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Biomedical subjects

N Ayache

Publications and source records attributed to N Ayache.

16 recordsLinked to original sources
PubMed2001

Fully automatic anatomical, pathological, and functional segmentation from CT scans for hepatic surgery.

OBJECTIVE: To improve the planning of hepatic surgery, we have developed a fully automatic anatomical, pathological, and functional segmentation of the liver derived from a spiral CT scan. MATERIALS AND METHODS: From a 2 mm-thick enhanced spiral CT scan, the first stage automatically delineates skin, bones, lungs, kidneys, and spleen by combining the use of thresholding, mathematical morphology, and distance maps. Next, a reference 3D model is immersed in the image and automatically deformed to the liver contours. Then an automatic Gaussian fitting on the imaging histogram estimates the intensities of parenchyma, vessels, and lesions. This first result is next improved through an original topological and geometrical analysis, providing an automatic delineation of lesions and veins. Finally, a topological and geometrical analysis based on medical knowledge provides hepatic functional information that is invisible in medical imaging: portal vein labeling and hepatic anatomical segmentation according to the Couinaud classification. RESULTS: Clinical validation performed on more than 30 patients shows that delineation of anatomical structures by this method is often more sensitive and more specific than manual delineation by a radiologist. CONCLUSION: This study describes the methodology used to create the automatic segmentation of the liver with delineation of important anatomical, pathological, and functional structures from a routine CT scan. Using the methods proposed in this study, we have confirmed the accuracy and utility of the creation of a 3D liver model compared with the conventional reading of the CT scan by a radiologist. This work may allow improved preoperative planning of hepatic surgery by more precisely delineating liver pathology and its relationship to normal hepatic structures. In the future, this data may be integrated with computer-assisted surgery and thus represents a first step towards the development of an augmented-reality surgical system.

Humans↗
PubMed2001

Three-dimensional multimodal brain warping using the demons algorithm and adaptive intensity corrections.

This paper presents an original method for three-dimensional elastic registration of multimodal images. We propose to make use of a scheme that iterates between correcting for intensity differences between images and performing standard monomodal registration. The core of our contribution resides in providing a method that finds the transformation that maps the intensities of one image to those of another. It makes the assumption that there are at most two functional dependencies between the intensities of structures present in the images to register, and relies on robust estimation techniques to evaluate these functions. We provide results showing successful registration between several imaging modalities involving segmentations, T1 magnetic resonance (MR), T2 MR, proton density (PD) MR and computed tomography (CT). We also argue that our intensity modeling may be more appropriate than mutual information (MI) in the context of evaluating high-dimensional deformations, as it puts more constraints on the parameters to be estimated and, thus, permits a better search of the parameter space.

Algorithms↗
PubMed2001

Rigid registration of 3-D ultrasound with MR images: a new approach combining intensity and gradient information.

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.

Algorithms↗
PubMed2000

An automatic virtual patient reconstruction from CT-scans for hepatic surgical planning.

UNLABELLED: PROBLEM/BACKGROUND: In order to help hepatic surgical planning we perfected automatic 3D reconstruction of patients from conventional CT-scan, and interactive visualization and virtual resection tools. TOOLS AND METHODS: From a conventional abdominal CT-scan, we have developed several methods allowing the automatic 3D reconstruction of skin, bones, kidneys, lung, liver, hepatic lesions, and vessels. These methods are based on deformable modeling or thresholding algorithms followed by the application of mathematical morphological operators. From these anatomical and pathological models, we have developed a new framework for translating anatomical knowledge into geometrical and topological constraints. More precisely, our approach allows to automatically delineate the hepatic and portal veins but also to label the portal vein and finally to build an anatomical segmentation of the liver based on Couinaud definition which is currently used by surgeons all over the world. Finally, we have developed a user friendly interface for the 3D visualization of anatomical and pathological structures, the accurate evaluation of volumes and distances and for the virtual hepatic resection along a user-defined cutting plane. RESULTS: A validation study on a 30 patients database gives 2 mm of precision for liver delineation and less than 1 mm for all other anatomical and pathological structures delineation. An in vivo validation performed during surgery also showed that anatomical segmentation is more precise than the delineation performed by a surgeon based on external landmarks. This surgery planning system has been routinely used by our medical partner, and this has resulted in an improvement of the planning and performance of hepatic surgery procedures. CONCLUSION: We have developed new tools for hepatic surgical planning allowing a better surgery through an automatic delineation and visualization of anatomical and pathological structures. These tools represent a first step towards the development of an augmented reality system combined with computer assisted tele-robotical surgery.

Computer Graphics↗
PubMed1999

Efficient linear elastic models of soft tissues for real-time surgery simulation.

In this paper, we describe the basic components of a surgery simulator prototype developed at INRIA. We present two physical models which are well suited for surgery simulation. These models are based on linear elasticity theory and finite elements modeling. The former model can deforme large tetrahedral meshes in real-time but does not allow any topological changes. On the contrary, the latter biomechanical model can simulate the cutting and tearing of soft tissue but must have a limited number of vertices to run in real-time. We propose a method for combining these two approaches into a hybrid model which may allow real time deformations and cuttings of large enough anatomical structures.

Biomechanical Phenomena↗
PubMed1998

[A new concept in surgery of the digestive tract: surgical procedure assisted by computer, from virtual reality to telemanipulation].

Surgical simulation increasingly appears to be an essential aspect of tomorrow's surgery. The development of a hepatic surgery simulator is an advanced concept calling for a new writing system which will transform the medical world: virtual reality. Virtual reality extends the perception of our five senses by representing more than the real state of things by the means of computer sciences and robotics. It consists of three concepts: immersion, navigation and interaction. Three reasons have led us to develop this simulator: the first is to provide the surgeon with a comprehensive visualisation of the organ. The second reasons is to allow for planning and surgical simulation that could be compared with the detailed flight-plan for a commercial jet pilot. The third lies in the fact that virtual reality is an integrated part of the concept of computer assisted surgical procedure. The project consists of a sophisticated simulator which must include five requirements: a) visual fidelity, b) interactivity, c) physical properties, d) physiological properties, e) sensory input and output. In this report we describe how to obtain a realistic 3D model of the liver from bi-dimensional 2D medical images for anatomical and surgical training. The introduction of a tumor and the consequent planning and virtual resection is also described, as are force feedback and real-time interaction.

Anatomy, Cross-Sectional↗
PubMed1998

A scheme for automatically building three-dimensional morphometric anatomical atlases: application to a skull atlas.

We present a general scheme for automatically building a morphometric anatomical atlas. We detail each stage of the method, including the non-rigid registration algorithm, three-dimensional line averaging and statistical processes. We apply the method to obtain a quantitative atlas of skull crest lines. Finally, we use the resulting atlas to study a craniofacial disease; we show how we can obtain qualitative and quantitative results by contrasting a skull affected by a mandible deformation with the atlas.

Algorithms↗
PubMed1998

Definition of a four-dimensional continuous planispheric transformation for the tracking and the analysis of left-ventricle motion.

Cardiologists assume that analysis of the motion of the heart (especially the left ventricle) can provide useful information about the health of the myocardium. A 4-D polar transformation is defined to describe the left-ventricle (LV) motion and a method is presented to estimate it from sequences of 3-D images. The transformation is defined in 3-D planispheric coordinates (3PC) by a small number of parameters involved in a set of simple linear equations. It is continuous and regular in time and space, and periodicity in time can be imposed. The local motion can be easily decomposed into a few canonical motions (radial motion, rotation around the long-axis, elevation). To recover the motion from original data, the 4-D polar transformation is calculated using an adaptation of the iterative closest-point algorithm. We present the mathematical framework and a demonstration of its feasability on a series of gated SPECT sequences.

Humans↗
PubMed1998

A geometric algorithm to find small but highly similar 3D substructures in proteins.

MOTIVATION: Most biological actions of proteins depend on some typical parts of their three-dimensional structure, called 3D motifs. It is desirable to find automatically common geometric substructures between proteins to discover similarities in new structures or to model precisely a particular motif. Most algorithms for structural comparison of proteins deal with large (fold) similarities. Here, we focus on small but precise similarities. RESULTS: We propose a new 3D substructure matching algorithm based on geometric hashing techniques. The key feature of the method is the introduction of a 3D reference frame attached to each residue. This allows us to reduce drastically the complexity of the recognition. Our experimental results confirm the validity of the approach and allow us to find smaller similarities than previous methods. AVAILABILITY: The program uses commercial libraries and thus cannot be completely freely distributed. It can be found at ftp://www.inria.fr in the directory epidaure/Outgoing/xpennec/Prospect, but it requires a key to be run, available by request to xavier.pennec@sophia.inria.fr CONTACT: Xavier.Pennec@sophia.inria.fr; Nicholas.Ayache@sophia.inria.fr

Algorithms↗
PubMed1998

Virtual reality applied to hepatic surgery simulation: the next revolution.

OBJECTIVE: This article describes a preliminary work on virtual reality applied to liver surgery and discusses the repercussions of assisted surgical strategy and surgical simulation on tomorrow's surgery. SUMMARY BACKGROUND DATA: Liver surgery is considered difficult because of the complexity and variability of the organ. Common generic tools for presurgical medical image visualization do not fulfill the requirements for the liver, restricting comprehension of a patient's specific liver anatomy. METHODS: Using data from the National Library of Medicine, a realistic three-dimensional image was created, including the envelope and the four internal arborescences. A computer interface was developed to manipulate the organ and to define surgical resection planes according to internal anatomy. The first step of surgical simulation was implemented, providing the organ with real-time deformation computation. RESULTS: The three-dimensional anatomy of the liver could be clearly visualized. The virtual organ could be manipulated and a resection defined depending on the anatomic relations between the arborescences, the tumor, and the external envelope. The resulting parts could also be visualized and manipulated. The simulation allowed the deformation of a liver model in real time by means of a realistic laparoscopic tool. CONCLUSIONS: Three-dimensional visualization of the organ in relation to the pathology is of great help to appreciate the complex anatomy of the liver. Using virtual reality concepts (navigation, interaction, and immersion), surgical planning, training, and teaching for this complex surgical procedure may be possible. The ability to practice a given gesture repeatedly will revolutionize surgical training, and the combination of surgical planning and simulation will improve the efficiency of intervention, leading to optimal care delivery.

Computer Simulation↗
PubMed1997

X-ray angiography in stereotactic conditions: techniques and interest for interventional neuroradiology.

This paper reports work in progress on X-ray angiography acquired under stereotactic conditions. The objective is to be able to match multimodality images (typically MRI and X-ray) without a stereotactic frame but with stereotactic precision. We have identified potential problems and have studied them in detail. We conclude that, although the overall application is feasible, much work remains to be done on the estimation of the X-ray system conic projection and on automatic matching based on vascular structures.

Angiography, Digital Subtraction↗
PubMed1997

Open synovectomy for the prevention of recurrent hemarthrosis of the ankle in patients with hemophilia. A report of five cases with magnetic resonance imaging documentation.

Hemophilic arthropathy is an incapacitating complication of severe hemophilia resulting from recurrent bleeding in the same joint. Open synovectomy has been used since 1969 to prevent recurrent hemarthrosis of target joints. Between 1988 and 1993 we performed open synovectomy of the ankle in five hemophiliacs aged 6 to 9 years with early-stage hemophilic arthropathy. Magnetic resonance imaging proved very useful for evaluating the severity of joint damage, usually underestimated on plain radiographs; for determining the degree of synovial membrane hypertrophy, which is a critical factor in the decision to perform synovectomy; for planning the surgical procedure and for explaining treatment failures. A decrease in the frequency of hemarthrosis episodes occurred in all five ankles. A repeat synovectomy was needed in one case and in another patient the frequency of hemarthrosis episodes increased somewhat after the fourth year. There was no loss of range of motion. Our data suggest that open synovectomy is effective and safe for reducing the frequency of hemarthrosis and that magnetic resonance imaging should be routinely performed before the procedure.

Ankle↗
PubMed1997

[A new concept in digestive surgery: the computer assisted surgical procedure, from virtual reality to telemanipulation].

Surgical simulation increasingly appears to be an essential aspect of tomorrow's surgery. The development of a hepatic surgery simulator is an advanced concept calling for a new writing system which will transform the medical world: virtual reality. Virtual reality extends the perception of our five senses by representing more than the real state of things by the means of computer sciences and robotics. It consists of three concepts: immersion, navigation and interaction. Three reasons have led us to develop this simulator: the first is to provide the surgeon with a comprehensive visualisation of the organ. The second reason is to allow for planning and surgical simulation that could be compared with the detailed flight-plan for a commercial jet pilot. The third lies in the fact that virtual reality is an integrated part of the concept of computer assisted surgical procedure. The project consists of a sophisticated simulator which has to include five requirements: visual fidelity, interactivity, physical properties, physiological properties, sensory input and output. In this report we will describe how to get a realistic 3D model of the liver from bi-dimensional 2D medical images for anatomical and surgical training. The introduction of a tumor and the consequent planning and virtual resection is also described, as are force feedback and real-time interaction.

Computer Simulation↗
PubMed1996

Tracking and motion analysis of the left ventricle with deformable superquadrics.

We present a new approach to analyse the deformation of the left ventricle of the heart based on a parametric model that gives a compact representation of a set of points in a 3-D image. We present a strategy for tracking surfaces in a sequence of 3-D cardiac images. Following tracking, we then infer quantitative parameters which characterize: left ventricle motion, volume of left ventricle, ejection fraction, amplitude and twist component of cardiac motion. We explain the computation of these parameters using our model. Experimental results are shown in time sequences of two modalities of medical images, nuclear medicine and X-ray computed tomography (CT). Video sequences presenting these results are on the CD-ROM.

Computer Simulation↗
PubMed1996

Geometric and physical representations for a simulator of hepatic surgery.

Despite the large interest in simulators of minimally invasive surgery, it is still unclear to what extent simulators can achieve the task of training medical students in surgical procedures. The answer to that question is certainly linked to the realism of displays and force-feedback systems and to the level of interaction provided by the computer system. In this paper, we describe the virtual environment for anatomical and surgical training on the liver, currently under construction at INRIA. We specifically address the problems of geometric representation and physical modeling and their impact on the two aforementioned problems: realism and real-time interaction.

Computer Simulation↗