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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
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
Left-ventricle myocardium segmentation using a coupled level-set with a priori knowledge
This paper presents a coupled level-set segmentation of the myocardium of the left ventricle of the heart using a priori information. From a fast marching initialisation, two fronts representing the endocardium and epicardium boundaries of the left ventricle are evolved as the zero level-set of a higher dimension function. We introduce a novel and robust stopping term using both gradient and region-based information. The segmentation is supervised both with a coupling function and using a probabilistic model built from training instances. The robustness of the segmentation scheme is evaluated by performing a segmentation on four unseen data-sets containing high variation and the performance of the segmentation is quantitatively assessed
Comparison of different segmentation approaches without using gold standard. Application to the estimation of the left ventricle ejection fraction from cardiac cine MRI sequences.
International audienceA statistical method is proposed to compare several estimates of a relevant clinical parameter when no gold standard is available. The method is illustrated by considering the left ventricle ejection fraction derived from cardiac magnetic resonance images and computed using seven approaches with different degrees of automation. The proposed method did not use any a priori regarding with the reliability of each method and its degree of automation. The results showed that the most accurate estimates of the ejection fraction were obtained using manual segmentations, followed by the semiautomatic methods, while the methods with the least user input yielded the least accurate ejection fraction estimates. These results were consistent with the expected performance of the estimation methods, suggesting that the proposed statistical approach might be helpful to assess the performance of estimation methods on clinical data for which no gold standard is available
Automated Diagnosis of Cardiovascular Diseases from Cardiac Magnetic Resonance Imaging Using Deep Learning Models: A Review
In recent years, cardiovascular diseases (CVDs) have become one of the
leading causes of mortality globally. CVDs appear with minor symptoms and
progressively get worse. The majority of people experience symptoms such as
exhaustion, shortness of breath, ankle swelling, fluid retention, and other
symptoms when starting CVD. Coronary artery disease (CAD), arrhythmia,
cardiomyopathy, congenital heart defect (CHD), mitral regurgitation, and angina
are the most common CVDs. Clinical methods such as blood tests,
electrocardiography (ECG) signals, and medical imaging are the most effective
methods used for the detection of CVDs. Among the diagnostic methods, cardiac
magnetic resonance imaging (CMR) is increasingly used to diagnose, monitor the
disease, plan treatment and predict CVDs. Coupled with all the advantages of
CMR data, CVDs diagnosis is challenging for physicians due to many slices of
data, low contrast, etc. To address these issues, deep learning (DL) techniques
have been employed to the diagnosis of CVDs using CMR data, and much research
is currently being conducted in this field. This review provides an overview of
the studies performed in CVDs detection using CMR images and DL techniques. The
introduction section examined CVDs types, diagnostic methods, and the most
important medical imaging techniques. In the following, investigations to
detect CVDs using CMR images and the most significant DL methods are presented.
Another section discussed the challenges in diagnosing CVDs from CMR data.
Next, the discussion section discusses the results of this review, and future
work in CVDs diagnosis from CMR images and DL techniques are outlined. The most
important findings of this study are presented in the conclusion section
Towards automating cine DENSE MRI image analysis : segmentation, tissue tracking and strain computation
Includes bibliographical references (p. 192-206).Over the past two decades, magnetic resonance imaging (MRI) has developed into a powerful imaging tool for the heart. Imaging cardiac morphology is now commonplace in clinical practice, and a plethora of quantitative techniques have also arisen on the research front. Myocardial tagging is an established quantitative cardiac MRI method that involves magnetically tagging the heart with a set of saturated bands, and monitoring the deformation of these bands as the heart contracts
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