the segmented data (after the first two steps of our CAD system for automatic nodule detection) - no a priori learning of the parameters density function is needed. We show quantitatively that this template modeling approach drastically reduces the number of false positives in the nodule detection (the third step of our CAD system for automatic nodule detection), thus improving the overall accuracy of CAD systems. We compare the performance of this approach with other approaches in the literature and with respect to human experts. The impact of the new template model includes: 1) flexibility with respect to nodule topology - thus various nodules can be detected simultaneously by the same technique; 2) automatic parameter estimation of the nodule models using the gray level information of the segmented data; and 3) the ability to provide exhaustive search for all the possible nodules in the scan without excessive processing time - this provides an enhanced accuracy of the CAD system without increase in the overall diagnosis time.

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).

A Framework for Automatic Segmentation of Lung Nodules from Low Dose Chest CT Scans

To accurately separate each pulmonary nodule from its background in a low dose computer tomography (LDCT) chest image, two new adaptive probability models of the visual appearance of small 2D and large 3D pulmonary nodules are jointly used to control the evolution of the de-formable model. The appearance prior is modeled with a translation and rotation invariant Markov-Gibbs random field of voxel intensities with pairwise interaction. The model is analytically identified from a set of training nodule images with normalized intensity ranges. Both the nodules and their background in each current multi-modal chest image are also modeled with a linear combination of discrete Gaussians that closely approximate the empirical marginal probability distribution of voxel intensities. Experiments with real LDCT chest images confirm the high accuracy of the proposed approach

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.