Image Analysis and Visualization of the Human Mastoid Air Cell System

From an engineering background, it is often believed that the human anatomy has already been fully described. Radiology has greatly contributed to understand the inside of the human body without surgical intervention. Despite great advances in clinical CT scanning, image quality is still related to a limited amount X-ray exposure for the patient safety. This limitation prevents fine anatomical structures to be visible and, more importantly, to be detected. Where such modality is of great advantage for screening patients, extracting parameters like surface area and volume implies the bone structure to be large enough in relation to the scan resolution. The mastoid, located in the temporal bone, houses an air cell system whose cells have a variation in size that can go far below current conventional clinical CT scanner resolution. Therefore, the mastoid air cell system is only partially represented on a CT scan. Any statistical analysis will be biased towards air cells of smaller size. To allow a complete representation of the mastoid air cell system, a micro-CT scanner is more adequate. Micro-CT scanning uses approximately the same amount of X-rays but for a much longer exposure time compared to what is normally allowed for patients. Human temporal bone specimens are therefore necessary when using such scanning method. Where the conventional clinical CT scanner lacks level of minutes details, micro-CT scanning provides an overwhelming amount of fine details. Prior to any image analysis of medical data, visualization of the data is often needed to learn how to extract the structures of interest for further processing. Visualization of micro-CT scans is of no exception. Due to the high resolution nature of the data, visualization of such data not only requires modern and powerful computers, but also necessitates a tremendous amount of time to adjust the hiding of irrelevant structures, to find the correct orientation, while emphasising the structure of interest. Once the quality of the data has been assessed, and a strategy for the image processing has been decided, the image processing can start, to in turn extract metrics such as the surface area or volume and draw statistics from it. The temporal bone being one of the most complex in the human body, visualization of micro-CT scanning of this bone awakens the curiosity of the experimenter, especially with the correct visualization settings. This thesis first presents a statistical analysis determining the surface area to volume ratio of the mastoid air cell system of human temporal bone, from micro-CT scanning using methods previously applied for conventional clinical CT scannings. The study compared current resul s with previous studies, with successive downsampling the data down to a resolution found in conventional clinical CT scanning. The results from the statistical analysis showed that all the small mastoid air cells, that cannot be detected in conventional clinical CT scans, do heavily contribute to the estimation of the surface area, and in consequence to the estimation of the surface area to volume ratio by a factor of about 2.6. Such a result further strengthens the idea of the mastoid to play an active role in pressure regulation and gas exchange. Discovery of micro-channels through specific use of a non-traditional transfer function was then reported, where a qualitative and a quantitative preanalysis was performed are described. To gain more knowledge about these micro-channels, a local structure tensor analysis was applied where structures are described in terms of planar, tubular, or isotropic structures. The results from this structural tensor analysis, also reported in this thesis, suggest these micro-channels to potentially be part of a more complex framework, which hypothetically would provide a separate blood supply for the mucosa lining the mastoid air cell system.