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Biomedical subjects

R A Robb

Publications and source records attributed to R A Robb.

At least 19 recordsLinked to original sources
PubMed2006

An integrated system for real-time image guided cardiac catheter ablation.

Minimally invasive cardiac catheter ablation procedures require effective visualization of the relevant heart anatomy and electrophysiology (EP). In a typical ablation procedure, the visualization tools available to the cardiologist include bi-plane fluoroscopy, real-time ultrasound, and a coarse 3D model which gives a rough representation of cardiac anatomy and electrical activity. Recently, there has been increased interest in incorporating detailed, patient specific anatomical data into the cardiac ablation procedure. We are currently developing a prototype system which both integrates a patient specific, preoperative data model into the procedure as well as fuses the various visualization modalities (i.e. fluoroscopy, ultrasound, EP) into a single display. In this paper, we focus on two aspects of the prototype system. First, we describe the framework for integrating the various system components, including an efficient communication protocol. Second, using a simple two-chamber phantom of the heart, we demonstrate the ability to integrate preoperative data into the ablation procedure. This involves the registration and visualization of tracked catheter points within the cardiac chambers of the preoperative model.

Cardiac Catheterization↗
PubMed2005

Quantitative characterization of lung disease.

The increase in prevalence, incidence and variety of pulmonary diseases has precipitated the need for more non-invasive quantitative assessment of structure/function relationships in the lung. This need requires concise description not only of lung anatomy but also of associated underlying mechanics of pulmonary function, as well as deviation from normal in specific diseases. This can be facilitated through the use of adaptive deformable surface models of the lung at end inspiratory and expiratory volumes. Lung surface deformation may be used to represent tissue excursion, which can characterize both global and regional lung mechanics. In this paper, we report a method for robust determination and visualization of pulmonary structure and function using clinical CT scans. The method provides both intuitive 3D parametric visualization and objective quantitative assessment of lung structure and associated function, in both normal and pathological cases.

Humans↗
PubMed2004

Patient specific dynamic geometric models from sequential volumetric time series image data.

Generating patient specific dynamic models is complicated by the complexity of the motion intrinsic and extrinsic to the anatomic structures being modeled. Using a physics-based sequentially deforming algorithm, an anatomically accurate dynamic four-dimensional model can be created from a sequence of 3-D volumetric time series data sets. While such algorithms may accurately track the cyclic non-linear motion of the heart, they generally fail to accurately track extrinsic structural and non-cyclic motion. To accurately model these motions, we have modified a physics-based deformation algorithm to use a meta-surface defining the temporal and spatial maxima of the anatomic structure as the base reference surface. A mass-spring physics-based deformable model, which can expand or shrink with the local intrinsic motion, is applied to the metasurface, deforming this base reference surface to the volumetric data at each time point. As the meta-surface encompasses the temporal maxima of the structure, any extrinsic motion is inherently encoded into the base reference surface and allows the computation of the time point surfaces to be performed in parallel. The resultant 4-D model can be interactively transformed and viewed from different angles, showing the spatial and temporal motion of the anatomic structure. Using texture maps and per-vertex coloring, additional data such as physiological and/or biomechanical variables (e.g., mapping electrical activation sequences onto contracting myocardial surfaces) can be associated with the dynamic model, producing a 5-D model. For acquisition systems that may capture only limited time series data (e.g., only images at end-diastole/end-systole or inhalation/exhalation), this algorithm can provide useful interpolated surfaces between the time points. Such models help minimize the number of time points required to usefully depict the motion of anatomic structures for quantitative assessment of regional dynamics.

Algorithms↗
PubMed2001

Measurement and display of regional myocardial motion during post infarct treatment.

Quantitative assessment of 3-D regional heart motion has significant potential to provide more specific diagnosis of cardiac malfunction than currently possible. Using functional parametric mapping, regional myocardial motion during a cardiac cycle can be color-mapped onto a deformable heart model to provide better understanding of the structure-to-function relationships in the myocardium, including regional patterns of akinesis or dyskinesis associated with ischemia or infarction. In this study, 3-D reconstructions of human hearts were obtained from Electron-Beam Computed Tomography [1] (EB-CT), comparing stages of treatment after myocardial infarction.

Computer Simulation↗
PubMed2001

3D localization of implanted radioactive sources in the prostate using trans-urethral ultrasound.

Prostate cancer is the most common cancer diagnosed in men in the United States. Many techniques have been developed to diagnose and treat prostate cancer. 3D Trans-Urethral Ultrasound (TUUS) is a new technique for the diagnosis and treatment of prostate disease. This research focuses on the potential of TUUS for therapy-guidance during and after transperineal interstitial permanent prostate brachytherapy (TIPPB). Computed tomography (CT) is currently used to determine the source locations and the effective radiation dose distribution throughout the tissue after the completion of the procedure. TUUS may be a viable alternative to CT for determining source locations within the prostate. Placement of the TUUS catheter into the urethra provides excellent 2D images of the prostate. In addition, the catheter can be used to acquire 3D volumetric data for 3D analysis of the prostate, associated tissue, and radioactive sources. Initial work on source localization was conducted on an ultrasound-equivalent prostate phantom. Cylindrical dummy radiation sources with diameter of .8 mm and length of 4.5 mm were placed into the prostate phantom for assessment with TUUS. The TUUS imaging device is a 10 fr catheter with a linear array of ultrasonic crystals at one end. The ultrasound catheter operates at 10 MHz and is controlled by the Acuson Sequoia ultrasound workstation. The catheter was placed in the phantom urethra and 3D scans were acquired. A corresponding CT was acquired for comparative purposes. Segmentation of the prostate capsule was done semi-automatically. Dummy radiation seed segmentation was conducted manually. Additional processing was necessary to account for image artifact and correctly reconstruct the seeds. The prostate shell and radioactive source reconstructions provide an excellent 3D representation. Comparison to the CT data suggests that the TUUS data provided: 1) greater resolution and 2) better soft tissue differentiation. The reconstructed sources were measured and corresponded to the physical dimensions of those placed in the phantoms. The method is now being evaluated on cadavers and patients.

Brachytherapy↗
PubMed2000

Voxel significance mapping using local image variances in subtraction ictal SPET.

Subtraction ictal SPET co-registered to MRI (SISCOM) has been shown to aid epileptogenic localization and improve surgical outcome in partial epilepsy patients. This paper reports a method of identifying significant areas of epileptogenic activation in the SISCOM subtraction image, taking into account normal variation between sequential 99Tcm-ethyl cysteinate diethylester SPET scans of single individuals, and attempts to assess the clinical value of statistical mapping in subtraction SPET. Non-linear inter-subject registration is used to combine a group of subtraction images into a common anatomical framework. A map of the pixel intensity standard deviation values in the subtraction images is created, and this map is non-linearly registered to a patient's SISCOM subtraction image. Pixels in the patient subtraction image were then evaluated based upon the statistical characteristics of corresponding pixels in the atlas. SISCOM images created with the voxel variance method were rated higher in quality than the conventional image variance method in 15 patients. No difference in localization rate was observed between the voxel variance mapping and image variance methods. The voxel significance mapping method was shown to improve the quality of clinical SISCOM images.

Brain↗
PubMed2000

Subtraction ictal SPECT coregistered to MRI for seizure focus localization in partial epilepsy.

Peri-ictal single-photon emission computed tomography (SPECT) of the brain is increasingly used in localizing the seizure focus in presurgical evaluation of patients with partial epilepsy. However, traditional side-by-side visual interpretation of ictal and interictal SPECT films is hampered by differences in slice location and tracer activity. Precise correlation of the seizure focus with a high-quality image of the underlying brain anatomy can improve the physician's understanding of seizure neurophysiology and assist in surgical planning. Computer-based methods have been developed for aligning, normalizing, and subtracting digital ictal and interictal SPECT images of the patient's brain to produce a map of the blood flow changes occurring between the seizure and resting states. These maps are then aligned with a high-resolution magnetic resonance image (MRI) of the patient's brain anatomy and fused to identify anatomical regions involved in the seizure. The purpose of this article is to review the technical components and clinical implementation of subtraction ictal SPECT, as well as to discuss recent technological advances that could extend and improve the diagnostic and localizing capacity of this method.

Acute Disease↗
PubMed2000

Patient specific physics-based model for interactive visualization of cardiac dynamics.

Cardiac disorders result mainly from defects in cardiac structure or failure to generate and regulate electrical impulses. Knowledge of the structure, motion patterns, local deformation, and associated electrical activation patterns of the heart is necessary for precise diagnosis and treatment. Electrical and mechanical performance of the heart is strongly influenced by the anisotropic nature of myocardial tissue. Diffusion-encoded MR imaging provides in vivo myocardial fiber track information that can be used for precise simulation of cardiac conduction and contraction. We propose a method that incorporates such fiber track information with a physics-based deformable model to realistically simulate cardiac contraction and subsequent relaxation. The simulation aims to reproduce the myocardial deformation during the heartbeat. The system allows interactive visualization of dynamic 3-D heart structures during the cardiac cycle. In procedures such as catheter ablation, the interactive 4-D model provides updated anatomy and physiology of the patient's heart simultaneously, and can be used to guide the procedure for efficient targeting of the treatment regions.

Computer Simulation↗
PubMed2000

An axial skeleton based surface deformation algorithm for patient specific anatomic modeling.

Traditionally, finite element analysis or mass-spring systems are used to calculate deformations of geometric surfaces. Patient-specific geometric models can be comprised of tens of thousands, even hundreds of thousands of polygons, making finite element analysis and mass-spring systems computationally demanding. Simulations using deformable patient specific models at real time rates are prohibitive under such a computational burden. This paper presents a method for simulating deformable surfaces by deforming a skeletal representation of the surface, rather than the surface itself, yielding an efficient method for interactive simulation with models.

Algorithms↗
PubMed1999

3-D visualization in biomedical applications.

Visualizable objects in biology and medicine extend across a vast range of scale, from individual molecules and cells through the varieties of tissue and interstitial interfaces to complete organs, organ systems, and body parts. These objects include functional attributes of these systems, such as biophysical, biomechanical, and physiological properties. Visualization in three dimensions of such objects and their functions is now possible with the advent of high-resolution tomographic scanners and imaging systems. Medical applications include accurate anatomy and function mapping, enhanced diagnosis, accurate treatment planning and rehearsal, and education/training. Biologic applications include study and analysis of structure-to-function relationships in individual cells and organelles. The potential for revolutionary innovation in the practice of medicine and in biologic investigations lies in direct, fully immersive, real-time multisensory fusion of real and virtual information data streams into online, real-time visualizations available during actual clinical procedures or biological experiments. Current high-performance computing, advanced image processing, and high-fidelity rendering capabilities have facilitated major progress toward realization of these goals. With these advances in hand, there are several important applications of three-dimensional visualization that will have a significant impact on the practice of medicine and on biological research.

Biomedical Engineering↗
PubMed1999

Dual-isotope SPECT using simultaneous acquisition of 99mTc and 123I radioisotopes: a double-injection technique for peri-ictal functional neuroimaging.

UNLABELLED: The acquisition of multiple radiotracer studies at different time points during a neurological event permits the study of different functional activation states in humans. Peri-ictal SPECT is a promising technique for localizing the epileptogenic zone and would be enhanced by the ability to acquire sequentially coregistered ictal and postictal SPECT images of a single seizure. This study was designed to develop and validate an accurate method for the simultaneous acquisition of 99mTc and 123I SPECT images of the brain. METHODS: A multicompartment, transaxial Hoffman brain-slice phantom was filled with 99mTc, 123I or a 3:1 mixture of the two isotopes. Planar and SPECT images were acquired by a dual-head gamma camera system equipped with parallel and fanbeam collimators, respectively. Thirty-two energy windows (2 keV width) were acquired over the energy range 120-184 keV. From the planar data, the signal-to-noise characteristics and crosstalk were measured for each energy window and used to devise an energy window acquisition strategy that was then applied to the SPECT data. Three summed energy windows were created: a primary 99mTc image (130-146 keV), a primary 123I image (152-168 keV) and a secondary 99mTc crosstalk image (134-140 keV). A fraction (0.041) of the 99mTc crosstalk image was subtracted from the 123I image. No crosstalk correction was performed on the primary 99mTc image. RESULTS: (a) Planar images: results showed 1.3% crosstalk in the 123I image compared with 19.7% for a 10% asymmetric energy window alone. 123I crosstalk into the 99mTc window was 2.79% and was relatively constant with changes in the location of the 99mTc energy window. (b) Tomographic images: results showed 1.51% 99mTc crosstalk in the 123I image compared with 12.44% for the uncorrected image and 3.70% 123I crosstalk in the 99mTc image. CONCLUSION: An effective technique for the simultaneous acquisition of 99mTc and 123I radiotracer distributions in the brain has been developed and validated in a phantom model and should have clinical application in peri-ictal functional activation studies of the brain.

Brain↗
PubMed1999

Quantitative and clinical analysis of SPECT image registration for epilepsy studies.

UNLABELLED: This study reports quantitative measurements of the accuracy of two popular voxel-based registration algorithms--Woods' automated image registration algorithm and mutual information correlation--and compares these with conventional surface matching (SM) registration. METHODS: The registration algorithms were compared (15 different matches each) for (a) three-dimensional brain phantom images, (b) an ictal SPECT image from a patient with partial epilepsy matched to itself after modification to simulate changes in the cerebral blood flow pattern and (c) ictal/interictal SPECT images from 15 patients with partial epilepsy. Blinded visual ranking and localization of the subtraction images derived from the patient images were also performed. RESULTS: Both voxel-based registration methods were more accurate than SM registration (P < 0.0005). Automated image registration algorithm was more accurate than mutual information correlation for the computer-simulated ictal/interictal images and the patient ictal/interictal studies (P < 0.05). The subtraction SPECTs from SM were poorer in visual ranking more often than the voxel-based methods (P < 0.05). CONCLUSION: Voxel intensity-based registration algorithms provide significant improvement in ictal/interictal SPECT registration accuracy and result in a clinically detectable improvement in the subtraction SPECT images.

Algorithms↗
PubMed1999

Dynamic volume texture mapping and model deformation for visually realistic surgical simulation.

For computer assisted surgical simulation to be effective, objects in the simulated environment should respond to the user's actions dynamically with correct visual information. This includes dragging and cutting that cause changes in geometry, topology and appearance. Geometric object representation can be manipulated intuitively in real-time but does not preserve interior information. Volumetric data representation, on the other hand, preserves volume content but direct manipulation is compute-intensive. 3-D texture mapping provides an alternative in representing volumetric information. We present a surgical simulation system based on geometric models that allows interactive deformation and incision of objects while displaying correct volumetric information corresponding to these changes. This is accomplished by dynamic 3-D texture mapping. This method can be applied to anatomical data and patient CT and MR images to facilitate data/patient specific surgical simulations.

Algorithms↗
PubMed1999

Haptic rendering of isosurfaces directly from medical images.

Virtual environments for surgical training, planning and rehearsal have the potential to significantly enhance patient treatment and diagnosis. Haptic feedback devices provide forces to the physician through a manipulator, simulating palpation, scalpel cuts, or retraction of tissue. While haptics have been studied in other fields, medical applications of haptics remain in their infancy. We propose a method of haptically rendering isosurfaces (representing hard structures) directly from anatomical datasets rather than through traditional intermediate graphical representations such as polygons. Our algorithm determines an implicit surface representation of a volumetric isosurface on the fly, and renders the structure using standard haptic algorithms to calculate the forces felt by the user. This approach has the advantage of providing easy access to the rich volume dataset containing the actual anatomy. By relating Hounsfield units to density, haptic rendering has the ability to provide different resistances based on the tissue type being rendered. We developed and tested our algorithm using a quadric implicit surface, a common primitive in computer graphics, and have applied it to a variety of anatomical image datasets. Our paper describes the algorithm in sufficient detail to facilitate reproduction by others.

Algorithms↗
PubMed1998

Prostate cancer microvessels: a novel method for three-dimensional reconstruction and analysis.

BACKGROUND: Studies of prostate cancer microvessels to date have relied on routine two-dimensional images from histologic tissue sections, and there have been no previous reports of three-dimensional (3D) reconstruction and analysis of prostatic microvessels in benign or malignant specimens. Knowledge about the 3D architecture of microvessels would be useful for determining the utility and limitations of two-dimensional (2D) measures, as well as for determining the usefulness of 3D measures to predict pathologic stage and patient outcome in prostate cancer. However, the ability to study microvessels in 3D must first be demonstrated. METHODS: We developed a novel method to visualize and analyze prostate microvessels in three dimensions from serially-sectioned prostate specimens, including tissue preparation, reconstruction of serial histologic sections into 3D volumes, extraction of vessels from this data set, and calculation of geometric characteristics. Eleven regions of benign and cancer tissue were studied and compared in an effort to validate our methodology. RESULTS: Microvessels and glandular elements from benign and malignant tissue were visualized together in three dimensions. In the 3D visualizations, microvessels associated with cancer were seen to have more arbitrary pathways, increased tortuosity, and a more casual relationship with glandular elements than microvessels associated with benign tissue. A quantitative measure, the volume length density, discriminated between benign tissue and cancer better than simple microvessel density in this exploratory study. CONCLUSIONS: Microvessels in prostate cancer have a more homogeneous distribution and greater tortuosity than those in benign tissue. Volume length density of microvessels shows promise as a 3D marker in prostate cancer.

Adenocarcinoma↗
PubMed1998

Scalp-recorded EEG localization in MRI volume data.

Scalp-recorded EEG is a noninvasive and widely available tool for studying normal and dysfunctional human neurophysiology with unsurpassed temporal resolution. However, scalp-recorded EEG data is difficult to correlate with anatomy, and most current display and neural source estimation algorithms are based on unrealistic spherical or elliptical models of the head. It is possible to measure the positions of electrodes on the patient's scalp, and to register those electrode positions into the space of a high-resolution MRI volume, and to then use the patient-specific anatomy as the basis for display and estimation of neural sources. We use a surface matching algorithm to register digitized electrode and scalp surface coordinates to a three-dimensional MRI volume. This study uses fiducial markers in phantom and volunteer studies to quantitatively estimate the accuracy of the electrode registration method. Our electrode registration procedure is accurate to 2.21 mm for a realistic head phantom and accurate to 4.16 mm on average for five volunteers. This level of accuracy is considered within acceptable limits for clinical applications.

Algorithms↗