Angiographic enhancement of non-contrast CT (NCCT) using AI techniques is essential for diagnosing patients unable to use contrast agents. However, AI angiography remains a challenging task because of the feature fragility, structural complexity, and spatial continuity. In this paper, we propose an angiographic framework based on a conditional multi-view diffusion model called AEGIS with three innovations: multi-view hybrid learning (MHL), conditional angiographic diffusion estimation (CADE), and multi-view map fusion (MMF). 1) MHL targets Contrast Map (CM), the difference between NCCT and CT angiography, from multiple views to perceive 3D features in 2D space, enhancing the stability of feature representation. 2) CADE is a conditional diffusion model using NCCT as spatial guidance, providing crucial information for CM generation. 3) MMF adopts a lightweight AutoEncoder for filtering and fusing multi-view CMs, maintaining coherence between adjacent slices while modifying slight bias in low-dimensional representations, thus optimizing data quality and accuracy. Experiments demonstrate our superior performance, which achieve state-of-the-art image quality (PSNR+6.69, SSIM+3.17, MSE-46.38), segmentation evaluation (CADIR×10.49, HSDIR×5.57) and feature distance (FID-64.27). Visualizations and positive evaluation scores from clinicians further reveals that AEGIS has significant potential in clinical applications.

External beam radiotherapy is extensively used to treat cervical carcinomas. A single planning CT scan enables the calculation of the dose distribution. The treatment is delivered over five weeks. Large per-treatment anatomical variations may hamper the dose delivery, with the potential of an organ-at-risk (OAR) overdose and a tumor underdose. To anticipate these deformations, a recent approach proposed three planning CTs with variable bladder volumes, which had the limitation of not covering all per-treatment anatomical variations. An original patient-specific population-based library has been proposed. It consisted of generating two representative anatomies, in addition to the standard planning CT anatomy. First, the cervix and bladder meshes of a population of 20 patients (314 images) were registered to an anatomical template, using a deformable mesh registration. An iterative point-matching algorithm was developed based on local shape context (histogram of polar or cylindrical coordinates and geodesic distance to the base) and on a topology constraint filter. Second, a standard principal component analysis (PCA) model of the cervix and bladder was generated to extract the dominant deformation modes. Finally, specific deformations were obtained using posterior PCA models, with a constraint representing the top of the uterus deformation. For a new patient, the cervix-uterus and bladder were registered to the template, and the patient's modeled planning library was built according to the model deformations. This method was applied following a leave-one-patient-out cross-validation. The performances of the modeled library were compared to those of the three-CT-based library, showing an improvement in both target coverage and OAR sparing.

External radiotherapy is a major clinical treatment for localized prostate cancer. Currently, computed tomography (CT) is used to delineate the prostate and to plan the radiotherapy treatment. However, CT images suffer from a poor soft-tissue contrast and do not allow an accurate organ delineation. On the contrary, magnetic resonance imaging (MRI) provides rich details and high soft-tissue contrast, allowing tumor detection. Thus, the intraindividual propagation of MRI delineations toward the planning CT may improve tumor targeting. In this paper, we introduce a new method to propagate MRI prostate delineations to the planning CT. In the first step, a random forest classification is performed to coarsely detect the prostate in the CT images, yielding a prostate probability membership for each voxel and a prostate hard segmentation. Then, the registration is performed using a new similarity metric which maximizes the probability and the collinearity between the normals of the manual registration (MR) existing contour and the contour resulting from the CT classification. The first study on synthetic data was performed to analyze the influence of the metric parameters with different levels of noise. Then, the method was also evaluated on real MR-CT data using manual alignments and intraprostatic fiducial markers and compared to a classically used mutual information (MI) approach. The proposed metric outperformed MI by 7% in terms of Dice score coefficient, by 3.14 mm the Hausdorff distance, and 2.13 mm the markers position errors. Finally, the impact of registration uncertainties on the treatment planning was evaluated, demonstrating the potential advantage of the proposed approach in a clinical setup to define a precise target.

This paper addresses the issue of cumulative dose estimation from cone beam computed tomography (CBCT) images in prostate cancer radiotherapy. It focuses on the dose received by the surfaces of the main organs at risk, namely the bladder and rectum. We have proposed both a surface-constrained dose accumulation approach and its extensive evaluation. Our approach relied on the nonrigid registration (NRR) of daily acquired CBCT images on the planning CT image. This proposed NRR method was based on a Demons-like algorithm, implemented in combination with mutual information metric. It allowed for different levels of geometrical constraints to be considered, ensuring a better point to point correspondence, especially when large deformations occurred, or in high dose gradient areas. The three following implementations: 1) full iconic NRR; 2) iconic NRR constrained with landmarks (LCNRR); 3) NRR constrained with full delineation of organs (DBNRR). To obtain reference data, we designed a numerical phantom based on finite-element modeling and image simulation. The methods were assessed on both the numerical phantom and real patient data in order to quantify uncertainties in terms of dose accumulation. The LCNRR method appeared to constitute a good compromise for dose monitoring in clinical practice.

This work deals with the extraction of patient-specific coronary venous anatomy in preoperative multislice computed tomography (MSCT) volumes. A hybrid approach has been specifically designed for low-contrast vascular structure detection. It makes use of a minimum cost path technique with a Fast-Marching front propagation to extract the vessel centerline. A second procedure was applied to refine the position of the path and estimate the local radius along the vessel. This was achieved with an iterative multiscale algorithm based on geometrical moments. Parameter tuning was performed using a dedicated numerical phantom, and then the algorithm was applied to extract the coronary venous system. Results are provided on three MSCT volume sequences acquired for patients selected for a cardiac resynchronization therapy procedure. A visibility study was carried out by a medical expert who labeled venous segments on a set of 18 volumes. A comparison with two other Fast-Marching techniques and a geometrical moment based tracking method is also reported.

Discrete orthogonal moments have been recently introduced in the field of image analysis. It was shown that they have better image representation capability than the continuous orthogonal moments. One problem concerning the use of moments as feature descriptors is the high computational cost, which may limit their application to the problems where the online computation is required. In this paper, we present a new approach for fast computation of the 2-D Tchebichef moments. By deriving some properties of Tchebichef polynomials, and using the image block representation for binary images and intensity slice representation for grayscale images, a fast algorithm is proposed for computing the moments of binary and grayscale images. The theoretical analysis shows that the computational complexity of the proposed method depends upon the number of blocks of the image, thus, it can speed up the computational efficiency as far as the number of blocks is smaller than the image size.

This paper describes an extended ray casting scheme for three-dimensional (3-D) navigation into the heart cavities for preoperative planning using multislice X-ray computed tomography data. The key benefit is that artifacts due to contrast inhomogeneities can be eliminated during volume traversal, thus improving the visual perception of the endocardial wall.

This paper presents a new approach dealing with virtual exploratory navigation inside vascular structures. It is based on the notion of active vision in which only visual perception drives the motion of the virtual angioscope. The proposed fly-through approach does not require a premodeling of the volume dataset or an interactive control of the virtual sensor during the fly-through. Active navigation combines the on-line computation of the scene view and its analysis, to automatically define the three-dimensional sensor path. The navigation environment and the camera-like model are first sketched. The basic stages of the active navigation framework are then described: the virtual image computation (based on ray casting), the scene analysis process (using depth map), the navigation strategy, and the virtual path estimation. Experimental results obtained from phantom model and patient computed tomography data are finally reported.