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Jan Egger

Publications and source records attributed to Jan Egger.

At least 73 records · Page 4Linked to original sources

Learning to Rearrange Voxels in Binary Segmentation Masks for Smooth Manifold Triangulation

Medical images, especially volumetric images, are of high resolution and often exceed the capacity of standard desktop GPUs. As a result, most deep learning-based medical image analysis tasks require the input images to be downsampled, often substantially, before these can be fed to a neural network. However, downsampling can lead to a loss of image quality, which is undesirable especially in reconstruction tasks, where the fine geometric details need to be preserved. In this paper, we propose that high-resolution images can be reconstructed in a coarse-to-fine fashion, where a deep learning algorithm is only responsible for generating a coarse representation of the image, which consumes moderate GPU memory. For producing the high-resolution outcome, we propose two novel methods: learned voxel rearrangement of the coarse output and hierarchical image synthesis. Compared to the coarse output, the high-resolution counterpart allows for smooth surface triangulation, which can be 3D-printed in the highest possible quality. Experiments of this paper are carried out on the dataset of AutoImplant 2021 (https://autoimplant2021.grand-challenge.org/), a MICCAI challenge on cranial implant design. The dataset contains high-resolution skulls that can be viewed as 2D manifolds embedded in a 3D space. Codes associated with this study can be accessed at https://github.com/Jianningli/voxel_rearrangement.

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A Baseline Approach for AutoImplant: the MICCAI 2020 Cranial Implant Design Challenge

In this study, we present a baseline approach for AutoImplant (https://autoimplant.grand-challenge.org/) - the cranial implant design challenge, which, as suggested by the organizers, can be formulated as a volumetric shape learning task. In this task, the defective skull, the complete skull and the cranial implant are represented as binary voxel grids. To accomplish this task, the implant can be either reconstructed directly from the defective skull or obtained by taking the difference between a defective skull and a complete skull. In the latter case, a complete skull has to be reconstructed given a defective skull, which defines a volumetric shape completion problem. Our baseline approach for this task is based on the former formulation, i.e., a deep neural network is trained to predict the implants directly from the defective skulls. The approach generates high-quality implants in two steps: First, an encoder-decoder network learns a coarse representation of the implant from down-sampled, defective skulls; The coarse implant is only used to generate the bounding box of the defected region in the original high-resolution skull. Second, another encoder-decoder network is trained to generate a fine implant from the bounded area. On the test set, the proposed approach achieves an average dice similarity score (DSC) of 0.8555 and Hausdorff distance (HD) of 5.1825 mm. The code is publicly available at https://github.com/Jianningli/autoimplant.

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An Online Platform for Automatic Skull Defect Restoration and Cranial Implant Design

We introduce a fully automatic system for cranial implant design, a common task in cranioplasty operations. The system is currently integrated in Studierfenster (http://studierfenster.tugraz.at/), an online, cloud-based medical image processing platform for medical imaging applications. Enhanced by deep learning algorithms, the system automatically restores the missing part of a skull (i.e., skull shape completion) and generates the desired implant by subtracting the defective skull from the completed skull. The generated implant can be downloaded in the STereoLithography (.stl) format directly via the browser interface of the system. The implant model can then be sent to a 3D printer for in loco implant manufacturing. Furthermore, thanks to the standard format, the user can thereafter load the model into another application for post-processing whenever necessary. Such an automatic cranial implant design system can be integrated into the clinical practice to improve the current routine for surgeries related to skull defect repair (e.g., cranioplasty). Our system, although currently intended for educational and research use only, can be seen as an application of additive manufacturing for fast, patient-specific implant design.

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Design and Development of a Web-based Tool for Inpainting of Dissected Aortae in Angiography Images

Medical imaging is an important tool for the diagnosis and the evaluation of an aortic dissection (AD); a serious condition of the aorta, which could lead to a life-threatening aortic rupture. AD patients need life-long medical monitoring of the aortic enlargement and of the disease progression, subsequent to the diagnosis of the aortic dissection. Since there is a lack of 'healthy-dissected' image pairs from medical studies, the application of inpainting techniques offers an alternative source for generating them by doing a virtual regression from dissected aortae to healthy aortae; an indirect way to study the origin of the disease. The proposed inpainting tool combines a neural network, which was trained on the task of inpainting aortic dissections, with an easy-to-use user interface. To achieve this goal, the inpainting tool has been integrated within the 3D medical image viewer of StudierFenster (www.studierfenster.at). By designing the tool as a web application, we simplify the usage of the neural network and reduce the initial learning curve.

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Client/Server Based Online Environment for Manual Segmentation of Medical Images

Segmentation is a key step in analyzing and processing medical images. Due to the low fault tolerance in medical imaging, manual segmentation remains the de facto standard in this domain. Besides, efforts to automate the segmentation process often rely on large amounts of manually labeled data. While existing software supporting manual segmentation is rich in features and delivers accurate results, the necessary time to set it up and get comfortable using it can pose a hurdle for the collection of large datasets. This work introduces a client/server based online environment, referred to as Studierfenster (studierfenster.at), that can be used to perform manual segmentations directly in a web browser. The aim of providing this functionality in the form of a web application is to ease the collection of ground truth segmentation datasets. Providing a tool that is quickly accessible and usable on a broad range of devices, offers the potential to accelerate this process. The manual segmentation workflow of Studierfenster consists of dragging and dropping the input file into the browser window and slice-by-slice outlining the object under consideration. The final segmentation can then be exported as a file storing its contours and as a binary segmentation mask. In order to evaluate the usability of Studierfenster, a user study was performed. The user study resulted in a mean of 6.3 out of 7.0 possible points given by users, when asked about their overall impression of the tool. The evaluation also provides insights into the results achievable with the tool in practice, by presenting two ground truth segmentations performed by physicians.

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Exploit fully automatic low-level segmented PET data for training high-level deep learning algorithms for the corresponding CT data

We present an approach for fully automatic urinary bladder segmentation in CT images with artificial neural networks in this study. Automatic medical image analysis has become an invaluable tool in the different treatment stages of diseases. Especially medical image segmentation plays a vital role, since segmentation is often the initial step in an image analysis pipeline. Since deep neural networks have made a large impact on the field of image processing in the past years, we use two different deep learning architectures to segment the urinary bladder. Both of these architectures are based on pre-trained classification networks that are adapted to perform semantic segmentation. Since deep neural networks require a large amount of training data, specifically images and corresponding ground truth labels, we furthermore propose a method to generate such a suitable training data set from Positron Emission Tomography/Computed Tomography image data. This is done by applying thresholding to the Positron Emission Tomography data for obtaining a ground truth and by utilizing data augmentation to enlarge the dataset. In this study, we discuss the influence of data augmentation on the segmentation results, and compare and evaluate the proposed architectures in terms of qualitative and quantitative segmentation performance. The results presented in this study allow concluding that deep neural networks can be considered a promising approach to segment the urinary bladder in CT images.

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Computed tomography data collection of the complete human mandible and valid clinical ground truth models

Image-based algorithmic software segmentation is an increasingly important topic in many medical fields. Algorithmic segmentation is used for medical three-dimensional visualization, diagnosis or treatment support, especially in complex medical cases. However, accessible medical databases are limited, and valid medical ground truth databases for the evaluation of algorithms are rare and usually comprise only a few images. Inaccuracy or invalidity of medical ground truth data and image-based artefacts also limit the creation of such databases, which is especially relevant for CT data sets of the maxillomandibular complex. This contribution provides a unique and accessible data set of the complete mandible, including 20 valid ground truth segmentation models originating from 10 CT scans from clinical practice without artefacts or faulty slices. From each CT scan, two 3D ground truth models were created by clinical experts through independent manual slice-by-slice segmentation, and the models were statistically compared to prove their validity. These data could be used to conduct serial image studies of the human mandible, evaluating segmentation algorithms and developing adequate image tools.

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Clinical evaluation of semi-automatic opensource algorithmic software segmentation of the mandibular bone: Practical feasibility and assessment of a new course of action

Computer assisted technologies based on algorithmic software segmentation are an increasing topic of interest in complex surgical cases. However - due to functional instability, time consuming software processes, personnel resources or licensed-based financial costs many segmentation processes are often outsourced from clinical centers to third parties and the industry. Therefore, the aim of this trial was to assess the practical feasibility of an easy available, functional stable and licensed-free segmentation approach to be used in the clinical practice. In this retrospective, randomized, controlled trail the accuracy and accordance of the open-source based segmentation algorithm GrowCut (GC) was assessed through the comparison to the manually generated ground truth of the same anatomy using 10 CT lower jaw data-sets from the clinical routine. Assessment parameters were the segmentation time, the volume, the voxel number, the Dice Score (DSC) and the Hausdorff distance (HD). Overall segmentation times were about one minute. Mean DSC values of over 85% and HD below 33.5 voxel could be achieved. Statistical differences between the assessment parameters were not significant (p<0.05) and correlation coefficients were close to the value one (r > 0.94). Complete functional stable and time saving segmentations with high accuracy and high positive correlation could be performed by the presented interactive open-source based approach. In the cranio-maxillofacial complex the used method could represent an algorithmic alternative for image-based segmentation in the clinical practice for e.g. surgical treatment planning or visualization of postoperative results and offers several advantages. Systematic comparisons to other segmentation approaches or with a greater data amount are areas of future works.

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In-depth Assessment of an Interactive Graph-based Approach for the Segmentation for Pancreatic Metastasis in Ultrasound Acquisitions of the Liver with two Specialists in Internal Medicine

The manual outlining of hepatic metastasis in (US) ultrasound acquisitions from patients suffering from pancreatic cancer is common practice. However, such pure manual measurements are often very time consuming, and the results repeatedly differ between the raters. In this contribution, we study the in-depth assessment of an interactive graph-based approach for the segmentation for pancreatic metastasis in US images of the liver with two specialists in Internal Medicine. Thereby, evaluating the approach with over one hundred different acquisitions of metastases. The two physicians or the algorithm had never assessed the acquisitions before the evaluation. In summary, the physicians first performed a pure manual outlining followed by an algorithmic segmentation over one month later. As a result, the experts satisfied in up to ninety percent of algorithmic segmentation results. Furthermore, the algorithmic segmentation was much faster than manual outlining and achieved a median Dice Similarity Coefficient (DSC) of over eighty percent. Ultimately, the algorithm enables a fast and accurate segmentation of liver metastasis in clinical US images, which can support the manual outlining in daily practice.

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Vertebral body segmentation with GrowCut: Initial experience, workflow and practical application

In this contribution, we used the GrowCut segmentation algorithm publicly available in three-dimensional Slicer for three-dimensional segmentation of vertebral bodies. To the best of our knowledge, this is the first time that the GrowCut method has been studied for the usage of vertebral body segmentation. In brief, we found that the GrowCut segmentation times were consistently less than the manual segmentation times. Hence, GrowCut provides an alternative to a manual slice-by-slice segmentation process.

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Algorithm guided outlining of 105 pancreatic cancer liver metastases in Ultrasound

Manual segmentation of hepatic metastases in ultrasound images acquired from patients suffering from pancreatic cancer is common practice. Semiautomatic measurements promising assistance in this process are often assessed using a small number of lesions performed by examiners who already know the algorithm. In this work, we present the application of an algorithm for the segmentation of liver metastases due to pancreatic cancer using a set of 105 different images of metastases. The algorithm and the two examiners had never assessed the images before. The examiners first performed a manual segmentation and, after five weeks, a semiautomatic segmentation using the algorithm. They were satisfied in up to 90% of the cases with the semiautomatic segmentation results. Using the algorithm was significantly faster and resulted in a median Dice similarity score of over 80%. Estimation of the inter-operator variability by using the intra class correlation coefficient was good with 0.8. In conclusion, the algorithm facilitates fast and accurate segmentation of liver metastases, comparable to the current gold standard of manual segmentation.

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Computer-aided position planning of miniplates to treat facial bone defects

In this contribution, a software system for computer-aided position planning of miniplates to treat facial bone defects is proposed. The intra-operatively used bone plates have to be passively adapted on the underlying bone contours for adequate bone fragment stabilization. However, this procedure can lead to frequent intra-operatively performed material readjustments especially in complex surgical cases. Our approach is able to fit a selection of common implant models on the surgeon's desired position in a 3D computer model. This happens with respect to the surrounding anatomical structures, always including the possibility of adjusting both the direction and the position of the used osteosynthesis material. By using the proposed software, surgeons are able to pre-plan the out coming implant in its form and morphology with the aid of a computer-visualized model within a few minutes. Further, the resulting model can be stored in STL file format, the commonly used format for 3D printing. Using this technology, surgeons are able to print the virtual generated implant, or create an individually designed bending tool. This method leads to adapted osteosynthesis materials according to the surrounding anatomy and requires further a minimum amount of money and time.

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Computer-aided implant design for the restoration of cranial defects

Patient-specific cranial implants are important and necessary in the surgery of cranial defect restoration. However, traditional methods of manual design of cranial implants are complicated and time-consuming. Our purpose is to develop a novel software named EasyCrania to design the cranial implants conveniently and efficiently. The process can be divided into five steps, which are mirroring model, clipping surface, surface fitting, the generation of the initial implant and the generation of the final implant. The main concept of our method is to use the geometry information of the mirrored model as the base to generate the final implant. The comparative studies demonstrated that the EasyCrania can improve the efficiency of cranial implant design significantly. And, the intra- and inter-rater reliability of the software were stable, which were 87.07+/-1.6% and 87.73+/-1.4% respectively.

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Interactive Outlining of Pancreatic Cancer Liver Metastases in Ultrasound Images

Ultrasound (US) is the most commonly used liver imaging modality worldwide. Due to its low cost, it is increasingly used in the follow-up of cancer patients with metastases localized in the liver. In this contribution, we present the results of an interactive segmentation approach for liver metastases in US acquisitions. A (semi-) automatic segmentation is still very challenging because of the low image quality and the low contrast between the metastasis and the surrounding liver tissue. Thus, the state of the art in clinical practice is still manual measurement and outlining of the metastases in the US images. We tackle the problem by providing an interactive segmentation approach providing real-time feedback of the segmentation results. The approach has been evaluated with typical US acquisitions from the clinical routine, and the datasets consisted of pancreatic cancer metastases. Even for difficult cases, satisfying segmentations results could be achieved because of the interactive real-time behavior of the approach. In total, 40 clinical images have been evaluated with our method by comparing the results against manual ground truth segmentations. This evaluation yielded to an average Dice Score of 85% and an average Hausdorff Distance of 13 pixels.

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HTC Vive MeVisLab integration via OpenVR for medical applications

Virtual Reality, an immersive technology that replicates an environment via computer-simulated reality, gets a lot of attention in the entertainment industry. However, VR has also great potential in other areas, like the medical domain, Examples are intervention planning, training and simulation. This is especially of use in medical operations, where an aesthetic outcome is important, like for facial surgeries. Alas, importing medical data into Virtual Reality devices is not necessarily trivial, in particular, when a direct connection to a proprietary application is desired. Moreover, most researcher do not build their medical applications from scratch, but rather leverage platforms like MeVisLab, MITK, OsiriX or 3D Slicer. These platforms have in common that they use libraries like ITK and VTK, and provide a convenient graphical interface. However, ITK and VTK do not support Virtual Reality directly. In this study, the usage of a Virtual Reality device for medical data under the MeVisLab platform is presented. The OpenVR library is integrated into the MeVisLab platform, allowing a direct and uncomplicated usage of the head mounted display HTC Vive inside the MeVisLab platform. Medical data coming from other MeVisLab modules can directly be connected per drag-and-drop to the Virtual Reality module, rendering the data inside the HTC Vive for immersive virtual reality inspection.

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Development of a computer-aided design software for dental splint in orthognathic surgery

In the orthognathic surgery, dental splints are important and necessary to help the surgeon reposition the maxilla or mandible. However, the traditional methods of manual design of dental splints are difficult and time-consuming. The research on computer-aided design software for dental splints is rarely reported. Our purpose is to develop a novel special software named EasySplint to design the dental splints conveniently and efficiently. The design can be divided into two steps, which are the generation of initial splint base and the Boolean operation between it and the maxilla-mandibular model. The initial splint base is formed by ruled surfaces reconstructed using the manually picked points. Then, a method to accomplish Boolean operation based on the distance filed of two meshes is proposed. The interference elimination can be conducted on the basis of marching cubes algorithm and Boolean operation. The accuracy of the dental splint can be guaranteed since the original mesh is utilized to form the result surface. Using EasySplint, the dental splints can be designed in about 10 minutes and saved as a stereo lithography (STL) file for 3D printing in clinical applications. Three phantom experiments were conducted and the efficiency of our method was demonstrated.

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Interactive reconstructions of cranial 3D implants under MeVisLab as an alternative to commercial planning software

In this publication, the interactive planning and reconstruction of cranial 3D Implants under the medical prototyping platform MeVisLab as alternative to commercial planning software is introduced. In doing so, a MeVisLab prototype consisting of a customized data-flow network and an own C++ module was set up. As a result, the Computer-Aided Design (CAD) software prototype guides a user through the whole workflow to generate an implant. Therefore, the workflow begins with loading and mirroring the patients head for an initial curvature of the implant. Then, the user can perform an additional Laplacian smoothing, followed by a Delaunay triangulation. The result is an aesthetic looking and well-fitting 3D implant, which can be stored in a CAD file format, e.g. STereoLithography (STL), for 3D printing. The 3D printed implant can finally be used for an in-depth pre-surgical evaluation or even as a real implant for the patient. In a nutshell, our research and development shows that a customized MeVisLab software prototype can be used as an alternative to complex commercial planning software, which may also not be available in every clinic. Finally, not to conform ourselves directly to available commercial software and look for other options that might improve the workflow.

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Cellular Automata Segmentation of the Boundary between the Compacta of Vertebral Bodies and Surrounding Structures

Due to the aging population, spinal diseases get more and more common nowadays; e.g., lifetime risk of osteoporotic fracture is 40% for white women and 13% for white men in the United States. Thus the numbers of surgical spinal procedures are also increasing with the aging population and precise diagnosis plays a vital role in reducing complication and recurrence of symptoms. Spinal imaging of vertebral column is a tedious process subjected to interpretation errors. In this contribution, we aim to reduce time and error for vertebral interpretation by applying and studying the GrowCut-algorithm for boundary segmentation between vertebral body compacta and surrounding structures. GrowCut is a competitive region growing algorithm using cellular automata. For our study, vertebral T2-weighted Magnetic Resonance Imaging (MRI) scans were first manually outlined by neurosurgeons. Then, the vertebral bodies were segmented in the medical images by a GrowCut-trained physician using the semi-automated GrowCut-algorithm. Afterwards, results of both segmentation processes were compared using the Dice Similarity Coefficient (DSC) and the Hausdorff Distance (HD) which yielded to a DSC of 82.99+/-5.03% and a HD of 18.91+/-7.2 voxel, respectively. In addition, the times have been measured during the manual and the GrowCut segmentations, showing that a GrowCut-segmentation - with an average time of less than six minutes (5.77+/-0.73) - is significantly shorter than a pure manual outlining.

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