Eric Kerfoot

King's College London | KCL · Division of Imaging Sciences and Biomedical Engineering

Background: Self-reported symptom studies rapidly increased understanding of SARS-CoV-2 during the COVID-19 pandemic and enabled monitoring of long-term effects of COVID-19 outside hospital settings. Post-COVID-19 condition presents as heterogeneous profiles, which need characterisation to enable personalised patient care. We aimed to describe pos...

Current methods for magnetic resonance-based positron emission tomography attenuation correction (PET-MR AC) are time consuming, and less able than computed tomography (CT)-based AC methods to capture inter-individual variability and skull abnormalities. Deep learning methods have been proposed to produce pseudo-CT from MR images, but these methods...

Background: Individual skull models of bone density and geometry are important when planning the expected transcranial ultrasound acoustic field and estimating mechanical and thermal safety in low-intensity transcranial ultrasound stimulation (TUS) studies. Computed tomography (CT) images have typically been used to estimate skull acoustic properti...

In this paper, we applied a method for quantifying several left intraventricular hemodynamic parameters from 4D Flow data and its application in a proof-of-concept study in dilated cardiomyopathy (DCM) patients. In total, 12 healthy volunteers and 13 DCM patients under treatment underwent short-axis cine b-SSFP and 4D Flow MRI. Following 3D segment...

Parameterised patient-specific models of the heart enable quantitative analysis of cardiac function as well as estimation of regional stress and intrinsic tissue stiffness. However, the development of personalised models and subsequent simulations have often required lengthy manual setup, from image labelling through to generating the finite elemen...

Automatic quantification of the left ventricle (LV) from cardiac magnetic resonance (CMR) images plays an important role in making the diagnosis procedure efficient, reliable, and alleviating the laborious reading work for physicians. Considerable efforts have been devoted to LV quantification using different strategies that include segmentation-ba...

Delayed-enhancement cardiac magnetic resonance (DE-CMR) provides important diagnostic and prognostic information on myocardial viability. The presence and extent of late gadolinium enhancement (LGE) in DE-CMR is negatively associated with the probability of improvement in left ventricular function after revascularization. Moreover, LGE findings can...

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, characterised by a rapid and irregular electrical activation of the atria. Treatments for AF are often ineffective and few atrial biomarkers exist to automatically characterise atrial function and aid in treatment selection for AF. Clinical metrics of left atrial (LA) functio...

Valve annuli motion and morphology, measured from non-invasive imaging, can be used to gain a better understanding of healthy and pathological heart function. Measurements such as long-axis strain as well as peak strain rates provide markers of systolic function. Likewise, early and late-diastolic filling velocities are used as indicators of diasto...

One of the challenges in developing deep learning algorithms for medical image segmentation is the scarcity of annotated training data. To overcome this limitation, data augmentation and semi-supervised learning (SSL) methods have been developed. However, these methods have limited effectiveness as they either exploit the existing data set only (da...

Introduction The importance of atrial mechanical dysfunction in atrial and ventricular pathologies is becoming increasingly recognised. Although machine learning (ML) tools have the ability to automatically estimate atrial function, to date ML techniques have not been used to automatically estimate atrial volumes and functional parameters directly...

Valve annuli motion and morphology, measured from non-invasive imaging, can be used to gain a better understanding of healthy and pathological heart function. Measurements such as long-axis strain as well as peak strain rates provide markers of systolic function. Likewise, early and late-diastolic filling velocities are used as indicators of diasto...

Delayed-enhancement cardiac magnetic resonance (DE-CMR)provides important diagnostic and prognostic information on myocardial viability. The presence and extent of late gadolinium enhancement (LGE)in DE-CMR is negatively associated with the probability of improvement in left ventricular function after revascularization. Moreover, LGE findings can s...

One of the challenges in developing deep learning algorithms for medical image segmentation is the scarcity of annotated training data. To overcome this limitation, data augmentation and semi-supervised learning (SSL) methods have been developed. However, these methods have limited effectiveness as they either exploit the existing data set only (da...

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, characterised by a rapid and irregular electrical activation of the atria. Treatments for AF are often ineffective and few atrial biomarkers exist to automatically characterise atrial function and aid in treatment selection for AF. Clinical metrics of left atrial (LA) functio...

An important number of patients with dilated cardiomyopathy have improved their left ventricular function with an optimal treatment. However, it is not well understood whether remodeling represents a recovery in left ventricular (LV) hemodynamics. In this abstract, we discuss the capacity of the ejection fraction to represent disease remission, by...

Motivation: Computational models of the heart are increasingly being used in the development of devices, patient diagnosis and therapy guidance. While software techniques have been developed for simulating single hearts, there remain significant challenges in simulating cohorts of virtual hearts from multiple patients. Dataset Description: We prese...

Background: Cardiac resynchronization therapy (CRT) is associated with increased risk of ventricular arrhythmias when pacemaker leads are implanted in proximity to a scar. However, the mechanisms leading to this increased risk remain poorly understood. Investigating the role of lead location on arrhythmia risk in the clinical setting is impractical...

[\({}^{18}\)F]fluorodeoxyglucose (FDG) positron emission tomography (PET) aids in the localisation of the epileptogenic zone in patients with focal epilepsy, especially when magnetic resonance imaging (MRI) is normal or non-contributory. We propose a two-stage deep learning framework to support the clinical evaluation of patients with focal epileps...

Real-time (RT) sequences for cardiac magnetic resonance imaging (CMR) have recently been proposed as alternatives to standard cine CMR sequences for subjects unable to hold the breath or suffering from arrhythmia. RT image acquisitions during free breathing produce comparatively poor quality images, a trade-off necessary to achieve the high tempora...

Background: Cardiac resynchronization therapy (CRT) increases the risk of ventricular tachycardia (VT) in patients with ischemic cardiomyopathy (ICM) when the left ventricular (LV) epicardial lead is implanted in proximity to scar. Objective: To determine the mechanisms underpinning this risk, we investigate the effects of pacing on local electrop...

Vortices in AF: The video shows the velocity magnitude field overlaid with red velocity vectors on a plane cut intersecting the MV, RPV, LPV and the LAA for patient A in AF. The video shows a single relatively slow vortex moving anti-clockwise in the middle of the LA cavity.

Vortices in SR: The video shows the velocity magnitude field overlaid with red velocity vectors on a plane cut intersecting the MV, RPV, LPV and the LAA for patient A in SR. The video shows multiple fast moving, short-lived vortices created at peak systole, one is seen between the LPV and RPV (left) and another one near the LAA (top right). This is...

Introduction: Atrial fibrillation (AF) is a widespread cardiac arrhythmia that commonly affects the left atrium (LA), causing it to quiver instead of contracting effectively. This behavior is triggered by abnormal electrical impulses at a specific site in the atrial wall. Catheter ablation (CA) treatment consists of isolating this driver site by bu...

We present a methodology for reconstructing full-cycle respiratory and cardiac gated short-axis cine MR sequences from real-time MR data. For patients who are too ill or otherwise incapable of consistent breath holds, real-time MR sequences are the preferred means of acquiring cardiac images, but suffer from inferior image quality compared to stand...

Abnormal cardiac motion can indicate different forms of disease, which can manifest at different spatial scales in the myocardium. Many studies have sought to characterise particular motion abnormalities associated with specific diseases, and to utilise motion information to improve diagnoses. However, the importance of spatial scale in the analysi...

Cardiac motion is inherently tied to the disease state of the heart, and as such can be used to identify the presence and extent of different cardiac pathologies. Abnormal cardiac motion can manifest at different spatial scales of the myocardium depending on the disease present. The importance of spatial scale in the analysis of cardiac motion has...

Biomedical research, combining multi-modal image and geometry data, presents unique challenges for data visualization, processing, and quantitative analysis. Medical imaging provides rich information, from anatomical to deformation, but extracting this to a coherent picture across image modalities with preserved quality is not trivial. Addressing t...

Patient-specific modelling has emerged as a tool for studying heart function, demonstrating the potential to provide non-invasive estimates of tissue passive stiffness. However, reliable use of model-derived stiffness requires sufficient model accuracy and unique estimation of model parameters. In this paper we present personalised models of cardia...

From basic science to translation, modern biomedical research demands computational models which integrate several interacting physical systems. This paper describes the infrastructural framework for a generic multi- physics integration implemented in the software CHeart, a finite-element code for biomedical research. To generalize the coupling of...

From basic science to translation, modern biomedical research demands computational models which integrate several interacting physical systems. This paper describes the infrastructural framework for generic multiphysics integration implemented in the software CHeart, a finite-element code for biomedical research. To generalize the coupling of phys...

Computational cardiac physiology has great potential to improve the management of cardiovascular diseases. One of the main bottlenecks in this field is the customization of the computational model to the anatomical and physiological status of the patient. We present a fully automatic service for the geometrical personalization of cardiac ventricula...

Sharing data between scientists and with clinicians in cardiac research has been facilitated significantly by the use of web technologies. The potential of this technology has meant that information sharing has been routinely promoted through databases that have encouraged stakeholder participation in communities around these services. In this pape...

Ongoing developments in cardiac modelling have resulted, in particular, in the development of advanced and increasingly complex computational frameworks for simulating cardiac tissue electrophysiology. The goal of these simulations is often to represent the detailed physiology and pathologies of the heart using codes that exploit the computational...

The applicability of aspects as a means of implementing runtime contract checking has been demonstrated in prior work, where contracts are identified as cross-cutting concerns [12, 13]. Checking contracts at runtime encounters a set of challenges within concurrent environments, such as the risk that evaluation will introduce deadlock to code which...

Active objects are an attractive method of introducing con-currency into Java-like languages by decoupling method ex-ecution from invocation. In this paper, we show how owner-ship is used in the Java [14] subset language CoJava [17] to prevent deadlock associated with active object method calls. This approach builds on existing type-based approache...

Object invariants are critical components to the specification of object-oriented systems, which define valid states for objects and how they may be interrelated. A complex problem is created when an invariant relies on objects that are externally aliased and mod-ified, since the invariant's class cannot ensure that modification to these objects pr...

ESpec is a suite of tools that facilitates the testing and veriflcation of object-oriented Eifiel programs in an integrated environment. The suite includes unit testing tools (ES-Test) and Fit tables (ES-Fit for customer requirements) that report contract failures. This paper describes ES-Verify (part of ESpec) for automatically verifying a signifl...