Biomechanical 3-D finite element modeling of the human breast using MRI data

Breast tissue deformation modeling has recently gained considerable interest in various medical applications. A biomechanical model of the breast is presented using a finite element (FE) formulation. Emphasis is given to the modeling of breast tissue deformation which takes place in breast imaging procedures. The first step in implementing the FE modeling (FEM) procedure is mesh generation. For objects with irregular and complex geometries such as the breast, this step is one of the most difficult and tedious tasks. For FE mesh generation, two automated methods are presented which process MRI breast images to create a patient-specific mesh. The main components of the breast are adipose, fibroglandular and skin tissues. For modeling the adipose and fibroglandular tissues, we used eight noded hexahedral elements with hyperelastic properties, while for the skin, we chose four noded hyperelastic membrane elements. For model validation, an MR image of an agarose phantom was acquired and corresponding FE meshes were created. Based on assigned elasticity parameters, a numerical experiment was performed using the FE meshes, and good results were obtained. The model was also applied to a breast image registration problem of a volunteer's breast. Although qualitatively reasonable, further work is required to validate the results quantitatively.     

Volumetric breast density estimation from full-field digital mammograms

A method is presented for estimation of dense breast tissue volume from mammograms obtained with full-field digital mammography (FFDM). The thickness of dense tissue mapping to a pixel is determined by using a physical model of image acquisition. This model is based on the assumption that the breast is composed of two types of tissue, fat and parenchyma. Effective linear attenuation coefficients of these tissues are derived from empirical data as a function of tube voltage (kVp), anode material, filtration, and compressed breast thickness. By employing these, tissue composition at a given pixel is computed after performing breast thickness compensation, using a reference value for fatty tissue determined by the maximum pixel value in the breast tissue projection. Validation has been performed using 22 FFDM cases acquired with a GE Senographe 2000D by comparing the volume estimates with volumes obtained by semi-automatic segmentation of breast magnetic resonance imaging (MRI) data. The correlation between MRI and mammography volumes was 0.94 on a per image basis and 0.97 on a per patient basis. Using the dense tissue volumes from MRI data as the gold standard, the average relative error of the volume estimates was 13.6%.     

Modality independent elastography (MIE): a new approach to elasticity imaging

The correlation between tissue stiffness and health is an accepted form of organ disease assessment. As a result, there has been a significant amount of interest in developing methods to image elasticity parameters (i.e., elastography). The modality independent elastography (MIE) method combines a nonlinear optimization framework, computer models of soft-tissue deformation, and standard measures of image similarity to reconstruct elastic property distributions within soft tissue. In this paper, simulation results demonstrate successful elasticity image reconstructions in breast cross-sectional images acquired from magnetic resonance (MR) imaging. Results from phantom experiments illustrate its modality independence by reconstructing elasticity images of the same phantom in both MR and computed tomographic imaging units. Additional results regarding the performance of a new multigrid strategy to MIE and the implementation of a parallel architecture are also presented.     

Hierarchical scale-based multiobject recognition of 3-D anatomical structures

Segmentation of anatomical structures from medical images is a challenging problem, which depends on the accurate recognition (localization) of anatomical structures prior to delineation. This study generalizes anatomy segmentation problem via attacking two major challenges: 1) automatically locating anatomical structures without doing search or optimization, and 2) automatically delineating the anatomical structures based on the located model assembly. For 1), we propose intensity weighted ball-scale object extraction concept to build a hierarchical transfer function from image space to object (shape) space such that anatomical structures in 3-D medical images can be recognized without the need to perform search or optimization. For 2), we integrate the graph-cut (GC) segmentation algorithm with prior shape model. This integrated segmentation framework is evaluated on clinical 3-D images consisting of a set of 20 abdominal CT scans. In addition, we use a set of 11 foot MR images to test the generalizability of our method to the different imaging modalities as well as robustness and accuracy of the proposed methodology. Since MR image intensities do not possess a tissue specific numeric meaning, we also explore the effects of intensity nonstandardness on anatomical object recognition. Experimental results indicate that: 1) effective recognition can make the delineation more accurate; 2) incorporating a large number of anatomical structures via a model assembly in the shape model improves the recognition and delineation accuracy dramatically; 3) ball-scale yields useful information about the relationship between the objects and the image; 4) intensity variation among scenes in an ensemble degrades object recognition performance.     

基于抗混叠轮廓波的乳腺图像降噪与增强方法

乳腺X射线成像是乳腺疾病早期检测的有效手段.然而典型的乳腺X射线图像往往对比度低,噪声污染严重,本文提出一种新颖的基于抗混叠轮廓波变换的乳腺图像降噪及增强方案.首先分析了原始轮廓波变换的频谱混叠问题,设计出一种能稀疏表示图像边界及纹理信息,同时能抑制混叠影响的抗混叠轮廓波变换;在此基础上,分别采用高斯分布与广义拉普拉斯分布来刻划噪声相关及信号相关的变换系数,实现阈值萎缩降噪;接着对处理后的系数进行非线性增强,达到增强乳腺图像中细节信息的效果.实验结果表明,本文方法能有效提高乳腺图像的质量,在计算机辅助乳腺诊断方面有较高应用价值.     

Validation of nonrigid image registration using finite-element methods: application to breast MR images

This paper presents a novel method for validation of nonrigid medical image registration. This method is based on the simulation of physically plausible, biomechanical tissue deformations using finite-element methods. Applying a range of displacements to finite-element models of different patient anatomies generates model solutions which simulate gold standard deformations. From these solutions, deformed images are generated with a range of deformations typical of those likely to occur in vivo. The registration accuracy with respect to the finite-element simulations is quantified by co-registering the deformed images with the original images and comparing the recovered voxel displacements with the biomechanically simulated ones. The functionality of the validation method is demonstrated for a previously described nonrigid image registration technique based on free-form deformations using B-splines and normalized mutual information as a voxel similarity measure, with an application to contrast-enhanced magnetic resonance mammography image pairs. The exemplar nonrigid registration technique is shown to be of subvoxel accuracy on average for this particular application. The validation method presented here is an important step toward more generic simulations of biomechanically plausible tissue deformations and quantification of tissue motion recovery using nonrigid image registration. It will provide a basis for improving and comparing different nonrigid registration techniques for a diversity of medical applications, such as intrasubject tissue deformation or motion correction in the brain, liver or heart.     

A hybrid breast biopsy system combining ultrasound and MRI

System design and initial phantom accuracy results for a novel biopsy system integrating both magnetic resonance (MR) and ultrasound (US) imaging modalities are presented. A phantom experiment was performed to investigate the efficacy of this hybrid guidance biopsy technique in a breast tissue mimicking phantom. A comparison between MR-guided core biopsy verses MR/US-guided core biopsy of phantom targets was realized using a scoring system based on the consistency of the acquired core samples (14 gauge). It was determined that the addition of US to guide needle placement improved the accuracy from an average score of 7.4 out of 10 (MRI guidance alone), to 9.6 (MRI/US guidance) over 21 trials. The average amount of needle tip correction resulting from the additional US information was determined to be 3.7 mm. This correction value is substantial, equal to approximately one radius of the intended targets. Hybrid US/MRI guided biopsy appears to offer a simple means to ensure accurate breast tissue sampling without the need for repeat MRI scans for verification or the need for real-time imaging in open MRI geometries.     

A reconstruction algorithm for breast cancer imaging with electrical impedance tomography in mammography geometry

The conductivity and permittivity of breast tumors are known to differ significantly from those of normal breast tissues, and electrical impedance tomography (EIT) is being studied as a modality for breast cancer imaging to exploit these differences. At present, X-ray mammography is the primary standard imaging modality used for breast cancer screening in clinical practice, so it is desirable to study EIT in the geometry of mammography. This paper presents a forward model of a simplified mammography geometry and a reconstruction algorithm for breast tumor imaging using EIT techniques. The mammography geometry is modeled as a rectangular box with electrode arrays on the top and bottom planes. A forward model for the electrical impedance imaging problem is derived for a homogeneous conductivity distribution and is validated by experiment using a phantom tank. A reconstruction algorithm for breast tumor imaging based on a linearization approach and the proposed forward model is presented. It is found that the proposed reconstruction algorithm performs well in the phantom experiment, and that the locations of a 5-mm-cube metal target and a 6-mm-cube agar target could be recovered at a target depth of 15 mm using a 32 electrode system.     

Registration of 3-D intraoperative MR images of the brain using a finite-element biomechanical model

We present a new algorithm for the nonrigid registration of three-dimensional magnetic resonance (MR) intraoperative image sequences showing brain shift. The algorithm tracks key surfaces of objects (cortical surface and the lateral ventricles) in the image sequence using a deformable surface matching algorithm. The volumetric deformation field of the objects is then inferred from the displacements at the boundary surfaces using a linear elastic biomechanical finite-element model. Two experiments on synthetic image sequences are presented, as well as an initial experiment on intraoperative MR images showing brain shift. The results of the registration algorithm show a good correlation of the internal brain structures after deformation, and a good capability of measuring surface as well as subsurface shift. We measured distances between landmarks in the deformed initial image and the corresponding landmarks in the target scan. Cortical surface shifts of up to 10 mm and subsurface shifts of up to 6 mm were recovered with an accuracy of 1 mm or less and 3 mm or less respectively.     

Patch-based reconstruction of surfaces undergoing different types of deformations

We deal with the reconstruction of surfaces that deform under a variety of conditions. The deformation can range from no extension to a certain degree of extensibility. The deformed surface is reconstructed from a single image, given a 3D reference shape. This shape corresponds to the undeformed state of the surface and can be computed using any appropriate technique. In particular, we use homographies defined from two views of the surface. To proceed with the 3D reconstruction of the deformed surface, we assume that the deformations are locally homogeneous and that the overall surface deformation can be obtained by combining the local homogeneous deformations. For this purpose, the surface is split into small patches. For each patch, a mapping between the undeformed and the deformed shapes is computed. The mapping is specified by using the quadratic deformation model Fayad et al. (Proceedings of British Machine Vision Conference (BMVC), 2004). As a result, given the undeformed shape, we define an optimization procedure whose goal is to estimate the 3D positions of deformed points in each image. The optimization is performed on each patch, independently of the others. The experimental results show that this approach allows precise reconstruction of a wide class of real deformations.     

Registered 3-D ultrasound and digital stereotactic mammography for breast biopsy guidance

Large core needle biopsy is a common procedure used to obtain histological samples when cancer is suspected in diagnostic breast images. The procedure is typically performed under image guidance, with freehand ultrasound and stereotactic mammography (SM) being the most common modalities used. To utilize the advantages of both modalities, a biopsy device combining three-dimensional ultrasound (3DUS) and digital SM imaging with computer-aided needle guidance was developed. An implementation of a stereo camera method was applied to SM calibration, providing a target localization error of 0.35 mm. The 3-D transformation between the two imaging modalities was then derived, with a target registration error of 0.52 mm. Finally, the needle guidance error of the device was evaluated using tissue-mimicking phantoms, showing a sample mean and standard deviation of 0.44 +/- 0.22 and 0.49 +/- 0.27 mm for targets planned from 3DUS and SM images, respectively. These results suggest that a biopsy procedure guided using this device would successfully sample breast lesions at a size greater than or equal to the smallest typically detected in mammographic screening (approximately 2 mm).     

Authenticity and integrity of digital mammography images

Data security becomes more and more important in telemammography which uses a public high-speed wide area network connecting the examination site with the mammography expert center. Generally, security is characterized in terms of privacy, authenticity and integrity of digital data. Privacy is a network access issue and is not considered in this paper. We present a method, authenticity and integrity of digital mammography, here which can meet the requirements of authenticity and integrity for mammography image (IM) transmission. The authenticity and integrity for mammography (AIDM) consists of the following four modules. 1) Image preprocessing: To segment breast pixels from background and extract patient information from digital imaging and communication in medicine (DICOM) image header. 2) Image hashing: To compute an image hash value of the mammogram using the MD5 hash algorithm. 3) Data encryption: To produce a digital envelope containing the encrypted image hash value (digital signature) and corresponding patient information. 4) Data embedding: To embed the digital envelope into the image. This is done by replacing the least significant bit of a random pixel of the mammogram by one bit of the digital envelope bit stream and repeating for all bits in the bit stream. Experiments with digital IMs demonstrate the following. 1) In the expert center, only the user who knows the private key can open the digital envelope and read the patient information data and the digital signature of the mammogram transmitted from the examination site. 2) Data integrity can be verified by matching the image hash value decrypted from the digital signature with that computed from the transmitted image. 3) No visual quality degradation is detected in the embedded image compared with the original. Our preliminary results demonstrate that AIDM is an effective method for image authenticity and integrity in telemammography application.     

A concentric morphology model for the detection of masses in mammography

We propose a technique for the automated detection of malignant masses in screening mammography. The technique is based on the presence of concentric layers surrounding a focal area with suspicious morphological characteristics and low relative incidence in the breast region. Mammographic locations with high concentration of concentric layers with progressively lower average intensity are considered suspicious deviations from normal parenchyma. The multiple concentric layers (MCLs) technique was trained and tested using the craniocaudal views of 270 mammographic cases with biopsy proven malignant masses from the digital database of screening mammography. One-half of the available cases were used for optimizing the parameters of the detection algorithm. The remaining cases were used for testing. During testing, malignant masses were detected with 92%, 88%, and 81% sensitivity at 5.4, 2.4, and 0.6 false positive marks per image. Testing on 82 normal screening mammograms showed a false positive rate of 5.0, 1.7, and 0.2 marks per image at the previously reported operating points. Furthermore, additional evaluation on 135 benign cases produced a significantly lower detection rate for benign masses (61.6%, 58.3%, and 43.7% at 5.1, 2.8, and 1.2 false positives per image, respectively). Overall, MCL is a promising computer-assisted detection strategy for screening mammograms to identify malignant masses while maintaining the detection rate of benign masses considerably lower.     

Nonrigid image registration in shared-memory multiprocessor environments with application to brains, breasts, and bees

One major problem with nonrigid image registration techniques is their high computational cost. Because of this, these methods have found limited application to clinical situations where fast execution is required, e.g., intraoperative imaging. This paper presents a parallel implementation of a nonrigid image registration algorithm. It takes advantage of shared-memory multiprocessor computer architectures using multithreaded programming by partitioning of data and partitioning of tasks, depending on the computational subproblem. For three different biomedical applications (intraoperative brain deformation, contrast-enhanced MR mammography, intersubject brain registration), the scaling behavior of the algorithm is quantitatively analyzed. The method is demonstrated to perform the computation of intra-operative brain deformation in less than a minute using 64 CPUs on a 128-CPU shared-memory supercomputer (SGI Origin 3800). It is shown that its serial component is no more than 2% of the total computation time, allowing a speedup of at least a factor of 50. In most cases, the theoretical limit of the speedup is substantially higher (up to 132-fold in the application examples presented in this paper). The parallel implementation of our algorithm is, therefore, capable of solving nonrigid registration problems with short execution time requirements and may be considered an important step in the application of such techniques to clinically important problems such as the computation of brain deformation during cranial image-guided surgery.     

An integrated region-, boundary-, shape-based active contour for multiple object overlap resolution in histological imagery

Active contours and active shape models (ASM) have been widely employed in image segmentation. A major limitation of active contours, however, is in their 1) inability to resolve boundaries of intersecting objects and to 2) handle occlusion. Multiple overlapping objects are typically segmented out as a single object. On the other hand, ASMs are limited by point correspondence issues since object landmarks need to be identified across multiple objects for initial object alignment. ASMs are also are constrained in that they can usually only segment a single object in an image. In this paper, we present a novel synergistic boundary and region-based active contour model that incorporates shape priors in a level set formulation with automated initialization based on watershed. We demonstrate an application of these synergistic active contour models using multiple level sets to segment nuclear and glandular structures on digitized histopathology images of breast and prostate biopsy specimens. Unlike previous related approaches, our model is able to resolve object overlap and separate occluded boundaries of multiple objects simultaneously. The energy functional of the active contour is comprised of three terms. The first term is the prior shape term, modeled on the object of interest, thereby constraining the deformation achievable by the active contour. The second term, a boundary-based term detects object boundaries from image gradients. The third term drives the shape prior and the contour towards the object boundary based on region statistics. The results of qualitative and quantitative evaluation on 100 prostate and 14 breast cancer histology images for the task of detecting and segmenting nuclei and lymphocytes reveals that the model easily outperforms two state of the art segmentation schemes (geodesic active contour and Rousson shape-based model) and on average is able to resolve up to 91% of overlapping/occluded structures in the images.     

3-D active appearance models: segmentation of cardiac MR and ultrasound images

A model-based method for three-dimensional image segmentation was developed and its performance assessed in segmentation of volumetric cardiac magnetic resonance (MR) images and echocardiographic temporal image sequences. Comprehensive design of a three-dimensional (3-D) active appearance model (AAM) is reported for the first time as an involved extension of the AAM framework introduced by Cootes et al. The model's behavior is learned from manually traced segmentation examples during an automated training stage. Information about shape and image appearance of the cardiac structures is contained in a single model. This ensures a spatially and/or temporally consistent segmentation of three-dimensional cardiac images. The clinical potential of the 3-D AAM is demonstrated in short-axis cardiac MR images and four-chamber echocardiographic sequences. The method's performance was assessed by comparison with manually identified independent standards in 56 clinical MR and 64 clinical echo image sequences. The AAM method showed good agreement with the independent standard using quantitative indexes of border positioning errors, endo- and epicardial volumes, and left ventricular mass. In MR, the endocardial volumes, epicardial volumes, and left ventricular wall mass correlation coefficients between manual and AAM were R2 = 0.94, 0.97, 0.82, respectively. For echocardiographic analysis, the area correlation was R2 = 0.79. The AAM method shows high promise for successful application to MR and echocardiographic image analysis in a clinical setting.     

Shape statistics variational approach for the outer contour segmentation of left ventricle MR images.

Segmentation of left ventricles is one of the important research topics in cardiac magnetic resonance (MR) imaging. The segmentation precision influences the authenticity of ventricular motion reconstruction. In left ventricle MR images, the weak and broken boundary increases the difficulty of segmenting the outer contour precisely. In this paper, we present an improved shape statistics variational approach for the outer contour segmentation of left ventricle MR images. We use the Mumford-Shah model in an object feature space and incorporate the shape statistics and an edge image to the variational framework. The introduction of shape statistics can improve the segmentation with broken boundaries. The edge image can enhance the weak boundary and thus improve the segmentation precision. The generation of the object feature image, which has homogenous "intensities" in the left ventricle, facilitates the application of the Mumford-Shah model. A comparison of mean absolute distance analysis between different contours generated with our algorithm and that generated by hand demonstrated that our method can achieve a higher segmentation precision and a better stability than various approaches. It is a semiautomatic way for the segmentation of the outer contour of the left ventricle in clinical applications.     

A novel approach to microcalcification detection using fuzzy logictechnique

Breast cancer continues to be a significant public health problem in the United States. Approximately, 182,000 new cases of breast cancer are diagnosed and 46,000 women die of breast cancer each year. Even more disturbing is the fact that one out of eight women in the United States will develop breast cancer at some point during her lifetime. Since the cause of breast cancer remains unknown, primary prevention becomes impossible. Computer-aided mammography is an important and challenging task in automated diagnosis. It has great potential over traditional interpretation of film-screen mammography in terms of efficiency and accuracy. Microcalcifications are the earliest sign of breast carcinomas and their detection is one of the key issues for breast cancer control. In this study, a novel approach to microcalcification detection based on fuzzy logic technique is presented. Microcalcifications are first enhanced based on their brightness and nonuniformity. Then, the irrelevant breast structures are excluded by a curve detector. Finally, microcalcifications are located using an iterative threshold selection method. The shapes of microcalcifications are reconstructed and the isolated pixels are removed by employing the mathematical morphology technique. The essential idea of the proposed approach is to apply a fuzzified image of a mammogram to locate the suspicious regions and to interact the fuzzified image with the original image to preserve fidelity. The major advantage of the proposed method is its ability to detect microcalcifications even in very dense breast mammograms. A series of clinical mammograms are employed to test the proposed algorithm and the performance is evaluated by the free-response receiver operating characteristic curve. The experiments aptly show that the microcalcifications can be accurately detected even in very dense mammograms using the proposed approach     

Surface-based labeling of cortical anatomy using a deformable atlas

The authors describe a computerized method to automatically find and label the cortical surface in three-dimensional (3-D) magnetic resonance (MR) brain images. The approach the authors take is to model a prelabeled brain atlas as a physical object and give it elastic properties, allowing it to warp itself onto regions in a preprocessed image. Preprocessing consists of boundary-finding and a morphological procedure which automatically extracts the brain and sulci from an MR image and provides a smoothed representation of the brain surface to which the deformable model can rapidly converge. The authors' deformable models are energy-minimizing elastic surfaces that can accurately locate image features. The models are parameterized with 3-D bicubic B-spline surfaces. The authors design the energy function such that cortical fissure (sulci) points on the model are attracted to fissure points on the image and the remaining model points are attracted to the brain surface. A conjugate gradient method minimizes the energy function, allowing the model to automatically converge to the smoothed brain surface. Finally, labels are propagated from the deformed atlas onto the high-resolution brain surface     

The information content of MR images

The theoretical information content, defined by C.E. Shannon (1948), is proposed as an objective measure of MR (magnetic resonance) image quality. This measure takes into account the contrast-to-noise ratio (CNR), scan resolution, and field of view. It is used to derive an optimum in the tradeoff problem between image resolution and CNR, and as a criterion to assess the usefulness of high-resolution (512(2)) MR images. The result tells that for a given total acquisition time, an optimum value of the resolution can be found. This optimum is very broad. To apply Shannon's theory on information constant to MR images, a model for the spatial spectral power density of these images is required. Such a model has been derived from experimental observations of ordinary MR images, as well as from theoretical considerations.