8 research outputs found
Myocardial Infarction Quantification From Late Gadolinium Enhancement MRI Using Top-hat Transforms and Neural Networks
Significance: Late gadolinium enhanced magnetic resonance imaging (LGE-MRI)
is the gold standard technique for myocardial viability assessment. Although
the technique accurately reflects the damaged tissue, there is no clinical
standard for quantifying myocardial infarction (MI), demanding most algorithms
to be expert dependent. Objectives and Methods: In this work a new automatic
method for MI quantification from LGE-MRI is proposed. Our novel segmentation
approach is devised for accurately detecting not only hyper-enhanced lesions,
but also microvascular-obstructed areas. Moreover, it includes a myocardial
disease detection step which extends the algorithm for working under healthy
scans. The method is based on a cascade approach where firstly, diseased slices
are identified by a convolutional neural network (CNN). Secondly, by means of
morphological operations a fast coarse scar segmentation is obtained. Thirdly,
the segmentation is refined by a boundary-voxel reclassification strategy using
an ensemble of CNNs. For its validation, reproducibility and further comparison
against other methods, we tested the method on a big multi-field expert
annotated LGE-MRI database including healthy and diseased cases. Results and
Conclusion: In an exhaustive comparison against nine reference algorithms, the
proposal achieved state-of-the-art segmentation performances and showed to be
the only method agreeing in volumetric scar quantification with the expert
delineations. Moreover, the method was able to reproduce the intra- and
inter-observer variability ranges. It is concluded that the method could
suitably be transferred to clinical scenarios.Comment: Submitted to IEE
Evaluation of state-of-the-art segmentation algorithms for left ventricle infarct from late Gadolinium enhancement MR images
Studies have demonstrated the feasibility of late Gadolinium enhancement (LGE) cardiovascular magnetic
resonance (CMR) imaging for guiding the management of patients with sequelae to myocardial infarction,
such as ventricular tachycardia and heart failure. Clinical implementation of these developments necessitates
a reproducible and reliable segmentation of the infarcted regions. It is challenging to compare
new algorithms for infarct segmentation in the left ventricle (LV) with existing algorithms. Benchmarking
datasets with evaluation strategies are much needed to facilitate comparison. This manuscript presents
a benchmarking evaluation framework for future algorithms that segment infarct from LGE CMR of the
LV. The image database consists of 30 LGE CMR images of both humans and pigs that were acquired
from two separate imaging centres. A consensus ground truth was obtained for all data using maximum
likelihood estimation.
Six widely-used fixed-thresholding methods and five recently developed algorithms are tested on the
benchmarking framework. Results demonstrate that the algorithms have better overlap with the consensus
ground truth than most of the n-SD fixed-thresholding methods, with the exception of the FullWidth-at-Half-Maximum
(FWHM) fixed-thresholding method. Some of the pitfalls of fixed thresholding
methods are demonstrated in this work. The benchmarking evaluation framework, which is a contribution
of this work, can be used to test and benchmark future algorithms that detect and quantify infarct
in LGE CMR images of the LV. The datasets, ground truth and evaluation code have been made publicly
available through the website: https://www.cardiacatlas.org/web/guest/challenges
Recommended from our members
Evaluation of current algorithms for segmentation of scar tissue from late Gadolinium enhancement cardiovascular magnetic resonance of the left atrium: an open-access grand challenge
Background: Late Gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging can be used to visualise regions of fibrosis and scarring in the left atrium (LA) myocardium. This can be important for treatment stratification of patients with atrial fibrillation (AF) and for assessment of treatment after radio frequency catheter ablation (RFCA). In this paper we present a standardised evaluation benchmarking framework for algorithms segmenting fibrosis and scar from LGE CMR images. The algorithms reported are the response to an open challenge that was put to the medical imaging community through an ISBI (IEEE International Symposium on Biomedical Imaging) workshop. Methods: The image database consisted of 60 multicenter, multivendor LGE CMR image datasets from patients with AF, with 30 images taken before and 30 after RFCA for the treatment of AF. A reference standard for scar and fibrosis was established by merging manual segmentations from three observers. Furthermore, scar was also quantified using 2, 3 and 4 standard deviations (SD) and full-width-at-half-maximum (FWHM) methods. Seven institutions responded to the challenge: Imperial College (IC), Mevis Fraunhofer (MV), Sunnybrook Health Sciences (SY), Harvard/Boston University (HB), Yale School of Medicine (YL), King’s College London (KCL) and Utah CARMA (UTA, UTB). There were 8 different algorithms evaluated in this study. Results: Some algorithms were able to perform significantly better than SD and FWHM methods in both pre- and post-ablation imaging. Segmentation in pre-ablation images was challenging and good correlation with the reference standard was found in post-ablation images. Overlap scores (out of 100) with the reference standard were as follows: Pre: IC = 37, MV = 22, SY = 17, YL = 48, KCL = 30, UTA = 42, UTB = 45; Post: IC = 76, MV = 85, SY = 73, HB = 76, YL = 84, KCL = 78, UTA = 78, UTB = 72. Conclusions: The study concludes that currently no algorithm is deemed clearly better than others. There is scope for further algorithmic developments in LA fibrosis and scar quantification from LGE CMR images. Benchmarking of future scar segmentation algorithms is thus important. The proposed benchmarking framework is made available as open-source and new participants can evaluate their algorithms via a web-based interface
Design and clinical validation of novel imaging strategies for analysis of arrhythmogenic substrate
_CURRENT CHALLENGES IN ELECTROPHYSIOLOGY_
Technical advances in cardiovascular electrophysiology have resulted in an increasing number of catheter ablation procedures reaching 200 000 in Europe for the year 2013. These advanced interventions are often complex and time consuming and may cause significant radiation exposure. Furthermore, a substantial number of ablation
procedures remain associated with poor (initial) outcomes and frequently require ≥1 redo procedures. Innovations in modalities for substrate imaging could facilitate our understanding of the arrhythmogenic substrate, improve the design of patient-specific ablation strategies and improve the results of ablation procedures.
_NOVEL SUBSTRATE IMAGING MODALITIES_
__Cardiac magnetic resonance__
Cardiac magnetic resonance imaging (CMR) can be considered the most comprehensive and suitable modality for the complete electrophysiology and catheter ablation workup (including patient selection, procedural guidance, and [procedural] follow-up). Utilizing inversion recovery CMR, fibrotic myocardium can be visualized and quantified 10–15 min after intravenous administration of Gadolinium contrast. This imaging
technique is known as late Gadolinium enhancement (LGE) imaging. Experimental models have shown excellent agreement between size and shape in LGE CMR and areas of myocardial infarction by histopathology. Recent studies have also demonstrated how scar size, shape and location from pre-procedural LGE can be useful in guiding ventricular tachycardia’s (VT) ablation or atrial fibrillation (AF) ablation. These procedures are often time-consuming due to the preceding electrophysiological mapping study required to identify slow conduction zones involved in re-entry circuits. Post-processed LGE images provide scar maps, which could be integrated with electroanatomic mapping systems to facilitate these procedures.
__Inverse potential mapping__
Through the years, various noninvasive electrocardiographic imaging techniques have emerged that estimate epicardial potentials or myocardial activation times from potentials recorded on the thorax. Utilizing an inverse procedure, the potentials on the heart surface or activation times of the myocardium are estimated with the recorded
body surface potentials as source data. Although this procedure only estimates the time course of unipolar epicardial electrograms, several
studies have demonstrated that the epicardial potentials and electrograms provide substantial information about intramyocardial activity and have great potential to facilitate risk-stratification and generate personalized ablation strategies.
__Objectives of this thesis__
1. To evaluate the utility of cardiac magnetic resonance derived geometrical and tissue characteristic information for patient stratification and guidance of AF ablation.
2. To design and evaluate the performance of a finite element model based inverse potential mapping in predicting the arrhythmogenic focus in idiopathic ventricular tachycardia using invasive electro-anatomical activation mapping as a reference standard