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Purpose: Fusing preoperative and intra-operative information into a single space aims at taking advantage of two complementary modalities and necessitates a step of registration that must provide good alignment and relevant correspondences. This paper addresses both purposes in the case of 3D/2D vessel tree matching., Method: We propose a registration algorithm endorsing this vascular tree nature by providing a pairing procedure that preserves the tree topology and by integrating this pairing into an iterative algorithm maintaining pairing coherence. In addition, we define two complementary error measures quantifying the resulting alignment error and pairing error, and both are based on manual ground-truth that is independent of the type of transformation to retrieve., Results: Experiments were conducted on a database of 63 clinical cases, evaluating robustness and accuracy of our approach with respect to the iterative closest point algorithm., Conclusion: The proposed method exhibits good results in terms of both pairing and alignment as well as low sensitivity to rotations to be compensated (up to 30°).

Respiratory motion can blur the tomographic reconstruction of positron emission tomography or single-photon emission computed tomography (SPECT) images, which subsequently impair quantitative measurements, e.g. in the upper abdomen area. Respiratory signal phase-based gated reconstruction addresses this problem, but deteriorates the signal-to-noise ratio (SNR) and other intensity-based quality measures. This paper proposes a 3D reconstruction method dedicated to micro-SPECT imaging of mice. From a 4D acquisition, the phase images exhibiting motion are identified and the associated list-mode data are discarded, which enables the reconstruction of a 3D image without respiratory artefacts. The proposed method allows a motion-free reconstruction exhibiting both satisfactory count statistics and accuracy of measures. With respect to standard 3D reconstruction (non-gated 3D reconstruction) without breathing motion correction, an increase of 14.6% of the mean standardized uptake value has been observed, while, with respect to a gated 4D reconstruction, up to 60% less noise and an increase of up to 124% of the SNR have been demonstrated.

Treatment coronary arteries endovascular involves catheter navigation through patient vasculature. The projective angiography guidance is limited in the case of chronic total occlusion where occluded vessel can not be seen. Integrating standard preoperative CT angiography information with live fluoroscopic images addresses this limitation but requires alignment of both modalities. This article proposes a structure-based registration method that intrinsically preserves both the geometrical and topological coherencies of the vascular centrelines to be registered, by the means of a dedicated curve-to-curve distance pairs of closest curves are identified, while pairing their points. Preliminary experiments demonstrate that the proposed approach performs better than the standard Iterative Closest Point method giving a wider attraction basin and improved accuracy.

Radiotherapy planning requires accurate delineations of the critical structures. To avoid manual contouring, atlas-based segmentation can be used to get automatic delineations. However, the results strongly depend on the chosen atlas, especially for the head and neck region where the anatomical variability is high. To address this problem, atlases adapted to the patient's anatomy may allow for a better registration, and already showed an improvement in segmentation accuracy. However, building such atlases requires the definition of a criterion to select among a database the images that are the most similar to the patient. Moreover, the inter-expert variability of manual contouring may be high, and therefore bias the segmentation if selecting only one image for each region. To tackle these issues, we present an original method to design a piecewise most similar atlas. Given a query image, we propose an efficient criterion to select for each anatomical region the K most similar images among a database by considering local volume variations possibly induced by the tumor. Then, we present a new approach to combine the K images selected for each region into a piecewise most similar template. Our results obtained with 105 CT images of the head and neck show that our method reduces the over-segmentation seen with an average atlas while being robust to inter-expert manual segmentation variability.

Object: The localization of any given target in the brain has become a challenging issue because of the increased use of deep brain stimulation to treat Parkinson disease, dystonia, and nonmotor diseases (for example, Tourette syndrome, obsessive compulsive disorders, and depression). The aim of this study was to develop an automated method of adapting an atlas of the human basal ganglia to the brains of individual patients., Methods: Magnetic resonance images of the brain specimen were obtained before extraction from the skull and histological processing. Adaptation of the atlas to individual patient anatomy was performed by reshaping the atlas MR images to the images obtained in the individual patient using a hierarchical registration applied to a region of interest centered on the basal ganglia, and then applying the reshaping matrix to the atlas surfaces., Results: Results were evaluated by direct visual inspection of the structures visible on MR images and atlas anatomy, by comparison with electrophysiological intraoperative data, and with previous atlas studies in patients with Parkinson disease. The method was both robust and accurate, never failing to provide an anatomically reliable atlas to patient registration. The registration obtained did not exceed a 1-mm mismatch with the electrophysiological signatures in the region of the subthalamic nucleus., Conclusions: This registration method applied to the basal ganglia atlas forms a powerful and reliable method for determining deep brain stimulation targets within the basal ganglia of individual patients.

Conformal radiotherapy planning needs accurate delineations of the critical structures. Atlas-based segmentation has been shown to be very efficient to delineate brain structures. It would therefore be very interesting to develop an atlas for the head and neck region where 7% of the cancers arise. However, the construction of an atlas in this region is very difficult due to the high variability of the anatomies. This can generate segmentation errors and over-segmented structures in the atlas. To overcome this drawback, we present an alternative method to build a template locally adapted to the patient's anatomy. This is done first by selecting in a database the images that are the most similar to the patient on predefined regions of interest, using on a distance between transformations. The first major contribution is that we do not compute every patient-to-image registration to find the most similar image, but only the registration of the patient towards an average image. This method is therefore computationally very efficient. The second major contribution is a novel method to use the selected images and the predefined regions to build a "Frankenstein's creature" for segmentation. We present a qualitative and quantitative comparison between the proposed method and a classical atlas-based segmentation method. This evaluation is performed on a subset of 58 patients among a database of 105 head and neck CT images and shows a great improvement of the specificity of the results.

This paper describes the construction of an atlas of the human basal ganglia. The successive steps of the construction were as follows. First a postmortem specimen was subjected to a MRI acquisition prior to extraction of the brain from the skull. The brain was then cryosectioned (70 microm thickness). One section out of ten (80 sections) was Nissl-stained with cresyl violet, another series of 80 sections was immunostained for the calcium binding protein calbindin. Contours of basal ganglia nuclei including their calbindin-stained functional subdivisions, fiber bundles and ventricles (n=80 structures) were traced from histological sections and digitized. A novelty of this atlas is the MRI acquisition, which represents the core data element of the study. MRI was used for the coregistration of the atlas data and permitted, through multimodal (Nissl, calbindin, images of cryosectioning, T1 and T2 MRI) and 3D optimization, the production of anatomically and geometrically consistent 3D surfaces, which can be sliced through any desired orientation. The atlas MRI is also used for its deformation to provide accurate conformation to the MRI of living patients, thus adding information at the histological level to the patient's MRI volume. This latter aspect will be presented in a forthcoming paper.

The study of cerebral microvascular networks requires high-resolution images. However, to obtain statistically relevant results, a large area of the brain (several square millimeters) must be analyzed. This leads us to consider huge images, too large to be loaded and processed at once in the memory of a standard computer. To consider a large area, a compact representation of the vessels is required. The medial axis is the preferred tool for this application. To extract it, a dedicated skeletonization algorithm is proposed. Numerous approaches already exist which focus on computational efficiency. However, they all implicitly assume that the image can be completely processed in the computer memory, which is not realistic with the large images considered here. We present in this paper a skeletonization algorithm that processes data locally (in subimages) while preserving global properties (i.e., homotopy). We then show some results obtained on a mosaic of three-dimensional images acquired by confocal microscopy.

This manuscript tackles the reconstruction of 3-D volumes via mono-modal registration of series of 2-D biological images (histological sections, autoradiographs, cryosections, etc.). The process of acquiring these images typically induces composite transformations that we model as a number of rigid or affine local transformations embedded in an elastic one. We propose a registration approach closely derived from this model. Given a pair of input images, we first compute a dense similarity field between them with a block matching algorithm. We use as a similarity measure an extension of the classical correlation coefficient that improves the consistency of the field. A hierarchical clustering algorithm then automatically partitions the field into a number of classes from which we extract independent pairs of sub-images. Our clustering algorithm relies on the Earth mover's distribution metric and is additionally guided by robust least-square estimation of the transformations associated with each cluster. Finally, the pairs of sub-images are, independently, affinely registered and a hybrid affine/non-linear interpolation scheme is used to compose the output registered image. We investigate the behavior of our approach on several batches of histological data and discuss its sensitivity to parameters and noise.

Cardiovascular diseases remain the primary cause of death in developed countries. In most cases, exploration of possibly underlying coronary artery pathologies is performed using X-ray coronary angiography. Current clinical routine in coronary angiography is directly conducted in two-dimensional projection images from several static viewing angles. However, for diagnosis and treatment purposes, coronary artery reconstruction is highly suitable. The purpose of this study is to provide physicians with a three-dimensional (3-D) model of coronary arteries, e.g., for absolute 3-D measures for lesion assessment, instead of direct projective measures deduced from the images, which are highly dependent on the viewing angle. In this paper, we propose a novel method to reconstruct coronary arteries from one single rotational X-ray projection sequence. As a side result, we also obtain an estimation of the coronary artery motion. Our method consists of three main consecutive steps: 1) 3-D reconstruction of coronary artery centerlines, including respiratory motion compensation; 2) coronary artery four-dimensional motion computation; 3) 3-D tomographic reconstruction of coronary arteries, involving compensation for respiratory and cardiac motions. We present some experiments on clinical datasets, and the feasibility of a true 3-D Quantitative Coronary Analysis is demonstrated.

We propose a new model to simulate the three-dimensional (3-D) growth of glioblastomas multiforma (GBMs), the most aggressive glial tumors. The GBM speed of growth depends on the invaded tissue: faster in white than in gray matter, it is stopped by the dura or the ventricles. These different structures are introduced into the model using an atlas matching technique. The atlas includes both the segmentations of anatomical structures and diffusion information in white matter fibers. We use the finite element method (FEM) to simulate the invasion of the GBM in the brain parenchyma and its mechanical interaction with the invaded structures (mass effect). Depending on the considered tissue, the former effect is modeled with a reaction-diffusion or a Gompertz equation, while the latter is based on a linear elastic brain constitutive equation. In addition, we propose a new coupling equation taking into account the mechanical influence of the tumor cells on the invaded tissues. The tumor growth simulation is assessed by comparing the in-silico GBM growth with the real growth observed on two magnetic resonance images (MRIs) of a patient acquired with 6 mo difference. Results show the feasibility of this new conceptual approach and justifies its further evaluation.

In functional neurosurgery, there is a growing need for accurate localization of the functional targets. Since deep brain stimulation (DBS) of the Vim thalamic nucleus has been proposed for the treatment of Parkinson's disease, the target has evolved toward the globus pallidus and subthalamic nucleus (STN) and the therapeutic indications have enlarged to include psychiatric disorders such as Tourette syndrome or obsessive compulsive disorders. In these pathologies, the target has been restrained to smaller functional subterritories of the basal ganglia, requiring more refined techniques to localize smaller and smallerbrain regions, often invisible in routine clinical MRI. Different strategies have been developed to identify such deep brain targets. Direct methods can identify structures in the MRI itself, but only the larger ones. Indirect methods are based on the use of anatomical atlases. The present strategy comprised a 3D histological atlas and the MRI of the same brain specimen, and deformation methodology developped to fit the atlas toward the brain of any given patient. In this paper, this method is evaluated in the aim of being applied to further studies of anatomo-clinical correlation. The accuracy of the method is first discussed, followed by the study of short series of Parkinsonian patients treated by DBS, allowing to compare the deformed atlas with various per- and post-operative data.

In the past years, the development of 3-D medical imaging has enabled the 3-D imaging of in vivo tissues, from an anatomical (MR, CT) or even functional (fMRI, PET, SPECT) point of view. However, despite immense technological progress, the resolution of these images is still short of the level of anatomical or functional details that in vitro imaging (e.g., histology, autoradiography) permits. The motivation of this work is to compare fMRI activations to activations observed in autoradiographic images from the same animals. We aim to fuse post-mortem autoradiographic data with a pre-mortem anatomical MR image. We first reconstruct a 3-D volume from the 2-D autoradiographic sections, coherent both in geometry and intensity. Then, this volume is fused with the MR image. This way, we ensure that the reconstructed 3-D volume can be superimposed onto the MR image that represents the reference anatomy. We demonstrate that this fusion can be achieved by using only simple global transformations (rigid and/or affine, 2-D and 3-D), while yielding very satisfactory results.

In this paper, we present a new method to perform 3D tomographic reconstruction of coronary arteries from cone-beam rotational x-ray angiography acquisitions. We take advantage of the precomputation of the coronary artery motion, modelled as a parametric 4D motion field. Contrary to data gating or data triggering approaches, we homogeneously use all available frames, independently of the cardiac phase. In addition, we artificially subtract angiograms from their background structures. Our method significantly improves the reconstruction, by removing both motion and background artefacts. We have successfully tested it on the datasets from a synthetic phantom and 10 patients.

Although numerous methods to register brains of different individuals have been proposed, no work has been done, as far as we know, to evaluate and objectively compare the performances of different nonrigid (or elastic) registration methods on the same database of subjects. In this paper, we propose an evaluation framework, based on global and local measures of the relevance of the registration. We have chosen to focus more particularly on the matching of cortical areas, since intersubject registration methods are dedicated to anatomical and functional normalization, and also because other groups have shown the relevance of such registration methods for deep brain structures. Experiments were conducted using 6 methods on a database of 18 subjects. The global measures used show that the quality of the registration is directly related to the transformation's degrees of freedom. More surprisingly, local measures based on the matching of cortical sulci did not show significant differences between rigid and non rigid methods.

The recent development of 3-D medical imaging devices has given access to the 3-D imaging of in vivo tissues, from an anatomical (MR, CT) or even functional point of view (fMRI, PET, SPECT). However, the resolution of these images is still not sufficient to image anatomical or functional details, that can only be revealed by in vitro imaging (e.g. histology, autoradiography). The deep motivation of this work is the comparison of activations detected by fMRI series analysis to the ones that can be observed in autoradiographic images. The aim of the presented work is to fuse the autoradiographic data with the pre-mortem anatomical MR image, to facilitate the above-mentioned comparison. We show that this fusion can be achieved by using only simple global transformations (rigid and affine), yielding a very satisfactory result.

Recently, radiotherapy possibilities have been dramatically increased by software and hardware developments. Improvements in medical imaging devices have increased the importance of three-dimensional (3D) images as the complete examination of these data by a physician is not possible. Computer techniques are needed to present only the pertinent information for clinical applications. We describe a technique for an automatic 3D reconstruction of the eye and CT scan merging with fundus photographs (retinography). The final result is a "virtual eye" to guide ocular tumor protontherapy. First, we make specific software to automatically detect the position of the eyeball, the optical nerve, and the lens in the CT scan. We obtain a 3D eye reconstruction using this automatic method. Second, we describe the retinography and demonstrate the projection of this modality. Then we combine retinography with a reconstructed eye, using a CT scan to get a virtual eye. The result is a computer 3D scene rendering a virtual eye into a skull reconstruction. The virtual eye can be useful for the simulation, the planning, and the control of ocular tumor protontherapy. It can be adapted to treatment planning to automatically detect eye and organs at risk position. It should be highlighted that all the image processing is fully automatic to allow the reproduction of results, this is a useful property to conduct a consistent clinical validation. The automatic localization of the organ at risk in a CT scan or an MRI by automatic software could be of great interest for radiotherapy in the future for comparison of one patient at different times, the comparison of different treatments centers, the possibility of pooling results of different treatments centers, the automatic generation of doses-volumes histograms, the comparison between different treatment planning for the same patient and the comparison between different patients at the same time. It will also be less time consuming.

We present a new image-based technique to rigidly register intraoperative three-dimensional ultrasound (US) with preoperative magnetic resonance (MR) images. Automatic registration is achieved by maximization of a similarity measure which generalizes the correlation ratio, and whose novelty is to incorporate multivariate information from the MR data (intensity and gradient). In addition, the similarity measure is built upon a robust intensity-based distance measure, which makes it possible to handle a variety of US artifacts. A cross-validation study has been carried out using a number of phantom and clinical data. This indicates that the method is quite robust and that the worst registration errors are of the order of the MR image resolution.