Automated Segmentation and Non-Rigid Registration for the Quantitative Evaluation of Myocardial Perfusion from Magnetic Resonance Images

Myocardial perfusion quantification by means of Contrast-Enhanced Cardiac Magnetic Resonance images relies on time consuming frame-by-frame manual tracing of regions of interest. In this Thesis, a novel automated technique for myocardial segmentation and non-rigid registration as a basis for perfusion quantification is presented. The proposed technique is based on three steps: reference frame selection, myocardial segmentation and non-rigid registration. In the first step, the reference frame in which both endo- and epicardial segmentation will be performed is chosen. Endocardial segmentation is achieved by means of a statistical region-based level-set technique followed by a curvature-based regularization motion. Epicardial segmentation is achieved by means of an edge-based level-set technique followed again by a regularization motion. To take into account the changes in position, size and shape of myocardium throughout the sequence due to out of plane respiratory motion, a non-rigid registration algorithm is required. The proposed non-rigid registration scheme consists in a novel multiscale extension of the normalized cross-correlation algorithm in combination with level-set methods. The myocardium is then divided into standard segments. Contrast enhancement curves are computed measuring the mean pixel intensity of each segment over time, and perfusion indices are extracted from each curve. The overall approach has been tested on synthetic and real datasets. For validation purposes, the sequences have been manually traced by an experienced interpreter, and contrast enhancement curves as well as perfusion indices have been computed. Comparisons between automatically extracted and manually obtained contours and enhancement curves showed high inter-technique agreement. Comparisons of perfusion indices computed using both approaches against quantitative coronary angiography and visual interpretation demonstrated that the two technique have similar diagnostic accuracy. In conclusion, the proposed technique allows fast, automated and accurate measurement of intra-myocardial contrast dynamics, and may thus address the strong clinical need for quantitative evaluation of myocardial perfusion.

Diversity of baculoviruses isolated from cutworms (Agrotis spp.)

Larven der Eulenfalter, Gattung Agrotis (Lepidoptera: Noctuidae), sind Schädlinge in der Landwirtschaft, welche gravierende Fraßschäden an bodennahen Pflanzenteilen verursachen. Häufig kommt es zum Absterben der noch jungen Pflanzen oder zu Beschädigungen der pflanzlichen Produkte, was zu finanziellen Ertragsverlusten führt. Zwei der wichtigsten landwirtschaftlichen Schädlinge der Gattung Agrotis sind die Larven der Saateule (Agrotis segetum) und der Ypsiloneule (Agrotis ipsilon), welche bisher überwiegend mittels chemischer Pestizide bekämpft werden. Als eine umweltfreundliche, nachhaltige und vielversprechende Alternative in der Bekämpfung wird der Einsatz von Baculoviren berücksichtigt. Baculoviren zeichnen sich durch eine hohe Virulenz und einem sehr engen Wirtsbereich aus. Häufig werden nur wenige nah verwandte Arten der gleichen Gattung infiziert. Aus der Gattung Agrotis wurden bisher mindestens vier Baculoviren isoliert und charakterisiert, welche als potentielle biologische Pflanzenschutzmittel in Frage kommen; sie gehören zu zwei Gattungen der Baculoviren: rnAlphabaculovirusrn(i) Agrotis segetum nucleopolyhedrovirus A (AgseNPV-A)rn(ii) Agrotis segetum nucleopolyhedrovirus B (AgseNPV-B)rn(iii) Agrotis ipsilon nucleopolyhedrovirus (AgipNPV)rnBetabaculovirusrn(i) Agrotis segetum granulovirus (AgseGV).rnDie Genome der AgseNPV-A, AgipNPV sowie des AgseGV wurden in vorherigen Studien bereits vollständig sequenziert und publiziert. In der vorgelegten Dissertation wurde das AgseNPV-B sequenziert und umfassend mit AgseNPV-A und AgipNPV verglichen. Das Genom von AgseNPV-B ist 148981 Kbp groß und kodiert ….. offene Leseraster. Phylogenetische Analysen zeigen eine enge Verwandtschaft dieser drei Viren und klassifizieren AgseNPV-B als eine neue Art innerhalb der Gattung Alphabaculovirus. Auf Basis der vorhandenen Genomsequenzen konnte eine PCR-basierende Methode zur Detektion und Quantifizierung on AgseNPV-A, AgseNPV-B, AgipNPV und AgseGV etabliert werden. Dises Verfahren ermöglichte die Quantifizierung von AgseNPV-B und AgseGV in Larven von A. segetum, die von beiden Viren zeitgleichinfiziert waren. Durch das gemeinsame Auftreten dieser beiden Wiren innerhalb eines Wirtsindividuums stellte sich die Frage, welche Art der Interaktion bei einer Ko-Infektion vorliegt. Durch Mischinfektionsversuche von AgseNPV-B und AgseGV konnte gezeigt werden, dass beide Viren um die Ressourcen der Larven konkurrieren. Eine für landwirtschaftliche Zwecke vorteilige Interaktion, wie das vorzeitige Verenden der Larven, das bereits für andere interagierende Baculoviren nachgewiesen wurde, konnte ausgeschlossen werden. Neben den Mischinfektionsversuchen wurden auch AgseGV und AgseNPV-B einzeln auf ihre Eignung als biologisches Pflanzenschutzmittel getestet. AgseGV zeigte in den Laborversuchen eine relativ langsame Wirkung, während AgseNPV-B durchaus Potential für ein rasche Abtötung besitzt. rnDie durchgeführten Aktivitätsstudien und die Charakterisierung von AgseNPV-B als neue Art erlauben ein vertieftes biologisches und molekulares Verständnis des Virus legen den Grundstein für und eine mögliche spätere Zulassung als Pflanzenschutzmittel. Die Methode zur Identifizierung und Quantifizierung der Agrotis-Baculoviren stellt ein wichtiges Instrument in der Qualitätskontrolle für Produzenten dar und ermöglicht zudem weitere Untersuchungen von Agrotis-Baculoviren in Mischinfektionen.

Multimodal Registration Procedure for the Initial Spatial Alignment of a Retinal Video Sequence to a Retinal Composite Image

Accurate placement of lesions is crucial for the effectiveness and safety of a retinal laser photocoagulation treatment. Computer assistance provides the capability for improvements to treatment accuracy and execution time. The idea is to use video frames acquired from a scanning digital ophthalmoscope (SDO) to compensate for retinal motion during laser treatment. This paper presents a method for the multimodal registration of the initial frame from an SDO retinal video sequence to a retinal composite image, which may contain a treatment plan. The retinal registration procedure comprises the following steps: 1) detection of vessel centerline points and identification of the optic disc; 2) prealignment of the video frame and the composite image based on optic disc parameters; and 3) iterative matching of the detected vessel centerline points in expanding matching regions. This registration algorithm was designed for the initialization of a real-time registration procedure that registers the subsequent video frames to the composite image. The algorithm demonstrated its capability to register various pairs of SDO video frames and composite images acquired from patients.

A Hybrid Multimodal Non-Rigid Registration of MR Images Based on Diffeomorphic Demons

n this paper we present a novel hybrid approach for multimodal medical image registration based on diffeomorphic demons. Diffeomorphic demons have proven to be a robust and efficient way for intensity-based image registration. A very recent extension even allows to use mutual information (MI) as a similarity measure to registration multimodal images. However, due to the intensity correspondence uncertainty existing in some anatomical parts, it is difficult for a purely intensity-based algorithm to solve the registration problem. Therefore, we propose to combine the resulting transformations from both intensity-based and landmark-based methods for multimodal non-rigid registration based on diffeomorphic demons. Several experiments on different types of MR images were conducted, for which we show that a better anatomical correspondence between the images can be obtained using the hybrid approach than using either intensity information or landmarks alone.

Atlas-Based Segmentation of Brain Tumor Images Using a Markov Random Field-Based Tumor Growth Model and Non-Rigid Registration

We propose a new and clinically oriented approach to perform atlas-based segmentation of brain tumor images. A mesh-free method is used to model tumor-induced soft tissue deformations in a healthy brain atlas image with subsequent registration of the modified atlas to a pathologic patient image. The atlas is seeded with a tumor position prior and tumor growth simulating the tumor mass effect is performed with the aim of improving the registration accuracy in case of patients with space-occupying lesions. We perform tests on 2D axial slices of five different patient data sets and show that the approach gives good results for the segmentation of white matter, grey matter, cerebrospinal fluid and the tumor.

Multi-modal diffeomorphic demons registration based on point-wise mutual information

In this paper we propose a variational approach for multimodal image registration based on the diffeomorphic demons algorithm. Diffeomorphic demons has proven to be a robust and efficient way for intensity-based image registration. However, the main drawback is that it cannot deal with multiple modalities. We propose to replace the standard demons similarity metric (image intensity differences) by point-wise mutual information (PMI) in the energy function. By comparing the accuracy between our PMI based diffeomorphic demons and the B-Spline based free-form deformation approach (FFD) on simulated deformations, we show the proposed algorithm performs significantly better.

Postoperative evaluation of surgery for craniosynostosis based on image registration techniques

Craniosynostosis consists of a premature fusion of the sutures in an infant skull, which restricts the skull and brain growth. During the last decades there has been a rapid increase of fundamentally diverse surgical treatment methods. At present, the surgical outcome has been assessed using global variables such as cephalic index, head circumerence and intracranial volume. However, the variables have failed in describing the local deformations and morphological changes, which are proposed to more likely induce neurological disorders.

Information Filtering for Ultrasound-based Real-time Registration

This paper presents methods based on Information Filters for solving matching problems with emphasis on real-time, or effectively real-time applications. Both applications discussed in this work deal with ultrasound-based rigid registration in computer-assisted orthopedic surgery. In the first application, the usual workflow of rigid registration is reformulated such that registration algorithms would iterate while the surgeon is acquiring ultrasound images of the anatomy to be operated. Using this effectively real-time approach to registration, the surgeon would then receive feedback in order to better gauge the quality of the final registration outcome. The second application considered in this paper circumvents the need to attach physical markers to bones for anatomical referencing. Experiments using anatomical objects immersed in water are performed in order to evaluate and compare the different methods presented herein, using both 2D as well as real-time 3D ultrasound.

Simultaneous bilateral hip replacement reveals superior outcome and fewer complications than two-stage procedures: a prospective study including 1819 patients and 5801 follow-ups from a total joint replacement registry

Background Total joint replacements represent a considerable part of day-to-day orthopaedic routine and a substantial proportion of patients undergoing unilateral total hip arthroplasty require a contralateral treatment after the first operation. This report compares complications and functional outcome of simultaneous versus early and delayed two-stage bilateral THA over a five-year follow-up period. Methods The study is a post hoc analysis of prospectively collected data in the framework of the European IDES hip registry. The database query resulted in 1819 patients with 5801 follow-ups treated with bilateral THA between 1965 and 2002. According to the timing of the two operations the sample was divided into three groups: I) 247 patients with simultaneous bilateral THA, II) 737 patients with two-stage bilateral THA within six months, III) 835 patients with two-stage bilateral THA between six months and five years. Results Whereas postoperative hip pain and flexion did not differ between the groups, the best walking capacity was observed in group I and the worst in group III. The rate of intraoperative complications in the first group was comparable to that of the second. The frequency of postoperative local and systemic complication in group I was the lowest of the three groups. The highest rate of complications was observed in group III. Conclusions From the point of view of possible intra- and postoperative complications, one-stage bilateral THA is equally safe or safer than two-stage interventions. Additionally, from an outcome perspective the one-stage procedure can be considered to be advantageous.

A new technique for simultaneous validation of two manual nonmercury auscultatory sphygmomanometers (A;D UM-101 and Accoson Greenlight 300) based on the International protocol

Auscultatory nonmercury manual devices seem good alternatives for the mercury sphygmomanometers in the clinic and for research settings, but individual internal validation of each device is time-consuming. The aim of this study was to validate a new technique capable of testing two devices simultaneously, based on the International protocol of the European Society of Hypertension.

EPITHET: Positive Result After Reanalysis Using Baseline Diffusion-Weighted Imaging/Perfusion-Weighted Imaging Co-Registration

the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET) was a prospective, randomized, double-blinded, placebo-controlled, phase II trial of alteplase between 3 and 6 hours after stroke onset. The primary outcome of infarct growth attenuation on MRI with alteplase in mismatch patients was negative when mismatch volumes were assessed volumetrically, without coregistration, which underestimates mismatch volumes. We hypothesized that assessing the extent of mismatch by coregistration of perfusion and diffusion MRI maps may more accurately allow the effects of alteplase vs placebo to be evaluated.