recent clinical advances and applications for medical...

copy L Joskowicz 2011

Recent clinical advances and applications

for medical image segmentation

Prof Leo Joskowicz

Lab website httpwwwcshujiacil~caslabsite


Key trends in clinical radiology bull Filmlight table Digital imagesscreen -- early 80rsquo

bull 2D X-rays US 25D CT MRI -- mid 80rsquo ndash 90rsquo

bull 25D CT MRI 3D visualization -- mid 00lsquo

bull 3D visualization 3D anatomical modeling -- now

bull 3D modeling Advanced modeling ndash coming soon


Centerline and lumen

Colon and intestine surface Abdominal CT scan

What is a patient-specific 3D model

Surface model

Polyp


What is the difference between 3D

visualization and 3D modeling

Visualization Model rendering

You do the interpretation

You fillomit missing info

Computer interprets

Explicit delineation


Why patient-specific modeling

bull 3D visualization is great -- but it has limitationshellip

minus no explicit delineation

minus no validation ndash what you see is what is there

minus limited measurements

minus limited structures discrimination

bull 3D models allow

minus spatial and volumetric measurements ndash with validation

minus advanced analysis

minus wide variety of uses in the treatment cycle

minus reduction of radiologist time easier learning curve


Segmentation in commercial systems

Copyright L Joskowicz 2007






Segmentation in commercial

systems


3D models in the patient treatment cycle

Diagnosis Planning

Delivery

CAD mammography

Virtual colonoscopy

Neurosurgery -- trajectory

Orthopaedics -- fixation

Tumor follow-up

Implant location

MODEL Interventional

Radiology

Navigation

Robotics Evaluation

Training

Learning


Diagnosis computer-aided radiology

stenosis

thrombus aneurism

tumor

volume

with Prof J Sosna


liver contour

blood vessels

tumors

4-phase CT dataset

kidneycontour

blood vessels

urinary vessels with Dr Y Mintz with Prof J Sosna



Planning neurosurgery

entry point

with Dr Y Shoshan



with Dr Y Shoshan


Conventional Our method


with Dr Y Shoshan


Planning orthopaedics

internal fixation external fixation

Fracture

fixation

alternatives

with Dr E Peleg and Profs M Liebergall R Mosheiff

copy L Joskowicz 2011 with Dr E Peleg and Profs M Liebergall R Mosheiff






bull EM real-time tracking

bull US and X-ray imaging

add patient-specific

models from CT

Delivery interventional radiology


Delivery intraoperative image guidance

augmented continuous X-ray fluoroscopy

with Simbionix and Prof J Sosna





Evaluation brain tumor follow-up

Dec 15 2009 June 9 2010

Disease

progression T2-weighted T1-weighted

Tumor internal components

solid enhancing cyst

with TA Sourasky and Dana Hospital


Key issue model creation

Currently

bull mostly manual delineation

bull slice by slice

Desired

bull automaticnearly automatic ndash a few

clicks by physician

bull no technician

bull accurate and reliable

HARD NO METHOD

SUITABLE FOR ALL STRUCTURES

Modeling requires segmentation

Very difficult task

ndash organpathology specific

ndash imagescanning protocol

ndash anatomical variability

ndash intensity values overlap

ndash structures proximity

Identify and delineate anatomical structure contours

1 2

3 4


Very difficult task







1 2

3 4

Clinical dataset challenges

proximity calcifications stenosis

Segmentation ndash state of the art

bull Hundreds anatomical segmentation methods for a

variety of structures and imaging modalities

bull Families of techniques thresholding region

growing level sets active contours and more

bull Very few if any in routine clinical use

ndash huge gap between prototype and clinical use

ndash time-consuming fragile limited in scope

ndash require technical knowledge

ndash most have limited validation

ndash clinical benefits unproven

bull Segmentation specificity is unavoidable ndash each

anatomical structure and pathology has unique

characteristics and nearby structures

bull Organ structure and pathology-specific

algorithms heart liver long bones spine

bull Very laborious top develop and validate a

segmentation algorithm for each ndash trial and error

process many man-months

No universal segmentation method

Observations (1)

Observations (2) bull Applications have different requirements wrt

ndash Accuracy

ndash Robustness

ndash User interaction

ndash Quality

bull Consider the different requirements of

ndash 3D visualization

ndash Training simulation

ndash FEA simulation

Defining application

requirements ahead of time is

essential

Goals Clinical

bull Automatic or nearly automatic lt 5mins user time

bull Can be used by clinician without a technician

bull Produces robust results

Technical

bull Requires significantly less time than developing from

scratch

bull Takes into account intensity and shape

bull Incorporates shape and intensity priors

MIS validation

bull Algorithms without validation are clinically

worthless

bull Validation is with respect to a clinical task

bull Validation requires a ground truth for comparison

bull Physical anatomical models andor phantoms are

typically not available (except sometimes for bones)

bull Ground truth is usually obtained by manual

identification andor segmentation by a user

bull Experts in most cases radiologists

bull Extrinsic comparison compare vs other methods



MIS validation issues

bull Large inter- and intra- variability across experts and clinical sites

bull May not be representative of population variability

bull Main quantitative parameters

ndash validation set size

ndash number and type of observers

ndash intra and inter-observer manual segmentation variability

ndash surface-based and volume-based error measures

MIS validation anatomical variability

stenosis

looping

narrowing


MIS validation metrics

bull Surface-based error measurements

ndash Mean surface distance

ndash RMS surface distance

ndash Maximum surface distance

bull Volume-based error measurements

ndash Dice coefficient

ndash Volumetric overlap error



Surface-based error measurements

bull Mean surface distance

bull RMS surface distance

bull Maximum surface distance


Reference Result


Volume-based error measurements

bull Volumetric overlap error

bull Dice similarity


Reference Result

Aorta

Int + Ext Carotids

All arteries

Subclavian Arteries Bifurcations

16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid

MIS validation observers variability

bull Intra-observer variability determine how much

variation there is when a single observer

produced the ground-truth segmentation

repeat 5 times the segmentation

bull Inter-observer variability determine how much

variation there is between multiple observers that


ask 3 radiologists to do the

segmentation

bull Observer expertise and frequency variability


Study [Weltens 2001]

bull Axial MRI slice

bull Nine independent

observers

bull Repeated delineations

bull Interintra observer

variability 30

Key issue fuzzy tumor boundaries

Inter observer variability

Intra-observer variability

8

50

Carotid Lumen Segmentation and Stenosis

Grading Challenge -- The MIDAS Journal


MIS validation manual annotation


MIS validation ground-truth generation

centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS


Measurements characteristics

bull Ground-truth not know

bull Repeatability intra-observer variability

bull Reliability inter observer variability

bull Measure correlation between repeated

measurements

bull Intrinsic uncertainty about the tumor volume

bull Accuracy for clinical significance is unknown

Inaccuracy gt Uncertainty

bull Uncertainty may not be improved

bull Goal improve accuracy to obtain

Inaccuracy vs Uncertainty

Results can be

meaningless

Inaccuracy lt Uncertainty

In summaryhellip

bull Medical image segmentation is on the risehellip

bull Basis of many clinical applications

bull Validation is a MUST

bull Many methods and approaches ndash do not re-invent

the wheel

bull I expect patient-specific 3D models to be in the

clinical mainstream in 3-5 years


Segmentation challenges

bull Rigorous quantification and evaluation of

segmentation algorithms performance

bull Shape priors for pathologies

bull Incorporation of functional information from

diffusionperfusion MRI fMRI PET into

segmentation algorithms


Summary (1)

bull Patient-specific anatomy model creation is

currently a major bottleneck in many clinical

applications

bull Automatic anatomical segmentation is essential for

model creation

bull Current tools are limited in scope and coverage

bull Clinical use requires the elimination of the

technician ndash model generation by the physician

Summary (2) bull Great opportunity for the development and

incorporation of anatomy modeling tools in

commercial platforms

bull Growing need and variety of users for anatomical

models

ndash Training simulators surgery rehersal

ndash Intraoperative guidance

ndash Computer Aided Radiology

bull Service providers -- shifting paradigms


Key trends in clinical radiology bull Filmlight table Digital imagesscreen -- early 80rsquo

bull 2D X-rays US 25D CT MRI -- mid 80rsquo ndash 90rsquo

bull 25D CT MRI 3D visualization -- mid 00lsquo

bull 3D visualization 3D anatomical modeling -- now

bull 3D modeling Advanced modeling ndash coming soon





Surface model

Polyp







Computer interprets























systems



Diagnosis Planning

Delivery

CAD mammography

Virtual colonoscopy



Tumor follow-up

Implant location


Radiology

Navigation

Robotics Evaluation

Training

Learning



stenosis

thrombus aneurism

tumor

volume

with Prof J Sosna


liver contour

blood vessels

tumors

4-phase CT dataset

kidneycontour

blood vessels





entry point

with Dr Y Shoshan



with Dr Y Shoshan




with Dr Y Shoshan




Fracture

fixation

alternatives











models from CT











Dec 15 2009 June 9 2010

Disease







Currently


bull slice by slice

Desired


clicks by physician

bull no technician


HARD NO METHOD



Very difficult task







1 2

3 4


Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models









Surface model

Polyp







Computer interprets























systems



Diagnosis Planning

Delivery

CAD mammography

Virtual colonoscopy



Tumor follow-up

Implant location


Radiology

Navigation

Robotics Evaluation

Training

Learning



stenosis

thrombus aneurism

tumor

volume

with Prof J Sosna


liver contour

blood vessels

tumors

4-phase CT dataset

kidneycontour

blood vessels





entry point

with Dr Y Shoshan



with Dr Y Shoshan




with Dr Y Shoshan




Fracture

fixation

alternatives











models from CT











Dec 15 2009 June 9 2010

Disease







Currently


bull slice by slice

Desired


clicks by physician

bull no technician


HARD NO METHOD



Very difficult task







1 2

3 4


Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models











Computer interprets























systems



Diagnosis Planning

Delivery

CAD mammography

Virtual colonoscopy



Tumor follow-up

Implant location


Radiology

Navigation

Robotics Evaluation

Training

Learning



stenosis

thrombus aneurism

tumor

volume

with Prof J Sosna


liver contour

blood vessels

tumors

4-phase CT dataset

kidneycontour

blood vessels





entry point

with Dr Y Shoshan



with Dr Y Shoshan




with Dr Y Shoshan




Fracture

fixation

alternatives











models from CT











Dec 15 2009 June 9 2010

Disease







Currently


bull slice by slice

Desired


clicks by physician

bull no technician


HARD NO METHOD



Very difficult task







1 2

3 4


Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models


























systems



Diagnosis Planning

Delivery

CAD mammography

Virtual colonoscopy



Tumor follow-up

Implant location


Radiology

Navigation

Robotics Evaluation

Training

Learning



stenosis

thrombus aneurism

tumor

volume

with Prof J Sosna


liver contour

blood vessels

tumors

4-phase CT dataset

kidneycontour

blood vessels





entry point

with Dr Y Shoshan



with Dr Y Shoshan




with Dr Y Shoshan




Fracture

fixation

alternatives











models from CT











Dec 15 2009 June 9 2010

Disease







Currently


bull slice by slice

Desired


clicks by physician

bull no technician


HARD NO METHOD



Very difficult task







1 2

3 4


Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models







Diagnosis Planning

Delivery

CAD mammography

Virtual colonoscopy



Tumor follow-up

Implant location


Radiology

Navigation

Robotics Evaluation

Training

Learning



stenosis

thrombus aneurism

tumor

volume

with Prof J Sosna


liver contour

blood vessels

tumors

4-phase CT dataset

kidneycontour

blood vessels





entry point

with Dr Y Shoshan



with Dr Y Shoshan




with Dr Y Shoshan




Fracture

fixation

alternatives











models from CT











Dec 15 2009 June 9 2010

Disease







Currently


bull slice by slice

Desired


clicks by physician

bull no technician


HARD NO METHOD



Very difficult task







1 2

3 4


Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models







stenosis

thrombus aneurism

tumor

volume

with Prof J Sosna


liver contour

blood vessels

tumors

4-phase CT dataset

kidneycontour

blood vessels





entry point

with Dr Y Shoshan



with Dr Y Shoshan




with Dr Y Shoshan




Fracture

fixation

alternatives











models from CT











Dec 15 2009 June 9 2010

Disease







Currently


bull slice by slice

Desired


clicks by physician

bull no technician


HARD NO METHOD



Very difficult task







1 2

3 4


Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models






liver contour

blood vessels

tumors

4-phase CT dataset

kidneycontour

blood vessels





entry point

with Dr Y Shoshan



with Dr Y Shoshan




with Dr Y Shoshan




Fracture

fixation

alternatives











models from CT











Dec 15 2009 June 9 2010

Disease







Currently


bull slice by slice

Desired


clicks by physician

bull no technician


HARD NO METHOD



Very difficult task







1 2

3 4


Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models







entry point

with Dr Y Shoshan



with Dr Y Shoshan




with Dr Y Shoshan




Fracture

fixation

alternatives











models from CT











Dec 15 2009 June 9 2010

Disease







Currently


bull slice by slice

Desired


clicks by physician

bull no technician


HARD NO METHOD



Very difficult task







1 2

3 4


Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models







with Dr Y Shoshan




with Dr Y Shoshan




Fracture

fixation

alternatives











models from CT











Dec 15 2009 June 9 2010

Disease







Currently


bull slice by slice

Desired


clicks by physician

bull no technician


HARD NO METHOD



Very difficult task







1 2

3 4


Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models








with Dr Y Shoshan




Fracture

fixation

alternatives











models from CT











Dec 15 2009 June 9 2010

Disease







Currently


bull slice by slice

Desired


clicks by physician

bull no technician


HARD NO METHOD



Very difficult task







1 2

3 4


Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models








Fracture

fixation

alternatives











models from CT











Dec 15 2009 June 9 2010

Disease







Currently


bull slice by slice

Desired


clicks by physician

bull no technician


HARD NO METHOD



Very difficult task







1 2

3 4


Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models














models from CT











Dec 15 2009 June 9 2010

Disease







Currently


bull slice by slice

Desired


clicks by physician

bull no technician


HARD NO METHOD



Very difficult task







1 2

3 4


Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models














Dec 15 2009 June 9 2010

Disease







Currently


bull slice by slice

Desired


clicks by physician

bull no technician


HARD NO METHOD



Very difficult task







1 2

3 4


Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models







Currently


bull slice by slice

Desired


clicks by physician

bull no technician


HARD NO METHOD



Very difficult task







1 2

3 4


Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models






Very difficult task







1 2

3 4


Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models






Very difficult task







1 2

3 4























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models



























Observations (1)


ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models






ndash Accuracy

ndash Robustness


ndash Quality







essential

Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models





Goals Clinical




Technical


scratch



MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models





MIS validation


worthless




















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models















stenosis

looping

narrowing

















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models




















Reference Result






Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models










Reference Result

Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models





Aorta

Int + Ext Carotids

All arteries


16mm (std=08mm)

13mm (std=10mm)

15mm

std=13mm 17mm

std=09mm

07mm

std=07mm

Surface

RMS

Common

Carotid










segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models














segmentation






observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models








observers



variability 30




8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models






8

50







centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models











centerlines

(manual)

contours

(manual)

Partial Volume

Segmentation

Reference

standard

from 3PVS







measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models










measurements







Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models











Results can be

meaningless


In summaryhellip





the wheel












Summary (1)



applications


model creation








models





In summaryhellip





the wheel












Summary (1)



applications


model creation








models













Summary (1)



applications


model creation








models









models





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