Time-efficient three-dimensional transmural scar assessment provides relevant substrate characterization for ventricular tachycardia features and long-term recurrences in ischemic cardiomyopathy.

Delayed gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) imaging requires novel and time-efficient approaches to characterize the myocardial substrate associated with ventricular arrhythmia in patients with ischemic cardiomyopathy. Using a translational approach in pigs and patients with established myocardial infarction, we tested and validated a novel 3D methodology to assess ventricular scar using custom transmural criteria and a semiautomatic approach to obtain transmural scar maps in ventricular models reconstructed from both 3D-acquired and 3D-upsampled-2D-acquired LGE-CMR images. The results showed that 3D-upsampled models from 2D LGE-CMR images provided a time-efficient alternative to 3D-acquired sequences to assess the myocardial substrate associated with ischemic cardiomyopathy. Scar assessment from 2D-LGE-CMR sequences using 3D-upsampled models was superior to conventional 2D assessment to identify scar sizes associated with the cycle length of spontaneous ventricular tachycardia episodes and long-term ventricular tachycardia recurrences after catheter ablation. This novel methodology may represent an efficient approach in clinical practice after manual or automatic segmentation of myocardial borders in a small number of conventional 2D LGE-CMR slices and automatic scar detection.

Computation of exact g-factor maps in 3D GRAPPA reconstructions.

PURPOSE: To characterize the noise distributions in 3D-MRI accelerated acquisitions reconstructed with GRAPPA using an exact noise propagation analysis that operates directly in k-space. THEORY AND METHODS: We exploit the extensive symmetries and separability in the reconstruction steps to account for the correlation between all the acquired k-space samples. Monte Carlo simulations and multi-repetition phantom experiments were conducted to test both the accuracy and feasibility of the proposed method; a high-resolution in-vivo experiment was performed to assess the applicability of our method to clinical scenarios. RESULTS: Our theoretical derivation shows that the direct k-space analysis renders an exact noise characterization under the assumptions of stationarity and uncorrelation in the original k-space. Simulations and phantom experiments provide empirical support to the theoretical proof. Finally, the high-resolution in-vivo experiment demonstrates the ability of the proposed method to assess the impact of the sub-sampling pattern on the overall noise behavior. CONCLUSIONS: By operating directly in the k-space, the proposed method is able to provide an exact characterization of noise for any Cartesian pattern sub-sampled along the two phase-encoding directions. Exploitation of the symmetries and separability into independent blocks through the image reconstruction procedure allows us to overcome the computational challenges related to the very large size of the covariance matrices involved.

A Second Order Multi-Stencil Fast Marching Method with a Non-Constant Local Cost Model.

The Fast Marching method is widely employed in several fields of image processing. Some years ago a Multi-Stencil version (MSFM) was introduced to improve its accuracy by solving the equation for a set of stencils and choosing the best solution at each considered node. The following work proposes a modified numerical scheme for MSFM to take into account the variation of the local cost, which has proven to be second order. The influence of the stencil set choice on the algorithm outcome with respect to stencil orthogonality and axis swapping is also explored, where stencils are taken from neighborhoods of varying radius. The experimental results show that the proposed schemes improve the accuracy of their original counterparts, and that the use of permutation-invariant stencil sets provides robustness against shifted vector coordinates in the stencil set.

Vortical features for myocardial rotation assessment in hypertrophic cardiomyopathy using cardiac tagged magnetic resonance.

Left ventricular rotational motion is a feature of normal and diseased cardiac function. However, classical torsion and twist measures rely on the definition of a rotational axis which may not exist. This paper reviews global and local rotation descriptors of myocardial motion and introduces new curl-based (vortical) features built from tensorial magnitudes, intended to provide better comprehension about fibrotic tissue characteristics mechanical properties. Fifty-six cardiomyopathy patients and twenty-two healthy volunteers have been studied using tagged magnetic resonance by means of harmonic phase analysis. Rotation descriptors are built, with no assumption about a regular geometrical model, from different approaches. The extracted vortical features have been tested by means of a sequential cardiomyopathy classification procedure; they have proven useful for the regional characterization of the left ventricular function by showing great separability not only between pathologic and healthy patients but also, and specifically, between heterogeneous phenotypes within cardiomyopathies.

A Markov random field approach for topology-preserving registration: application to object-based tomographic image interpolation.

This paper proposes a topology-preserving multiresolution elastic registration method based on a discrete Markov random field of deformations and a block-matching procedure. The method is applied to the object-based interpolation of tomographic slices. For that purpose, the fidelity of a given deformation to the data is established by a block-matching strategy based on intensity- and gradient-related features, the smoothness of the transformation is favored by an appropriate prior on the field, and the deformation is guaranteed to maintain the topology by imposing some hard constraints on the local configurations of the field. The resulting deformation is defined as the maximum a posteriori configuration. Additionally, the relative influence of the fidelity and smoothness terms is weighted by the unsupervised estimation of the field parameters. In order to obtain an unbiased interpolation result, the registration is performed both in the forward and backward directions, and the resulting transformations are combined by using the local information content of the deformation. The method is applied to magnetic resonance and computed tomography acquisitions of the brain and the torso. Quantitative comparisons offer an overall improvement in performance with respect to related works in the literature. Additionally, the application of the interpolation method to cardiac magnetic resonance images has shown that the removal of any of the main components of the algorithm results in a decrease in performance which has proven to be statistically significant.

Endocardium and epicardium contour modeling based on Markov Random Fields and active contours.

A segmentation application prototype of the volume of the left ventricle for Magnetic Resonance Imaging is being developed. The foundation for this work is given by modeling possible radial deformations of the epicardium and endocardium contours by means of a Markov Random Field over which the most probable configuration is estimated. The field makes use of a Bayesian approach based on a priori terms which impose smoothness along the coupled contours and likelihood terms which gather information provided by the images about the areas where the contours are supposed to be. The parameters of the field are estimated on a supervised basis.

Image quality assessment based on local variance.

A new and complementary method to assess image quality is presented. It is based on the comparison of the local variance distribution of two images. This new quality index is better suited to assess the non-stationarity of images, therefore it explicitly focuses on the image structure. We show that this new index outperforms other methods for the assessment of image quality in medical images.

An approach for contour detection of human kidneys from ultrasound images using Markov random fields and active contours.

In this paper, a novel method for the boundary detection of human kidneys from three dimensional (3D) ultrasound (US) is proposed. The inherent difficulty of interpretation of such images, even by a trained expert, makes the problem unsuitable for classical methods. The method here proposed finds the kidney contours in each slice. It is a probabilistic Bayesian method. The prior defines a Markov field of deformations and imposes the restriction of contour smoothness. The likelihood function imposes a probabilistic behavior to the data, conditioned to the contour position. This second function, which is also Markov, uses an empirical model of distribution of the echographical data and a function of the gradient of the data. The model finally includes, as a volumetric extension of the prior, a term that forces smoothness along the depth coordinate. The experiments that have been carried out on echographies from real patients validate the model here proposed. A sensitivity analysis of the model parameters has also been carried out.

A computational TW3 classifier for skeletal maturity assessment. A Computing with Words approach.

This paper proposes a fuzzy methodology to translate the natural language descriptions of the TW3 method for bone age assessment into an automatic classifier. The classifier is built upon a modified version of a fuzzy ID3 decision tree. No large data records are needed to train the classifier, i.e., to find out the classification rules, since the classifier is built upon rules given by the TW3 method. Only small data records are needed to fine-tune the fuzzy sets used to implement the rulebase.