OntoDiagram Ontology Based  Diagram Generation   Congenital Heart Defects in Pediatric Cardiology Kartik Vishwanath, Venka...
OntoDiagram <ul><li>A pplication for  pediatric cardiology  that generates Mullin’s like diagram based on domain descripti...
S ample  M ullin ’ s  D iagrams Pulmonary Atresia Tricuspid Atresia Complex TOF TAPVR LSVC
Why  G enerate  D iagrams?
<ul><li>Situs and Relations:  </li></ul><ul><li>There is levocardia with visceral and atrial situs solitus, atrioventricul...
Diagram  is easier  to understand! Complex TOF
Motivation <ul><li>Visual representation is intuitively easier to understand than text information. </li></ul><ul><li>Pedi...
Pulmonary Artery Aortic stenosis Tricuspid insufficiency Normal Bicuspid valve Mitral valve cleft Coarctation Right-left s...
Challenges <ul><li>Heart Structure—”simple & complex” </li></ul><ul><li>Mapping domain knowledge onto diagram specificatio...
Heart Structure “ S imple  &   C omplex ”   <ul><li>Simple </li></ul><ul><li>An  anatomically simple structure </li></ul><...
Simple  Complex
OntoDiagram : Focus <ul><li>Translation from domain description to diagram </li></ul><ul><li>Key  issues </li></ul><ul><ul...
OntoDiagram Architecture Congenital Heart Defect Ontology Heart Anatomy Ontology Diagram Ontology OntoDiagram Query Interf...
Walk through the  S ystem
Ontologies <ul><li>An ontology is a n explicit formal specification of the terms in the domain and relations among them (G...
Domain Modeling <ul><li>Modularizing  domain knowledge </li></ul><ul><ul><li>Congenital Heart Defect Ontology  [UMLS] </li...
Diagram Modeling <ul><li>Diagram Models </li></ul><ul><ul><li>Component Association Model (Spatial Orientation between com...
Component Association Model   <ul><li>Spatial relations with components and their neighboring components  </li></ul><ul><l...
Structure  Model <ul><li>The heart is considered to be made of two layers </li></ul><ul><ul><li>The first layer consisting...
Interface Points & Gate Points Component—Component Layer—Layer
Conversion Model <ul><li>Transformation of components </li></ul><ul><ul><li>Geometric transformation (e.g., Scale, Rotate,...
Hierarchical Composition <ul><li>Hierarchical  m odel—   closer to domain perspective </li></ul><ul><li>Faster  d iagram g...
Hierarchical Composition Steps <ul><li>Step 1: Configuration </li></ul><ul><ul><li>Identify an appropriate set of componen...
Diagram Composer Congenital Heart Defect Ontology Anatomy  Ontology Measurement Ontology Diagram Ontology M apping   Syste...
OntoDiagram Prototype <ul><li>Constructed domain ontologies using the protégé in OWL.  </li></ul><ul><li>Implemented the q...
Sample Output   (Patent Ductus Arteriosus)
Conclusion <ul><li>The domain descriptions of the congenital heart defects are mapped to generate a diagrammatic represent...
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  • Failure of the ductus arteriosus to close in the early weeks of life, as normally occurs, results in a patent ductus arteriosus (PDA), which allows blood to flow between the aorta and the pulmonary artery, leading to an increase in blood flow to the lungs. If the PDA is large the pressure in the lungs may also be abnormally elevated.
  • OntoDiagram.ppt

    1. 1. OntoDiagram Ontology Based Diagram Generation Congenital Heart Defects in Pediatric Cardiology Kartik Vishwanath, Venkatesh Viswanath, Yugyung Lee, Ph.D School of Computing and Engineering University of Missouri—Kansas City William Drake, MD Children's’ Mercy Hospital—Kansas City
    2. 2. OntoDiagram <ul><li>A pplication for pediatric cardiology that generates Mullin’s like diagram based on domain descriptions, clinical observations and measurements </li></ul><ul><ul><li>Mullin’s Atlas —A collection of widely used diagrammatic representation of anatomy of heart structure (Mullins Diagram) </li></ul></ul><ul><ul><li>Mullin’s Diagrams are useful in hospital reporting tools as they efficiently represent the defects </li></ul></ul><ul><ul><li>Given a description of heart by domain experts, the system should automatically generate the Mullin’s diagram representing the conditions as described </li></ul></ul>
    3. 3. S ample M ullin ’ s D iagrams Pulmonary Atresia Tricuspid Atresia Complex TOF TAPVR LSVC
    4. 4. Why G enerate D iagrams?
    5. 5. <ul><li>Situs and Relations: </li></ul><ul><li>There is levocardia with visceral and atrial situs solitus, atrioventricular concordance (D-looped ventricles) and normally related great arteries {S,D,S} note Venous Connections: </li></ul><ul><li>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. note Atria: </li></ul><ul><li>The left and right atria have normal chamber size, structure, and relations. note Atrioventricular Valves: </li></ul><ul><li>The mitral and tricuspid valves have normal structure, size, placement and function. There is no mitral insufficiency and only physiologic tricuspid insufficiency. note Ventricles: </li></ul><ul><li>There is normal left ventricular chamber size and normal subjective left ventricular funtion with flattened interventricular septal motion. note There is normal right ventricular chamber size. note The right ventricle wall thickness is moderately increased. note There is normal global left ventricular function. note There is flattened interventricular septal motion. note Outflow Tracts: </li></ul><ul><li>The left ventricular outflow tract has normal size and geometry, without stenosis or narrowing. note The right ventricular outflow tract has moderate hypoplasia. note There is no subaortic conus. note There is marked right ventricular outflow tract turbulence (stenosis). note The peak right ventricular outflow tract velocity is 4.1 meters/second. note The peak right ventricular outflow tract gradient is 67 mmHg. note Semilunar Valves: </li></ul><ul><li>The aortic valve is normal, with three normal leaflets, normal mobility and no prolapse. note There is non-turbulent flow and a normal flow velocity across the aortic valve with no evidence of stenosis. note There is marked hypoplasia of the pulmonary valve annulus. note The pulmonary valve annulus measures 2.1 mm in the long axis outflow view. note The peak velocity across the aortic valve is 1.3 meters/second. note The pulmonary valve leaflets are moderately thickened. note Aortic Root Ascending Aorta: </li></ul><ul><li>The aortic root, including the sinuses of valsalva, sinotubular ridge, and proximal ascending aorta are normal without stenosis, narrowing, or dilation. note Pulmonary and Thoracic Arteries: </li></ul><ul><li>There was supravalvular pulmonary stenosis present. note There was hypoplasia of the main pulmonary artery. note The left pulmonary artery appeared hypoplastic. note The right pulmonary artery appeared hypoplastic. note There was a right-sided aortic arch present. note There was a patent ductus arteriosus visualized. note There was a right-sided patent ductus arteriosus present. note There was left-to-right shunting demonstrated across the patent ductus arteriosus. note There was a right aortic arch with a retroesophageal segment and left descending aorta forming a vascular ring. note Septal Defects: </li></ul><ul><li>There is a malalignment type ventricular septal defect present. note The ventricular septal defect measures 12 mm from the apical four-chamber view. note There is a moderate degree of aortic override. Fibro-annular continuity of the aortic and mitral valves is present. note The aorta has about 50 per cent override. note </li></ul>Comprehending textual descriptions is time consuming!
    6. 6. Diagram is easier to understand! Complex TOF
    7. 7. Motivation <ul><li>Visual representation is intuitively easier to understand than text information. </li></ul><ul><li>Pediatric C ardiology faces new or variations of heart defects </li></ul><ul><li>Mullin’s atlas are comprehensive but not complete </li></ul><ul><ul><li>Difficult to search and retrieve similar diagrams </li></ul></ul><ul><li>Domain experts m anually draw diagrams by hand or modify existing ones in Mullin's atlas </li></ul>
    8. 8. Pulmonary Artery Aortic stenosis Tricuspid insufficiency Normal Bicuspid valve Mitral valve cleft Coarctation Right-left shunt PDA Patent Foramen Ovale Bifurcation of PA anterior 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 Heterogeneity of Perspectives
    9. 9. Challenges <ul><li>Heart Structure—”simple & complex” </li></ul><ul><li>Mapping domain knowledge onto diagram specifications </li></ul><ul><ul><li>Perspective and representational gap between medical domain and diagram domain </li></ul></ul><ul><li>Domain Modeling </li></ul><ul><ul><li>Modeling congenital defect information </li></ul></ul><ul><ul><li>Modeling anatomical structure </li></ul></ul><ul><ul><li>Implicit domain knowledge </li></ul></ul><ul><ul><li>Anatomical consequence of defects </li></ul></ul><ul><li>Diagram Modeling </li></ul><ul><ul><li>Individual component modeling </li></ul></ul><ul><ul><li>Spatial orientation between components </li></ul></ul><ul><ul><li>Transformations on components to reflect changes </li></ul></ul>
    10. 10. Heart Structure “ S imple & C omplex ” <ul><li>Simple </li></ul><ul><li>An anatomically simple structure </li></ul><ul><li>Intuitively hierarchical “part-of” relationships (left heart, right heart , etc.) </li></ul><ul><li>H eart components are less in count </li></ul><ul><li>Anatomically new additions are very less and predictable </li></ul><ul><li>Complex </li></ul><ul><li>V ariations of each component are large </li></ul><ul><li>V ariations of heart as a whole are diverse </li></ul><ul><li>Complex relationship between various anomalous conditions </li></ul>
    11. 11. Simple Complex
    12. 12. OntoDiagram : Focus <ul><li>Translation from domain description to diagram </li></ul><ul><li>Key issues </li></ul><ul><ul><li>Domain modeling (Ontology approach) </li></ul></ul><ul><ul><li>Diagram modeling (Component based approach) </li></ul></ul><ul><ul><li>Mapping domain onto diagram (Domain rules) </li></ul></ul>OntoDiagram Physician ’ s description Diagram
    13. 13. OntoDiagram Architecture Congenital Heart Defect Ontology Heart Anatomy Ontology Diagram Ontology OntoDiagram Query Interface Diagram Composer Diagram repository Databases Medical Database Medical Database Measurement Ontology Domain Ontolog ies Domain Rules D iagram Ontolog y Mapping System
    14. 14. Walk through the S ystem
    15. 15. Ontologies <ul><li>An ontology is a n explicit formal specification of the terms in the domain and relations among them (Gruber 1993). </li></ul><ul><li>To s hare common understanding of the domain knowledge on congenital heart defects among cardiologists , nurse, database engineer or software agents </li></ul><ul><li>To make domain assumptions explicit so that defect associations patterns could be extracted </li></ul><ul><li>To separate domain knowledge from operational knowledge </li></ul><ul><li>To map different perspectives of domain and diagram </li></ul>
    16. 16. Domain Modeling <ul><li>Modularizing domain knowledge </li></ul><ul><ul><li>Congenital Heart Defect Ontology [UMLS] </li></ul></ul><ul><ul><ul><li>Classification of defects, anomalous conditions </li></ul></ul></ul><ul><ul><ul><li>Definition for domain terms like stenosis, atresia, etc. </li></ul></ul></ul><ul><ul><ul><li>Anatomical consequences of defects </li></ul></ul></ul><ul><ul><ul><li>Association between defects </li></ul></ul></ul><ul><ul><li>Anatomy ontology [FMA] </li></ul></ul><ul><ul><ul><li>Multi-perspective classification of heart anatomy </li></ul></ul></ul><ul><ul><ul><li>Possible anatomical changes in each heart component </li></ul></ul></ul><ul><ul><ul><li>Orientation between components </li></ul></ul></ul><ul><ul><li>Measurement and Diagram Ontology [LOINC] </li></ul></ul>
    17. 17. Diagram Modeling <ul><li>Diagram Models </li></ul><ul><ul><li>Component Association Model (Spatial Orientation between components) </li></ul></ul><ul><ul><li>Structure Model (Component hierarchy) </li></ul></ul><ul><ul><li>Conversion Model (Transformations) </li></ul></ul><ul><ul><li>Annotation Model (Relevant annotations) </li></ul></ul><ul><li>Diagram perspective of changes </li></ul><ul><ul><li>Abnormal growth </li></ul></ul><ul><ul><li>Missing parts </li></ul></ul><ul><ul><li>Transposition </li></ul></ul><ul><ul><li>Transformation </li></ul></ul><ul><ul><li>Combination </li></ul></ul>
    18. 18. Component Association Model <ul><li>Spatial relations with components and their neighboring components </li></ul><ul><li>Six-tuple { Ct , Cn , D , A , O , P } where </li></ul><ul><ul><li>Ct and Cn components, D— spatial orientation of Ct with respect to Cn, A—interface presence, O —orientation, P —presence of component </li></ul></ul><ul><li>e.g. { Descending Aorta, Aortic Arch, bottom, attached, below, present } </li></ul>bottom top right top top top right right
    19. 19. Structure Model <ul><li>The heart is considered to be made of two layers </li></ul><ul><ul><li>The first layer consisting of the chambers of the heart ( wall of atria and ventricles ) </li></ul></ul><ul><ul><li>The second layer consists of the other components of heart ( Pulmonary artery and Pulmonary valves , Aorta and Aorta valves , etc. ) </li></ul></ul><ul><li>The relationships between the first and the second layer components </li></ul>
    20. 20. Interface Points & Gate Points Component—Component Layer—Layer
    21. 21. Conversion Model <ul><li>Transformation of components </li></ul><ul><ul><li>Geometric transformation (e.g., Scale, Rotate, Translate) </li></ul></ul><ul><ul><li>Polynomial transformation (e.g., Shear) </li></ul></ul><ul><ul><li>Domain specific transformation (e.g, dilation, coarctation) </li></ul></ul><ul><li>Transformation model defined as {C T ,T, P} </li></ul><ul><ul><li>C T —component being transformed </li></ul></ul><ul><ul><li>T—name of the transformation </li></ul></ul><ul><ul><li>P—transformation parameters </li></ul></ul>
    22. 22. Hierarchical Composition <ul><li>Hierarchical m odel— closer to domain perspective </li></ul><ul><li>Faster d iagram generation—few components change </li></ul><ul><li>Optimal s election of components </li></ul>
    23. 23. Hierarchical Composition Steps <ul><li>Step 1: Configuration </li></ul><ul><ul><li>Identify an appropriate set of components and their abstraction level to be composed [Congenital Defects and Association models] </li></ul></ul><ul><ul><li>Determine the components to be transformed [Conversion Model] </li></ul></ul><ul><ul><li>Determine the relationships between components ( below , above ) [Component Structure Model] </li></ul></ul><ul><li>Step 2: Composition </li></ul><ul><li>Starting from the most specific level to the root </li></ul><ul><ul><li>Transform component images using the transformation operations if necessary (scale, rotation, etc) </li></ul></ul><ul><ul><li>Rank the components [Image Model - Color Schema] </li></ul></ul><ul><ul><li>Compose the components using interface points [Structure Model] </li></ul></ul><ul><ul><li>Forward the interface points to the upper level </li></ul></ul><ul><li>Step 3: Annotation </li></ul>
    24. 24. Diagram Composer Congenital Heart Defect Ontology Anatomy Ontology Measurement Ontology Diagram Ontology M apping System Domain Description Diagram Instruction Files Domain ontologies Ontological Framework OntoDiagram System
    25. 25. OntoDiagram Prototype <ul><li>Constructed domain ontologies using the protégé in OWL. </li></ul><ul><li>Implemented the query interface in Java using the Jena. </li></ul><ul><li>Implemented the image composition module using the Java Advanced Imaging package. </li></ul>
    26. 26. Sample Output (Patent Ductus Arteriosus)
    27. 27. Conclusion <ul><li>The domain descriptions of the congenital heart defects are mapped to generate a diagrammatic representation of defects. </li></ul><ul><ul><li>Ontology based domain modeling </li></ul></ul><ul><ul><li>Component based diagram modeling </li></ul></ul><ul><ul><li>Rule based mapping between domain and diagram </li></ul></ul><ul><ul><li>Hierarchical composition of components </li></ul></ul><ul><li>A prototype system is currently under testing at the Children’s Mercy Hospitals and Clinics </li></ul><ul><ul><li>facilitate existing treatments for managing patients with severe heart disorders. </li></ul></ul>

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