H. Neale Cardinal

Bio: H. Neale Cardinal is an academic researcher from Robarts Research Institute. The author has contributed to research in topics: Image segmentation & Nonlinear system. The author has an hindex of 11, co-authored 13 publications receiving 1378 citations. Previous affiliations of H. Neale Cardinal include University of Western Ontario.

Three-Dimensional Ultrasound Imaging

Abstract: Ultrasound is an inexpensive and widely used imaging modality for the diagnosis and staging of a number of diseases. In the past two decades, it has benefited from major advances in technology and has become an indispensable imaging modality, due to its flexibility and non-invasive character. In the last decade, research investigators and commercial companies have further advanced ultrasound imaging with the development of 3D ultrasound. This new imaging approach is rapidly achieving widespread use with numerous applications. The major reason for the increase in the use of 3D ultrasound is related to the limitations of 2D viewing of 3D anatomy, using conventional ultrasound. This occurs because: (a) Conventional ultrasound images are 2D, yet the anatomy is 3D, hence the diagnostician must integrate multiple images in his mind. This practice is inefficient, and may lead to variability and incorrect diagnoses. (b) The 2D ultrasound image represents a thin plane at some arbitrary angle in the body. It is difficult to localize the image plane and reproduce it at a later time for follow-up studies. In this review article we describe how 3D ultrasound imaging overcomes these limitations. Specifically, we describe the developments of a number of 3D ultrasound imaging systems using mechanical, free-hand and 2D array scanning techniques. Reconstruction and viewing methods of the 3D images are described with specific examples. Since 3D ultrasound is used to quantify the volume of organs and pathology, the sources of errors in the reconstruction techniques as well as formulae relating design specification to geometric errors are provided. Finally, methods to measure organ volume from the 3D ultrasound images and sources of errors are described.

Intra- and inter-observer variability and reliability of prostate volume measurement via two-dimensional and three-dimensional ultrasound imaging

Abstract: We describe the results of a study to evaluate the intra- and inter-observer variability and reliability of prostate volume measurements made from transrectal ultrasound (TRUS) images, using either the (optimal) height-width-length (HWL) method (V = pi/6 HWL) with two-dimensional (2D) TRUS images (obtained as cross-sections of three-dimensional [3D] TRUS images) or manual planimetry of 3D TRUS images (the 3D US method). In this study, eight observers measured 15 prostate images, twice via each method, and an analysis of variance (ANOVA) was performed. This analysis shows that, with the 3D US method, intra-observer prostate volume estimates have 5.1% variability and 99% reliability, and inter-observer estimates have 11.4% variability and 96% reliability. With the HWL method, intra-observer estimates have 15.5% variability and 93% reliability, and inter-observer estimates have 21.9% variability and 87% reliability. Thus, in vivo prostate volume estimates from manual planimetry of 3D TRUS images have much lower variability and higher reliability than HWL estimates from 2D TRUS images.

An accurate method for direct dual-energy calibration and decomposition.

Abstract: We propose the use of conic and cubic surface equations (surfaces of second and third order) to directly approximate the dual‐energy equations (the integral equations for the dual‐energy log‐signal functions, i.e., the negative logarithms of the relative detector signals, considered as functions of the basis‐material component thicknesses of the object) and especially their inverses. These types of surface equations require a minimum number of calibration points, and their solutions are smooth, monotonic functions with the correct linear asymptotic behavior. The accuracy of this method is investigated and compared to that of conventional polynomial approximations, both for simulated and real calibration data, taken from two split‐detector systems. These systems provide a more stringent test of our method than comparable dual‐kVp systems, due to the greater nonlinearity of their log‐signal and inverse functions. For these systems, we show that direct approximation of the inverse dual‐energy equations using the simple eight‐term rational form of the conic surface equation provides an extremely fast decomposition algorithm, which is accurate, robust in the presence of noise, and which can be calibrated with as few as 9 calibration points, or robustly calibrated, with a built‐in accuracy check, using only 16 calibration points. Also, we show that extreme accuracy of approximation (to within less than 10−6 in log‐signal and 1 μm in material thickness) is theoretically attainable using the eighteen‐term form of the cubic surface equation, which has a closed‐form analytic solution. Finally, we consider the effects of noise on calibration accuracy, and derive simple formulas which relate the true and apparent root‐mean‐square (rms) accuracies. These formulas then allow the comparison of the true rms calibration accuracies of various surface approximations, considered as functions of the total calibration heat loading of the x‐ray tube.

Semiautomatic three-dimensional segmentation of the prostate using two-dimensional ultrasound images.

Abstract: In this paper, we report on two methods for semiautomatic three-dimensional (3-D) prostate boundary segmentation using 2-D ultrasound images. For each method, a 3-D ultrasound prostate image was sliced into the series of contiguous 2-D images, either in a parallel manner, with a uniform slice spacing of 1 mm, or in a rotational manner, about an axis approximately through the center of the prostate, with a uniform angular spacing of 5 degrees. The segmentation process was initiated by manually placing four points on the boundary of a selected slice, from which an initial prostate boundary was determined. This initial boundary was refined using the Discrete Dynamic Contour until it fit the actual prostate boundary. The remaining slices were then segmented by iteratively propagating this result to an adjacent slice and repeating the refinement, pausing the process when necessary to manually edit the boundary. The two methods were tested with six 3-D prostate images. The results showed that the parallel and rotational methods had mean editing rates of 20% and 14%, and mean (mean absolute) volume errors of -5.4% (6.5%) and -1.7% (3.1%), respectively. Based on these results, as well as the relative difficulty in editing, we conclude that the rotational segmentation method is superior.

Automatic needle segmentation in three-dimensional ultrasound images using two orthogonal two-dimensional image projections

Abstract: In this paper, we describe an algorithm to segment a needle from a three-dimensional (3D) ultrasoundimage by using two orthogonal two-dimensional (2D) image projections. Not only is the needle more conspicuous in a projected (volume-rendered) image, but its direction in 3D lies in the plane defined by the projection direction and the needle direction in the projected 2D image. Hence, using two such projections, the 3D vector describing the needle direction lies along the intersection of the two corresponding planes. Thus, the task of 3D needle segmentation is reduced to two 2D needle segmentations. For improved accuracy and robustness, we use orthogonal projection directions (both orthogonal to a given a priori estimate of the needle direction), and use volume cropping and Gaussian transfer functions to remove complex background from the 2D projection images. To evaluate our algorithm, we tested it with 3D ultrasoundimages of agar and turkey breast phantoms. Using a 500 MHz personal computer equipped with a commercial volume-rendering card, we found that our 3D needle segmentation algorithm performed in near real time (about 10 fps) with a root-mean-square accuracy in needle length and endpoint coordinates of better than 0.8 mm, and about 0.5 mm on average, for needles lengths in the 3D image from 4.0 mm to 36.7 mm.

EAE/ASE Recommendations for Image Acquisition and Display Using Three-Dimensional Echocardiography

Abstract: CRT : Cardiac resynchronization therapy ECG : Electrocardiographic LV : Left ventricular RV : Right ventricular SDI : Systolic dyssynchrony index TEE : Transesophageal echocardiographic 3D : Three-dimensional 3DE : Three-dimensional echocardiographic TTE : Transthoracic echocardiographic TV : Tricuspid valve 2D : Two-dimensional Three-dimensional (3D) echocardiographic (3DE) imaging represents a major innovation in cardiovascular ultrasound. Advancements in computer and transducer technologies permit real-time 3DE acquisition and presentation of cardiac structures from any spatial point of view. The usefulness of 3D echocardiography has been demonstrated in (1) the evaluation of cardiac chamber volumes and mass, which avoids geometric assumptions; (2) the assessment of regional left ventricular (LV) wall motion and quantification of systolic dyssynchrony; (3) presentation of realistic views of heart valves; (4) volumetric evaluation of regurgitant lesions and shunts with 3DE color Doppler imaging; and (5) 3DE stress imaging. However, for 3D echocardiography to be implemented in routine clinical practice, a full understanding of its technical principles and a systematic approach to image acquisition and analysis are required. The main goal of this document is to provide a practical guide on how to acquire, analyze, and display the various cardiac structures using 3D echocardiography, as well as limitations of the technique. In addition, this document describes the current and potential clinical applications of 3D echocardiography along with their strengths and weaknesses. ### a. Fully Sampled Matrix-Array Transducers An important milestone in the history of real-time 3D echocardiography was reached shortly after the year 2000, with the development of fully sampled matrix-array transducers. These transducers provided excellent real-time imaging of the beating heart in three dimensions and required significant technological developments in both hardware and software, including transducer design, microelectronic techniques, and computing. Currently, 3DE matrix-array transducers are composed of nearly 3,000 piezoelectric elements with operating frequencies ranging from 2 to 4 MHz and from 5 to 7 MHz for transthoracic echocardiographic (TTE) and transesophageal echocardiographic (TEE) imaging, respectively. These piezoelectric elements are arranged in a matrix configuration within the transducer and require a large number of digital channels for these fully sampled elements to be connected. To reduce both …

Three-Dimensional Ultrasound Imaging

Abstract: Ultrasound is an inexpensive and widely used imaging modality for the diagnosis and staging of a number of diseases. In the past two decades, it has benefited from major advances in technology and has become an indispensable imaging modality, due to its flexibility and non-invasive character. In the last decade, research investigators and commercial companies have further advanced ultrasound imaging with the development of 3D ultrasound. This new imaging approach is rapidly achieving widespread use with numerous applications. The major reason for the increase in the use of 3D ultrasound is related to the limitations of 2D viewing of 3D anatomy, using conventional ultrasound. This occurs because: (a) Conventional ultrasound images are 2D, yet the anatomy is 3D, hence the diagnostician must integrate multiple images in his mind. This practice is inefficient, and may lead to variability and incorrect diagnoses. (b) The 2D ultrasound image represents a thin plane at some arbitrary angle in the body. It is difficult to localize the image plane and reproduce it at a later time for follow-up studies. In this review article we describe how 3D ultrasound imaging overcomes these limitations. Specifically, we describe the developments of a number of 3D ultrasound imaging systems using mechanical, free-hand and 2D array scanning techniques. Reconstruction and viewing methods of the 3D images are described with specific examples. Since 3D ultrasound is used to quantify the volume of organs and pathology, the sources of errors in the reconstruction techniques as well as formulae relating design specification to geometric errors are provided. Finally, methods to measure organ volume from the 3D ultrasound images and sources of errors are described.

Quantification of volumetric and geometric changes occurring during fractionated radiotherapy for head-and-neck cancer using an integrated CT/linear accelerator system.

Abstract: Purpose Many patients receiving fractionated radiotherapy (RT) for head-and-neck cancer have marked anatomic changes during their course of treatment, including shrinking of the primary tumor or nodal masses, resolving postoperative changes/edema, and changes in overall body habitus/weight loss. We conducted a pilot study to quantify the magnitude of these anatomic changes with systematic CT imaging. Methods and materials Fourteen assessable patients were enrolled in this pilot study. Eligible patients had to have a pathologic diagnosis of head-and-neck cancer, be treated with definitive external beam RT, and had have gross primary and/or cervical nodal disease measuring at least 4 cm in maximal diameter. All patients were treated using a new commercial integrated CT-linear accelerator system (EXaCT) that allows CT imaging at the daily RT sessions while the patient remains immobilized in the treatment position. CT scans were acquired three times weekly during the entire course of RT, and both gross tumor volumes (GTVs: primary tumor and involved lymph nodes) and normal tissues (parotid glands, spinal canal, mandible, and external contour) were manually contoured on every axial slice. Volumetric and positional changes relative to a central bony reference (the center of mass of the C2 vertebral body) were determined for each structure. Results Gross tumor volumes decreased throughout the course of fractionated RT, at a median rate of 0.2 cm 3 per treatment day (range, 0.01–1.95 cm 3 /d). In terms of the percentage of the initial volume, the GTVs decreased at a median rate of 1.8%/treatment day (range, 0.2–3.1%/d). On the last day of treatment, this corresponded to a median total relative loss of 69.5% of the initial GTV (range, 9.9–91.9%). In addition, the center of the mass of shrinking tumors changed position with time, indicating that GTV loss was frequently asymmetric. At treatment completion, the median center of the mass displacement (after corrections for daily setup variation) was 3.3 mm (range, 0–17.3 mm). Parotid glands also decreased in volume (median, 0.19 cm 3 /d range, 0.04–0.84 cm 3 /d), and generally shifted medially (median, 3.1 mm; range, 0–9.9 mm) with time. This medial displacement of the parotid glands correlated highly with the weight loss that occurred during treatment. Conclusion Measurable anatomic changes occurred throughout fractionated external beam RT for head-and-neck cancers. These changes in the external contour, shape, and location of the target and critical structures appeared to be significant during the second half of treatment (after 3–4 weeks of treatment) and could have potential dosimetric impact when highly conformal treatment techniques are used. These data may, therefore, be useful in the development of an adaptive RT scheme (periodic adjustment of the conformal treatment plan) that takes into account such treatment-related anatomic changes. In theory, such a strategy would maximize the therapeutic ratio of RT.

An accurate method for computer-generating tungsten anode x-ray spectra from 30 to 140 kV.

Abstract: A tungsten anode spectral model using interpolating polynomials (TASMIP) was used to compute x-ray spectra at 1 keV intervals over the range from 30 kV to 140 kV. The TASMIP is not semi-empirical and uses no physical assumptions regarding x-ray production, but rather interpolates measured constant potential x-ray spectra published by Fewell et al. [Handbook of Computed Tomography X-ray Spectra (U.S. Government Printing Office, Washington, D.C., 1981)]. X-ray output measurements (mR/mAs measured at 1 m) were made on a calibrated constant potential generator in our laboratory from 50 kV to 124 kV, and with 0-5 mm added aluminum filtration. The Fewell spectra were slightly modified (numerically hardened) and normalized based on the attenuation and output characteristics of a constant potential generator and metal-insert x-ray tube in our laboratory. Then, using the modified Fewell spectra of different kVs, the photon fluence phi at each 1 keV energy bin (E) over energies from 10 keV to 140 keV was characterized using polynomial functions of the form phi (E) = a0[E] + a1[E] kV + a2[E] kV2 + ... + a(n)[E] kVn. A total of 131 polynomial functions were used to calculate accurate x-ray spectra, each function requiring between two and four terms. The resulting TASMIP algorithm produced x-ray spectra that match both the quality and quantity characteristics of the x-ray system in our laboratory. For photon fluences above 10% of the peak fluence in the spectrum, the average percent difference (and standard deviation) between the modified Fewell spectra and the TASMIP photon fluence was -1.43% (3.8%) for the 50 kV spectrum, -0.89% (1.37%) for the 70 kV spectrum, and for the 80, 90, 100, 110, 120, 130 and 140 kV spectra, the mean differences between spectra were all less than 0.20% and the standard deviations were less than approximately 1.1%. The model was also extended to include the effects of generator-induced kV ripple. Finally, the x-ray photon fluence in the units of photons/mm2 per mR was calculated as a function of HVL, kV, and ripple factor, for various (water-equivalent) patient thicknesses (0, 10, 20, and 30 cm). These values may be useful for computing the detective quantum efficiency, DQE(f), of x-ray detector systems. The TASMIP algorithm and ancillary data are made available on line at http:/(/)www.aip.org/epaps/epaps.html.

Carotid Plaque Area A Tool for Targeting and Evaluating Vascular Preventive Therapy

Abstract: Background and Purpose—Carotid plaque area measured by ultrasound (cross-sectional area of longitudinal views of all plaques seen) was studied as a way of identifying patients at increased risk of stroke, myocardial infarction, and vascular death. Methods—Patients from an atherosclerosis prevention clinic were followed up annually for up to 5 years (mean, 2.51.3 years) with baseline and follow-up measurements recorded. Plaque area progression (or regression) was defined as an increase (or decrease) of 0.05 cm 2 from baseline. Results—Carotid plaque areas from 1686 patients were categorized into 4 quartile ranges: 0.00 to 0.11 cm 2 (n422), 0.12 to 0.45 cm 2 (n424), 0.46 to 1.18 cm 2 (n421), and 1.19 to 6.73 cm 2 (n419). The combined 5-year risk of stroke, myocardial infarction, and vascular death increased by quartile of plaque area: 5.6%, 10.7%, 13.9%, and 19.5%, respectively (P0.001) after adjustment for all baseline patient characteristics. A total of 1085 patients had 1 annual carotid plaque area measurements: 685 (63.1%) had carotid plaque progression, 306 (28.2%) had plaque regression, and 176 (16.2%) had no change in carotid plaque area over the period of follow-up. The 5-year adjusted risk of combined outcome was 9.4%, 7.6%, and 15.7% for patients with carotid plaque area regression, no change, and progression, respectively (P0.003). Conclusions—Carotid plaque area and progression of plaque identified high-risk patients. Plaque measurement may be useful for targeting preventive therapy and evaluating new treatments and response to therapy and may improve cost-effectiveness of secondary preventive treatment. (Stroke. 2002;33:2916-2922.)