Atlases and statistical models play important roles in the personalization and simulation of cardiac physiology. For the study of the heart, however, the construction of comprehensive atlases and spatio-temporal models is faced with a number of challenges, in particular the need to handle large and highly variable image datasets, the multi-region nature of the heart, and the presence of complex as well as small cardiovascular structures. In this paper, we present a detailed atlas and spatio-temporal statistical model of the human heart based on a large population of 3D+time multi-slice computed tomography sequences, and the framework for its construction. It uses spatial normalization based on nonrigid image registration to synthesize a population mean image and establish the spatial relationships between the mean and the subjects in the population. Temporal image registration is then applied to resolve each subject-specific cardiac motion and the resulting transformations are used to warp a surface mesh representation of the atlas to fit the images of the remaining cardiac phases in each subject. Subsequently, we demonstrate the construction of a spatio-temporal statistical model of shape such that the inter-subject and dynamic sources of variation are suitably separated. The framework is applied to a 3D+time data set of 138 subjects. The data is drawn from a variety of pathologies, which benefits its generalization to new subjects and physiological studies. The obtained level of detail and the extendability of the atlas present an advantage over most cardiac models published previously.

The accurate diagnosis of osteoporosis has gained increasing importance due to the aging of our society. Areal bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) is an established criterion in the diagnosis of osteoporosis. This measure, however, is limited by its two-dimensionality. This work presents a method to reconstruct both the 3D bone shape and 3D BMD distribution of the proximal femur from a single DXA image used in clinical routine. A statistical model of the combined shape and BMD distribution is presented, together with a method for its construction from a set of quantitative computed tomography (QCT) scans. A reconstruction is acquired in an intensity based 3D-2D registration process whereby an instance of the model is found that maximizes the similarity between its projection and the DXA image. Reconstruction experiments were performed on the DXA images of 30 subjects, with a model constructed from a database of QCT scans of 85 subjects. The accuracy was evaluated by comparing the reconstructions with the same subject QCT scans. The method presented here can potentially improve the diagnosis of osteoporosis and fracture risk assessment from the low radiation dose and low cost DXA devices currently used in clinical routine.

Bone is in a continuous state of remodeling whereby old bone is absorbed and new bone is formed in its place. During this process, new formations reinforce the bone in the direction of the dominant stress trajectories through a functional adaptation. In normal aging, the balance between bone resorption and formation can be shifted. How this affects the functional adaptation remains to be investigated. Furthermore, how or whether the bone continues to change beyond the age of 85 is not yet studied in detail. In this study we examined the age-related changes in the cortical and trabecular bone in old age, and assessed whether we can find evidence of the presence of functional adaptation. We measured cortical and trabecular parameters from micro-computed tomography scans of the femoral head extracted from hip fracture patients between the age of 70 and 93 years. A significant decrease in global trabecular bone mineral density (38.1%) and cortical thickness (13.0%) was seen from the 9th to the 10th decade of life. The degree of anisotropy was maintained globally as well as locally in both high and low stress regions. The local trabecular bone mineral density decreased in both high stress and low stress regions between the 9th and 10th decade of life with similar trends. This suggests that the role of functional adaptation in maintaining the bone structural integrity in old age may be limited. This study highlights the need for a controlled clinical trial examining the cause of the continued bone degradation throughout old age.