Deformation analysis to detect and quantify active lesions in three-dimensional medical image sequences

Evaluating precisely the temporal variations of lesion volumes is very important for at least three types of practical applications: pharmaceutical trials, decision making for drug treatment or surgery, and patient follow-up. Here, the authors present a volumetric analysis technique, combining precise rigid registration of three-dimensional (3-D) (volumetric) medical images, nonrigid deformation computation, and flow-field analysis. Their analysis technique has two outcomes: the detection of evolving lesions and the quantitative measurement of volume variations. The originality of the authors' approach is that no precise segmentation of the lesion is needed but the approximative designation of a region of interest (ROI) which can be automated. They distinguish between tissue transformation (image intensity changes without deformation) and expansion or contraction effects reflecting a change of mass within the tissue. A real lesion is generally the combination of both effects. The method is tested with synthesized volumetric image sequences and applied, in a first attempt to quantify in vivo a mass effect, to the analysis of a real patient case with multiple sclerosis (MS).