Feasibility of dosimetric measurements using Al2O3:C OSL dosimeter during fluoroscopy-guided procedures.

This study investigated the feasibility of dosimetric measurements using Al2O3:C optically stimulated luminescence (OSL) dosimeters during fluoroscopy-guided procedures. The linearity and energy dependence of Al2O3:C OSL dosimeters were evaluated, and the air kerma rate at the operator's position was measured. The response of Al2O3:C OSL dosimeters to short, repetitive irradiations was compared to that of long uninterrupted irradiation. The change in response of the Al2O3:C OSL dosimeter under automatic exposure rate control (AERC) was evaluated with the use of various thicknesses of polymethyl-methacrylate (PMMA) plates (15-30 cm). The Al2O3:C OSL dosimeters could detect 5µGy and showed good linearity in doses of ≥10µGy (R2: 0.997-0.999,p< 0.001). The relative response of the Al2O3:C OSL dosimeter normalised to that of 36.8 keV was 0.828-1.101 at the energies investigated (30.6-46.0 keV). The air kerma rate at the operator's position was estimated to be 2.61-7.17µGy min-1depending on the heights representing different body parts. Repetitive short irradiations had no significant impact on the relative response of the Al2O3:C OSL dosimeters (p> 0.05). Despite a high energy dependence on the low energy beam used in fluoroscopy, the change in relative response of the Al2O3:C OSL dosimeter under AERC was within 5.7% depending on the thickness of the PMMA plates. Dosimetric measurement using Al2O3:C OSL dosimeters for patients and operators is feasible. However, one should be cautious about high standard deviations when measuring small doses of ≤20µGy using Al2O3:C OSL dosimeters. It is essential to perform intensive bleaching before measuring very small doses to minimise pre-irradiation counts.

Multipass active contours for an adaptive contour map.

Isocontour mapping is efficient for extracting meaningful information from a biomedical image in a topographic analysis. Isocontour extraction from real world medical images is difficult due to noise and other factors. As such, adaptive selection of contour generation parameters is needed. This paper proposes an algorithm for generating an adaptive contour map that is spatially adjusted. It is based on the modified active contour model, which imposes successive spatial constraints on the image domain. The adaptability of the proposed algorithm is governed by the energy term of the model. This work focuses on mammograms and the analysis of their intensity. Our algorithm employs the Mumford-Shah energy functional, which considers an image's intensity distribution. In mammograms, the brighter regions generally contain significant information. Our approach exploits this characteristic to address the initialization and local optimum problems of the active contour model. Our algorithm starts from the darkest region; therefore, local optima encountered during the evolution of contours are populated in less important regions, and the important brighter regions are reserved for later stages. For an unrestricted initial contour, our algorithm adopts an existing technique without re-initialization. To assess its effectiveness and robustness, the proposed algorithm was tested on a set of mammograms.

Selective image segmentation driven by region, edge and saliency functions.

Present active contour methods often struggle with the segmentation of regions displaying variations in texture, color, or intensity a phenomenon referred to as inhomogeneities. These limitation impairs their ability to precisely distinguish and outline diverse components within an image. Further some of these methods employ intricate mathematical formulations for energy minimization. Such complexity introduces computational sluggishness, making these methods unsuitable for tasks requiring real-time processing or rapid segmentation. Moreover, these methods are susceptible to being trapped in energy configurations corresponding to local minimum points. Consequently, the segmentation process fails to converge to the desired outcome. Additionally, the efficacy of these methods diminishes when confronted with regions exhibiting weak or subtle boundaries. To address these limitations comprehensively, our proposed approach introduces a fresh paradigm for image segmentation through the synchronization of region-based, edge-based, and saliency-based segmentation techniques. Initially, we adapt an intensity edge term based on the zero crossing feature detector (ZCD), which is used to highlight significant edges of an image. Secondly, a saliency function is formulated to detect salient regions from an image. We have also included a globally tuned region based SPF (signed pressure force) term to move contour away and capture homogeneous regions. ZCD, saliency and global SPF are jointly incorporated with some scaled value for the level set evolution to develop an effective image segmentation model. In addition, proposed method is capable to perform selective object segmentation, which enables us to choose any single or multiple objects inside an image. Saliency function and ZCD detector are considered feature enhancement tools, which are used to get important features of an image, so this method has a solid capacity to segment nature images (homogeneous or inhomogeneous) precisely. Finally, the adaption of the Gaussian kernel removes the need of any penalization term for level set reinitialization. Experimental results will exhibit the efficiency of the proposed method.

Self-initialized active contours for microscopic cell image segmentation.

Level set models are suitable for processing topological changes in different regions of images while performing segmentation. Active contour models require an empirical setting for initial parameters, which is tedious for the end-user. This study proposes an incremental level set model with the automatic initialization of contours based on local and global fitting energies that enable it to capture image regions containing intensity corruption or other light artifacts. The region-based area and the region-based length terms use signed pressure force (SPF) to strengthen the balloon force. SPF helps to achieve a smooth version of the gradient descent flow in terms of energy minimization. The proposed model is tested on multiple synthetic and real images. Our model has four advantages: first, there is no need for the end user to initialize the parameters; instead, the model is self-initialized. Second, it is more accurate than other methods. Third, it shows lower computational complexity. Fourth, it does not depend on the starting position of the contour. Finally, we evaluated the performance of our model on microscopic cell images (Coelho et al., in: 2009 IEEE international symposium on biomedical imaging: from nano to macro, IEEE, 2009) to confirm that its performance is superior to that of other state-of-the-art models.

Segmentation of Intensity-Corrupted Medical Images Using Adaptive Weight-Based Hybrid Active Contours.

Segmentation accuracy is an important criterion for evaluating the performance of segmentation techniques used to extract objects of interest from images, such as the active contour model. However, segmentation accuracy can be affected by image artifacts such as intensity inhomogeneity, which makes it difficult to extract objects with inhomogeneous intensities. To address this issue, this paper proposes a hybrid region-based active contour model for the segmentation of inhomogeneous images. The proposed hybrid energy functional combines local and global intensity functions; an incorporated weight function is parameterized based on local image contrast. The inclusion of this weight function smoothens the contours at different intensity level boundaries, thereby yielding improved segmentation. The weight function suppresses false contour evolution and also regularizes object boundaries. Compared with other state-of-the-art methods, the proposed approach achieves superior results over synthetic and real images. Based on a quantitative analysis over the mini-MIAS and PH2 databases, the superiority of the proposed model in terms of segmentation accuracy, as compared with the ground truths, was confirmed. Furthermore, when using the proposed model, the processing time for image segmentation is lower than those when using other methods.

SRIS: Saliency-Based Region Detection and Image Segmentation of COVID-19 Infected Cases.

Noise or artifacts in an image, such as shadow artifacts, deteriorate the performance of state-of-the-art models for the segmentation of an image. In this study, a novel saliency-based region detection and image segmentation (SRIS) model is proposed to overcome the problem of image segmentation in the existence of noise and intensity inhomogeneity. Herein, a novel adaptive level-set evolution protocol based on the internal and external functions is designed to eliminate the initialization sensitivity, thereby making the proposed SRIS model robust to contour initialization. In the level-set energy function, an adaptive weight function is formulated to adaptively alter the intensities of the internal and external energy functions based on image information. In addition, the sign of energy function is modulated depending on the internal and external regions to eliminate the effects of noise in an image. Finally, the performance of the proposed SRIS model is illustrated on complex real and synthetic images and compared with that of the previously reported state-of-the-art models. Moreover, statistical analysis has been performed on coronavirus disease (COVID-19) computed tomography images and THUS10000 real image datasets to confirm the superior performance of the SRIS model from the viewpoint of both segmentation accuracy and time efficiency. Results suggest that SRIS is a promising approach for early screening of COVID-19.

Hybrid two-stage active contour method with region and edge information for intensity inhomogeneous image segmentation.

This paper presents a novel two-stage image segmentation method using an edge scaled energy functional based on local and global information for intensity inhomogeneous image segmentation. In the first stage, we integrate global intensity term with a geodesic edge term, which produces a preliminary rough segmentation result. Thereafter, by taking final contour of the first stage as initial contour, we begin second stage segmentation process by integrating local intensity term with geodesic edge term to get final segmentation result. Due to the suitable initialization from the first stage, the second stage precisely achieves desirable segmentation result for inhomogeneous image segmentation. Two stage segmentation technique not only increases the accuracy but also eliminates the problem of initial contour existed in traditional local segmentation methods. The energy function of the proposed method uses both global and local terms incorporated with compacted geodesic edge term in an additive fashion which uses image gradient information to delineate obscured boundaries of objects inside an image. A Gaussian kernel is adapted for the regularization of the level set function and to avoid an expensive re-initialization. The experiments were carried out on synthetic and real images. Quantitative validations were performed on Multimodal Brain Tumor Image Segmentation Benchmark (BRATS) 2015 and PH2 skin lesion database. The visual and quantitative comparisons will demonstrate the efficiency of the proposed method.

Modifying and evaluating efficacy of interactive computerized program using motion tracking technology to improve unilateral neglect in patients with chronic stroke.

BACKGROUND: To modify and evaluate the efficacy of a computerized visual perception rehabilitation program using interactive motion tracking technology with unilateral neglect after chronic stroke. METHODS: Study design is single-blinded (analyst-blinded) controlled prospective clinical trial. Subjects are 16 patients with chronic stroke and unilateral neglect for over 6 months and 19 healthy volunteers. We modified our previous program to 9 tasks with built-in scoring system, and the subjects performed 3 sessions per week, 30 minutes per session for 4 weeks. RESULTS: Scores for the Modified Barthel Index (MBI), Mini-Mental State Examination (MMSE), Motor-free Visual Perception Test (MVPT), Line bisection test, Star cancellation test, Forward Digit Test, and Backward Digit Test showed significant improvement at the end of the sessions in the patient group. By comparing the parameters of built-in scoring system of each task among the control group, the first session of training in the patient group, and the last session of training in the patient group, we categorized the parameters for optional measurement to determine the effect of training or to be a candidate for evaluative use. CONCLUSIONS: Our modified computerized visual perception rehabilitation program using improved unilateral neglect in patients post-stroke. Built-in scoring system in this program was helpful to assess availability of it more objectively.

Morphometry of the proximal tibia to design the tibial component of total knee arthroplasty for the Korean population.

We carried out an anthropometric analysis using three dimensional computer tomographic measurements of the cut surface of the proximal tibia in 200 knees that were obtained from 50 male and 50 female Korean cadavers. We measured the mediolateral (ML), middle anteroposterior (AP), medial and lateral anteroposterior dimensions and the aspect ratio (ML/AP) of the resected proximal tibial surface; we then compared this data with the five conventionally used symmetric total knee components. We found that the ML (73.5+/-5.6 mm) and AP (47.3+/-3.8 mm) average dimensions of our study population were smaller than the dimensions of the symmetric commercially available TKA implants. We found a progressive decrease in the aspect ratio with the increasing anteroposterior dimension of the proximal tibia, as compared to the constant aspect ratio shown by the conventional tibial prostheses. The smaller sized prostheses were found to show mediolateral undersizing and the larger sized prostheses were found to show mediolateral overhang. This study may provide guidelines for designing a suitable tibial component of total knee prostheses for the Korean population, the aspect ratio of which decreases with increasing anteroposterior dimension.

Segmentation of Left and Right Ventricles in Cardiac MRI Using Active Contours.

Segmentation of left and right ventricles plays a crucial role in quantitatively analyzing the global and regional information in the cardiac magnetic resonance imaging (MRI). In MRI, the intensity inhomogeneity and weak or blurred object boundaries are the problems, which makes it difficult for the intensity-based segmentation methods to properly delineate the regions of interests (ROI). In this paper, a hybrid signed pressure force function (SPF) is proposed, which yields both local and global image fitted differences in an additive fashion. A characteristic term is also introduced in the SPF function to restrict the contour within the ROI. The overlapping dice index and Hausdorff-Distance metrics have been used over cardiac datasets for quantitative validation. Using 2009 LV MICCAI validation dataset, the proposed method yields DSC values of 0.95 and 0.97 for endocardial and epicardial contours, respectively. Using 2012 RV MICCAI dataset, for the endocardial region, the proposed method yields DSC values of 0.97 and 0.90 and HD values of 8.51 and 7.67 for ED and ES, respectively. For the epicardial region, it yields DSC values of 0.92 and 0.91 and HD values of 6.47 and 9.34 for ED and ES, respectively. Results show its robustness in the segmentation application of the cardiac MRI.

Active Contours Using Additive Local and Global Intensity Fitting Models for Intensity Inhomogeneous Image Segmentation.

This paper introduces an improved region based active contour method with a level set formulation. The proposed energy functional integrates both local and global intensity fitting terms in an additive formulation. Local intensity fitting term influences local force to pull the contour and confine it to object boundaries. In turn, the global intensity fitting term drives the movement of contour at a distance from the object boundaries. The global intensity term is based on the global division algorithm, which can better capture intensity information of an image than Chan-Vese (CV) model. Both local and global terms are mutually assimilated to construct an energy function based on a level set formulation to segment images with intensity inhomogeneity. Experimental results show that the proposed method performs better both qualitatively and quantitatively compared to other state-of-the-art-methods.

Segmentation of Regions of Interest Using Active Contours with SPF Function.

Segmentation of regions of interest is a well-known problem in image segmentation. This paper presents a region-based image segmentation technique using active contours with signed pressure force (SPF) function. The proposed algorithm contemporaneously traces high intensity or dense regions in an image by evolving the contour inwards. In medical image modalities these high intensity or dense regions refer to tumor, masses, or dense tissues. The proposed method partitions an image into an arbitrary number of subregions and tracks down salient regions step by step. It is implemented by enforcing a new region-based SPF function in a traditional edge-based level set model. It partitions an image into subregions and then discards outer subregion and partitions inner region into two more subregions; this continues iteratively until a stopping condition is fulfilled. A Gaussian kernel is used to regularize the level set function, which not only regularizes it but also removes the need of computationally expensive reinitialization. The proposed segmentation algorithm has been applied to different images in order to demonstrate the accuracy, effectiveness, and robustness of the algorithm.

Segmentation of intensity inhomogeneous brain MR images using active contours.

Segmentation of intensity inhomogeneous regions is a well-known problem in image analysis applications. This paper presents a region-based active contour method for image segmentation, which properly works in the context of intensity inhomogeneity problem. The proposed region-based active contour method embeds both region and gradient information unlike traditional methods. It contains mainly two terms, area and length, in which the area term practices a new region-based signed pressure force (SPF) function, which utilizes mean values from a certain neighborhood using the local binary fitted (LBF) energy model. In turn, the length term uses gradient information. The novelty of our method is to locally compute new SPF function, which uses local mean values and is able to detect boundaries of the homogenous regions. Finally, a truncated Gaussian kernel is used to regularize the level set function, which not only regularizes it but also removes the need of computationally expensive reinitialization. The proposed method targets the segmentation problem of intensity inhomogeneous images and reduces the time complexity among locally computed active contour methods. The experimental results show that the proposed method yields better segmentation result as well as less time complexity compared with the state-of-the-art active contour methods.