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At least 973 records · Page 54

Segmentation and tracking in echocardiographic sequences: active contours guided by optical flow estimates

This paper presents a method for segmentation and tracking of cardiac structures in ultrasound image sequences. The developed algorithm is based on the active contour framework. This approach requires initial placement of the contour close to the desired position in the image, usually an object outline. Best contour shape and position are then calculated, assuming that at this configuration a global energy function, associated with a contour, attains its minimum. Active contours can be used for tracking by selecting a solution from a previous frame as an initial position in a present frame. Such an approach, however, fails for large displacements of the object of interest. This paper presents a technique that incorporates the information on pixel velocities (optical flow) into the estimate of initial contour to enable tracking of fast-moving objects. The algorithm was tested on several ultrasound image sequences, each covering one complete cardiac cycle. The contour successfully tracked boundaries of mitral valve leaflets, aortic root and endocardial borders of the left ventricle. The algorithm-generated outlines were compared against manual tracings by expert physicians. The automated method resulted in contours that were within the boundaries of intraobserver variability.

Non-NASA Center↗

[Quantification and monitoring of vascular resistance in the lower limbs by the Doppler method (animal model)]

The object of this study was to define and validate a non-invasive method of evaluation and monitoring of vascular resistances in the leg. Blood flow velocity was measured by Doppler ultrasound in an animal model (ewe) with similar blood flow characteristics in the lower limb as man and allowing access to the required invasive measurements for validation of the method (pressure and flow). Vascular resistances distal to the measuring point (femoral, for example) were assessed using the resistance index R = D/S, S being the peak systolic deflection and D that of diastolic reflux of the Doppler spectral analysis of flow in the femoral artery. The values and variations of this resistance index were compared with the vascular resistances calculated from measurements of pressure and flow at the point of Doppler sampling and expressed in mmHg/ml/min. Femoral flow was measured by Doppler ultrasound (Doppler-echo), and mean pressure by an arterial catheter introduced into the abdominal aorta. Compression of the lower limb veins induced a venous return resulting in a reduction of cardiac output and femoral flow. During compression, femoral flow decreased by an average of 29% (p < 0.001) although mean pressure and heart rate did not change significantly. The femoral resistance index (Rf) increased by an average of 37.5% (p < 0.01) and vascular resistances increased by 45.9% (p < 0.01). Injection of 1 mg adrenaline induced peripheral vasoconstriction with an increase in blood pressure and a decrease in heart rate and femoral flow.(ABSTRACT TRUNCATED AT 250 WORDS).

Non-NASA Center↗

Lack of deleterious effect of slow-release sodium fluoride treatment on cortical bone histology and quality in osteoporotic patients

We evaluated the effects of intermittent slow-release sodium fluoride (SRNaF) and continuous calcium citrate therapy on cortical bone histology, reflection ultrasound velocity (material strength) and back-scattered electron image analysis (BEI) in 26 osteoporotic patients before and following therapy. All measurements were made on transiliac crest bone biopsies obtained before and following 2 years of therapy in each patient. For all 26 patients there were no significant changes in cortical bone histomorphometric parameters. In 15 patients in whom bone material quality was assessed by reflection ultrasound, there was no change in velocity (4000 +/- 227 SD to 4013 +/- 240 m/s). BEI disclosed no mineralization defects or the presence of woven bone. Mean atomic number (density) of bone increased slightly, but significantly (9.261 +/- 0.311 to 9.457 +/- 0.223, P = 0.031). While these changes are less marked than those observed for cancellous bone, they indicate that this form of therapy does not adversely affect cortical bone remodelling.

NASA Discipline Regulatory Physiology↗

The cerebral hemodynamics of normotensive hypovolemia during lower-body negative pressure

Although severe hypovolemia can lead to hypotension and neurological decline, many patients with neurosurgical disorders experience a significant hypovolemia while autonomic compensatory mechanisms maintain a normal blood pressure. To assess the effects of normotensive hypovolemia upon cerebral hemodynamics, transcranial Doppler ultrasound monitoring of 13 healthy volunteers was performed during graded lower-body negative pressure of up to -50 mm Hg, an accepted laboratory model for reproducing the physiological effects of hypovolemia. Middle cerebral artery flow velocity declined by 16% +/- 4% (mean +/- standard error of the mean) and the ratio between transcranial Doppler ultrasound pulsatility and systemic pulsatility rose 22% +/- 8%, suggesting cerebral small-vessel vasoconstriction in response to the sympathetic activation unmasked by lower-body negative pressure. This vasoconstriction may interfere with the autoregulatory response to a sudden fall in blood pressure, and may explain the common observation of neurological deficit during hypovolemia even with a normal blood pressure.

Non-NASA Center↗

Nondestructive Evaluation of the Gimbal Joint Flowliner Slots in the Space Shuttle Main Propulsion System Hydrogen Feedline

Fatigue cracks were discovered in the STS-112 Liquid Hydrogen Feedline flowliners in 2002. This led to a development program aimed at providing nondestructive evaluation methods and techniques to verify the existence of these types of cracks in oval shaped slots cut into the ends of the feedlines above the bellows joints. These slots were used to improve flow dynamics and to facilitate cleaning in the bellow joint region. These types of fatigue cracks posed a possible metal debris ingestion threat for the Space Shuttle Main Engines, which attached to these particular joints. Results of this program produced three reliable inspection techniques utilizing the imaging of replisets with a Scanning Electron microscope, eddy current, and ultrasound. The program developed unique probes and fixtures and in the case of eddy current and ultrasound, provided qualification and certification of the particular techniques by various Design of Experiments and Probability of Detection studies utilizing multiple inspectors.

Suits, Michael W.↗

Diagnostic Imaging in the Medical Support of the Future Missions to the Moon

This viewgraph presentation is a course that reviews the diagnostic imaging techniques available for medical support on the future moon missions. The educational objectives of the course are to: 1) Update the audience on the curreultrasound imaging in space flight; 2) Discuss the unique aspects of conducting ultrasound imaging on ISS, interplanetary transit, ultrasound imaging on ISS, interplanetary transit, and lunar surface operations; and 3) Review preliminary data obtained in simulations of medical imaging in lunar surface operations.

Sargsyan, Ashot E.↗

Detecting thermal discrepancies in vessel walls

An infrared, heat-sensing catheter particularly useful for identifying potentially fatal arterial plaques in patients with disease of the coronary or other arteries and its use are detailed. In one embodiment, an infrared fiberoptic system (with or without ultrasound) is employed at the tip of the catheter to locate inflamed, heat-producing, atherosclerotic plaque, which is at greater risk for rupture, fissure, or ulceration, and consequent thrombosis and occlusion of the artery. In another embodiment, a catheter with an infrared detector (with or without ultrasound) employed at its tip will likewise locate inflamed heat-producing atherosclerotic plaque. The devices and methods of the invention may be used to detect abscesses, infection, and cancerous regions by the heat such regions differentially display over the ambient temperature of immediately adjacent tissues. The methods and devices of the invention may also be used to detect regions of cooler than ambient tissue in a vessel or organ which indicate cell death, thrombosis, cell death, hemorrhage, calcium or cholesterol accumulations, or foreign materials.

Casscells, S. Ward↗

Crew Activity Analyzer

The crew activity analyzer (CAA) is a system of electronic hardware and software for automatically identifying patterns of group activity among crew members working together in an office, cockpit, workshop, laboratory, or other enclosed space. The CAA synchronously records multiple streams of data from digital video cameras, wireless microphones, and position sensors, then plays back and processes the data to identify activity patterns specified by human analysts. The processing greatly reduces the amount of time that the analysts must spend in examining large amounts of data, enabling the analysts to concentrate on subsets of data that represent activities of interest. The CAA has potential for use in a variety of governmental and commercial applications, including planning for crews for future long space flights, designing facilities wherein humans must work in proximity for long times, improving crew training and measuring crew performance in military settings, human-factors and safety assessment, development of team procedures, and behavioral and ethnographic research. The data-acquisition hardware of the CAA (see figure) includes two video cameras: an overhead one aimed upward at a paraboloidal mirror on the ceiling and one mounted on a wall aimed in a downward slant toward the crew area. As many as four wireless microphones can be worn by crew members. The audio signals received from the microphones are digitized, then compressed in preparation for storage. Approximate locations of as many as four crew members are measured by use of a Cricket indoor location system. [The Cricket indoor location system includes ultrasonic/radio beacon and listener units. A Cricket beacon (in this case, worn by a crew member) simultaneously transmits a pulse of ultrasound and a radio signal that contains identifying information. Each Cricket listener unit measures the difference between the times of reception of the ultrasound and radio signals from an identified beacon. Assuming essentially instantaneous propagation of the radio signal, the distance between that beacon and the listener unit is estimated from this time difference and the speed of sound in air.] In this system, six Cricket listener units are mounted in various positions on the ceiling, and as many as four Cricket beacons are attached to crew members. The three-dimensional position of each Cricket beacon can be estimated from the time-difference readings of that beacon from at least three Cricket listener units

Murray, James↗

Background: Preflight Screening, In-flight Capabilities, and Postflight Testing

Recommendations for minimal in-flight capabilities: Retinal Imaging - provide in-flight capability for the visual monitoring of ocular health (specifically, imaging of the retina and optic nerve head) with the capability of downlinking video/still images. Tonometry - provide more accurate and reliable in-flight capability for measuring intraocular pressure. Ultrasound - explore capabilities of current on-board system for monitoring ocular health. We currently have limited in-flight capabilities on board the International Space Station for performing an internal ocular health assessment. Visual Acuity, Direct Ophthalmoscope, Ultrasound, Tonometry(Tonopen):

Gibson, Charles Robert↗

On-Orbit Prospective Echocardiography on International Space Station Crew

Introduction A prospective trial of echocardiography was conducted on of six crewmembers onboard the International Space Station. The main objective was to determine the efficacy of remotely guided tele-echocardiography, including just-in-time e-training methods and determine what "space normal" echocardiographic data is. Methods Each crewmember operator (n=6) had 2-hour preflight training. Baseline echocardiographic data were collected 55 to 167days preflight. Similar equipment was used in each 60-minute in-flight session (mean microgravity exposure - 114 days (34 -- 190)). On Orbit ultrasound operators used an e-learning system within 24h of these sessions. Expert assistance was provided using ultrasound video downlink and two-way voice. Testing was repeated 5 to 16 days after landing. Separate ANOVA was used on each echocardiographic variable (n=33). Within each ANOVA, three tests were made: a) effect of mission phase (preflight, in-flight, post flight); b) effect of echo technician (two technicians independently analyzed the data); c) interaction between mission phase and technician. Results Nine rejections of the null hypothesis (mission phase or technician or both had no effect) were discovered and considered for follow up. Of these, six rejections were for significant technician effects, not as a result of space flight. Three rejections of the null hypothesis (Aortic Valve time velocity integral, Mitral E wave Velocity and heart rate) were attributable to space flight, however determined not to be clinically significant. No rejections were due to the interaction between technician and space flight. Conclusion No consistent clinically significant effects of long-duration space flight were seen in echocardiographic variables of the given group of subjects.

Hamilton, Douglas R.↗

Characterizing Methods of Measuring Flow-Mediated Dilation in the Brachial Artery

Regulation of vascular tone is one of the many important functions of the vascular endothelium. Endothelial dysfunction is a critical early event in the pathogenesis of atherosclerosis and occurs in the absence of angiographic disease. Flow-Mediated Dilation (FMD) is a noninvasive technique commonly used to evaluate endothelium-dependent vasodilation in humans and gauge the health of the cardiovascular system. Reductions in brachial artery FMD have been strongly correlated with disease progression and are predictive of future cardiac events. The flow stimulus for brachial artery FMD occurs as a result of the increased shear stress following deflation of an occlusion cuff around the upper arm. Using 2-dimensional ultrasound, changes in arterial diameter up to 5-minutes following cuff deflation are calculated from baseline image measurements. Along with pulsed Doppler measures of flow velocity through the artery, flow-mediated, endothelium-dependent vasodilation can be assessed. There is debate among investigators, however, about the proper positioning of the occlusion cuff during FMD testing. It is thought that placement of the cuff around the upper arm may not accurately reflect the impact of nitric oxide, a critically important molecule released as a result of the increased shear stress created by the FMD technique. Data suggest that the production of other endogenous metabolites may also contribute to FMD-related changes when positioning the cuff around the upper arm. To overcome the potential influence of such molecules, researchers now suggest that the occlusion cuff be placed below the elbow allowing a more precise estimate of nitric oxide mediated dilation. The purpose of this study is to compare the differences in FMD between the two methodologies of occlusion cuff placement. In addition, this study will determine the method that is easier for ultrasound technicians to perform and will produce a low coefficient of variance between technicians. Ultimately, the results of this study will help in tracking any adverse cardiovascular effects of spaceflight.

Callender, Ariane R.↗

Astronaut Preflight Cardiovascular Variables Associated with Vascular Compliance are Highly Correlated with Post-Flight Eye Outcome Measures in the Visual Impairment Intracranial Pressure (VIIP) Syndrome Following Long Duration Spaceflight

The detection of the first VIIP case occurred in 2005, and adequate eye outcome measures were available for 31 (67.4%) of the 46 long duration US crewmembers who had flown on the ISS since its first crewed mission in 2000. Therefore, this analysis is limited to a subgroup (22 males and 9 females). A "cardiovascular profile" for each astronaut was compiled by examining twelve individual parameters; eleven of these were preflight variables: systolic blood pressure, pulse pressure, body mass index, percentage body fat, LDL, HDL, triglycerides, use of anti‐lipid medication, fasting serum glucose, and maximal oxygen uptake in ml/kg. Each of these variables was averaged across three preflight annual physical exams. Astronaut age prior to the long duration mission, and inflight salt intake was also included in the analysis. The group of cardiovascular variables for each crew member was compared with seven VIIP eye outcome variables collected during the immediate post‐flight period: anterior-posterior axial length of the globe measured by ultrasound and optical biometry; optic nerve sheath diameter, optic nerve diameter, and optic nerve to sheath ratio‐ each measured by ultrasound and magnetic resonance imaging (MRI), intraocular pressure (IOP), change in manifest refraction, mean retinal nerve fiber layer (RNFL) on optical coherence tomography (OCT), and RNFL of the inferior and superior retinal quadrants. Since most of the VIIP eye outcome measures were added sequentially beginning in 2005, as knowledge of the syndrome improved, data were unavailable for 22.0% of the outcome measurements. To address the missing data, we employed multivariate multiple imputation techniques with predictive mean matching methods to accumulate 200 separate imputed datasets for analysis. We were able to impute data for the 22.0% of missing VIIP eye outcomes. We then applied Rubin's rules for collapsing the statistical results across our 200 multiply imputed data sets to assess the canonical correlation between the eye outcomes and the twelve astronaut cardiovascular variables available for all 31 subjects. Results: A highly significant canonical correlation was observed among the canonical solutions (p<.00001), with an average best canonical correlation of.97. The results suggest a strong association between astronauts' measures of cardiovascular health and the seven eye outcomes of the VIIP syndrome used in this analysis. Furthermore, the "joint test" revealed a significant difference in cardiovascular profile between male and female astronauts (Prob > F = 0.00001). Overall, female astronauts demonstrated a significantly healthier cardiovascular status. Individually, the female astronauts had significantly healthier profiles on seven of twelve cardiovascular variables than the men (p values ranging from <0.0001 to <0.05). Male astronauts did not demonstrate significantly healthier values on any of the twelve cardiovascular variables measured

Otto, Christian↗

NDE and SHM Simulation for CFRP Composites

Ultrasound-based nondestructive evaluation (NDE) is a common technique for damage detection in composite materials. There is a need for advanced NDE that goes beyond damage detection to damage quantification and characterization in order to enable data driven prognostics. The damage types that exist in carbon fiber-reinforced polymer (CFRP) composites include microcracking and delaminations, and can be initiated and grown via impact forces (due to ground vehicles, tool drops, bird strikes, etc), fatigue, and extreme environmental changes. X-ray microfocus computed tomography data, among other methods, have shown that these damage types often result in voids/discontinuities of a complex volumetric shape. The specific damage geometry and location within ply layers affect damage growth. Realistic threedimensional NDE and structural health monitoring (SHM) simulations can aid in the development and optimization of damage quantification and characterization techniques. This paper is an overview of ongoing work towards realistic NDE and SHM simulation tools for composites, and also discusses NASA's need for such simulation tools in aeronautics and spaceflight. The paper describes the development and implementation of a custom ultrasound simulation tool that is used to model ultrasonic wave interaction with realistic 3-dimensional damage in CFRP composites. The custom code uses elastodynamic finite integration technique and is parallelized to run efficiently on computing cluster or multicore machines.

Leckey, Cara A. C.↗

Clinical Outcome Metrics for Optimization of Robust Training

Introduction: The emphasis of this research is on the Human Research Program (HRP) Exploration Medical Capability's (ExMC) "Risk of Unacceptable Health and Mission Outcomes Due to Limitations of In-Flight Medical Capabilities." Specifically, this project aims to contribute to the closure of gap ExMC 2.02: We do not know how the inclusion of a physician crew medical officer quantitatively impacts clinical outcomes during exploration missions. The experiments are specifically designed to address clinical outcome differences between physician and non-physician cohorts in both near-term and longer-term (mission impacting) outcomes. Methods: Medical simulations will systematically compare success of individual diagnostic and therapeutic procedure simulations performed by physician and non-physician crew medical officer (CMO) analogs using clearly defined short-term (individual procedure) outcome metrics. In the subsequent step of the project, the procedure simulation outcomes will be used as input to a modified version of the NASA Integrated Medical Model (IMM) to analyze the effect of the outcome (degree of success) of individual procedures (including successful, imperfectly performed, and failed procedures) on overall long-term clinical outcomes and the consequent mission impacts. The procedures to be simulated are endotracheal intubation, fundoscopic examination, kidney/urinary ultrasound, ultrasound-guided intravenous catheter insertion, and a differential diagnosis exercise. Multiple assessment techniques will be used, centered on medical procedure simulation studies occurring at 3, 6, and 12 months after initial training (as depicted in the following flow diagram of the experiment design). Discussion: Analysis of procedure outcomes in the physician and non-physician groups and their subsets (tested at different elapsed times post training) will allow the team to 1) define differences between physician and non-physician CMOs in terms of both procedure performance (pre-IMM analysis) and overall mitigation of the mission medical impact (IMM analysis); 2) refine the procedure outcome and clinical outcome metrics themselves; 3) refine or develop innovative medical training products and solutions to maximize CMO performance; and 4) validate the methods and products of this experiment for operational use in the planning, execution, and quality assurance of the CMO training process The team has finalized training protocols and developed a software training/testing tool in collaboration with Butler Graphics (Detroit, MI). In addition to the "hands on" medical procedure modules, the software includes a differential diagnosis exercise (limited clinical decision support tool) to evaluate the diagnostic skills of participants. Human subject testing will occur over the next year.

Ebert, D.↗

Performance Improvement of Friction Stir Welds by Better Surface Finish

The as-welded friction stir weld has a cross section that may act as a stress concentrator. The geometry associated with the stress concentration may reduce the weld strength and it makes the weld challenging to inspect with ultrasound. In some cases, the geometry leads to false positive nondestructive evaluation (NDE) indications and, in many cases, it requires manual blending to facilitate the inspection. This study will measure the stress concentration effect and develop an improved phased array ultrasound testing (PAUT) technique for friction stir welding. Post-welding, the friction stir weld (FSW) tool would be fitted with an end mill that would machine the weld smooth, trimmed shaved. This would eliminate the need for manual weld preparation for ultrasonic inspections. Manual surface preparation is a hand operation that varies widely depending on the person preparing the welds. Shaving is a process that can be automated and tightly controlled.

Russell, Sam↗

Implementing Reliability Centered Maintenance (RCM) with State of the Art PT&I Technologies

Building on the work that was started two decades ago, Jacobs Space Operations Group has utilized state of the art PTI technologies to assess the current condition of the assets they manage under the Test and Operations Support Contract (TOSC). Specifically, the Asset Management department leveraged the benefits of ultrasound technology to quantify a motor issue in the Liquid Oxygen Storage Area, and troubleshoot the sources prior to loading the tank to perform Verification and Validation (VV) activities. This technology was efficient, easy to implement, and provided system engineers with data on a possible source of the problem. In situations where legacy motors are exhibiting unexpected noises, it may seem easier to remove and refurbish the motor and replace the bearings because that solution resolves most of the common causes of the noise. However, that solution would have involved additional spending and may not have solved issues stemming from the foundation, if those existed. By utilizing the ultrasound equipment provided by UE Systems, the sound profiles allowed Jacobs TOSC team to determine that the issue resembled a faulty bearing. After replacing the bearing, the unexpected noise ceased.

Reliability Centered Maintenance↗

Space Technology - Game Changing Development NASA Facts: Autonomous Medical Operations

The AMO (Autonomous Medical Operations) Project is working extensively to train medical models on the reliability and confidence of computer-aided interpretation of ultrasound images in various clinical settings, and of various anatomical structures. AI (Artificial Intelligence) algorithms recognize and classify features in the ultrasound images, and these are compared to those features that clinicians use to diagnose diseases. The acquisition of clinically validated image assessment and the use of the AI algorithms constitutes fundamental baseline for a Medical Decision Support System that will advise crew on long-duration, remote missions.

Autonomous Medical Operations Project↗

Medics: Medical Decision Support System for Long-Duration Space Exploration

The Autonomous Medical Operations (AMO) group at NASA Ames is developing a “medical decision support system” to enable astronauts on long-duration exploration missions to operate autonomously. The system will support clinical actions by providing medical interpretation advice and procedural recommendations during emergent care and clinical work performed by crew. The current state of development of the system, called MedICS (Medical Interpretation Classification and Segmentation) includes two separate aspects: a set of machine learning diagnostic models trained to analyze organ images and patient health records, and an interface to ultrasound diagnostic hardware and to medical repositories. Three sets of images of different organs and medical records were utilized for training machine learning models for various analyses, as follows: 1. Pneumothorax condition (collapsed lung). The trained model provides a positive or negative diagnosis of the condition. 2. Carotid artery occlusion. The trained model produces a diagnosis of 5 different occlusion levels (including “normal”). 3. Ocular retinal images. The model extracts optic disc pixels (image segmentation). This is a precursor step for advanced autonomous fundus clinical evaluation algorithms to be implemented in FY20. 4. Medical health records. The model produces a differential diagnosis for any particular individual, based on symptoms and other health and demographic information. A probability is calculated for each of 25 most common conditions. The same model provides the likelihood of survival. All results are provided with a confidence level. Item 1 images were provided by the US Army and were part of a data set for the clinical treatment of injured battlefield soldiers. This condition is relevant to possible space mishaps, due to pressure management issues. Item 2 images were provided by Houston Methodist Hospital, and item 3 health records were acquired from the MIT laboratory of computational physiology. The machine learning technology utilized is deep multilayer networks (Deep Learning), and new models will continue to be produced, as relevant data is made available and specific health needs of astronaut crews are identified. The interfacing aspects of the system include a GUI for running the different models, and retrieving and storing data, as well as support for integration with an augmented reality (AR) system deployed at JSC by Tietronix Software Inc. (HoloLens). The AR system provides guidance for the placement of an ultrasound transducer that captures images to be sent to the MedICS system for diagnosis. The image captured and the associated diagnosis appear in the technician’s AR visual display.

Colombano, Silvano↗