Superimposing brain atlas images and brain images with delineation of infarct and penumbra for stroke diagnosis

• US 8,019,142 B2
• Filed: 11/21/2006
• Issued: 09/13/2011
• Est. Priority Date: 11/21/2005
• Status: Expired due to Fees

• Current Assignee: Agency For Science Technology and Research
• Original Assignee: Agency For Science Technology and Research
• Inventors: Beauchamp, Norman J., Nowinski, Wieslaw L.
• Primary Examiner(s): Kiknadze; Irakli
• Application Number:
  US12/067,894
• Publication Number:
  US 20090034812A1
• Time in Patent Office: 1,757 Days
• Field of Search: 378/4, 378/19, 378/62, 378/64, 382/128, 382/130, 382/131, 382/132, 382/284, 382/294
• US Class Current: 382/131
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/7425 Displaying combinations of multiple images regardless of image source, e.g. displaying a reference anatomical image with a live image geometric transforms for image registration G06T3/14; enhancement using image fusion G06T5/50; algorithms for registration of images G06T7/30
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/466 adapted to display 3D data
• CPC Class Codes: A61B 6/501 for diagnosis of the head, e.g. neuroimaging or craniography
• CPC Class Codes: A61B 6/504 for diagnosis of blood vessels, e.g. by angiography
• CPC Class Codes: G06T 19/00 Manipulating 3D models or images for computer graphics
• CPC Class Codes: G06T 2200/24 involving graphical user interfaces [GUIs]
• CPC Class Codes: G06T 2207/30016 Brain
• CPC Class Codes: G06T 2210/41 Medical
• CPC Class Codes: G06T 7/0012 Biomedical image inspection
• CPC Class Codes: G06T 7/38 Registration of image sequences

Abstract

Brain images are processed and analyzed with the aid of a computer for stroke diagnosis or therapeutic decision making, where multiple stroke-related images are superimposed. The superimposed images include brain images that have infarct and penumbra regions, and patient-specific brain atlas images. The infarct and penumbra regions are determined and delineated on the superimposed images. Each patient-specific brain atlas image may be formed by mapping a pre-existing brain atlas to a co-ordinate system in which the brain images are co-registered. A brain atlas may depict brain structures such as anatomy structures, blood supply territories (BST), or cerebral vasculature. The superimposed images may be used to determine any overlap between a particular brain structure and the infarct and penumbra regions.

Claims

1. A method of analyzing brain images of a patient for stroke diagnosis of said patient, comprising:

capturing a first image of the brain of said patient suitable for determining infarct regions of said brain;

capturing a second image of said brain suitable for determining penumbra regions of said brain;

determining an infarct region of said brain from said first image;

determining a penumbra region of said brain from said second image;

co-registering said first and second images to a co-ordinate system;

mapping pre-existing brain atlas images to said co-ordinate system to form patient-specific brain atlas images;

delineating said infarct region and said penumbra region of said brain on said patient-specific brain atlas images in said co-ordinate system; and

superimposing said first and second images, with said patient-specific brain atlas images.

2. The method of claim 1, comprising modifying delineation of said infarct region and said penumbra region on said superimposed images.

3. The method of claim 1, comprising determining a degree of overlap between one of said infarct and penumbra regions and a brain structure depicted in said patient-specific brain atlas images.

4. The method of claim 3, wherein said determining a degree of overlap comprises calculating a volume of said overlap.

5. The method of claim 4, wherein said determining a degree of overlap comprises calculating a volume ratio between said volume of said overlap and a volume of said brain structure.

6. The method of claim 5, comprising presenting an identification of said brain structure and at least one of said volume of said overlap and said volume ratio to a user.

7. The method of claim 1, comprising identifying brain structures in said patient-specific brain atlas images that overlap with said one of said infarct and penumbra regions.

8. The method of claim 1, wherein said pre-existing brain atlas images comprise an anatomy atlas image depicting at least one anatomical structure and a blood supply territory (BST) atlas image depicting blood supply territories.

9. The method of claim 8, wherein said BST atlas image depicts a middle cerebral artery (MCA), said method comprising calculating a volume ratio between said infarct region and said MCA.

10. The method of claim 8, wherein said BST atlas image depicts a middle cerebral artery (MCA), said method comprising calculating a volume ratio between said infarct region and an overlap between said infarct region and said MCA.

11. The method of claim 1, wherein said first image comprises a diffusion image.

12. The method of claim 11, wherein said diffusion image is a diffusion weighted imaging (DWI) image.

13. The method of claim 1, wherein said determining said infarct region comprises:

generating an apparent diffusion coefficient (ADC) map image from at least two diffusion images;

determining a present infarct region from one of said diffusion images;

determining a prior infarct region from said one of said diffusion images and said ADC map image; and

combining said present and prior infarct regions to form said infarct region.

14. The method of claim 1, wherein said second image comprises a perfusion image.

15. The method of claim 14, wherein said perfusion image is a perfusion-weighted imaging (PWI) image.

16. The method of claim 14, wherein said determining said penumbra region comprises:

generating at least one perfusion map image from said perfusion image, said at least one perfusion map image selected from mean transit time (MTT), cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), and peak-height (PKHT) map images;

superimposing said perfusion image and said at least one perfusion map image; and

determining an apparent penumbra region from said superimposed perfusion image and said at least one perfusion map image.

17. The method of claim 16, wherein said determining said penumbra region comprises excluding from said apparent penumbra region any overlap with said infract region to form said penumbra region.

18. The method of claim 1, comprising capturing at least one additional image of said brain and superimposing said at least one additional image with said first and second images and said patient-specific brain atlas images, said at least one additional image selected from gradient echo (GRE), fast spin echo (FSE), magnetic resonance angiography (MRA), diffusion weighted imaging (DWI), perfusion weighted imaging (PWI), and fluid-attenuated inversion-recovery (FLAIR) images.

19. The method of claim 1, wherein at least one of said first and second images is a computerized tomography (CT) image.

20. The method of claim 1, wherein each one of said images is two-dimensional (2D) or three-dimensional (3D).

21. A computer readable medium storing computer executable instructions which, when executed by a computer, adopt said computer to perform the method of claim 1.

22. A computer comprising a processor and a computer readable medium, said computer readable medium storing computer executable instructions which, when executed by said processor, adopt said computer to perform the method of claim 1.

23. The computer of claim 22, comprising a display for displaying said images.