Biomedical subjects

Massimo Mischi

Publications and source records attributed to Massimo Mischi.

5 recordsLinked to original sources

PubMed2006

An improved adaptive power line interference canceller for electrocardiography.

Power line interference may severely corrupt a biomedical recording. Notch filters and adaptive cancellers have been suggested to suppress this interference. We propose an improved adaptive canceller for the reduction of the fundamental power line interference component and harmonics in electrocardiogram (ECG) recordings. The method tracks. the amplitude, phase, and frequency of all the interference components for power line frequency deviations up to about 4 Hz. A comparison is made between the performance of our method, former adaptive cancellers, and a narrow and a wide notch filter in suppressing the fundamental power line interference component. For this purpose a real ECG signal is corrupted by an artificial power line interference signal. The cleaned signal after applying all methods is compared with the original ECG signal. Our improved adaptive canceller shows a signal-to-power-line-interference ratio for the fundamental component up to 30 dB higher than that produced by the other methods. Moreover, our method is also effective for the suppression of the harmonics of the power line interference.

Algorithms↗

PubMed2006

Quantification in echocardiography.

Until recently, more than 2200 Swan Ganz catheters were used annually in the operating rooms (OR) and intensive care unit (ICU) of the Catharina Hospital in Eindhoven, The Netherlands. After cardiologists who were specialists in echocardiography (ECHO) trained anesthesiologists in ECHO, the need for these catheters in cardiac and noncardiac surgery was reduced. Initially intended as a local teaching project, an ECHO teaching compact disk (CD) was produced during the training and distributed later worldwide, thanks to a positive review in a major anesthesiology publication. By reducing the number of Swan Ganz catheters, the hospital could finance and acquire two echocardiography machines for the OR and ICU. The availability of these machines resulted in a further reduction of the number of Swan Ganz catheters. However, the need for quantification (eg, measurements of cardiac output) remained. During the creation of the ECHO teaching CD, the idea was born to apply indicator-dilution principles on injected echo contrast. This study was performed in cooperation with the Signal Processing Department of the Eindhoven University of Technology. Advanced signal processing and modelling were used to develop algorithms to enable quantification of intrapulmonary blood volume, ejection-fraction, and flow from the transesophageal echocardiography approach. These quantitative measurements, which can be performed on an outpatient basis, may become a real asset in cardiology, anesthesiology, and intensive care.

Algorithms↗

PubMed2005

Cardiac image segmentation for contrast agent videodensitometry.

Indicator dilution techniques are widely used in the intensive care unit and operating room for cardiac parameter measurements. However, the invasiveness of current techniques represents a limitation for their clinical use. The development of stable ultrasound contrast agents allows new applications of the indicator dilution method. Ultrasound contrast agent dilutions permit an echographic noninvasive measurement of cardiac output, ejection fraction, and blood volumes. The indicator dilution curves are measured by videodensitometry of specific regions of interest and processed for the cardiac parameter assessment. Therefore, the major indicator dilution imaging issue is the detection of proper contrast videodensitometry regions that maximize the signal-to-noise ratio of the measured indicator dilution curves. This paper presents an automatic contour detection algorithm for indicator dilution videodensitometry. The algorithm consists of a radial filter combined with an outlier correction. It maximizes the region of interest by excluding cardiac structures that act as interference to the videodensitometric analysis. It is fast, projection independent, and allows the simultaneous detection of multiple contours in real time. The system is compared to manual contour definition on both echographic and magnetic resonance images.

Algorithms↗

PubMed2005

Identification of ultrasound contrast agent dilution systems for ejection fraction measurements.

Left ventricular ejection fraction is an important cardiac-efficiency measure. Standard estimations are based on geometric analysis and modeling; they require time and experienced cardiologists. Alternative methods make use of indicator dilutions, but they are invasive due to the need for catheterization. This study presents a new minimally invasive indicator dilution technique for ejection fraction quantification. It is based on a peripheral injection of an ultrasound contrast agent bolus. Left atrium and left ventricle acoustic intensities are recorded versus time by transthoracic echocardiography. The measured curves are corrected for attenuation distortion and processed by an adaptive Wiener deconvolution algorithm for the estimation of the left ventricle impulse response, which is interpolated by a monocompartment exponential model for the ejection fraction assessment. This technique measures forward ejection fraction, which excludes regurgitant volumes. The feasibility of the method was tested on a group of 20 patients with left ventricular ejection fractions going from 10% to 70%. The results are promising and show a 0.93 correlation coefficient with echographic bi-plane ejection fraction measurements. A more extensive validation as well as an investigation on the method applicability for valve insufficiency and right ventricular ejection fraction quantification will be an object of future study.

Algorithms↗

PubMed2004

Contrast echocardiography for pulmonary blood volume quantification.

Pulmonary blood volume quantification is important both for diagnosis and for monitoring of the circulatory system. It requires employment of transpulmonary indicator dilution techniques, which are very invasive due to the need for double catheterization. This paper presents a new minimally invasive technique for blood volume quantification. An ultrasound contrast agent bolus is injected peripherally and detected by an ultrasound transducer in the central circulation. Several echocardiographic views permit simultaneous detection of contrast in different cardiac cavities and central vessels, and acoustic backscatter measurements produce multiple indicator dilution curves (IDCs). Contrast mean-transit-time differences are derived from the IDC analysis and multiplied times cardiac output for the assessment of blood volumes between different detection sites. For pulmonary blood volume estimates, the right ventricle and the left atrium IDCs are measured. The mean transit time of the IDC is estimated by specific modelling. The Local Density Random Walk and the First Passage Time models were tested for IDC interpolation and interpretation. The system was validated in vitro for a wide range of flows. The results show very accurate volume measurements. The volume estimate determination coefficient is greater than 0.999 for both model fits. A preliminary study in patients shows promising results.

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