Automated Segmentation of Left and Right Ventricles in MRI and Classification of the Myocarfium Abnormalities

A fundamental step in diagnosis of cardiovascular diseases, automated left and right ventricle (LV and RV) segmentation in cardiac magnetic resonance images (MRI) is still acknowledged to be a difficult problem. Although algorithms for LV segmentation do exist, they require either extensive training or intensive user inputs. RV segmentation in MRI has yet to be solved and is still acknowledged a completely unsolved problem because its shape is not symmetric and circular, its deformations are complex and varies extensively over the cardiac phases, and it includes papillary muscles. In this thesis, I investigate fast detection of the LV endo- and epi-cardium surfaces (3D) and contours (2D) in cardiac MRI via convex relaxation and distribution matching. A rapid 3D segmentation of the RV in cardiac MRI via distribution matching constraints on segment shape and appearance is also investigated. These algorithms only require a single subject for training and a very simple user input, which amounts to one click. The solution is sought following the optimization of functionals containing probability product kernel constraints on the distributions of intensity and geometric features. The formulations lead to challenging optimization problems, which are not directly amenable to convex-optimization techniques. For each functional, the problem is split into a sequence of sub-problems, each of which can be solved exactly and globally via a convex relaxation and the augmented Lagrangian method. Finally, an information-theoretic based artificial neural network (ANN) is proposed for normal/abnormal LV myocardium motion classification. Using the LV segmentation results, the LV cavity points is estimated via a Kalman filter and a recursive dynamic Bayesian filter. However, due to the similarities between the statistical information of normal and abnormal points, differentiating between distributions of abnormal and normal points is a challenging problem. The problem was investigated with a global measure based on the Shannon\u27s differential entropy (SDE) and further examined with two other information-theoretic criteria, one based on Renyi entropy and the other on Fisher information. Unlike the existing information-theoretic studies, the approach addresses explicitly the overlap between the distributions of normal and abnormal cases, thereby yielding a competitive performance. I further propose an algorithm based on a supervised 3-layer ANN to differentiate between the distributions farther. The ANN is trained and tested by five different information measures of radial distance and velocity for points on endocardial boundary

Constrained manifold learning for the characterization of pathological deviations from normality

International audienceThis paper describes a technique to (1) learn the representation of a pathological motion pattern from a given population, and (2) compare individuals to this population. Our hypothesis is that this pattern can be modeled as a deviation from normal motion by means of non-linear embedding techniques. Each subject is represented by a 2D map of local motion abnormalities, obtained from a statistical atlas of myocardial motion built from a healthy population. The algorithm estimates a manifold from a set of patients with varying degrees of the same disease, and compares individuals to the training population using a mapping to the manifold and a distance to normality along the manifold. The approach extends recent manifold learning techniques by constraining the manifold to pass by a physiologically meaningful origin representing a normal motion pattern. Interpolation techniques using locally adjustable kernel improve the accuracy of the method. The technique is applied in the context of cardiac resynchronization therapy (CRT), focusing on a specific motion pattern of intra-ventricular dyssynchrony called septal flash (SF). We estimate the manifold from 50 CRT candidates with SF and test it on 37 CRT candidates and 21 healthy volunteers. Experiments highlight the relevance of nonlinear techniques to model a pathological pattern from the training set and compare new individuals to this pattern

An improved classification approach for echocardiograms embedding temporal information

Cardiovascular disease is an umbrella term for all diseases of the heart. At present, computer-aided echocardiogram diagnosis is becoming increasingly beneficial. For echocardiography, different cardiac views can be acquired depending on the location and angulations of the ultrasound transducer. Hence, the automatic echocardiogram view classification is the first step for echocardiogram diagnosis, especially for computer-aided system and even for automatic diagnosis in the future. In addition, heart views classification makes it possible to label images especially for large-scale echo videos, provide a facility for database management and collection. This thesis presents a framework for automatic cardiac viewpoints classification of echocardiogram video data. In this research, we aim to overcome the challenges facing this investigation while analyzing, recognizing and classifying echocardiogram videos from 3D (2D spatial and 1D temporal) space. Specifically, we extend 2D KAZE approach into 3D space for feature detection and propose a histogram of acceleration as feature descriptor. Subsequently, feature encoding follows before the application of SVM to classify echo videos. In addition, comparison with the state of the art methodologies also takes place, including 2D SIFT, 3D SIFT, and optical flow technique to extract temporal information sustained in the video images. As a result, the performance of 2D KAZE, 2D KAZE with Optical Flow, 3D KAZE, Optical Flow, 2D SIFT and 3D SIFT delivers accuracy rate of 89.4%, 84.3%, 87.9%, 79.4%, 83.8% and 73.8% respectively for the eight view classes of echo videos

Medical image segmentation and analysis using statistical shape modelling and inter-landmark relationships

The study of anatomical morphology is of great importance to medical imaging, with applications varying from clinical diagnosis to computer-aided surgery. To this end, automated tools are required for accurate extraction of the anatomical boundaries from the image data and detailed interpretation of morphological information. This thesis introduces a novel approach to shape-based analysis of medical images based on Inter- Landmark Descriptors (ILDs). Unlike point coordinates that describe absolute position, these shape variables represent relative configuration of landmarks in the shape. The proposed work is motivated by the inherent difficulties of methods based on landmark coordinates in challenging applications. Through explicit invariance to pose parameters and decomposition of the global shape constraints, this work permits anatomical shape analysis that is resistant to image inhomogeneities and geometrical inconsistencies. Several algorithms are presented to tackle specific image segmentation and analysis problems, including automatic initialisation, optimal feature point search, outlier handling and dynamic abnormality localisation. Detailed validation results are provided based on various cardiovascular magnetic resonance datasets, showing increased robustness and accuracy.Open acces

An image segmentation and registration approach to cardiac function analysis using MRI

Cardiovascular diseases (CVDs) are one of the major causes of death in the world. In recent years, significant progress has been made in the care and treatment of patients with such diseases. A crucial factor for this progress has been the development of magnetic resonance (MR) imaging which makes it possible to diagnose and assess the cardiovascular function of the patient. The ability to obtain high-resolution, cine volume images easily and safely has made it the preferred method for diagnosis of CVDs. MRI is also unique in its ability to introduce noninvasive markers directly into the tissue being imaged(MR tagging) during the image acquisition process. With the development of advanced MR imaging acquisition technologies, 3D MR imaging is more and more clinically feasible. This recent development has allowed new potentially 3D image analysis technologies to be deployed. However, quantitative analysis of cardiovascular system from the images remains a challenging topic. The work presented in this thesis describes the development of segmentation and motion analysis techniques for the study of the cardiac anatomy and function in cardiac magnetic resonance (CMR) images. The first main contribution of the thesis is the development of a fully automatic cardiac segmentation technique that integrates and combines a series of state-of-the-art techniques. The proposed segmentation technique is capable of generating an accurate 3D segmentation from multiple image sequences. The proposed segmentation technique is robust even in the presence of pathological changes, large anatomical shape variations and locally varying contrast in the images. Another main contribution of this thesis is the development of motion tracking techniques that can integrate motion information from different sources. For example, the radial motion of the myocardium can be tracked easily in untagged MR imaging since the epi- and endocardial surfaces are clearly visible. On the other hand, tagged MR imaging allows easy tracking of both longitudinal and circumferential motion. We propose a novel technique based on non-rigid image registration for the myocardial motion estimation using both untagged and 3D tagged MR images. The novel aspect of our technique is its simultaneous use of complementary information from both untagged and 3D tagged MR imaging. The similarity measure is spatially weighted to maximise the utility of information from both images. The thesis also proposes a sparse representation for free-form deformations (FFDs) using the principles of compressed sensing. The sparse free-form deformation (SFFD) model can capture fine local details such as motion discontinuities without sacrificing robustness. We demonstrate the capabilities of the proposed framework to accurately estimate smooth as well as discontinuous deformations in 2D and 3D CMR image sequences. Compared to the standard FFD approach, a significant increase in registration accuracy can be observed in datasets with discontinuous motion patterns. Both the segmentation and motion tracking techniques presented in this thesis have been applied to clinical studies. We focus on two important clinical applications that can be addressed by the techniques proposed in this thesis. The first clinical application aims at measuring longitudinal changes in cardiac morphology and function during the cardiac remodelling process. The second clinical application aims at selecting patients that positively respond to cardiac resynchronization therapy (CRT). The final chapter of this thesis summarises the main conclusions that can be drawn from the work presented here and also discusses possible avenues for future research

Automatic Assessment of Cardiac Left Ventricular Function Via Magnetic Resonance Images

Automating global and segmental (regional) assessments of cardiac Left Ventricle (LV) function in Magnetic Resonance Images (MRI) has recently sparked an impressive research effort, which has resulted a number of techniques delivering promising performances. However, despite such an effort, the problem is still acknowledged to be challenging, with substantial room for improvements in regard to accuracy. Furthermore, most of the existing techniques are labour intensive, requiring delineations of the endo- and/or epi-cardial boundaries in all frames of a cardiac sequence. On the one hand, global assessments of LV function focus on estimation of the Ejection Fraction (EF), which quantifies how much blood the heart is pumping within each beat. On the other hand, regional assessments focus on comprehensive analysis of the wall motions within each of the standardized segments of the myocardium, the muscle which contracts and sends the blood out of the LV. In clinical practice, the EF is often estimated via manual segmentations of several images in a cardiac sequence. This is prohibitively time consuming, or via automatic segmentations, which is a challenging and computationally expensive task that may result in high estimation errors. Additionally, the diagnosis of the segmental dysfunction is based on visual LV assessments, which are subject to high inter-observer variability. In this thesis, we propose accurate methods to estimate both global and regional LV function with minimal user inputs in real-time from statistics estimated in MRI. From a simple user input, we build image statistics for all the images in a subject dataset. We demonstrate that these statistics are correlated with regional as well as global LV function. Different machine learning techniques have been employed to find these correlations. The regional dysfunction is investigated in terms of a binary/multi-classification problem. A comprehensive evaluation over 20 subjects demonstrated that the estimated EFs correlated very well with those obtained from independent manual segmentations. Furthermore, comparisons with estimating EF with recent segmentation algorithms show that the proposed method yielded a very competitive performance. For regional binary classification, we report a comprehensive experimental evaluation of the proposed algorithm over 928 cardiac segments obtained from 58 subjects. Compared against ground-truth evaluations by experienced radiologists, the proposed algorithm performed competitively, with an overall classification accuracy of 86.09% and a kappa measure of 0.73. We also report a comprehensive experimental evaluation of the proposed multi-classification algorithm over the same dataset. Compared against ground-truth labels assessed by experienced radiologists, the proposed algorithm yielded an overall 4-class accuracy of 74.14%