In the past few years we witnessed an increase in mortality due to cancer relative to mortality due to cardiovascular diseases. In 2008, the Netherlands Statistics Agency reports that 33.900 people died of cancer against 33.100 deaths due to cardiovascular diseases, making cancer the number one cause of death in the Netherlands . Even if the rate of people affected by heart diseases is continually rising, they "simply don’t die of it", according to the research director Prof. Mat Daemen of research institute CARIM of the University of Maastricht . The reason for this is the early diagnosis, and the treatment of people with identified risk factors for diseases like ischemic heart disease, hypertrophic cardiomyopathy, thoracic aortic disease, pericardial (sac around the heart) disease, cardiac tumors, pulmonary artery disease, valvular disease, and congenital heart disease before and after surgical repair. Cardiac imaging plays a crucial role in the early diagnosis, since it allows the accurate investigation of a large amount of imaging data in a small amount of time. Moreover, cardiac imaging reduces costs of inpatient care, as has been shown in recent studies . With this in mind, in this work we have provided several tools with the aim to help the investigation of the cardiac motion. In chapters 2 and 3 we have explored a novel variational optic flow methodology based on multi-scale feature points to extract cardiac motion from tagged MR images. Compared to constant brightness methods, this new approach exhibits several advantages. Although the intensity of critical points is also influenced by fading, critical points do retain their characteristic even in the presence of intensity changes, such as in MR imaging. In an experiment in section 5.4 we have applied this optic flow approach directly on tagged MR images. A visual inspection confirmed that the extracted motion fields realistically depicted the cardiac wall motion. The method exploits also the advantages from the multiscale framework. Because sparse velocity formulas 2.9, 3.7, 6.21, and 7.5 provide a number of equations equal to the number of unknowns, the method does not suffer from the aperture problem in retrieving velocities associated to the critical points. In chapters 2 and 3 we have moreover introduced a smoothness component of the optic flow equation described by means of covariant derivatives. This is a novelty in the optic flow literature. Many variational optic flow methods present a smoothness component that penalizes for changes from global assumptions such as isotropic or anisotropic smoothness. In the smoothness term proposed deviations from a predefined motion model are penalized. Moreover, the proposed optic flow equation has been decomposed in rotation-free and divergence-free components. This decomposition allows independent tuning of the two components during the vector field reconstruction. The experiments and the Table of errors provided in 3.8 showed that the combination of the smoothness term, influenced by a predefined motion model, and the Helmholtz decomposition in the optic flow equation reduces the average angular error substantially (20%-25%) with respect to a similar technique that employs only standard derivatives in the smoothness term. In section 5.3 we extracted the motion field of a phantom of which we know the ground truth of and compared the performance of this optic flow method with the performance of other optic flow methods well known in the literature, such as the Horn and Schunck  approach, the Lucas and Kanade  technique and the tuple image multi-scale optic flow constraint equation of Van Assen et al. . Tests showed that the proposed optic flow methodology provides the smallest average angular error (AAE = 3.84 degrees) and L2 norm = 0.1. In this work we employed the Helmholtz decomposition also to study the cardiac behavior, since the vector field decomposition allows to investigate cardiac contraction and cardiac rotation independently. In chapter 4 we carried out an analysis of cardiac motion of ten volunteers and one patient where we estimated the kinetic energy for the different components. This decomposition is useful since it allows to visualize and quantify the contributions of each single vector field component to the heart beat. Local measurements of the kinetic energy have also been used to detect areas of the cardiac walls with little movement. Experiments on a patient and a comparison between a late enhancement cardiac image and an illustration of the cardiac kinetic energy on a bull’s eye plot illustrated that a correspondence between an infarcted area and an area with very small kinetic energy exists. With the aim to extend in the future the proposed optic flow equation to a 3D approach, in chapter 6 we investigated the 3D winding number approach as a tool to locate critical points in volume images. We simplified the mathematics involved with respect to a previous work  and we provided several examples and applications such as cardiac motion estimation from 3-dimensional tagged images, follicle and neuronal cell counting. Finally in chapter 7 we continued our investigation on volume tagged MR images, by retrieving the cardiac motion field using a 3-dimensional and simple version of the proposed optic flow equation based on standard derivatives. We showed that the retrieved motion fields display the contracting and rotating behavior of the cardiac muscle. We moreover extracted the through-plane component, which provides a realistic illustration of the vector field and is missed by 2-dimensional approaches.
|Qualification||Doctor of Philosophy|
|Award date||24 Nov 2010|
|Place of Publication||Eindhoven|
|Publication status||Published - 2010|