Vipimage Bernard 2013

1 / 64
3D Echocardiography: recent advances and

future directions
1
University of Lyon, France
O. Bernard
1
, D. Barbosa
2
, M. Alessandrini
2
,
D. Friboulet
1
, J. Dhooge
2
2
K.U. Leuven, Belgium
2 / 64
Outline
Context

Basics on image formation

Ultra realistic simulation

Echocardiographic image processing

Future directions
3 / 64
3D Echocardiographic imaging
In summary

Non invasive modality

Assess mechanical
properties of the heart
such as the strain in
real time

One of the cheapest
modality in 2D and 3D

4 / 64
Clinical useful information

Clinical indices such as the Ejection Fraction (EF)
or the Stroke Volume (SV)

Necessity to perform accurate segmentation

End Diastolic
Volume (EDV)
End Systolic
Volume (ESV)
(%) =

5 / 64
Clinical useful information

Strain and strain rate measurement
Opens the door to local cardiac deformation assessment

Necessity to perform motion analysis

6 / 64
BASICS ON ULTRASOUND IMAGE
FORMATION
7 / 64
Basics on US image formation
2D Ultrasound probe

Phased array transducer
(less than 192 elements)

Delays on each element

Possibility to focalize the
energy in various part of
the medium
y (elevation)
x (lateral)
z (axial)
Width
Pitch
Kerf
Height
8 / 64
Different kind of signals

1
3
2
Rf image
Enveloppe image
B-mode image
9 / 64
Different kind of signals

1
3
2
Rf image
Enveloppe image
B-mode image
Image mostly used in 3D
echocardiography
10 / 64
3D Ultrasound probe

2D matrix array transducer
(3000 elements involved)

Technical difficulties in
driving all the elements

Impact spatial resolution

Technical difficulties in
scanning the volume of
interest in real time

Impact temporal resolution

Open head of probe
11 / 64
Image properties

Typical voxel size: 0.80 x 1.00 x 1.00

Temporal resolution: 20 volumes per second
Long Axis 4 chambers Short Axis
Long Axis 2 chambers
12 / 64
ECHOCARDIOGRAPHIC IMAGE
PROCESSING
13 / 64
Image properties

Spatial

No clear contours
Noisy nature (speckle)

Temporal

Speckle decorrelation
Linked to frame rate
14 / 64
Current needs

No real consensus on the accuracy of what we can
extract from this modality

Strong need of evaluation platform for quality
assurance of algorithms applied to this modality for:

Segmentation
Motion estimation
Tissue characterisation

15 / 64
ULTRA REALISTIC SYNTHETIC
ECHOCARDIOGRAPHIC SEQUENCES
16 / 64
Ultra realistic echocardiographic simulations
State-of-the-art

Ultrasound Simulator
Field II [Jensen et al., 1992]
Cole [Gao et al., 2009]
Creanuis [Varray et al., 2011]
Realistic Simulation
[Gao et al., UMB, 2009]
[Alessandrini et al., ICIP, 2012]
[De Craene et al., IEEE TMI, 2013]
17 / 64

BASICS
18 / 64
Simulator principle
Speckle
pattern
Simulate a realistic point spread
function that characterises the
ultrasound probe
Simulate a medium from a set of
scatterer points with specific
backscattering coefficients

?
How many scatterers ?
Which positions ?
Which amplitudes ?
Which motion ?
sector in degree
d
e
p
t
h

i n

m
m
-40 -30 -20 -10 0 10 20 30 40
20
40
60
80
100
120
19 / 64

MOST ADVANCED SOLUTIONS
De Craene et al. Philips Research France
20 / 64
Most advanced solutions in US simulations
[De Craene et al., TMI, 2013]

Anatomical
model

Obtained from MR
segmentation
Electromechanical
motion model

Properties

Realistic motion model
Need to improve image quality
Contractility Activation
[Sermesant et al., TMI, 2013]
Ultrasound simulator

- Inside myocardium: motion
derived from the EM model

- Outside myocardium: random
scatterers position and motion

- Scatterers amplitudes: simple
gaussian distribution
21 / 64

Alessandrini et al. Creatis, France
22 / 64

Improvement of image quality : Image-based approach
Build a simulation based on a real clinical sequence

Learn the motion to be applied to the scatterers inside
the myocardium from the real sequence

23 / 64

Improvement of image quality : Image-based approach
Build a simulation getting inspired by a real clinical
sequence

Learn the scatterers amplitudes from the real sequence

= 10
20

1
A: scatterers amplitude
I : real image intensity
K: controls dB range of the
resulting image
24 / 64

Real clinical
recording

Simulated
sequence

Reference
motion

Properties
Simulation of surrounding structures
Simulation of image artifacts
No motion model
Only implemented in 2D
25 / 64

FUTURE DIRECTIONS
26 / 64
Future directions in US simulations
How to still improve simulations ?

Merge the model-based simulation with the image-
based one

Anatomical + Electromechanical models
Dedicated registration
algorithm
Real clinical recording
27 / 64
Ultra realistic echocardiographic simulations
Future directions

Quantitative comparison of existing 3D
segmentation, motion and strain estimation
techniques

Improving the heart models for the generation of
a set of controlled pathological cases

Creation of a publicly available library of
sequences including clinically relevant cases

28 / 64
PROCESSING

FEATURE EXTRACTION
29 / 64
Feature extraction
What kind of features ?

Information support: B-mode image

Most accessible and time efficient support

Edge information

Monogenic signal

Region information

First order statistics computed locally

30 / 64
ECHOCARDIOGRAPHIC
FEATURE EXTRACTION

Noble et al. Institute of Biomedical
Engineering, U.K.
31 / 64
Most advanced algorithms in feature extraction
Monogenic signal in few words

Extension of the analytic signal in n-D
Assumption: local image patches have intrinsic
dimensionality one

Efficiently extract local amplitude, local orientation,
local phase and instantaneous frequency in the
direction of maximum energy

( )
32 / 64
[Rajpoot et al., ISBI, 2009]

Exploit the monogenic signal for edge detection in
3D echocardiography images

Feature asymmetry (FA) operator for phase-
congruency measure in the particular case of step
edges

33 / 64
34 / 64
[Stebbing et al., MEDIA, 2013]

Machine learning based on boundary fragment model
to classify the different detected edges

35 / 64
PROCESSING

SEGMENTATION
36 / 64
3D Echo segmentation

Left ventricle
Full myocardium
3D Transesophageal
4 chambers
37 / 64
3D Echo segmentation

Left ventricle
Full myocardium
3D Transesophageal
4 chambers
38 / 64
State-of-the-art in 3D Left Ventricle segmentation

Without prior
Statistical Shape/Appearance Model
Leung, ISBI 2010
Zhang, UMB 2013
Butakoff, FIMH 2011
With prior
Supervised tissue classification
Lempitsky, FIMH2009
Verhoek, MLMI2011
Machine learning from large
databases
Yang, IEEE TMI 2011
Graph Cuts
Juang, ISBI 2011
Dynamic Programming
van Stralen, Academic Radiology 2005
Deformable models
Simplex Meshes
Nillesen, Phy. Med. Biol. 2009
Level-sets
Rajpoot, MedIA 2011
B-Spline Explicit Active Surfaces
Barbosa, UMB 2013
Kalman-based surface tracking
Dikici, MICCAI 2012
39 / 64
State-of-the-art : Performance evaluation

Study Year
#
Exams
Analysis time (s)
EDV
MAD
( mm)
R BA (2 ml)
Van Stralen 2005 14 90+Manual Init 0.93 -1060 X
Nillesen 2009 5 X X 6.74.6 X
Lempitsky 2009 14 2-22 X X X
Leung 2010 99 X 0.95 1.540 2.911.0
Juang 2011 4 X X X 2.43.2
Rajpoot 2011 34 X X -5.049 2.20.7
Butakoff 2011 10 X X 6.414 1.61.1
Butakoff 2011 20 X X 3.147 1.81.9
Verhoek 2011 25 2 X X X
Yang 2011 67 1.5 X 1.312 1.31.1
Dikici 2012 29 0.08 X X 2.0X
Barbosa 2013 24 1 0.97 -2.423 X
Zhang 2013 50 45-60 0.83 4.235 3.21.0
40 / 64
State-of-the-art : Performance evaluation

Study Year
#
Exams
Analysis time (s)
EDV
MAD
( mm)
R BA (2 ml)
Van Stralen 2005 14 90+Manual Init 0.93 -1060 X
Nillesen 2009 5 X X 6.74.6 X
Lempitsky 2009 14 2-22 X X X
Leung 2010 99 X 0.95 1.540 2.911.0
Juang 2011 4 X X X 2.43.2
Rajpoot 2011 34 X X -5.049 2.20.7
Butakoff 2011 10 X X 6.414 1.61.1
Butakoff 2011 20 X X 3.147 1.81.9
Verhoek 2011 25 2 X X X
Yang 2011 67 1.5 X 1.312 1.31.1
Dikici 2012 29 0.08 X X 2.0X
Barbosa 2013 24 1 0.97 -2.423 X
Zhang 2013 50 45-60 0.83 4.235 3.21.0
41 / 64
SEGMENTATION

Barbosa et al. Creatis KULeuven,
France, Belgium
42 / 64
Most advanced algorithms in segmentation
[Barbosa et al., UMB, 2013]

Formalism specifically dedicated for near real time
3D segmentation

Exploit equivalence under specific constraint
between implicit and explicit representation inside
the variational framework of level-set methods

Solve a 3D problem in a 2D space (dimensionality
reduction)

Segmentation performed through a B-Spline
formulation in order to decrease even more
computational time

43 / 64

Interface evolution corresponds to a succession of
simple separable convolutions

with:
Energy to minimize
[] B-Spline coefficients
(
) data attachment term

B-spline function
44 / 64
A
u
et A
v
: interior and exterior regions
used for the computation of the
local means

2
with coordinates {
1
,
2
}
) restriction of to interface
B(x,y)
x

Evolution equation

With

45 / 64
Results

Validation performed on 24 patients among whom
80% present different cardiac pathologies

All data were manually segmented by 3 experts

Corr. Coeff: 0.97 (EDV), 0.97 (ESV), 0.91 (EF)

Average Cpu time per volume: 25 ms
2.9-GHz 4-Core laptop, with 7.7GB Memory running Fedora

46 / 64
PROCESSING

MOTION ESTIMATION
47 / 64
Motion estimation
State-of-the-art in motion estimation

Many algorithms have been proposed

The most well known is based on block matching

Most of them are based on intensity conservation

Assumption: a moving structure should conserve
its brightness appearance between two
consecutive time instants

48 / 64
Motion estimation
State-of-the-art in motion estimation

Without prior
Statistical model
Wang, STACOM, 2010
Leung, UMB, 2011
With prior
Mechanical model
Papademitris, MEDIA, 2001
Sermesant, MICCAI, 2001
B-Spline transformation
Heyde, STACOM, 2013
De Craene, MEDIA, 2012
Piella, STACOM, 2013
Optical flow
Alessandrini, TIP, 2013
Tautz, STACOM, 2013
Mansi, IJCV, 2011
Block-matching
Isla, JASE, 2011
Crosby, UMB, 2009
Seo, JACC, 2011
49 / 64
Motion estimation
MICCAI12 Challenge [De Craene et al., TMI, 2013]

Synthetic motion from an Electro-Mechanical model
Simulate normal and pathological cases (13 patients)
Comparison of 5 methods

2 B-Spline transformation based methods
3 Optical flow based methods
50 / 64
Motion estimation evaluation

Magnitude errors

Globally over a cardiac cycle
For each time instant in the sequence

Motion estimation
51 / 64
Motion estimation
MICCAI12 Challenge

Average magnitude error over a cardiac cycle

Ischemic sub groups Dyssynchrony sub groups
52 / 64
Motion estimation
MICCAI12 Challenge

Average magnitude error over a cardiac cycle

Ischemic sub groups Dyssynchrony sub groups
53 / 64
ECHOCARDIOGRAPHIC
MOTION ESTIMATION

Heyde et al. KULeuven, Belgium
54 / 64
Most advanced algorithms in motion estimation
[Heyde et al., FIMH 2013]

Free-form deformations in 3D to estimate motion

Model displacement in B-Spline space

Registration performed in a recursive minimization way

+1
= [, ]

1,
,[1,
]

=
,
+
, +()
with: Energy to minimized
Sum of Square diff. measurement
Regularization function
55 / 64

Illustration in 2D

Extension in 3D

Derivation of
motion and strain
Image warping
Registration
56 / 64

Anatomical shaped control grid

Less control points (efficiency)
Naturally enforce smoothness in the physiologically
relevant directions

Anatomically shaped control grid Regular control grid
57 / 64
Acute myocardial infarct
On going results

Feasibility on 6 clinical data

3 healthy patients + 3 with pathologies
(Acute myocardial infarct)

Average Cpu time per volume:
4 minutes

2.8-GHz 4-Core laptop, with 8.0GB
Memory running Windows
58 / 64
FUTURE DIRECTIONS
59 / 64
Future directions
Key point: image quality

Deeply depend on the capacity to improve or not
3D echocardiographic image quality

Scenario 1: No real improvement

Needs of quantifying what
exactly we could extract from
this modality

Needs of going further in
adapted image processing

Needs of doing real time
processing
60 / 64
Future directions
Key point: image quality

Deeply depend on the capacity to improve or not
3D echocardiographic image quality

Scenario 2: Improvement is possible

Needs of working on the
acquisition process itself
61 / 64
Future directions
3D echocardiographic acquisition improvements

Strong efforts are currently made to improve image
quality

Temporal resolution
Compressed sensing in ultrasound
[Wagner et al., IEEE TSP, 2012]

Spatial resolution
Fourier ultrasound imaging
[Garcia et al., IEEE UFFC, 2013]

Modify the image to facilitate motion estimation
Ultrasound-tagging imaging
[Liebgott et al., IEEE UFFC, 2013]
62 / 64
Future directions
Ultrasound-tagging [Liebgott et al., UFFC 2013]

Main idea: reproduce the principle of tagged MR
imaging in ultrasound

63 / 64
Future directions
Classical B-mode image US-tagging
Tagged ultrasound imaging [Liebgott et al., UFFC 2013]

http://www.creatis.insa-lyon.fr/us-tagging/
64 / 64
THANK FOR YOUR ATTENTION

Vipimage Bernard 2013

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Vipimage Bernard 2013

Uploaded by

Copyright:

Available Formats

1 / 64

3D Echocardiography: recent advances and

) data attachment term

You might also like