Abstract: Included are a storage unit for storing as first medical image information a three-dimensional image representing information about an inside of the subject; an image processor for generating a display image on the basis of the first medical image information and second medical image information; and a display for displaying the display image generated by the image processor. The image processor includes: a catheter position information detector for calculating a position of the balloon catheter C and detecting position information; and a balloon pressure-contact degree calculator for calculating a pressure-contact degree A of the tissues of the subject and a balloon b on the basis of the first medical image information and the position information.

Abstract: The system provides new ways to ensure that a patient is positioned correctly, e.g. identically with an original planning scan if the patient is to undergo radiotherapy. The system also detects if there is patient movement during a scan. It is an aspect of the present method to immobilize the patient based on a specific site of interest by using positioning sensors that record patient physical orientation based on measurements of patient weight distribution and pressure distribution among other features.

Abstract: A system and method for indirectly monitoring the position of a target inside a body is disclosed. The method includes generating position data associated with one or more surrogate devices and predicting a location of the target from the position data based on a target position model that establishes a relationship between an actual location of the target and the position data of the one or more surrogate devices. The method also includes determining that the predicted location of the target deviates from the actual location of the target when an analysis of an error prediction model results in a confidence threshold being exceeded.

Abstract: A method is disclosed for segmentation of a calcified blood vessel in image data. An embodiment of the method includes providing a vesseltree representation of the blood vessel; providing a number of preliminary boundary representations of a number of cross-sections of the blood vessel; providing a number of intensity profiles in the image data in the number of cross-sections; determining a calcification in the cross-section based on the intensity profile; and correcting each preliminary boundary representation into a corrected boundary representation which excludes the calcification from an inner part of the blood vessel. A segmentation system is also disclosed.

Abstract: A method for producing an attenuation-corrected time-gated PET image comprising includes obtaining a baseline MR image and a cine MR image of a structure; registering the baseline MR image to the cine MR image to create an image transform; and generating a corresponding cine ACF matrix using the image transform, and time-correlating the ACF matrix to a time-gated PET data set to produce an attenuation-corrected time-gated PET image.

Abstract: A system for wearable/man-portable electromagnetic tomographic imaging includes a wearable/man-portable boundary apparatus adapted to receive a biological object within, a position determination system, electromagnetic transmitting/receiving hardware, and a hub computer system. The electromagnetic transmitting/receiving hardware collectively generates an electromagnetic field that passes into the boundary apparatus and receives the electromagnetic field after being scattered/interferenced by the biological object within. The hub computer system performs electromagnetic tomographic imaging based on the received electromagnetic field.

Abstract: A system for wearable/man-portable electromagnetic tomographic imaging includes a wearable/man-portable boundary apparatus adapted to receive a biological object within, a position determination system, electromagnetic transmitting/receiving hardware, and a hub computer system. The electromagnetic transmitting/receiving hardware collectively generates an electromagnetic field that passes into the boundary apparatus and receives the electromagnetic field after being scattered/interferenced by the biological object within. The hub computer system performs electromagnetic tomographic imaging based on the received electromagnetic field.

Abstract: A system that incorporates teachings of the present disclosure may include, for example, an avatar engine having a controller to retrieve a user profile of a user, present the user an avatar having characteristics that correlate to the user profile, detect one or more responses of the user during a communication exchange between the user and the avatar, identify from the one or more responses a need to determine a medical status of the user, establish communications with a medical diagnostic system, receive physiological information associated with the user, submit the physiological information to the medical diagnostic system, receive from the medical diagnostic system a diagnostic analysis of the physiological information, and present the diagnostic analysis to at least one of the user and a medical agent of the user, wherein the user is presented the diagnostic analysis by way of the avatar. Other embodiments are disclosed.

Abstract: A method and system for steering an insertion tube of a video inspection device is disclosed for detecting a precise steering request made by displacing a pointing device from its stationary position and then returning the pointing device to or near its stationary position within a short interval of time. This precise steering request is then used by the video inspection device to steer the insertion tube a fixed distance in a direction based on the direction of the displacement of the pointing device for precise positioning of the camera head of the insertion tube.

Abstract: A system for generating surgical procedure training media draws upon the realistic data of an actual surgical procedure for realistic training without the risks. A 3D capturing component records three-dimensional model plus imaging data over time of a portion of a patient's body undergoing a surgical procedure. A spatial detection system detects an orientation of a surgical instrument relative to the patient's body during the surgical procedure. A modeling component creates a four-dimensional model (3D model+time) of the portion of the patient's body. Animation such as contingent events, trainee prompts, a virtual surgical instrument, etc., can be added to the model to expand upon the training potential. A user interface processes and edits training media for playback of the four-dimensional model including defining triggers responsive to a trainee simulated surgical inputs to pace sequencing of playback.

Abstract: A method of generating a density enhanced model of an object is described. The method includes generating a customized a model of an object using a pre-defined set of models in combination with at least one projection image of the object, where the customized model is formed of a plurality of volume elements including density information. A density map is generated by relating a synthesized projection image of the customized model to an actual projection image of the object. Gains from the density map are back-projected into the customized model to provide a density enhanced customized model of the object. Because the density map is calculated using information from the synthesized projection image in combination with actual projection images of the structure, it has been shown to provide spatial geometry and volumetric density results comparable to those of QCT but with reduced patient exposure, equipment cost and examination time.

Abstract: A method and system for model based fusion pre-operative image data, such as computed tomography (CT), and intra-operative C-arm CT is disclosed. A first pericardium model is segmented in the pre-operative image data and a second pericardium model is segmented in a C-arm CT volume. A deformation field is estimated between the first pericardium model and the second pericardium model. A model of a target cardiac structure, such as a heart chamber model or an aorta model, extracted from the pre-operative image data is fused with the C-arm CT volume based on the estimated deformation field between the first pericardium model and the second pericardium model. An intelligent weighted average may be used improve the model based fusion results using models of the target cardiac structure extracted from pre-operative image data of patients other than a current patient.

Abstract: A method of pre-operatively forming a surgical splint configured to receive a patient's dentition can include combining a 3-D facial computer model and a 3-D dental computer model. The method includes the step of obtaining a 3-D facial computer model of at least the patient's maxilla, mandible, and dentition from a CT scanner and the step of obtaining a 3-D dental computer model of the patient's dentition with an optical scanner. The 3-D dental computer model is then combined with the 3-D facial computer model to form a composite virtual model. The composite virtual model can be manipulated into a planned post-operative shape, and a surgical splint can be custom constructed to match the planned post-operative shape. The surgical splint can be configured to receive the patient's dentition.

Abstract: A projection system includes a projector, an uncalibrated DDL output unit, a light detection device, a characteristic curve computation unit, a calibration unit and a calibrated DDL output unit. The uncalibrated DDL output unit is used for driving the projector to project a frame to an area of a projected object. The light detection device is used for detecting brightness values of the area. The characteristic curve computation unit is used for obtaining a characteristic curve based on the uncalibrated DDLs and the detected brightness values. The calibration unit is used for executing a calibration process according to the characteristic curve and GSDF, so as to map each of the uncalibrated DDLs to a calibrated DDL. The calibrated DDL output unit is used for driving the projector to project another frame to the area of the projected object.

Abstract: A gantry scanner system comprises a radiation source, a plurality of detectors and a support frame supporting the detectors. The support frame includes an elongate support member arranged to support the detectors, cable support means arranged to support power cables or signal cables connected to the detectors, and cover means arranged to cover the support member, the cable support means and the detectors.

Abstract: An image data processing apparatus comprising a image data processing unit for obtaining segmented image data segmented using a segmentation process and including a representation of a vessel, wherein a region of the vessel is missing from the representation, a boundary identification unit for identifying at least one point at or near a boundary of the missing region, wherein the image data processing unit is configured to perform a further segmentation process to identify the missing region of the vessel, using the location of the at least one identified point at or near the boundary of the missing region, and the image data processing unit is further configured to generate a revised representation of the vessel including the missing region of the vessel.

Abstract: The techniques and systems described herein create and train a multiple clustered instance learning (MCIL) model based on image features and patterns extracted from training images. The techniques and systems separate each of the training images into a plurality of instances (or patches), and then learn multiple instance-level classifiers based on the extracted image features. The instance-level classifiers are then integrated into the MCIL model so that the MCIL model, when applied to unclassified images, can perform image-level classification, patch-level clustering, and pixel-level segmentation.

Abstract: Systems and methods are provided for volumetric analysis of pathologies. A segmentation component is configured to determine, for each of a series of images of a region of interest containing a pathological feature, a set of segmentation boundaries within the image representing a cross-section of the pathological feature. A mesh generation component is configured to link the sets of segmentation boundaries from adjacent images in the series of images to generate a polygonal mesh representing a volumetric reconstruction of the pathological feature. A volumetric measurement component is configured to calculate volumetric parameters from the volumetric reconstruction representing the pathological feature. A user interface is configured to provide the calculated volumetric parameters to an associated display.

Abstract: An object guide system includes a plurality of light projecting devices, at least one image capture device, a control device electrically coupled with the light projecting devices, and a display unit electrically coupled with the at least one image capture device and the control device. When an object enters an operation space, a projected information is imaged on the object. Then, the at least one image capture device captures the cross information of the operation space and the three-dimensional position information of the object. Then, the control device calculates the coordinates of the object that is moving in the operation space. Thus, after the at least one image capture device captures the cross information of the operation space and the three-dimensional position information of the object, the object guide system proceeds interactive and guiding operations.

Abstract: An image diagnosis assistance apparatus calculates a first characteristic value based on an image feature of an image that is a diagnosis target, acquires a second characteristic value based on the findings information of the image input by a user via an operation unit, and performs diagnostic inference for a predetermined region of the image based on the first characteristic value, the second characteristic value, and the reliability of inference of the first characteristic value and the second characteristic value.

Abstract: To provide a fluid flow rate detection device which can be evaluated as adequate from a medical point of view. The velocity of a fluid flowing through a luminal organ in vivo is to be obtained. V?(r, ?)=w·V??+(1?w)·V+? is calculated to obtain a calculated value V?(r, ?) of the flow rate regarding a component of the fluid in the direction perpendicular to the ultrasonic beam direction. Here, the weight w is a value proportional to the distance d from the wall on one side of the organ at least when the distance is smaller than a predetermined distance from the wall on the one side, and the weight is a value proportional to the distance d? from the wall on the other side of the organ at least when the distance is smaller than a predetermined distance from the wall on the one other side.

Abstract: An example image layout and display navigator system includes a navigator that includes a miniature layout representation corresponding to the layout of images on the display. The navigator is to appear on the display based on user action with respect to displayed content and to allow a user to select an image series via the miniature layout and to select one or more series level operations for application to the image series via the miniature layout. The navigator is to apply a selected series level operation to the image series via the miniature layout based on user input. An action in one of the navigator and the display is to translate into a corresponding action on the other of the navigator and the display. The content display manager is to update the content displayed to reflect the selected series level operation applied to the image series.

Abstract: A method is disclosed for identifying potential perfusion defects in a tissue region through which blood flows in an object under investigation, based on at least one high-energy image data set covering the tissue region and at least one low-energy image data set covering the tissue region. A virtual contrast medium image data set is established based on the high-energy image data set and the low-energy image data set. Furthermore, first candidate perfusion regions within the virtual contrast medium image data set, and second candidate perfusion defect regions within a further image data set based on the high-energy image data set and/or the low-energy image data are detected, the first candidate perfusion defect regions being compared with the second candidate perfusion defect regions and, based on the comparison, potential perfusion defects being identified. Further disclosed are a corresponding image analysis apparatus and a computed tomography system.

Abstract: Described herein are systems, devices and methods for guiding placement of electrodes, and particularly ECG electrodes on a patient. A picture of the patient's body the patient can be analyzed to determine where on the patient's body to place electrodes according to a predetermined, conventional or standard placement pattern. The methods, devices and systems may then guide a user in positioning or correcting the position of electrodes on the patient. For example, an image of the patient may be provided showing the correct position of the electrodes, which may act as a patient-specific map or guide. The electrode placement positions can correspond to conventional or standard 12-lead ECG electrode positions.

Abstract: An image display apparatus has: a first image generator that defines each position between a predetermined start point and end point of a tubular structure as a first viewpoint and generates a first image obtained by observing an image of the inside of the tubular structure from each first viewpoint toward the end point; a second image generator that defines each position between the start point and the end point as a second viewpoint and generates a second image obtained by observing an image of the inside of the tubular structure from each second viewpoint toward the start point; and a user interface that is provided with an operation part, a monitor and a display controller and is configured so that, in response to an instruction from the operation part, the display controller makes the monitor display the first image and the second image.

Abstract: An axial motion distortion-corrected optical coherence tomography system. The system can include an optical coherence tomography sensor, a light source, a fiber-optic system arranged to provide a reference beam and an observation beam, an optical detection system arranged to receive combined light from the reference beam and the observation beam and to provide detection signals, and a data processing system arranged to receive said detection signals, construct a plurality of A-scans from said detection signals, and construct one or more images from said plurality of A-scans. The data processing system can be configured to correct distortion in the images caused by net axial motion of at least one of said optical coherence tomography sensor or a target of said optical coherence tomography sensor by calculating an estimate of the net axial motion using Doppler shift, and then shifting the A-scans according to the estimate.

Abstract: Surgical controlling systems and methods. A surgical controlling system includes: at least one surgical tool adapted to be inserted into a surgical environment of a human body for assisting a surgical procedure; at least one location estimating unit to real-time locate the 3D spatial position of at least one surgical tool at any given time t; and at least one movement detection unit in communication with a movement's database and with the location estimating means. The system also includes a controller having a processing unit in communication with a controller's database. The controller controls the spatial position of at least one surgical tool.

Abstract: According to an embodiment, an image processing device generates a three-dimensional image to be displayed on a display unit. The display unit includes a display element unit that has pixels each containing a plurality of sub-pixels arranged thereon and a ray control element unit that controls emission directions of rays emitted from the sub-pixels. The image processing device includes a first acquiring unit configured to acquire three-dimensional data for generating the three-dimensional image; and a generating unit configured to calculate, for each of the sub-pixels, a luminance value of the sub-pixel on the basis of an emission direction of a ray emitted from the sub-pixel through the ray control element unit and the three-dimensional data to generate the three-dimensional image.

Abstract: A content analysis engine receives video input and performs analysis of the video input to produce one or more gross change primitives. A view engine coupled to the content analysis engine receives the one or more gross change primitives from the content analysis engine and provides view identification information. A rules engine coupled to the view engine receives the view identification information from the view engine and provides one or more rules based on the view identification information. An inference engine performs video analysis based on the one or more rules provided by the rules engine and the one or more gross change primitives.

Abstract: A method and apparatus for providing biometric information are provided. The method includes measuring biometric information corresponding to at least one body part of a user; processing the biometric information based on at least one of a type of the biometric information and a type of the body part; and displaying the processed biometric information over at least one of image data obtained by photographing the body part and the body part.

Abstract: A medical imaging apparatus and/or method includes a gantry, a control unit, and a display unit. The gantry has a source for generating an X-ray and a detector for detecting the X-ray passing through an object. The gantry allows the source and the detector to rotate around the object. The control unit obtains operational information of the gantry. The display unit outputs the obtained operational information of the gantry.

Abstract: A computer-implemented method for determining changes in parameters of a hip joint due to modification of the hip joint comprises establishing a first position of a pre-operative center of rotation of the joint in a first coordinate space. The method further comprises estimating a second position of the pre-operative center of rotation of the joint in the first coordinate space, when the estimated pre-operative center of rotation is maintained in a constant position in a second coordinate space. A change in a parameter associated with the joint is determined based on the first and second positions of the pre-operative center of rotation of the joint.

Abstract: A method for attenuation correction of a plurality of time-gated PET images of a moving structure includes establishing an ACF matrix, based on a baseline MR image of the structure; developing a plurality of image transforms, each of the image transforms registering the baseline MR image to a respective cine MR image of the moving structure; applying each of the image transforms to the ACF matrix to generate a corresponding cine ACF matrix; time-correlating each of the cine MR images, and its corresponding cine ACF matrix, to one of the plurality of time-gated PET data sets; and producing from each of the time-gated PET data sets an attenuation-corrected time-gated PET image.

Abstract: According to one embodiment, an apparatus includes a slice image generation unit, a three-dimensional image generation unit, a display unit, a setting unit, an updating unit, and a changing unit. The slice image generation unit generates the data of slice images based on a volume data. The three-dimensional image generation unit generates the data of a three-dimensional image based on the volume data. The display unit displays the slice images and the three-dimensional image. The setting unit sets the vector on the first slice image of the displayed slice images in accordance with an instruction from an operator. The updating unit updates the displayed three-dimensional image based on the vector. The changing unit changes the position of a slice of a remaining slice image of the displayed slice images to a position where the slice intersects the vector and is perpendicular to the slice of the first slice image.

Abstract: A method for visualizing the quality of an ablation process with a processing and display unit is provided. A 3D dataset of an anatomical object and a 3D image model of an ablation instrument are provided, wherein the 3D image model models at least the surface of the ablation instrument. A position and an alignment of the 3D image model of the ablation instrument within the anatomical object is specified, wherein the 3D image model of the ablation instrument is incorporated into the 3D dataset of the anatomical object. At least a part of the incorporated 3D image model of the ablation instrument and of the 3D dataset of the anatomical object is presented and at least one characteristic quality value is determined as a function of the location of the 3D image model of the ablation instrument in relation to the anatomical object.

Abstract: Background information is subtracted from projection data in medical diagnostic imaging. The background is removed using data acquired in a single rotational sweep of a C-arm. The removal may be by masking out a target, leaving the background, in the data as constructed into a volume. For subtraction, the masked background information is projected to a plane and subtracted from the data representing the plane.

Abstract: A method of analyzing a stream of imaging data is disclosed. The method comprises: for each picture-element of the data, associating a vector of features indicative of temporal intensity variation relative to baseline intensity, thereby providing a plurality of vectors. The method further comprises clustering the picture-elements according to the vectors, thereby providing a plurality of clusters, and identifying different compartments in the vasculature based on the clusters.

Abstract: A probe (20) generates a plurality of image volumes (13i, 13j) of an anatomical object (10) within a coordinate system (11) and an imaging device (21) generates imaging data (22) representative of the image volumes (13i, 13j) of the anatomical object (10). A position sensor (30) is attached to the probe (20), and a tracking device (31) generates tracking data (22) representative of a tracking of the position sensor (30) within the coordinate system (11). A registration device (40) executes a validation testing of a calibration matrix (51) associated with a spatial relationship between the image volumes (13i, 13j) and the position sensor (30). The validation testing includes a testing of an absolute differential between an image based volume motion (VMIB) and a tracking based volume motion (VMTB) relative to a calibration threshold (CT).

Abstract: A method for displaying a sequence of fluoroscopic images of a subject defines, within the image area of a digital image receiver and in response to one or more viewer instructions, a region of interest and a background region that lies outside the defined region of interest. A succession of fluoroscopic images is obtained from the digital image receiver and, for image pixels within each of the succession of fluoroscopic images, background region pixel data are encoded and transmitted to the display apparatus using a lossy encoding. Region of interest pixel data is transmitted to the display apparatus using a lossless encoding. The succession of fluoroscopic images is displayed.

Abstract: A medical image processing device includes an input section to which a biological mucous membrane image obtained by picking up an image of a biological mucous membrane is inputted, a region extracting section that extracts a mucous membrane microstructure region corresponding to a mucous membrane microstructure from the inputted biological mucous membrane image, a closed region identifying section that identifies at least one closed region regarded as being surrounded by the mucous membrane microstructure region, and a unit region setting section that sets a biologically histological unit region on the basis of the mucous membrane microstructure region and the closed region.

Abstract: Methods and systems for processing a set of images are described. In accordance with this disclosure, images are registered and an analysis is performed in view of one or more constraints (such as constraints based upon anatomical or physiological considerations). Weighting factors are determined based on the analysis. The weighting factors are used in subsequent processing of the registered (and/or unregistered) images and/or to formulate a visualization that conveys the degree of confidence in the motion estimation used in the registration process.

Abstract: Various methods, techniques or modules are provided to allow for the automated analysis of the 3-D representation of the upper front torso (i) to recognize 3-D anatomical features, (ii) to orient the subject with reference to their anatomy or a display, (iii) to determine dimensional analysis including direct point-to-point lines, 3-D surface lines, and volume values, (iv) to simulate the outcome with the addition of breast implants including breast and nipple positioning, (v) to assist in the selection of the breast implants, and/or (vi) to assist in the planning of breast surgery. The automated analysis is based on the analysis of changes in a 3-D contour map of the upper torso, orientation analysis of 3-D features and planes, color analysis of 3-D features, and/or dimensional analysis of 3-D features and positions of the upper torso.

Abstract: A medical image display apparatus includes an image obtainment unit configured to obtain a first image and a second image of a subject generated based on volume data, a base line setting unit configured to set a base line in the first image obtained by the image obtainment unit, an image division unit configured to divide, based on the base line that has been set in the first image by the base line setting unit, the second image into two divided images, and a display control unit configured to display the two divided images, which have been divided by the image division unit, on the first image at a display device in such a manner that the two divided images are away from the base line by a predetermined distance.

Abstract: An optical apparatus is disclosed. The optical apparatus includes an optical scanning module and a rotation axis module. The optical scanning module is used to provide an optical signal for optical tomography. The rotation axis module and the optical scanning module are integrated. When the rotation axis module rotates, the rotation axis module makes the optical scanning module to perform a rotation scanning process to an object.

Abstract: A dual head contrast media injection system performs a patency check or test injection, determining flow rate and/or flow volume from the programmed protocol. The tubing that connects syringes to a patient shares only a short common section near to the patient. Appropriate injection steps are taken to compensate for tubing elasticity. A wireless remote control and a touch screen control are provided, improving functionality and information delivery. The display brightness is controlled based on the ambient light, and the display panel includes a double swivel permitting re-orientation. The orientation of the display may also be controlled based on, e.g., the current step, the tilt angle of the powerhead, or a manual control. Furthermore, the display is customizable to identify the type of fluid (contrast, saline, etc.) on either side of the injector, to provide matched color coding, and to provide a folder/tab analogy for retrieving injection protocol parameters.

Abstract: A system uses range and Doppler velocity measurements from a lidar system and images from a video system to estimate a six degree-of-freedom trajectory of a target. The system estimates this trajectory in two stages: a first stage in which the range and Doppler measurements from the lidar system along with various feature measurements obtained from the images from the video system are used to estimate first stage motion aspects of the target (i.e., the trajectory of the target); and a second stage in which the images from the video system and the first stage motion aspects of the target are used to estimate second stage motion aspects of the target. Once the second stage motion aspects of the target are estimated, a three-dimensional image of the target may be generated.

Abstract: Functional tissue areas in a tissue region are located by illuminating the tissue by measurement illumination. Stimulation in the functional tissue areas leads to a change in at least one optical property of the reflected measurement illumination compared to the original measurement illumination. The functional tissue areas are located based on the change in the at least one optical property of the reflected measurement illumination by determining the difference between a stimulation image of the tissue region obtained during the stimulation and a comparison image of the tissue region obtained without stimulation. The difference may be formed from at least one image recorded with the measurement illumination and at least one image recorded without the measurement illumination to bring about an increase in contrast. An obtained image may be corrected on the basis of the determined topography of the tissue region to bring about an increase in contrast.

Abstract: The present invention relates to the determination of the specific orientation of an object. In order to provide enhanced positioning information of an object to a user, a medical imaging system and a method for operating of a medical imaging system are proposed wherein 2D image data (14) of an object is acquired (12) with an imaging system, wherein the object is provided with at least three markers visible in the 2D image; and wherein (16) the markers are detected in the 2D image; and wherein the spatial positioning and rotation angle (20) of the object in relation to the system geometry is identified (18) on behalf of the markers; and wherein an object-indicator (24) is displayed (22) indicating the spatial positioning and rotation angle of the object.

Abstract: A method, apparatus and computer program product are provided in order to integrate clinical data with the medical images reviewed by radiologists or other healthcare providers. In the context of a method, one or more findings related to a respective risk profile of a patient are identified. The method also includes concurrently presenting both one or more medical images of the patient and a visual representation of at least a portion of the patient's body with respect to visual indications of the one or more findings. The method also includes providing information regarding a respective finding upon selection of the visual indication associated with the respective finding. A corresponding apparatus and computer program product are also provided.

Abstract: An automated skin lesion assessment system may automatically assess a suspect skin lesion. An electronic image library may contain diagnosed skin lesion image data representative of images of a plurality of diagnosed skin lesions and, for each, a diagnosis of the skin lesion. An image capture system may capture an image of the suspect skin lesion. A computer processing system may compare the image of the suspect skin lesion with the diagnosed skin lesion image data and, based on this comparison, identify one or more diagnosed skin lesions which match the suspect skin lesion. A user interface may report the diagnoses of the diagnosed skin lesions that match the image of the suspect skin lesion.