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Automated volumetric approach for quantifying bronchial wall remodeling in MDCT

机译:自动化的容积法量化MDCT中的支气管壁重塑

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Follow-up studies of bronchial wall remodeling in asthmatics based on multi-detector computed tomography (MDCT) imaging is the emerging modality for therapy assessment. While providing statistically significant quantification of global variation before/after treatment, the employed cross-section-area estimation techniques cannot guarantee the absolute accuracy of point-by-point estimation. Such uncertainty comes from the impossibility to define an accurate cross-sectional plane of a bronchus at locations where the notion of central axis is questionable. In order to overcome such limitation, this paper develops an original automated volumetric approach for bronchial wall quantification involving a successive model-based 3D reconstruction of the inner and outer bronchial wall surfaces. The inner surface is segmented by means of strong 3D morphological filtering and model-fitting. An optimal geometrico-topological model is generated by using a restricted Delaunay triangulation approach. The model is then dynamically deformed in the surface normal direction, under the constraint of local energy minimization acting at each evolving vertex. The energy potentials oppose a mesh-derived elastic component combining topological and geometric features in order to preserve shape regularity, and an expansion potential exploiting image characteristics. The deformation process both adapts the mesh resolution and handles topology changes and auto-collisions. The developed 3D modeling stabilizes the deformation at the level of the outer surface of the bronchial wall and provides robustness with respect to bronchus-blood vessel contacts, where image data is irrelevant. The accuracy of the volumetric segmentation approach was evaluated with respect to 3D mathematically-simulated phantoms of bronchial subdivisions. Comparisons with recent 2D techniques, carried out on simulated and real MDCT data showed similar performances in cross-section wall area quantification. The benefit of using volumetric versus cross-section area quantification is finally argued in the context of bronchial reactivity and wall remodeling follow-up.
机译:基于多探测器计算机断层扫描(MDCT)成像的哮喘患者支气管壁重塑的后续研究是治疗评估的新兴方式。虽然在处理之前/之后提供了统计上显着的整体变化量化,但采用的横截面积估计技术不能保证逐点估计的绝对准确性。这种不确定性是由于无法在中心轴概念可疑的位置定义支气管的准确横截面。为了克服这种限制,本文开发了一种用于支气管壁定量的原始自动体积方法,该方法涉及对支气管内壁和内壁表面进行基于模型的连续3D重建。内表面通过强大的3D形态过滤和模型拟合进行分割。通过使用受限的Delaunay三角剖分方法可以生成最佳的几何拓扑模型。然后,在作用于每个演化顶点的局部能量最小化的约束下,使模型在表面法线方向上动态变形。能量势与网格和拓扑特征相结合的弹性成分相反,以便保持形状规则性,而势能则利用图像特征。变形过程既可以适应网格分辨率,也可以处理拓扑变化和自动碰撞。所开发的3D建模可在支气管壁外表面的水平处稳定变形,并针对与图像数据无关的支气管-血液血管接触提供鲁棒性。针对3D数学模拟的支气管细分体模,评估了体积分割方法的准确性。在仿真的和实际的MDCT数据上与最新的2D技术进行的比较显示出在横截面壁面积量化中的相似性能。最后,在支气管反应性和壁重塑随访的背景下,争论了使用体积与横截面积定量的好处。

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