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Danny Ruijters

Publications and source records attributed to Danny Ruijters.

8 recordsLinked to original sources

Direct vascular territory segmentation on cerebral digital subtraction angiography

X-ray digital subtraction angiography (DSA) is frequently used when evaluating minimally invasive medical interventions. DSA predominantly visualizes vessels, and soft tissue anatomy is less visible or invisible in DSA. Visualization of cerebral anatomy could aid physicians during treatment. This study aimed to develop and evaluate a deep learning model to predict vascular territories that are not explicitly visible in DSA imaging acquired during ischemic stroke treatment. We trained an nnUNet model with manually segmented intracranial carotid artery and middle cerebral artery vessel territories on minimal intensity projection DSA acquired during ischemic stroke treatment. We compared the model to a traditional atlas registration model using the Dice similarity coefficient (DSC) and average surface distance (ASD). Additionally, we qualitatively assessed the success rate in both models using an external test. The segmentation model was trained on 1224 acquisitions from 361 patients with ischemic stroke. The segmentation model had a significantly higher DSC (0.96 vs 0.82, p<0.001) and lower ASD compared to the atlas model (13.8 vs 47.3, p<0.001). The success rate of the segmentation model (85%) was higher compared to the atlas registration model (66%) in the external test set. A deep learning method for the segmentation of vascular territories without explicit borders on cerebral DSA demonstrated superior accuracy and quality compared to the traditional atlas-based method. This approach has the potential to be applied to other anatomical structures for enhanced visualization during X-ray guided medical procedures. The code is publicly available at https://github.com/RuishengSu/autoTICI.

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OccluNet: Spatio-Temporal Deep Learning for Occlusion Detection on DSA

Accurate detection of vascular occlusions during endovascular thrombectomy (EVT) is critical in acute ischemic stroke (AIS). Interpretation of digital subtraction angiography (DSA) sequences poses challenges due to anatomical complexity and time constraints. This work proposes OccluNet, a spatio-temporal deep learning model that integrates YOLOX, a single-stage object detector, with transformer-based temporal attention mechanisms to automate occlusion detection in DSA sequences. We compared OccluNet with a YOLOv11 baseline trained on either individual DSA frames or minimum intensity projections. Two spatio-temporal variants were explored for OccluNet: pure temporal attention and divided space-time attention. Evaluation on DSA images from the MR CLEAN Registry revealed the model's capability to capture temporally consistent features, achieving precision and recall of 89.02% and 74.87%, respectively. OccluNet significantly outperformed the baseline models, and both attention variants attained similar performance. Source code is available at https://github.com/anushka-kore/OccluNet.git

cs.CV

CLAIRE-DSA: Fluoroscopic Image Classification for Quality Assurance of Computer Vision Pipelines in Acute Ischemic Stroke

Computer vision models can be used to assist during mechanical thrombectomy (MT) for acute ischemic stroke (AIS), but poor image quality often degrades performance. This work presents CLAIRE-DSA, a deep learning--based framework designed to categorize key image properties in minimum intensity projections (MinIPs) acquired during MT for AIS, supporting downstream quality control and workflow optimization. CLAIRE-DSA uses pre-trained ResNet backbone models, fine-tuned to predict nine image properties (e.g., presence of contrast, projection angle, motion artefact severity). Separate classifiers were trained on an annotated dataset containing $1,758$ fluoroscopic MinIPs. The model achieved excellent performance on all labels, with ROC-AUC ranging from $0.91$ to $0.98$, and precision ranging from $0.70$ to $1.00$. The ability of CLAIRE-DSA to identify suitable images was evaluated on a segmentation task by filtering poor quality images and comparing segmentation performance on filtered and unfiltered datasets. Segmentation success rate increased from $42%$ to $69%$, $p < 0.001$. CLAIRE-DSA demonstrates strong potential as an automated tool for accurately classifying image properties in DSA series of acute ischemic stroke patients, supporting image annotation and quality control in clinical and research applications. Source code is available at https://gitlab.com/icai-stroke-lab/wp3_neurointerventional_ai/claire-dsa.

cs.CV

NerT-CA: Efficient Dynamic Reconstruction from Sparse-view X-ray Coronary Angiography

Three-dimensional (3D) and dynamic 3D+time (4D) reconstruction of coronary arteries from X-ray coronary angiography (CA) has the potential to improve clinical procedures. However, there are multiple challenges to be addressed, most notably, blood-vessel structure sparsity, poor background and blood vessel distinction, sparse-views, and intra-scan motion. State-of-the-art reconstruction approaches rely on time-consuming manual or error-prone automatic segmentations, limiting clinical usability. Recently, approaches based on Neural Radiance Fields (NeRF) have shown promise for automatic reconstructions in the sparse-view setting. However, they suffer from long training times due to their dependence on MLP-based representations. We propose NerT-CA, a hybrid approach of Neural and Tensorial representations for accelerated 4D reconstructions with sparse-view CA. Building on top of the previous NeRF-based work, we model the CA scene as a decomposition of low-rank and sparse components, utilizing fast tensorial fields for low-rank static reconstruction and neural fields for dynamic sparse reconstruction. Our approach outperforms previous works in both training time and reconstruction accuracy, yielding reasonable reconstructions from as few as three angiogram views. We validate our approach quantitatively and qualitatively on representative 4D phantom datasets.

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ICA-based Resting-State Networks Obtained on Large Autism fMRI Dataset ABIDE

Functional magnetic resonance imaging (fMRI) has become instrumental in researching brain function. One application of fMRI is investigating potential neural features that distinguish people with autism spectrum disorder (ASD) from healthy controls. The Autism Brain Imaging Data Exchange (ABIDE) facilitates this research through its extensive data-sharing initiative. While ABIDE offers data preprocessed with various atlases, independent component analysis (ICA) for dimensionality reduction remains underutilized. We address this gap by presenting ICA-based resting-state networks (RSNs) from preprocessed scans from ABIDE, now publicly available: https://github.com/SjirSchielen/groupICAonABIDE. These RSNs unveil neural activation clusters without atlas constraints, offering a perspective on ASD analyses that complements the predominantly atlas-based literature. This contribution provides a valuable resource for further research into ASD, potentially aiding in developing new analytical approaches.

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NeRF-CA: Dynamic Reconstruction of X-ray Coronary Angiography with Extremely Sparse-views

Dynamic three-dimensional (4D) reconstruction from two-dimensional X-ray coronary angiography (CA) remains a significant clinical problem. Existing CA reconstruction methods often require extensive user interaction or large training datasets. Recently, Neural Radiance Field (NeRF) has successfully reconstructed high-fidelity scenes in natural and medical contexts without these requirements. However, challenges such as sparse-views, intra-scan motion, and complex vessel morphology hinder its direct application to CA data. We introduce NeRF-CA, a first step toward a fully automatic 4D CA reconstruction that achieves reconstructions from sparse coronary angiograms. To the best of our knowledge, we are the first to address the challenges of sparse-views and cardiac motion by decoupling the scene into the moving coronary artery and the static background, effectively translating the problem of motion into a strength. NeRF-CA serves as a first stepping stone for solving the 4D CA reconstruction problem, achieving adequate 4D reconstructions from as few as four angiograms, as required by clinical practice, while significantly outperforming state-of-the-art sparse-view X-ray NeRF. We validate our approach quantitatively and qualitatively using representative 4D phantom datasets and ablation studies. To accelerate research in this domain, we made our codebase public: https://github.com/kirstenmaas/NeRF-CA.

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AngioMoCo: Learning-based Motion Correction in Cerebral Digital Subtraction Angiography

Cerebral X-ray digital subtraction angiography (DSA) is the standard imaging technique for visualizing blood flow and guiding endovascular treatments. The quality of DSA is often negatively impacted by body motion during acquisition, leading to decreased diagnostic value. Time-consuming iterative methods address motion correction based on non-rigid registration, and employ sparse key points and non-rigidity penalties to limit vessel distortion. Recent methods alleviate subtraction artifacts by predicting the subtracted frame from the corresponding unsubtracted frame, but do not explicitly compensate for motion-induced misalignment between frames. This hinders the serial evaluation of blood flow, and often causes undesired vasculature and contrast flow alterations, leading to impeded usability in clinical practice. To address these limitations, we present AngioMoCo, a learning-based framework that generates motion-compensated DSA sequences from X-ray angiography. AngioMoCo integrates contrast extraction and motion correction, enabling differentiation between patient motion and intensity changes caused by contrast flow. This strategy improves registration quality while being substantially faster than iterative elastix-based methods. We demonstrate AngioMoCo on a large national multi-center dataset (MR CLEAN Registry) of clinically acquired angiographic images through comprehensive qualitative and quantitative analyses. AngioMoCo produces high-quality motion-compensated DSA, removing motion artifacts while preserving contrast flow. Code is publicly available at https://github.com/RuishengSu/AngioMoCo.

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CAVE: Cerebral Artery-Vein Segmentation in Digital Subtraction Angiography

Cerebral X-ray digital subtraction angiography (DSA) is a widely used imaging technique in patients with neurovascular disease, allowing for vessel and flow visualization with high spatio-temporal resolution. Automatic artery-vein segmentation in DSA plays a fundamental role in vascular analysis with quantitative biomarker extraction, facilitating a wide range of clinical applications. The widely adopted U-Net applied on static DSA frames often struggles with disentangling vessels from subtraction artifacts. Further, it falls short in effectively separating arteries and veins as it disregards the temporal perspectives inherent in DSA. To address these limitations, we propose to simultaneously leverage spatial vasculature and temporal cerebral flow characteristics to segment arteries and veins in DSA. The proposed network, coined CAVE, encodes a 2D+time DSA series using spatial modules, aggregates all the features using temporal modules, and decodes it into 2D segmentation maps. On a large multi-center clinical dataset, CAVE achieves a vessel segmentation Dice of 0.84 ($\pm$0.04) and an artery-vein segmentation Dice of 0.79 ($\pm$0.06). CAVE surpasses traditional Frangi-based K-means clustering (P<0.001) and U-Net (P<0.001) by a significant margin, demonstrating the advantages of harvesting spatio-temporal features. This study represents the first investigation into automatic artery-vein segmentation in DSA using deep learning. The code is publicly available at https://github.com/RuishengSu/CAVE_DSA.

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