PubMed Health⌕ Search

Biomedical subjects

Stephen Aylward

Publications and source records attributed to Stephen Aylward.

6 recordsLinked to original sources

Teaching medical image analysis with the Insight Toolkit.

We present several case studies which examine the role that the Insight Toolkit (ITK) played in three medical image analysis courses and several conference tutorials. These courses represent the first use of ITK in a teaching environment, and we believe that a discussion of the teaching approach in each case and the benefits and challenges of ITK will be useful to future medical image analysis course development. ITK was found to provide significant value in a classroom setting since it provides both working "canned" algorithms, including some recently developed methods that are unavailable elsewhere, as well as a framework for developing new techniques and applications. Several areas of difficulty, particularly in regards to code complexity and advanced object-oriented design techniques, have been identified which may make the learning curve of ITK somewhat more complex than a language such as Matlab.

Algorithms↗

Vessel tortuosity and brain tumor malignancy: a blinded study.

RATIONALE AND OBJECTIVES: Malignancy provokes regional changes to vessel shape. Characteristic vessel tortuosity abnormalities appear early during tumor development, affect initially healthy vessels, spread beyond the confines of tumor margins, and do not simply mirror tissue perfusion. The ability to detect and quantify tortuosity abnormalities on high-resolution magnetic resonance angiography (MRA) images offers a new approach to the noninvasive diagnosis of malignancy. This report evaluates a computerized, statistical method of analyzing the shapes of vessels extracted from MRA in diagnosing cancer. MATERIALS AND METHODS: The regional vasculature of 34 healthy subjects was compared with the tumor-associated vasculature of 30 brain tumors before surgical resection. The operator performing the analysis was blinded to the diagnosis. Vessels were segmented from an MRA of each subject, a region of interest was defined in each tumor patient and was mapped to all healthy controls, and a statistical analysis of vessel shape measures was then performed over the region of interest. Many difficult cases were included, such as pinpoint, hemorrhagic, and irradiated tumors, as were hypervascular benign tumors. Tumors were identified as benign or malignant on the basis of histological evaluation. RESULTS: A discriminant analysis performed at the study's conclusion successfully classified all but one of the 30 tumors as benign or malignant on the basis of vessel tortuosity. CONCLUSIONS: Quantitative, statistical measures of vessel shape offer a new approach to the diagnosis and staging of disease. Although the methods developed under the current report must be tested against a new series of cases, initial results are promising.

Adult↗

Analyzing attributes of vessel populations.

Almost all diseases affect blood vessel attributes (vessel number, radius, tortuosity, and branching pattern). Quantitative measurement of vessel attributes over relevant vessel populations could thus provide an important means of diagnosing and staging disease. Unfortunately, little is known about the statistical properties of vessel attributes. In particular, it is unclear whether vessel attributes fit a Gaussian distribution, how dependent these values are upon anatomical location, and how best to represent the attribute values of the multiple vessels comprising a population of interest in a single patient. The purpose of this report is to explore the distributions of several vessel attributes over vessel populations located in different parts of the head. In 13 healthy subjects, we extract vessels from MRA data, define vessel trees comprising the anterior cerebral, right and left middle cerebral, and posterior cerebral circulations, and, for each of these four populations, analyze the vessel number, average radius, branching frequency, and tortuosity. For the parameters analyzed, we conclude that statistical methods employing summary measures for each attribute within each region of interest for each patient are preferable to methods that deal with individual vessels, that the distributions of the summary measures are indeed Gaussian, and that attribute values may differ by anatomical location. These results should be useful in designing studies that compare patients with suspected disease to a database of healthy subjects and are relevant to groups interested in atlas formation and in the statistics of tubular objects.

Cerebral Arteries↗

Extracting branching tubular object geometry via cores.

Blood vessels and other anatomic objects in the human body can be described as trees of branching tubes. The focus of this paper is the extraction of the branching geometry in three-dimensional, as well as the extraction of the tubes themselves, via skeletons computed as cores. Cores are height ridges of a graded measure of medial strength called medialness, which measures how much a given location resembles the middle of an object as indicated by image intensities. Object bifurcations are detected using an affine-invariant corner detector and computations on the core's medialness values. The methods presented in this paper are evaluated on synthetic images of branching tubular objects as well as on blood vessels in head MR angiogram data. Results show impressive resistance to noise and the ability to detect branches spanning a variety of widths and branching angles. An extension that allows cores to extract general branching structures, not only branching tubes, is introduced.

Cerebrovascular Circulation↗

Abnormal vessel tortuosity as a marker of treatment response of malignant gliomas: preliminary report.

Despite multiple advances in medical imaging, noninvasive monitoring of therapeutic efficacy for malignant gliomas remains problematic. An underutilized observation is that malignancy induces characteristic abnormalities of vessel shape. These characteristic shape abnormalities affect both capillaries and much larger vessels in the tumor vicinity, involve larger vessels prior to sprout formation, and are generally not present in hypervascular benign tumors. Vessel shape abnormalities associated with malignancy thus may appear independently of increase in vessel density. We hypothesize that an automated, computerized analysis of vessel shape as defined from high-resolution MRA can provide valuable information about tumor activity during the treatment of malignant gliomas. This report describes vessel shape properties in 10 malignant gliomas prior to treatment, in 2 patients in remission during treatment, and in 2 patients with recurrent disease. One subject was scanned multiple times. The method involves an automated, statistical analysis of vessel shape within a region of interest for each tumor, normalized by the values obtained from the vessels within the same region of interest of 34 healthy subjects. Results indicate that untreated tumors display statistically significant vessel tortuosity abnormalities. These abnormalities involve vessels not only within the tumor margins as defined from MR but also vessels in the surrounding tissue. The abnormalities resolve during effective treatment and recur with tumor recurrence. We conclude that vessel shape analysis could provide an important means of assessing tumor activity.

Cerebrovascular Circulation↗

Engineering and algorithm design for an image processing Api: a technical report on ITK--the Insight Toolkit.

We present the detailed planning and execution of the Insight Toolkit (ITK), an application programmers interface (API) for the segmentation and registration of medical image data. This public resource has been developed through the NLM Visible Human Project, and is in beta test as an open-source software offering under cost-free licensing. The toolkit concentrates on 3D medical data segmentation and registration algorithms, multimodal and multiresolution capabilities, and portable platform independent support for Windows, Linux/Unix systems. This toolkit was built using current practices in software engineering. Specifically, we embraced the concept of generic programming during the development of these tools, working extensively with C++ templates and the freedom and flexibility they allow. Software development tools for distributed consortium-based code development have been created and are also publicly available. We discuss our assumptions, design decisions, and some lessons learned.

Algorithms↗