Semiautomated segmentation of myocardial contours for fast strain analysis in cine displacement-encoded MRI

The role of artificial intelligence in cardiovascular magnetic resonance imaging

Cardiovascular magnetic resonance (CMR) imaging is the gold standard test for myocardial tissue characterization and chamber volumetric and functional evaluation. However, manual CMR analysis can be time-consuming and is subject to intra- and inter-observer variability. Artificial intelligence (AI) is a field that permits automated task performance through the identification of high-level and complex data relationships. In this review, we review the rapidly growing role of AI in CMR, including image acquisition, sequence prescription, artifact detection, reconstruction, segmentation, and data reporting and analysis including quantification of volumes, function, myocardial infarction (MI) and scar detection, and prediction of outcomes. We conclude with a discussion of the emerging challenges to widespread adoption and solutions that will allow for successful, broader uptake of this powerful technology.

Automatic detection of myocardial ischaemia using generalisable spatio-temporal hierarchical Bayesian modelling of DCE-MRI

Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI) can be used as a non-invasive method for the assessment of myocardial perfusion. The acquired images can be utilised to analyse the spatial extent and severity of myocardial ischaemia (regions with impaired microvascular blood flow). In the present paper, we propose a novel generalisable spatio-temporal hierarchical Bayesian model (GST-HBM) to automate the detection of ischaemic lesions and improve the in silico prediction accuracy by systematically integrating spatio-temporal context information. We present a computational inference procedure with an adequate trade-off between accuracy and computational efficiency, whereby model parameters are sampled from the posterior distribution with Gibbs sampling, while lower-level hyperparameters are selected using model selection strategies based on the Watanabe Akaike information criterion (WAIC). We have assessed our method on both synthetic (in silico) data with known gold-standard and 12 sets of clinical first-pass myocardial perfusion DCE-MRI datasets. We have also carried out a comparative performance evaluation with four established alternative methods: Gaussian mixture model (GMM), opening and closing operations based on Gaussian mixture model (GMMC&Omax), Markov random field constrained Gaussian mixture model (GMM-MRF) and model-based hierarchical Bayesian model (M-HBM). Our results show that the proposed GST-HBM method achieves much higher in silico prediction accuracy than the established alternative methods. Furthermore, this method appears to provide a more robust delineation of ischaemic lesions in datasets affected by spatially variant noise.

Automatic right ventricular segmentation for cine cardiac magnetic resonance images based on a new deep atlas network

BACKGROUND

The high morbidity and mortality of heart disease present a significant threat to human health. The development of methods for the quick and accurate diagnosis of heart diseases, enabling their effective treatment, has become a key issue of concern. Right ventricular (RV) segmentation from cine cardiac magnetic resonance (CMR) images plays a significant role in evaluating cardiac function for clinical diagnosis and prognosis. However, due to the complex structure of the RV, traditional segmentation methods are ineffective for RV segmentation.

PURPOSE

In this paper, we propose a new deep atlas network to improve the learning efficiency and segmentation accuracy of a deep learning network by integrating multi-atlas.

METHODS

First, a dense multi-scale U-net (DMU-net) is presented to acquire transformation parameters from atlas images to target images. The transformation parameters map the atlas image labels to the target image labels. Second, using a spatial transformation layer, the atlas images are deformed based on these parameters. Finally, the network is optimized by backpropagation with two loss functions where the mean squared error function (MSE) is used to measure the similarity of the input images and transformed images. Further, the Dice metric (DM) is used to quantify the overlap between the predicted contours and the ground truth. In our experiments, 15 datasets are used in testing, and 20 cine CMR images are selected as atlas.

RESULTS

The mean values and standard deviations for the DM and Hausdorff distance are 0.871 and 4.67 mm, 0.104 and 2.528 mm, respectively. The correlation coefficients of endo-diastolic volume, endo-systolic volume, ejection fraction, and stroke volume are 0.984, 0.926, 0.980, and 0.991, respectively, and the mean differences between all of the mentioned parameters are 3.2, -1.7, 0.02, and 4.9, respectively. Most of these differences are within the allowable range of 95%, indicating that the results are acceptable and show good consistency. The segmentation results obtained in this method are compared with those obtained by other methods that provide satisfactory performance. The other methods provide better segmentation effects at the base, but either no segmentation or the wrong segmentation at the top, which demonstrate that the deep atlas network can improve top-area segmentation accuracy.

CONCLUSION

Our results indicate that the proposed method can achieve better segmentation results than the previous methods, with both high relevance and consistency, and has the potential for clinical application.

Novel User-Friendly Application for MRI Segmentation of Brain Resection following Epilepsy Surgery

Delineation of resected brain cavities on magnetic resonance images (MRIs) of epilepsy surgery patients is essential for neuroimaging/neurophysiology studies investigating biomarkers of the epileptogenic zone. The gold standard to delineate the resection on MRI remains manual slice-by-slice tracing by experts. Here, we proposed and validated a semiautomated MRI segmentation pipeline, generating an accurate model of the resection and its anatomical labeling, and developed a graphical user interface (GUI) for user-friendly usage. We retrieved pre- and postoperative MRIs from 35 patients who had focal epilepsy surgery, implemented a region-growing algorithm to delineate the resection on postoperative MRIs and tested its performance while varying different tuning parameters. Similarity between our output and hand-drawn gold standards was evaluated via dice similarity coefficient (DSC; range: 0-1). Additionally, the best segmentation pipeline was trained to provide an automated anatomical report of the resection (based on presurgical brain atlas). We found that the best-performing set of parameters presented DSC of 0.83 (0.72-0.85), high robustness to seed-selection variability and anatomical accuracy of 90% to the clinical postoperative MRI report. We presented a novel user-friendly open-source GUI that implements a semiautomated segmentation pipeline specifically optimized to generate resection models and their anatomical reports from epilepsy surgery patients, while minimizing user interaction.

Sequential shape similarity for active contour based left ventricle segmentation in cardiac cine MR image

Delineation of the boundaries of the Left Ventricle (LV) in cardiac Magnetic Resonance Images (MRI) is a hot topic due to its important diagnostic power. In this paper, an approach is proposed to extract the LV in a sequence of MR images. In the proposed paper, all images in the sequence are segmented simultaneously and the shape of the LV in each image is supposed to be similar to that of the LV in nearby images in the sequence. We coined the novel shape similarity constraint, and it is called sequential shape similarity (SSS in short). The proposed segmentation method takes the Active Contour Model as the base model and our previously proposed Gradient Vector Convolution (GVC) external force is also adopted. With the SSS constraint, the snake contour can accurately delineate the LV boundaries. We evaluate our method on two cardiac MRI datasets and the Mean Absolute Distance (MAD) metric and the Hausdorff Distance (HD) metric demonstrate that the proposed approach has good performance on segmenting the boundaries of the LV.

One Shot Segmentation: Unifying Rigid Detection and Non-Rigid Segmentation Using Elastic Regularization

This paper proposes a novel approach for the non-rigid segmentation of deformable objects in image sequences, which is based on one-shot segmentation that unifies rigid detection and non-rigid segmentation using elastic regularization. The domain of application is the segmentation of a visual object that temporally undergoes a rigid transformation (e.g., affine transformation) and a non-rigid transformation (i.e., contour deformation). The majority of segmentation approaches to solve this problem are generally based on two steps that run in sequence: a rigid detection, followed by a non-rigid segmentation. In this paper, we propose a new approach, where both the rigid and non-rigid segmentation are performed in a single shot using a sparse low-dimensional manifold that represents the visual object deformations. Given the multi-modality of these deformations, the manifold partitions the training data into several patches, where each patch provides a segmentation proposal during the inference process. These multiple segmentation proposals are merged using the classification results produced by deep belief networks (DBN) that compute the confidence on each segmentation proposal. Thus, an ensemble of DBN classifiers is used for estimating the final segmentation. Compared to current methods proposed in the field, our proposed approach is advantageous in four aspects: (i) it is a unified framework to produce rigid and non-rigid segmentations; (ii) it uses an ensemble classification process, which can help the segmentation robustness; (iii) it provides a significant reduction in terms of the number of dimensions of the rigid and non-rigid segmentations search spaces, compared to current approaches that divide these two problems; and (iv) this lower dimensionality of the search space can also reduce the need for large annotated training sets to be used for estimating the DBN models. Experiments on the problem of left ventricle endocardial segmentation from ultrasound images, and lip segmentation from frontal facial images using the extended Cohn-Kanade (CK+) database, demonstrate the potential of the methodology through qualitative and quantitative evaluations, and the ability to reduce the search and training complexities without a significant impact on the segmentation accuracy.

An iterative multi-path fully convolutional neural network for automatic cardiac segmentation in cine MR images

PURPOSE

Segmentation of the left ventricle (LV), right ventricle (RV) cavities and the myocardium (MYO) from cine cardiac magnetic resonance (MR) images is an important step for diagnosis and monitoring cardiac diseases. Spatial context information may be highly beneficial for segmentation performance improvement. To this end, this paper proposes an iterative multi-path fully convolutional network (IMFCN) to effectively leverage spatial context for automatic cardiac segmentation in cine MR images.

METHODS

To effectively leverage spatial context information, the proposed IMFCN explicitly models the interslice spatial correlations using a multi-path late fusion strategy. First, the contextual inputs including both the adjacent slices and the already predicted mask of the above adjacent slice are processed by independent feature-extraction paths. Then, an atrous spatial pyramid pooling (ASPP) module is employed at the feature fusion process to combine the extracted high-level contextual features in a more effective way. Finally, deep supervision (DS) and batch-wise class re-weighting mechanism are utilized to enhance the training of the proposed network.

RESULTS

The proposed IMFCN was evaluated and analyzed on the MICCAI 2017 automatic cardiac diagnosis challenge (ACDC) dataset. On the held-out training dataset reserved for testing, our method effectively improved its counterparts that without spatial context and that with spatial context but using an early fusion strategy. On the 50 subjects test dataset, our method achieved Dice similarity coefficient of 0.935, 0.920, and 0.905, and Hausdorff distance of 7.66, 12.10, and 8.80 mm for LV, RV, and MYO, respectively, which are comparable or even better than the state-of-the-art methods of ACDC Challenge. In addition, to explore the applicability to other datasets, the proposed IMFCN was retrained on the Sunnybrook dataset for LV segmentation and also produced comparable performance to the state-of-the-art methods.

CONCLUSIONS

We have presented an automatic end-to-end fully convolutional architecture for accurate cardiac segmentation. The proposed method provides an effective way to leverage spatial context in a two-dimensional manner and results in precise and consistent segmentation results.

Deep Learning Techniques for Automatic MRI Cardiac Multi-Structures Segmentation and Diagnosis: Is the Problem Solved?

Delineation of the left ventricular cavity, myocardium, and right ventricle from cardiac magnetic resonance images (multi-slice 2-D cine MRI) is a common clinical task to establish diagnosis. The automation of the corresponding tasks has thus been the subject of intense research over the past decades. In this paper, we introduce the "Automatic Cardiac Diagnosis Challenge" dataset (ACDC), the largest publicly available and fully annotated dataset for the purpose of cardiac MRI (CMR) assessment. The dataset contains data from 150 multi-equipments CMRI recordings with reference measurements and classification from two medical experts. The overarching objective of this paper is to measure how far state-of-the-art deep learning methods can go at assessing CMRI, i.e., segmenting the myocardium and the two ventricles as well as classifying pathologies. In the wake of the 2017 MICCAI-ACDC challenge, we report results from deep learning methods provided by nine research groups for the segmentation task and four groups for the classification task. Results show that the best methods faithfully reproduce the expert analysis, leading to a mean value of 0.97 correlation score for the automatic extraction of clinical indices and an accuracy of 0.96 for automatic diagnosis. These results clearly open the door to highly accurate and fully automatic analysis of cardiac CMRI. We also identify scenarios for which deep learning methods are still failing. Both the dataset and detailed results are publicly available online, while the platform will remain open for new submissions.

FoCA: A new framework of coupled geometric active contours for segmentation of 3D cardiac magnetic resonance images

In this paper, a new framework of coupled active contours (FoCA) is proposed for segmentation of the left ventricle myocardium, in cardiac magnetic resonance (CMR) images, without primary learning and user-driven segmentation. Primarily, we suggest a pair of coupled geometric active contours (GACs) for segmentation of the endo- and epicardial boundaries of the left ventricle in every CMR slice. The energy functional of each active contour includes the edge and shape terms of the STACS energy functional, regulator term of the local binary fitting (LBF), and new region and coupling terms. Two new patch-based region terms, inspired by LBF and piecewise model, are proposed to effectively handle intensity inhomogeneity of CMR images. Furthermore, a coupling energy term is added to the epicardial energy functional to avoid intersection with the endocardial curve. For 3D implementation, every 2D active contour in each slice is effectively jointed to the corresponding curves in the previous and next slices (of the same volume) by using a new coupling energy term, obtained by extending the 2D length-shortening regulator. Also, the initial contour and algorithm parameters are automatically regulated. Finally, 3D+t implementation is performed by using the sequential initialization method. Experimental results demonstrated that the proposed method provided superior solution quality compared to a large number of counterpart algorithms by using two well-known frequently-used databases.

Deep Learning on Sparse Manifolds for Faster Object Segmentation

We propose a new combination of deep belief networks and sparse manifold learning strategies for the 2D segmentation of non-rigid visual objects. With this novel combination, we aim to reduce the training and inference complexities while maintaining the accuracy of machine learning-based non-rigid segmentation methodologies. Typical non-rigid object segmentation methodologies divide the problem into a rigid detection followed by a non-rigid segmentation, where the low dimensionality of the rigid detection allows for a robust training (i.e., a training that does not require a vast amount of annotated images to estimate robust appearance and shape models) and a fast search process during inference. Therefore, it is desirable that the dimensionality of this rigid transformation space is as small as possible in order to enhance the advantages brought by the aforementioned division of the problem. In this paper, we propose the use of sparse manifolds to reduce the dimensionality of the rigid detection space. Furthermore, we propose the use of deep belief networks to allow for a training process that can produce robust appearance models without the need of large annotated training sets. We test our approach in the segmentation of the left ventricle of the heart from ultrasound images and lips from frontal face images. Our experiments show that the use of sparse manifolds and deep belief networks for the rigid detection stage leads to segmentation results that are as accurate as the current state of the art, but with lower search complexity and training processes that require a small amount of annotated training data.

A competitive strategy for atrial and aortic tract segmentation based on deformable models

Multiple strategies have previously been described for atrial region (i.e. atrial bodies and aortic tract) segmentation. Although these techniques have proven their accuracy, inadequate results in the mid atrial walls are common, restricting their application for specific cardiac interventions. In this work, we introduce a novel competitive strategy to perform atrial region segmentation with correct delineation of the thin mid walls, and integrated it into the B-spline Explicit Active Surfaces framework. A double-stage segmentation process is used, which starts with a fast contour growing followed by a refinement stage with local descriptors. Independent functions are used to define each region, being afterward combined to compete for the optimal boundary. The competition locally constrains the surface evolution, prevents overlaps and allows refinement to the walls. Three different scenarios were used to demonstrate the advantages of the proposed approach, through the evaluation of its segmentation accuracy, and its performance for heterogeneous mid walls. Both computed tomography and magnetic resonance imaging datasets were used, presenting results similar to the state-of-the-art methods for both atria and aorta. The competitive strategy showed its superior performance with statistically significant differences against the traditional free-evolution approach in cases with bad image quality or missed atrial/aortic walls. Moreover, only the competitive approach was able to accurately segment the atrial/aortic wall. Overall, the proposed strategy showed to be suitable for atrial region segmentation with a correct segmentation of the mid thin walls, demonstrating its added value with respect to the traditional techniques.

A review of heart chamber segmentation for structural and functional analysis using cardiac magnetic resonance imaging

Cardiovascular magnetic resonance (CMR) has become a key imaging modality in clinical cardiology practice due to its unique capabilities for non-invasive imaging of the cardiac chambers and great vessels. A wide range of CMR sequences have been developed to assess various aspects of cardiac structure and function, and significant advances have also been made in terms of imaging quality and acquisition times. A lot of research has been dedicated to the development of global and regional quantitative CMR indices that help the distinction between health and pathology. The goal of this review paper is to discuss the structural and functional CMR indices that have been proposed thus far for clinical assessment of the cardiac chambers. We include indices definitions, the requirements for the calculations, exemplar applications in cardiovascular diseases, and the corresponding normal ranges. Furthermore, we review the most recent state-of-the art techniques for the automatic segmentation of the cardiac boundaries, which are necessary for the calculation of the CMR indices. Finally, we provide a detailed discussion of the existing literature and of the future challenges that need to be addressed to enable a more robust and comprehensive assessment of the cardiac chambers in clinical practice.

Automatic segmentation of the left ventricle in cardiac MRI using local binary fitting model and dynamic programming techniques

Segmentation of the left ventricle is very important to quantitatively analyze global and regional cardiac function from magnetic resonance. The aim of this study is to develop a novel algorithm for segmenting left ventricle on short-axis cardiac magnetic resonance images (MRI) to improve the performance of computer-aided diagnosis (CAD) systems. In this research, an automatic segmentation method for left ventricle is proposed on the basis of local binary fitting (LBF) model and dynamic programming techniques. The validation experiments are performed on a pool of data sets of 45 cases. For both endo- and epi-cardial contours of our results, percentage of good contours is about 93.5%, the average perpendicular distance are about 2 mm. The overlapping dice metric is about 0.91. The regression and determination coefficient between the experts and our proposed method on the LV mass is 1.038 and 0.9033, respectively; they are 1.076 and 0.9386 for ejection fraction (EF). The proposed segmentation method shows the better performance and has great potential in improving the accuracy of computer-aided diagnosis systems in cardiovascular diseases.

Deformable models with sparsity constraints for cardiac motion analysis

Deformable models integrate bottom-up information derived from image appearance cues and top-down priori knowledge of the shape. They have been widely used with success in medical image analysis. One limitation of traditional deformable models is that the information extracted from the image data may contain gross errors, which adversely affect the deformation accuracy. To alleviate this issue, we introduce a new family of deformable models that are inspired from the compressed sensing, a technique for accurate signal reconstruction by harnessing some sparseness priors. In this paper, we employ sparsity constraints to handle the outliers or gross errors, and integrate them seamlessly with deformable models. The proposed new formulation is applied to the analysis of cardiac motion using tagged magnetic resonance imaging (tMRI), where the automated tagging line tracking results are very noisy due to the poor image quality. Our new deformable models track the heart motion robustly, and the resulting strains are consistent with those calculated from manual labels.

Semi-automated left ventricular segmentation based on a guide point model approach for 3D cine DENSE cardiovascular magnetic resonance

BACKGROUND

The most time consuming and limiting step in three dimensional (3D) cine displacement encoding with stimulated echoes (DENSE) MR image analysis is the demarcation of the left ventricle (LV) from its surrounding anatomical structures. The aim of this study is to implement a semi-automated segmentation algorithm for 3D cine DENSE CMR using a guide point model approach.

METHODS

A 3D mathematical model is fitted to guide points which were interactively placed along the LV borders at a single time frame. An algorithm is presented to robustly propagate LV epicardial and endocardial surfaces of the model using the displacement information encoded in the phase images of DENSE data. The accuracy, precision and efficiency of the algorithm are tested.

RESULTS

The model-defined contours show good accuracy when compared to the corresponding manually defined contours as similarity coefficients Dice and Jaccard consist of values above 0.7, while false positive and false negative measures show low percentage values. This is based on a measure of segmentation error on intra- and inter-observer spatial overlap variability. The segmentation algorithm offers a 10-fold reduction in the time required to identify LV epicardial and endocardial borders for a single 3D DENSE data set.

CONCLUSION

A semi-automated segmentation method has been developed for 3D cine DENSE CMR. The algorithm allows for contouring of the first cardiac frame where blood-myocardium contrast is almost nonexistent and reduces the time required to segment a 3D DENSE data set significantly.

Combining multiple dynamic models and deep learning architectures for tracking the left ventricle endocardium in ultrasound data

We present a new statistical pattern recognition approach for the problem of left ventricle endocardium tracking in ultrasound data. The problem is formulated as a sequential importance resampling algorithm such that the expected segmentation of the current time step is estimated based on the appearance, shape, and motion models that take into account all previous and current images and previous segmentation contours produced by the method. The new appearance and shape models decouple the affine and nonrigid segmentations of the left ventricle to reduce the running time complexity. The proposed motion model combines the systole and diastole motion patterns and an observation distribution built by a deep neural network. The functionality of our approach is evaluated using a dataset of diseased cases containing 16 sequences and another dataset of normal cases comprised of four sequences, where both sets present long axis views of the left ventricle. Using a training set comprised of diseased and healthy cases, we show that our approach produces more accurate results than current state-of-the-art endocardium tracking methods in two test sequences from healthy subjects. Using three test sequences containing different types of cardiopathies, we show that our method correlates well with interuser statistics produced by four cardiologists.

A scale space based algorithm for automated segmentation of single shot tagged MRI of shearing deformation

OBJECT

This study proposes a scale space based algorithm for automated segmentation of single-shot tagged images of modest SNR. Furthermore the algorithm was designed for analysis of discontinuous or shearing types of motion, i.e. segmentation of broken tag patterns.

MATERIALS AND METHODS

The proposed algorithm utilises non-linear scale space for automatic segmentation of single-shot tagged images. The algorithm's ability to automatically segment tagged shearing motion was evaluated in a numerical simulation and in vivo. A typical shearing deformation was simulated in a Shepp-Logan phantom allowing for quantitative evaluation of the algorithm's success rate as a function of both SNR and the amount of deformation. For a qualitative in vivo evaluation tagged images showing deformations in the calf muscles and eye movement in a healthy volunteer were acquired.

RESULTS

Both the numerical simulation and the in vivo tagged data demonstrated the algorithm's ability for automated segmentation of single-shot tagged MR provided that SNR of the images is above 10 and the amount of deformation does not exceed the tag spacing. The latter constraint can be met by adjusting the tag delay or the tag spacing.

CONCLUSION

The scale space based algorithm for automatic segmentation of single-shot tagged MR enables the application of tagged MR to complex (shearing) deformation and the processing of datasets with relatively low SNR.

Three-dimensional segmentation of the left ventricle in late gadolinium enhanced MR images of chronic infarction combining long- and short-axis information

Automatic segmentation of the left ventricle (LV) in late gadolinium enhanced (LGE) cardiac MR (CMR) images is difficult due to the intensity heterogeneity arising from accumulation of contrast agent in infarcted myocardium. In this paper, we present a comprehensive framework for automatic 3D segmentation of the LV in LGE CMR images. Given myocardial contours in cine images as a priori knowledge, the framework initially propagates the a priori segmentation from cine to LGE images via 2D translational registration. Two meshes representing respectively endocardial and epicardial surfaces are then constructed with the propagated contours. After construction, the two meshes are deformed towards the myocardial edge points detected in both short-axis and long-axis LGE images in a unified 3D coordinate system. Taking into account the intensity characteristics of the LV in LGE images, we propose a novel parametric model of the LV for consistent myocardial edge points detection regardless of pathological status of the myocardium (infarcted or healthy) and of the type of the LGE images (short-axis or long-axis). We have evaluated the proposed framework with 21 sets of real patient and four sets of simulated phantom data. Both distance- and region-based performance metrics confirm the observation that the framework can generate accurate and reliable results for myocardial segmentation of LGE images. We have also tested the robustness of the framework with respect to varied a priori segmentation in both practical and simulated settings. Experimental results show that the proposed framework can greatly compensate variations in the given a priori knowledge and consistently produce accurate segmentations.

A comprehensive 3-D framework for automatic quantification of late gadolinium enhanced cardiac magnetic resonance images

Late gadolinium enhanced (LGE) cardiac magnetic resonance (CMR) can directly visualize nonviable myocardium with hyperenhanced intensities with respect to normal myocardium. For heart attack patients, it is crucial to facilitate the decision of appropriate therapy by analyzing and quantifying their LGE CMR images. To achieve accurate quantification, LGE CMR images need to be processed in two steps: segmentation of the myocardium followed by classification of infarcts within the segmented myocardium. However, automatic segmentation is difficult usually due to the intensity heterogeneity of the myocardium and intensity similarity between the infarcts and blood pool. Besides, the slices of an LGE CMR dataset often suffer from spatial and intensity distortions, causing further difficulties in segmentation and classification. In this paper, we present a comprehensive 3-D framework for automatic quantification of LGE CMR images. In this framework, myocardium is segmented with a novel method that deforms coupled endocardial and epicardial meshes and combines information in both short- and long-axis slices, while infarcts are classified with a graph-cut algorithm incorporating intensity and spatial information. Moreover, both spatial and intensity distortions are effectively corrected with specially designed countermeasures. Experiments with 20 sets of real patient data show visually good segmentation and classification results that are quantitatively in strong agreement with those manually obtained by experts.

Automatic left ventricle segmentation in cardiac MRI using topological stable-state thresholding and region restricted dynamic programming

RATIONALE AND OBJECTIVES

Segmentation of the left ventricle (LV) is very important in the assessment of cardiac functional parameters. The aim of this study is to develop a novel and robust algorithm which can improve the accuracy of automatic LV segmentation on short-axis cardiac magnetic resonance images (MRI).

MATERIALS AND METHODS

The database used in this study consists of 45 cases obtained from the Sunnybrook Health Sciences Centre. The 45 cases contain 12 ischemic heart failures, 12 non-ischemic heart failures, 12 LV hypertrophies, and 9 normal cases. Three key techniques are developed in this segmentation algorithm: 1) topological stable-state thresholding method is proposed to refine the endocardial contour, 2) an edge map with non-maxima gradient suppression approach, and 3) a region-restricted technique that is proposed to improve the dynamic programming to derive the epicardial boundary.

RESULTS

The validation experiments were performed on a pool of data sets of 45 cases. For both endo- and epicardial contours of our results, percentage of good contours is about 91%, the average perpendicular distance is about 2 mm, and the overlapping dice metric is about 0.91. The regression and determination coefficient for the experts and our proposed method on the ejection fraction is 1.05 and 0.9048, respectively; they are 0.98 and 0.8221 for LV mass.

CONCLUSIONS

An automatic method using topological stable-state thresholding and region restricted dynamic programming has been proposed to segment left ventricle in short-axis cardiac MRI. Evaluation results indicate that the proposed segmentation method can improve the accuracy and robust of left ventricle segmentation. The proposed segmentation approach shows the better performance and has great potential in improving the accuracy of computer-aided diagnosis systems in cardiovascular diseases.

The segmentation of the left ventricle of the heart from ultrasound data using deep learning architectures and derivative-based search methods

We present a new supervised learning model designed for the automatic segmentation of the left ventricle (LV) of the heart in ultrasound images. We address the following problems inherent to supervised learning models: 1) the need of a large set of training images; 2) robustness to imaging conditions not present in the training data; and 3) complex search process. The innovations of our approach reside in a formulation that decouples the rigid and nonrigid detections, deep learning methods that model the appearance of the LV, and efficient derivative-based search algorithms. The functionality of our approach is evaluated using a data set of diseased cases containing 400 annotated images (from 12 sequences) and another data set of normal cases comprising 80 annotated images (from two sequences), where both sets present long axis views of the LV. Using several error measures to compute the degree of similarity between the manual and automatic segmentations, we show that our method not only has high sensitivity and specificity but also presents variations with respect to a gold standard (computed from the manual annotations of two experts) within interuser variability on a subset of the diseased cases. We also compare the segmentations produced by our approach and by two state-of-the-art LV segmentation models on the data set of normal cases, and the results show that our approach produces segmentations that are comparable to these two approaches using only 20 training images and increasing the training set to 400 images causes our approach to be generally more accurate. Finally, we show that efficient search methods reduce up to tenfold the complexity of the method while still producing competitive segmentations. In the future, we plan to include a dynamical model to improve the performance of the algorithm, to use semisupervised learning methods to reduce even more the dependence on rich and large training sets, and to design a shape model less dependent on the training set.

Detection of the whole myocardium in 2D-echocardiography for multiple orientations using a geometrically constrained level-set

The segmentation of the myocardium in echocardiographic images is an important task for the diagnosis of heart disease. This task is difficult due to the inherent problems of echographic images (i.e. low contrast, speckle noise, signal dropout, presence of shadows). In this article, we propose a method to segment the whole myocardium (endocardial and epicardial contours) in 2D echographic images. This is achieved using a level-set model constrained by a new shape formulation that allows to model both contours. The novelty of this work also lays in the fact that our framework allows to segment the whole myocardium for the four main views used in clinical routine. The method is validated on a dataset of clinical images and compared with expert segmentation.

Numerical and in vivo validation of fast cine displacement-encoded with stimulated echoes (DENSE) MRI for quantification of regional cardiac function

Quantitative assessment of regional cardiac function can improve the accuracy of detecting wall motion abnormalities due to heart disease. While recently developed fast cine displacement-encoded with stimulated echoes (DENSE) MRI is a promising modality for the quantification of regional myocardial function, it has not been validated for clinical applications. The purpose of this study, therefore, was to validate the accuracy of fast cine DENSE MRI with numerical simulation and in vivo experiments. A numerical phantom was generated to model physiologically relevant deformation of the heart, and the accuracy of fast cine DENSE was evaluated against the numerical reference. For in vivo validation, 12 controls and 13 heart-disease patients were imaged using both fast cine DENSE and myocardial tagged MRI. Numerical simulation demonstrated that the echo-combination DENSE reconstruction method is relatively insensitive to clinically relevant resonance frequency offsets. The strain measurements by fast cine DENSE and the numerical reference were strongly correlated and in excellent agreement (mean difference = 0.00; 95% limits of agreement were 0.01 and -0.02). The strain measurements by fast cine DENSE and myocardial tagged MRI were strongly correlated (correlation coefficient = 0.92) and in good agreement (mean difference = 0.01; 95% limits of agreement were 0.07 and -0.04).

A DATA-DRIVEN APPROACH TO PRIOR EXTRACTION FOR SEGMENTATION OF LEFT VENTRICLE IN CARDIAC MR IMAGES

In this paper, we propose a data-driven approach that extracts prior information for segmentation of the left ventricle in cardiac MR images of transplanted rat hearts. In our approach, probabilistic priors are generated from prominent features, i.e., corner points and scale-invariant edges, for both endo-and epi-cardium segmentation. We adopt a level set formulation that integrates probabilistic priors with intensity, texture, and edge information for segmentation. Our experimental results show that with minimal user input, representative priors are correctly extracted from the data itself, and the proposed method is effective and robust for segmentation of the left ventricle myocardium even in images with very low contrast. More importantly, it avoids inter- and intra- observer variations and makes accurate quantitative analysis of low-quality cardiac MR images possible.