Publications by authors named "Marko Rak"

7 Publications

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Anisotropic 3D Multi-Stream CNN for Accurate Prostate Segmentation from Multi-Planar MRI.

Comput Methods Programs Biomed 2021 Mar 4;200:105821. Epub 2020 Nov 4.

Faculty of Computer Science and Research Campus STIMULATE, University of Magdeburg, Germany.

Background And Objective: Accurate and reliable segmentation of the prostate gland in MR images can support the clinical assessment of prostate cancer, as well as the planning and monitoring of focal and loco-regional therapeutic interventions. Despite the availability of multi-planar MR scans due to standardized protocols, the majority of segmentation approaches presented in the literature consider the axial scans only. In this work, we investigate whether a neural network processing anisotropic multi-planar images could work in the context of a semantic segmentation task, and if so, how this additional information would improve the segmentation quality.

Methods: We propose an anisotropic 3D multi-stream CNN architecture, which processes additional scan directions to produce a high-resolution isotropic prostate segmentation. We investigate two variants of our architecture, which work on two (dual-plane) and three (triple-plane) image orientations, respectively. The influence of additional information used by these models is evaluated by comparing them with a single-plane baseline processing only axial images. To realize a fair comparison, we employ a hyperparameter optimization strategy to select optimal configurations for the individual approaches.

Results: Training and evaluation on two datasets spanning multiple sites show statistical significant improvement over the plain axial segmentation (p<0.05 on the Dice similarity coefficient). The improvement can be observed especially at the base (0.898 single-plane vs. 0.906 triple-plane) and apex (0.888 single-plane vs. 0.901 dual-plane).

Conclusion: This study indicates that models employing two or three scan directions are superior to plain axial segmentation. The knowledge of precise boundaries of the prostate is crucial for the conservation of risk structures. Thus, the proposed models have the potential to improve the outcome of prostate cancer diagnosis and therapies.
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http://dx.doi.org/10.1016/j.cmpb.2020.105821DOI Listing
March 2021

4D MRI: Robust sorting of free breathing MRI slices for use in interventional settings.

PLoS One 2020 22;15(6):e0235175. Epub 2020 Jun 22.

Faculty of Computer Science, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.

Purpose: We aim to develop a robust 4D MRI method for large FOVs enabling the extraction of irregular respiratory motion that is readily usable with all MRI machines and thus applicable to support a wide range of interventional settings.

Method: We propose a 4D MRI reconstruction method to capture an arbitrary number of breathing states. It uses template updates in navigator slices and search regions for fast and robust vessel cross-section tracking. It captures FOVs of 255 mm x 320 mm x 228 mm at a spatial resolution of 1.82 mm x 1.82 mm x 4mm and temporal resolution of 200ms. A total of 37 4D MRIs of 13 healthy subjects were reconstructed to validate the method. A quantitative evaluation of the reconstruction rate and speed of both the new and baseline method was performed. Additionally, a study with ten radiologists was conducted to assess the subjective reconstruction quality of both methods.

Results: Our results indicate improved mean reconstruction rates compared to the baseline method (79.4% vs. 45.5%) and improved mean reconstruction times (24s vs. 73s) per subject. Interventional radiologists perceive the reconstruction quality of our method as higher compared to the baseline (262.5 points vs. 217.5 points, p = 0.02).

Conclusions: Template updates are an effective and efficient way to increase 4D MRI reconstruction rates and to achieve better reconstruction quality. Search regions reduce reconstruction time. These improvements increase the applicability of 4D MRI as a base for seamless support of interventional image guidance in percutaneous interventions.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235175PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307760PMC
September 2020

Combining convolutional neural networks and star convex cuts for fast whole spine vertebra segmentation in MRI.

Comput Methods Programs Biomed 2019 Aug 16;177:47-56. Epub 2019 May 16.

Department of Simulation and Graphics, University of Magdeburg Universitätsplatz 2, Magdeburg, 39106 Germany.

Background And Objective: We propose an automatic approach for fast vertebral body segmentation in three-dimensional magnetic resonance images of the whole spine. Previous works are limited to the lower thoracolumbar section and often take minutes to compute, which is problematic in clinical routine, for study data sets with numerous subjects or when the cervical or upper thoracic spine is to be analyzed.

Methods: We address these limitations by a novel graph cut formulation based on vertebra patches extracted along the spine. For each patch, our formulation incorporates appearance and shape information derived from a task-specific convolutional neural network as well as star-convexity constraints that ensure a topologically correct segmentation of each vertebra. When segmenting vertebrae individually, ambiguities will occur due to overlapping segmentations of adjacent vertebrae. We tackle this problem by novel non-overlap constraints between neighboring patches based on so-called encoding swaps. The latter allow us to obtain a globally optimal multi-label segmentation of all vertebrae in polynomial time.

Results: We validated our approach on two data sets. The first contains T- and T-weighted whole spine images of 64 subjects with varying health conditions. The second comprises 23 T-weighted thoracolumbar images of young healthy adults and is publicly available. Our method yielded Dice coefficients of 93.8  ±  2.6% and 96.0  ±  1.0% for both data sets with a run time of 1.35  ±  0.08 s and 0.90  ±  0.03 s per vertebra on consumer hardware. A complete whole spine segmentation took 32.4 ± 1.92 s on average.

Conclusions: Our results are superior to those of previous works at a fraction of their run time, which illustrates the efficiency and effectiveness of our whole spine segmentation approach.
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http://dx.doi.org/10.1016/j.cmpb.2019.05.003DOI Listing
August 2019

Joint deformable liver registration and bias field correction for MR-guided HDR brachytherapy.

Int J Comput Assist Radiol Surg 2017 Dec 6;12(12):2169-2180. Epub 2017 Jul 6.

Department of Radiology, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany.

Purpose: In interstitial high-dose rate brachytherapy, liver cancer is treated by internal radiation, requiring percutaneous placement of applicators within or close to the tumor. To maximize utility, the optimal applicator configuration is pre-planned on magnetic resonance images. The pre-planned configuration is then implemented via a magnetic resonance-guided intervention. Mapping the pre-planning information onto interventional data would reduce the radiologist's cognitive load during the intervention and could possibly minimize discrepancies between optimally pre-planned and actually placed applicators.

Methods: We propose a fast and robust two-step registration framework suitable for interventional settings: first, we utilize a multi-resolution rigid registration to correct for differences in patient positioning (rotation and translation). Second, we employ a novel iterative approach alternating between bias field correction and Markov random field deformable registration in a multi-resolution framework to compensate for non-rigid movements of the liver, the tumors and the organs at risk. In contrast to existing pre-correction methods, our multi-resolution scheme can recover bias field artifacts of different extents at marginal computational costs.

Results: We compared our approach to deformable registration via B-splines, demons and the SyN method on 22 registration tasks from eleven patients. Results showed that our approach is more accurate than the contenders for liver as well as for tumor tissues. We yield average liver volume overlaps of 94.0 ± 2.7% and average surface-to-surface distances of 2.02 ± 0.87 mm and 3.55 ± 2.19 mm for liver and tumor tissue, respectively. The reported distances are close to (or even below) the slice spacing (2.5 - 3.0 mm) of our data. Our approach is also the fastest, taking 35.8 ± 12.8 s per task.

Conclusion: The presented approach is sufficiently accurate to map information available from brachytherapy pre-planning onto interventional data. It is also reasonably fast, providing a starting point for computer-aidance during intervention.
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http://dx.doi.org/10.1007/s11548-017-1633-2DOI Listing
December 2017

On computerized methods for spine analysis in MRI: a systematic review.

Int J Comput Assist Radiol Surg 2016 Aug 9;11(8):1445-65. Epub 2016 Feb 9.

Department of Simulation and Graphics, Otto von Guericke University, Universitätsplatz 2, 39106, Magdeburg, Germany.

Purpose: In the last decades, the increasing medical interest in magnetic resonance imaging (MRI) of the spine gave rise to a growing number of publications on computerized methods for spine analysis, covering goals such as localization and segmentation of vertebrae and intervertebral discs as well as the extraction and segmentation of the spinal canal and cord. We provide a critical systematic review to work in the field, putting focus on approaches that can be applied to different imaging sequences and settings.

Methods: Work is analysed on two levels. First, methods are reviewed in detail so that the reader understands justifications and constraints of particular work. Second, work is classified according to relevant attributes and tabulated to give an impression on recent trends. We discuss the general methodical and evaluational aspects of the work as well as challenges specific to MRI such as the lack of intensity standardization and partial volume effects.

Results: Methods can be condensed to a small number of optimization frameworks, e.g., graphical models, cost-minimal paths and deformable models. Works sharing the same framework mainly differentiate by the types of information, i.e., pose, geometry and appearance, that are used and by the implementation thereof. MRI-specific challenges are rarely addressed explicitly, calling into question the applicability of most methods to changing imaging sequences or settings. Most often, little attention is paid to evaluation, meaning that results lack comparability and reproducibility although publicly available data sets exist.

Conclusion: The diversity of MRI sequences and settings still poses challenges to computerized spine analysis. Further research is necessary to implement methods that are actually applicable in practice, e.g., in clinical routine or for study purposes. Certainly, manual guidance will be necessary at some point, for instance to deal with changing subject positions. Therefore, future work should put attention to the appropriate integration of manual interaction.
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http://dx.doi.org/10.1007/s11548-016-1350-2DOI Listing
August 2016

Ultrasound texture-based CAD system for detecting neuromuscular diseases.

Int J Comput Assist Radiol Surg 2015 Sep 2;10(9):1493-503. Epub 2014 Dec 2.

Department of Simulation and Graphics, Otto von Guericke University, Universitätsplatz 2, 39106, Magdeburg, Germany,

Purpose: Diagnosis of neuromuscular diseases in ultrasonography is a challenging task since experts are often unable to discriminate between healthy and pathological cases. A computer-aided diagnosis (CAD) system for skeletal muscle ultrasonography was developed and tested for myositis detection in ultrasound images of biceps brachii.

Methods: Several types of features were extracted from rectangular and polygonal image regions-of-interest (ROIs), including first-order statistics, wavelet-based features, and Haralick's features. Features were chosen that are sensitive to the change in contrast and structure for pathological ultrasound images of neuromuscular diseases. The number of features was reduced by applying different sequential feature selection strategies followed by a supervised principal component analysis. For classification, two linear approaches were investigated: Fisher's classifier and the linear support vector machine (SVM) as well as the nonlinear [Formula: see text]-nearest neighbor approach. The CAD system was benchmarked on datasets of 18 subjects, seven of which were healthy, while 11 were affected by myositis. Three expert radiologists provided pre-classification and testing interpretations.

Results: Leave-one-out cross-validation on the training data revealed that the linear SVM was best suited for discriminating healthy and pathological muscle tissue, achieving 85/87 % accuracy, 90 % sensitivity, and 83/85 % specificity, depending on the radiologist.

Conclusion: A muscle ultrasonography CAD system was developed, allowing a classification of an ultrasound image by one-click positioning of rectangular ROIs with minimal user effort. The applicability of the system was demonstrated with the challenging example of myositis detection, showing highly accurate results that were robust to imprecise user input.
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http://dx.doi.org/10.1007/s11548-014-1133-6DOI Listing
September 2015

Deformable part models for object detection in medical images.

Biomed Eng Online 2014 28;13 Suppl 1:S1. Epub 2014 Feb 28.

Background: Object detection in 3-D medical images is often necessary for constraining a segmentation or registration task. It may be a task in its own right as well, when instances of a structure, e.g. the lymph nodes, are searched. Problems from occlusion, illumination and projection do not arise, making the problem simpler than object detection in photographies. However, objects of interest are often not well contrasted against the background. Influence from noise and other artifacts is much stronger and shape and appearance may vary substantially within a class.

Methods: Deformable models capture the characteristic shape of an anatomic object and use constrained deformation for hypothesing object boundaries in image regions of low or non-existing contrast. Learning these constraints requires a large sample data base. We show that training may be replaced by readily available user knowledge defining a prototypical deformable part model. If structures have a strong part-relationship, or if they may be found based on spatially related guiding structures, or if the deformation is rather restricted, the supporting data information suffices for solving the detection task. We use a finite element model to represent anatomic variation by elastic deformation. Complex shape variation may be represented by a hierarchical model with simpler part variation. The hierarchy may be represented explicitly as a hierarchy of sub-shapes, or implicitly by a single integrated model. Data support and model deformation of the complete model can be represented by an energy term, serving as quality-of-fit function for object detection.

Results: The model was applied to detection and segmentation tasks in various medical applications in 2- and 3-D scenes. It has been shown that model fitting and object detection can be carried out efficiently by a combination of a local and global search strategy using models that are parameterized for the different tasks.

Conclusions: A part-based elastic model represents complex within-class object variation without training. The hierarchy of parts may specify relationship to neighboring anatomical objects in object detection or a part-decomposition of a complex anatomic structure. The intuitive way to incorporate domain knowledge has a high potential to serve as easily adaptable method to a wide range of different detection tasks in medical image analysis.
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http://dx.doi.org/10.1186/1475-925X-13-S1-S1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4108871PMC
March 2015