Multiview diffeomorphic registration: application to motion and strain estimation from 3D echocardiography

Spatiotemporal Free-Form Registration Method Assisted by a Minimum Spanning Tree During Discontinuous Transformations

The sliding motion along the boundaries of discontinuous regions has been actively studied in B-spline free-form deformation framework. This study focusses on the sliding motion for a velocity field-based 3D+t registration. The discontinuity of the tangent direction guides the deformation of the object region, and a separate control of two regions provides a better registration accuracy. The sliding motion under the velocity field-based transformation is conducted under the [Formula: see text]-Rényi entropy estimator using a minimum spanning tree (MST) topology. Moreover, a new topology changing method of the MST is proposed. The topology change is performed as follows: inserting random noise, constructing the MST, and removing random noise while preserving a local connection consistency of the MST. This random noise process (RNP) prevents the [Formula: see text]-Rényi entropy-based registration from degrading in sliding motion, because the RNP creates a small disturbance around special locations. Experiments were performed using two publicly available datasets: the DIR-Lab dataset, which consists of 4D pulmonary computed tomography (CT) images, and a benchmarking framework dataset for cardiac 3D ultrasound. For the 4D pulmonary CT images, RNP produced a significantly improved result for the original MST with sliding motion (p<0.05). For the cardiac 3D ultrasound dataset, only a discontinuity-based registration indicated activity of the RNP. In contrast, the single MST without sliding motion did not show any improvement. These experiments proved the effectiveness of the RNP for sliding motion.

Multiview Three-Dimensional Echocardiography Image Fusion Using a Passive Measurement Arm

Three-dimensional (3D) echocardiography offers a fast and efficient way to scan and assess the structures and function of the heart. However, due to limitations inherent to 3D echocardiography such as limited field-of-view and low signal-to-noise ratio, 3D assessment of the heart is performed only in a minority of patients who undergo transthoracic echocardiography. One approach for improving the field-of-view and image quality is to scan the heart from multiple locations by moving the transducer and fusing the resulting images into a single volume, which requires 3D alignment of individual volumetric echocardiography scans. Previous approaches relied on optical or electromagnetic trackers for transducer tracking. This study proposes a passive measurement arm system for tracking the position of the ultrasound transducer and thereby aligning multiple echocardiography scans. The proposed system does not suffer from line-of-sight limitation as in the case of an optical tracking based fusion system. Additionally, in contrast to an electromagnetic based tracking system, measurement arm measurements are not affected by other ferromagnetic materials in the vicinity. The proposed approach was tested by scanning a heart phantom and fusing nine echocardiography volumes acquired from different locations. The fusion of all nine scans yielded a percentage field-of-view improvement of 98.5%.

Ultrasound 2D strain measurement for arm lymphedema using deformable registration: A feasibility study

Purpose

Lymphedema, a swelling of the extremity, is a debilitating morbidity of cancer treatment. Current clinical evaluation of lymphedema is often based on medical history and physical examinations, which is subjective. In this paper, the authors report an objective, quantitative 2D strain imaging approach using a hybrid deformable registration to measure soft-tissue stiffness and assess the severity of lymphedema.

Methods

The authors have developed a new 2D strain imaging method using registration of pre- and post-compression ultrasound B-mode images, which combines the statistical intensity- and structure-based similarity measures using normalized mutual information (NMI) metric and normalized sum-of-squared-differences (NSSD), with an affine-based global and B-spline-based local transformation model. This 2D strain method was tested through a series of experiments using elastography phantom under various pressures. Clinical feasibility was tested with four participants: two patients with arm lymphedema following breast-cancer radiotherapy and two healthy volunteers.

Results

The phantom experiments have shown that the proposed registration-based strain method significantly increased the signal-to-noise and contrast-to-noise ratio under various pressures as compared with the commonly used cross-correlation-based elastography method. In the pilot study, the strain images were successfully generated for all participants. The averaged strain values of the lymphedema affected arms were much higher than those of the normal arms.

Conclusions

The authors have developed a deformable registration-based 2D strain method for the evaluation of arm lymphedema. The initial findings are encouraging and a large clinical study is warranted to further evaluate this 2D ultrasound strain imaging technology.

Multiview echocardiography fusion using an electromagnetic tracking system

Three-dimensional ultrasound is an emerging modality for the assessment of complex cardiac anatomy and function. The advantages of this modality include lack of ionizing radiation, portability, low cost, and high temporal resolution. Major limitations include limited field-of-view, reliance on frequently limited acoustic windows, and poor signal to noise ratio. This study proposes a novel approach to combine multiple views into a single image using an electromagnetic tracking system in order to improve the field-of-view. The novel method has several advantages: 1) it does not rely on image information for alignment, and therefore, the method does not require image overlap; 2) the alignment accuracy of the proposed approach is not affected by any poor image quality as in the case of image registration based approaches; 3) in contrast to previous optical tracking based system, the proposed approach does not suffer from line-of-sight limitation; and 4) it does not require any initial calibration. In this pilot project, we were able to show that using a heart phantom, our method can fuse multiple echocardiographic images and improve the field-of view. Quantitative evaluations showed that the proposed method yielded a nearly optimal alignment of image data sets in three-dimensional space. The proposed method demonstrates the electromagnetic system can be used for the fusion of multiple echocardiography images with a seamless integration of sensors to the transducer.

Patient movement compensation for 3D echocardiography fusion

Limited field of view (FOV) is a major problem for 3D real-time echocardiography (3DRTE), which results in an incomplete representation of cardiac anatomy. Various image registration techniques have been proposed to improve the field of view in 3DRTE by fusing multiple image volumes. However, these techniques require significant overlap between the individual volumes and rely on high image resolution and high signal-to-noise ratio. Changes in the heart position due to patient movement during image acquisition can also reduce the quality of image fusion. In this paper, we propose a multi-camera based optical tracking system which 1) eliminates the need for image overlap and 2) compensates for patient movement during acquisition. We compensate for patient movement by continuously tracking the patient position using skin markers and incorporating this information into the fusion process. We fuse volumes acquired during R-R wave peaks based on Electrocardiogram (ECG) data to account for retrospective image acquisition. The fusion technique was validated using a heart phantom (Shelley Medical Imaging Technologies) and on one healthy volunteer. The fused ultrasound volumes could be generated in within 2 seconds and were found to have complete myocardial boundaries alignment upon visual assessment. No stitching artefacts or movement related artefacts were observed in the fused image.

Multiview 3-D Echocardiography Fusion with Breath-Hold Position Tracking Using an Optical Tracking System

Recent advances in echocardiography allow real-time 3-D dynamic image acquisition of the heart. However, one of the major limitations of 3-D echocardiography is the limited field of view, which results in an acquisition insufficient to cover the whole geometry of the heart. This study proposes the novel approach of fusing multiple 3-D echocardiography images using an optical tracking system that incorporates breath-hold position tracking to infer that the heart remains at the same position during different acquisitions. In six healthy male volunteers, 18 pairs of apical/parasternal 3-D ultrasound data sets were acquired during a single breath-hold as well as in subsequent breath-holds. The proposed method yielded a field of view improvement of 35.4 ± 12.5%. To improve the quality of the fused image, a wavelet-based fusion algorithm was developed that computes pixelwise likelihood values for overlapping voxels from multiple image views. The proposed wavelet-based fusion approach yielded significant improvement in contrast (66.46 ± 21.68%), contrast-to-noise ratio (49.92 ± 28.71%), signal-to-noise ratio (57.59 ± 47.85%) and feature count (13.06 ± 7.44%) in comparison to individual views.

Reconstruction of the descending thoracic aorta by multiview compounding of 3-D transesophageal echocardiographic aortic data sets for improved examination and quantification of atheroma burden

A robust and efficient approach to reconstruction of the descending thoracic aorta from contiguous 3-D transesophageal echocardiographic (TEE) images is proposed. An ad hoc image acquisition protocol was designed to acquire ordered and partially overlapped 3-D TEE data sets, followed by dedicated image processing to align and fuse all acquired data sets. Alignment strategy implemented pairwise rigid registration guided by a priori knowledge, and it was validated using artificially misaligned images. Image fusion was finally performed to enable visualization and analysis of extended field-of-view of the acquired aorta. The application of different fusion techniques was also investigated. The method was applied to a population of 17 consecutive patients. Qualitative and quantitative results supported the feasibility and accuracy of the proposed approach. In a clinical scenario, its application could allow the quantitative assessment of aortic plaque burden in the descending thoracic aorta from 3-D TEE images.

Improved myocardial motion estimation combining tissue Doppler and B-mode echocardiographic images

We propose a technique for myocardial motion estimation based on image registration using both B-mode echocardiographic images and tissue Doppler sequences acquired interleaved. The velocity field is modeled continuously using B-splines and the spatiotemporal transform is constrained to be diffeomorphic. Images before scan conversion are used to improve the accuracy of the estimation. The similarity measure includes a model of the speckle pattern distribution of B-mode images. It also penalizes the disagreement between tissue Doppler velocities and the estimated velocity field. Registration accuracy is evaluated and compared to other alternatives using a realistic synthetic dataset, obtaining mean displacement errors of about 1 mm. Finally, the method is demonstrated on data acquired from six volunteers, both at rest and during exercise. Robustness is tested against low image quality and fast heart rates during exercise. Results show that our method provides a robust motion estimate in these situations.

Update on cardiac imaging techniques 2013

Cardiac imaging is a cornerstone of diagnosis in heart conditions, and an essential tool for assessing prognosis and establishing treatment decisions. This year, echocardiography stands out as a guide in interventional procedures and in choosing the size of the prosthesis. It is also proving to be a valuable technique in low-flow, low-gradient aortic stenosis. Three-dimensional echocardiography is advancing our knowledge of cardiac anatomy and valvular measurements. The parameters indicating tissue deformation have predictive power in valve disease and in the follow-up of drug-induced cardiotoxicity. Single-photon emission computed tomography and positron emission tomography are proving useful in ischemic heart disease and in the diagnosis of cardiac inflammation and infections. The role of computed tomography has been strengthened in noninvasive coronary angiography, the emergency room management of chest pain, assessment of chronic occlusions, and morphologic study of coronary plaque. Cardiac magnetic resonance imaging remains the gold standard for tissue characterization in ischemic heart disease and cardiomyopathies, and is assuming a greater role in stress studies and in the assessment of myocardial viability.