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Lozano-Vicario L, Muñoz-Vázquez ÁJ, Ramírez-Vélez R, Galbete-Jiménez A, Fernández-Irigoyen J, Santamaría E, Cedeno-Veloz BA, Zambom-Ferraresi F, Van Munster BC, Ortiz-Gómez JR, Hidalgo-Ovejero ÁM, Romero-Ortuno R, Izquierdo M, Martínez-Velilla N. Association of postoperative delirium with serum and cerebrospinal fluid proteomic profiles: a prospective cohort study in older hip fracture patients. GeroScience 2024; 46:3235-3247. [PMID: 38236313 PMCID: PMC11009174 DOI: 10.1007/s11357-024-01071-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 01/08/2024] [Indexed: 01/19/2024] Open
Abstract
Postoperative delirium (POD) is a common neuropsychiatric complication in geriatric inpatients after hip fracture surgery and its occurrence is associated with poor outcomes. The purpose of this study was to investigate the relationship between preoperative biomarkers in serum and cerebrospinal fluid (CSF) and the development of POD in older hip fracture patients, exploring the possibility of integrating objective methods into future predictive models of delirium. Sixty hip fracture patients were recruited. Blood and CSF samples were collected at the time of spinal anesthesia when none of the subjects had delirium. Patients were assessed daily using the 4AT scale, and based on these results, they were divided into POD and non-POD groups. The Olink® platform was used to analyze 45 cytokines. Twenty-one patients (35%) developed POD. In the subsample of 30 patients on whom proteomic analyses were performed, a proteomic profile was associated with the incidence of POD. Chemokine (C-X-C motif) ligand 9 (CXCL9) had the strongest correlation between serum and CSF samples in patients with POD (rho = 0.663; p < 0.05). Although several cytokines in serum and CSF were associated with POD after hip fracture surgery in older adults, there was a significant association with lower preoperative levels of CXCL9 in CSF and serum. Despite the small sample size, this study provides preliminary evidence of the potential role of molecular biomarkers in POD, which may provide a basis for the development of new delirium predictive models.
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Affiliation(s)
- Lucía Lozano-Vicario
- Department of Geriatric Medicine, Hospital Universitario de Navarra (HUN), Pamplona, Spain.
| | | | - Robinson Ramírez-Vélez
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Arkaitz Galbete-Jiménez
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Joaquín Fernández-Irigoyen
- Proteomics Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain
| | - Enrique Santamaría
- Proteomics Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain
| | | | - Fabricio Zambom-Ferraresi
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Barbara C Van Munster
- Department of Geriatric Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - José Ramón Ortiz-Gómez
- Department of Anesthesiology and Reanimation, Hospital Universitario de Navarra (HUN), Pamplona, Spain
| | | | - Román Romero-Ortuno
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Nicolás Martínez-Velilla
- Department of Geriatric Medicine, Hospital Universitario de Navarra (HUN), Pamplona, Spain
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
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2
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Cedeno-Veloz BA, Lozano-Vicario L, Zambom-Ferraresi F, Fernández-Irigoyen J, Santamaría E, Rodríguez-García A, Romero-Ortuno R, Mondragon-Rubio J, Ruiz-Ruiz J, Ramírez-Vélez R, Izquierdo M, Martínez-Velilla N. Effect of immunology biomarkers associated with hip fracture and fracture risk in older adults. Immun Ageing 2023; 20:55. [PMID: 37853468 PMCID: PMC10583364 DOI: 10.1186/s12979-023-00379-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/02/2023] [Indexed: 10/20/2023]
Abstract
Osteoporosis is a skeletal disease that can increase the risk of fractures, leading to adverse health and socioeconomic consequences. However, current clinical methods have limitations in accurately estimating fracture risk, particularly in older adults. Thus, new technologies are necessary to improve the accuracy of fracture risk estimation. In this observational study, we aimed to explore the association between serum cytokines and hip fracture status in older adults, and their associations with fracture risk using the FRAX reference tool. We investigated the use of a proximity extension assay (PEA) with Olink. We compared the characteristics of the population, functional status and detailed body composition (determined using densitometry) between groups. We enrolled 40 participants, including 20 with hip fracture and 20 without fracture, and studied 46 cytokines in their serum. After conducting a score plot and two unpaired t-tests using the Benjamini-Hochberg method, we found that Interleukin 6 (IL-6), Lymphotoxin-alpha (LT-α), Fms-related tyrosine kinase 3 ligand (FLT3LG), Colony stimulating factor 1 (CSF1), and Chemokine (C-C motif) ligand 7 (CCL7) were significantly different between fracture and non-fracture patients (p < 0.05). IL-6 had a moderate correlation with FRAX (R2 = 0.409, p < 0.001), while CSF1 and CCL7 had weak correlations with FRAX. LT-α and FLT3LG exhibited a negative correlation with the risk of fracture. Our results suggest that targeted proteomic tools have the capability to identify differentially regulated proteins and may serve as potential markers for estimating fracture risk. However, longitudinal studies will be necessary to validate these results and determine the temporal patterns of changes in cytokine profiles.
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Affiliation(s)
- Bernardo Abel Cedeno-Veloz
- Geriatric Department, Hospital Universitario de Navarra (HUN), 2 Navarrabiomed, Pamplona, Navarra, IdiSNA, 31008, Spain.
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain.
- Department of Health Sciences, Public University of Navarra, Pamplona, Navarra, 31008, Spain.
| | - Lucía Lozano-Vicario
- Geriatric Department, Hospital Universitario de Navarra (HUN), 2 Navarrabiomed, Pamplona, Navarra, IdiSNA, 31008, Spain
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain
| | - Fabricio Zambom-Ferraresi
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain
- Department of Health Sciences, Public University of Navarra, Pamplona, Navarra, 31008, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Joaquín Fernández-Irigoyen
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain
- Clinical Neuroproteomics Unit, Navarrabiomed, Pamplona, 31008, Spain
| | - Enrique Santamaría
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain
- Clinical Neuroproteomics Unit, Navarrabiomed, Pamplona, 31008, Spain
| | - Alba Rodríguez-García
- Geriatric Department, Hospital Universitario de Navarra (HUN), 2 Navarrabiomed, Pamplona, Navarra, IdiSNA, 31008, Spain
| | - Roman Romero-Ortuno
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Jaime Mondragon-Rubio
- Department of Orthopaedics Clinics and Traumatology, University Hospital of Navarre (HUN), Pamplona, Navarra, 31008, Spain
| | - Javier Ruiz-Ruiz
- Department of Orthopaedics Clinics and Traumatology, University Hospital of Navarre (HUN), Pamplona, Navarra, 31008, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain
- Department of Health Sciences, Public University of Navarra, Pamplona, Navarra, 31008, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain
- Department of Health Sciences, Public University of Navarra, Pamplona, Navarra, 31008, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Nicolás Martínez-Velilla
- Geriatric Department, Hospital Universitario de Navarra (HUN), 2 Navarrabiomed, Pamplona, Navarra, IdiSNA, 31008, Spain
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain
- Department of Health Sciences, Public University of Navarra, Pamplona, Navarra, 31008, Spain
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3
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Baxter JSH, Croci S, Delmas A, Bredoux L, Lefaucheur JP, Jannin P. Reference-free Bayesian model for pointing errors of typein neurosurgical planning. Int J Comput Assist Radiol Surg 2023:10.1007/s11548-023-02943-w. [PMID: 37249748 DOI: 10.1007/s11548-023-02943-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/27/2023] [Indexed: 05/31/2023]
Abstract
PURPOSE Many neurosurgical planning tasks rely on identifying points of interest in volumetric images. Often, these points require significant expertise to identify correctly as, in some cases, they are not visible but instead inferred by the clinician. This leads to a high degree of variability between annotators selecting these points. In particular, errors of type are when the experts fundamentally select different points rather than the same point with some inaccuracy. This complicates research as their mean may not reflect any of the experts' intentions nor the ground truth. METHODS We present a regularised Bayesian model for measuring errors of type in pointing tasks. This model is reference-free; in that it does not require a priori knowledge of the ground truth point but instead works on the basis of the level of consensus between multiple annotators. We apply this model to simulated data and clinical data from transcranial magnetic stimulation for chronic pain. RESULTS Our model estimates the probabilities of selecting the correct point in the range of 82.6[Formula: see text]88.6% with uncertainties in the range of 2.8[Formula: see text]4.0%. This agrees with the literature where ground truth points are known. The uncertainty has not previously been explored in the literature and gives an indication of the dataset's strength. CONCLUSIONS Our reference-free Bayesian framework easily models errors of type in pointing tasks. It allows for clinical studies to be performed with a limited number of annotators where the ground truth is not immediately known, which can be applied widely for better understanding human errors in neurosurgical planning.
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Affiliation(s)
- John S H Baxter
- Laboratoire Traitement du Signal et de l'Image (LTSI - INSERM UMR 1099), Université de Rennes 1, Rennes, France.
| | | | | | | | - Jean-Pascal Lefaucheur
- ENT Team, EA4391, Faculty of Medicine, Paris Est Créteil University, Créteil, France
- Clinical Neurophysiology Unit, Department of Physiology, Henri Mondor Hospital, Hôpitaux de Paris, Créteil, France
| | - Pierre Jannin
- Laboratoire Traitement du Signal et de l'Image (LTSI - INSERM UMR 1099), Université de Rennes 1, Rennes, France
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4
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Min Z, Liu J, Liu L, Meng MQH. Generalized Coherent Point Drift With Multi-Variate Gaussian Distribution and Watson Distribution. IEEE Robot Autom Lett 2021. [DOI: 10.1109/lra.2021.3093011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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5
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Miao Y, Gao J, Zhang K, Shi W, Li Y, Zhao J, Jiang Z, Yang H, He F, He W, Qin J, Chen T. Logarithmic Fuzzy Entropy Function for Similarity Measurement in Multimodal Medical Images Registration. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2020; 2020:5487168. [PMID: 32104203 PMCID: PMC7037956 DOI: 10.1155/2020/5487168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/16/2019] [Accepted: 12/14/2019] [Indexed: 11/18/2022]
Abstract
Multimodal medical images are useful for observing tissue structure clearly in clinical practice. To integrate multimodal information, multimodal registration is significant. The entropy-based registration applies a structure descriptor set to replace the original multimodal image and compute similarity to express the correlation of images. The accuracy and converging rate of the registration depend on this set. We propose a new method, logarithmic fuzzy entropy function, to compute the descriptor set. It is obvious that the proposed method can increase the upper bound value from log(r) to log(r) + ∆(r) so that a more representative structural descriptor set is formed. The experiment results show that our method has faster converging rate and wider quantified range in multimodal medical images registration.
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Affiliation(s)
- Yu Miao
- Changchun University of Science and Technology, School of Computer Science and Technology, WeiXing Road, Changchun 130022, China
| | - Jiaying Gao
- Changchun University of Science and Technology, School of Computer Science and Technology, WeiXing Road, Changchun 130022, China
| | - Ke Zhang
- Changchun University of Science and Technology, School of Computer Science and Technology, WeiXing Road, Changchun 130022, China
| | - Weili Shi
- Changchun University of Science and Technology, School of Computer Science and Technology, WeiXing Road, Changchun 130022, China
| | - Yanfang Li
- Changchun University of Science and Technology, School of Computer Science and Technology, WeiXing Road, Changchun 130022, China
| | - Jiashi Zhao
- Changchun University of Science and Technology, School of Computer Science and Technology, WeiXing Road, Changchun 130022, China
| | - Zhengang Jiang
- Changchun University of Science and Technology, School of Computer Science and Technology, WeiXing Road, Changchun 130022, China
| | - Huamin Yang
- Changchun University of Science and Technology, School of Computer Science and Technology, WeiXing Road, Changchun 130022, China
| | - Fei He
- Changchun University of Science and Technology, School of Computer Science and Technology, WeiXing Road, Changchun 130022, China
| | - Wei He
- Changchun University of Science and Technology, School of Computer Science and Technology, WeiXing Road, Changchun 130022, China
| | - Jun Qin
- Changchun University of Science and Technology, School of Computer Science and Technology, WeiXing Road, Changchun 130022, China
| | - Tao Chen
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
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Machado I, Toews M, George E, Unadkat P, Essayed W, Luo J, Teodoro P, Carvalho H, Martins J, Golland P, Pieper S, Frisken S, Golby A, Wells Iii W, Ou Y. Deformable MRI-Ultrasound registration using correlation-based attribute matching for brain shift correction: Accuracy and generality in multi-site data. Neuroimage 2019; 202:116094. [PMID: 31446127 DOI: 10.1016/j.neuroimage.2019.116094] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/18/2019] [Accepted: 08/09/2019] [Indexed: 11/16/2022] Open
Abstract
Intraoperative tissue deformation, known as brain shift, decreases the benefit of using preoperative images to guide neurosurgery. Non-rigid registration of preoperative magnetic resonance (MR) to intraoperative ultrasound (iUS) has been proposed as a means to compensate for brain shift. We focus on the initial registration from MR to predurotomy iUS. We present a method that builds on previous work to address the need for accuracy and generality of MR-iUS registration algorithms in multi-site clinical data. High-dimensional texture attributes were used instead of image intensities for image registration and the standard difference-based attribute matching was replaced with correlation-based attribute matching. A strategy that deals explicitly with the large field-of-view mismatch between MR and iUS images was proposed. Key parameters were optimized across independent MR-iUS brain tumor datasets acquired at 3 institutions, with a total of 43 tumor patients and 758 reference landmarks for evaluating the accuracy of the proposed algorithm. Despite differences in imaging protocols, patient demographics and landmark distributions, the algorithm is able to reduce landmark errors prior to registration in three data sets (5.37±4.27, 4.18±1.97 and 6.18±3.38 mm, respectively) to a consistently low level (2.28±0.71, 2.08±0.37 and 2.24±0.78 mm, respectively). This algorithm was tested against 15 other algorithms and it is competitive with the state-of-the-art on multiple datasets. We show that the algorithm has one of the lowest errors in all datasets (accuracy), and this is achieved while sticking to a fixed set of parameters for multi-site data (generality). In contrast, other algorithms/tools of similar performance need per-dataset parameter tuning (high accuracy but lower generality), and those that stick to fixed parameters have larger errors or inconsistent performance (generality but not the top accuracy). Landmark errors were further characterized according to brain regions and tumor types, a topic so far missing in the literature.
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Affiliation(s)
- Inês Machado
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Mechanical Engineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
| | - Matthew Toews
- Department of Systems Engineering, École de Technologie Supérieure, Montreal, Canada
| | - Elizabeth George
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Prashin Unadkat
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Walid Essayed
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jie Luo
- Graduate School of Frontier Sciences, University of Tokyo, Tokyo, Japan
| | - Pedro Teodoro
- Escola Superior Náutica Infante D. Henrique, Lisbon, Portugal
| | - Herculano Carvalho
- Department of Neurosurgery, Hospital de Santa Maria, CHLN, Lisbon, Portugal
| | - Jorge Martins
- Department of Mechanical Engineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Polina Golland
- Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, MA, USA
| | - Steve Pieper
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Isomics, Inc., Cambridge, MA, USA
| | - Sarah Frisken
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexandra Golby
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - William Wells Iii
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, MA, USA
| | - Yangming Ou
- Department of Pediatrics and Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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van der Spoel E, Choi J, Roelfsema F, Cessie SL, van Heemst D, Dekkers OM. Comparing Methods for Measurement Error Detection in Serial 24-h Hormonal Data. J Biol Rhythms 2019; 34:347-363. [PMID: 31187683 PMCID: PMC6637814 DOI: 10.1177/0748730419850917] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Measurement errors commonly occur in 24-h hormonal data and may affect the outcomes of such studies. Measurement errors often appear as outliers in such data sets; however, no well-established method is available for their automatic detection. In this study, we aimed to compare performances of different methods for outlier detection in hormonal serial data. Hormones (glucose, insulin, thyroid-stimulating hormone, cortisol, and growth hormone) were measured in blood sampled every 10 min for 24 h in 38 participants of the Leiden Longevity Study. Four methods for detecting outliers were compared: (1) eyeballing, (2) Tukey’s fences, (3) stepwise approach, and (4) the expectation-maximization (EM) algorithm. Eyeballing detects outliers based on experts’ knowledge, and the stepwise approach incorporates physiological knowledge with a statistical algorithm. Tukey’s fences and the EM algorithm are data-driven methods, using interquartile range and a mathematical algorithm to identify the underlying distribution, respectively. The performance of the methods was evaluated based on the number of outliers detected and the change in statistical outcomes after removing detected outliers. Eyeballing resulted in the lowest number of outliers detected (1.0% of all data points), followed by Tukey’s fences (2.3%), the stepwise approach (2.7%), and the EM algorithm (11.0%). In all methods, the mean hormone levels did not change materially after removing outliers. However, their minima were affected by outlier removal. Although removing outliers affected the correlation between glucose and insulin on the individual level, when averaged over all participants, none of the 4 methods influenced the correlation. Based on our results, the EM algorithm is not recommended given the high number of outliers detected, even where data points are physiologically plausible. Since Tukey’s fences is not suitable for all types of data and eyeballing is time-consuming, we recommend the stepwise approach for outlier detection, which combines physiological knowledge and an automated process.
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Affiliation(s)
- Evie van der Spoel
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Jungyeon Choi
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ferdinand Roelfsema
- Section Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Saskia le Cessie
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.,Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Diana van Heemst
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Olaf M Dekkers
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.,Section Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
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8
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Bayer S, Zhai Z, Strumia M, Tong X, Gao Y, Staring M, Stoel B, Fahrig R, Nabavi A, Maier A, Ravikumar N. Registration of vascular structures using a hybrid mixture model. Int J Comput Assist Radiol Surg 2019; 14:1507-1516. [PMID: 31175535 DOI: 10.1007/s11548-019-02007-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 05/28/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE Morphological changes to anatomy resulting from invasive surgical procedures or pathology, typically alter the surrounding vasculature. This makes it useful as a descriptor for feature-driven image registration in various clinical applications. However, registration of vasculature remains challenging, as vessels often differ in size and shape, and may even miss branches, due to surgical interventions or pathological changes. Furthermore, existing vessel registration methods are typically designed for a specific application. To address this limitation, we propose a generic vessel registration approach useful for a variety of clinical applications, involving different anatomical regions. METHODS A probabilistic registration framework based on a hybrid mixture model, with a refinement mechanism to identify missing branches (denoted as HdMM+) during vasculature matching, is introduced. Vascular structures are represented as 6-dimensional hybrid point sets comprising spatial positions and centerline orientations, using Student's t-distributions to model the former and Watson distributions for the latter. RESULTS The proposed framework is evaluated for intraoperative brain shift compensation, and monitoring changes in pulmonary vasculature resulting from chronic lung disease. Registration accuracy is validated using both synthetic and patient data. Our results demonstrate, HdMM+ is able to reduce more than [Formula: see text] of the initial error for both applications, and outperforms the state-of-the-art point-based registration methods such as coherent point drift and Student's t-distribution mixture model, in terms of mean surface distance, modified Hausdorff distance, Dice and Jaccard scores. CONCLUSION The proposed registration framework models complex vascular structures using a hybrid representation of vessel centerlines, and accommodates intricate variations in vascular morphology. Furthermore, it is generic and flexible in its design, enabling its use in a variety of clinical applications.
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Affiliation(s)
- Siming Bayer
- Pattern Recognition Lab, Friedrich-Alexander University, Martenstraße 3, 91058, Erlangen, Germany.
| | - Zhiwei Zhai
- Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | | | - Xiaoguang Tong
- Tianjin Huanhu Hospital, Nankai University, Jizhao Road 6, Tianjin, 300350, China
| | - Ying Gao
- Siemens Healthineers Ltd, Wanjing Zhonghuan Nanlu, Beijing, 100102, China
| | - Marius Staring
- Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Berend Stoel
- Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Rebecca Fahrig
- Siemens Healthcare GmbH, Siemensstraße 1, 91301, Forchheim, Germany
| | - Arya Nabavi
- Department of Neurosurgery, Nordstadt Hospital, KRH, Haltenhoffstr 41, 30167, Hannover, Germany
| | - Andreas Maier
- Pattern Recognition Lab, Friedrich-Alexander University, Martenstraße 3, 91058, Erlangen, Germany
| | - Nishant Ravikumar
- Pattern Recognition Lab, Friedrich-Alexander University, Martenstraße 3, 91058, Erlangen, Germany
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