Towards radiological diagnosis of abdominal adhesions based on motion signatures derived from sequences of cine-MRI images.
This paper reports novel development and preliminary application of an image registration technique for diagnosis of abdominal adhesions imaged with cine-MRI (cMRI). Adhesions can severely compromise the movement and physiological function of the abdominal contents, and their presence is difficult to detect. The image registration approach presented here is designed to expose anomalies in movement of the abdominal organs, providing a movement signature that is indicative of underlying structural abnormalities. Validation of the technique was performed using structurally based in vitro and in silico models, supported with Receiver Operating Characteristic (ROC) methods. For the more challenging cases presented to the small cohort of 4 observers, the AUC (area under curve) improved from a mean value of 0.67 ± 0.02 (without image registration assistance) to a value of 0.87 ± 0.02 when image registration support was included. Also, in these cases, a reduction in time to diagnosis was observed, decreasing by between 20% and 50%. These results provided sufficient confidence to apply the image registration diagnostic protocol to sample magnetic resonance imaging data from healthy volunteers as well as a patient suffering from encapsulating peritoneal sclerosis (an extreme form of adhesions) where immobilization of the gut by cocooning of the small bowel is observed. The results as a whole support the hypothesis that movement analysis using image registration offers a possible method for detecting underlying structural anomalies and encourages further investigation.
Medical Physics Group, Dept of Cardiovascular Science, University of Sheffield, Beech Hill Road, Sheffield, Sth Yorks. S10 2RX, UK. Electronic address: j.w.fenner@sheffield.ac.uk.
John
J
Fenner
Medical Physics Group, Dept of Cardiovascular Science, University of Sheffield, Beech Hill Road, Sheffield, Sth Yorks. S10 2RX, UK.
Benjamin
B
Wright
Medical Physics Group, Dept of Cardiovascular Science, University of Sheffield, Beech Hill Road, Sheffield, Sth Yorks. S10 2RX, UK.
Jonathan
J
Emberey
The Rotherham NHS Foundation Trust, Rotherham Hospital, Moorgate Road, Rotherham S60 2UD, UK.
Paul
P
Spencer
The Rotherham NHS Foundation Trust, Rotherham Hospital, Moorgate Road, Rotherham S60 2UD, UK.
Richard
R
Gillott
Renal Research Labs, University Dept of Medicine, Manchester Royal Infirmary, Manchester M13 9WL, UK.
Angela
A
Summers
University of Warwick, Health Sciences, Clifford Bridge Road, Coventry CV2 2DX, UK.
Charles
C
Hutchinson
Medical Physics Group, Dept of Cardiovascular Science, University of Sheffield, Beech Hill Road, Sheffield, Sth Yorks. S10 2RX, UK.
Pat
P
Lawford
Renal Research Labs, University Dept of Medicine, Manchester Royal Infirmary, Manchester M13 9WL, UK.
Paul
P
Brenchley
The Rotherham NHS Foundation Trust, Rotherham Hospital, Moorgate Road, Rotherham S60 2UD, UK.
Karna Dev
KD
Bardhan
D000005:Abdomen / Q000002:abnormalities*; D000268:Adhesiveness; D016477:Artifacts; D003198:Computer Simulation; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D009068:Movement; D011871:Radiology
Abdominal adhesions; Computer-aided detection and diagnosis; Image registration; Magnetic resonance imaging (MRI); ROC analysis