3D Consistent Biventricular Myocardial Segmentation Using Deep Learning for Mesh Generation

We present a novel automated method to segment the myocardium of both left and right ventricles in MRI volumes. The segmentation is consistent in 3D across the slices such that it can be directly used for mesh generation. Two specific neural networks with multi-scale coarse-to-fine prediction structure are proposed to cope with the small training dataset and trained using an original loss function. The former segments a slice in the middle of the volume. Then the latter iteratively propagates the slice segmentations towards the base and the apex, in a spatially consistent way. We perform 5-fold cross-validation on the 15 cases from STACOM to validate the method. For training, we use real cases and their synthetic variants generated by combining motion simulation and image synthesis. Accurate and consistent testing results are obtained

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 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

Automated Multi-sequence Cardiac MRI Segmentation Using Supervised Domain Adaptation

Left ventricle segmentation and morphological assessment are essential for improving diagnosis and our understanding of cardiomyopathy, which in turn is imperative for reducing risk of myocardial infarctions in patients. Convolutional neural network (CNN) based methods for cardiac magnetic resonance (CMR) image segmentation rely on supervision with pixel-level annotations, and may not generalize well to images from a different domain. These methods are typically sensitive to variations in imaging protocols and data acquisition. Since annotating multi-sequence CMR images is tedious and subject to inter- and intra-observer variations, developing methods that can automatically adapt from one domain to the target domain is of great interest. In this paper, we propose an approach for domain adaptation in multi-sequence CMR segmentation task using transfer learning that combines multi-source image information. We first train an encoder-decoder CNN on T2-weighted and balanced-Steady State Free Precession (bSSFP) MR images with pixel-level annotation and fine-tune the same network with a limited number of Late Gadolinium Enhanced-MR (LGE-MR) subjects, to adapt the domain features. The domain-adapted network was trained with just four LGE-MR training samples and obtained an average Dice score of ∼∼85.0% on the test set comprises of 40 LGE-MR subjects. The proposed method significantly outperformed a network without adaptation trained from scratch on the same set of LGE-MR training data

3D Consistent Biventricular Myocardial Segmentation Using Deep Learning for Mesh Generation

We present a novel automated method to segment the my-ocardium of both left and right ventricles in MRI volumes. The segmen-tation is consistent in 3D across the slices such that it can be directly used for mesh generation. Two specific neural networks with multi-scale coarse-to-fine prediction structure are proposed to cope with the small training dataset and trained using an original loss function. The former segments a slice in the middle of the volume. Then the latter iteratively propagates the slice segmentations towards the base and the apex, in a spatially consistent way. We perform 5-fold cross-validation on the 15 cases from STACOM to validate the method. For training, we use real cases and their synthetic variants generated by combining motion simulation and image synthesis. Accurate and consistent testing results are obtained

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

Improving the domain generalization and robustness of neural networks for medical imaging

Deep neural networks are powerful tools to process medical images, with great potential to accelerate clinical workflows and facilitate large-scale studies. However, in order to achieve satisfactory performance at deployment, these networks generally require massive labeled data collected from various domains (e.g., hospitals, scanners), which is rarely available in practice. The main goal of this work is to improve the domain generalization and robustness of neural networks for medical imaging when labeled data is limited. First, we develop multi-task learning methods to exploit auxiliary data to enhance networks. We first present a multi-task U-net that performs image classification and MR atrial segmentation simultaneously. We then present a shape-aware multi-view autoencoder together with a multi-view U-net, which enables extracting useful shape priors from complementary long-axis views and short-axis views in order to assist the left ventricular myocardium segmentation task on the short-axis MR images. Experimental results show that the proposed networks successfully leverage complementary information from auxiliary tasks to improve model generalization on the main segmentation task. Second, we consider utilizing unlabeled data. We first present an adversarial data augmentation method with bias fields to improve semi-supervised learning for general medical image segmentation tasks. We further explore a more challenging setting where the source and the target images are from different data distributions. We demonstrate that an unsupervised image style transfer method can bridge the domain gap, successfully transferring the knowledge learned from labeled balanced Steady-State Free Precession (bSSFP) images to unlabeled Late Gadolinium Enhancement (LGE) images, achieving state-of-the-art performance on a public multi-sequence cardiac MR segmentation challenge. For scenarios with limited training data from a single domain, we first propose a general training and testing pipeline to improve cardiac image segmentation across various unseen domains. We then present a latent space data augmentation method with a cooperative training framework to further enhance model robustness against unseen domains and imaging artifacts.Open Acces

Rapid Segmentation Techniques for Cardiac and Neuroimage Analysis

Recent technological advances in medical imaging have allowed for the quick acquisition of highly resolved data to aid in diagnosis and characterization of diseases or to guide interventions. In order to to be integrated into a clinical work flow, accurate and robust methods of analysis must be developed which manage this increase in data. Recent improvements in in- expensive commercially available graphics hardware and General-Purpose Programming on Graphics Processing Units (GPGPU) have allowed for many large scale data analysis problems to be addressed in meaningful time and will continue to as parallel computing technology improves. In this thesis we propose methods to tackle two clinically relevant image segmentation problems: a user-guided segmentation of myocardial scar from Late-Enhancement Magnetic Resonance Images (LE-MRI) and a multi-atlas segmentation pipeline to automatically segment and partition brain tissue from multi-channel MRI. Both methods are based on recent advances in computer vision, in particular max-flow optimization that aims at solving the segmentation problem in continuous space. This allows for (approximately) globally optimal solvers to be employed in multi-region segmentation problems, without the particular drawbacks of their discrete counterparts, graph cuts, which typically present with metrication artefacts. Max-flow solvers are generally able to produce robust results, but are known for being computationally expensive, especially with large datasets, such as volume images. Additionally, we propose two new deformable registration methods based on Gauss-Newton optimization and smooth the resulting deformation fields via total-variation regularization to guarantee the problem is mathematically well-posed. We compare the performance of these two methods against four highly ranked and well-known deformable registration methods on four publicly available databases and are able to demonstrate a highly accurate performance with low run times. The best performing variant is subsequently used in a multi-atlas segmentation pipeline for the segmentation of brain tissue and facilitates fast run times for this computationally expensive approach. All proposed methods are implemented using GPGPU for a substantial increase in computational performance and so facilitate deployment into clinical work flows. We evaluate all proposed algorithms in terms of run times, accuracy, repeatability and errors arising from user interactions and we demonstrate that these methods are able to outperform established methods. The presented approaches demonstrate high performance in comparison with established methods in terms of accuracy and repeatability while largely reducing run times due to the employment of GPU hardware

Role of deep learning techniques in non-invasive diagnosis of human diseases.

Machine learning, a sub-discipline in the domain of artificial intelligence, concentrates on algorithms able to learn and/or adapt their structure (e.g., parameters) based on a set of observed data. The adaptation is performed by optimizing over a cost function. Machine learning obtained a great attention in the biomedical community because it offers a promise for improving sensitivity and/or specificity of detection and diagnosis of diseases. It also can increase objectivity of the decision making, decrease the time and effort on health care professionals during the process of disease detection and diagnosis. The potential impact of machine learning is greater than ever due to the increase in medical data being acquired, the presence of novel modalities being developed and the complexity of medical data. In all of these scenarios, machine learning can come up with new tools for interpreting the complex datasets that confront clinicians. Much of the excitement for the application of machine learning to biomedical research comes from the development of deep learning which is modeled after computation in the brain. Deep learning can help in attaining insights that would be impossible to obtain through manual analysis. Deep learning algorithms and in particular convolutional neural networks are different from traditional machine learning approaches. Deep learning algorithms are known by their ability to learn complex representations to enhance pattern recognition from raw data. On the other hand, traditional machine learning requires human engineering and domain expertise to design feature extractors and structure data. With increasing demands upon current radiologists, there are growing needs for automating the diagnosis. This is a concern that deep learning is able to address. In this dissertation, we present four different successful applications of deep learning for diseases diagnosis. All the work presented in the dissertation utilizes medical images. In the first application, we introduce a deep-learning based computer-aided diagnostic system for the early detection of acute renal transplant rejection. The system is based on the fusion of both imaging markers (apparent diffusion coefficients derived from diffusion-weighted magnetic resonance imaging) and clinical biomarkers (creatinine clearance and serum plasma creatinine). The fused data is then used as an input to train and test a convolutional neural network based classifier. The proposed system is tested on scans collected from 56 subjects from geographically diverse populations and different scanner types/image collection protocols. The overall accuracy of the proposed system is 92.9% with 93.3% sensitivity and 92.3% specificity in distinguishing non-rejected kidney transplants from rejected ones. In the second application, we propose a novel deep learning approach for the automated segmentation and quantification of the LV from cardiac cine MR images. We aimed at achieving lower errors for the estimated heart parameters compared to the previous studies by proposing a novel deep learning segmentation method. Using fully convolutional neural networks, we proposed novel methods for the extraction of a region of interest that contains the left ventricle, and the segmentation of the left ventricle. Following myocardial segmentation, functional and mass parameters of the left ventricle are estimated. Automated Cardiac Diagnosis Challenge dataset was used to validate our framework, which gave better segmentation, accurate estimation of cardiac parameters, and produced less error compared to other methods applied on the same dataset. Furthermore, we showed that our segmentation approach generalizes well across different datasets by testing its performance on a locally acquired dataset. In the third application, we propose a novel deep learning approach for automated quantification of strain from cardiac cine MR images of mice. For strain analysis, we developed a Laplace-based approach to track the LV wall points by solving the Laplace equation between the LV contours of each two successive image frames over the cardiac cycle. Following tracking, the strain estimation is performed using the Lagrangian-based approach. This new automated system for strain analysis was validated by comparing the outcome of these analysis with the tagged MR images from the same mice. There were no significant differences between the strain data obtained from our algorithm using cine compared to tagged MR imaging. In the fourth application, we demonstrate how a deep learning approach can be utilized for the automated classification of kidney histopathological images. Our approach can classify four classes: the fat, the parenchyma, the clear cell renal cell carcinoma, and the unusual cancer which has been discovered recently, called clear cell papillary renal cell carcinoma. Our framework consists of three convolutional neural networks and the whole-slide kidney images were divided into patches with three different sizes to be inputted to the networks. Our approach can provide patch-wise and pixel-wise classification. Our approach classified the four classes accurately and surpassed other state-of-the-art methods such as ResNet (pixel accuracy: 0.89 Resnet18, 0.93 proposed). In conclusion, the results of our proposed systems demonstrate the potential of deep learning for the efficient, reproducible, fast, and affordable disease diagnosis