Automatic Segmentation of the Left Ventricle in Cardiac CT Angiography Using Convolutional Neural Network

Accurate delineation of the left ventricle (LV) is an important step in evaluation of cardiac function. In this paper, we present an automatic method for segmentation of the LV in cardiac CT angiography (CCTA) scans. Segmentation is performed in two stages. First, a bounding box around the LV is detected using a combination of three convolutional neural networks (CNNs). Subsequently, to obtain the segmentation of the LV, voxel classification is performed within the defined bounding box using a CNN. The study included CCTA scans of sixty patients, fifty scans were used to train the CNNs for the LV localization, five scans were used to train LV segmentation and the remaining five scans were used for testing the method. Automatic segmentation resulted in the average Dice coefficient of 0.85 and mean absolute surface distance of 1.1 mm. The results demonstrate that automatic segmentation of the LV in CCTA scans using voxel classification with convolutional neural networks is feasible.Comment: This work has been published as: Zreik, M., Leiner, T., de Vos, B. D., van Hamersvelt, R. W., Viergever, M. A., I\v{s}gum, I. (2016, April). Automatic segmentation of the left ventricle in cardiac CT angiography using convolutional neural networks. In Biomedical Imaging (ISBI), 2016 IEEE 13th International Symposium on (pp. 40-43). IEE

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

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

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

Multi-Planar Deep Segmentation Networks for Cardiac Substructures from MRI and CT

Non-invasive detection of cardiovascular disorders from radiology scans requires quantitative image analysis of the heart and its substructures. There are well-established measurements that radiologists use for diseases assessment such as ejection fraction, volume of four chambers, and myocardium mass. These measurements are derived as outcomes of precise segmentation of the heart and its substructures. The aim of this paper is to provide such measurements through an accurate image segmentation algorithm that automatically delineates seven substructures of the heart from MRI and/or CT scans. Our proposed method is based on multi-planar deep convolutional neural networks (CNN) with an adaptive fusion strategy where we automatically utilize complementary information from different planes of the 3D scans for improved delineations. For CT and MRI, we have separately designed three CNNs (the same architectural configuration) for three planes, and have trained the networks from scratch for voxel-wise labeling for the following cardiac structures: myocardium of left ventricle (Myo), left atrium (LA), left ventricle (LV), right atrium (RA), right ventricle (RV), ascending aorta (Ao), and main pulmonary artery (PA). We have evaluated the proposed method with 4-fold-cross validation on the multi-modality whole heart segmentation challenge (MM-WHS 2017) dataset. The precision and dice index of 0.93 and 0.90, and 0.87 and 0.85 were achieved for CT and MR images, respectively. While a CT volume was segmented about 50 seconds, an MRI scan was segmented around 17 seconds with the GPUs/CUDA implementation.Comment: The paper is accepted to STACOM 201