3D vasculature segmentation using localized hybrid level-set method

Background: Intensity inhomogeneity occurs in many medical images, especially in vessel images. Overcoming the difficulty due to image inhomogeneity is crucial for the segmentation of vessel image. Methods: This paper proposes a localized hybrid level-set method for the segmentation of 3D vessel image. The proposed method integrates both local region information and boundary information for vessel segmentation, which is essential for the accurate extraction of tiny vessel structures. The local intensity information is firstly embedded into a region-based contour model, and then incorporated into the level-set formulation of the geodesic active contour model. Compared with the preset global threshold based method, the use of automatically calculated local thresholds enables the extraction of the local image information, which is essential for the segmentation of vessel images. Results: Experiments carried out on the segmentation of 3D vessel images demonstrate the strengths of using locally specified dynamic thresholds in our level-set method. Furthermore, both qualitative comparison and quantitative validations have been performed to evaluate the effectiveness of our proposed model. Conclusions: Experimental results and validations demonstrate that our proposed model can achieve more promising segmentation results than the original hybrid method does

Accurate geometry reconstruction of vascular structures using implicit splines

3-D visualization of blood vessel from standard medical datasets (e.g. CT or MRI) play an important role in many clinical situations, including the diagnosis of vessel stenosis, virtual angioscopy, vascular surgery planning and computer aided vascular surgery. However, unlike other human organs, the vasculature system is a very complex network of vessel, which makes it a very challenging task to perform its 3-D visualization. Conventional techniques of medical volume data visualization are in general not well-suited for the above-mentioned tasks. This problem can be solved by reconstructing vascular geometry. Although various methods have been proposed for reconstructing vascular structures, most of these approaches are model-based, and are usually too ideal to correctly represent the actual variation presented by the cross-sections of a vascular structure. In addition, the underlying shape is usually expressed as polygonal meshes or in parametric forms, which is very inconvenient for implementing ramification of branching. As a result, the reconstructed geometries are not suitable for computer aided diagnosis and computer guided minimally invasive vascular surgery. In this research, we develop a set of techniques associated with the geometry reconstruction of vasculatures, including segmentation, modelling, reconstruction, exploration and rendering of vascular structures. The reconstructed geometry can not only help to greatly enhance the visual quality of 3-D vascular structures, but also provide an actual geometric representation of vasculatures, which can provide various benefits. The key findings of this research are as follows: 1. A localized hybrid level-set method of segmentation has been developed to extract the vascular structures from 3-D medical datasets. 2. A skeleton-based implicit modelling technique has been proposed and applied to the reconstruction of vasculatures, which can achieve an accurate geometric reconstruction of the vascular structures as implicit surfaces in an analytical form. 3. An accelerating technique using modern GPU (Graphics Processing Unit) is devised and applied to rendering the implicitly represented vasculatures. 4. The implicitly modelled vasculature is investigated for the application of virtual angioscopy

Méthodes multi-organes rapides avec a priori de forme pour la localisation et la segmentation en imagerie médicale 3D

With the ubiquity of imaging in medical applications (diagnostic, treatment follow-up, surgery planning. . . ), image processing algorithms have become of primary importance. Algorithms help clinicians extract critical information more quickly and more reliably from increasingly large and complex acquisitions. In this context, anatomy localization and segmentation is a crucial component in modern clinical workflows. Due to particularly high requirements in terms of robustness, accuracy and speed, designing such tools remains a challengingtask.In this work, we propose a complete pipeline for the segmentation of multiple organs in medical images. The method is generic, it can be applied to varying numbers of organs, on different imaging modalities. Our approach consists of three components: (i) an automatic localization algorithm, (ii) an automatic segmentation algorithm, (iii) a framework for interactive corrections. We present these components as a coherent processing chain, although each block could easily be used independently of the others. To fulfill clinical requirements, we focus on robust and efficient solutions. Our anatomy localization method is based on a cascade of Random Regression Forests (Cuingnet et al., 2012). One key originality of our work is the use of shape priors for each organ (thanks to probabilistic atlases). Combined with the evaluation of the trained regression forests, they result in shape-consistent confidence maps for each organ instead of simple bounding boxes. Our segmentation method extends the implicit template deformation framework of Mory et al. (2012) to multiple organs. The proposed formulation builds on the versatility of the original approach and introduces new non-overlapping constraintsand contrast-invariant forces. This makes our approach a fully automatic, robust and efficient method for the coherent segmentation of multiple structures. In the case of imperfect segmentation results, it is crucial to enable clinicians to correct them easily. We show that our automatic segmentation framework can be extended with simple user-driven constraints to allow for intuitive interactive corrections. We believe that this final component is key towards the applicability of our pipeline in actual clinical routine.Each of our algorithmic components has been evaluated on large clinical databases. We illustrate their use on CT, MRI and US data and present a user study gathering the feedback of medical imaging experts. The results demonstrate the interest in our method and its potential for clinical use.Avec l’utilisation de plus en plus répandue de l’imagerie dans la pratique médicale (diagnostic, suivi, planification d’intervention, etc.), le développement d’algorithmes d’analyse d’images est devenu primordial. Ces algorithmes permettent aux cliniciens d’analyser et d’interpréter plus facilement et plus rapidement des données de plus en plus complexes. Dans ce contexte, la localisation et la segmentation de structures anatomiques sont devenues des composants critiques dans les processus cliniques modernes. La conception de tels outils pour répondre aux exigences de robustesse, précision et rapidité demeure cependant un réel défi technique.Ce travail propose une méthode complète pour la segmentation de plusieurs organes dans des images médicales. Cette méthode, générique et pouvant être appliquée à un nombre varié de structures et dans différentes modalités d’imagerie, est constituée de trois composants : (i) un algorithme de localisation automatique, (ii) un algorithme de segmentation, (iii) un outil de correction interactive. Ces différentes parties peuvent s’enchaîner aisément pour former un outil complet et cohérent, mais peuvent aussi bien être utilisées indépendemment. L’accent a été mis sur des méthodes robustes et efficaces afin de répondre aux exigences cliniques. Notre méthode de localisation s’appuie sur une cascade de régression par forêts aléatoires (Cuingnet et al., 2012). Elle introduit l’utilisation d’informations a priori de forme, spécifiques à chaque organe (grâce à des atlas probabilistes) pour des résultats plus cohérents avec la réalité anatomique. Notre méthode de segmentation étend la méthode de segmentation par modèle implicite (Mory et al., 2012) à plusieurs modèles. La formulation proposée permet d’obtenir des déformations cohérentes, notamment en introduisant des contraintes de non recouvrement entre les modèles déformés. En s’appuyant sur des forces images polyvalentes, l’approche proposée se montre robuste et performante pour la segmentation de multiples structures. Toute méthode automatique n’est cependant jamais parfaite. Afin que le clinicien garde la main sur le résultat final, nous proposons d’enrichir la formulation précédente avec des contraintes fournies par l’utilisateur. Une optimisation localisée permet d’obtenir un outil facile à utiliser et au comportement intuitif. Ce dernier composant est crucial pour que notre outil soit réellement utilisable en pratique. Chacun de ces trois composants a été évalué sur plusieurs grandes bases de données cliniques (en tomodensitométrie, imagerie par résonance magnétique et ultrasons). Une étude avec des utilisateurs nous a aussi permis de recueillir des retours positifs de plusieurs experts en imagerie médicale. Les différents résultats présentés dans ce manuscrit montrent l’intérêt de notre méthode et son potentiel pour une utilisation clinique

State of the Art of Level Set Methods in Segmentation and Registration of Medical Imaging Modalities

Segmentation of medical images is an important step in various applications such as visualization, quantitative analysis and image-guided surgery. Numerous segmentation methods have been developed in the past two decades for extraction of organ contours on medical images. Low-level segmentation methods, such as pixel-based clustering, region growing, and filter-based edge detection, require additional pre-processing and post-processing as well as considerable amounts of expert intervention or information of the objects of interest. Furthermore the subsequent analysis of segmented objects is hampered by the primitive, pixel or voxel level representations from those region-based segmentation. Deformable models, on the other hand, provide an explicit representation of the boundary and the shape of the object. They combine several desirable features such as inherent connectivity and smoothness, which counteract noise and boundary irregularities, as well as the ability to incorporate knowledge about the object of interest. However, parametric deformable models have two main limitations. First, in situations where the initial model and desired object boundary differ greatly in size and shape, the model must be re-parameterized dynamically to faithfully recover the object boundary. The second limitation is that it has difficulty dealing with topological adaptation such as splitting or merging model parts, a useful property for recovering either multiple objects or objects with unknown topology. This difficulty is caused by the fact that a new parameterization must be constructed whenever topology change occurs, which requires sophisticated schemes. Level set deformable models, also referred to as geometric deformable models, provide an elegant solution to address the primary limitations of parametric deformable models. These methods have drawn a great deal of attention since their introduction in 1988. Advantages of the contour implicit formulation of the deformable model over parametric formulation include: (1) no parameterization of the contour, (2) topological flexibility, (3) good numerical stability, (4) straightforward extension of the 2D formulation to n-D. Recent reviews on the subject include papers from Suri. In this chapter we give a general overview of the level set segmentation methods with emphasize on new frameworks recently introduced in the context of medical imaging problems. We then introduce novel approaches that aim at combining segmentation and registration in a level set formulation. Finally we review a selective set of clinical works with detailed validation of the level set methods for several clinical applications

복부 CT에서 간과 혈관 분할 기법

학위논문(박사)--서울대학교 대학원 :공과대학 컴퓨터공학부,2020. 2. 신영길.복부 전산화 단층 촬영 (CT) 영상에서 정확한 간 및 혈관 분할은 체적 측정, 치료 계획 수립 및 추가적인 증강 현실 기반 수술 가이드와 같은 컴퓨터 진단 보조 시스템을 구축하는데 필수적인 요소이다. 최근 들어 컨볼루셔널 인공 신경망 (CNN) 형태의 딥 러닝이 많이 적용되면서 의료 영상 분할의 성능이 향상되고 있지만, 실제 임상에 적용할 수 있는 높은 일반화 성능을 제공하기는 여전히 어렵다. 또한 물체의 경계는 전통적으로 영상 분할에서 매우 중요한 요소로 이용되었지만, CT 영상에서 간의 불분명한 경계를 추출하기가 어렵기 때문에 현대 CNN에서는 이를 사용하지 않고 있다. 간 혈관 분할 작업의 경우, 복잡한 혈관 영상으로부터 학습 데이터를 만들기 어렵기 때문에 딥 러닝을 적용하기가 어렵다. 또한 얇은 혈관 부분의 영상 밝기 대비가 약하여 원본 영상에서 식별하기가 매우 어렵다. 본 논문에서는 위 언급한 문제들을 해결하기 위해 일반화 성능이 향상된 CNN과 얇은 혈관을 포함하는 복잡한 간 혈관을 정확하게 분할하는 알고리즘을 제안한다. 간 분할 작업에서 우수한 일반화 성능을 갖는 CNN을 구축하기 위해, 내부적으로 간 모양을 추정하는 부분이 포함된 자동 컨텍스트 알고리즘을 제안한다. 또한, CNN을 사용한 학습에 경계선의 개념이 새롭게 제안된다. 모호한 경계부가 포함되어 있어 전체 경계 영역을 CNN에 훈련하는 것은 매우 어렵기 때문에 반복되는 학습 과정에서 인공 신경망이 스스로 예측한 확률에서 부정확하게 추정된 부분적 경계만을 사용하여 인공 신경망을 학습한다. 실험적 결과를 통해 제안된 CNN이 다른 최신 기법들보다 정확도가 우수하다는 것을 보인다. 또한, 제안된 CNN의 일반화 성능을 검증하기 위해 다양한 실험을 수행한다. 간 혈관 분할에서는 간 내부의 관심 영역을 지정하기 위해 앞서 획득한 간 영역을 활용한다. 정확한 간 혈관 분할을 위해 혈관 후보 점들을 추출하여 사용하는 알고리즘을 제안한다. 확실한 후보 점들을 얻기 위해, 삼차원 영상의 차원을 먼저 최대 강도 투영 기법을 통해 이차원으로 낮춘다. 이차원 영상에서는 복잡한 혈관의 구조가 보다 단순화될 수 있다. 이어서, 이차원 영상에서 혈관 분할을 수행하고 혈관 픽셀들은 원래의 삼차원 공간상으로 역 투영된다. 마지막으로, 전체 혈관의 분할을 위해 원본 영상과 혈관 후보 점들을 모두 사용하는 새로운 레벨 셋 기반 알고리즘을 제안한다. 제안된 알고리즘은 복잡한 구조가 단순화되고 얇은 혈관이 더 잘 보이는 이차원 영상에서 얻은 후보 점들을 사용하기 때문에 얇은 혈관 분할에서 높은 정확도를 보인다. 실험적 결과에 의하면 제안된 알고리즘은 잘못된 영역의 추출 없이 다른 레벨 셋 기반 알고리즘들보다 우수한 성능을 보인다. 제안된 알고리즘은 간과 혈관을 분할하는 새로운 방법을 제시한다. 제안된 자동 컨텍스트 구조는 사람이 디자인한 학습 과정이 일반화 성능을 크게 향상할 수 있다는 것을 보인다. 그리고 제안된 경계선 학습 기법으로 CNN을 사용한 영상 분할의 성능을 향상할 수 있음을 내포한다. 간 혈관의 분할은 이차원 최대 강도 투영 기반 이미지로부터 획득된 혈관 후보 점들을 통해 얇은 혈관들이 성공적으로 분할될 수 있음을 보인다. 본 논문에서 제안된 알고리즘은 간의 해부학적 분석과 자동화된 컴퓨터 진단 보조 시스템을 구축하는 데 매우 중요한 기술이다.Accurate liver and its vessel segmentation on abdominal computed tomography (CT) images is one of the most important prerequisites for computer-aided diagnosis (CAD) systems such as volumetric measurement, treatment planning, and further augmented reality-based surgical guide. In recent years, the application of deep learning in the form of convolutional neural network (CNN) has improved the performance of medical image segmentation, but it is difficult to provide high generalization performance for the actual clinical practice. Furthermore, although the contour features are an important factor in the image segmentation problem, they are hard to be employed on CNN due to many unclear boundaries on the image. In case of a liver vessel segmentation, a deep learning approach is impractical because it is difficult to obtain training data from complex vessel images. Furthermore, thin vessels are hard to be identified in the original image due to weak intensity contrasts and noise. In this dissertation, a CNN with high generalization performance and a contour learning scheme is first proposed for liver segmentation. Secondly, a liver vessel segmentation algorithm is presented that accurately segments even thin vessels. To build a CNN with high generalization performance, the auto-context algorithm is employed. The auto-context algorithm goes through two pipelines: the first predicts the overall area of a liver and the second predicts the final liver using the first prediction as a prior. This process improves generalization performance because the network internally estimates shape-prior. In addition to the auto-context, a contour learning method is proposed that uses only sparse contours rather than the entire contour. Sparse contours are obtained and trained by using only the mispredicted part of the network's final prediction. Experimental studies show that the proposed network is superior in accuracy to other modern networks. Multiple N-fold tests are also performed to verify the generalization performance. An algorithm for accurate liver vessel segmentation is also proposed by introducing vessel candidate points. To obtain confident vessel candidates, the 3D image is first reduced to 2D through maximum intensity projection. Subsequently, vessel segmentation is performed from the 2D images and the segmented pixels are back-projected into the original 3D space. Finally, a new level set function is proposed that utilizes both the original image and vessel candidate points. The proposed algorithm can segment thin vessels with high accuracy by mainly using vessel candidate points. The reliability of the points can be higher through robust segmentation in the projected 2D images where complex structures are simplified and thin vessels are more visible. Experimental results show that the proposed algorithm is superior to other active contour models. The proposed algorithms present a new method of segmenting the liver and its vessels. The auto-context algorithm shows that a human-designed curriculum (i.e., shape-prior learning) can improve generalization performance. The proposed contour learning technique can increase the accuracy of a CNN for image segmentation by focusing on its failures, represented by sparse contours. The vessel segmentation shows that minor vessel branches can be successfully segmented through vessel candidate points obtained by reducing the image dimension. The algorithms presented in this dissertation can be employed for later analysis of liver anatomy that requires accurate segmentation techniques.Chapter 1 Introduction 1 1.1 Background and motivation 1 1.2 Problem statement 3 1.3 Main contributions 6 1.4 Contents and organization 9 Chapter 2 Related Works 10 2.1 Overview 10 2.2 Convolutional neural networks 11 2.2.1 Architectures of convolutional neural networks 11 2.2.2 Convolutional neural networks in medical image segmentation 21 2.3 Liver and vessel segmentation 37 2.3.1 Classical methods for liver segmentation 37 2.3.2 Vascular image segmentation 40 2.3.3 Active contour models 46 2.3.4 Vessel topology-based active contour model 54 2.4 Motivation 60 Chapter 3 Liver Segmentation via Auto-Context Neural Network with Self-Supervised Contour Attention 62 3.1 Overview 62 3.2 Single-pass auto-context neural network 65 3.2.1 Skip-attention module 66 3.2.2 V-transition module 69 3.2.3 Liver-prior inference and auto-context 70 3.2.4 Understanding the network 74 3.3 Self-supervising contour attention 75 3.4 Learning the network 81 3.4.1 Overall loss function 81 3.4.2 Data augmentation 81 3.5 Experimental Results 83 3.5.1 Overview 83 3.5.2 Data configurations and target of comparison 84 3.5.3 Evaluation metric 85 3.5.4 Accuracy evaluation 87 3.5.5 Ablation study 93 3.5.6 Performance of generalization 110 3.5.7 Results from ground-truth variations 114 3.6 Discussion 116 Chapter 4 Liver Vessel Segmentation via Active Contour Model with Dense Vessel Candidates 119 4.1 Overview 119 4.2 Dense vessel candidates 124 4.2.1 Maximum intensity slab images 125 4.2.2 Segmentation of 2D vessel candidates and back-projection 130 4.3 Clustering of dense vessel candidates 135 4.3.1 Virtual gradient-assisted regional ACM 136 4.3.2 Localized regional ACM 142 4.4 Experimental results 145 4.4.1 Overview 145 4.4.2 Data configurations and environment 146 4.4.3 2D segmentation 146 4.4.4 ACM comparisons 149 4.4.5 Evaluation of bifurcation points 154 4.4.6 Computational performance 159 4.4.7 Ablation study 160 4.4.8 Parameter study 162 4.5 Application to portal vein analysis 164 4.6 Discussion 168 Chapter 5 Conclusion and Future Works 170 Bibliography 172 초록 197Docto

Statistical Shape Modelling and Segmentation of the Respiratory Airway

The human respiratory airway consists of the upper (nasal cavity, pharynx) and the lower (trachea, bronchi) respiratory tracts. Accurate segmentation of these two airway tracts can lead to better diagnosis and interpretation of airway-specific diseases, and lead to improvement in the localization of abnormal metabolic or pathological sites found within and/or surrounding the respiratory regions. Due to the complexity and the variability displayed in the anatomical structure of the upper respiratory airway along with the challenges in distinguishing the nasal cavity from non-respiratory regions such as the paranasal sinuses, it is difficult for existing algorithms to accurately segment the upper airway without manual intervention. This thesis presents an implicit non-parametric framework for constructing a statistical shape model (SSM) of the upper and lower respiratory tract, capable of distinct shape generation and be adapted for segmentation. An SSM of the nasal cavity was successfully constructed using 50 nasal CT scans. The performance of the SSM was evaluated for compactness, specificity and generality. An averaged distance error of 1.47 mm was measured for the generality assessment. The constructed SSM was further adapted with a modified locally constrained random walk algorithm to segment the nasal cavity. The proposed algorithm was evaluated on 30 CT images and outperformed comparative state-of-the-art and conventional algorithms. For the lower airway, a separate algorithm was proposed to automatically segment the trachea and bronchi, and was designed to tolerate the image characteristics inherent in low-contrast CT images. The algorithm was evaluated on 20 clinical low-contrast CT from PET-CT patient studies and demonstrated better performance (87.1±2.8 DSC and distance error of 0.37±0.08 mm) in segmentation results against comparative state-of-the-art algorithms

A shape base framework to segmentation of tongue contours from MRI data

ISBN: 978-1-4244-4296-6 ISSN: 1520-6149International audienceWe propose a shape-based variational framework to curve evolution for the segmen tation of tongue contours from MRI mid-sagittal images. In particular, we first build a PCA model on tongue contours of different articulations of a reference s peaker, and use it as shape priors. The parameters of the curve representation a re then manipulated to minimize an objective function. The designed energy integ rates both global and local image information. The global term extracts roughly the object in the whole image domain; while the local term improves precision in side a small neighborhood around the contour. Promising results and comparisons with other approaches demonstrate the efficiency of our new model

Fast fully automatic myocardial segmentation in 4D cine cardiac magnetic resonance datasets

Dissertação de mestrado integrado em Engenharia BiomédicaCardiovascular diseases (CVDs) are the leading cause of death in the world, representing 30% of all global deaths. Among others, assessment of the left ventricular (LV) morphology and global function using non-invasive cardiac imaging is an interesting technique for diagnosis and treatment follow-up of patients with CVDs. Nowadays, cardiac magnetic resonance (CMR) imaging is the gold-standard technique for the quantification of LV volumes, mass and ejection fraction, requiring the delineation of endocardial and epicardial contours of the left ventricle from cine MR images. In clinical practice, the physicians perform this segmentation manually, being a tedious, time consuming and unpractical task. Even though several (semi-)automated methods have been presented for LV CMR segmentation, fast, automatic and optimal boundaries assessment is still lacking, usually requiring the physician to manually correct the contours. In the present work, we propose a novel fast fully automatic 3D+time LV segmentation framework for CMR datasets. The proposed framework presents three conceptual blocks: 1) an automatic 2D mid-ventricular initialization and segmentation; 2) an automatic stack initialization followed by a 3D segmentation at the end-diastolic phase; and 3) a tracking procedure to delineate both endo and epicardial contours throughout the cardiac cycle. In each block, specific CMR-targeted algorithms are proposed for the different steps required. Hereto, we propose automatic and feasible initialization procedures. Moreover, we adapt the recent B-spline Explicit Active Surfaces (BEAS) framework to the properties of CMR image segmentation by integrating dedicated energy terms and making use of a cylindrical coordinate system that better fits the topology of CMR data. At last, two tracking methods are presented and compared. The proposed framework has been validated on 45 4D CMR datasets from a publicly available database and on a large database from an ongoing multi-center clinical trial with 318 4D datasets. In the technical validation, the framework showed competitive results against the state-of-the-art methods, presenting leading results in both accuracy and average computational time in the common database used for comparative purposes. Moreover, the results in the large scale clinical validation confirmed the high feasibility and robustness of the proposed framework for accurate LV morphology and global function assessment. In combination with the low computational burden of the method, the present methodology seems promising to be used in daily clinical practice.As doenças cardiovasculares (DCVs) são a principal causa de morte no mundo, representando 30% destas a nível global. Na prática clínica, uma técnica empregue no diagnóstico de pacientes com DCVs é a avaliação da morfologia e da função global do ventrículo esquerdo (VE), através de técnicas de imagiologia não-invasivas. Atualmente, a ressonância magnética cardíaca (RMC) é a modalidade de referência na quantificação dos volumes, massa e fração de ejeção do VE, exigindo a delimitação dos contornos do endocárdio e epicárdio a partir de imagens dinâmicas de RMC. Na prática clínica diária, o método preferencial é a segmentação manual. No entanto, esta é uma tarefa demorada, sujeita a erro humano e pouco prática. Apesar de até à data diversos métodos (semi)-automáticos terem sido apresentados para a segmentação do VE em imagens de RMC, ainda não existe um método capaz de avaliar idealmente os contornos de uma forma automática, rápida e precisa, levando a que geralmente o médico necessite de corrigir manualmente os contornos. No presente trabalho é proposta uma nova framework para a segmentação automática do VE em imagens 3D+tempo de RMC. O algoritmo apresenta três blocos principais: 1) uma inicialização e segmentação automática 2D num corte medial do ventrículo; 2) uma inicialização e segmentação tridimensional no volume correspondente ao final da diástole; e 3) um algoritmo de tracking para obter os contornos ao longo de todo o ciclo cardíaco. Neste sentido, são propostos procedimentos de inicialização automática com elevada robustez. Mais ainda, é proposta uma adaptação da recente framework “B-spline Explicit Active Surfaces” (BEAS) com a integração de uma energia específica para as imagens de RMC e utilizando uma formulação cilíndrica para tirar partido da topologia destas imagens. Por último, são apresentados e comparados dois algoritmos de tracking para a obtenção dos contornos ao longo do tempo. A framework proposta foi validada em 45 datasets de RMC provenientes de uma base de dados disponível ao público, bem como numa extensa base de dados com 318 datasets para uma validação clínica. Na avaliação técnica, a framework proposta obteve resultados competitivos quando comparada com outros métodos do estado da arte, tendo alcançado resultados de precisão e tempo computacional superiores a estes. Na validação clínica em larga escala, a framework provou apresentar elevada viabilidade e robustez na avaliação da morfologia e função global do VE. Em combinação com o baixo custo computacional do algoritmo, a presente metodologia apresenta uma perspetiva promissora para a sua aplicação na prática clínica diária