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3D point cloud processing

Methods for processing a 3D point cloud of a building into polygons using an electronic computing device are presented, the methods including: causing the electronic computing device to receive the 3D point cloud; causing the electronic computing device to segment the 3D point cloud into a number of facades; and causing the electronic computing device to generate a number of polygons representing the number of facades. In some embodiments, the causing the electronic computing device to segment the 3D point cloud into a number of facades includes: performing voxel downsampling operation on the 3D point cloud; calculating a point normal for every point in the voxel downsampled 3D point cloud; and performing region growing to find each of the number of facades.

Wang, Richard↗

3D TEM reconstruction and segmentation process of laminar bio-nanocomposites

The microstructure of laminar bio-nanocomposites (Poly (lactic acid)(PLA)/clay) depends on the amount of clay platelet opening after integration with the polymer matrix and determines the final properties of the material. Transmission electron microscopy (TEM) technique is the only one that can provide a direct observation of the layer dispersion and the degree of exfoliation. However, the orientation of the clay platelets, which affects the final properties, is practically immeasurable from a single 2D TEM image. This issue can be overcome using transmission electron tomography (ET), a technique that allows the complete 3D characterization of the structure, including the measurement of the orientation of clay platelets, their morphology and their 3D distribution. ET involves a 3D reconstruction of the study volume and a subsequent segmentation of the study object. Currently, accurate segmentation is performed manually, which is inefficient and tedious. The aim of this work is to propose an objective/automated segmentation methodology process of a 3D TEM tomography reconstruction. In this method the segmentation threshold is optimized by minimizing the variation of the dimensions of the segmented objects and matching the segmented V{sub clay} (%) and the actual one. The method is first validated using a fictitious set of objects, and then applied on a nanocomposite.

75 CONDENSED MATTER PHYSICS, SUPERCONDUCTIVITY AND↗

3D Histopathology—a Lung Tissue Segmentation Workflow for Microfocus X-ray-Computed Tomography Scans

Lung histopathology is currently based on the analysis of 2D sections of tissue samples. The use of microfocus X-ray-computed tomography imaging of unstained soft tissue can provide high-resolution 3D image datasets in the range of 2–10 μm without affecting the current diagnostic workflow. Important details of structural features such as the tubular networks of airways and blood vessels are contained in these datasets but are difficult and time-consuming to identify by manual image segmentation. Providing 3D structures permits a better understanding of tissue functions and structural interrelationships. It also provides a more complete picture of heterogeneous samples. In addition, 3D analysis of tissue structure provides the potential for an entirely new level of quantitative measurements of this structure that have previously been based only on extrapolation from 2D sections. In this paper, a workflow for segmenting such 3D images semi-automatically has been created using and extending the ImageJ open-source software and key steps of the workflow have been integrated into a new ImageJ plug-in called LungJ. Results indicate an improved workflow with a modular organization of steps facilitating the optimization for different sample and scan properties with expert input as required. This allows for incremental and independent optimization of algorithms leading to faster segmentation. Representation of the tubular networks in samples of human lung, building on those segmentations, has been demonstrated using this approach.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

3D exemplar-based random walks for tooth segmentation from cone-beam computed tomography images

Purpose: Tooth segmentation is an essential step in acquiring patient-specific dental geometries from cone-beam computed tomography (CBCT) images. Tooth segmentation from CBCT images is still a challenging task considering the comparatively low image quality caused by the limited radiation dose, as well as structural ambiguities from intercuspation and nearby alveolar bones. The goal of this paper is to present and discuss the latest accomplishments in semisupervised tooth segmentation with adaptive 3D shape constraints. Methods: The authors propose a 3D exemplar-based random walk method of tooth segmentation from CBCT images. The proposed method integrates semisupervised label propagation and regularization by 3D exemplar registration. To begin with, the pure random walk method is to get an initial segmentation of the teeth, which tends to be erroneous because of the structural ambiguity of CBCT images. And then, as an iterative refinement, the authors conduct a regularization by using 3D exemplar registration, as well as label propagation by random walks with soft constraints, to improve the tooth segmentation. In the first stage of the iteration, 3D exemplars with well-defined topologies are adapted to fit the tooth contours, which are obtained from the random walks based segmentation. The soft constraints on voxel labeling are defined by shape-based foreground dentine probability acquired by the exemplar registration, as well as the appearance-based probability from a support vector machine (SVM) classifier. In the second stage, the labels of the volume-of-interest (VOI) are updated by the random walks with soft constraints. The two stages are optimized iteratively. Instead of the one-shot label propagation in the VOI, an iterative refinement process can achieve a reliable tooth segmentation by virtue of exemplar-based random walks with adaptive soft constraints. Results: The proposed method was applied for tooth segmentation of twenty clinically captured CBCT images. Three metrics, including the Dice similarity coefficient (DSC), the Jaccard similarity coefficient (JSC), and the mean surface deviation (MSD), were used to quantitatively analyze the segmentation of anterior teeth including incisors and canines, premolars, and molars. The segmentation of the anterior teeth achieved a DSC up to 98%, a JSC of 97%, and an MSD of 0.11 mm compared with manual segmentation. For the premolars, the average values of DSC, JSC, and MSD were 98%, 96%, and 0.12 mm, respectively. The proposed method yielded a DSC of 95%, a JSC of 89%, and an MSD of 0.26 mm for molars. Aside from the interactive definition of label priors by the user, automatic tooth segmentation can be achieved in an average of 1.18 min. Conclusions: The proposed technique enables an efficient and reliable tooth segmentation from CBCT images. This study makes it clinically practical to segment teeth from CBCT images, thus facilitating pre- and interoperative uses of dental morphologies in maxillofacial and orthodontic treatments.

60 APPLIED LIFE SCIENCES↗

Insight into 3D micro-CT data: exploring segmentation algorithms through performance metrics

Three-dimensional (3D) micro-tomography (µ-CT) has proven to be an important imaging modality in industry and scientific domains. Understanding the properties of material structure and behavior has produced many scientific advances. An important component of the 3D µ-CT pipeline is image partitioning (or image segmentation), a step that is used to separate various phases or components in an image. Image partitioning schemes require specific rules for different scientific fields, but a common strategy consists of devising metrics to quantify performance and accuracy. The present article proposes a set of protocols to systematically analyze and compare the results of unsupervised classification methods used for segmentation of synchrotron-based data. Additionally, the proposed dataflow for Materials Segmentation and Metrics (MSM) provides 3D micro-tomography image segmentation algorithms, such as statistical region merging (SRM), k-means algorithm and parallel Markov random field (PMRF), while offering different metrics to evaluate segmentation quality, confidence and conformity with standards. Both experimental and synthetic data are assessed, illustrating quantitative results through the MSM dashboard, which can return sample information such as media porosity and permeability. The main contributions of this work are: (i) to deliver tools to improve material design and quality control; (ii) to provide datasets for benchmarking and reproducibility; (iii) to yield good practices in the absence of standards or ground-truth for ceramic composite analysis.

97 MATHEMATICS AND COMPUTING↗

MATBOX, an Open-Source Microstructure Analysis Toolbox for Meshing, Generation, Segmentation, and Characterization of 3D Heterogenous Volumes

Battery performance is strongly correlated with electrode microstructural properties. To account for its impact, lithium-ion battery (LIB) models either abstract the microstructural heterogeneity of composite electrodes using effective macroscopic properties (macro- or meso- scale models) or directly solve the system of equations on the microstructure geometry or mesh (microstructure-scale models). Therefore, to be adequate, both families of models require information from the microstructure geometry, which can be provided by the numerical tool presented in this work. MATBOX is a MATLAB open-source application [1] developed by NREL for performing various microstructure-related tasks including microstructure numerical generation, image filtering and microstructure segmentation, microstructure characterization and correlation, visualization, and microstructure meshing. MATBOX was originally developed for the analysis of LIB electrode microstructures; however, the algorithms provided by the toolbox are widely applicable to other heterogeneous materials. The toolbox provides a user-friendly experience thanks to a Graphical-User Interface, requires no coding by the user, and is well documented. This presentation will illustrate various MATBOX features for the characterization of a LIB electrode, including a fully automated Representative Volume Element (RVE) analysis, the numerical generation of complex 'virtual' microstructure, including dual-layer electrodes and carbon-binder additive phase, and the meshing of a complex NMC/graphite full cell microstructure suitable for 3D finite-element modeling. Other modules (segmentation, visualization, and correlation) will be briefly presented. Thanks to its modular, open-source approach, MATBOX can easily incorporate third-party algorithms to eventually build a standard in the field that will benefit the whole scientific community. Effective diffusion coefficient [2], additive phase numerical generation [3], and meshing [4] third-party algorithms have been already integrated in the toolbox with more to come.

DIRECT ENERGY CONVERSION,MATHEMATICS AND COMPUTING↗

Acquisition, preprocessing, and reconstruction of ultralow dose volumetric CT scout for organ-based CT scan planning

Purpose: Traditionally, 2D radiographic preparatory scan images (scout scans) are used to plan diagnostic CT scans. However, a 3D CT volume with a full 3D organ segmentation map could provide superior information for customized scan planning and other purposes. A practical challenge is to design the volumetric scout acquisition and processing steps to provide good image quality (at least good enough to enable 3D organ segmentation) while delivering a radiation dose similar to that of the conventional 2D scout. Methods: The authors explored various acquisition methods, scan parameters, postprocessing methods, and reconstruction methods through simulation and cadaver data studies to achieve an ultralow dose 3D scout while simultaneously reducing the noise and maintaining the edge strength around the target organ. Results: In a simulation study, the 3D scout with the proposed acquisition, preprocessing, and reconstruction strategy provided a similar level of organ segmentation capability as a traditional 240 mAs diagnostic scan, based on noise and normalized edge strength metrics. At the same time, the proposed approach delivers only 1.25% of the dose of a traditional scan. In a cadaver study, the authors’ pictorial-structures based organ localization algorithm successfully located the major abdominal-thoracic organs from the ultralow dose 3D scout obtained with the proposed strategy. Conclusions: The authors demonstrated that images with a similar degree of segmentation capability (interpretability) as conventional dose CT scans can be achieved with an ultralow dose 3D scout acquisition and suitable postprocessing. Furthermore, the authors applied these techniques to real cadaver CT scans with a CTDI dose level of less than 0.1 mGy and successfully generated a 3D organ localization map.

60 APPLIED LIFE SCIENCES↗

The Tiny Triplet Finder as a Versatile Track Segment Seeding Engine for Trigger Systems

In high energy physics experiment trigger systems, track segment seeding is a resource consuming function and the primary reason is the computing complexity of the segment finding process. As the Moore's Law is reaching its physical limit, reducing computing complexity should be carefully considered, rather than keep piling up silicon resources. The Tiny Triplet Finder is a scheme that reduces the computing complexity of the segment seeding. As a proof of concept, a 3D track segment seeding engine core based on the Tiny Triplet Finder has been implemented and tested in a low-cost FPGA device. The seeding engine is designed to preselect and group hits (stubs) from detector layers to feed subsequent track fitting stage. The seeding engine consists of a Hough transform space for r-z view and a Tiny Triplet Finder for r-phi view to implement 3D constraints. The seeding engine is organized as a pipeline so that each hit is processed in a single clock cycle. Taking advantage of the register-like storage block scheme which enables effectively resetting of a block RAM within a single clock cycle, clearing or refreshing the seeding engine takes only one clock cycles between two events. The Tiny Triplet Finder is also a generic coincidence finding scheme that can be used for many tasks. As a versatility demonstration, track segment finding performances for two distinctive detector geometries are tested in our seeding engine. In a collider barrel-layer geometry, the fake segment rates are studied for 3D (i.e., both r-phi and r-z views) and 2D (i.e., r-phi or r-z view only) configurations for high hit multiplicity events (>4000 hits/layer in the barrel region). Another detector geometry contains strip plane layers with timing information. The numbers of coincidences, both real or fake, with or without timing ("3D" or "2D") information at various hit multiplicities are studied.

43 PARTICLE ACCELERATORS↗

SwinCell: a 3D transformer and flow-based framework for improved cell segmentation

Segmentation of three-dimensional (3D) cellular images is fundamental for studying and understanding cell structure and function. However, 3D cellular segmentation is challenging, particularly for dense cells and tissues. This challenge arises mainly from the complex contextual information within 3D images, anisotropic properties, and the sensitivity to internal cellular structures, which often lead to incorrect segmentation. In this work, we introduce SwinCell, a 3D transformer-based framework that leverages Swin-transformer to predict flow and differentiate individual cell instances. We demonstrate SwinCell’s utility in the segmentation of nuclei, colon tissue cells, and densely cultured cells. SwinCell strikes a balance between maintaining detailed local feature recognition and understanding broader contextual information. Through extensive testing with both public and in-house 3D cell imaging datasets, SwinCell shows utility in segmenting dense cells, making it a valuable tool for 3D segmentation in cellular analysis that could expedite research in cell biology and tissue engineering.

59 BASIC BIOLOGICAL SCIENCES↗

The use of atlas registration and graph cuts for prostate segmentation in magnetic resonance images

Purpose: An automatic method for 3D prostate segmentation in magnetic resonance (MR) images is presented for planning image-guided radiotherapy treatment of prostate cancer. Methods: A spatial prior based on intersubject atlas registration is combined with organ-specific intensity information in a graph cut segmentation framework. The segmentation is tested on 67 axial T{sub 2}-weighted MR images in a leave-one-out cross validation experiment and compared with both manual reference segmentations and with multiatlas-based segmentations using majority voting atlas fusion. The impact of atlas selection is investigated in both the traditional atlas-based segmentation and the new graph cut method that combines atlas and intensity information in order to improve the segmentation accuracy. Best results were achieved using the method that combines intensity information, shape information, and atlas selection in the graph cut framework. Results: A mean Dice similarity coefficient (DSC) of 0.88 and a mean surface distance (MSD) of 1.45 mm with respect to the manual delineation were achieved. Conclusions: This approaches the interobserver DSC of 0.90 and interobserver MSD 0f 1.15 mm and is comparable to other studies performing prostate segmentation in MR.

60 APPLIED LIFE SCIENCES↗

Bayesian Segmentation (BCNN) v.1

Deep learning has been applied with great success to the segmentation of 3D X-Ray Computed Tomography (CT) scans. Establishing the credibility of these segmentations requires uncertainty quantification (UQ) to identify problem areas. Bayesian neural networks (BNNs), which use variational inference to learn the posterior distribution of the neural network weights, have been proposed to incorporate UQ into deep learning models. This software is an implementation of a novel 3D Bayesian convolutional neural network (BCNN) that provides accurate binary segmentations and uncertainty maps for 3D volumes. In particular, the uncertainty maps generated by this BCNN capture continuity and visual gradients, making them interpretable as confidence intervals for segmentation usable in numerical simulations. SAND2019-12927 M Sandia National Laboratories is a multimission laboratory managed and operated by National Technology & Engineering Solutions of Sandia, LLC, a wholly owned subsidiary of Honeywell International Inc., for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-NA0003525.

LaBonte, TylerMatthew↗

Interactive volumetric segmentation for textile micro-tomography data using wavelets and nonlocal means

This work addresses segmentation of volumetric images of woven carbon fiber textiles from micro-tomography data. We propose a semi-supervised algorithm to classify carbon fibers that requires sparse input as opposed to completely labeled images. The main contributions are: (a) design of effective discriminative classifiers, for three-dimensional textile samples, trained on wavelet features for segmentation; (b) coupling of previous step with nonlocal means as simple, efficient alternative to the Potts model; and (c) demonstration of reuse of classifier to diverse samples containing similar content. We evaluate our work by curating test sets of voxels in the absence of a complete ground truth mask. The algorithm obtains an average 0.95 F1 score on test sets and average F1 score of 0.93 on new samples. Finally, we conclude with discussion of failure cases and propose future directions toward analysis of spatiotemporal high-resolution micro-tomography images.

3D image processing↗

PlantSegNet: 3D point cloud instance segmentation of nearby plant organs with identical semantics

In this study, we introduce PlantSegNet, a novel neural network model for instance segmentation of nearby objects with similar geometric structures. Our work addresses the challenges of instance segmentation of plant point clouds, including the difficulty of annotating and labeling point clouds, the loss of local structural information in neural network components, and the generation of large numbers of incorrect small clusters due to poor choices of the loss function. One of the key contributions of our approach is a digital twin of sorghum, i.e., a procedural sorghum model, which was used to generate point clouds of sorghum fields. This allowed us to create a large-scale, annotated, synthetic dataset of sorghum plants that we used to train our PlantSegNet model. We demonstrated the effectiveness of our method in segmenting instances of sorghum leaves grown in outdoor field settings. To the best of our knowledge, this is the first study to address this specific instance segmentation problem for plants grown in such a setting. We compared our proposed method with other state-of-the-art methods for indoor settings, including SGPN and TreePartNet, on both synthetic and real data. Furthermore, our results show that PlantSegNet outperforms these methods regarding accuracy, robustness, and efficiency.

97 MATHEMATICS AND COMPUTING↗

Deep Learning Model Segmentations on Computed Tomography 3D Reconstructions of Coffee Beans to Determine Void Ratio (U-Net) and Roast Level (LinkNet)

This project will evaluate the functionality of Object Research Dragonfly software’s user produced deep learning (DL) models on Computed Tomography (CT) scanned coffee beans from green (unroasted) through a dark roast. DL models will be expected to identify voids within the coffee beans, and identify the level of roast of the bean from the CT reconstruction. The scope of this project is intended to meet the Capstone Project requirements of University of California San Diego (UCSD) Structural Engineering master’s degree and offer useful insight on Dragonfly’s DL capability for LANL’s Non-Destructive Evaluation (NDE) CT team. The results of this project will be presented to the E-6 NDE group within LANL. Data acquisition was completed with a North Star Imaging (NSI) X-25 CT Cabinet.

97 MATHEMATICS AND COMPUTING↗

We Know Where We Don't Know: 3D Bayesian CNNs for Credible Geometric Uncertainty

Deep learning has been successfully applied to the segmentation of 3D Computed Tomography (CT) scans. Establishing the credibility of these segmentations requires uncertainty quantification (UQ) to identify untrustworthy predictions. Recent UQ architectures include Monte Carlo dropout networks (MCDNs), which approximate deep Gaussian processes, and Bayesian neural networks (BNNs), which learn the distribution of the weight space. BNNs are advantageous over MCDNs for UQ but are thought to be computationally infeasible in high dimension, and neither architecture has produced interpretable geometric uncertainty maps. We propose a novel 3D Bayesian convolutional neural network (BCNN), the first deep learning method which generates statistically credible geometric uncertainty maps and scales for application to 3D data. We present experimental results on CT scans of graphite electrodes and laser-welded metals and show that our BCNN outperforms an MCDN in recent uncertainty metrics. The geometric uncertainty maps generated by our BCNN capture distributions of sigmoid values that are interpretable as confidence intervals, critical for applications that rely on deep learning for high-consequence decisions.

97 MATHEMATICS AND COMPUTING↗

SU-F-J-93: Automated Segmentation of High-Resolution 3D WholeBrain Spectroscopic MRI for Glioblastoma Treatment Planning

Purpose: We report on an automated segmentation algorithm for defining radiation therapy target volumes using spectroscopic MR images (sMRI) acquired at nominal voxel resolution of 100 microliters. Methods: Wholebrain sMRI combining 3D echo-planar spectroscopic imaging, generalized auto-calibrating partially-parallel acquisitions, and elliptical k-space encoding were conducted on 3T MRI scanner with 32-channel head coil array creating images. Metabolite maps generated include choline (Cho), creatine (Cr), and N-acetylaspartate (NAA), as well as Cho/NAA, Cho/Cr, and NAA/Cr ratio maps. Automated segmentation was achieved by concomitantly considering sMRI metabolite maps with standard contrast enhancing (CE) imaging in a pipeline that first uses the water signal for skull stripping. Subsequently, an initial blob of tumor region is identified by searching for regions of FLAIR abnormalities that also display reduced NAA activity using a mean ratio correlation and morphological filters. These regions are used as starting point for a geodesic level-set refinement that adapts the initial blob to the fine details specific to each metabolite. Results: Accuracy of the segmentation model was tested on a cohort of 12 patients that had sMRI datasets acquired pre, mid and post-treatment, providing a broad range of enhancement patterns. Compared to classical imaging, where heterogeneity in the tumor appearance and shape across posed a greater challenge to the algorithm, sMRI’s regions of abnormal activity were easily detected in the sMRI metabolite maps when combining the detail available in the standard imaging with the local enhancement produced by the metabolites. Results can be imported in the treatment planning, leading in general increase in the target volumes (GTV60) when using sMRI+CE MRI compared to the standard CE MRI alone. Conclusion: Integration of automated segmentation of sMRI metabolite maps into planning is feasible and will likely streamline acceptance of this new acquisition modality in clinical practice.

60 APPLIED LIFE SCIENCES↗

Computer-Assisted Diagnosis System for Breast Cancer in Computed Tomography Laser Mammography (CTLM)

Computed tomography laser mammography (Eid et al. Egyp J Radiol Nucl Med, 37(1): p. 633–643, 1) is a non-invasive imaging modality for breast cancer diagnosis, which is time-consuming and challenging for the radiologist to interpret the images. Some issues have increased the missed diagnosis of radiologists in visual manner assessment in CTLM images, such as technical reasons which are related to imaging quality and human error due to the structural complexity in appearance. The purpose of this study is to develop a computer-aided diagnosis framework to enhance the performance of radiologist in the interpretation of CTLM images. The proposed CAD system contains three main stages including segmentation of volume of interest (VOI), feature extraction and classification. A 3D Fuzzy segmentation technique has been implemented to extract the VOI. The shape and texture of angiogenesis in CTLM images are significant characteristics to differentiate malignancy or benign lesions. The 3D compactness features and 3D Grey Level Co-occurrence matrix (GLCM) have been extracted from VOIs. Multilayer perceptron neural network (MLPNN) pattern recognition has developed for classification of the normal and abnormal lesion in CTLM images. The performance of the proposed CAD system has been measured with different metrics including accuracy, sensitivity, and specificity and area under receiver operative characteristics (AROC), which are 95.2, 92.4, 98.1, and 0.98%, respectively.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Three-dimensional quadratic modeling and quantitative evaluation of the diaphragm on a volumetric CT scan in patients with chronic obstructive pulmonary disease

Purpose: In patients with chronic obstructive pulmonary disease (COPD), diaphragm function may deteriorate due to reduced muscle fiber length. Quantitative analysis of the morphology of the diaphragm is therefore important. In the authors current study, they propose a diaphragm segmentation method for COPD patients that uses volumetric chest computed tomography (CT) data, and they provide a quantitative analysis of the diaphragmatic dimensions. Methods: Volumetric CT data were obtained from 30 COPD patients and 10 normal control patients using a 16-row multidetector CT scanner (Siemens Sensation 16) with 0.75-mm collimation. Diaphragm segmentation using 3D ray projections on the lower surface of the lungs was performed to identify the draft diaphragmatic lung surface, which was modeled using quadratic 3D surface fitting and robust regression in order to minimize the effects of segmentation error and parameterize diaphragm morphology. This result was visually evaluated by an expert thoracic radiologist. To take into consideration the shape features of the diaphragm, several quantification parameters—including the shape index on the apex (SIA) (which was computed using gradient set to 0), principal curvatures on the apex on the fitted diaphragm surface (CA), the height between the apex and the base plane (H), the diaphragm lengths along the x-, y-, and z-axes (XL, YL, ZL), quadratic-fitted diaphragm lengths on the z-axis (FZL), average curvature (C), and surface area (SA)—were measured using in-house software and compared with the pulmonary function test (PFT) results. Results: The overall accuracy of the combined segmentation method was 97.22% ± 4.44% while the visual accuracy of the models for the segmented diaphragms was 95.28% ± 2.52% (mean ± SD). The quantitative parameters, including SIA, CA, H, XL, YL, ZL, FZL, C, and SA were 0.85 ± 0.05 (mm{sup −1}), 0.01 ± 0.00 (mm{sup −1}), 17.93 ± 10.78 (mm), 129.80 ± 11.66 (mm), 163.19 ± 13.45 (mm), 71.27 ± 17.52 (mm), 61.59 ± 16.98 (mm), 0.01 ± 0.00 (mm{sup −1}), and 34 380.75 ± 6680.06 (mm{sup 2}), respectively. Several parameters were correlated with the PFT parameters. Conclusions: The authors propose an automatic method for quantitatively evaluating the morphological parameters of the diaphragm on volumetric chest CT in COPD patients. By measuring not only the conventional length and surface area but also the shape features of the diaphragm using quadratic 3D surface modeling, the proposed method is especially useful for quantifying diaphragm characteristics. Their method may be useful for assessing morphological diaphragmatic changes in COPD patients.

60 APPLIED LIFE SCIENCES↗