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

Feature Tracking Cardiac Magnetic Resonance via Deep Learning and Spline Optimization

Feature tracking Cardiac Magnetic Resonance (CMR) has recently emerged as an area of interest for quantification of regional cardiac function from balanced, steady state free precession (SSFP) cine sequences. However, currently available techniques lack full automation, limiting reproducibility. We propose a fully automated technique whereby a CMR image sequence is first segmented with a deep, fully convolutional neural network (CNN) architecture, and quadratic basis splines are fitted simultaneously across all cardiac frames using least squares optimization. Experiments are performed using data from 42 patients with hypertrophic cardiomyopathy (HCM) and 21 healthy control subjects. In terms of segmentation, we compared state-of-the-art CNN frameworks, U-Net and dilated convolution architectures, with and without temporal context, using cross validation with three folds. Performance relative to expert manual segmentation was similar across all networks: pixel accuracy was ~97%, intersection-over-union (IoU) across all classes was ~87%, and IoU across foreground classes only was ~85%. Endocardial left ventricular circumferential strain calculated from the proposed pipeline was significantly different in control and disease subjects (-25.3% vs -29.1%, p = 0.006), in agreement with the current clinical literature.Comment: Accepted to Functional Imaging and Modeling of the Heart (FIMH) 201

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

Automatic Segmentation and Disease Classification Using Cardiac Cine MR Images

Segmentation of the heart in cardiac cine MR is clinically used to quantify cardiac function. We propose a fully automatic method for segmentation and disease classification using cardiac cine MR images. A convolutional neural network (CNN) was designed to simultaneously segment the left ventricle (LV), right ventricle (RV) and myocardium in end-diastole (ED) and end-systole (ES) images. Features derived from the obtained segmentations were used in a Random Forest classifier to label patients as suffering from dilated cardiomyopathy, hypertrophic cardiomyopathy, heart failure following myocardial infarction, right ventricular abnormality, or no cardiac disease. The method was developed and evaluated using a balanced dataset containing images of 100 patients, which was provided in the MICCAI 2017 automated cardiac diagnosis challenge (ACDC). The segmentation and classification pipeline were evaluated in a four-fold stratified cross-validation. Average Dice scores between reference and automatically obtained segmentations were 0.94, 0.88 and 0.87 for the LV, RV and myocardium. The classifier assigned 91% of patients to the correct disease category. Segmentation and disease classification took 5 s per patient. The results of our study suggest that image-based diagnosis using cine MR cardiac scans can be performed automatically with high accuracy.Comment: Accepted in STACOM Automated Cardiac Diagnosis Challenge 201

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

FastVentricle: Cardiac Segmentation with ENet

Cardiac Magnetic Resonance (CMR) imaging is commonly used to assess cardiac structure and function. One disadvantage of CMR is that post-processing of exams is tedious. Without automation, precise assessment of cardiac function via CMR typically requires an annotator to spend tens of minutes per case manually contouring ventricular structures. Automatic contouring can lower the required time per patient by generating contour suggestions that can be lightly modified by the annotator. Fully convolutional networks (FCNs), a variant of convolutional neural networks, have been used to rapidly advance the state-of-the-art in automated segmentation, which makes FCNs a natural choice for ventricular segmentation. However, FCNs are limited by their computational cost, which increases the monetary cost and degrades the user experience of production systems. To combat this shortcoming, we have developed the FastVentricle architecture, an FCN architecture for ventricular segmentation based on the recently developed ENet architecture. FastVentricle is 4x faster and runs with 6x less memory than the previous state-of-the-art ventricular segmentation architecture while still maintaining excellent clinical accuracy.Comment: 11 pages, 6 figures, Accepted to Functional Imaging and Modeling of the Heart (FIMH) 201

Automated Diagnosis of Cardiovascular Diseases from Cardiac Magnetic Resonance Imaging Using Deep Learning Models: A Review

In recent years, cardiovascular diseases (CVDs) have become one of the leading causes of mortality globally. CVDs appear with minor symptoms and progressively get worse. The majority of people experience symptoms such as exhaustion, shortness of breath, ankle swelling, fluid retention, and other symptoms when starting CVD. Coronary artery disease (CAD), arrhythmia, cardiomyopathy, congenital heart defect (CHD), mitral regurgitation, and angina are the most common CVDs. Clinical methods such as blood tests, electrocardiography (ECG) signals, and medical imaging are the most effective methods used for the detection of CVDs. Among the diagnostic methods, cardiac magnetic resonance imaging (CMR) is increasingly used to diagnose, monitor the disease, plan treatment and predict CVDs. Coupled with all the advantages of CMR data, CVDs diagnosis is challenging for physicians due to many slices of data, low contrast, etc. To address these issues, deep learning (DL) techniques have been employed to the diagnosis of CVDs using CMR data, and much research is currently being conducted in this field. This review provides an overview of the studies performed in CVDs detection using CMR images and DL techniques. The introduction section examined CVDs types, diagnostic methods, and the most important medical imaging techniques. In the following, investigations to detect CVDs using CMR images and the most significant DL methods are presented. Another section discussed the challenges in diagnosing CVDs from CMR data. Next, the discussion section discusses the results of this review, and future work in CVDs diagnosis from CMR images and DL techniques are outlined. The most important findings of this study are presented in the conclusion section