ArXiv Preprint
Background and Objective: Pelvic floor disorders are prevalent diseases and
patient care remains difficult as the dynamics of the pelvic floor remains
poorly known. So far, only 2D dynamic observations of straining exercises at
excretion are available in the clinics and the understanding of
three-dimensional pelvic organs mechanical defects is not yet achievable. In
this context, we proposed a complete methodology for the 3D representation of
the non-reversible bladder deformations during exercises, directly combined
with synthesized 3D representation of the location of the highest strain areas
on the organ surface. Methods: Novel image segmentation and registration
approaches have been combined with three geometrical configurations of
up-to-date rapid dynamic multi-slices MRI acquisition for the reconstruction of
real-time dynamic bladder volumes. Results: For the first time, we proposed
real-time 3D deformation fields of the bladder under strain from in-bore forced
breathing exercises. The potential of our method was assessed on eight control
subjects undergoing forced breathing exercises. We obtained average volume
deviation of the reconstructed dynamic volume of bladders around 2.5\% and high
registration accuracy with mean distance values of 0.4 $\pm$ 0.3 mm and
Hausdorff distance values of 2.2 $\pm$ 1.1 mm. Conclusions: Immediately
transferable to the clinics with rapid acquisitions, the proposed framework
represents a real advance in the field of pelvic floor disorders as it
provides, for the first time, a proper 3D+t spatial tracking of bladder
non-reversible deformations. This work is intended to be extended to patients
with cavities filling and excretion to better characterize the degree of
severity of pelvic floor pathologies for diagnostic assistance or in
preoperative surgical planning.
Augustin C. Ogier, Stanislas Rapacchi, Marc-Emmanuel Bellemare
2023-01-18
