Predicate-Based Focus-and-Context Visualization for 3D Ultrasound

Direct volume visualization techniques offer powerful insight into volumetric medical images and are part of the clinical routine for many applications. Up to now, however, their use is mostly limited to tomographic imaging modalities such as CT or MRI. With very few exceptions, such as fetal ultrasound, classic volume rendering using one-dimensional intensity-based transfer functions fails to yield satisfying results in case of ultrasound volumes. This is particularly due its gradient-like nature, a high amount of noise and speckle, and the fact that individual tissue types are rather characterized by a similar texture than by similar intensity values. Therefore, clinicians still prefer to look at 2D slices extracted from the ultrasound volume. In this work, we present an entirely novel approach to the classification and compositing stage of the volume rendering pipeline, specifically designed for use with ultrasonic images. We introduce point predicates as a generic formulation for integrating the evaluation of not only low-level information like local intensity or gradient, but also of high-level information, such as non-local image features or even anatomical models. Thus, we can successfully filter clinically relevant from non-relevant information. In order to effectively reduce the potentially high dimensionality of the predicate configuration space, we propose the predicate histogram as an intuitive user interface. This is augmented by a scribble technique to provide a comfortable metaphor for selecting predicates of interest. Assigning importance factors to the predicates allows for focus-and-context visualization that ensures to always show important (focus) regions of the data while maintaining as much context information as possible. Our method naturally integrates into standard ray casting algorithms and yields superior results in comparison to traditional methods in terms of visualizing a specific target anatomy in ultrasound volumes.