Robust temporal alignment of multimodal cardiac sequences

Given the dynamic nature of cardiac function, correct temporal alignment of pre-operative models and intraoperative images is crucial for augmented reality in cardiac image-guided interventions. As such, the current study focuses on the development of an image-based strategy for temporal alignment of multimodal cardiac imaging sequences, such as cine Magnetic Resonance Imaging (MRI) or 3D Ultrasound (US). First, we derive a robust, modality-independent signal from the image sequences, estimated by computing the normalized crosscorrelation between each frame in the temporal sequence and the end-diastolic frame. This signal is a resembler for the left-ventricle (LV) volume curve over time, whose variation indicates di erent temporal landmarks of the cardiac cycle. We then perform the temporal alignment of these surrogate signals derived from MRI and US sequences of the same patient through Dynamic Time Warping (DTW), allowing to synchronize both sequences. The proposed framework was evaluated in 98 patients, which have undergone both 3D+t MRI and US scans. The end-systolic frame could be accurately estimated as the minimum of the image-derived surrogate signal, presenting a relative error of 1:6 1:9% and 4:0 4:2% for the MRI and US sequences, respectively, thus supporting its association with key temporal instants of the cardiac cycle. The use of DTW reduces the desynchronization of the cardiac events in MRI and US sequences, allowing to temporally align multimodal cardiac imaging sequences. Overall, a generic, fast and accurate method for temporal synchronization of MRI and US sequences of the same patient was introduced. This approach could be straightforwardly used for the correct temporal alignment of pre-operative MRI information and intra-operative US images.

Improving The Robustness Of Interventional 4D Ultrasound Segmentation Through The Use Of Personalized Shape Priors

While fluoroscopy is still the most widely used imaging modality to guide cardiac interventions, the fusion of pre-operative Magnetic Resonance Imaging (MRI) with real-time intra-operative ultrasound (US) is rapidly gaining clinical acceptance as a viable, radiation-free alternative. In order to improve the detection of the left ventricular (LV) surface in 4D ultrasound, we propose to take advantage of the pre-operative MRI scans to extract a realistic geometrical model representing the patients cardiac anatomy. This could serve as prior information in the interventional setting, allowing to increase the accuracy of the anatomy extraction step in US data. We have made use of a real-time 3D segmentation framework used in the recent past to solve the LV segmentation problem in MR and US data independently and we take advantage of this common link to introduce the prior information as a soft penalty term in the ultrasound segmentation algorithm. We tested the proposed algorithm in a clinical dataset of 38 patients undergoing both MR and US scans. The introduction of the personalized shape prior improves the accuracy and robustness of the LV segmentation, as supported by the error reduction when compared to core lab manual segmentation of the same US sequences.

Multi-centre validation of an automatic algorithm for fast 4D myocardial segmentation in cine CMR datasets

Quantitative analysis of cine cardiac magnetic resonance (CMR) images for the assessment of global left ventricular morphology and function remains a routine task in clinical cardiology practice. To date, this process requires user interaction and therefore prolongs the examination (i.e. cost) and introduces observer variability. In this study, we sought to validate the feasibility, accuracy, and time efficiency of a novel framework for automatic quantification of left ventricular global function in a clinical setting.

Fast left ventricle tracking in CMR images using localized anatomical affine optical flow

In daily cardiology practice, assessment of left ventricular (LV) global function using non-invasive imaging remains central for the diagnosis and follow-up of patients with cardiovascular diseases. Despite the different methodologies currently accessible for LV segmentation in cardiac magnetic resonance (CMR) images, a fast and complete LV delineation is still limitedly available for routine use. In this study, a localized anatomically constrained affine optical flow method is proposed for fast and automatic LV tracking throughout the full cardiac cycle in short-axis CMR images. Starting from an automatically delineated LV in the end-diastolic frame, the endocardial and epicardial boundaries are propagated by estimating the motion between adjacent cardiac phases using optical flow. In order to reduce the computational burden, the motion is only estimated in an anatomical region of interest around the tracked boundaries and subsequently integrated into a local affine motion model. Such localized estimation enables to capture complex motion patterns, while still being spatially consistent. The method was validated on 45 CMR datasets taken from the 2009 MICCAI LV segmentation challenge. The proposed approach proved to be robust and efficient, with an average distance error of 2.1 mm and a correlation with reference ejection fraction of 0.98 (1.9 ± 4.5%). Moreover, it showed to be fast, taking 5 seconds for the tracking of a full 4D dataset (30 ms per image). Overall, a novel fast, robust and accurate LV tracking methodology was proposed, enabling accurate assessment of relevant global function cardiac indices, such as volumes and ejection fraction.

Quantificação da difusão na ressonância magnética da mama: ADC e Kurtosis

Mestrado em Radiações Aplicadas às Tecnologias da Saúde. Área de especialização: Ressonância Magnética

Quantificação de fluxo do líquido cefalorraquidiano (LCR) por ressonância magnética

Mestrado em Radiações Aplicadas às Tecnologias da Saúde. Especialização: Ressonância Magnética.

Imaging for radiofrequency ablation

Many solid tumors have a poor response to systemic chemotherapy, local radiotherapy or surgical recession. They are responsible for premature morbidity and decreased patient survival. The radiofrequency ablation is an emerging technique, and is now becoming more widespread throughout the world because it is minimally invasive, image guided, which offers the possibility of an effective and less costly approach. The procedure can be performed percutaneously, guided by several imaging modalities as Ultrasound, Computed Tomography and Magnetic Resonance. This article pretends to demonstrate the state-of-the-art of this technique focusing in the technical aspects and application of radiofrequency ablation.

Ressonância magnética de corpo inteiro/whole-body MRI

A introdução de Ressonância Magnética de Corpo Inteiro (RM-CI) de alta resolução é baseada no desenvolvimento rápido e intensivo dos equipamentos de RM. Estes avanços associados ao aparecimento de novos métodos de aquisição de imagem, como as técnicas de Multistation ou imagem paralela impulsionam a RM-CI. Associado ao desenvolvimento tecnológico, a RM-CI apresenta vantagens clínicas essencialmente para patologias oncológicas como é o caso das metástases ósseas, e para patologias do foro cardiovascular. Muitas destas situações ainda se encontram em investigação mas os primeiros resultados têm superado todas as expectativas nomeadamente a RM-CI com a aplicação da técnica de Difusão.

Avanços da ressonância magnética mamária no diagnóstico do carcinoma da mama

A Ressonância Magnética Mamaria (RMM), ao longo da década, tem demonstrado um franco desenvolvimento no diagnóstico e caracterização do Carcinoma Mamário. O objectivo deste trabalho científico é demonstrar, através de uma revisão bibliográfica, os avanços desta modalidade na avaliação das lesões da mama, tendo em conta as características: elasticidade (Elastografia), bioquímicas (Espectroscopia), celularidade (Difusão) e vascularização (Perfusão). A avaliação destas em consonância com as morfológicas e cinéticas (RMM), permitem um aumento da especificidade da RMM, reduzindo assim o número de biopsias desnecessárias. Contudo estas evoluções técnicas devem estar em consonância com a inovação em questões de software de processamento de Imagem e hardware dos equipamentos de Ressonância Magnética.

Pre-operative tractography of the facial nerve in vestibular schwannomas: inter-observer agreement with surgical findings

Pre-operative diffusion tensor (DT) tractography is currently employed in our institutions. We use it to predict the course of the facial nerve (FN) in the vicinity of vestibular schwannomas (VS) of the cerebellopontine angle (CPA). In this study we were interested to assess the inter-observer reproducibility of this method. Two Neuroradiologists (PMGP and TT) determined independently the location of the FN by tractography and compared the results with in-vivo findings of microsurgery of VS.

Simulation of the Magnetic Induction Vector of a Magnetic Core to be Used in FFC NMR Relaxometry

This paper is a contribution for the assessment and comparison of magnet properties based on magnetic field characteristics particularly concerning the magnetic induction uniformity in the air gaps. For this aim, a solver was developed and implemented to determine the magnetic field of a magnetic core to be used in Fast Field Cycling (FFC) Nuclear Magnetic Resonance (NMR) relaxometry. The electromagnetic field computation is based on a 2D finite-element method (FEM) using both the scalar and the vector potential formulation. Results for the magnetic field lines and the magnetic induction vector in the air gap are presented. The target magnetic induction is 0.2 T, which is a typical requirement of the FFC NMR technique, which can be achieved with a magnetic core based on permanent magnets or coils. In addition, this application requires high magnetic induction uniformity. To achieve this goal, a solution including superconducting pieces is analyzed. Results are compared with a different FEM program.

FMRI 3D registration based on Fourier space subsets using neural networks

In this work, we present a neural network (NN) based method designed for 3D rigid-body registration of FMRI time series, which relies on a limited number of Fourier coefficients of the images to be aligned. These coefficients, which are comprised in a small cubic neighborhood located at the first octant of a 3D Fourier space (including the DC component), are then fed into six NN during the learning stage. Each NN yields the estimates of a registration parameter. The proposed method was assessed for 3D rigid-body transformations, using DC neighborhoods of different sizes. The mean absolute registration errors are of approximately 0.030 mm in translations and 0.030 deg in rotations, for the typical motion amplitudes encountered in FMRI studies. The construction of the training set and the learning stage are fast requiring, respectively, 90 s and 1 to 12 s, depending on the number of input and hidden units of the NN. We believe that NN-based approaches to the problem of FMRI registration can be of great interest in the future. For instance, NN relying on limited K-space data (possibly in navigation echoes) can be a valid solution to the problem of prospective (in frame) FMRI registration.

Morfometria do trato vocal por ressonância magnética: simulação de padrões patológicos articulatórios

Introdução – A análise da forma ou morfometria de estruturas anatómicas, como o trato vocal, pode ser efetuada a partir de imagens bidimensionais (2D) como de aquisições volumétricas (3D) de ressonância magnética (RM). Esta técnica de imagem tem vindo a ter uma utilização crescente no estudo da produção da fala. Objetivos – Demonstrar como pode ser efetuada a morfometria do trato vocal a partir da imagem por ressonância magnética e ainda apresentar padrões anatómicos normais durante a produção das vogais [i a u] e dois padrões articulatórios patológicos em contexto simulado. Métodos – As imagens consideradas foram recolhidas a partir de aquisições 2D (Turbo Spin-eco) e 3D (Flash Gradiente-Eco) de RM em quatro sujeitos durante a produção das vogais em estudo; adicionalmente procedeu-se à avaliação de duas perturbações articulatórias usando o mesmo protocolo de RM. A morfometria do trato vocal foi extraída com recurso a técnicas manuais (para extração de cinco medidas articulatórias) e automáticas (para determinação de volumes) de processamento e análise de imagem. Resultados – Foi possível analisar todo o trato vocal, incluindo a posição e a forma dos articuladores, tendo por base cinco medidas descritivas do posicionamento destes órgãos durante a produção das vogais. A determinação destas medições permitiu identificar quais as estratégias mais comummente adotadas na produção de cada som, nomeadamente a postura articulatória e a variação de cada medida para cada um dos sujeitos em estudo. No contexto de voz falada intersujeitos, foi notória a variabilidade nos volumes estimados do trato vocal para cada som e, em especial, o aumento do volume do trato vocal na perturbação articulatória de sigmatismo. Conclusão – A imagem por RM é, sem dúvida, uma técnica promissora no estudo da fala, inócua, não-invasiva e que fornece informação fiável da morfometria do trato vocal.

Efeito fisiológico da cafeína em estudos neurológicos com base na ponderação em susceptibilidade ferromagnética (SWI)

Introdução – O presente estudo avaliou o efeito da cafeína no valor da razão contraste ruído (CNR) em imagens SWI. Objetivos – Avaliar o efeito da cafeína qualitativamente e quantificado pelo cálculo do valor CNR em imagens de magnitude e MIP para as estruturas: veia cerebral interna, seio sagital superior, tórcula e artéria cerebral média. Metodologia – A população do estudo incluiu 24 voluntários saudáveis que estiveram pelo menos 24h privados da ingestão de cafeína. Adquiriram-se imagens SWI antes e após a ingestão de 100ml de café. Os voluntários foram subdivididos em quatro grupos de seis indivíduos/grupo e avaliados separadamente após decorrido um intervalo de tempo diferente para cada grupo (15, 25, 30 ou 45min pós-cafeína). Utilizou-se um scanner Siemens Avanto 1,5 T com bobine standard de crânio e os parâmetros: T2* GRE 3D de alta resolução no plano axial, TR=49; TE=40; FA=15; FOV=187x230; matriz=221x320. O processamento de imagem foi efetuado no software OsiriX® e a análise estatística no GraphPadPrism®. Resultados e Discussão – As alterações de sinal e diferenças de contraste predominaram nas estruturas venosas e não foram significantes na substância branca, LCR e artéria cerebral média. Os valores CNR pré-cafeína diferiram significativamente do pós-cafeína nas imagens de magnitude e MIP na veia cerebral interna e nas imagens de magnitude do seio sagital superior e da tórcula (p<0,0001). Não se verificaram diferenças significativas entre os grupos avaliados nos diferentes tempos pós-cafeína. Conclusões – Especulamos que a cafeína possa vir a ser usada como agente de contraste nas imagens SWI barato, eficaz e de fácil administração.

Comparison of inverse planning systems based on biological or physical factors: Pinnacle®, Corvus® and Monaco®

Radiotherapy (RT) is one of the most important approaches in the treatment of cancer and its performance can be improved in three different ways: through the optimization of the dose distribution, by the use of different irradiation techniques or through the study of radiobiological initiatives. The first is purely physical because is related to the physical dose distributiuon. The others are purely radiobiological because they increase the differential effect between the tumour and the health tissues. The Treatment Planning Systems (TPS) are used in RT to create dose distributions with the purpose to maximize the tumoral control and minimize the complications in the healthy tissues. The inverse planning uses dose optimization techniques that satisfy the criteria specified by the user, regarding the target and the organs at risk (OAR’s). The dose optimization is possible through the analysis of dose-volume histograms (DVH) and with the use of computed tomography, magnetic resonance and other digital image techniques.