WSEAS TRANSACTIONS on SIGNAL PROCESSING

Mahani Hafizah, Tan Kok, Eko Supriyanto

Development of 3D Image Reconstruction Based on Untracked 2D Fetal

Phantom Ultrasound Images using VTK
MAHANI HAFIZAH, TAN KOK, EKO SUPRIYANTO
Department of Clinical Science and Engineering
University Technology of Malaysia
UTM Skudai, 81310 Johor
MALAYSIA
wmhafizah@gmail.com http://www.biomedical.utm.my
Abstract: - Three dimensional (3D) ultrasound image reconstruction based on two dimensional (2D) images has
become a famous method for analyzing some anatomy related to abnormalities. 3D ultrasound image reconstruction
system is required in order to view the specific part of the object and so that it can be used for analysis purpose. In this
paper, 2D images of fetal phantom were taken by using untracked free-hand ultrasound system. Few sets of 2D images
were taken with different number of slices and after some basic 2D image processing, 3D reconstruction is done by
using surface rendering techniques by implementing contour filtering and marching cubes algorithm in Visual C++ 6.0
with Visualization Toolkit (VTK) toolbox. From the experiment, we can conclude that in order to reconstruct a better
3D image, the aid of tracking sensor is important. Besides, image processing need to be performed thoroughly by
adding other detailed processing techniques so that noises can be fully removed. From the result also, it can be
concluded that the marching cube algorithm can give a better result compare to contour filtering where marching cubes
algorithm can generate higher intensity 3D image which can make user easy to detect inner part and edges of 3D
images. The number of slices should also be increased to improve the accuracy of the 3D image constructed.
Key-Words: - 2D ultrasound, 3D ultrasound, marching cubes, contour filtering, visualization toolkit (VTK)
systems, the operator holds an assembly composed of
the transducer and an attachment, and manipulates it
over the anatomy and 2D images are digitized as the
transducer is moved. For untracked free-hand systems
approach, the operator moves the transducer in a steady
and regular motion while 2D images are digitized and in
order to reconstruct a 3D image, a linear or angular
spacing between digitized images is assumed. In
mechanical localizers, the transducer is translated or
rotated mechanically, while 2D ultrasound images are
digitized at predefined spatial or angular intervals while
2D arrays generates a pyramidal pulse of ultrasound and
processes the echoes to generate 3D information in realtime [9-12].
The 3D reconstruction process refers to the
generation of a 3D image from a digitized set of 2D
images and two approaches can be used which is either
3D surface model or voxel-based volume. Besides, the
ability to visualize information in the 3D image depends
critically on the rendering technique. Three basic types
being used are surface-based viewing techniques, multiplane viewing techniques and volume-based rendering
techniques [13-14].
In this paper, 2D images were taken by using
untracked free-hand system. Few sets of 2D images
were taken with different number of slices and after
some 2D image processing, 3D reconstruction is done

1 Introduction
Medical imaging is the technique used to create images
of the human body for clinical purposes especially for
analyzing some anatomy related to abnormalities. Some
of the commonly used imaging techniques are
ultrasound, CT, and MRI [1-2]. However, the major
difference between the other medical imaging equipment
and ultrasound is that it is safer, low cost, non-invasive
and non-traumatic. This made the diagnostic ultrasound
machine become more popular than the other diagnostic
tools [3]. Diagnostic ultrasound is applied for obtaining
images of almost the entire range of internal organs in
the abdomen including genitourinary system which
consists of kidneys, urinary bladder, urethra and
reproductive system of male and female [4, 44 - 47].
However, conventional 2D ultrasound imaging has
limitations in quantifying the volume of structures of
interest in the body, because only a two dimensional
frame is produced at a given time. Volume
quantification is important in assessing the progression
of disease and tracking progression of response to
treatment. Thus, 3D ultrasound imaging has drawn great
attention in recent years especially in high quality
hospitals and medical centers [56].
The 3D ultrasound systems can be classified as
tracked free-hand, untracked free-hand, mechanical
assemblies, and 2D arrays [7-8]. In tracked free-hand

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by using surface rendering techniques by implementing

contour filtering and marching cubes algorithm in Visual
C++ 6.0 with Visualization Toolkit (VTK) toolbox.

2 Material and Methods

In this experiment, the images were taken by using the
untracked free-hand 2D ultrasound. The 2D images of
fetal phantom are taken using Portable Ultrasound
Diagnostic Scanner NeuCrystal C40 by Landwind and
store into laptop by using TV grabber as a connector.
The ultrasound images of fetal phantom are scanned
from the head until the legs of the fetus. This can ensure
the images of the whole body of fetus stack in a good
arrangement condition. Since the images is taken using
free hand without any tracking system or tool, some
position or degree for taking the images will be slightly
different from one image to another.
After the 2D ultrasound image acquisition step, the
images were then undergoing some image processing
techniques in order to enhance the images and remove
noises in the images. Then, 3D image is reconstructed
by using contour filtering and marching cubes
algorithms. Figure 1 shows the block diagram of
experiment setup and figure 2 shows the flow chart of
the experiment.

Fig.2 Flow chart of experiment

2.1

2D Ultrasound Image Acquisition

When creating a 3D image from a set of 2D images, the

relative locations and orientations of the individual
image frames must be known to create an accurate
reconstruction. In order to develop a more accurate
approach for volume quantification, many approaches of
3D ultrasound image reconstruction have been
developed. One of the current practices involves a 2D
ultrasound machine and a position sensor attached to the
ultrasound scanner probe. The 2D ultrasound machine
provides slices of images through the structure of
interest while the position sensor provides the relative
position of these slices in space [15].
Many research have been conducted in order to find
the most accurate and convenient technique in this kind
of systems. Richard JH et al propose the use of
alternative position sensor, the Xsens MT9-B, which is
relatively unobtrusive but measures orientation only
[16]. A. M. Goldsmith et al propose 5 Degree of
Freedom, low cost, integrated tracking device for
quantitative, freehand, 3D ultrasound where it uses a
combination of optical and inertial sensors to track the
position and orientation of the ultrasound probe during
3D scan [17].
However, if the medical doctors use the untracked
free-hand 2D/3D ultrasound, some problem will occur
because, without the aid of an external sensing device,
the doctors have the challenging task to maintain
constant scan rate and transducer attitude and cannot
employ the angle variation for better and complete
image visualization.

Fig.1 Block diagram of experiment setup

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Mahani Hafizah, Tan Kok, Eko Supriyanto

[21]. This technique eliminates impulsive noise or the

salt-and-pepper type of noise quite well.

Image processing

Analysis of the images cover the image acquisition,

image formation, image enhancement, image
segmentation, image compression and storage, image
matching, motion tracking, measurement of parameters,
and image-based visualization [18, 39 - 43]. In this
experiment, after the images have been stored into
laptop, the process of generate region of interest (ROI)
will start. The ROI of the images will make the
resolution of the image become smaller and take less
time in running image processing step. The gray scale
image of ROI is generated using manual crop function in
image processing toolbox. The output resolution of is
237 x d 174.
Then, these 2D images have to go through some
enhancement process. Image enhancement is needed in
order to reduce the noise and increase the contract of
image. Flemming F et al [19] use volumetric image
processing techniques for reducing noise and speckle
while retaining tissue structures in 3-dimensional (3D)
gray scale ultrasound imaging while S. Sudha et al [20]
propose wavelet-based thresholding scheme for noise
suppression in ultrasound images.
In this experiment, few steps of image processing
have been done consist of median filtering, image
contrasting, global thresholding and noise reduction.
Figure 3 shows the flow chart of image processing.

Fig.4 Calculating the median value of a pixel

neighborhood
The median filter considers each pixel in the image
in turn and looks at its nearby neighbors to decide
whether or not it is representative of its surroundings.
The median is calculated by first sorting all the pixel
values from the surrounding neighborhood into
numerical order and then replacing the pixel being
considered with the middle pixel value. Figure 4

illustrates an example calculation.

2.2.2 Image Contrasting
Contrast within an image is depends on the brightness or
darkness of a pixel in relation to other pixels. Therefore,
by modifying the contrast among neighboring pixels can
enhance the ability to extract information from the
image. Operations such as noise removal and smoothing
decrease contrast and make neighboring pixel values
more similar while other operations such as scaling pixel
values, edge detection and sharpening increase contrast
to highlight specific image features [22-23].
In this experiment, image contrasting is used to
sharpened the images. Sharpening an image increases
the contrast between bright and dark regions to bring out
features. The sharpening process is basically the
application of a high pass filter to an image. The
following array is a kernel for a common high pass filter
used to sharpen an image:

Fig.3 Flow chart of image enhancement process

2.2.1 Median Filtering
The median filtering is applied to the images for
smoothing purpose. Median filters are quite popular
because, for certain types of random noise, they provide
excellent noise-reduction capabilities, with considerably
less blurring than linear smoothing filters of similar size

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2.2.3 Global Thresholding

Global thresholding is used for generating the binary
image. Binary image is the image only consists of 1 bit
pixel value. There is only one threshold value needed to
be set in order to differentiate the object and background
of the image. Thresholding creates binary images from
grey-level ones by turning all pixels below some
threshold to zero and all pixels about that threshold to
one [24]. Figure 5 shows the image of the histogram of
global thersholding.

2.3.1 Contour Filtering

The contour filtering is one of the method for generate
the 3D image in this project. It attempts to generate a
surface by connecting the vertices of adjacent contours
in order to produce a mesh that passes through all
contours. These approaches generally need to address
the correspondence (how to connect vertices between
contours), tiling (how to create meshes from these
edges) and branching (how to cope with slices with
different numbers of contours) problems.
Keppel and Fuchs et al. described the first
algorithms for creating polygonal meshes from a series
of contours and the Fuchs work defines the best
reconstructed surface as the one with minimal surface
area [26-27]. Later, many other researches have made
improvements to these initial algorithms. Several
solutions to the correspondence problem have been
proposed, including those based on parameterization of
the contours, contour decomposition, Minimum
Spanning Trees, Angular Bisector Networks, medial
axes and partial curve matching algorithms [28-33].
Figure 6 shows the steps for contour filtering.

# of
pixel

background

object

graylevel

Fig.5 Image histogram of global thresholding

If g(x, y) is a thresholded version of f(x, y) at some
global threshold T,

Two adjacent data slices

Find one closed contour,
connect curves with
triangles, and render the
triangles

(2)
2.2.4 Noise Reduction
Noise reduction is the process of removing noise from a
signal or image. The key to noise reduction is to reduce
or eliminate the noise without deteriorating other aspects
of the image. Filtering is one of the common methods
used for noise reduction and this time, the filter used
will removes small and unwanted image [25].

2.3

Fitting triangles to
contour lines

3D Surface Constructions

Visualization is the process of comprehending the

structure of the object system. There are some methods
that can be use to reconstruct the 3D image by
visualization. The method that is used in this paper is
only surface rendering technique. Surface rendering is
the process of improvement of interpretation of data sets
through generating a set of polygons that represent the
surface and display three dimensional models. The
surface consist points which have the same intensity on
the every slice.

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Fig.6 Step for contour filtering

2.3.2 Marching Cube Algorithm
One of the famous algorithm of surface rendering is
marching cube algorithm. Marching cubes is one of the
latest algorithms of surface construction used for
viewing 3D data. This algorithm produces a triangle
mesh by computing iso surfaces from discrete data. By
connecting the patches from all cubes on the iso-surface
boundary, we get a surface representation. Marching

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Cubes (MC) algorithm is a 3D reconstruction method

developed by W. Lorensen in 1987. Because of its
merits of simple, easy to achieve, it has been widely
used, is considered as one of the most popular
algorithms for display [34-38].
This algorithm will take the eight neighbor
locations when pass through the images and determining
the polygon needed to represent the iso surface. The
polygons will treat each of the eight scalars as 8-bit
integer. The value will set inside the surface if the scalar
value is higher than iso-value and vice versa. The figure
7 shows the 15 unique cube configurations or patterns of
polygons generated by Marching Cubes algorithm.

controlling the process of converting the geometry, light,

camera view of the image.
The process of surface rendering using marching
cubes algorithm is follow the pipeline of function
vtkJPEGReader,
vtkMarchingCubes,
vtkPolyDataMapper,
vtkActor
and
renderer.
vtkMarchingCubes is used to extract the iso surface of
the volume based on the identical intensity of each
images. It will also generate many triangles of iso
surface. vtkPolyDataMapper is used to generate the
mapping to rendering from poly data while vtkActor is
used as an entity for rendering purpose.
Figure 8 and Figure 9 show the flow chart of the
contour filtering and marching cube algorithm
implemented in VTK respectively.
vtkJPEGReader

vtkContourFilter

vtkPolyDataNormals

vtkPolyDataMapper

vtkActor

Fig.7 15 Unique Cube Configurations generated by

Marching Cubes Algorithm

Renderer

2.3.2 Visualization Toolkit

VTK is an open source, object-oriented software system
for computer graphics, visualization, and image
processing, and visualization used by thousands of
researchers and developers around the world.
In this experiment, all of the slices of images need
to be read as a volume into the system by using the
function vtkJPEGReader in VTK. As the data input
become volume, contour filtering and marching cubes
algorithm can be applied for reconstruction of 3D image.
For contour filtering, after the function
vtkJPEGReader, vtkContourFilter act as the main role to
extract the iso-surface of the volume. The iso-surface
value then needs to be process by vtkPolyDataNormals
to generate the normal point of the iso- surface. Next,
the vtkPolyDataMapper use to generate the mapping to
rendering from poly data. The vtkActor is used as an
entity for rendering purpose. It is act like a connector
between renderer and the input data. Besides that, it also
represents the object which is geometry or poly data to
be render. Last, the render will generate the 3D image by

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Fig.8 Flow chart of contour filtering implemented in

VTK
vtkJPEGReader

vtkMarchingCubes

vtkPolyDataMapper

vtkActor

Renderer

Fig.9 Flow chart of

implemented in VTK

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marching

cube

algorithm

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smooth because we use the untracked free-hand system

which may lead to inconsistency of scan rate and angle.

3 Result and Analysis

The fetus model is scanned by ultrasound machine and
connects it to laptop with TV grabber. The images are
stored in the laptop for 2D image processing and
visualization process. The 2D image is taken using
freehand with ruler as guideline for every image at
constant distance of one millimeter. Several set of
ultrasound image with different number of slices were
taken for comparison purposes.
Figure 10 shows the result after the image
processing consists of median filtering, image
contrasting, global thresholding and noise reduction.

Fig.11 3D reconstruction using contour filtering

Fig.12 3D
algorithm

using marching cubes

The result is analyzed by comparing the images

based on certain criteria such as:
1. Analysis A: Comparing the 3D ultrasound
image reconstructed with the real fetal
phantom
2. Analysis B: Comparing the 3D ultrasound
image based on reconstruction techniques
(contour filtering and marching cubes
algorithm)
3. Analysis C: Comparing the 3D ultrasound
image reconstructed based on different set
of 2D ultrasound images with different
number of slices (103 slices, 155 slices and
183 slices).

Fig.10 2D image processing A) Original Ultrasound

image B) ROI C) Image after median filtering D) Image
after contrasting E) Image after global thresholding F)
Image after noise removing
Figure 11 and figure 12 show the result of 3D
reconstruction of contour filtering and marching cubes
algorithm. Based on the results, we can see that the 3D
image of the fetal phantom is successfully reconstructed.
However, the result is not smooth due to the noise
unfiltered in the enhancement process. This result shows
that the currently used image enhancement methods
were not good enough to obtain a good result. Therefore,
in order to overcome this problem, we should choose
and added better image enhancement methods. The
result also shows that the surface of the image is also not

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Analysis A

In analysis A, the real fetal phantom has been compared

with the 3D image reconstruct to ensure the image is
matched with the real object. Figure 13 shows the
correct match of head, hand and leg between 3D image
and real fetal phantom. The result proved that 3D image
has successfully been reconstructed as we can directly
identify certain part of the fetal body. Even though the
3D image reconstructed is not good, we still can visually
differentiate head, hands and legs of fetal phantom.

Fig.14 Comparison of top view of different 3D

visualization methods

3.3

In order to generate a good 3D image, the minimum

amount of slices taken need to be set and taken from the
object. In this experiment, three set of images with
different slices (103 slices, 155 slices and 183 slices)
were taken and reconstructed. Figure 7 shows the
comparison between three different amounts of slices for
reconstruct 3D image. Based on the result, we can see
that the 183 slices of images can produce a better look
and similar image when compared to the real object.
Therefore, in order to reconstruct a better 3D image, we
need to increase the amount of slices in a set.

Fig.13 Comparison between real fetal phantom and 3D

fetus image

3.2

Analysis C

Analysis B

Besides comparing the result with the real phantom, the

result is also compared between those two techniques
used for 3D reconstruction which is the contour filtering
and marching cubes algorithm. Based on the figure
below, we can see that the marching cubes algorithm can
produce the sharper image compare to contour filtering.
This is due to the different algorithm when reconstruct
the 3D image.
The 3D image reconstructed by marching cubes
algorithm has higher intensity which can help us easily
to detect the edges and inner part of the object. Since the
3D result using the marching cube algorithm is better
than contour filtering, the marching cubes algorithm is
more suggested for 3D reconstruction of the images.
Figure 14 shows the comparison of top view of different
3D visualization methods which are contour filtering
and marching cube respectively.

Fig.15 Comparison between different amounts of slices

for reconstruct 3D image

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[5] Detmer P, Bashein G, Hodges T, Beach K, Filer E,

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4 Conclusion
The 3D reconstruction of fetal phantom has been
developed using contour filtering and marching cube
algorithm by implementing in Visual C++ 6.0 with
Visualization Toolkit (VTK). From the experiment, we
can conclude that in order to reconstruct a smooth and
better 3D image, we need to use ultrasound machine
together with tracking sensor to maintain constant scan
rate rather than just using the untracked freehand 2D
ultrasound which leads to inconsistency of the scanning
rate and angle. Besides, for a set of ultrasound image
from a low cost machine, image processing need to be
performed thoroughly by adding other detailed
processing techniques so that noises can be fully
removed. From the result also, it can be concluded that
the marching cube algorithm can give a better result
compare to contour filtering where marching cubes
algorithm can generate higher intensity 3D image which
can make user easy to detect inner part and edges of 3D
images. The number of slices should also be increased to
improve the accuracy of the 3D image constructed. The
higher the number of slices in a set of images, the better
the 3D image reconstructed.
For future work, some recommendations have been
made based on the problems and inaccuracy occurred
during the experiment. Firstly, the quality and accuracy
of the 3D result is determined by the position of taking
the 2D image from the object. Therefore, it is suggested
that the use of tracking device is important and crucial.
Besides, higher quality of ultrasound machine should be
used in order to get a higher quality of 2D images. This
can ensure that the object scanned from the transducer
have higher intensity and less noise. Lastly, in order to
have a more concrete result and analysis, further
experiment should be made by trying different 3D
reconstruction algorithm and using some other different
object as subject.

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Mahani Hafizah, Tan Kok, Eko Supriyanto

Processing, 514-519, Issue 8, Volume 4, August

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Ultrasound Images, WSEAS Transactions on Signal
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[44] Mahani Hafizah, Tan Kok, Eko Supriyanto, 3D
Ultrasound Image Reconstruction Based on VTK,
Proceedings of the 9th WSEAS International
Conference on SIGNAL PROCESSING, 102-106,
2010.
[45] Maheza Irna Mohamad Salim, Mohammad Azizi
Tumiran, Siti Noormiza Makhtar, Bustanur Rosidi,
Ismail Ariffin, Abdul Hamid Ahmad, Eko
Supriyanto, Quantitative Analysis of Hybrid
Magnetoacoustic Method for Detection of Normal
and Pathological Breast Tissue, Proceedings of the
12th WSEAS International Conference on
AUTOMATIC
CONTROL,
MODELLING
&
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[46] Lai Khin Wee, Eko Supriyanto, Automatic

Detection of Fetal Nasal Bone in 2 Dimensional

Ultrasound Image Using Map Matching,
Proceedings of the 12th WSEAS International
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AUTOMATIC
CONTROL,
MODELLING & SIMULATION, 305-309, 2010.
[47] Lai Khin Wee, Lim Miin, Eko Supriyanto,

Automated Risk Calculation for Trisomy 21

Based on Maternal Serum Markers Using
Trivariate Lognormal Distribution, Proceedings
of the 12th WSEAS International Conference on
AUTOMATIC
CONTROL,
MODELLING
&
SIMULATION, 327-332, 2010.

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Issue 4, Volume 6, October 2010