Automatic segmentation and functional assessment of the left ventricle using u-net fully convolutional network

© 2019 IEEE. A new method for the automatic segmentation and quantitative assessment of the left ventricle (LV) is proposed in this paper. The method is composed of two steps. First, a fully convolutional U-net is used for the segmentation of the epi- A nd endo-cardial boundaries of the LV from cine MR images. This step incorporates a novel loss function that accounts for the class imbalance problem caused by the binary cross entropy (BCE) loss function. Our novel loss function maximizes the segmentation accuracy and penalizes the effect of the class-imbalance caused by BCE. In the second step, the ventricular volume curves are constructed from which LV function parameter is estimated (i.e., ejection fraction). Our method demonstrated a statistical significance in the segmentation of the epi- A nd endo-cardial boundaries (Dice score of 0.94 and 0.96, respectively) compared with the BCE loss (Dice score of 0.89 and 0.86, respectively). Furthermore, a high positive correlation of 0.97 between the estimated ejection fraction and the gold standard was obtained

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

Recurrent Fully Convolutional Neural Networks for Multi-slice MRI Cardiac Segmentation

In cardiac magnetic resonance imaging, fully-automatic segmentation of the heart enables precise structural and functional measurements to be taken, e.g. from short-axis MR images of the left-ventricle. In this work we propose a recurrent fully-convolutional network (RFCN) that learns image representations from the full stack of 2D slices and has the ability to leverage inter-slice spatial dependences through internal memory units. RFCN combines anatomical detection and segmentation into a single architecture that is trained end-to-end thus significantly reducing computational time, simplifying the segmentation pipeline, and potentially enabling real-time applications. We report on an investigation of RFCN using two datasets, including the publicly available MICCAI 2009 Challenge dataset. Comparisons have been carried out between fully convolutional networks and deep restricted Boltzmann machines, including a recurrent version that leverages inter-slice spatial correlation. Our studies suggest that RFCN produces state-of-the-art results and can substantially improve the delineation of contours near the apex of the heart.Comment: MICCAI Workshop RAMBO 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

GridNet with automatic shape prior registration for automatic MRI cardiac segmentation

In this paper, we propose a fully automatic MRI cardiac segmentation method based on a novel deep convolutional neural network (CNN) designed for the 2017 ACDC MICCAI challenge. The novelty of our network comes with its embedded shape prior and its loss function tailored to the cardiac anatomy. Our model includes a cardiac centerof-mass regression module which allows for an automatic shape prior registration. Also, since our method processes raw MR images without any manual preprocessing and/or image cropping, our CNN learns both high-level features (useful to distinguish the heart from other organs with a similar shape) and low-level features (useful to get accurate segmentation results). Those features are learned with a multi-resolution conv-deconv "grid" architecture which can be seen as an extension of the U-Net. Experimental results reveal that our method can segment the left and right ventricles as well as the myocardium from a 3D MRI cardiac volume in 0.4 second with an average Dice coefficient of 0.90 and an average Hausdorff distance of 10.4 mm.Comment: 8 pages, 1 tables, 2 figure

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

Deep learning analysis of the myocardium in coronary CT angiography for identification of patients with functionally significant coronary artery stenosis

In patients with coronary artery stenoses of intermediate severity, the functional significance needs to be determined. Fractional flow reserve (FFR) measurement, performed during invasive coronary angiography (ICA), is most often used in clinical practice. To reduce the number of ICA procedures, we present a method for automatic identification of patients with functionally significant coronary artery stenoses, employing deep learning analysis of the left ventricle (LV) myocardium in rest coronary CT angiography (CCTA). The study includes consecutively acquired CCTA scans of 166 patients with FFR measurements. To identify patients with a functionally significant coronary artery stenosis, analysis is performed in several stages. First, the LV myocardium is segmented using a multiscale convolutional neural network (CNN). To characterize the segmented LV myocardium, it is subsequently encoded using unsupervised convolutional autoencoder (CAE). Thereafter, patients are classified according to the presence of functionally significant stenosis using an SVM classifier based on the extracted and clustered encodings. Quantitative evaluation of LV myocardium segmentation in 20 images resulted in an average Dice coefficient of 0.91 and an average mean absolute distance between the segmented and reference LV boundaries of 0.7 mm. Classification of patients was evaluated in the remaining 126 CCTA scans in 50 10-fold cross-validation experiments and resulted in an area under the receiver operating characteristic curve of 0.74 +- 0.02. At sensitivity levels 0.60, 0.70 and 0.80, the corresponding specificity was 0.77, 0.71 and 0.59, respectively. The results demonstrate that automatic analysis of the LV myocardium in a single CCTA scan acquired at rest, without assessment of the anatomy of the coronary arteries, can be used to identify patients with functionally significant coronary artery stenosis.Comment: This paper was submitted in April 2017 and accepted in November 2017 for publication in Medical Image Analysis. Please cite as: Zreik et al., Medical Image Analysis, 2018, vol. 44, pp. 72-8

Multi-Estimator Full Left Ventricle Quantification through Ensemble Learning

Cardiovascular disease accounts for 1 in every 4 deaths in United States. Accurate estimation of structural and functional cardiac parameters is crucial for both diagnosis and disease management. In this work, we develop an ensemble learning framework for more accurate and robust left ventricle (LV) quantification. The framework combines two 1st-level modules: direct estimation module and a segmentation module. The direct estimation module utilizes Convolutional Neural Network (CNN) to achieve end-to-end quantification. The CNN is trained by taking 2D cardiac images as input and cardiac parameters as output. The segmentation module utilizes a U-Net architecture for obtaining pixel-wise prediction of the epicardium and endocardium of LV from the background. The binary U-Net output is then analyzed by a separate CNN for estimating the cardiac parameters. We then employ linear regression between the 1st-level predictor and ground truth to learn a 2nd-level predictor that ensembles the results from 1st-level modules for the final estimation. Preliminary results by testing the proposed framework on the LVQuan18 dataset show superior performance of the ensemble learning model over the two base modules.Comment: Jiasha Liu, Xiang Li and Hui Ren contribute equally to this wor