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3D+T echocardiography is a valuable tool for assessing cardiac function, as it enables real-time, non-invasive and low cost acquisition of volumetric images of the heart. The automated tracking of heart chambers in 3D+T echocardiography remains a challenging task due to reasons including speckle noise, shadowing, and the existence of intra-cavity structures [6]. Furthermore, the real-time detection of endocardial borders might be desirable for the invasive procedures and intensive care applications. State-space analysis using Kalman filtering can be employed for the detection of left ventricle (LV) structures in time-dependent recordings. Orderud et al. proposed a Kalman tracking framework for the real-time detection of LV structures in 3D+T echocardiography [5]. The study took advantage of compact Doo-Sabin model representations for rapid tracking, but it did not utilize physical properties to constrain model deformations. Liu et al. introduced a biomechanical-model constrained statespace analysis framework for the tracking of short-axis 2D+T echocardiography recordings [4]. Their study used dense Delaunay triangulated models and employed basic tri-nodal linear elements during the finite element analysis (FEA). Due to triangulated high resolution model representations, it offered a computationally expensive solution. This paper proposes an approach to combine the compact model representations with biomechanical constraints for rapid and accurate tracking. We extend the real-time Kalman tracking framework described in [5] by employing biomechanically constrained state transitions. First, FEA for the tracked Doo-Sabin surface model is performed using the isoparametric method introduced in [3]. This step enables the computation of a stiffness matrix K for a given endocardial model using shell elements without changing the model geometry. However, the computed model might lead to inaccurate deformation modes due to hypothesized model shape and FEA parameters (e.g. Young’s modulus, Poisson’s ratio). Accordingly, we improve the model shape and stiffness matrix using statistical information collected from a training data via Control Point Distribution Models (CPDM) [2]. During the improvement stage, (1) the model shape is updated to the population mean, (2) the stiffness matrix for the updated model shape is computed as K′ (see Figure 1), and (3) K′ is further modified to Kopt to produce similar modes of deformation as the statistically observed ones using Baruch and Bar-Itzhack direct matrix modifications (BBDMM) [1]. Finally, the state prediction stage of the Kalman tracking framework is formulated to perform biomechanically constrained tracking. In the results section, endocardial surface tracking quality is compared among (1) Doo-Sabin surface models with different control node resolutions, (2) biomechanically constrained and non-constrained state transitions, and (3) the systems employing statistically improved and not improved Doo-Sabin models (see Figure 2). Our analyses showed that

Doo-Sabin Surface Models with Biomechanical Constraints for Kalman Filter Based Endocardial Wall Tracking in 3D+T Echocardiography