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Veeraraghavan, H

Publications and source records attributed to Veeraraghavan, H.

TU-AB-BRA-03: Atlas-Based Algorithms with Local Registration-Goodness Weighting for MRI-Driven Electron Density Mapping

Purpose: To develop image-analysis algorithms to synthesize CT with accurate electron densities for MR-only radiotherapy of head & neck (H&N) and pelvis anatomies. Methods: CT and 3T-MRI (Philips, mDixon sequence) scans were randomly selected from a pool of H&N (n=11) and pelvis (n=12) anatomies to form an atlas. All MRIs were pre-processed to eliminate scanner and patient-induced intensity inhomogeneities and standardize their intensity histograms. CT and MRI for each patient were then co-registered to construct CT-MRI atlases. For more accurate CT-MR fusion, bone intensities in CT were suppressed to improve the similarity between CT and MRI. For a new patient, all CT-MRI atlases are deformed onto the new patients’ MRI initially. A newly-developed generalized registration error (GRE) metric was then calculated as a measure of local registration accuracy. The synthetic CT value at each point is a 1/GRE-weighted average of CTs from all CT-MR atlases. For evaluation, the mean absolute error (MAE) between the original and synthetic CT (generated in a leave-one-out scheme) was computed. The planning dose from the original and synthetic CT was also compared. Results: For H&N patients, MAE was 67±9, 114±22, and 116±9 HU over the entire-CT, air and bone regions, respectively. For pelvis anatomy, MAE was 47±5 and 146±14 for the entire and bone regions. In comparison with MIRADA medical, an FDA-approved registration tool, we found that our proposed registration strategy reduces MAE by ∼30% and ∼50% over the entire and bone regions, respectively. GRE-weighted strategy further lowers MAE by ∼15% to ∼40%. Our primary dose calculation also showed highly consistent results between the original and synthetic CT. Conclusion: We’ve developed a novel image-analysis technique to synthesize CT for H&N and pelvis anatomies. Our proposed image fusion strategy and GRE metric help generate more accurate synthetic CT using locally more similar atlases (Support: Philips Healthcare). The research is supported by Philips HealthCare.

60 APPLIED LIFE SCIENCES↗

SU-E-J-253: The Radiomics Toolbox in the Computational Environment for Radiological Research (CERR)

Purpose: To present an open source and free platform to facilitate radiomics research — The “Radiomics toolbox” in CERR. Method: There is scarcity of open source tools that support end-to-end modeling of image features to predict patient outcomes. The “Radiomics toolbox” strives to fill the need for such a software platform. The platform supports (1) import of various kinds of image modalities like CT, PET, MR, SPECT, US. (2) Contouring tools to delineate structures of interest. (3) Extraction and storage of image based features like 1st order statistics, gray-scale co-occurrence and zonesize matrix based texture features and shape features and (4) Statistical Analysis. Statistical analysis of the extracted features is supported with basic functionality that includes univariate correlations, Kaplan-Meir curves and advanced functionality that includes feature reduction and multivariate modeling. The graphical user interface and the data management are performed with Matlab for the ease of development and readability of code and features for wide audience. Open-source software developed with other programming languages is integrated to enhance various components of this toolbox. For example: Java-based DCM4CHE for import of DICOM, R for statistical analysis. Results: The Radiomics toolbox will be distributed as an open source, GNU copyrighted software. The toolbox was prototyped for modeling Oropharyngeal PET dataset at MSKCC. The analysis will be presented in a separate paper. Conclusion: The Radiomics Toolbox provides an extensible platform for extracting and modeling image features. To emphasize new uses of CERR for radiomics and image-based research, we have changed the name from the “Computational Environment for Radiotherapy Research” to the “Computational Environment for Radiological Research”.

60 APPLIED LIFE SCIENCES↗

TU-G-204-02: Automatic Sclerotic Bone Metastases Detection in the Pelvic Region From Dual Energy CT

Purpose: To automatically detect sclerotic bone metastases in the pelvic region using dual energy computed tomography (DECT). Methods: We developed a two stage algorithm to automatically detect sclerotic bone metastases in the pelvis from DECT for patients with multiple bone metastatic lesions and with hip implants. The first stage consists of extracting the bone and marrow regions by using a support vector machine (SVM) classifier. We employed a novel representation of the DECT images using multi-material decomposition, which represents each voxel as a mixture of different physical materials (e.g. bone+water+fat). Following the extraction of bone and marrow, in the second stage, a bi -histogram equalization method was employed to enhance the contrast to reveal the bone metastases. Next, meanshift segmentation was performed to separate the voxels by their intensity levels. Finally, shape-based filtering was performed to extract the possible locations of the metastatic lesions using multiple shape criteria. We used the following shape parameters: area, eccentricity, major and minor axis, perimeter and skeleton. Results: A radiologist with several years of experience with DECT manually labeled 64 regions consisting of metastatic lesions from 10 different patients. However, the patients had many more metastasic lesions throughout the pelvis. Our method correctly identified 46 of the marked 64 regions (72%). In addition, our method also identified several other lesions, which can then be validated by the radiologist. The missed lesions were typically very large elongated regions consisting of several islands of very small (<4mm) lesions. Conclusion: We developed an algorithm to automatically detect sclerotic lesions in the pelvic region from DECT. Preliminary assessment shows that our algorithm generated lesions agreeing with the radiologist generated candidate regions. Furthermore, our method reveals additional lesions that can be inspected by the radiologist, thereby, reducing radiologist effort in identifying all the lesions with poor contrast from the DECT images.

60 APPLIED LIFE SCIENCES↗

TU-A-12A-08: Computing Longitudinal Material Changes in Bone Metastases Using Dual Energy Computed Tomography

Purpose: This study demonstrates a methodology for tracking changes in metastatic bone disease using trajectories in material basis space in serial dual energy computed tomography (DECT) studies. Methods: This study includes patients with bone metastases from breast cancer that had clinical surveillance CT scans using a General Electric CT750HD in dual energy mode. A radiologist defined regions-of-interested (ROI) for bone metastasis, normal bone, and marrow across the serial DECT scans. Our approach employs a Radon transform to forward-projection the basis images, namely, water and iodine, into sinogram space. This data is then repartitioned into fat/bone and effective density/Z image pairs using assumed energy spectrums for the x-ray energies. This approach both helps remove negative material densities and avoids adding spectrum-hardening artifacts. These new basis data sets were then reconstructed via filtered back-projection to create new material basis pair images. The trajectories of these pairs were then plotted in the new basis space providing a means to both visualize and quantitatively measure changes in the material properties of the tumors. Results: ROI containing radiologist defined metastatic bone disease showed well-defined trajectories in both fat/bone and effective density/Z space. ROI that contained radiologist defined normal bone and marrow did not exhibit any discernible trajectories and were stable from scan to scan. Conclusions: The preliminary results show that changes in material composition and effective density/Z image pairs were seen primarily in metastasis and not in normal tissue. This study indicates that by using routine clinical DECT it may be possible to monitor therapy response of bone metastases because healing or worsening bone metastases change material composition of bone. Additional studies are needed to further validate these results and to test for their correlation with outcome.

60 APPLIED LIFE SCIENCES↗

WE-D-9A-04: Improving Multi-Modality Image Registration Using Edge-Based Transformations

Purpose: Multi-modality deformable image registration (DIR) for head and neck (HN) radiotherapy is difficult, particularly when matching computed tomography (CT) scans with magnetic resonance imaging (MRI) scans. We hypothesized that the ‘shared information’ between images of different modalities was to be found in some form of edge-based transformation, and that novel edge-based DIR methods might outperform standard DIR methods. Methods: We propose a novel method that combines gray-scale edge-based morphology and mutual information (MI) in two stages. In the first step, we applied a modification of a previously published mathematical morphology method as an efficient gray scale edge estimator, with denoising function. The results were fed into a MI-based solver (plastimatch). The method was tested on 5 HN patients with pretreatment CT and MR datasets and associated follow-up weekly MR scans. The followup MRs showed significant regression in tumor and normal structure volumes as compared to the pretreatment MRs. The MR images used in this study were obtained using fast spin echo based T2w images with a 1 mm isotropic resolution and FOV matching the CT scan. Results: In all cases, the novel edge-based registration method provided better registration quality than MI-based DIR using the original CT and MRI images. For example, the mismatch in carotid arteries was reduced from 3–5 mm to within 2 mm. The novel edge-based method with different registration regulation parameters did not show any distorted deformations as compared to the non-realistic deformations resulting from MI on the original images. Processing time was 1.3 to 2 times shorter (edge vs. non-edge). In general, we observed quality improvement and significant calculation time reduction with the new method. Conclusion: Transforming images to an ‘edge-space,’ if designed appropriately, greatly increases the speed and accuracy of DIR.

60 APPLIED LIFE SCIENCES↗

TH-C-18A-02: Machine Learning and STAPLE Based Simultaneous Longitudinal Segmentation of Bone and Marrow Structures From Dual Energy CT

Purpose: To develop a fully-automatic longitudinal bone and marrow segmentation method in the pelvic region from dual energy computed tomography (DECT). Methods: We developed a two-step automatic bone and marrow segmentation method for simultaneous longitudinal evaluation of patients with metastatic bone disease using dual energy CT (DECT). Our approach transforms the DECT images into a multi-material decomposition (MMD) model that represents the voxels as a mixture of multiple materials. A support vector machine (SVM) was trained using a single scan. In the first step of the longitudinal segmentation the trained SVM model detects bone and marrow structures on all available longitudinal scans. Segmentation is further refined through active contour segmentation. In the second step, the segmentations from the individual scans are merged by employing the simultaneous truth and performance level estimation (STAPLE) algorithm. The scans are registered using affine and deformable registration. We found that our approach improves the segmentation in all the scans under reliable registration performance between the same scans. Improving registration was not under the scope of this work. Results: We applied our approach to segment bone and marrow in DECT scans in the pelvic regions for multiple patients. Each patient had three to five follow up scans. All the patients in the analysis had artificial metal prostheses which introduced challenges for the registration. Our algorithm achieved reasonable accurate segmentation despite the presence of metal artifacts and high-density oral contrast in neighboring structures. Our approach obtained an overall segmentation accuracy of 80% using DICE metric. Conclusion: We developed a two-step automatic longitudinal segmentation technique for bone and marrow region structures in the pelvic areas from dual energy CT. Our approach achieves robust segmentation despite the presence of confounding structures with similar intensities as the bone and marrow regions due to uptake of oral contrast and metal artifacts.

60 APPLIED LIFE SCIENCES↗

SU-E-J-196: New Visualization Methods for Longitudinal MRI Registrations and Segmentations

Purpose: To develop visualization techniques to facilitate easy assessment of (a) registration and (b) tracking volumetric changes in structures during radiation therapy from MRI. Method: The frequently used method for visualizing registrations between scans is a multi-color overlay technique or deformation vector fields. However, the overlay technique is unintuitive and does not help to appreciate the quality of registration particularly when the registration mismatches are not very large. Similarly, the deformation fields give an indication of extent of deformation but do not help to assess the differences in registration. We present a mirroring and edge-augmented mirroring technique that places the fixed and moving image next to each other and allows the user to quickly assess the small differences in registration. Next, we present a volumetric intersection based 3D model to visualize the changes in diseased lymph node volumes in head and neck cancer. 3D model-based visualization provides more information about the location-specific changes in volume rather than the simplistic one dimensional information obtained from 2D plot of nodal volume changes. Result: We show results comparing our approach with the standard colorbased overlay method for comparing registrations of intra-patient registrations using T2-MRI. Upon comparing the mirroring technique with the color-overlay, one can more easily appreciate the differences in registration. Adding edge-based mirroring seems to further assist in evaluating the registration. Our approach for viewing registrations seems to be more intuitive and easy to use in order to help assess the quality of registration compared to color-based overlays. Similarly, the change volumetric model together with a 2D plot reveals more information including the locations undergoing changes and responding to treatment. Conclusions: Better approaches are necessary for assessing the quality of registrations and changes in diseased structures over time. Our approach presents some novel visualization solutions for registration and segmentation.

60 APPLIED LIFE SCIENCES↗

SU-E-J-238: Monitoring Lymph Node Volumes During Radiotherapy Using Semi-Automatic Segmentation of MRI Images

Purpose: Identification and image-based monitoring of lymph nodes growing due to disease, could be an attractive alternative to prophylactic head and neck irradiation. We evaluated the accuracy of the user-interactive Grow Cut algorithm for volumetric segmentation of radiotherapy relevant lymph nodes from MRI taken weekly during radiotherapy. Method: The algorithm employs user drawn strokes in the image to volumetrically segment multiple structures of interest. We used a 3D T2-wturbo spin echo images with an isotropic resolution of 1 mm3 and FOV of 492×492×300 mm3 of head and neck cancer patients who underwent weekly MR imaging during the course of radiotherapy. Various lymph node (LN) levels (N2, N3, N4'5) were individually contoured on the weekly MR images by an expert physician and used as ground truth in our study. The segmentation results were compared with the physician drawn lymph nodes based on DICE similarity score. Results: Three head and neck patients with 6 weekly MR images were evaluated. Two patients had level 2 LN drawn and one patient had level N2, N3 and N4'5 drawn on each MR image. The algorithm took an average of a minute to segment the entire volume (512×512×300 mm3). The algorithm achieved an overall DICE similarity score of 0.78. The time taken for initializing and obtaining the volumetric mask was about 5 mins for cases with only N2 LN and about 15 mins for the case with N2,N3 and N4'5 level nodes. The longer initialization time for the latter case was due to the need for accurate user inputs to separate overlapping portions of the different LN. The standard deviation in segmentation accuracy at different time points was utmost 0.05. Conclusions: Our initial evaluation of the grow cut segmentation shows reasonably accurate and consistent volumetric segmentations of LN with minimal user effort and time.

60 APPLIED LIFE SCIENCES↗