Unsupervised Myocardial Segmentation for Cardiac BOLD

A fully automated 2-D+time myocardial segmentation framework is proposed for cardiac magnetic resonance (CMR) blood-oxygen-level-dependent (BOLD) data sets. Ischemia detection with CINE BOLD CMR relies on spatio-temporal patterns in myocardial intensity, but these patterns also trouble supervised segmentation methods, the de facto standard for myocardial segmentation in cine MRI. Segmentation errors severely undermine the accurate extraction of these patterns. In this paper, we build a joint motion and appearance method that relies on dictionary learning to find a suitable subspace.Our method is based on variational pre-processing and spatial regularization using Markov random fields, to further improve performance. The superiority of the proposed segmentation technique is demonstrated on a data set containing cardiac phase resolved BOLD MR and standard CINE MR image sequences acquired in baseline and is chemic condition across ten canine subjects. Our unsupervised approach outperforms even supervised state-of-the-art segmentation techniques by at least 10% when using Dice to measure accuracy on BOLD data and performs at par for standard CINE MR. Furthermore, a novel segmental analysis method attuned for BOLD time series is utilized to demonstrate the effectiveness of the proposed method in preserving key BOLD patterns

Synthetic generation of myocardial blood-oxygen-level-dependent MRI time series via structural sparse decomposition modeling

This paper aims to identify approaches that generate appropriate synthetic data (computer generated) for cardiac phase-resolved blood-oxygen-level-dependent (CP-BOLD) MRI. CP-BOLD MRI is a new contrast agent- and stress-free approach for examining changes in myocardial oxygenation in response to coronary artery disease. However, since signal intensity changes are subtle, rapid visualization is not possible with the naked eye. Quantifying and visualizing the extent of disease relies on myocardial segmentation and registration to isolate the myocardium and establish temporal correspondences and ischemia detection algorithms to identify temporal differences in BOLD signal intensity patterns. If transmurality of the defect is of interest pixel-level analysis is necessary and thus a higher precision in registration is required. Such precision is currently not available affecting the design and performance of the ischemia detection algorithms. In this work, to enable algorithmic developments of ischemia detection irrespective to registration accuracy, we propose an approach that generates synthetic pixel-level myocardial time series. We do this by 1) modeling the temporal changes in BOLD signal intensity based on sparse multi-component dictionary learning, whereby segmentally derived myocardial time series are extracted from canine experimental data to learn the model; and 2) demonstrating the resemblance between real and synthetic time series for validation purposes. We envision that the proposed approach has the capacity to accelerate development of tools for ischemia detection while markedly reducing experimental costs so that cardiac BOLD MRI can be rapidly translated into the clinical arena for the noninvasive assessment of ischemic heart disease

Dictionary Learning Based Image Descriptor for Myocardial Registration of CP-BOLD MR:Medical Image Computing and Computer-Assisted Intervention -- MICCAI 2015

Cardiac Phase-resolved Blood Oxygen-Level-Dependent (CP-BOLD) MRI is a new contrast agent- and stress-free imaging technique for the assessment of myocardial ischemia at rest. The precise registration among the cardiac phases in this cine type acquisition is essential for automating the analysis of images of this technique, since it can potentially lead to better specificity of ischemia detection. However, inconsistency in myocardial intensity patterns and the changes in myocardial shape due to the heart’s motion lead to low registration performance for state-of-the-art methods. This low accuracy can be explained by the lack of distinguishable features in CP-BOLD and inappropriate metric definitions in current intensity-based registration frameworks. In this paper, the sparse representations, which are defined by a discriminative dictionary learning approach for source and target images, are used to improve myocardial registration. This method combines appearance with Gabor and HOG features in a dictionary learning framework to sparsely represent features in a low dimensional space. The sum of absolute differences of these distinctive sparse representations are used to define a similarity term in the registration framework. The proposed approach is validated on a dataset of CP-BOLD MR and standard CINE MR acquired in baseline and ischemic condition across 10 canines

Unsupervised Myocardial Segmentation for Cardiac MRI:Medical Image Computing and Computer-Assisted Intervention – MICCAI 2015

Though unsupervised segmentation was a de-facto standard for cardiac MRI segmentation early on, recently cardiac MRI segmentation literature has favored fully supervised techniques such as Dictionary Learning and Atlas-based techniques. But, the benefits of unsupervised techniques e.g., no need for large amount of training data and better potential of handling variability in anatomy and image contrast, is more evident with emerging cardiac MR modalities. For example, CP-BOLD is a new MRI technique that has been shown to detect ischemia without any contrast at stress but also at rest conditions. Although CP-BOLD looks similar to standard CINE, changes in myocardial intensity patterns and shape across cardiac phases, due to the heart’s motion, BOLD effect and artifacts affect the underlying mechanisms of fully supervised segmentation techniques resulting in a significant drop in segmentation accuracy. In this paper, we present a fully unsupervised technique for segmenting myocardium from the background in both standard CINE MR and CP-BOLD MR. We combine appearance with motion information (obtained via Optical Flow) in a dictionary learning framework to sparsely represent important features in a low dimensional space and separate myocardium from background accordingly. Our fully automated method learns background-only models and one class classifier provides myocardial segmentation. The advantages of the proposed technique are demonstrated on a dataset containing CP-BOLD MR and standard CINE MR image sequences acquired in baseline and ischemic condition across 10 canine subjects, where our method outperforms state-of-the-art supervised segmentation techniques in CP-BOLD MR and performs at-par for standard CINE MR

Fast dynamic magnetic resonance imaging using sparse recovery methods and novel signal encoding formulations

Magnetic resonance imaging (MRI) is a non-invasive imaging modality that provides excellent soft tissue contrast without using ionizing radiations. These qualities/properties make MRI the preferred imaging modality for critical organs like heart and brain. Over the past decade, the advancement in hardware and image reconstruction algorithms has led to substantial improvements in MRI in terms of imaging speeds, quality and reliability. However, MRI speeds need to be further improved while retaining/maintaining the image quality given that the emerging medical diagnostic procedures are increasingly relying on detailed characterization of physiological functions that evolve on time scales too fast to be captured using conventional MRI methods. This dissertation starts with presenting a sparse signal recovery based fast MRI method. This method synergistically combines a data redundancy scheme for high frequency details with a novel and physically realizable MR signal encoding formulation. The new signal encoding formulation uses clinically deployed tagging radio frequency pulses to mix information in the spatial frequency domain prior to acquisition. Thus, the new formulation leads to a more uniform coverage of spatial frequency information even at high accelerations. The synergistic combination of image-detail redundancy encoding with tagging based signal encoding allows recovery of edges and fine structures with unprecedented quality. Next, this dissertation evaluates the use of fast spiral trajectories for high spatial resolution functional imaging of human superior colliculus. Gradient efficient and motion-robust spiral trajectories are used to keep fMRI scan durations short. . However, high resolution imaging of human subcortical structures using these trajectories is limited due to the weak functional responses of SC structures and also low signal-to-noise ratio associated with small voxels. To improve the functional sensitivity of spiral trajectories, dual echo variants are used. Combination of two echoes of the dual-echo variants reduces noise and thereby improves the functional sensitivity of high resolution fMRI. Lastly, this dissertation presents a novel formulation for fast dynamic MRI which combines the generic linear dynamical system model with sparse recovery techniques. Specifically, the formulation uses a known prior spatio-temporal model to predict the underlying image and uses sparse recovery techniques to recover the residual image. The spatio-temporal evolution model inherently encodes for coupled data redundancies in the spatial- and temporal-dimensions. Also, the generalizability of the formulation in choosing the evolution model allows it to be applicable to various physiological functions.Electrical and Computer Engineerin

Disentangled representation learning in cardiac image analysis

Typically, a medical image offers spatial information on the anatomy (and pathology) modulated by imaging specific characteristics. Many imaging modalities including Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) can be interpreted in this way. We can venture further and consider that a medical image naturally factors into some spatial factors depicting anatomy and factors that denote the imaging characteristics. Here, we explicitly learn this decomposed (disentangled) representation of imaging data, focusing in particular on cardiac images. We propose Spatial Decomposition Network (SDNet), which factorises 2D medical images into spatial anatomical factors and non-spatial modality factors. We demonstrate that this high-level representation is ideally suited for several medical image analysis tasks, such as semi-supervised segmentation, multi-task segmentation and regression, and image-to-image synthesis. Specifically, we show that our model can match the performance of fully supervised segmentation models, using only a fraction of the labelled images. Critically, we show that our factorised representation also benefits from supervision obtained either when we use auxiliary tasks to train the model in a multi-task setting (e.g. regressing to known cardiac indices), or when aggregating multimodal data from different sources (e.g. pooling together MRI and CT data). To explore the properties of the learned factorisation, we perform latent-space arithmetic and show that we can synthesise CT from MR and vice versa, by swapping the modality factors. We also demonstrate that the factor holding image specific information can be used to predict the input modality with high accuracy. Code will be made available at https://github.com/agis85/anatomy_modality_decomposition

Multimodal and disentangled representation learning for medical image analysis

Automated medical image analysis is a growing research field with various applications in modern healthcare. Furthermore, a multitude of imaging techniques (or modalities) have been developed, such as Magnetic Resonance (MR) and Computed Tomography (CT), to attenuate different organ characteristics. Research on image analysis is predominately driven by deep learning methods due to their demonstrated performance. In this thesis, we argue that their success and generalisation relies on learning good latent representations. We propose methods for learning spatial representations that are suitable for medical image data, and can combine information coming from different modalities. Specifically, we aim to improve cardiac MR segmentation, a challenging task due to varied images and limited expert annotations, by considering complementary information present in (potentially unaligned) images of other modalities. In order to evaluate the benefit of multimodal learning, we initially consider a synthesis task on spatially aligned multimodal brain MR images. We propose a deep network of multiple encoders and decoders, which we demonstrate outperforms existing approaches. The encoders (one per input modality) map the multimodal images into modality invariant spatial feature maps. Common and unique information is combined into a fused representation, that is robust to missing modalities, and can be decoded into synthetic images of the target modalities. Different experimental settings demonstrate the benefit of multimodal over unimodal synthesis, although input and output image pairs are required for training. The need for paired images can be overcome with the cycle consistency principle, which we use in conjunction with adversarial training to transform images from one modality (e.g. MR) to images in another (e.g. CT). This is useful especially in cardiac datasets, where different spatial and temporal resolutions make image pairing difficult, if not impossible. Segmentation can also be considered as a form of image synthesis, if one modality consists of semantic maps. We consider the task of extracting segmentation masks for cardiac MR images, and aim to overcome the challenge of limited annotations, by taking into account unannanotated images which are commonly ignored. We achieve this by defining suitable latent spaces, which represent the underlying anatomies (spatial latent variable), as well as the imaging characteristics (non-spatial latent variable). Anatomical information is required for tasks such as segmentation and regression, whereas imaging information can capture variability in intensity characteristics for example due to different scanners. We propose two models that disentangle cardiac images at different levels: the first extracts the myocardium from the surrounding information, whereas the second fully separates the anatomical from the imaging characteristics. Experimental analysis confirms the utility of disentangled representations in semi-supervised segmentation, and in regression of cardiac indices, while maintaining robustness to intensity variations such as the ones induced by different modalities. Finally, our prior research is aggregated into one framework that encodes multimodal images into disentangled anatomical and imaging factors. Several challenges of multimodal cardiac imaging, such as input misalignments and the lack of expert annotations, are successfully handled in the shared anatomy space. Furthermore, we demonstrate that this approach can be used to combine complementary anatomical information for the purpose of multimodal segmentation. This can be achieved even when no annotations are provided for one of the modalities. This thesis creates new avenues for further research in the area of multimodal and disentangled learning with spatial representations, which we believe are key to more generalised deep learning solutions in healthcare

Cardiac motion estimation in ultrasound images using a sparse representation and dictionary learning

Les maladies cardiovasculaires sont de nos jours un problème de santé majeur. L'amélioration des méthodes liées au diagnostic de ces maladies représente donc un réel enjeu en cardiologie. Le coeur étant un organe en perpétuel mouvement, l'analyse du mouvement cardiaque est un élément clé pour le diagnostic. Par conséquent, les méthodes dédiées à l'estimation du mouvement cardiaque à partir d'images médicales, plus particulièrement en échocardiographie, font l'objet de nombreux travaux de recherches. Cependant, plusieurs difficultés liées à la complexité du mouvement du coeur ainsi qu'à la qualité des images échographiques restent à surmonter afin d'améliorer la qualité et la précision des estimations. Dans le domaine du traitement d'images, les méthodes basées sur l'apprentissage suscitent de plus en plus d'intérêt. Plus particulièrement, les représentations parcimonieuses et l'apprentissage de dictionnaires ont démontré leur efficacité pour la régularisation de divers problèmes inverses. Cette thèse a ainsi pour but d'explorer l'apport de ces méthodes, qui allient parcimonie et apprentissage, pour l'estimation du mouvement cardiaque. Trois principales contributions sont présentées, chacune traitant différents aspects et problématiques rencontrées dans le cadre de l'estimation du mouvement en échocardiographie. Dans un premier temps, une méthode d'estimation du mouvement cardiaque se basant sur une régularisation parcimonieuse est proposée. Le problème d'estimation du mouvement est formulé dans le cadre d'une minimisation d'énergie, dont le terme d'attache aux données est construit avec l'hypothèse d'un bruit de Rayleigh multiplicatif. Une étape d'apprentissage de dictionnaire permet une régularisation exploitant les propriétés parcimonieuses du mouvement cardiaque, combinée à un terme classique de lissage spatial. Dans un second temps, une méthode robuste de flux optique est présentée. L'objectif de cette approche est de robustifier la méthode d'estimation développée au premier chapitre de manière à la rendre moins sensible aux éléments aberrants. Deux régularisations sont mises en oeuvre, imposant d'une part un lissage spatial et de l'autre la parcimonie des champs de mouvements dans un dictionnaire approprié. Afin d'assurer la robustesse de la méthode vis-à-vis des anomalies, une stratégie de minimisation récursivement pondérée est proposée. Plus précisément, les fonctions employées pour cette pondération sont basées sur la théorie des M-estimateurs. Le dernier travail présenté dans cette thèse, explore une méthode d'estimation du mouvement cardiaque exploitant une régularisation parcimonieuse combinée à un lissage à la fois dans les domaines spatial et temporel. Le problème est formulé dans un cadre général d'estimation de flux optique. La régularisation temporelle proposée impose des trajectoires de mouvement lisses entre images consécutives. De plus, une méthode itérative d'estimation permet d'incorporer les trois termes de régularisations, tout en rendant possible le traitement simultané d'un ensemble d'images. Dans cette thèse, les contributions proposées sont validées en employant des images synthétiques et des simulations réalistes d'images ultrasonores. Ces données avec vérité terrain permettent d'évaluer la précision des approches considérées, et de souligner leur compétitivité par rapport à des méthodes de l'état-del'art. Pour démontrer la faisabilité clinique, des images in vivo de patients sains ou atteints de pathologies sont également considérées pour les deux premières méthodes. Pour la dernière contribution de cette thèse, i.e., exploitant un lissage temporel, une étude préliminaire est menée en utilisant des données de simulation.Cardiovascular diseases have become a major healthcare issue. Improving the diagnosis and analysis of these diseases have thus become a primary concern in cardiology. The heart is a moving organ that undergoes complex deformations. Therefore, the quantification of cardiac motion from medical images, particularly ultrasound, is a key part of the techniques used for diagnosis in clinical practice. Thus, significant research efforts have been directed toward developing new cardiac motion estimation methods. These methods aim at improving the quality and accuracy of the estimated motions. However, they are still facing many challenges due to the complexity of cardiac motion and the quality of ultrasound images. Recently, learning-based techniques have received a growing interest in the field of image processing. More specifically, sparse representations and dictionary learning strategies have shown their efficiency in regularizing different ill-posed inverse problems. This thesis investigates the benefits that such sparsity and learning-based techniques can bring to cardiac motion estimation. Three main contributions are presented, investigating different aspects and challenges that arise in echocardiography. Firstly, a method for cardiac motion estimation using a sparsity-based regularization is introduced. The motion estimation problem is formulated as an energy minimization, whose data fidelity term is built using the assumption that the images are corrupted by multiplicative Rayleigh noise. In addition to a classical spatial smoothness constraint, the proposed method exploits the sparse properties of the cardiac motion to regularize the solution via an appropriate dictionary learning step. Secondly, a fully robust optical flow method is proposed. The aim of this work is to take into account the limitations of ultrasound imaging and the violations of the regularization constraints. In this work, two regularization terms imposing spatial smoothness and sparsity of the motion field in an appropriate cardiac motion dictionary are also exploited. In order to ensure robustness to outliers, an iteratively re-weighted minimization strategy is proposed using weighting functions based on M-estimators. As a last contribution, we investigate a cardiac motion estimation method using a combination of sparse, spatial and temporal regularizations. The problem is formulated within a general optical flow framework. The proposed temporal regularization enforces smoothness of the motion trajectories between consecutive images. Furthermore, an iterative groupewise motion estimation allows us to incorporate the three regularization terms, while enabling the processing of the image sequence as a whole. Throughout this thesis, the proposed contributions are validated using synthetic and realistic simulated cardiac ultrasound images. These datasets with available groundtruth are used to evaluate the accuracy of the proposed approaches and show their competitiveness with state-of-the-art algorithms. In order to demonstrate clinical feasibility, in vivo sequences of healthy and pathological subjects are considered for the first two methods. A preliminary investigation is conducted for the last contribution, i.e., exploiting temporal smoothness, using simulated data

Preclinical MRI of the Kidney

This Open Access volume provides readers with an open access protocol collection and wide-ranging recommendations for preclinical renal MRI used in translational research. The chapters in this book are interdisciplinary in nature and bridge the gaps between physics, physiology, and medicine. They are designed to enhance training in renal MRI sciences and improve the reproducibility of renal imaging research. Chapters provide guidance for exploring, using and developing small animal renal MRI in your laboratory as a unique tool for advanced in vivo phenotyping, diagnostic imaging, and research into potential new therapies. Written in the highly successful Methods in Molecular Biology series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and tips on troubleshooting and avoiding known pitfalls. Cutting-edge and thorough, Preclinical MRI of the Kidney: Methods and Protocols is a valuable resource and will be of importance to anyone interested in the preclinical aspect of renal and cardiorenal diseases in the fields of physiology, nephrology, radiology, and cardiology. This publication is based upon work from COST Action PARENCHIMA, supported by European Cooperation in Science and Technology (COST). COST (www.cost.eu) is a funding agency for research and innovation networks. COST Actions help connect research initiatives across Europe and enable scientists to grow their ideas by sharing them with their peers. This boosts their research, career and innovation. PARENCHIMA (renalmri.org) is a community-driven Action in the COST program of the European Union, which unites more than 200 experts in renal MRI from 30 countries with the aim to improve the reproducibility and standardization of renal MRI biomarkers