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

Bridging spatiotemporal scales in biomechanical models for living tissues : from the contracting Esophagus to cardiac growth

Appropriate functioning of our body is determined by the mechanical behavior of our organs. An improved understanding of the biomechanical functioning of the soft tissues making up these organs is therefore crucial for the choice for, and development of, efficient clinical treatment strategies focused on patient-specific pathophysiology. This doctoral dissertation describes the passive and active biomechanical behavior of gastrointestinal and cardiovascular tissue, both in the short and long term, through computer models that bridge the cell, tissue and organ scale. Using histological characterization, mechanical testing and medical imaging techniques, virtual esophagus and heart models are developed that simulate the patient-specific biomechanical organ behavior as accurately as possible. In addition to the diagnostic value of these models, the developed modeling technology also allows us to predict the acute and chronic effect of various treatment techniques, through e.g. drugs, surgery and/or medical equipment. Consequently, this dissertation offers insights that will have an unmistakable impact on the personalized medicine of the future.Het correct functioneren van ons lichaam wordt bepaald door het mechanisch gedrag van onze organen. Een verbeterd inzicht in het biomechanisch functioneren van deze zachte weefsels is daarom van cruciale waarde voor de keuze voor, en ontwikkeling van, efficiënte klinische behandelingsstrategieën gefocust op de patiënt-specifieke pathofysiologie. Deze doctoraatsthesis brengt het passieve en actieve biomechanisch gedrag van gastro-intestinaal en cardiovasculair weefsel, zowel op korte als lange termijn, in kaart via computermodellen die een brug vormen tussen cel-, weefsel- en orgaanniveau. Aan de hand van histologische karakterisering, mechanische testen en medische beeldvormingstechnieken worden virtuele slokdarm- en hartmodellen ontwikkeld die het patiënt-specifieke orgaangedrag zo accuraat mogelijk simuleren. Naast de diagnostische waarde van deze modellen, laat de ontwikkelde modelleringstechnologie ook toe om het effect van verschillende behandelingstechnieken, via medicatie, chirurgie en/of medische apparatuur bijvoorbeeld, acuut en chronisch te voorspellen. Bijgevolg biedt deze doctoraatsthesis inzichten die een onmiskenbare impact zullen hebben op de gepersonaliseerde geneeskunde van de toekomst

Multi-views Fusion CNN for Left Ventricular Volumes Estimation on Cardiac MR Images

Left ventricular (LV) volumes estimation is a critical procedure for cardiac disease diagnosis. The objective of this paper is to address direct LV volumes prediction task. Methods: In this paper, we propose a direct volumes prediction method based on the end-to-end deep convolutional neural networks (CNN). We study the end-to-end LV volumes prediction method in items of the data preprocessing, networks structure, and multi-views fusion strategy. The main contributions of this paper are the following aspects. First, we propose a new data preprocessing method on cardiac magnetic resonance (CMR). Second, we propose a new networks structure for end-to-end LV volumes estimation. Third, we explore the representational capacity of different slices, and propose a fusion strategy to improve the prediction accuracy. Results: The evaluation results show that the proposed method outperforms other state-of-the-art LV volumes estimation methods on the open accessible benchmark datasets. The clinical indexes derived from the predicted volumes agree well with the ground truth (EDV: R2=0.974, RMSE=9.6ml; ESV: R2=0.976, RMSE=7.1ml; EF: R2=0.828, RMSE =4.71%). Conclusion: Experimental results prove that the proposed method may be useful for LV volumes prediction task. Significance: The proposed method not only has application potential for cardiac diseases screening for large-scale CMR data, but also can be extended to other medical image research fieldsComment: to appear on Transactions on Biomedical Engineerin

Segmentación rápida del ventrículo derecho en cine-MRI a partir de una representación densa de Hough

Segmentation of the right ventricle (RV) is essential for the diagnosis of multiple cardiac pathologies and conditions. However, its manual delineation is a tedious task and computational support is complex due to geometric and dynamic variability.  This work introduces a dense Hough transform and representation (HT) that allows a nonparametric characterization of the shape, encoding each voxel by its curvature and orientation. This representation is integrated into a bayesian tracking approach, which efficiently segments the RV structure throughout the cardiac cycle. The proposed approach was evaluated on a public dataset, with 16 patients, achieving a Sørensen-Dice coefficient of 0.87 and 0.92, for complete volumes and basal structures, respectively. These results evidence an adequate fit of the proposed model with respect to RV shape throughout the entire cardiac cycle. La segmentación del Ventrículo Derecho (VD) es esencial para el diagnóstico de múltiples patologías y condiciones cardiacas. Sin embargo, su delineación manual es una tarea tediosa y el soporte computacional resulta complejo debido a la variabilidad geométrica y dinámica.  Este trabajo introduce una transformación y representación densa de Hough (TH) que permite una caracterización no paramétrica de la forma, codificando cada vóxel por su curvatura y orientación. Esta representación es integrada en un enfoque de seguimiento bayesiano, que logra de forma eficiente segmentar la estructura del VD, a lo largo del ciclo cardíaco. El enfoque propuesto fue evaluado en un conjunto de datos públicos, con 16 pacientes, logrando un coeficiente Sørensen-Dice de 0,87 y 0,92, para volúmenes completos y estructuras basales, respectivamente. Estos resultados evidencian una adecuada adaptación del modelo propuesto respecto a la forma del VD a lo largo de todo el ciclo cardíaco.La segmentación del Ventrículo Derecho (VD) es esencial para el diagnóstico de múltiples patologías y condiciones cardiacas. Sin embargo, su delineación manual es una tarea tediosa y el soporte computacional resulta complejo debido a la variabilidad geométrica y dinámica.  Este trabajo introduce una transformación y representación densa de Hough (TH) que permite una caracterización no paramétrica de la forma, codificando cada vóxel por su curvatura y orientación. Esta representación es integrada en un enfoque de seguimiento bayesiano, que logra de forma eficiente segmentar la estructura del VD, a lo largo del ciclo cardíaco. El enfoque propuesto fue evaluado en un conjunto de datos públicos, con 16 pacientes, logrando un coeficiente Sørensen-Dice de 0,87 y 0,92, para volúmenes completos y estructuras basales, respectivamente. Estos resultados evidencian una adecuada adaptación del modelo propuesto respecto a la forma del VD a lo largo de todo el ciclo cardíaco

Computational Methods for Segmentation of Multi-Modal Multi-Dimensional Cardiac Images

Segmentation of the heart structures helps compute the cardiac contractile function quantified via the systolic and diastolic volumes, ejection fraction, and myocardial mass, representing a reliable diagnostic value. Similarly, quantification of the myocardial mechanics throughout the cardiac cycle, analysis of the activation patterns in the heart via electrocardiography (ECG) signals, serve as good cardiac diagnosis indicators. Furthermore, high quality anatomical models of the heart can be used in planning and guidance of minimally invasive interventions under the assistance of image guidance. The most crucial step for the above mentioned applications is to segment the ventricles and myocardium from the acquired cardiac image data. Although the manual delineation of the heart structures is deemed as the gold-standard approach, it requires significant time and effort, and is highly susceptible to inter- and intra-observer variability. These limitations suggest a need for fast, robust, and accurate semi- or fully-automatic segmentation algorithms. However, the complex motion and anatomy of the heart, indistinct borders due to blood flow, the presence of trabeculations, intensity inhomogeneity, and various other imaging artifacts, makes the segmentation task challenging. In this work, we present and evaluate segmentation algorithms for multi-modal, multi-dimensional cardiac image datasets. Firstly, we segment the left ventricle (LV) blood-pool from a tri-plane 2D+time trans-esophageal (TEE) ultrasound acquisition using local phase based filtering and graph-cut technique, propagate the segmentation throughout the cardiac cycle using non-rigid registration-based motion extraction, and reconstruct the 3D LV geometry. Secondly, we segment the LV blood-pool and myocardium from an open-source 4D cardiac cine Magnetic Resonance Imaging (MRI) dataset by incorporating average atlas based shape constraint into the graph-cut framework and iterative segmentation refinement. The developed fast and robust framework is further extended to perform right ventricle (RV) blood-pool segmentation from a different open-source 4D cardiac cine MRI dataset. Next, we employ convolutional neural network based multi-task learning framework to segment the myocardium and regress its area, simultaneously, and show that segmentation based computation of the myocardial area is significantly better than that regressed directly from the network, while also being more interpretable. Finally, we impose a weak shape constraint via multi-task learning framework in a fully convolutional network and show improved segmentation performance for LV, RV and myocardium across healthy and pathological cases, as well as, in the challenging apical and basal slices in two open-source 4D cardiac cine MRI datasets. We demonstrate the accuracy and robustness of the proposed segmentation methods by comparing the obtained results against the provided gold-standard manual segmentations, as well as with other competing segmentation methods

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