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Baturalp TB, Bozkurt S. Design and Analysis of a Polymeric Left Ventricular Simulator via Computational Modelling. Biomimetics (Basel) 2024; 9:269. [PMID: 38786479 PMCID: PMC11117906 DOI: 10.3390/biomimetics9050269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/12/2024] [Accepted: 04/27/2024] [Indexed: 05/25/2024] Open
Abstract
Preclinical testing of medical devices is an essential step in the product life cycle, whereas testing of cardiovascular implants requires specialised testbeds or numerical simulations using computer software Ansys 2016. Existing test setups used to evaluate physiological scenarios and test cardiac implants such as mock circulatory systems or isolated beating heart platforms are driven by sophisticated hardware which comes at a high cost or raises ethical concerns. On the other hand, computational methods used to simulate blood flow in the cardiovascular system may be simplified or computationally expensive. Therefore, there is a need for low-cost, relatively simple and efficient test beds that can provide realistic conditions to simulate physiological scenarios and evaluate cardiovascular devices. In this study, the concept design of a novel left ventricular simulator made of latex rubber and actuated by pneumatic artificial muscles is presented. The designed left ventricular simulator is geometrically similar to a native left ventricle, whereas the basal diameter and long axis length are within an anatomical range. Finite element simulations evaluating left ventricular twisting and shortening predicted that the designed left ventricular simulator rotates approximately 17 degrees at the apex and the long axis shortens around 11 mm. Experimental results showed that the twist angle is 18 degrees and the left ventricular simulator shortens 5 mm. Twist angles and long axis shortening as in a native left ventricle show it is capable of functioning like a native left ventricle and simulating a variety of scenarios, and therefore has the potential to be used as a test platform.
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Affiliation(s)
- Turgut Batuhan Baturalp
- Department of Mechanical Engineering, Texas Tech University, P.O. Box 41021, Lubbock, TX 79409, USA
| | - Selim Bozkurt
- School of Engineering, Ulster University, York Street, Belfast BT15 1AP, UK
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Bozkurt S. Mathematical modeling of cardiac function to evaluate clinical cases in adults and children. PLoS One 2019; 14:e0224663. [PMID: 31671136 PMCID: PMC6822734 DOI: 10.1371/journal.pone.0224663] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 10/18/2019] [Indexed: 11/18/2022] Open
Abstract
Time-varying elastance models can simulate only the pressure and volume signals in the heart chambers while the diagnosis of clinical cases and evaluation of different treatment techniques require more information. In this study, an extended model utilizing the geometric dimensions of the heart chambers was developed to describe the cardiac function. The new cardiac model was evaluated by simulating a healthy and dilated cardiomyopathy (DCM) condition for adults and children. The left ventricular ejection fraction, end-diastolic volume, end-diastolic diameter and diastolic sphericity index were 53.60%, 125 mL, 5.08 cm and 1.82 in the healthy adult cardiovascular system model and 23.70%, 173 mL, 6.60 cm and 1.40 in the DCM adult cardiovascular system model. In the healthy child cardiovascular system model, the left ventricular ejection fraction, end-diastolic volume, end-diastolic diameter and diastolic sphericity index were 59.70%, 92 mL, 4.10 cm and 2.26 respectively and 30.70%, 125 mL, 4.94 cm and 1.87 in the DCM child cardiovascular system model. The developed cardiovascular system model simulates the hemodynamic variables and clinical diagnostic indicators within the physiological range for healthy and DCM conditions proving the feasibility of this new model to evaluate clinical cases in adults and children.
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Affiliation(s)
- Selim Bozkurt
- Institute of Cardiovascular Science, University College London, London, United Kingdom
- * E-mail:
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Virtual M-Mode for Echocardiography: A New Approach for the Segmentation of the Anterior Mitral Leaflet. IEEE J Biomed Health Inform 2019; 23:305-313. [DOI: 10.1109/jbhi.2018.2799738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Lee SE, Lee J, Yoo TH, Cho IJ, Chang HJ. End-Stage Renal Disease Impairs the Multidirectional Movements of the Common Carotid Artery: Assessment Using Dimensional Speckle-Tracking Carotid Strain Ultrasonography. J Cardiovasc Imaging 2018; 26:155-164. [PMID: 30310883 PMCID: PMC6160811 DOI: 10.4250/jcvi.2018.26.e16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 09/03/2018] [Accepted: 09/04/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Arterial stiffening is a major contributing factor in the development of cardiovascular disease in patients with end-stage renal disease (ESRD). However, there is no gold standard for evaluating arterial stiffness. This study aimed to evaluate the newly developed speckle-tracking carotid strain imaging method in assessing arterial stiffness in patients with ESRD. METHODS In total, 85 patients with normal renal function (controls) and 36 with ESRD were enrolled in this single-center study. Carotid B-mode ultrasonography was performed for all patients. Arterial stiffness indices and strain parameters of the common carotid arteries were analyzed. Values were compared between the groups, and multivariate linear regression analysis was performed to assess the impact of ESRD on carotid strain. RESULTS There were no differences in the intima-media thickness, β stiffness index, and arterial compliance, but arterial distensibility was lower, and the elastic modulus and pulse wave velocity β (PWV) were higher among patients with ESRD (all p < 0.05), whether assessed in the longitudinal or transverse plane. Both longitudinal and transverse strain rates were reduced in patients with ESRD (all p < 0.05). In multivariate analyses, ESRD independently reduced both transverse radial strain and strain rate (all p < 0.05), and the transverse circumferential strain and strain rate (p < 0.05). However, all conventional aortic stiffness indices and longitudinal strain parameters were not associated with ESRD. CONCLUSIONS Speckle-tracking carotid strain ultrasonography was successfully performed in both normal subjects and patients with ESRD. Multidirectional carotid strain analyses may provide more value than conventional aortic stiffness indices for risk stratification in patients with ESRD.
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Affiliation(s)
- Sang-Eun Lee
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.,Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
| | - Jinyong Lee
- Medical Imaging Research Group, Samsung Medison, Seoul, Korea
| | - Tae-Hyun Yoo
- Department of Internal Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
| | - In-Jeong Cho
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
| | - Hyuk-Jae Chang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.,Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
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Jolley MA, Hammer PE, Ghelani SJ, Adar A, Sleeper LA, Lacro RV, Marx GR, Nathan M, Harrild DM. Three-Dimensional Mitral Valve Morphology in Children and Young Adults With Marfan Syndrome. J Am Soc Echocardiogr 2018; 31:1168-1177.e1. [PMID: 30098871 DOI: 10.1016/j.echo.2018.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Mitral valve (MV) prolapse is common in children with Marfan syndrome (MFS) and is associated with varying degrees of mitral regurgitation (MR). However, the three-dimensional (3D) morphology of the MV in children with MFS and its relation to the degree of MR are not known. The goals of this study were to describe the 3D morphology of the MV in children with MFS and to compare it to that in normal children. METHODS Three-dimensional transthoracic echocardiography was performed in 27 patients (3-21 years of age) meeting the revised Ghent criteria for MFS and 27 normal children matched by age (±1 year). The 3D geometry of the MV apparatus in midsystole was measured, and its association with clinical and two-dimensional echocardiographic parameters was examined. RESULTS Compared with age-matched control subjects, children with MFS had larger 3D annular areas (P < .02), smaller annular height/commissural width ratios (P < .001), greater billow volumes (P < .001), and smaller tenting heights, areas, and volumes (P < .001 for all). In multivariate modeling, larger leaflet billow volume in MFS was strongly associated with moderate or greater MR (P < .01). Intra- and interuser variability of 3D metrics was acceptable. CONCLUSIONS Children with MFS have flatter and more dilated MV annuli, greater billow volumes, and smaller tenting heights compared with normal control subjects. Larger billow volume is associated with MR. Three-dimensional MV quantification may contribute to the identification of patients with MFS and other connective tissue disorders. Further study of 3D MV geometry and its relation to the clinical progression of MV disease is warranted in this vulnerable population.
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Affiliation(s)
- Matthew A Jolley
- Department of Anesthesia and Critical Care Medicine and Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts.
| | - Peter E Hammer
- Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts
| | - Sunil J Ghelani
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Adi Adar
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts
| | - Lynn A Sleeper
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Ronald V Lacro
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Gerald R Marx
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Meena Nathan
- Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts; Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - David M Harrild
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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Yoon JH, Han D, Kim S, Cho IJ, Sung JM, Lee J, Ryoo H, Shim CY, Hong GR, Chang HJ. Assessment of multidirectional movements of the common carotid artery in atherothrombotic stroke using dimensional speckle tracking carotid ultrasonography: A prospective, controlled cohort study. Echocardiography 2018; 35:957-964. [PMID: 29600550 DOI: 10.1111/echo.13881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIM We aimed to explore the relevance of multidirectional movements of the common carotid artery in atherothrombotic stroke. METHODS AND RESULTS We prospectively enrolled 69 patients with atherothrombotic stroke (stroke group) and 69 age-matched and sex-matched controls (control group) who underwent carotid ultrasonography. Based on the speckle tracking technique, circumferential and radial movements of the common carotid artery were analyzed from transverse and longitudinal B-mode images of the common carotid artery. Peak longitudinal and radial displacements, strain, and strain rate were measured. Mean age of the overall population was 64 ± 11 years, and 57% (78 patients) were men. In the transverse image, circumferential strain was significantly lower in the stroke group than in the control group (5.6 ± 1.6 vs 4.2 ± 1.7, P < .001). In multivariate logistic regression analysis, circumferential strain was independently associated with stroke (odds ratio: 0.60, P = .001). Compared with conventional risk factors, as well as carotid intima-media thickness and carotid plaque, the addition of a strain parameter appeared to improve discrimination of a stroke event (area under the receiver operating characteristic curve: 0.65 and 0.75 vs 0.84, respectively; P < .05 for both). CONCLUSIONS Circumferential strain of the common carotid artery might serve as a novel surrogate marker of atherothrombotic stroke. Multidirectional strain imaging of the common carotid artery may provide more information than conventional carotid ultrasonography and identify clinical risk factors for risk stratification of an acute stroke event.
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Affiliation(s)
- Ji Hyun Yoon
- Cardiology Division, Department of Internal Medicine, Seoul, Korea.,Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Seoul, Korea
| | - Donghee Han
- Cardiology Division, Department of Internal Medicine, Seoul, Korea.,Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Seoul, Korea
| | - Sujin Kim
- Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Seoul, Korea
| | - In-Jeong Cho
- Cardiology Division, Department of Internal Medicine, Seoul, Korea.,Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Seoul, Korea
| | - Ji Min Sung
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jinyong Lee
- Medical Imaging Research Group, Samsung Medison, Seoul, Korea
| | - Hojin Ryoo
- Medical Imaging Research Group, Samsung Medison, Seoul, Korea
| | - Chi Young Shim
- Cardiology Division, Department of Internal Medicine, Seoul, Korea
| | - Geu-Ru Hong
- Cardiology Division, Department of Internal Medicine, Seoul, Korea
| | - Hyuk-Jae Chang
- Cardiology Division, Department of Internal Medicine, Seoul, Korea.,Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Seoul, Korea.,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
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Chien CY, Chen JW, Chang CH, Huang CC. Tracking Dynamic Tongue Motion in Ultrasound Images for Obstructive Sleep Apnea. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:2791-2805. [PMID: 28942270 DOI: 10.1016/j.ultrasmedbio.2017.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 07/19/2017] [Accepted: 08/02/2017] [Indexed: 06/07/2023]
Abstract
Obstructive sleep apnea (OSA), a breathing disorder characterized by repetitive collapse of the pharyngeal airway during sleep, can cause intermittent hypoxemia and frequent arousal. The evaluation of dynamic tongue motion not only provides the biomechanics and pathophysiology for OSA diagnosis, but also helps doctors to determine treatment strategies for these patients with OSA. The purpose of this study was to develop and verify a dedicated tracking algorithm, called the modified optical flow (OF)-based method, for monitoring the dynamic motion of the tongue base in ultrasound image sequences derived from controls and patients with OSA. The performance of the proposed method was verified by phantom and synthetic data. A common tracking method, the normalized cross-correlation method, was included for comparison. The efficacy of the algorithms was evaluated by calculating the estimated displacement error. All results indicated that the modified OF-based method exhibited higher accuracy in verification experiments. In the human subject experiment, all participants performed the Müller maneuver (MM) to simulate the contour changes of the tongue base with a negative pharyngeal airway pressure in sleep apnea. Ultrasound image sequences of the tongue were obtained during 10 s of a transition from normal breathing to the MM, and these were measured using the modified OF-based method. The results indicated that the displacement of the tongue base during the MM was larger in the controls than in the patients with OSA (p < 0.05); the calculated areas of the tongue in the controls and patients with OSA were 24.9 ± 3.0 and 27.6 ± 3.3 cm2, respectively, during normal breathing (p < 0.05), and 24.7 ± 3.6 and 27.3 ± 3.8 cm2, respectively, at the end of the MM. The percentage changes in the tongue area were 2.2% and 1.3% in the controls and patients with OSA, respectively. We found that quantitative assessment of tongue motion by ultrasound imaging is suitable for evaluating pharyngeal airway behavior in OSA patients with minimal invasiveness and easy accessibility.
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Affiliation(s)
- Chih-Yen Chien
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Jeng-Wen Chen
- Department of Otolaryngology Head and Neck Surgery, Cardinal Tien Hospital, New Taipei City, Taiwan; School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Chun-Hsiang Chang
- Department of Otolaryngology Head and Neck Surgery, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Chih-Chung Huang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
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Jolley MA, Ghelani SJ, Adar A, Harrild DM. Three-Dimensional Mitral Valve Morphology and Age-Related Trends in Children and Young Adults with Structurally Normal Hearts Using Transthoracic Echocardiography. J Am Soc Echocardiogr 2017; 30:561-571. [PMID: 28391001 DOI: 10.1016/j.echo.2017.01.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Indexed: 10/19/2022]
Abstract
BACKGROUND The mitral valve has a complex three-dimensional (3D) morphology that is incompletely described by two-dimensional echocardiography (echo). Three-dimensional echo provides a more robust tool to analyze the mitral valve. The shape of the mitral annulus and leaflets, and differences with age, have not been described by 3D echo in normal children. Our objective was to characterize and quantify the 3D mitral valve morphology in children with normal transthoracic echocardiograms over a broad spectrum of age and to identify differences in valve shape with age. METHODS Three-dimensional midsystolic mitral valve models were constructed in 100 children and young adults with normal echocardiograms using 3D transthoracic images. Annular and leaflet metrics were quantified and regression equations were prepared. Interuser and intrauser variability was measured. RESULTS Two hundred fifty patients, from neonate to young adult, were retrospectively reviewed to obtain 100 evaluable patients (40% evaluable). The annular height to commissural width ratio of the mitral valve ("saddle shape") was preserved across age (median 24.3, IQR 21.8-28.1). Three-dimensional mitral valve area, length, and volume parameters were linearly related to body surface area (P < .001). The ratio of anterior to posterior leaflet length and posterior leaflet angle increased with body surface area (P = .0004 and .002, respectively) suggesting posterior movement of the coaptation line. Two-dimensional lateral annular diameter underestimated 3D lateral annular metrics (P < .001, mean difference 20-22%) but was highly correlated (R > 0.87, P < .001). Interuser and intrauser variability were acceptable. CONCLUSIONS Assessment of 3D mitral valve morphology in children is possible in a modern clinical pediatric echocardiography laboratory using transthoracic images, although further optimization of imaging is needed. The saddle shape of the mitral annulus was preserved across age and size. Most mitral valve parameters increased linearly with patient size. Further investigation is warranted to explore changes in valve morphology in the pediatric population in health and with disease.
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Affiliation(s)
- Matthew A Jolley
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatric Cardiac Anesthesia and Pediatric Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
| | - Sunil J Ghelani
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Adi Adar
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts
| | - David M Harrild
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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Yoon JH, Cho IJ, Chang HJ, Sung JM, Lee J, Ryoo H, Shim CY, Hong GR, Chung N. The Value of Elastic Modulus Index as a Novel Surrogate Marker for Cardiovascular Risk Stratification by Dimensional Speckle-Tracking Carotid Ultrasonography. J Cardiovasc Ultrasound 2016; 24:215-222. [PMID: 27721952 PMCID: PMC5050310 DOI: 10.4250/jcu.2016.24.3.215] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/21/2016] [Accepted: 07/26/2016] [Indexed: 11/25/2022] Open
Abstract
Background Carotid intima media thickness (CIMT) and the presence of carotid plaque have been used for risk stratification of cardiovascular disease (CVD). To date, however, the association between multi-directional functional properties of carotid artery and CVD has not been fully elucidated. We sought to explore the multi-directional mechanics of the carotid artery in relation to cardiovascular risk. Methods Four hundred one patients who underwent carotid ultrasound were enrolled between January 2010 and April 2013. A high risk of CVD was defined as more than 20% of 10-year risk based on the Framingham risk score. Using a speckle-tracking technique, the longitudinal and radial movements were analyzed in the B-mode images. Peak longitudinal and radial displacements, strain and strain rate were also measured. Beta stiffness and elastic modulus index were calculated from the radial measurements. Results Of the overall sample, 13% (52) of patients comprised the high-risk group. In multivariate logistic regression, CIMT and elastic modulus index were independently associated with a high-risk of CVD {odds ratio (OR): 1.810 [95% confidence interval (CI) 1.249–2.622] and OR: 1.767 (95% CI: 1.177–2.652); p = 0.002, 0.006, respectively}. The combination of CIMT and elastic modulus index correlated with a high-risk of CVD more so than CIMT alone. Conclusion The elastic modulus index of the carotid artery might serve as a novel surrogate marker of high-risk CVD. Measurement of the multi-directional mechanics of the carotid artery using the speckle tracking technique has potential for providing further information over conventional B-mode ultrasound for stratification of CVD risk.
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Affiliation(s)
- Ji Hyun Yoon
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - In-Jeong Cho
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hyuk-Jae Chang
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Min Sung
- Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jinyong Lee
- Infrastructure Technology Lab, Samsung Medison, Seoul, Korea
| | - Hojin Ryoo
- Infrastructure Technology Lab, Samsung Medison, Seoul, Korea
| | - Chi Young Shim
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Geu-Ru Hong
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Namsik Chung
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
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De Luca V, Székely G, Tanner C. Estimation of Large-Scale Organ Motion in B-Mode Ultrasound Image Sequences: A Survey. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:3044-3062. [PMID: 26360977 DOI: 10.1016/j.ultrasmedbio.2015.07.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 06/13/2015] [Accepted: 07/16/2015] [Indexed: 06/05/2023]
Abstract
Reviewed here are methods developed for following (i.e., tracking) structures in medical B-mode ultrasound time sequences during large-scale motion. The resulting motion estimation problem and its key components are defined. The main tracking approaches are described, and their strengths and weaknesses are discussed. Existing motion estimation methods, tested on multiple in vivo sequences, are categorized with respect to their clinical applications, namely, cardiac, respiratory and muscular motion. A large number of works in this field had to be discarded as thorough validation of the results was missing. The remaining relevant works identified indicate the possibility of reaching an average tracking accuracy up to 1-2 mm. Real-time performance can be achieved using several methods. Yet only very few of these have progressed to clinical practice. The latest trends include incorporation of complementary and prior information. Advances are expected from common evaluation databases and 4-D ultrasound scanning technologies.
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Affiliation(s)
- Valeria De Luca
- Computer Vision Laboratory, ETH Zurich, Zurich, Switzerland.
| | - Gábor Székely
- Computer Vision Laboratory, ETH Zurich, Zurich, Switzerland
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Tsang W, Veronesi F, Sugeng L, Weinert L, Takeuchi M, Jeevanandam V, Lang RM. Mitral Valve Dynamics in Severe Aortic Stenosis before and after Aortic Valve Replacement. J Am Soc Echocardiogr 2013; 26:606-14. [DOI: 10.1016/j.echo.2013.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Indexed: 10/27/2022]
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Tsang W, Meineri M, Hahn RT, Veronesi F, Shah AP, Osten M, Nathan S, Russo M, Lang RM, Horlick EM. A three-dimensional echocardiographic study on aortic-mitral coupling in transcatheter aortic valve replacement. Eur Heart J Cardiovasc Imaging 2013; 14:950-6. [PMID: 23720379 DOI: 10.1093/ehjci/jet058] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS Normal aortic valve (AV) and mitral valve (MV) function in a reciprocal interdependent fashion. We hypothesized that MV function would be affected by severe aortic stenosis (AS) and that it would remain altered after transcatheter AV replacement (TAVR). Using three-dimensional (3D) echocardiography, we studied aortic-mitral coupling in patients with severe AS undergoing TAVR and compared them with controls. METHODS AND RESULTS Three-dimensional transoesophageal echocardiography (Philips iE33) was performed on 43 patients: 27 with severe AS studied pre- and post-TAVR and 16 controls. A custom software tracked the aortic annulus (AoA) and mitral annulus (MA), allowing dynamic automated measurements of AoA and MA morphology, angle, and motion. The AS pre-TAVR patients had significantly reduced MA displacement, MA area, and maximum AoA area compared with the controls. Post-TAVR, MA displacement, MA area, and AoA area remained reduced. End-systolic AoA-MA angle was significantly wider in the AS patients compared with the controls and remained wider post-TAVR. Pre-TAVR, there was no difference in MA or AoA dynamics between patients with mild vs. moderate-to-severe MA calcium; Edwards-Sapien vs. a Medtronic CoreValve valve; normal vs. reduced left ventricular systolic function whereas post-TAVR, MA dynamics were significantly reduced in those with moderate-to-severe MA calcium. CONCLUSION This is the first study to demonstrate that AS can affect a secondary 'unaffected' valve, the MV, due to the calcification in the aortic-mitral fibrous continuity. TAVR does not result in recovery of MV structure. These changes have implications in the future TAVR valve development and the possible need for MV assessment pre- and post-TAVR.
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Affiliation(s)
- Wendy Tsang
- University of Chicago Medical Center, 5841 South Maryland Avenue, MC 5084, Chicago, IL 60637, USA
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Robust myocardial motion tracking for echocardiography: variational framework integrating local-to-global deformation. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2013; 2013:974027. [PMID: 23554841 PMCID: PMC3608188 DOI: 10.1155/2013/974027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 01/28/2013] [Indexed: 11/17/2022]
Abstract
This paper proposes a robust real-time myocardial border tracking algorithm for echocardiography. Commonly, after an initial contour of LV border is traced at one or two frames from the entire cardiac cycle, LV contour tracking is performed over the remaining frames. Among a variety of tracking techniques, optical flow method is the most widely used for motion estimation of moving objects. However, when echocardiography data is heavily corrupted in some local regions, the errors bring the tracking point out of the endocardial border, resulting in distorted LV contours. This shape distortion often occurs in practice since the data acquisition is affected by ultrasound artifacts, dropouts, or shadowing phenomena of cardiac walls. The proposed method is designed to deal with this shape distortion problem by integrating local optical flow motion and global deformation into a variational framework. The proposed descent method controls the individual tracking points to follow the local motions of a specific speckle pattern, while their overall motions are confined to the global motion constraint being approximately an affine transform of the initial tracking points. Many real experiments show that the proposed method achieves better overall performance than conventional methods.
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Evaluation of advanced Lukas-Kanade optical flow on thoracic 4D-CT. J Clin Monit Comput 2013; 27:433-41. [PMID: 23549645 DOI: 10.1007/s10877-013-9454-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 03/14/2013] [Indexed: 10/27/2022]
Abstract
Extensive use of high frequency imaging in medical applications permit the estimation of velocity fields which corresponds to motion of landmarks in the imaging field. The focus of this work is on the development of a robust local optical flow algorithm for velocity field estimation in medical applications. Local polynomial fits to the medical image intensity-maps are used to generate convolution operators to estimate the spatial gradients. A novel polynomial window function with a compact support is used to differentially weight the optical flow gradient constraints in the region of interest. Tikhonov regularization is exploited to synthesize a well posed optimization problem and to penalize large displacements. The proposed algorithm is tested and validated on benchmark datasets for deformable image registration. The ten datasets include large and small deformations, and illustrate that the proposed algorithm outperforms or is competitive with other algorithms tested on this dataset, when using mean and variance of the displacement error as performance metrics.
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15
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Khabbaz KR, Mahmood F, Shakil O, Warraich HJ, Gorman JH, Gorman RC, Matyal R, Panzica P, Hess PE. Dynamic 3-dimensional echocardiographic assessment of mitral annular geometry in patients with functional mitral regurgitation. Ann Thorac Surg 2012; 95:105-10. [PMID: 23103005 DOI: 10.1016/j.athoracsur.2012.08.078] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 08/24/2012] [Accepted: 08/27/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mitral valve (MV) annular dynamics have been well described in animal models of functional mitral regurgitation (FMR). Despite this, little if any data exist regarding the dynamic MV annular geometry in humans with FMR. In the current study we hypothesized that 3-dimensional (3D) echocardiography, in conjunction with commercially available software, could be used to quantify the dynamic changes in MV annular geometry associated with FMR. METHODS Intraoperative 3D transesophageal echocardiographic data obtained from 34 patients with FMR and 15 controls undergoing cardiac operations were dynamically analyzed for differences in mitral annular geometry with TomTec 4D MV Assessment 2.0 software (TomTec Imaging Systems GmbH, Munich, Germany). RESULTS In patients with FMR, the mean mitral annular area (14.6 cm(2) versus 9.6 cm(2)), circumference (14.1 cm versus 11.4 cm), anteroposterior (4.0 cm versus 3.0 cm) and anterolateral-posteromedial (4.3 cm versus 3.6 cm) diameters, tenting volume (6.2 mm(3) versus 3.5 mm(3)) and nonplanarity angle (NPA) (154 degrees ± 15 versus 136 degrees ± 11) were greater at all points during systole compared with controls (p < 0.01). Vertical mitral annular displacement (5.8 mm versus 8.3 mm) was reduced in FMR compared with controls (p < 0.01). CONCLUSIONS There are significant differences in dynamic mitral annular geometry between patients with FMR and those without. We were able to analyze these changes in a clinically feasible fashion. Ready availability of this information has the potential to aid comprehensive quantification of mitral annular function and possibly assist in both clinical decision making and annuloplasty ring selection.
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Affiliation(s)
- Kamal R Khabbaz
- Division of Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
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Effect of Mitral Valve Repair on Mitral-Aortic Coupling: A Real-Time Three-Dimensional Transesophageal Echocardiography Study. J Am Soc Echocardiogr 2012; 25:524-31. [DOI: 10.1016/j.echo.2012.02.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Indexed: 01/06/2023]
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17
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Faust O, Acharya UR, Tamura T. Formal Design Methods for Reliable Computer-Aided Diagnosis: A Review. IEEE Rev Biomed Eng 2012; 5:15-28. [DOI: 10.1109/rbme.2012.2184750] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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18
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Corsi C, Tomasi C, Turco D, Margheri M, Lamberti C, Severi S. 3D dynamic position assessment of the coronary sinus lead in cardiac resynchronization therapy. Med Biol Eng Comput 2011; 49:901-8. [DOI: 10.1007/s11517-011-0794-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 06/18/2011] [Indexed: 12/24/2022]
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Leung KYE, Danilouchkine MG, van Stralen M, de Jong N, van der Steen AFW, Bosch JG. Left ventricular border tracking using cardiac motion models and optical flow. ULTRASOUND IN MEDICINE & BIOLOGY 2011; 37:605-616. [PMID: 21376448 DOI: 10.1016/j.ultrasmedbio.2011.01.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 01/14/2011] [Accepted: 01/14/2011] [Indexed: 05/30/2023]
Abstract
The use of automated methods is becoming increasingly important for assessing cardiac function quantitatively and objectively. In this study, we propose a method for tracking three-dimensional (3-D) left ventricular contours. The method consists of a local optical flow tracker and a global tracker, which uses a statistical model of cardiac motion in an optical-flow formulation. We propose a combination of local and global trackers using gradient-based weights. The algorithm was tested on 35 echocardiographic sequences, with good results (surface error: 1.35 ± 0.46 mm, absolute volume error: 5.4 ± 4.8 mL). This demonstrates the method's potential in automated tracking in clinical quality echocardiograms, facilitating the quantitative and objective assessment of cardiac function.
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Affiliation(s)
- K Y Esther Leung
- Biomedical Engineering, Thoraxcenter, Erasmus MC, The Netherlands.
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Caiani EG, Fusini L, Veronesi F, Tamborini G, Maffessanti F, Gripari P, Corsi C, Naliato M, Zanobini M, Alamanni F, Pepi M. Quantification of mitral annulus dynamic morphology in patients with mitral valve prolapse undergoing repair and annuloplasty during a 6-month follow-up. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2011; 12:375-83. [DOI: 10.1093/ejechocard/jer016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Leung KE, Danilouchkine MG, van Stralen M, de Jong N, van der Steen AF, Bosch JG. Probabilistic framework for tracking in artifact-prone 3D echocardiograms. Med Image Anal 2010; 14:750-8. [DOI: 10.1016/j.media.2010.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Revised: 06/03/2010] [Accepted: 06/03/2010] [Indexed: 10/19/2022]
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Little SH, Ben Zekry S, Lawrie GM, Zoghbi WA. Dynamic Annular Geometry and Function in Patients with Mitral Regurgitation: Insight From Three-Dimensional Annular Tracking. J Am Soc Echocardiogr 2010; 23:872-9. [DOI: 10.1016/j.echo.2010.06.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Indexed: 11/16/2022]
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Leung KYE, Bosch JG. Automated border detection in three-dimensional echocardiography: principles and promises. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2010; 11:97-108. [PMID: 20139440 DOI: 10.1093/ejechocard/jeq005] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Several automated border detection approaches for three-dimensional echocardiography have been developed in recent years, allowing quantification of a range of clinically important parameters. In this review, the background and principles of these approaches and the different classes of methods are described from a practical perspective, as well as the research trends to achieve a robust method.
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Affiliation(s)
- K Y Esther Leung
- Thoraxcenter Biomedical Engineering, Erasmus Medical Center, Rotterdam, The Netherlands
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Danilouchkine MG, Mastik F, van der Steen AFW. A study of coronary artery rotational motion with dense scale-space optical flow in intravascular ultrasound. Phys Med Biol 2009; 54:1397-418. [DOI: 10.1088/0031-9155/54/6/002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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25
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Duan Q, Angelini ED, Herz SL, Ingrassia CM, Costa KD, Holmes JW, Homma S, Laine AF. Region-based endocardium tracking on real-time three-dimensional ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2009; 35:256-65. [PMID: 18963396 PMCID: PMC2649777 DOI: 10.1016/j.ultrasmedbio.2008.08.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2007] [Revised: 07/30/2008] [Accepted: 08/14/2008] [Indexed: 05/25/2023]
Abstract
Matrix-phased array transducers for real-time 3-D ultrasound enable fast, noninvasive visualization of cardiac ventricles. Typically, 3-D ultrasound images are semiautomatically segmented to extract the left ventricular endocardial surface at end-diastole and end-systole. Automatic segmentation and propagation of this surface throughout the entire cardiac cycle is a challenging and cumbersome task. If the position of the endocardial surface is provided at one or two time frames during the cardiac cycle, automated tracking of the surface over the remaining time frames could reduce the workload of cardiologists and optimize analysis of 3-D ultrasound data. In this paper, we applied a region-based tracking algorithm to track the endocardial surface between two reference frames that were manually segmented. To evaluate the tracking of the endocardium, the method was applied to 40 open-chest dog datasets with 484 frames in total. Ventricular geometry and volumes derived from region-based endocardial surfaces and manual tracing were quantitatively compared, showing strong correlation between the two approaches. Statistical analysis showed that the errors from tracking were within the range of interobserver variability of manual tracing. Moreover, our algorithm performed well on ischemia datasets, suggesting that the method is robust-to-abnormal wall motion. In conclusion, the proposed optical flow-based surface tracking method is very efficient and accurate, providing dynamic "interpolation" of segmented endocardial surfaces.
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Affiliation(s)
- Qi Duan
- Department of Biomedical Engineering, Columbia University, New York, NY, USA.
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26
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Veronesi F, Corsi C, Sugeng L, Mor-Avi V, Caiani EG, Weinert L, Lamberti C, Lang RM. A study of functional anatomy of aortic-mitral valve coupling using 3D matrix transesophageal echocardiography. Circ Cardiovasc Imaging 2008; 2:24-31. [PMID: 19808561 DOI: 10.1161/circimaging.108.785907] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mitral and aortic valves are known to be coupled via fibrous tissue connecting the two annuli. Previous studies evaluating this coupling have been limited to experimental animals using invasive techniques. The new matrix array transesophageal transducer provides high-resolution real-time 3D images of both valves simultaneously. We sought to develop and test a technique for quantitative assessment of mitral and aortic valve dynamics and coupling. METHODS AND RESULTS Matrix array transesophageal (Philips iE33) imaging was performed in 24 patients with normal valves who underwent clinically indicated transesophageal echocardiography. Custom software was used to detect and track the mitral and aortic annuli in 3D space throughout the cardiac cycle, allowing automated measurement of changes in mitral and aortic valve morphology. Mitral annulus surface area and aortic annulus projected area changed reciprocally over time. Mitral annulus surface area was 8.0+/-2.1 cm(2) at end-diastole and decreased to 7.7+/-2.1 cm(2) in systole, reaching its maximum (10.0+/-2.2 cm(2)) at mitral valve opening. Aortic annulus projected area was 4.1+/-1.2 cm(2) at end-diastole, then increased during isovolumic contraction reaching its maximum (4.8+/-1.3 cm(2)) in the first third of systole and its minimum (3.6+/-1.0 cm(2)) during isovolumic relaxation. The angle between the mitral and aortic annuli was maximum (136+/-13 degrees ) at end-diastole and decreased to its minimum value (129+/-11 degrees ) during systole. CONCLUSIONS This is the first study to report quantitative 3D assessment of the mitral and aortic valve dynamics from matrix array transesophageal images and describe the mitral-aortic coupling in a beating human heart. This ability may have impact on patient evaluation for valvular surgical interventions and prosthesis design.
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Affiliation(s)
- Federico Veronesi
- Department of Electronics, Computer Science and Systems, University of Bologna, Italy
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27
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Danilouchkine MG, Mastik F, van der Steen AFW. Improving IVUS palpography by incorporation of motion compensation based on block matching and optical flow. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2008; 55:2392-2404. [PMID: 19049919 DOI: 10.1109/tuffc.947] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Intravascular ultrasound (IVUS) strain imaging of the luminal layer in coronary arteries, coined as IVUS palpography, utilizes conventional radio frequency (RF) signals acquired at 2 different levels of a compressional load. The signals are cross-correlated to obtain the microscopic tissue displacements, which can be directly translated into local strain of the vessel wall. However, (apparent) tissue motion and nonuniform deformation of the vessel wall, due to catheter wiggling, reduce signal correlation and result in invalid strain estimates. Implications of probe motion were studied on the tissue-mimicking phantom. The measured circumferential tissue displacement and level of the speckle decorrelation amounted to 12 degrees and 0.58, respectively, for the catheter displacement of 456 microm. To compensate for the motion artifacts in IVUS palpography, a novel method based on the feature-based scale-space optical flow (OF), and classical block matching (BM) algorithm, were employed. The computed OF vector and BM displacement fields quantify the amount of local tissue misalignment in consecutive frames. Subsequently, the extracted circumferential displacements are used to realign the signals before strain computation. Motion compensation reduces the RF signal decorrelation and increases the number of valid strain estimates. The advantage of applying the motion correction in IVUS palpography was demonstrated in a midscale validation study on 14 in vivo pullbacks. Both methods substantially increase the number of valid strain estimates in the partial and compounded palpograms. Mean relative improvement in the number of valid strain estimates with motion compensation in comparison to one without motion compensation amounts to 28% and 14%, respectively. Implementation of motion compensation methods boosts the diagnostic value of IVUS palpography.
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Leung KYE, van Stralen M, Nemes A, Voormolen MM, van Burken G, Geleijnse ML, Ten Cate FJ, Reiber JHC, de Jong N, van der Steen AFW, Bosch JG. Sparse registration for three-dimensional stress echocardiography. IEEE TRANSACTIONS ON MEDICAL IMAGING 2008; 27:1568-1579. [PMID: 18955173 DOI: 10.1109/tmi.2008.922685] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Three-dimensional (3-D) stress echocardiography is a novel technique for diagnosing cardiac dysfunction. It involves evaluating wall motion of the left ventricle, by visually analyzing ultrasound images obtained in rest and in different stages of stress. Since the acquisitions are performed minutes apart, variabilities may exist in the visualized cross-sections. To improve anatomical correspondence between rest and stress, aligning the images is essential. We developed a new intensity-based, sparse registration method to retrieve standard anatomical views from 3-D stress images that were equivalent to the manually selected views in the rest images. Using sparse image planes, the influence of common image artifacts could be reduced. We investigated different similarity measures and different levels of sparsity. The registration was tested using data of 20 patients and quantitatively evaluated based on manually defined anatomical landmarks. Alignment was best using sparse registration with two long-axis and two short-axis views; registration errors were reduced significantly, to the range of interobserver variabilities. In 91% of the cases, the registration result was qualitatively assessed as better than or equal to the manual alignment. In conclusion, sparse registration improves the alignment of rest and stress images, with a performance similar to manual alignment. This is an important step towards objective quantification in 3-D stress echocardiography.
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Affiliation(s)
- K Y Esther Leung
- Biomedical Engineering, Cardiology, Thoraxcenter, Erasmus MC, 3000 CA Rotterdam, The Netherlands.
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29
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Danilouchkine MG, Mastik F, van der Steen AFW. Accuracy in prediction of catheter rotation in IVUS with feature-based optical flow--a phantom study. ACTA ACUST UNITED AC 2008; 12:356-65. [PMID: 18693503 DOI: 10.1109/titb.2007.905864] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The quantitative assessment of and compensation for catheter rotation in intravascular ultrasound images presents a fundamental problem for noninvasive characterization of the mechanical properties of the coronary arteries. A method based on the scale-space optical flow algorithm with a feature-based weighting scheme is proposed to account for the aforementioned artifact. The computed vector field, describing the misalignment between two consecutive frames, allows the quantitative assessment of the amount of vessel wall tissue motion, which is directly related to the catheter rotation. Algorithm accuracy and robustness were demonstrated on two tissue-mimicking phantoms, subjected to controlled amount of angular deviation. The proposed method shows a great reliability in the prediction of catheter rotational motion up to 4 degrees.
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Affiliation(s)
- Mikhail G Danilouchkine
- Department of Biomedical Engineering, Thoraxcentre, Erasmus MC, 3000 CA Rotterdam, The Netherlands.
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30
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Veronesi F, Caiani EG, Toledo E, Corsi C, Collins KA, Lammertin G, Lamberti C, Lang RM, Mor-Avi V. Semi-automated analysis of dynamic changes in myocardial contrast from real-time three-dimensional echocardiographic images as a basis for volumetric quantification of myocardial perfusion. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2008; 10:485-90. [PMID: 18765416 DOI: 10.1093/ejechocard/jen209] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS Despite the potential of real-time three-dimensional (3D) echocardiography (RT3DE) to assess myocardial perfusion, there is no quantification method available for perfusion analysis from RT3DE images. Such method would require 3D regions of interest (ROI) to be defined and adjusted frame-by-frame to compensate for cardiac translation and deformation. Our aims were to develop and test a technique for automated identification of 3D myocardial ROI suitable for translation-free quantification of myocardial videointensity over time, MVI(t), from contrast-enhanced RT3DE images. METHODS AND RESULTS Twelve transthoracic RT3DE (Philips) data sets obtained in pigs during transition from no contrast to steady-state enhancement (Definity) were analysed using custom software. Analysis included: (i) semi-automated detection of left ventricular endo- and epicardial surfaces using level-set techniques in one frame to define a 3D myocardial ROI, (ii) rigid 3D registration to reduce translation and rotation, (iii) elastic 3D registration to compensate for deformation, and (iv) quantification of MVI(t) in the 3D ROI from the registered and non-registered data sets to assess the effectiveness of registration. For each MVI(t) curve we computed % variability during steady-state enhancement (100 x SD/mean) and goodness of fit (r2) to the indicator dilution equation MVI(t) = A[1-exp(-betat)]. Analysis of myocardial contrast throughout contrast inflow was feasible in all data sets. Three-dimensional registration improved MVI(t) curves in terms of both % variability (2.8 +/- 1.8 to 1.5 +/- 0.9%; P < 0.05) and goodness of fit (r2 from 0.79 +/- 0.2 to 0.90 +/- 0.1; P < 0.05). CONCLUSION This is the first study to describe a new technique for semi-automated volumetric quantification of myocardial contrast from RT3DE images that includes registration and thus provides the basis for 3D measurement of myocardial perfusion.
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Affiliation(s)
- Federico Veronesi
- Department of Electronics, Computer Science and Systems, Università di Bologna, Bologna, Italy
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Veronesi F, Corsi C, Sugeng L, Caiani EG, Weinert L, Mor-Avi V, Cerutti S, Lamberti C, Lang RM. Quantification of Mitral Apparatus Dynamics in Functional and Ischemic Mitral Regurgitation Using Real-time 3-Dimensional Echocardiography. J Am Soc Echocardiogr 2008; 21:347-54. [PMID: 17681731 DOI: 10.1016/j.echo.2007.06.017] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2007] [Indexed: 11/21/2022]
Abstract
Mitral regurgitation (MR) in dilated cardiomyopathy (DCM-MR) and MR in ischemic cardiomyopathy (ISC-MR) usually occurs as a result of mitral annulus (MA) dilatation and papillary muscle displacement secondary to global left ventricle remodelling. We propose a method to determine MA area and motion throughout the cardiac cycle and to define papillary muscle position in 3-dimensional space using real-time 3-dimensional echocardiography. Real-time 3-dimensional echocardiography was performed in 24 healthy individuals, and in 30 patients with DCM-MR (n = 15) or ISC-MR (n = 15). Significant intergroup differences were noted in MA surface area (control: 6.4 +/- 1.7 cm(2); DCM-MR: 11.1 +/- 2.6 cm(2); ISC-MR: 9.0 +/- 2.0 cm(2)) and in peak MA motion (control: 8.7 +/- 3.0 mm; DCM-MR: 3.4 +/- 1.7 mm; ISC-MR: 4.9 +/- 1.5 mm). In patients with DCM-MR, papillary muscle symmetry was preserved, whereas in patients with ISC-MR, papillary tethering lengths were unequal as a result of wall-motion abnormalities. Our methodology for dynamic volumetric measurements of the mitral apparatus allows better understanding of MR mechanisms.
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van Stralen M, Leung KYE, Voormolen MM, de Jong N, van der Steen AFW, Reiber JHC, Bosch JG. Time continuous detection of the left ventricular long axis and the mitral valve plane in 3-D echocardiography. ULTRASOUND IN MEDICINE & BIOLOGY 2008; 34:196-207. [PMID: 17935871 DOI: 10.1016/j.ultrasmedbio.2007.07.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2007] [Revised: 06/04/2007] [Accepted: 07/25/2007] [Indexed: 05/25/2023]
Abstract
Automated segmentation approaches for the left ventricle (LV) in 3-D echocardiography (3DE) often rely on manual initialization. So far, little effort has been put into automating the initialization procedure to get to a fully automatic segmentation approach. We propose a fully automatic method for the detection of the LV long axis (LAX) and the mitral valve plane (MVP) over the full cardiac cycle, for the initialization of segmentation algorithms in 3DE. Our method exploits the cyclic motion of the LV and therefore detects salient structures in a time-continuous way. Probabilities to candidate LV center points are assigned through a Hough transform for circles. The LV LAX is detected by combining dynamic programming detections on these probabilities in 3-D and 2D + time to obtain a time continuous solution. Subsequently, the mitral valve plane is detected in a projection of the data on a plane through the previously detected LAX. The method easily adjusts to different acquisition routines and combines robustness with good accuracy and low computational costs. Automatic detection was evaluated using patient data acquired with the fast rotating ultrasound (FRU) transducer (n=11 patients) and with the Philips Sonos 7500 ultrasound system (Philips Medical Systems, Andover, MA, USA), with the X4 matrix transducer (n=14 patients). For the FRU-transducer data, the LAX was estimated with a distance error of 2.85+/-1.70 mm (mean+/-SD) and an angle of 5.25+/-3.17 degrees; the mitral valve plane was estimated with a distance of -1.54+/-4.31 mm. For the matrix data, these distances were 1.96+/-1.30 mm with an angle error of 5.95+/-2.11 and -1.66+/-5.27 mm for the mitral valve plane. These results confirm that the method is very suitable for automatic detection of the LV LAX and MVP. It provides a basis for further automatic exploration of the LV and could therefore serve as a replacement of manual initialization of 3-D segmentation approaches.
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Affiliation(s)
- M van Stralen
- Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
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Nevo ST, van Stralen M, Vossepoel AM, Reiber JHC, de Jong N, van der Steen AFW, Bosch JG. Automated tracking of the mitral valve annulus motion in apical echocardiographic images using multidimensional dynamic programming. ULTRASOUND IN MEDICINE & BIOLOGY 2007; 33:1389-99. [PMID: 17513035 DOI: 10.1016/j.ultrasmedbio.2007.03.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2006] [Revised: 02/09/2007] [Accepted: 03/07/2007] [Indexed: 05/15/2023]
Abstract
We developed a semiautomatic method for tracking the mitral valve annulus (MVA) in echocardiographic images, in particular, tracking the septal and the lateral mitral valve hinge points. The algorithm is based on multidimensional dynamic programming combined with apodized block matching. The method was tested on single-beat apical four chamber image sequences of 20 patients with acute myocardial infarction. The automated tracking results were evaluated by comparing them with the average manual tracking results of two experts. The mitral valve hinge point displacements and the total mitral excursions obtained by the automatic technique agreed well with those obtained manually and outperformed two commonly used tracking methods (forward tracking and minimum tracking). In conclusion, this novel semiautomatic tracking method is clinically valuable and capable of tracking the MVA motion within the limits of interobserver variability. The technique is robust, even in low frame rate, redigitized VCR images of clinical quality.
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Affiliation(s)
- Shelly T Nevo
- Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
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34
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Duan Q, Angelini E, Homma S, Laine A. Tracking endocardium using optical flow along iso-value curve. CONFERENCE PROCEEDINGS : ... ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL CONFERENCE 2006; 2006:707-710. [PMID: 17946418 DOI: 10.1109/iembs.2006.260172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In cardiac image analysis, optical flow techniques are widely used to track ventricular borders as well as estimate myocardial motion fields. The optical flow computation is typically performed in Cartesian coordinates, and not constrained from a priori knowledge of normal myocardium deformation patterns. However, for cardiac motion analysis, displacements along specific directions and their derivatives are usually more interesting than 2D or 3D displacement fields themselves. In this context, we propose a general frame work on optical flow estimation along iso-value curves. We applied the proposed framework in a specific application: for endocardium tracking on cine cardiac MRI series. The endocardial surfaces tracked with the proposed algorithm were quantitatively compared with manual tracing at each frame. The proposed method was also compared to the regular Lucas-Kanade optical flow method directly applied to MRI image data in Cartesian coordinates. Quantitative comparison showed a positive improvement in average tracking errors, through the whole cardiac cycle.
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Affiliation(s)
- Qi Duan
- Dept. of Biomedical Engineering, Columbia University, New York, NY, USA
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