Analysis of blurring due to short T2 decay at different resolutions in 23Na MRI.

The nuclear magnetic resonance signal from sodium (23Na) nuclei demonstrates a fast bi-exponential T2 decay in biological tissues (T2,short = 0.5-5 ms and T2,long = 10-30 ms). Hence, blurring observed in sodium images acquired with center-out sequences is generally assumed to be dominated by signal attenuation at higher k-space frequencies. Most of the studies in the field primarily focus on the impact of readout duration on blurring but neglect the impact of resolution. In this paper, we examine the blurring effect of short T2 on images at different resolutions. A series of simulations, as well as phantom and in vivo scans were performed at varying resolutions and readout durations in order to evaluate progressive changes in image quality. We demonstrate that, given a fixed readout duration, T2 decay produces distinct blurring effects at different resolutions. Therefore, in addition to voxel size-dependent partial volume effects, the choice of resolution adds additional T2-dependent blurring.

Simultaneous 3D acquisition of 1 H MRF and 23 Na MRI.

PURPOSE: To develop a 3D MR technique to simultaneously acquire proton multiparametric maps (T1 , T2 , and proton density) and sodium density weighted images over the whole brain. METHODS: We implemented a 3D stack-of-stars MR pulse sequence which consists of interleaved proton (1 H) and sodium (23 Na) excitations, tailored slice encoding gradients that can encode the same slice for both nuclei, and simultaneous readout with different radial trajectories (1 H, full-radial; 23 Na, center-out radial). The receive chain of our 7T scanner was modified to enable simultaneous acquisition of 1 H and 23 Na signal. A heuristically optimized flip angle train was implemented for proton MR fingerprinting (MRF). The SNR and the accuracy of proton T1 and T2 were evaluated in phantoms. Finally, in vivo application of the method was demonstrated in five healthy subjects. RESULTS: The SNR for the simultaneous measurement was almost identical to that for the single-nucleus measurements (<2% change). The proton T1 and T2 maps remained similar to the results from a reference 2D MRF technique (normalized RMS error in T1 ≈ 4.2% and T2 ≈ 11.3%). Measurements in healthy subjects corroborated these results and demonstrated the feasibility of our method for in vivo application. The in vivo T1 values measured using our method were lower than the results measured by other conventional techniques. CONCLUSIONS: With the 3D simultaneous implementation, we were able to acquire sodium and proton density weighted images in addition to proton T1 , T2 , and B1+ from 1 H MRF that covers the whole brain volume within 21 min.

Knowledge transfer for surgical activity prediction.

PURPOSE: Lack of annotated training data hinders automatic recognition and prediction of surgical activities necessary for situation-aware operating rooms. We propose using knowledge transfer to compensate for data deficit and improve prediction. METHODS: We used two approaches to extract and transfer surgical process knowledge. First, we encoded semantic information about surgical terms using word embedding. Secondly, we passed knowledge between different clinical datasets of neurosurgical procedures using transfer learning. RESULTS: The combination of two methods provided 22% improvement of activity prediction. We also made several pertinent observations about surgical practices based on the results of the performed transfer. CONCLUSION: Word embedding boosts learning process. Transfer learning was shown to be more effective than a simple combination of data, especially for less similar procedures.

Automatic preoperative planning of DBS electrode placement using anatomo-clinical atlases and volume of tissue activated.

PURPOSE: Deep brain stimulation (DBS) is a procedure requiring accurate targeting and electrode placement. The two key elements for successful planning are preserving patient safety by ensuring a safe trajectory and creating treatment efficacy through optimal selection of the stimulation point. In this work, we present the first approach of computer-assisted preoperative DBS planning to automatically optimize both the safety of the electrode's trajectory and location of the stimulation point so as to provide the best clinical outcome. METHODS: Building upon the findings of previous works focused on electrode trajectory, we added a set of constraints guiding the choice of stimulation point. These took into account retrospective data represented by anatomo-clinical atlases and intersections between the stimulation region and sensitive anatomical structures causing side effects. We implemented our method into automatic preoperative planning software to assess if the algorithm was able to simultaneously optimize electrode trajectory and the stimulation point. RESULTS: Leave-one-out cross-validation on a dataset of 18 cases demonstrated an improvement in the expected outcome when using the new constraints. The distance to critical structures was not reduced. The intersection between the stimulation region and structures sensitive to stimulation was minimized. CONCLUSIONS: Introducing these new constraints guided the planning to select locations showing a trend toward symptom improvement, while minimizing the risks of side effects, and there was no cost in terms of trajectory safety.

Automatic data-driven real-time segmentation and recognition of surgical workflow.

PURPOSE: With the intention of extending the perception and action of surgical staff inside the operating room, the medical community has expressed a growing interest towards context-aware systems. Requiring an accurate identification of the surgical workflow, such systems make use of data from a diverse set of available sensors. In this paper, we propose a fully data-driven and real-time method for segmentation and recognition of surgical phases using a combination of video data and instrument usage signals, exploiting no prior knowledge. We also introduce new validation metrics for assessment of workflow detection. METHODS: The segmentation and recognition are based on a four-stage process. Firstly, during the learning time, a Surgical Process Model is automatically constructed from data annotations to guide the following process. Secondly, data samples are described using a combination of low-level visual cues and instrument information. Then, in the third stage, these descriptions are employed to train a set of AdaBoost classifiers capable of distinguishing one surgical phase from others. Finally, AdaBoost responses are used as input to a Hidden semi-Markov Model in order to obtain a final decision. RESULTS: On the MICCAI EndoVis challenge laparoscopic dataset we achieved a precision and a recall of 91 % in classification of 7 phases. CONCLUSION: Compared to the analysis based on one data type only, a combination of visual features and instrument signals allows better segmentation, reduction of the detection delay and discovery of the correct phase order.