A finite strain nonlinear human mitral valve model with fluid structure interaction

A simulated human mitral valve under a physiological pressure loading is developed using a hybrid finite element immersed boundary method, which incorporates experimentally based constitutive laws in a three-dimensional fluid-structure interaction framework. A transversely isotropic material constitutive model is used for characterizing the mechanical behaviour of the mitral valve tissue based on recent mechanical tests of healthy human mitral leaflets. Our results show good agreement, in terms of the flow rate and the closing and opening configurations, with the measurements from the magnetic resonance images. The stresses in the anterior leaflet are found to be higher than those in the posterior leaflet, and concentrated around the annulus trigons and free edges of the valve leaflets. Those areas are located where the leaflet has the highest curvature. Effects of the chordae tendineae in the material model are studied and the results show that these chordae play an important role in providing a secondary orifice for the flow when valve opens. Although there are some discrepancies to be overcome in future works, our simulations show that the developed computational model is promising in mimicking the in vivo mitral valve dynamics and providing important information that are not obtainable by in vivo measurements. This article is protected by copyright. All rights reserved

Automatic segmentation of the left ventricle cavity and myocardium in MRI data

A novel approach for the automatic segmentation has been developed to extract the epi-cardium and endo-cardium boundaries of the left ventricle (lv) of the heart. The developed segmentation scheme takes multi-slice and multi-phase magnetic resonance (MR) images of the heart, transversing the short-axis length from the base to the apex. Each image is taken at one instance in the heart's phase. The images are segmented using a diffusion-based filter followed by an unsupervised clustering technique and the resulting labels are checked to locate the (lv) cavity. From cardiac anatomy, the closest pool of blood to the lv cavity is the right ventricle cavity. The wall between these two blood-pools (interventricular septum) is measured to give an approximate thickness for the myocardium. This value is used when a radial search is performed on a gradient image to find appropriate robust segments of the epi-cardium boundary. The robust edge segments are then joined using a normal spline curve. Experimental results are presented with very encouraging qualitative and quantitative results and a comparison is made against the state-of-the art level-sets method

A Survey on Deep Learning in Medical Image Analysis

Deep learning algorithms, in particular convolutional networks, have rapidly become a methodology of choice for analyzing medical images. This paper reviews the major deep learning concepts pertinent to medical image analysis and summarizes over 300 contributions to the field, most of which appeared in the last year. We survey the use of deep learning for image classification, object detection, segmentation, registration, and other tasks and provide concise overviews of studies per application area. Open challenges and directions for future research are discussed.Comment: Revised survey includes expanded discussion section and reworked introductory section on common deep architectures. Added missed papers from before Feb 1st 201

A hybrid active contour segmentation method for myocardial D-SPECT images

Ischaemic heart disease has become one of the leading causes of mortality worldwide. Dynamic single-photon emission computed tomography (D-SPECT) is an advanced routine diagnostic tool commonly used to validate myocardial function in patients suffering from various heart diseases. Accurate automatic localization and segmentation of myocardial regions is helpful in creating a three-dimensional myocardial model and assisting clinicians to perform assessments of myocardial function. Thus, image segmentation is a key technology in preclinical cardiac studies. Intensity inhomogeneity is one of the common challenges in image segmentation and is caused by image artefacts and instrument inaccuracy. In this paper, a novel region-based active contour model that can segment the myocardial D-SPECT image accurately is presented. First, a local region-based fitting image is defined based on information related to the intensity. Second, a likelihood fitting image energy function is built in a local region around each point in a given vector-valued image. Next, the level set method is used to present a global energy function with respect to the neighbourhood centre. The proposed approach guarantees precision and computational efficiency by combining the region-scalable fitting energy (RSF) model and local image fitting energy (LIF) model, and it can solve the issue of high sensitivity to initialization for myocardial D-SPECT segmentation

Deep Learning in Cardiology

The medical field is creating large amount of data that physicians are unable to decipher and use efficiently. Moreover, rule-based expert systems are inefficient in solving complicated medical tasks or for creating insights using big data. Deep learning has emerged as a more accurate and effective technology in a wide range of medical problems such as diagnosis, prediction and intervention. Deep learning is a representation learning method that consists of layers that transform the data non-linearly, thus, revealing hierarchical relationships and structures. In this review we survey deep learning application papers that use structured data, signal and imaging modalities from cardiology. We discuss the advantages and limitations of applying deep learning in cardiology that also apply in medicine in general, while proposing certain directions as the most viable for clinical use.Comment: 27 pages, 2 figures, 10 table

Faster 3D cardiac CT segmentation with Vision Transformers

Accurate segmentation of the heart is essential for personalized blood flow simulations and surgical intervention planning. A recent advancement in image recognition is the Vision Transformer (ViT), which expands the field of view to encompass a greater portion of the global image context. We adapted ViT for three-dimensional volume inputs. Cardiac computed tomography (CT) volumes from 39 patients, featuring up to 20 timepoints representing the complete cardiac cycle, were utilized. Our network incorporates a modified ResNet50 block as well as a ViT block and employs cascade upsampling with skip connections. Despite its increased model complexity, our hybrid Transformer-Residual U-Net framework, termed TRUNet, converges in significantly less time than residual U-Net while providing comparable or superior segmentations of the left ventricle, left atrium, left atrial appendage, ascending aorta, and pulmonary veins. TRUNet offers more precise vessel boundary segmentation and better captures the heart's overall anatomical structure compared to residual U-Net, as confirmed by the absence of extraneous clusters of missegmented voxels. In terms of both performance and training speed, TRUNet exceeded U-Net, a commonly used segmentation architecture, making it a promising tool for 3D semantic segmentation tasks in medical imaging. The code for TRUNet is available at github.com/ljollans/TRUNet

Robust semi-automated path extraction for visualising stenosis of the coronary arteries

Computed tomography angiography (CTA) is useful for diagnosing and planning treatment of heart disease. However, contrast agent in surrounding structures (such as the aorta and left ventricle) makes 3-D visualisation of the coronary arteries difficult. This paper presents a composite method employing segmentation and volume rendering to overcome this issue. A key contribution is a novel Fast Marching minimal path cost function for vessel centreline extraction. The resultant centreline is used to compute a measure of vessel lumen, which indicates the degree of stenosis (narrowing of a vessel). Two volume visualisation techniques are presented which utilise the segmented arteries and lumen measure. The system is evaluated and demonstrated using synthetic and clinically obtained datasets