Similarity enhancement for automatic segmentation of cardiac structures in computed tomography volumes.

International audienceThe aim of this research is proposing a 3-D similarity enhancement technique useful for improving the segmentation of cardiac structures in Multi-Slice Computerized Tomography (MSCT) volumes. The similarity enhancement is obtained by subtracting the intensity of the current voxel and the gray levels of their adjacent voxels in two volumes resulting after preprocessing. Such volumes are: a. - a volume obtained after applying a Gaussian distribution and a morphological top-hat filter to the input and b. - a smoothed volume generated by processing the input with an average filter. Then, the similarity volume is used as input to a region growing algorithm. This algorithm is applied to extract the shape of cardiac structures, such as left and right ventricles, in MSCT volumes. Qualitative and quantitative results show the good performance of the proposed approach for discrimination of cardiac cavities

Deep Learning from Dual-Energy Information for Whole-Heart Segmentation in Dual-Energy and Single-Energy Non-Contrast-Enhanced Cardiac CT

Deep learning-based whole-heart segmentation in coronary CT angiography (CCTA) allows the extraction of quantitative imaging measures for cardiovascular risk prediction. Automatic extraction of these measures in patients undergoing only non-contrast-enhanced CT (NCCT) scanning would be valuable. In this work, we leverage information provided by a dual-layer detector CT scanner to obtain a reference standard in virtual non-contrast (VNC) CT images mimicking NCCT images, and train a 3D convolutional neural network (CNN) for the segmentation of VNC as well as NCCT images. Contrast-enhanced acquisitions on a dual-layer detector CT scanner were reconstructed into a CCTA and a perfectly aligned VNC image. In each CCTA image, manual reference segmentations of the left ventricular (LV) myocardium, LV cavity, right ventricle, left atrium, right atrium, ascending aorta, and pulmonary artery trunk were obtained and propagated to the corresponding VNC image. These VNC images and reference segmentations were used to train 3D CNNs for automatic segmentation in either VNC images or NCCT images. Automatic segmentations in VNC images showed good agreement with reference segmentations, with an average Dice similarity coefficient of 0.897 \pm 0.034 and an average symmetric surface distance of 1.42 \pm 0.45 mm. Volume differences [95% confidence interval] between automatic NCCT and reference CCTA segmentations were -19 [-67; 30] mL for LV myocardium, -25 [-78; 29] mL for LV cavity, -29 [-73; 14] mL for right ventricle, -20 [-62; 21] mL for left atrium, and -19 [-73; 34] mL for right atrium, respectively. In 214 (74%) NCCT images from an independent multi-vendor multi-center set, two observers agreed that the automatic segmentation was mostly accurate or better. This method might enable quantification of additional cardiac measures from NCCT images for improved cardiovascular risk prediction

A Survey on Deep Learning in Medical Image Analysis

Deep learning algorithms, in particular convolutional networks, have rapidly become a methodology of choice for analyzing medical images. This paper reviews the major deep learning concepts pertinent to medical image analysis and summarizes over 300 contributions to the field, most of which appeared in the last year. We survey the use of deep learning for image classification, object detection, segmentation, registration, and other tasks and provide concise overviews of studies per application area. Open challenges and directions for future research are discussed.Comment: Revised survey includes expanded discussion section and reworked introductory section on common deep architectures. Added missed papers from before Feb 1st 201

Vessel tractography using an intensity based tensor model with branch detection

In this paper, we present a tubular structure seg- mentation method that utilizes a second order tensor constructed from directional intensity measurements, which is inspired from diffusion tensor image (DTI) modeling. The constructed anisotropic tensor which is fit inside a vessel drives the segmen- tation analogously to a tractography approach in DTI. Our model is initialized at a single seed point and is capable of capturing whole vessel trees by an automatic branch detection algorithm developed in the same framework. The centerline of the vessel as well as its thickness is extracted. Performance results within the Rotterdam Coronary Artery Algorithm Evaluation framework are provided for comparison with existing techniques. 96.4% average overlap with ground truth delineated by experts is obtained in addition to other measures reported in the paper. Moreover, we demonstrate further quantitative results over synthetic vascular datasets, and we provide quantitative experiments for branch detection on patient Computed Tomography Angiography (CTA) volumes, as well as qualitative evaluations on the same CTA datasets, from visual scores by a cardiologist expert

Faster 3D cardiac CT segmentation with Vision Transformers

Accurate segmentation of the heart is essential for personalized blood flow simulations and surgical intervention planning. A recent advancement in image recognition is the Vision Transformer (ViT), which expands the field of view to encompass a greater portion of the global image context. We adapted ViT for three-dimensional volume inputs. Cardiac computed tomography (CT) volumes from 39 patients, featuring up to 20 timepoints representing the complete cardiac cycle, were utilized. Our network incorporates a modified ResNet50 block as well as a ViT block and employs cascade upsampling with skip connections. Despite its increased model complexity, our hybrid Transformer-Residual U-Net framework, termed TRUNet, converges in significantly less time than residual U-Net while providing comparable or superior segmentations of the left ventricle, left atrium, left atrial appendage, ascending aorta, and pulmonary veins. TRUNet offers more precise vessel boundary segmentation and better captures the heart's overall anatomical structure compared to residual U-Net, as confirmed by the absence of extraneous clusters of missegmented voxels. In terms of both performance and training speed, TRUNet exceeded U-Net, a commonly used segmentation architecture, making it a promising tool for 3D semantic segmentation tasks in medical imaging. The code for TRUNet is available at github.com/ljollans/TRUNet

Coronary Artery Segmentation and Motion Modelling

Conventional coronary artery bypass surgery requires invasive sternotomy and the use of a cardiopulmonary bypass, which leads to long recovery period and has high infectious potential. Totally endoscopic coronary artery bypass (TECAB) surgery based on image guided robotic surgical approaches have been developed to allow the clinicians to conduct the bypass surgery off-pump with only three pin holes incisions in the chest cavity, through which two robotic arms and one stereo endoscopic camera are inserted. However, the restricted field of view of the stereo endoscopic images leads to possible vessel misidentification and coronary artery mis-localization. This results in 20-30% conversion rates from TECAB surgery to the conventional approach. We have constructed patient-specific 3D + time coronary artery and left ventricle motion models from preoperative 4D Computed Tomography Angiography (CTA) scans. Through temporally and spatially aligning this model with the intraoperative endoscopic views of the patient's beating heart, this work assists the surgeon to identify and locate the correct coronaries during the TECAB precedures. Thus this work has the prospect of reducing the conversion rate from TECAB to conventional coronary bypass procedures. This thesis mainly focus on designing segmentation and motion tracking methods of the coronary arteries in order to build pre-operative patient-specific motion models. Various vessel centreline extraction and lumen segmentation algorithms are presented, including intensity based approaches, geometric model matching method and morphology-based method. A probabilistic atlas of the coronary arteries is formed from a group of subjects to facilitate the vascular segmentation and registration procedures. Non-rigid registration framework based on a free-form deformation model and multi-level multi-channel large deformation diffeomorphic metric mapping are proposed to track the coronary motion. The methods are applied to 4D CTA images acquired from various groups of patients and quantitatively evaluated