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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
Automatic segmentation of multiple cardiovascular structures from cardiac computed tomography angiography images using deep learning.
OBJECTIVES:To develop, demonstrate and evaluate an automated deep learning method for multiple cardiovascular structure segmentation. BACKGROUND:Segmentation of cardiovascular images is resource-intensive. We design an automated deep learning method for the segmentation of multiple structures from Coronary Computed Tomography Angiography (CCTA) images. METHODS:Images from a multicenter registry of patients that underwent clinically-indicated CCTA were used. The proximal ascending and descending aorta (PAA, DA), superior and inferior vena cavae (SVC, IVC), pulmonary artery (PA), coronary sinus (CS), right ventricular wall (RVW) and left atrial wall (LAW) were annotated as ground truth. The U-net-derived deep learning model was trained, validated and tested in a 70:20:10 split. RESULTS:The dataset comprised 206 patients, with 5.130 billion pixels. Mean age was 59.9 ± 9.4 yrs., and was 42.7% female. An overall median Dice score of 0.820 (0.782, 0.843) was achieved. Median Dice scores for PAA, DA, SVC, IVC, PA, CS, RVW and LAW were 0.969 (0.979, 0.988), 0.953 (0.955, 0.983), 0.937 (0.934, 0.965), 0.903 (0.897, 0.948), 0.775 (0.724, 0.925), 0.720 (0.642, 0.809), 0.685 (0.631, 0.761) and 0.625 (0.596, 0.749) respectively. Apart from the CS, there were no significant differences in performance between sexes or age groups. CONCLUSIONS:An automated deep learning model demonstrated segmentation of multiple cardiovascular structures from CCTA images with reasonable overall accuracy when evaluated on a pixel level
Deep learning applications in coronary anatomy imaging:a systematic review and meta-analysis
Background: The application of deep learning on medical imaging is growing in prevalence in the recent literature. One of the most studied areas is coronary artery disease (CAD). Imaging of coronary artery anatomy is fundamental, which has led to a high number of publications describing a variety of techniques. The aim of this systematic review is to review the evidence behind the accuracy of deep learning applications in coronary anatomy imaging. Methods: The search for the relevant studies, which applied deep learning on coronary anatomy imaging, was performed in a systematic approach on MEDLINE and EMBASE databases, followed by reviewing of abstracts and full texts. The data from the final studies was retrieved using data extraction forms. A meta-analysis was performed on a subgroup of studies, which looked at fractional flow reserve (FFR) prediction. Heterogeneity was tested using tau2, I2 and Q tests. Finally, a risk of bias was performed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS) approach. Results: A total of 81 studies met the inclusion criteria. The most common imaging modality was coronary computed tomography angiography (CCTA) (58%) and the most common deep learning method was convolutional neural network (CNN) (52%). The majority of studies demonstrated good performance metrics. The most common outputs were focused on coronary artery segmentation, clinical outcome prediction, coronary calcium quantification and FFR prediction, and most studies reported area under the curve (AUC) of ≥80%. The pooled diagnostic odds ratio (DOR) derived from 8 studies looking at FFR prediction using CCTA was 12.5 using the Mantel-Haenszel (MH) method. There was no significant heterogeneity amongst studies according to Q test (P=0.2496). Conclusions: Deep learning has been used in many applications on coronary anatomy imaging, most of which are yet to be externally validated and prepared for clinical use. The performance of deep learning, especially CNN models, proved to be powerful and some applications have already translated into medical practice, such as computed tomography (CT)-FFR. These applications have the potential to translate technology into better care of CAD patients.</p
A computationally efficient approach to segmentation of the aorta and coronary arteries using deep learning
Early detection and diagnosis of coronary artery disease could reduce the risk of developing a heart attack. The coronary arteries are optimally visualised using computed tomography coronary angiography (CTCA) imaging. These images are reviewed by specialist radiologists who evaluate the coronary arteries for potential narrowing. A lack of radiologists in the UK is a constraint to timely diagnosis of coronary artery disease, particularly in the acute accident and emergency department setting. The development of automated methods by which coronary artery narrowing can be identified rapidly and accurately are therefore timely. Such complex computer based tools also need to be sufficiently computationally efficient that they can run on servers typically found in hospital settings, where graphical processing units for example are unavailable. We propose a fully automatic two-dimensional Unet model to segment the aorta and coronary arteries on CTCA images. Two models are trained to segment two regions of interest, (1) the aorta and the coronary arteries or (2) the coronary arteries alone. Our method achieves 91.20% and 88.80% dice similarity coefficient accuracy on regions of interest 1 and 2 respectively. Compared with a semi-automatic segmentation method, our model performs better when segmenting the coronary arteries alone. The performance of the proposed method is comparable to existing published two-dimensional or three-dimensional deep learning models. Importantly, the algorithmic and graphical processing unit memory efficiencies are maintained such that the model can be deployed without requiring graphical processing units, and therefore can be used in a hospital setting
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
Coronary Artery Centerline Extraction in Cardiac CT Angiography Using a CNN-Based Orientation Classifier
Coronary artery centerline extraction in cardiac CT angiography (CCTA) images
is a prerequisite for evaluation of stenoses and atherosclerotic plaque. We
propose an algorithm that extracts coronary artery centerlines in CCTA using a
convolutional neural network (CNN).
A 3D dilated CNN is trained to predict the most likely direction and radius
of an artery at any given point in a CCTA image based on a local image patch.
Starting from a single seed point placed manually or automatically anywhere in
a coronary artery, a tracker follows the vessel centerline in two directions
using the predictions of the CNN. Tracking is terminated when no direction can
be identified with high certainty.
The CNN was trained using 32 manually annotated centerlines in a training set
consisting of 8 CCTA images provided in the MICCAI 2008 Coronary Artery
Tracking Challenge (CAT08). Evaluation using 24 test images of the CAT08
challenge showed that extracted centerlines had an average overlap of 93.7%
with 96 manually annotated reference centerlines. Extracted centerline points
were highly accurate, with an average distance of 0.21 mm to reference
centerline points. In a second test set consisting of 50 CCTA scans, 5,448
markers in the coronary arteries were used as seed points to extract single
centerlines. This showed strong correspondence between extracted centerlines
and manually placed markers. In a third test set containing 36 CCTA scans,
fully automatic seeding and centerline extraction led to extraction of on
average 92% of clinically relevant coronary artery segments.
The proposed method is able to accurately and efficiently determine the
direction and radius of coronary arteries. The method can be trained with
limited training data, and once trained allows fast automatic or interactive
extraction of coronary artery trees from CCTA images.Comment: Accepted in Medical Image Analysi
Data Augmentation through Pseudolabels in Automatic Region Based Coronary Artery Segmentation for Disease Diagnosis
Coronary Artery Diseases(CADs) though preventable are one of the leading
causes of death and disability. Diagnosis of these diseases is often difficult
and resource intensive. Segmentation of arteries in angiographic images has
evolved as a tool for assistance, helping clinicians in making accurate
diagnosis. However, due to the limited amount of data and the difficulty in
curating a dataset, the task of segmentation has proven challenging. In this
study, we introduce the idea of using pseudolabels as a data augmentation
technique to improve the performance of the baseline Yolo model. This method
increases the F1 score of the baseline by 9% in the validation dataset and by
3% in the test dataset.Comment: arXiv admin note: text overlap with arXiv:2310.0474
ImageCAS: A Large-Scale Dataset and Benchmark for Coronary Artery Segmentation based on Computed Tomography Angiography Images
Cardiovascular disease (CVD) accounts for about half of non-communicable
diseases. Vessel stenosis in the coronary artery is considered to be the major
risk of CVD. Computed tomography angiography (CTA) is one of the widely used
noninvasive imaging modalities in coronary artery diagnosis due to its superior
image resolution. Clinically, segmentation of coronary arteries is essential
for the diagnosis and quantification of coronary artery disease. Recently, a
variety of works have been proposed to address this problem. However, on one
hand, most works rely on in-house datasets, and only a few works published
their datasets to the public which only contain tens of images. On the other
hand, their source code have not been published, and most follow-up works have
not made comparison with existing works, which makes it difficult to judge the
effectiveness of the methods and hinders the further exploration of this
challenging yet critical problem in the community. In this paper, we propose a
large-scale dataset for coronary artery segmentation on CTA images. In
addition, we have implemented a benchmark in which we have tried our best to
implement several typical existing methods. Furthermore, we propose a strong
baseline method which combines multi-scale patch fusion and two-stage
processing to extract the details of vessels. Comprehensive experiments show
that the proposed method achieves better performance than existing works on the
proposed large-scale dataset. The benchmark and the dataset are published at
https://github.com/XiaoweiXu/ImageCAS-A-Large-Scale-Dataset-and-Benchmark-for-Coronary-Artery-Segmentation-based-on-CT.Comment: 17 pages, 12 figures, 4 table
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