Recent flood hazards in Kashmir put into context with millennium-long historical and tree-ring records.

In September 2014, the Kashmir valley (north-west India) experienced a massive flood causing significant economic losses and fatalities. This disaster underlined the high vulnerability of the local population and raised questions regarding the resilience of Kashmiris to future floods. Although the magnitude of the 2014 flood has been considered unprecedented within the context of existing measurements, we argue that the short flow series may lead to spurious misinterpretation of the probability of such extreme events. Here we use a millennium-long record of past floods in Kashmir based on historical and tree-ring records to assess the probability of 2014-like flood events in the region. Our flood chronology (635 CE-nowadays) provides key insights into the recurrence of flood disasters and propels understanding of flood variability in this region over the last millennium, showing enhanced activity during the Little Ice Age. We find that high-impact floods have frequently disrupted the Kashmir valley in the past. Thus, the inclusion of historical records reveals large flood hazard levels in the region. The newly gained information also underlines the critical need to take immediate action in the region, so as to reduce the exposure of local populations and to increase their resilience, despite existing constraints in watershed management related to the Indus Water Treaty.

Mixture of Probabilistic Principal Component Analyzers for Shapes from Point Sets.

Inferring a probability density function (pdf) for shape from a population of point sets is a challenging problem. The lack of point-to-point correspondences and the non-linearity of the shape spaces undermine the linear models. Methods based on manifolds model the shape variations naturally, however, statistics are often limited to a single geodesic mean and an arbitrary number of variation modes. We relax the manifold assumption and consider a piece-wise linear form, implementing a mixture of distinctive shape classes. The pdf for point sets is defined hierarchically, modeling a mixture of Probabilistic Principal Component Analyzers (PPCA) in higher dimension. A Variational Bayesian approach is designed for unsupervised learning of the posteriors of point set labels, local variation modes, and point correspondences. By maximizing the model evidence, the numbers of clusters, modes of variations, and points on the mean models are automatically selected. Using the predictive distribution, we project a test shape to the spaces spanned by the local PPCA's. The method is applied to point sets from: i) synthetic data, ii) healthy versus pathological heart morphologies, and iii) lumbar vertebrae. The proposed method selects models with expected numbers of clusters and variation modes, achieving lower generalization-specificity errors compared to state-of-the-art.

Accurate Segmentation of Vertebral Bodies and Processes Using Statistical Shape Decomposition and Conditional Models.

Detailed segmentation of the vertebrae is an important pre-requisite in various applications of image-based spine assessment, surgery and biomechanical modeling. In particular, accurate segmentation of the processes is required for image-guided interventions, for example for optimal placement of bone grafts between the transverse processes. Furthermore, the geometry of the processes is now required in musculoskeletal models due to their interaction with the muscles and ligaments. In this paper, we present a new method for detailed segmentation of both the vertebral bodies and processes based on statistical shape decomposition and conditional models. The proposed technique is specifically developed with the aim to handle the complex geometry of the processes and the large variability between individuals. The key technical novelty in this work is the introduction of a part-based statistical decomposition of the vertebrae, such that the complexity of the subparts is effectively reduced, and model specificity is increased. Subsequently, in order to maintain the statistical and anatomic coherence of the ensemble, conditional models are used to model the statistical inter-relationships between the different subparts. For shape reconstruction and segmentation, a robust model fitting procedure is used to exclude improbable inter-part relationships in the estimation of the shape parameters. Segmentation results based on a dataset of 30 healthy CT scans and a dataset of 10 pathological scans show a point-to-surface error improvement of 20% and 17% respectively, and the potential of the proposed technique for detailed vertebral modeling.

Anatomical labeling of the Circle of Willis using maximum a posteriori probability estimation.

Anatomical labeling of the cerebral arteries forming the Circle of Willis (CoW) enables inter-subject comparison, which is required for geometric characterization and discovering risk factors associated with cerebrovascular pathologies. We present a method for automated anatomical labeling of the CoW by detecting its main bifurcations. The CoW is modeled as rooted attributed relational graph, with bifurcations as its vertices, whose attributes are characterized as points on a Riemannian manifold. The method is first trained on a set of pre-labeled examples, where it learns the variability of local bifurcation features as well as the variability in the topology. Then, the labeling of the target vasculature is obtained as maximum a posteriori probability (MAP) estimate where the likelihood of labeling individual bifurcations is regularized by the prior structural knowledge of the graph they span. The method was evaluated by cross-validation on 50 subjects, imaged with magnetic resonance angiography, and showed a mean detection accuracy of 95%. In addition, besides providing the MAP, the method can rank the labelings. The proposed method naturally handles anatomical structural variability and is demonstrated to be suitable for labeling arterial segments of the CoW.

Automated landmarking and geometric characterization of the carotid siphon.

The geometry of the carotid siphon has a large variability between subjects, which has prompted its study as a potential geometric risk factor for the onset of vascular pathologies on and off the internal carotid artery (ICA). In this work, we present a methodology for an objective and extensive geometric characterization of carotid siphon parameterized by a set of anatomical landmarks. We introduce a complete and automated characterization pipeline. Starting from the segmentation of vasculature from angiographic image and its centerline extraction, we first identify ICA by characterizing vessel tree bifurcations and training a support vector machine classifier to detect ICA terminal bifurcation. On ICA centerline curve, we detect anatomical landmarks of carotid siphon by modeling it as a sequence of four bends and selecting their centers and interfaces between them. Bends are detected from the trajectory of the curvature vector expressed in the parallel transport frame of the curve. Finally, using the detected landmarks, we characterize the geometry in two complementary ways. First, with a set of local and global geometric features, known to affect hemodynamics. Second, using large deformation diffeomorphic metric curve mapping (LDDMCM) to quantify pairwise shape similarity. We processed 96 images acquired with 3D rotational angiography. ICA identification had a cross-validation success rate of 99%. Automated landmarking was validated by computing limits of agreement with the reference taken to be the locations of the manually placed landmarks averaged across multiple observers. For all but one landmark, either the bias was not statistically significant or the variability was within 50% of the inter-observer one. The subsequently computed values of geometric features and LDDMCM were commensurate to the ones obtained with manual landmarking. The characterization based on pair-wise LDDMCM proved better in classifying the carotid siphon shape classes than the one based on geometric features. The proposed characterization provides a rich description of geometry and is ready to be applied in the search for geometric risk factors of the carotid siphon.

Anatomical labeling of the anterior circulation of the Circle of Willis using maximum a posteriori classification.

Automated anatomical labeling of the arteries forming the Circle of Willis is of great interest as facilitates inter-subject comparison required to discover geometric risk factors for the development of vascular pathologies. In this paper, we present a method for anatomical labeling of vessels forming anterior part of the Circle of Willis by detecting the five main vessel bifurcations. The method is first trained on a set of pre-labeled examples, where it learns local bifurcation features as well as global variation in the anatomy of the extracted vascular trees. Then the labeling of the target vascular tree is formulated as maximum a posteriori solution where the classifications of individual bifurcations are regularized by the prior learned knowledge of the tree they span. The method was evaluated by cross-validation on 30 subjects, which showed the vascular trees were correctly anatomically labeled in 90% of cases. The proposed method can naturally handle anatomical variations and is shown to be suitable for labeling arterial segments of Circle of Willis.

Three-dimensional morphological analysis of intracranial aneurysms: a fully automated method for aneurysm sac isolation and quantification.

PURPOSE: Morphological descriptors are practical and essential biomarkers for diagnosis and treatment selection for intracranial aneurysm management according to the current guidelines in use. Nevertheless, relatively little work has been dedicated to improve the three-dimensional quantification of aneurysmal morphology, to automate the analysis, and hence to reduce the inherent intra and interobserver variability of manual analysis. In this paper we propose a methodology for the automated isolation and morphological quantification of saccular intracranial aneurysms based on a 3D representation of the vascular anatomy. METHOD: This methodology is based on the analysis of the vasculature skeleton's topology and the subsequent application of concepts from deformable cylinders. These are expanded inside the parent vessel to identify different regions and discriminate the aneurysm sac from the parent vessel wall. The method renders as output the surface representation of the isolated aneurysm sac, which can then be quantified automatically. The proposed method provides the means for identifying the aneurysm neck in a deterministic way. The results obtained by the method were assessed in two ways: they were compared to manual measurements obtained by three independent clinicians as normally done during diagnosis and to automated measurements from manually isolated aneurysms by three independent operators, nonclinicians, experts in vascular image analysis. All the measurements were obtained using in-house tools. The results were qualitatively and quantitatively compared for a set of the saccular intracranial aneurysms (n = 26). RESULTS: Measurements performed on a synthetic phantom showed that the automated measurements obtained from manually isolated aneurysms where the most accurate. The differences between the measurements obtained by the clinicians and the manually isolated sacs were statistically significant (neck width: p <0.001, sac height: p = 0.002). When comparing clinicians' measurements to automatically isolated sacs, only the differences for the neck width were significant (neck width: p <0.001, sac height: p = 0.95). However, the correlation and agreement between the measurements obtained from manually and automatically isolated aneurysms for the neck width: p = 0.43 and sac height: p = 0.95 where found. CONCLUSIONS: The proposed method allows the automated isolation of intracranial aneurysms, eliminating the interobserver variability. In average, the computational cost of the automated method (2 min 36 s) was similar to the time required by a manual operator (measurement by clinicians: 2 min 51 s, manual isolation: 2 min 21 s) but eliminating human interaction. The automated measurements are irrespective of the viewing angle, eliminating any bias or difference between the observer criteria. Finally, the qualitative assessment of the results showed acceptable agreement between manually and automatically isolated aneurysms.

Automatic aneurysm neck detection using surface Voronoi diagrams.

A new automatic approach for saccular intracranial aneurysm isolation is proposed in this work. Due to the inter- and intra-observer variability in manual delineation of the aneurysm neck, a definition based on a minimum cost path around the aneurysm sac is proposed that copes with this variability and is able to make consistent measurements along different data sets, as well as to automate and speedup the analysis of cerebral aneurysms. The method is based on the computation of a minimal path along a scalar field obtained on the vessel surface, to find the aneurysm neck in a robust and fast manner. The computation of the scalar field on the surface is obtained using a fast marching approach with a speed function based on the exponential of the distance from the centerline bifurcation between the aneurysm dome and the parent vessels. In order to assure a correct topology of the aneurysm sac, the neck computation is constrained to a region defined by a surface Voronoi diagram obtained from the branches of the vessel centerline. We validate this method comparing our results in 26 real cases with manual aneurysm isolation obtained using a cut-plane, and also with results obtained using manual delineations from three different observers by comparing typical morphological measures.

Dynamic estimation of three-dimensional cerebrovascular deformation from rotational angiography.

PURPOSE: The objective of this study is to investigate the feasibility of detecting and quantifying 3D cerebrovascular wall motion from a single 3D rotational x-ray angiography (3DRA) acquisition within a clinically acceptable time and computing from the estimated motion field for the further biomechanical modeling of the cerebrovascular wall. METHODS: The whole motion cycle of the cerebral vasculature is modeled using a 4D B-spline transformation, which is estimated from a 4D to 2D + t image registration framework. The registration is performed by optimizing a single similarity metric between the entire 2D + t measured projection sequence and the corresponding forward projections of the deformed volume at their exact time instants. The joint use of two acceleration strategies, together with their implementation on graphics processing units, is also proposed so as to reach computation times close to clinical requirements. For further characterizing vessel wall properties, an approximation of the wall thickness changes is obtained through a strain calculation. RESULTS: Evaluation on in silico and in vitro pulsating phantom aneurysms demonstrated an accurate estimation of wall motion curves. In general, the error was below 10% of the maximum pulsation, even in the situation when substantial inhomogeneous intensity pattern was present. Experiments on in vivo data provided realistic aneurysm and vessel wall motion estimates, whereas in regions where motion was neither visible nor anatomically possible, no motion was detected. The use of the acceleration strategies enabled completing the estimation process for one entire cycle in 5-10 min without degrading the overall performance. The strain map extracted from our motion estimation provided a realistic deformation measure of the vessel wall. CONCLUSIONS: The authors' technique has demonstrated that it can provide accurate and robust 4D estimates of cerebrovascular wall motion within a clinically acceptable time, although it has to be applied to a larger patient population prior to possible wide application to routine endovascular procedures. In particular, for the first time, this feasibility study has shown that in vivo cerebrovascular motion can be obtained intraprocedurally from a 3DRA acquisition. Results have also shown the potential of performing strain analysis using this imaging modality, thus making possible for the future modeling of biomechanical properties of the vascular wall.

Automated segmentation of cerebral vasculature with aneurysms in 3DRA and TOF-MRA using geodesic active regions: an evaluation study.

PURPOSE: To evaluate the suitability of an improved version of an automatic segmentation method based on geodesic active regions (GAR) for segmenting cerebral vasculature with aneurysms from 3D x-ray reconstruction angiography (3DRA) and time of flight magnetic resonance angiography (TOF-MRA) images available in the clinical routine. METHODS: Three aspects of the GAR method have been improved: execution time, robustness to variability in imaging protocols, and robustness to variability in image spatial resolutions. The improved GAR was retrospectively evaluated on images from patients containing intracranial aneurysms in the area of the Circle of Willis and imaged with two modalities: 3DRA and TOF-MRA. Images were obtained from two clinical centers, each using different imaging equipment. Evaluation included qualitative and quantitative analyses of the segmentation results on 20 images from 10 patients. The gold standard was built from 660 cross-sections (33 per image) of vessels and aneurysms, manually measured by interventional neuroradiologists. GAR has also been compared to an interactive segmentation method: isointensity surface extraction (ISE). In addition, since patients had been imaged with the two modalities, we performed an intermodality agreement analysis with respect to both the manual measurements and each of the two segmentation methods. RESULTS: Both GAR and ISE differed from the gold standard within acceptable limits compared to the imaging resolution. GAR (ISE) had an average accuracy of 0.20 (0.24) mm for 3DRA and 0.27 (0.30) mm for TOF-MRA, and had a repeatability of 0.05 (0.20) mm. Compared to ISE, GAR had a lower qualitative error in the vessel region and a lower quantitative error in the aneurysm region. The repeatability of GAR was superior to manual measurements and ISE. The intermodality agreement was similar between GAR and the manual measurements. CONCLUSIONS: The improved GAR method outperformed ISE qualitatively as well as quantitatively and is suitable for segmenting 3DRA and TOF-MRA images from clinical routine.

Efficient 3D geometric and Zernike moments computation from unstructured surface meshes.

This paper introduces and evaluates a fast exact algorithm and a series of faster approximate algorithms for the computation of 3D geometric moments from an unstructured surface mesh of triangles. Being based on the object surface reduces the computational complexity of these algorithms with respect to volumetric grid-based algorithms. In contrast, it can only be applied for the computation of geometric moments of homogeneous objects. This advantage and restriction is shared with other proposed algorithms based on the object boundary. The proposed exact algorithm reduces the computational complexity for computing geometric moments up to order N with respect to previously proposed exact algorithms, from N(9) to N(6). The approximate series algorithm appears as a power series on the rate between triangle size and object size, which can be truncated at any desired degree. The higher the number and quality of the triangles, the better the approximation. This approximate algorithm reduces the computational complexity to N(3). In addition, the paper introduces a fast algorithm for the computation of 3D Zernike moments from the computed geometric moments, with a computational complexity N(4), while the previously proposed algorithm is of order N(6). The error introduced by the proposed approximate algorithms is evaluated in different shapes and the cost-benefit ratio in terms of error, and computational time is analyzed for different moment orders.

Automated intracranial aneurysm isolation and quantification.

Until today, geometrical descriptors of intracranial aneurysms are largely used for diagnosis and treatment selection. Nevertheless, relatively little work has been devoted to automatize these measurements. In this work we propose a methodology for the automated isolation and quantification from vascular segmentation. The proposed methodology is based on skeleton topology analysis, geometrical analysis and deformable models to isolate, automatically, the aneurysm dome as well as its geometrical characteristics. The accuracy of this methodology when compared to manually isolated aneurysms is evaluated in 10 patient-specific vascular geometries. Good correspondence is observed between manual and automated results.

Feasibility of estimating regional mechanical properties of cerebral aneurysms in vivo.

PURPOSE: In this article, the authors studied the feasibility of estimating regional mechanical properties in cerebral aneurysms, integrating information extracted from imaging and physiological data with generic computational models of the arterial wall behavior. METHODS: A data assimilation framework was developed to incorporate patient-specific geometries into a given biomechanical model, whereas wall motion estimates were obtained from applying registration techniques to a pair of simulated MR images and guided the mechanical parameter estimation. A simple incompressible linear and isotropic Hookean model coupled with computational fluid-dynamics was employed as a first approximation for computational purposes. Additionally, an automatic clustering technique was developed to reduce the number of parameters to assimilate at the optimization stage and it considerably accelerated the convergence of the simulations. Several in silico experiments were designed to assess the influence of aneurysm geometrical characteristics and the accuracy of wall motion estimates on the mechanical property estimates. Hence, the proposed methodology was applied to six real cerebral aneurysms and tested against a varying number of regions with different elasticity, different mesh discretization, imaging resolution, and registration configurations. RESULTS: Several in silico experiments were conducted to investigate the feasibility of the proposed workflow, results found suggesting that the estimation of the mechanical properties was mainly influenced by the image spatial resolution and the chosen registration configuration. According to the in silico experiments, the minimal spatial resolution needed to extract wall pulsation measurements with enough accuracy to guide the proposed data assimilation framework was of 0.1 mm. CONCLUSIONS: Current routine imaging modalities do not have such a high spatial resolution and therefore the proposed data assimilation framework cannot currently be used on in vivo data to reliably estimate regional properties in cerebral aneurysms. Besides, it was observed that the incorporation of fluid-structure interaction in a biomechanical model with linear and isotropic material properties did not have a substantial influence in the final results.