TY - THES A1 - Tack, Alexander T1 - Gruppenweise Registrierung zur robusten Bewegungsfeldschätzung in artefaktbehafteten 4D-CT-Bilddaten N2 - Das Ziel der Strahlentherapie ist, eine möglichst hohe Dosis in den Tumor zu applizieren und zeitgleich die Strahlenexposition des Normalgewebes zu minimieren. Insbesondere bei thorakalen und abdominalen Tumoren treten aufgrund der Atmung während der Bestrahlung große, komplexe und patientenspezifisch unterschiedliche Bewegungen der Gewebe auf. Um den Einfluss dieser Bewegung auf die i.d.R. statisch geplante Dosisverteilung abzuschätzen, können unter Verwendung der nicht-linearen Bildregistrierung anhand von 3D-CT-Aufnahmen eines Atmungszyklus - also 4D-CT-Daten - zunächst die Bewegungsfelder für die strahlentherapeutisch relevanten Strukturen, beispielsweise für die Lunge, berechnet werden. Diese Informationen bilden die Grundlage für sogenannte 4D-Dosisberechnungs- oder Dosisakkumulationsverfahren. Deren Genauigkeit hängt aber wesentlich von der Genauigkeit der Bewegungsfeldschätzung ab. Klassisch erfolgt die Berechnung der Bewegungsfelder mittels paarweiser Bildregistrierung, womit für die Berechnung des Bewegungsfeldes zwischen zwei Bildern im Allgemeinen eine sehr hohe Genauigkeit erreicht wird. Auch für CT-Bilder, die Bewegungsartefakte, wie beispielsweise doppelte oder unvollständige Strukturen, enthalten, wird unter Verwendung der paarweisen Bildregistrierung im Kontext der Registrierung eine exakte Abbildung der anatomischen Strukturen zwischen den beiden Bildern erreicht. Dabei erfolgt aber eine physiologisch unplausible Anpassung der Felder an die Artefakte. Bei Verwendung der paarweisen Bildregistrierung müssen weiterhin für einen Atemzyklus die Voxel-Trajektorien aus Bewegungsfeldern zwischen mehreren dreidimensionalen Bildern zusammengesetzt werden. Durch Bewegungsartefakte entsprechen diese Trajektorien dann teilweise keiner natürlichen Bewegung der anatomischen Strukturen. Diese Ungenauigkeit stellt in der klinischen Anwendung ein Problem dar; dies gilt umso mehr, wenn Bewegungsartefakte im Bereich eines Tumors vorliegen. Im Gegensatz zu der paarweisen Registrierung kann mit der gruppenweisen Registrierung das Problem der durch Bewegungsartefakte hervorgerufenen ungenauen Abbildung der physiologischen Gegebenheiten dadurch reduziert werden, dass im Registrierungsprozess Bildinformationen aller Bilder, also in diesem Kontext der CT-Daten zu unterschiedlichen Atemphasen, gleichzeitig genutzt werden. Es kann bereits im Registrierungsprozess eine zeitliche Glattheit der Voxel-Trajektorien gefordert werden. In dieser Arbeit wird eine Methode zur B-Spline-basierten zeitlich regularisierten gruppenweisen Registrierung entwickelt. Die Genauigkeit der entwickelten Methode wird für frei zugängliche klinische Datensätze landmarkenbasiert evaluiert. Dabei wird mit dem Target Registration Error (TRE) die durchschnittliche dreidimensionale euklidische Distanz zwischen den korrespondierenden Landmarken nach Transformation der Landmarken bezeichnet. Eine Genauigkeit in der Größenordnung von aktuellen paarweisen Registrierungen verdeutlicht die Qualität des vorgestellten Registrierungs-Algorithmus. Anschließend werden die Vorteile der gruppenweisen Registrierung durch Experimente an einem Lungenphantom und an manipulierten, artefaktbehafteten klinischen 4D-CT-Bilddaten demonstriert. Dabei werden unter Verwendung der gruppenweisen Registrierung im Vergleich zu der paarweisen Registrierung glattere Trajektorien berechnet, die der realen Bewegung der anatomischen Strukturen stärker entsprechen. Für die Patientendaten wird außerdem anhand von automatisch detektierten Landmarken der TRE ausgewertet. Der TRE verschlechterte sich für die paarweise Bildregistrierung unter Vorliegen von Bewegungsartefakten von durchschnittlich 1,30 mm auf 3,94 mm. Auch hier zeigte sich für die gruppenweise Registrierung die Robustheit gegenüber Bewegungsartefakten und der TRE verschlechterte sich nur geringfügig von 1,45 mm auf 1,71 mm. KW - Gruppenweise Registrierung KW - 4D-CT Y1 - 2015 ER - TY - CHAP A1 - Ambellan, Felix A1 - Tack, Alexander A1 - Wilson, Dave A1 - Anglin, Carolyn A1 - Lamecker, Hans A1 - Zachow, Stefan T1 - Evaluating two methods for Geometry Reconstruction from Sparse Surgical Navigation Data T2 - Proceedings of the Jahrestagung der Deutschen Gesellschaft für Computer- und Roboterassistierte Chirurgie (CURAC) N2 - In this study we investigate methods for fitting a Statistical Shape Model (SSM) to intraoperatively acquired point cloud data from a surgical navigation system. We validate the fitted models against the pre-operatively acquired Magnetic Resonance Imaging (MRI) data from the same patients. We consider a cohort of 10 patients who underwent navigated total knee arthroplasty. As part of the surgical protocol the patients’ distal femurs were partially digitized. All patients had an MRI scan two months pre-operatively. The MRI data were manually segmented and the reconstructed bone surfaces used as ground truth against which the fit was compared. Two methods were used to fit the SSM to the data, based on (1) Iterative Closest Points (ICP) and (2) Gaussian Mixture Models (GMM). For both approaches, the difference between model fit and ground truth surface averaged less than 1.7 mm and excellent correspondence with the distal femoral morphology can be demonstrated. KW - Total Knee Arthoplasty KW - Sparse Geometry Reconstruction KW - Statistical Shape Models Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:0297-zib-65339 VL - 16 SP - 24 EP - 30 ER - TY - THES A1 - Reddy, Gutha Vaishnavi T1 - Automatic Classification of 3D MRI data using Deep Convolutional Neural Networks N2 - The chronic disease of Osteoarthritis of the knee that causes pain and discomfort in the knee is associated with the degradation of the joint between the tibia and the femur. The degeneration of this joint is attributed partially to the damage of the meniscus of the knee which forms an important part of the knee joint. Magnetic Resonance Imaging (MRI) is used to diagnose such a kind of osteoarthritis by identifying the degeneration of the knee meniscus. A computer aided diagnostic system that aims to assist a doctor in decision making regarding such a diagnosis can expedite the very diagnosis. Diagnostic decision making for medical imaging falls into the category of classification for a computer vision task. Very Deep Convolutional Networks have been central to the largest advances in computer vision, in recent years. This work entails application of such convolutional networks for the purpose of recognizing a meniscus tear in MRI images as attempting a step towards developing a computer aided diagnosis system for osteoarthritis. Consequently, state-of-the-art pre-trained image recognition networks namely Alexnet, Inceptionv3, VGG and Resnet and Xception were trained on MRI data of the knee meniscus to see if they work for the task of recognizing a tear. A comparison of their classification performance on MRI data was done. The best performing model was the fine-tuned InceptionV3 network which achieved an accuracy close to 60% for classifying 600 patients based on presence of a tear or not. Y1 - 2017 ER - TY - GEN A1 - Ambellan, Felix A1 - Tack, Alexander A1 - Wilson, Dave A1 - Anglin, Carolyn A1 - Lamecker, Hans A1 - Zachow, Stefan T1 - Evaluating two methods for Geometry Reconstruction from Sparse Surgical Navigation Data N2 - In this study we investigate methods for fitting a Statistical Shape Model (SSM) to intraoperatively acquired point cloud data from a surgical navigation system. We validate the fitted models against the pre-operatively acquired Magnetic Resonance Imaging (MRI) data from the same patients. We consider a cohort of 10 patients who underwent navigated total knee arthroplasty. As part of the surgical protocol the patients’ distal femurs were partially digitized. All patients had an MRI scan two months pre-operatively. The MRI data were manually segmented and the reconstructed bone surfaces used as ground truth against which the fit was compared. Two methods were used to fit the SSM to the data, based on (1) Iterative Closest Points (ICP) and (2) Gaussian Mixture Models (GMM). For both approaches, the difference between model fit and ground truth surface averaged less than 1.7 mm and excellent correspondence with the distal femoral morphology can be demonstrated. T3 - ZIB-Report - 17-71 KW - Knee Arthroplasty KW - Sparse Geometry Reconstruction KW - Statistical Shape Models Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:0297-zib-66052 SN - 1438-0064 ER - TY - JOUR A1 - Tack, Alexander A1 - Mukhopadhyay, Anirban A1 - Zachow, Stefan T1 - Knee Menisci Segmentation using Convolutional Neural Networks: Data from the Osteoarthritis Initiative JF - Osteoarthritis and Cartilage N2 - Abstract: Objective: To present a novel method for automated segmentation of knee menisci from MRIs. To evaluate quantitative meniscal biomarkers for osteoarthritis (OA) estimated thereof. Method: A segmentation method employing convolutional neural networks in combination with statistical shape models was developed. Accuracy was evaluated on 88 manual segmentations. Meniscal volume, tibial coverage, and meniscal extrusion were computed and tested for differences between groups of OA, joint space narrowing (JSN), and WOMAC pain. Correlation between computed meniscal extrusion and MOAKS experts' readings was evaluated for 600 subjects. Suitability of biomarkers for predicting incident radiographic OA from baseline to 24 months was tested on a group of 552 patients (184 incident OA, 386 controls) by performing conditional logistic regression. Results: Segmentation accuracy measured as Dice Similarity Coefficient was 83.8% for medial menisci (MM) and 88.9% for lateral menisci (LM) at baseline, and 83.1% and 88.3% at 12-month follow-up. Medial tibial coverage was significantly lower for arthritic cases compared to non-arthritic ones. Medial meniscal extrusion was significantly higher for arthritic knees. A moderate correlation between automatically computed medial meniscal extrusion and experts' readings was found (ρ=0.44). Mean medial meniscal extrusion was significantly greater for incident OA cases compared to controls (1.16±0.93 mm vs. 0.83±0.92 mm; p<0.05). Conclusion: Especially for medial menisci an excellent segmentation accuracy was achieved. Our meniscal biomarkers were validated by comparison to experts' readings as well as analysis of differences w.r.t groups of OA, JSN, and WOMAC pain. It was confirmed that medial meniscal extrusion is a predictor for incident OA. Y1 - 2018 U6 - https://doi.org/10.1016/j.joca.2018.02.907 VL - 26 IS - 5 SP - 680 EP - 688 ER - TY - GEN A1 - Tack, Alexander A1 - Mukhopadhyay, Anirban A1 - Zachow, Stefan T1 - Knee Menisci Segmentation using Convolutional Neural Networks: Data from the Osteoarthritis Initiative (Supplementary Material) N2 - Abstract: Objective: To present a novel method for automated segmentation of knee menisci from MRIs. To evaluate quantitative meniscal biomarkers for osteoarthritis (OA) estimated thereof. Method: A segmentation method employing convolutional neural networks in combination with statistical shape models was developed. Accuracy was evaluated on 88 manual segmentations. Meniscal volume, tibial coverage, and meniscal extrusion were computed and tested for differences between groups of OA, joint space narrowing (JSN), and WOMAC pain. Correlation between computed meniscal extrusion and MOAKS experts' readings was evaluated for 600 subjects. Suitability of biomarkers for predicting incident radiographic OA from baseline to 24 months was tested on a group of 552 patients (184 incident OA, 386 controls) by performing conditional logistic regression. Results: Segmentation accuracy measured as Dice Similarity Coefficient was 83.8% for medial menisci (MM) and 88.9% for lateral menisci (LM) at baseline, and 83.1% and 88.3% at 12-month follow-up. Medial tibial coverage was significantly lower for arthritic cases compared to non-arthritic ones. Medial meniscal extrusion was significantly higher for arthritic knees. A moderate correlation between automatically computed medial meniscal extrusion and experts' readings was found (ρ=0.44). Mean medial meniscal extrusion was significantly greater for incident OA cases compared to controls (1.16±0.93 mm vs. 0.83±0.92 mm; p<0.05). Conclusion: Especially for medial menisci an excellent segmentation accuracy was achieved. Our meniscal biomarkers were validated by comparison to experts' readings as well as analysis of differences w.r.t groups of OA, JSN, and WOMAC pain. It was confirmed that medial meniscal extrusion is a predictor for incident OA. Y1 - 2018 U6 - https://doi.org/10.12752/4.TMZ.1.0 N1 - Supplementary data to reproduce results from the related publication, including convolutional neural networks' weights. ER - TY - CHAP A1 - Ambellan, Felix A1 - Tack, Alexander A1 - Ehlke, Moritz A1 - Zachow, Stefan T1 - Automated Segmentation of Knee Bone and Cartilage combining Statistical Shape Knowledge and Convolutional Neural Networks: Data from the Osteoarthritis Initiative T2 - Medical Imaging with Deep Learning N2 - We present a method for the automated segmentation of knee bones and cartilage from magnetic resonance imaging, that combines a priori knowledge of anatomical shape with Convolutional Neural Networks (CNNs). The proposed approach incorporates 3D Statistical Shape Models (SSMs) as well as 2D and 3D CNNs to achieve a robust and accurate segmentation of even highly pathological knee structures. The method is evaluated on data of the MICCAI grand challenge "Segmentation of Knee Images 2010". For the first time an accuracy equivalent to the inter-observer variability of human readers has been achieved in this challenge. Moreover, the quality of the proposed method is thoroughly assessed using various measures for 507 manual segmentations of bone and cartilage, and 88 additional manual segmentations of cartilage. Our method yields sub-voxel accuracy. In conclusion, combining of anatomical knowledge using SSMs with localized classification via CNNs results in a state-of-the-art segmentation method. Y1 - 2018 ER - TY - GEN A1 - Tack, Alexander A1 - Mukhopadhyay, Anirban A1 - Zachow, Stefan T1 - Knee Menisci Segmentation using Convolutional Neural Networks: Data from the Osteoarthritis Initiative N2 - Abstract: Objective: To present a novel method for automated segmentation of knee menisci from MRIs. To evaluate quantitative meniscal biomarkers for osteoarthritis (OA) estimated thereof. Method: A segmentation method employing convolutional neural networks in combination with statistical shape models was developed. Accuracy was evaluated on 88 manual segmentations. Meniscal volume, tibial coverage, and meniscal extrusion were computed and tested for differences between groups of OA, joint space narrowing (JSN), and WOMAC pain. Correlation between computed meniscal extrusion and MOAKS experts' readings was evaluated for 600 subjects. Suitability of biomarkers for predicting incident radiographic OA from baseline to 24 months was tested on a group of 552 patients (184 incident OA, 386 controls) by performing conditional logistic regression. Results: Segmentation accuracy measured as Dice Similarity Coefficient was 83.8% for medial menisci (MM) and 88.9% for lateral menisci (LM) at baseline, and 83.1% and 88.3% at 12-month follow-up. Medial tibial coverage was significantly lower for arthritic cases compared to non-arthritic ones. Medial meniscal extrusion was significantly higher for arthritic knees. A moderate correlation between automatically computed medial meniscal extrusion and experts' readings was found (ρ=0.44). Mean medial meniscal extrusion was significantly greater for incident OA cases compared to controls (1.16±0.93 mm vs. 0.83±0.92 mm; p<0.05). Conclusion: Especially for medial menisci an excellent segmentation accuracy was achieved. Our meniscal biomarkers were validated by comparison to experts' readings as well as analysis of differences w.r.t groups of OA, JSN, and WOMAC pain. It was confirmed that medial meniscal extrusion is a predictor for incident OA. T3 - ZIB-Report - 18-15 Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:0297-zib-68038 SN - 1438-0064 VL - 26 IS - 5 SP - 680 EP - 688 ER - TY - CHAP A1 - Estacio, Laura A1 - Ehlke, Moritz A1 - Tack, Alexander A1 - Castro-Gutierrez, Eveling A1 - Lamecker, Hans A1 - Mora, Rensso A1 - Zachow, Stefan T1 - Unsupervised Detection of Disturbances in 2D Radiographs T2 - 2021 IEEE 18th International Symposium on Biomedical Imaging (ISBI) N2 - We present a method based on a generative model for detection of disturbances such as prosthesis, screws, zippers, and metals in 2D radiographs. The generative model is trained in an unsupervised fashion using clinical radiographs as well as simulated data, none of which contain disturbances. Our approach employs a latent space consistency loss which has the benefit of identifying similarities, and is enforced to reconstruct X-rays without disturbances. In order to detect images with disturbances, an anomaly score is computed also employing the Frechet distance between the input X-ray and the reconstructed one using our generative model. Validation was performed using clinical pelvis radiographs. We achieved an AUC of 0.77 and 0.83 with clinical and synthetic data, respectively. The results demonstrated a good accuracy of our method for detecting outliers as well as the advantage of utilizing synthetic data. Y1 - 2021 U6 - https://doi.org/10.1109/ISBI48211.2021.9434091 SP - 367 EP - 370 ER - TY - JOUR A1 - Tack, Alexander A1 - Preim, Bernhard A1 - Zachow, Stefan T1 - Fully automated Assessment of Knee Alignment from Full-Leg X-Rays employing a "YOLOv4 And Resnet Landmark regression Algorithm" (YARLA): Data from the Osteoarthritis Initiative JF - Computer Methods and Programs in Biomedicine N2 - We present a method for the quantification of knee alignment from full-leg X-Rays. A state-of-the-art object detector, YOLOv4, was trained to locate regions of interests (ROIs) in full-leg X-Ray images for the hip joint, the knee, and the ankle. Residual neural networks (ResNets) were trained to regress landmark coordinates for each ROI.Based on the detected landmarks the knee alignment, i.e., the hip-knee-ankle (HKA) angle, was computed. The accuracy of landmark detection was evaluated by a comparison to manually placed landmarks for 360 legs in 180 X-Rays. The accuracy of HKA angle computations was assessed on the basis of 2,943 X-Rays. Results of YARLA were compared to the results of two independent image reading studies(Cooke; Duryea) both publicly accessible via the Osteoarthritis Initiative. The agreement was evaluated using Spearman's Rho, and weighted kappa as well as regarding the correspondence of the class assignment (varus/neutral/valgus). The average difference between YARLA and manually placed landmarks was less than 2.0+- 1.5 mm for all structures (hip, knee, ankle). The average mismatch between HKA angle determinations of Cooke and Duryea was 0.09 +- 0.63°; YARLA resulted in a mismatch of 0.10 +- 0.74° compared to Cooke and of 0.18 +- 0.64° compared to Duryea. Cooke and Duryea agreed almost perfectly with respect to a weighted kappa value of 0.86, and showed an excellent reliability as measured by a Spearman's Rho value of 0.99. Similar values were achieved by YARLA, i.e., a weighted kappa value of0.83 and 0.87 and a Spearman's Rho value of 0.98 and 0.99 to Cooke and Duryea,respectively. Cooke and Duryea agreed in 92% of all class assignments and YARLA did so in 90% against Cooke and 92% against Duryea. In conclusion, YARLA achieved results comparable to those of human experts and thus provides a basis for an automated assessment of knee alignment in full-leg X-Rays. Y1 - 2021 U6 - https://doi.org/https://doi.org/10.1016/j.cmpb.2021.106080 VL - 205 IS - 106080 ER -