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

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

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

Spatio-temporal Multi-task Learning for Cardiac MRI Left Ventricle Quantification

Quantitative assessment of cardiac left ventricle (LV) morphology is essential to assess cardiac function and improve the diagnosis of different cardiovascular diseases. In current clinical practice, LV quantification depends on the measurement of myocardial shape indices, which is usually achieved by manual delineation. However, this process is time-consuming and subject to inter and intra-observer variability. In this paper, we propose a Spatio-temporal multi-task learning approach to obtain a complete set of measurements quantifying cardiac LV morphology, regional-wall thickness (RWT), and additionally detecting the cardiac phase cycle (systole and diastole) for a given 3D Cine-magnetic resonance (MR) image sequence. We first segment cardiac LVs using an encoder-decoder network and then introduce a multitask framework to regress 11 LV indices and classify the cardiac phase, as parallel tasks during model optimization. The proposed deep learning model is based on the 3D Spatio-temporal convolutions, which extract spatial and temporal features from MR images. We demonstrate the efficacy of the proposed method using cine-MR sequences of 145 subjects and comparing the performance with other state-of-the-art quantification methods. The proposed method achieved high prediction accuracy, with an average mean absolute error (MAE) of 129 mm2 , 1.23 mm , 1.76 mm , Pearson correlation coefficient (PCC) of 96.4%, 87.2%, and 97.5% for LV and myocardium (Myo) cavity regions, 6 RWTs, 3 LV dimensions, and an error rate of 9.0% for phase classification. The experimental results highlight the robustness of the proposed method, despite varying degrees of cardiac morphology, image appearance, and low contrast in the cardiac MR sequences

Large-scale inference of liver fat with neural networks on UK Biobank body MRI

The UK Biobank Imaging Study has acquired medical scans of more than 40,000 volunteer participants. The resulting wealth of anatomical information has been made available for research, together with extensive metadata including measurements of liver fat. These values play an important role in metabolic disease, but are only available for a minority of imaged subjects as their collection requires the careful work of image analysts on dedicated liver MRI. Another UK Biobank protocol is neck-to-knee body MRI for analysis of body composition. The resulting volumes can also quantify fat fractions, even though they were reconstructed with a two- instead of a three-point Dixon technique. In this work, a novel framework for automated inference of liver fat from UK Biobank neck-to-knee body MRI is proposed. A ResNet50 was trained for regression on two-dimensional slices from these scans and the reference values as target, without any need for ground truth segmentations. Once trained, it performs fast, objective, and fully automated predictions that require no manual intervention. On the given data, it closely emulates the reference method, reaching a level of agreement comparable to different gold standard techniques. The network learned to rectify non-linearities in the fat fraction values and identified several outliers in the reference. It outperformed a multi-atlas segmentation baseline and inferred new estimates for all imaged subjects lacking reference values, expanding the total number of liver fat measurements by factor six

Accurate automated Cobb angles estimation using multi-view extrapolation net

Abstract(#br)Accurate automated quantitative Cobb angle estimation that quantitatively evaluates scoliosis plays an important role in scoliosis diagnosis and treatment. It solves the problem of the traditional manual method, which is the current clinical standard for scoliosis assessment, but time-consuming and unreliable. However, it is very challenging to achieve highly accurate automated Cobb angle estimation because it is difficult to utilize the information of Anterior-posterior (AP) and Lateral (LAT) view X-rays efficiently. We therefore propose a Multi-View Extrapolation Net (MVE-Net) that provides accurate automated scoliosis estimation in multi-view (both AP and LAT) X-rays. The MVE-Net consists of three parts: Joint-view net learning AP and LAT angles jointly based on landmarks learned from joint representation; Independent-view net learning AP and LAT angles independently based on landmarks learned from unique independent feature of AP or LAT angles; Inter-error correction net learning a combination function adaptively to offset the first two nets’ errors for accurate angle estimation. Experimental results on 526 X-rays show 7.81 and 6.26 Circular Mean Absolute Error in AP and LAT angle estimation, which shows the MVE-Net provides an accurate Cobb angle estimation in multi-view X-rays. Our method therefore provides effective framework for automated, accurate, and reliable scoliosis estimation

Accurate automated Cobb angles estimation using multi-view extrapolation net.

Accurate automated quantitative Cobb angle estimation that quantitatively evaluates scoliosis plays an important role in scoliosis diagnosis and treatment. It solves the problem of the traditional manual method, which is the current clinical standard for scoliosis assessment, but time-consuming and unreliable. However, it is very challenging to achieve highly accurate automated Cobb angle estimation because it is difficult to utilize the information of Anterior-posterior (AP) and Lateral (LAT) view X-rays efficiently. We therefore propose a Multi-View Extrapolation Net (MVE-Net) that provides accurate automated scoliosis estimation in multi-view (both AP and LAT) X-rays. The MVE-Net consists of three parts: Joint-view net learning AP and LAT angles jointly based on landmarks learned from joint representation; Independent-view net learning AP and LAT angles independently based on landmarks learned from unique independent feature of AP or LAT angles; Inter-error correction net learning a combination function adaptively to offset the first two nets’ errors for accurate angle estimation. Experimental results on 526 X-rays show 7.81 and 6.26 Circular Mean Absolute Error in AP and LAT angle estimation, which shows the MVE-Net provides an accurate Cobb angle estimation in multi-view X-rays. Our method therefore provides effective framework for automated, accurate, and reliable scoliosis estimation

Multi-modality cardiac image computing: a survey

Multi-modality cardiac imaging plays a key role in the management of patients with cardiovascular diseases. It allows a combination of complementary anatomical, morphological and functional information, increases diagnosis accuracy, and improves the efficacy of cardiovascular interventions and clinical outcomes. Fully-automated processing and quantitative analysis of multi-modality cardiac images could have a direct impact on clinical research and evidence-based patient management. However, these require overcoming significant challenges including inter-modality misalignment and finding optimal methods to integrate information from different modalities. This paper aims to provide a comprehensive review of multi-modality imaging in cardiology, the computing methods, the validation strategies, the related clinical workflows and future perspectives. For the computing methodologies, we have a favored focus on the three tasks, i.e., registration, fusion and segmentation, which generally involve multi-modality imaging data, either combining information from different modalities or transferring information across modalities. The review highlights that multi-modality cardiac imaging data has the potential of wide applicability in the clinic, such as trans-aortic valve implantation guidance, myocardial viability assessment, and catheter ablation therapy and its patient selection. Nevertheless, many challenges remain unsolved, such as missing modality, modality selection, combination of imaging and non-imaging data, and uniform analysis and representation of different modalities. There is also work to do in defining how the well-developed techniques fit in clinical workflows and how much additional and relevant information they introduce. These problems are likely to continue to be an active field of research and the questions to be answered in the future