PhD Thesis Defense by Pierre Galmiche
11/28/2024
According to the World Health Organization’s 2022 statistics:
→ Research to improve the treatment.
Can be summarized into three main components:

→ We focus on radiation therapy.
Involves several steps:

Involves several steps:

Involves several steps:

Involves several steps:

Involves several steps:

Is a complex treatment:

What about breast changes during treatment?
Clinical experience showed changes in breast shape during treatment.
→ We want to learn more about such changes:
How much does the treated breast change during the treatment?
Does it impact the radiation dose?
Is the initially planned dose still optimal for a given session?
Objective: Study morphological changes in breast during radiotherapy and their effect on administrated dose.

ICANS clinical trial patient information
Various representations of the patient bust:
ICANS patient data
→ This data comes with challenges.
Surfaces are not initially aligned:

Bust coverage changes across acquisitions:

No correspondence between the various surfaces:

→ No ground truth correspondences.
Identify the treated breast (ROI\(^1\)) on all surfaces:


→ Our approach to deal with these challenges.
1: ROI: Region of Interest
Objective: Assist clinicians in measuring breast changes during treatment by using ICANS data.
Constraints:
ICANS data
Three main steps:
We developed and implemented a contribution for each step:
Definition
Shape Matching Problem:
Given \(N\) input shapes \(S_1 , S_2 , \ldots , S_N\) , find a meaningful relation between their elements.

→ How to optimize correspondences?
Our focus for ICANS data:

Our focus for ICANS data:

Our focus for ICANS data:

→ Which method should we use?
Extensive research has been conducted on various approaches:
→ We chose the Functional Maps approach.
Many advantages:
→ What are Functional Maps?
Functional Maps by Ovsjanikov et al. (2016)
→ How to optimize such maps?
Spectral Coefficients by Ovsjanikov et al. (2016)
Main ideas:

→ \(C^* = arg\,min_{C} \left\lVert CA - B \right\rVert^2 + E_{reg}(C)\)
The Laplace Beltrami Operator (LBO) eigenfunctions:
→ Good for shape matching and analysis
Eigenfunctions on bust data
Existing methods to deal with our challenges:
Fully Spectral Partial Shape Matching → Litany et al. (2017)

Partial FM slope by Rodolà et al. (2016)
Fully Spectral Partial Shape Matching → Litany et al. (2017)

Fully Spectral Partial Shape Matching → Litany et al. (2017)

New basis by Litany et al. (2017)
Fully Spectral Partial Shape Matching → Litany et al. (2017)

→ \(\min_{Q \in S(K,r)} \underbrace{off(Q^T \Lambda^{S_i} Q)}_{\text{smoothing term}} + \mu \underbrace{\left\lVert A_r - Q^TB \right\rVert_{2,1}}_{\text{data term}}\)
Existing methods to deal with our challenges:
Main concept:

ZoomOut upsampling strategy by Simone Melzi et al. (2019)
Existing methods to deal with our challenges:
Core idea:
→ Should not change information.

Core idea:

→ \(Y = arg\,min_{Y} \sum_{(i,j) \in \mathcal{E}} \omega_{ij} \left\lVert C_{i,j}Y_i - Y_j \right\rVert_F^2\)
\(1\): Canonical Consistent Latent Bases
Our Functional Map Network (FMN)
Core idea:
→ \(L_{id}\): Domain in which compare \(\neq\) shapes

Shape analysis with shape differences operators:
“Intrinsic” variability
\(D_i^A = Y_i^T Y_i\) and \(D_i^C = \Lambda_0^{-1} Y_i^T \Lambda^{S_i} Y_i\)
\(F=\sum_{i,j} (D_i -D_j)^2\)
\(H= \sum_{(i,j) \notin \mathcal{S}} (D_i^g-D_j^g)^2\) \(- \sum_{(i,j) \in \mathcal{S}} (D_i^g-D_j^g)^2\)

→ Eigenfunctions of F/H show sorted variability
Shape differences variability by Huang et al. (2019)
Existing methods to deal with our challenges:
Localized Manifold Harmonics by S. Melzi et al. (2017)
Main concept:

LMH: Localized Manifold Harmonics
Main concept:

LMH: Localized Manifold Harmonics
LMH Functional Maps by S. Melzi et al. (2017)
LMH Functional Maps by S. Melzi et al. (2017)
→ ✓ Background work
Approach:

S1 to CT FSPM colormap transfer
FSPM CT-to-scans colormap transfer
Approach:

→ ROI focus?
ROI focus:
ROI definition on CT
ROI focus:

→ Transfer ROI mask to scan acquisitions
ROI transfer to scan acquisitions:
CT-to-scan FSPM ROI transfer
FSPM for partial correspondences:

→ We need to refine these pairwise correspondences.
Approach:

FSPM+bidirZM colormap transfer


→ ROI transfer
Improved ROI transfer:
CT-to-scan FSPM+bidirZM ROI transfer
ROI transfer results:


→ Groupwise correspondences refinement + ROI focus
Approach:

→ Improve the treated breast representation
Approach:

Approach:
→ with MH only
→ with LMH only (ours)

Results: consistent LMH


Results: Better ROI transfer on bust data

→ Synthetic data
Results: Better ROI transfer on synthetic data

→ Quantitative improvement?
Results: Pointwise cyclic errors
Pointwise cyclic error illustration
| Shape | S1 | S2 | S3 | S4 | S5 |
|---|---|---|---|---|---|
| Pairwise | 34.62 | 22.79 | 18.27 | 15.69 | 30.96 |
| Groupwise | 1.15 | 1.04 | 0.88 | 1.57 | 2.10 |
| Ours | 1.11 | 0.98 | 0.81 | 1.46 | 1.19 |
| Pairwise ROI | 18.44 | 18.18 | 15.09 | 7.36 | 19.41 |
| Groupwise ROI | 1.57 | 1.62 | 1.48 | 1.99 | 5.02 |
| Ours ROI | 1.44 | 1.29 | 1.04 | 1.11 | 1.04 |
→ Shape analysis
Intra-patient correspondences
Core idea:

→ \(G\): Domain in which compare \(\neq\) patients
Core idea:

→ \(G = arg\,min_{G} \sum_{(i,j) \in \mathcal{E}} \omega_{ij} \left\lVert C_{L_i,L_j}G_i - G_j \right\rVert_F^2\)
\(1\): Global Latent Bases
Cross-Collections FMN
Cross-Collections FMN
→ \(G \approx\) average patient domain
Inter-patient colormap transfer
Global shape variability in \(G\):
→ Eigenfunctions of F for global variability

Results: Pairwise distinctive functions
Intrinsic conformal variability
Results: Intra-patient global distinctive functions
Intrinsic conformal variability
Results: Intra-patient global distinctive functions
Intrinsic conformal variability
Results: Inter-patient global distinctive functions


Right breast patients: intrinsic area global variability
Inter-session shape variability in \(G\):
→ Eigenfunctions of H for inter-session variability

s: session
Results: Inter-session distinctive functions


Left breast patients: intrinsic conformal inter-session variability
→ How to measure euclidean displacements?
Extrinsic analysis approach
Is difficult as the whole bust changes non-rigidly:

Is difficult as the whole bust changes non-rigidly:

Is difficult as the whole bust changes non-rigidly:
Scan ROI alignment on CT skin
ROI cut definition
Breast S25 deformation
Breast extrinsic changes: displacements amplitude on ROI cut
→ Displacements amplitudes
| SA | SB | S1 | S5 |
|---|---|---|---|
| 1.21±0.58 | 1.20±0.69 | 1.51±0.64 | 1.36±0.45 |
| S10 | S15 | S20 | S25 |
| 1.47±0.60 | 1.25±0.40 | 1.68±0.85 | 1.84±1.05 |
| S33 | M1 | M3 | Sessions avg |
| 1.62±0.78 | 1.98±0.62 | 2.82±1.56 | 1.62±0.72 |
| SA | SB | S1 | S5 |
|---|---|---|---|
| 2.17±1.62 | 2.02±1.97 | 3.31±2.51 | 2.89±2.37 |
| S10 | S15 | S20 | S25 |
| 2.77±2.45 | 2.11±2.05 | 3.24±3.13 | 5.34±6.30 |
| S33 | M1 | M3 | Sessions avg |
| 2.77±3.46 | 4.45±3.04 | 9.93±6.98 | 3.54±3.16 |
→ Dosimetric impact?


Skin dose in radiotherapy is a key issue to reduce patient side effects.

→ Our approach using the ICANS data
Approach
Results:

Results:

Results:
→ More skin dose than planned

Results:



→ Record such potential dose changes.
Results:



→ Correlations with patient skin reactions?
During this thesis:
During this thesis, we also implemented:

During this thesis, we also implemented:

During this thesis, we also implemented:

During this thesis, we also implemented:

From our experiments, we observed:
There are many possible continuations of this work:

Results: PCA in the global domain
Sessions Principal Component Analysis (PCA)