on to diagram

8/12/2019 On to Diagram

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OntoDiagram

Application for pediatric cardiologythatgenerates Mullins like diagram based on domaindescriptions, clinical observations andmeasurements Mullins AtlasA collection of widely used

diagrammatic representation of anatomy of heartstructure (Mullins Diagram)

Mullins Diagrams are useful in hospital reporting

tools as they efficiently represent the defects Given a description of heart by domain experts, the

system should automatically generate the Mullinsdiagram representing the conditions as described


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Sample Mullins D

iagramsPulmonary

Atresia

Tricuspid

Atresia

ComplexTOF

TAPVR LSVC


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Why Generate Diagrams?


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Situs and Relations:

There is levocardia with visceral and atrial situs solitus, atrioventricular concordance (D-looped ventricles) andnormally related great arteries {S,D,S} noteVenous Connections:There are normal systemic and pulmonary venous connections, with the superior and inferior vana cavae returning

normally to the right atrium, and all four pulmonary identified returning normally to the left atrium. noteAtria:The left and right atria have normal chamber size, structure, and relations. noteAtrioventricular Valves:The mitral and tricuspid valves have normal structure, size, placement and function. There is no mitral insufficiency

and only physiologic tricuspid insufficiency. noteVentricles:There is normal left ventricular chamber size and normal subjective left ventricular funtion with flattened

interventricular septal motion. noteThere is normal right ventricular chamber size. noteThe right ventricle wallthickness is moderately increased. noteThere is normal global left ventricular function. noteThere is flattened

interventricular septal motion. noteOutflow Tracts:The left ventricular outflow tract has normal size and geometry, without stenosis or narrowing. noteThe right

ventricular outflow tract has moderate hypoplasia. noteThere is no subaortic conus. noteThere is marked rightventricular outflow tract turbulence (stenosis). noteThe peak right ventricular outflow tract velocity is 4.1meters/second. noteThe peak right ventricular outflow tract gradient is 67 mmHg. noteSemilunar Valves:

The aortic valve is normal, with three normal leaflets, normal mobility and no prolapse. noteThere is non-turbulentflow and a normal flow velocity across the aortic valve with no evidence of stenosis. noteThere is markedhypoplasia of the pulmonary valve annulus. noteThe pulmonary valve annulus measures 2.1 mm in the long axisoutflow view. noteThe peak velocity across the aortic valve is 1.3 meters/second. noteThe pulmonary valve leafletsare moderately thickened. noteAortic Root Ascending Aorta:

The aortic root, including the sinuses of valsalva, sinotubular ridge, and proximal ascending aorta are normal withoutstenosis, narrowing, or dilation. notePulmonary and Thoracic Arteries:There was supravalvular pulmonary stenosis present. noteThere was hypoplasia of the main pulmonary artery. note

The left pulmonary artery appeared hypoplastic. noteThe right pulmonary artery appeared hypoplastic. noteTherewas a right-sided aortic arch present. noteThere was a patent ductus arteriosus visualized. noteThere was a right-sided patent ductus arteriosus present. noteThere was left-to-right shunting demonstrated across the patentductus arteriosus. noteThere was a right aortic arch with a retroesophageal segment and left descending aortaforming a vascular ring. noteSeptal Defects:

There is a malalignment type ventricular septal defect present. noteThe ventricular septal defect measures 12 mm fromthe apical four-chamber view. noteThere is a moderate degree of aortic override. Fibro-annular continuity of theaortic and mitral valves is present. noteThe aorta has about 50 per cent override. note

Comprehending textualdescriptions is time consuming!


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Diagram is easier to understand!

ComplexTOF


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Motivation

Visual representation is intuitively easier tounderstand than text information.

Pediatric Cardiology faces new or variations ofheart defects

Mullins atlas are comprehensive but notcomplete

Difficult to search and retrieve similar

diagrams Domain experts manually draw diagrams by

hand or modify existing ones in Mullin's atlas


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Pulmonary Artery

Aortic stenosis

Tricuspidinsufficiency

Normal Bicuspid valve

Mitral valve cleft

Coarctation

Right-left shunt

PDA

Patent Foramen Ovale

Bifurcation of PAanterior

Overriding Aorta

True PA

Parachute

Mitral Valve

hypoplasia

above

below

Hidden behind

Component sheared

Scaled along long axis

connections

missing

translation

transposition

translation

Ontological Framework

Diagram World

Domain World

Domain Experts Perspective

Diagram Perspective

Heterogeneityof

Perspectives


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Challenges Heart Structuresimple & complex

Mapping domain knowledge onto diagram specifications

Perspective and representational gap between medicaldomain and diagram domain

Domain Modeling

Modeling congenital defect information Modeling anatomical structure

Implicit domain knowledge

Anatomical consequence of defects

Diagram Modeling Individual component modeling

Spatial orientation between components

Transformations on components to reflect changes


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Heart StructureSimple & Complex

Simple An anatomically simple structure

Intuitively hierarchical part-of relationships (leftheart, right heart, etc.)

Heart components are less in count Anatomically new additions are very less and

predictable

Complex

Variations of each component are large

Variations of heart as a whole are diverse

Complex relationship between various anomalousconditions


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Simple Complex


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OntoDiagram: Focus

Translation from domain description to diagram

Key issues

Domain modeling (Ontology approach) Diagram modeling (Component based approach)

Mapping domain onto diagram (Domain rules)

OntoDiagram

Physicians description Diagram


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OntoDiagram ArchitectureCongenital

Heart Defect

Ontology

HeartAnatomy

Ontology

DiagramOntology

OntoDiagramQuery

Interface

DiagramComposer

Diagramrepository

DatabasesMedicalDatabase

MedicalDatabase

MeasurementOntology

Domain Ontologies

Domain Rules

Diagram Ontology

Mapping System


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Walk through the System


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Ontologies

An ontology is an explicit formal specification of theterms in the domain and relations among them (Gruber1993).

To share common understanding of the domain

knowledge on congenital heart defects amongcardiologists, nurse, database engineer or softwareagents

To make domain assumptions explicit so that defectassociations patterns could be extracted

To separate domain knowledge from operationalknowledge

To map different perspectives of domain and diagram


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Domain Modeling

Modularizing domain knowledge Congenital Heart Defect Ontology [UMLS]

Classification of defects, anomalous conditions

Definition for domain terms like stenosis, atresia, etc.

Anatomical consequences of defects Association between defects

Anatomy ontology [FMA]

Multi-perspective classification of heart anatomy

Possible anatomical changes in each heart component Orientation between components

Measurement and Diagram Ontology [LOINC]


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Diagram Modeling Diagram Models

Component Association Model (Spatial Orientationbetween components)

Structure Model (Component hierarchy)

Conversion Model (Transformations)

Annotation Model (Relevant annotations)

Diagram perspective of changes Abnormal growth

Missing parts

Transposition

Transformation

Combination


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Component Association Model

Spatial relations with components and their neighboringcomponents

Six-tuple {Ct, Cn,D,A, O,P} where

Ctand Cncomponents,Dspatial orientation of Ctwith respect to Cn,Ainterface presence, Oorientation,Ppresence of component

e.g. {Descending Aorta, Aortic Arch, bottom, attached, below, present}

bottom

top

right

top

top top

right right


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StructureModel

The heart is considered to be made oftwo layers

The first layer consisting of thechambers of the heart (wall of atriaand ventricles)

The second layer consists of theother components of heart(Pulmonary arteryandPulmonary

valves,AortaandAorta valves, etc.)

The relationships between the first andthe second layer components


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Interface Points & Gate Points

ComponentComponent LayerLayer


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Conversion Model Transformation of components

Geometric transformation (e.g., Scale, Rotate, Translate)

Polynomial transformation (e.g., Shear)

Domain specific transformation (e.g, dilation, coarctation)

Transformation model defined as {CT,T, P} CTcomponent being transformed

Tname of the transformation Ptransformation parameters


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Hierarchical Composition

Hierarchicalmodelcloser todomainperspective

Faster diagramgenerationfewcomponentschange

Optimal selectionof components


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Hierarchical Composition Steps

Step 1: Configuration

1. Identify an appropriate set of components and theirabstraction level to be composed [Congenital Defects andAssociation models]

2. Determine the components to be transformed [ConversionModel]

3. Determine the relationships between components (below,

above) [Component Structure Model]Step 2: Composition

Starting from the most specific level to the root1. Transform component images using the transformation

operations if necessary (scale, rotation, etc)

2. Rank the components [Image Model - Color Schema]3. Compose the components using interface points [Structure

Model]4. Forward the interface points to the upper level

Step 3: Annotation


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Diagram

Composer

Congenital

Heart Defect

Ontology

Anatom

y

Ontolog

y

Measurement

Ontology

Diagram

Ontology

Mapping System

Domain

Description

Diagram Instruction Files

Domainontologies

Ontological Framework

OntoDiagramSystem


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OntoDiagram Prototype

Constructed domain ontologies using theprotg in OWL.

Implemented the query interface in Javausing the Jena.

Implemented the image compositionmodule using the Java Advanced Imaging

package.


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Sample Output(Patent Ductus Arteriosus)


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Conclusion

The domain descriptions of the congenital heartdefects are mapped to generate a diagrammaticrepresentation of defects. Ontology based domain modeling Component based diagram modeling Rule based mapping between domain and diagram Hierarchical composition of components

A prototype system is currently under testing at

the Childrens Mercy Hospitals and Clinics facilitate existing treatments for managing patients

with severe heart disorders.

on to diagram

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