Deep learning for cardiac image segmentation: A review

Deep learning has become the most widely used approach for cardiac image segmentation in recent years. In this paper, we provide a review of over 100 cardiac image segmentation papers using deep learning, which covers common imaging modalities including magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound (US) and major anatomical structures of interest (ventricles, atria and vessels). In addition, a summary of publicly available cardiac image datasets and code repositories are included to provide a base for encouraging reproducible research. Finally, we discuss the challenges and limitations with current deep learning-based approaches (scarcity of labels, model generalizability across different domains, interpretability) and suggest potential directions for future research

Temporal diffeomorphic Free Form Deformation (TDFFD) applied to motion and deformation quantification of tagged MRI sequences

International audienceThis paper presents strain quantification results obtained from the Tagged Magnetic Resonance Imaging (TMRI) sequences acquired for the 1 st cardiac Motion Analysis Challenge (cMAC). We applied the Temporal Diffeomorphic Free Form Deformation (TDFFD) algorithm to the phantom and the 15 healthy volunteers of the cMAC database. The TDFFD was modified in two ways. First, we modified the similarity metric to incorporate frame to frame intensity differences. Second, on volunteer sequences, we performed the tracking backward in time since the first frames did not show the contrast between blood and myocardium, making these frames poor choices of reference. On the phantom, we propagated a grid adjusted to tag lines to all frames for visually assessing the influence of the different algorithmic parameters. The weight between the two metric terms appeared to be a critical parameter for making a compromise between good tag tracking while preventing drifts and avoiding tag jumps. For each volunteer, a volumet-ric mesh was defined in the Steady-State Free Precession (SSFP) image, at the closest cardiac time from the last frame of the tagging sequence. Uniform strain patterns were observed over all myocardial segments, as physiologically expected

Fully Automated 3D Cardiac MRI Localisation and Segmentation Using Deep Neural Networks

Cardiac magnetic resonance (CMR) imaging is used widely for morphological assessment and diagnosis of various cardiovascular diseases. Deep learning approaches based on 3D fully convolutional networks (FCNs), have improved state-of-the-art segmentation performance in CMR images. However, previous methods have employed several pre-processing steps and have focused primarily on segmenting low-resolutions images. A crucial step in any automatic segmentation approach is to first localize the cardiac structure of interest within the MRI volume, to reduce false positives and computational complexity. In this paper, we propose two strategies for localizing and segmenting the heart ventricles and myocardium, termed multi-stage and end-to-end, using a 3D convolutional neural network. Our method consists of an encoder–decoder network that is first trained to predict a coarse localized density map of the target structure at a low resolution. Subsequently, a second similar network employs this coarse density map to crop the image at a higher resolution, and consequently, segment the target structure. For the latter, the same two-stage architecture is trained end-to-end. The 3D U-Net with some architectural changes (referred to as 3D DR-UNet) was used as the base architecture in this framework for both the multi-stage and end-to-end strategies. Moreover, we investigate whether the incorporation of coarse features improves the segmentation. We evaluate the two proposed segmentation strategies on two cardiac MRI datasets, namely, the Automatic Cardiac Segmentation Challenge (ACDC) STACOM 2017, and Left Atrium Segmentation Challenge (LASC) STACOM 2018. Extensive experiments and comparisons with other state-of-the-art methods indicate that the proposed multi-stage framework consistently outperforms the rest in terms of several segmentation metrics. The experimental results highlight the robustness of the proposed approach, and its ability to generate accurate high-resolution segmentations, despite the presence of varying degrees of pathology-induced changes to cardiac morphology and image appearance, low contrast, and noise in the CMR volumes

Improving Understanding of Long-Term Cardiac Functional Remodelling via Cross-Sectional Analysis of Polyaffine Motion Parameters

International audienceChanges in cardiac motion dynamics occur as a direct result of alterations in structure, hemodynamics, and electrical activation. Abnormal ventricular motion compromises long-term sustainability of heart function. While motion abnormalities are reasonably well documented and have been identified for many conditions, the remodelling process that occurs as a condition progresses is not well understood. Thanks to the recent development of a method to quantify full ventricular motion (as opposed to 1D abstractions of the motion) with few comparable parameters, population-based statistical analysis is possible. A method for describing functional remodelling is proposed by performing statistical cross-sectional analysis of spatio-temporally aligned subject-specific polyaffine motion parameters. The proposed method is applied to pathological and control datasets to compare functional remodelling occurring as a process of disease as opposed to a process of ageing

Prediction of Post-Ablation Outcome in Atrial Fibrillation Using Shape Parameterization and Partial Least Squares Regression

International audienceTo analyze left atrial remodeling may reveal shape features related to post-ablation outcome in atrial fibrillation, which helps in identifying suitable candidates before ablation. In this article, we propose an application of diffeomorphometry and partial least squares regression to address this problem. We computed a template of left atrial shape in control group and then encoded the shapes in atrial fibrillation with a large set of parameters representing their diffeomorphic deformation. We applied a two-step partial least squares regression. The first step eliminates the influence of atrial volume in shape parameters. The second step links deformations directly to post-ablation recurrence and derives a few principle modes of deformation, which are unrelated to volume change but are involved in post-ablation recurrence. These modes contain information on ablation success due to shape differences, resulting from remodeling or influencing ablation procedure. Some details are consistent with the most complex area of ablation in clinical practice. Finally, we compared our method against the left atrial volume index by quantifying the risk of post-ablation recurrence within six months. Our results show that we get better prediction capabilities (area under receiver operating characteristic curves (AUC = 0.73) than left atrial dilation (AUC = 0.47), which outperforms the current state of the art

Atlas Construction for Measuring the Variability of Complex Anatomical Structures

RÉSUMÉ La recherche sur l'anatomie humaine, en particulier sur le cœur et le cerveau, est d'un intérêt particulier car leurs anomalies entraînent des pathologies qui sont parmi les principales causes de décès dans le monde et engendrent des coûts substantiels. Heureusement, les progrès en imagerie médicale permettent des diagnostics et des traitements autrefois impossibles. En contrepartie, la quantité phénoménale de données produites par ces technologies nécessite le développement d'outils efficaces pour leur traitement. L'objectif de cette thèse est de proposer un ensemble d'outils permettant de normaliser des mesures prélevées sur différents individus, essentiels à l'étude des caractéristiques de structures anatomiques complexes. La normalisation de mesures consiste à rassembler une collection d'images dans une référence commune, aussi appelée construction d'atlas numériques, afin de combiner des mesures provenant de différents patients. Le processus de construction inclut deux étapes principales; la segmentation d'images pour trouver des régions d'intérêts et le recalage d'images afin de déterminer les correspondances entres régions d'intérêts. Les méthodes actuelles de constructions d'atlas peuvent nécessiter des interventions manuelles, souvent fastidieuses, variables, et sont en outre limitées par leurs mécanismes internes. Principalement, le recalage d'images dépend d'une déformation incrémentales d'images sujettes a des minimums locaux. Le recalage n'est ainsi pas optimal lors de grandes déformations et ces limitations requièrent la nécessite de proposer de nouvelles approches pour la construction d'atlas. Les questions de recherche de cette thèse se concentrent donc sur l'automatisation des méthodes actuelles ainsi que sur la capture de déformations complexes de structures anatomiques, en particulier sur le cœur et le cerveau. La méthodologie adoptée a conduit à trois objectifs de recherche spécifiques. Le premier prévoit un nouveau cadre de construction automatise d'atlas afin de créer le premier atlas humain de l'architecture de fibres cardiaques. Le deuxième vise à explorer une nouvelle approche basée sur la correspondance spectrale, nommée FOCUSR, afin de capturer une grande variabilité de formes sur des maillages. Le troisième aboutit finalement à développer une approche fondamentalement différente pour le recalage d'images à fortes déformations, nommée les démons spectraux. Le premier objectif vise plus particulièrement à construire un atlas statistique de l'architecture des fibres cardiaques a partir de 10 cœurs ex vivo humains. Le système développé a mené à deux contributions techniques et une médicale, soit l'amélioration de la segmentation de structures cardiaques et l'automatisation du calcul de forme moyenne, ainsi que notamment la première étude chez l'homme de la variabilité de l'architecture des fibres cardiaques. Pour résumer les principales conclusions, les fibres du cœur humain moyen varient de +- 12 degrés, l'angle d'helix s'étend entre -41 degrés (+- 26 degrés) sur l'épicarde à +66 degrés (+- 15 degrés) sur l'endocarde, tandis que l'angle transverse varie entre +9 degrés (+- 12 degrés) et +34 degrés (+- 29 degrés) à travers le myocarde. Ces résultats sont importants car ces fibres jouent un rôle clef dans diverses fonctions mécaniques et électrophysiologiques du cœur. Le deuxième objectif cherche à capturer une grande variabilité de formes entre structures anatomiques complexes, plus particulièrement entre cortex cérébraux à cause de l'extrême variabilité de ces surfaces et de leur intérêt pour l'étude de fonctions cognitives. La nouvelle méthode de correspondance surfacique, nommée FOCUSR, exploite des représentations spectrales car l'appariement devient plus facile et rapide dans le domaine spectral plutôt que dans l'espace Euclidien classique. Dans sa forme la plus simple, FOCUSR améliore les méthodes spectrales actuelles par un recalage non rigide des représentations spectrales, toutefois, son plein potentiel est atteint en exploitant des données supplémentaires lors de la mise en correspondance. Par exemple, les résultats ont montré que la profondeur des sillons et de la courbure du cortex cérébral améliore significativement la correspondance de surfaces de cerveaux. Enfin, le troisième objectif vise à améliorer le recalage d'images d'organes ayant des fortes variabilités entre individus ou subis de fortes déformations, telles que celles créées par le mouvement cardiaque. La méthodologie amenée par la correspondance spectrale permet d'améliorer les approches conventionnelles de recalage d'images. En effet, les représentations spectrales, capturant des similitudes géométriques globales entre différentes formes, permettent de surmonter les limitations actuelles des méthodes de recalage qui restent guidées par des forces locales. Le nouvel algorithme, nommé démons spectraux, peut ainsi supporter de très grandes déformations locales et complexes entre images, et peut être tout autant adapté a d'autres approches, telle que dans un cadre de recalage conjoint d'images. Il en résulte un cadre complet de construction d'atlas, nommé démons spectraux multijoints, où la forme moyenne est calculée directement lors du processus de recalage plutôt qu'avec une approche séquentielle de recalage et de moyennage. La réalisation de ces trois objectifs spécifiques a permis des avancées dans l'état de l'art au niveau des méthodes de correspondance spectrales et de construction d'atlas, en permettant l'utilisation d'organes présentant une forte variabilité de formes. Dans l'ensemble, les différentes stratégies fournissent de nouvelles contributions sur la façon de trouver et d'exploiter des descripteurs globaux d'images et de surfaces. D'un point de vue global, le développement des objectifs spécifiques établit un lien entre : a) la première série d'outils, mettant en évidence les défis à recaler des images à fortes déformations, b) la deuxième série d'outils, servant à capturer de fortes déformations entre surfaces mais qui ne reste pas directement applicable a des images, et c) la troisième série d'outils, faisant un retour sur le traitement d'images en permettant la construction d'atlas a partir d'images ayant subies de fortes déformations. Il y a cependant plusieurs limitations générales qui méritent d'être investiguées, par exemple, les données partielles (tronquées ou occluses) ne sont pas actuellement prises en charge les nouveaux outils, ou encore, les stratégies algorithmiques utilisées laissent toujours place à l'amélioration. Cette thèse donne de nouvelles perspectives dans les domaines de l'imagerie cardiaque et de la neuroimagerie, toutefois, les nouveaux outils développés sont assez génériques pour être appliqués a tout recalage d'images ou de surfaces. Les recommandations portent sur des recherches supplémentaires qui établissent des liens avec la segmentation à base de graphes, pouvant conduire à un cadre complet de construction d'atlas où la segmentation, le recalage, et le moyennage de formes seraient tous interdépendants. Il est également recommandé de poursuivre la recherche sur la construction de meilleurs modèles électromécaniques cardiaques à partir des résultats de cette thèse. En somme, les nouveaux outils offrent de nouvelles bases de recherche et développement pour la normalisation de formes, ce qui peut potentiellement avoir un impact sur le diagnostic, ainsi que la planification et la pratique d'interventions médicales.----------ABSTRACT Research on human anatomy, in particular on the heart and the brain, is a primary concern for society since their related diseases are among top killers across the globe and have exploding associated costs. Fortunately, recent advances in medical imaging offer new possibilities for diagnostics and treatments. On the other hand, the growth in data produced by these relatively new technologies necessitates the development of efficient tools for processing data. The focus of this thesis is to provide a set of tools for normalizing measurements across individuals in order to study complex anatomical characteristics. The normalization of measurements consists of bringing a collection of images into a common reference, also known as atlas construction, in order to combine measurements made on different individuals. The process of constructing an atlas involves the topics of segmentation, which finds regions of interest in the data (e.g., an organ, a structure), and registration, which finds correspondences between regions of interest. Current frameworks may require tedious and hardly reproducible user interactions, and are additionally limited by their computational schemes, which rely on slow iterative deformations of images, prone to local minima. Image registration is, therefore, not optimal with large deformations. Such limitations indicate the need to research new approaches for atlas construction. The research questions are consequently addressing the problems of automating current frameworks and capturing global and complex deformations between anatomical structures, in particular between human hearts and brains. More precisely, the methodology adopted in the thesis led to three specific research objectives. Briefly, the first step aims at developing a new automated framework for atlas construction in order to build the first human atlas of the cardiac fiber architecture. The second step intends to explore a new approach based on spectral correspondence, named FOCUSR, in order to precisely capture large shape variability. The third step leads, finally, to a fundamentally new approach for image registration with large deformations, named the Spectral Demons algorithm. The first objective aims more specifically at constructing a statistical atlas of the cardiac fiber architecture from a unique human dataset of 10 ex vivo hearts. The developed framework made two technical, and one medical, contributions, that are the improvement of the segmentation of cardiac structures, the automation of the shape averaging process, and more importantly, the first human study on the variability of the cardiac fiber architecture. To summarize the main finding, the fiber orientations in human hearts has been found to vary with about +- 12 degrees, the range of the helix angle spans from -41 degrees (+- 26 degrees) on the epicardium to +66 degrees (+- 15 degrees) on the endocardium, while, the range of the transverse angle spans from +9 degrees (+- 12 degrees) to +34 degrees (+- 29 degrees) across the myocardial wall. These findings are significant in cardiology since the fiber architecture plays a key role in cardiac mechanical functions and in electrophysiology. The second objective intends to capture large shape variability between complex anatomical structures, in particular between cerebral cortices due to their highly convoluted surfaces and their high anatomical and functional variability across individuals. The new method for surface correspondence, named FOCUSR, exploits spectral representations since matching is easier in the spectral domain rather than in the conventional Euclidean space. In its simplest form, FOCUSR improves current spectral approaches by refining spectral representations with a nonrigid alignment; however, its full power is demonstrated when using additional features during matching. For instance, the results showed that sulcal depth and cortical curvature improve significantly the accuracy of cortical surface matching. Finally, the third objective is to improve image registration for organs with a high inter-subject variability or undergoing very large deformations, such as the heart. The new approach brought by the spectral matching technique allows the improvement of conventional image registration methods. Indeed, spectral representations, which capture global geometric similarities and large deformations between different shapes, may be used to overcome a major limitation of current registration methods, which are in fact guided by local forces and restrained to small deformations. The new algorithm, named Spectral Demons, can capture very large and complex deformations between images, and can additionally be adapted to other approaches, such as in a groupwise configuration. This results in a complete framework for atlas construction, named Groupwise Spectral Demons, where the average shape is computed during the registration process rather than in sequential steps. The achievements of these three specific objectives permitted advances in the state-of-the-art of spectral matching methods and of atlas construction, enabling the registration of organs with significant shape variability. Overall, the investigation of these different strategies provides new contributions on how to find and exploit global descriptions of images and surfaces. From a global perspective, these objectives establish a link between: a) the first set of tools, that highlights the challenges in registering images with very large deformations, b) the second set of tools, that captures very large deformations between surfaces but are not applicable to images, and c) the third set of tools, that comes back on processing images and allows a natural construction of atlases from images with very large deformations. There are, however, several general remaining limitations, for instance, partial data (truncated or occluded) is currently not supported by the new tools, or also, the strategy for computing and using spectral representations still leaves room for improvement. This thesis gives new perspectives in cardiac and neuroimaging, yet at the same time, the new tools remain general enough for virtually any application that uses surface or image registration. It is recommended to research additional links with graph-based segmentation methods, which may lead to a complete framework for atlas construction where segmentation, registration and shape averaging are all interlinked. It is also recommended to pursue research on building better cardiac electromechanical models from the findings of this thesis. Nevertheless, the new tools provide new grounds for research and application of shape normalization, which may potentially impact diagnostic, as well as planning and performance of medical interventions

Simulation of Cardiac Activity by using LabView

Import 04/11/2015Srdce, jako jeden z hlavních orgánů člověka má v těle důležitou funkci, kterou je pohánění krve do celého těla. Aby tato činnost mohla být uskutečněna je třeba určité mechanické a elektrické aktivity k tomu, aby se srdeční svalovina začala stahovat. Výsledkem práce je aplikace, sloužící jako výukový program pro studenty. Aplikace znázorňuje závislost mechanické činnosti srdce na elektrické aktivitě srdce. Tato závislost je zobrazena pomocí dvou grafů a znázornění odpovídajících míst. První graf je EKG křivka a druhý graf je pracovní diagram. Pracovní diagram znázorňuje čtyři dané části srdečního cyklu. Uživatel má možnost měnit různé hodnoty, jako například srdeční frekvence, objem levé komory nebo tlak levé komory. Při změně dané hodnoty je možné na pracovním diagramu pozorovat změnu oproti ideální křivce pracovní diagramu. Aplikace také umožňuje přepínat mezi grafy a pozorovat tak, jak se mění grafy v závislosti na různých patologiích.Heart, as one of the major organs in the human body has an important function, which is propelling the blood through the body. In order to this activity can be realize, it is necessary to be there some mechanical and electrical activity to start contraction of the heart muscle. The result of thesis is application, serving as a tutorial for students. Application shows the dependence of the mechanical activity on the electrical activity of the heart. This dependence is shown by two graphs and highlight the corresponding parts. The first graph is the ECG waveform and the second graph is a working diagram. Working diagram shows four of the cardiac cycle. The user has the possibility to modify various values such as heart rate, the volume of the left ventricle or left ventricle pressure. When you change the values you can watch, how the diagram changes from the ideal working diagram. The application also allows you to switch between graphs and watch changes of graphs depending on various pathologies.450 - Katedra kybernetiky a biomedicínského inženýrstvívelmi dobř

Meshless electrophysiological modeling of cardiac resynchronization therapy—benchmark analysis with finite-element methods in experimental data

Computational models of cardiac electrophysiology are promising tools for reducing the rates of non-response patients suitable for cardiac resynchronization therapy (CRT) by optimizing electrode placement. The majority of computational models in the literature are mesh-based, primarily using the finite element method (FEM). The generation of patient-specific cardiac meshes has traditionally been a tedious task requiring manual intervention and hindering the modeling of a large number of cases. Meshless models can be a valid alternative due to their mesh quality independence. The organization of challenges such as the CRT-EPiggy19, providing unique experimental data as open access, enables benchmarking analysis of different cardiac computational modeling solutions with quantitative metrics. We present a benchmark analysis of a meshless-based method with finite-element methods for the prediction of cardiac electrical patterns in CRT, based on a subset of the CRT-EPiggy19 dataset. A data assimilation strategy was designed to personalize the most relevant parameters of the electrophysiological simulations and identify the optimal CRT lead configuration. The simulation results obtained with the meshless model were equivalent to FEM, with the most relevant aspect for accurate CRT predictions being the parameter personalization strategy (e.g., regional conduction velocity distribution, including the Purkinje system and CRT lead distribution). © 2022 by the authors. Licensee MDPI, Basel, Switzerland

When Cardiac Biophysics Meets Groupwise Statistics: Complementary Modelling Approaches for Patient-Specific Medicine

This habilitation manuscript contains research on biophysical and statistical modeling of the heart, as well as interactions between these two approaches