OBJECTIVES: In this paper, we present an automatic method to segment four chambers by extracting a whole heart, separating the left and right sides of the heart, and spliting the atrium and ventricle regions from each heart in cardiac computed tomography angiography (CTA) efficiently. METHODS: We smooth the images by applying filters to remove noise. Next, the volume of interest is detected by using k-means clustering. In this step, the whole heart is coarsely extracted, and it is used for seed volumes in the next step. Then, we detect seed volumes using a geometric analysis based on anatomical information and separate the left and right heart regions with the power watershed algorithm. Finally, we refine the left and right sides of the heart using the level-set method, and extract the atrium and ventricle from the left and right heart regions using the split energy function. RESULTS: We tested the proposed heart segmentation method using 20 clinical scan datasets which were acquired from various patients. To validate the proposed heart segmentation method, we evaluated its accuracy in segmenting four chambers based on four error evaluation metrics. The average values of differences between the manual and automatic segmentations were less than 3.3%, approximately. CONCLUSIONS: The proposed method extracts the four chambers of the heart accurately, demonstrating that this approach can assist the cardiologist.
Angiography ; Dataset ; Heart ; Humans ; Methods* ; Noise

Objectives: Intraoperative navigation reduces the risk of major complications and increases the likelihood of optimal surgical outcomes. This paper presents an augmented reality (AR)-based simulation technique for ventriculostomy that visualizes brain deformations caused by the movements of a surgical instrument in a three-dimensional brain model. This is achieved by utilizing a position-based dynamics (PBD) physical deformation method on a preoperative brain image. Methods: An infrared camera-based AR surgical environment aligns the real-world space with a virtual space and tracks the surgical instruments. For a realistic representation and reduced simulation computation load, a hybrid geometric model is employed, which combines a high-resolution mesh model and a multiresolution tetrahedron model. Collision handling is executed when a collision between the brain and surgical instrument is detected. Constraints are used to preserve the properties of the soft body and ensure stable deformation. Results: The experiment was conducted once in a phantom environment and once in an actual surgical environment. The tasks of inserting the surgical instrument into the ventricle using only the navigation information presented through the smart glasses and verifying the drainage of cerebrospinal fluid were evaluated. These tasks were successfully completed, as indicated by the drainage, and the deformation simulation speed averaged 18.78 fps. Conclusions This experiment confirmed that the AR-based method for external ventricular drain surgery was beneficial to clinicians.