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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
Deep Learning in Cardiology
The medical field is creating large amount of data that physicians are unable
to decipher and use efficiently. Moreover, rule-based expert systems are
inefficient in solving complicated medical tasks or for creating insights using
big data. Deep learning has emerged as a more accurate and effective technology
in a wide range of medical problems such as diagnosis, prediction and
intervention. Deep learning is a representation learning method that consists
of layers that transform the data non-linearly, thus, revealing hierarchical
relationships and structures. In this review we survey deep learning
application papers that use structured data, signal and imaging modalities from
cardiology. We discuss the advantages and limitations of applying deep learning
in cardiology that also apply in medicine in general, while proposing certain
directions as the most viable for clinical use.Comment: 27 pages, 2 figures, 10 table
Automatic 3D bi-ventricular segmentation of cardiac images by a shape-refined multi-task deep learning approach
Deep learning approaches have achieved state-of-the-art performance in
cardiac magnetic resonance (CMR) image segmentation. However, most approaches
have focused on learning image intensity features for segmentation, whereas the
incorporation of anatomical shape priors has received less attention. In this
paper, we combine a multi-task deep learning approach with atlas propagation to
develop a shape-constrained bi-ventricular segmentation pipeline for short-axis
CMR volumetric images. The pipeline first employs a fully convolutional network
(FCN) that learns segmentation and landmark localisation tasks simultaneously.
The architecture of the proposed FCN uses a 2.5D representation, thus combining
the computational advantage of 2D FCNs networks and the capability of
addressing 3D spatial consistency without compromising segmentation accuracy.
Moreover, the refinement step is designed to explicitly enforce a shape
constraint and improve segmentation quality. This step is effective for
overcoming image artefacts (e.g. due to different breath-hold positions and
large slice thickness), which preclude the creation of anatomically meaningful
3D cardiac shapes. The proposed pipeline is fully automated, due to network's
ability to infer landmarks, which are then used downstream in the pipeline to
initialise atlas propagation. We validate the pipeline on 1831 healthy subjects
and 649 subjects with pulmonary hypertension. Extensive numerical experiments
on the two datasets demonstrate that our proposed method is robust and capable
of producing accurate, high-resolution and anatomically smooth bi-ventricular
3D models, despite the artefacts in input CMR volumes
Automatic Segmentation of the Left Ventricle in Cardiac CT Angiography Using Convolutional Neural Network
Accurate delineation of the left ventricle (LV) is an important step in
evaluation of cardiac function. In this paper, we present an automatic method
for segmentation of the LV in cardiac CT angiography (CCTA) scans. Segmentation
is performed in two stages. First, a bounding box around the LV is detected
using a combination of three convolutional neural networks (CNNs).
Subsequently, to obtain the segmentation of the LV, voxel classification is
performed within the defined bounding box using a CNN. The study included CCTA
scans of sixty patients, fifty scans were used to train the CNNs for the LV
localization, five scans were used to train LV segmentation and the remaining
five scans were used for testing the method. Automatic segmentation resulted in
the average Dice coefficient of 0.85 and mean absolute surface distance of 1.1
mm. The results demonstrate that automatic segmentation of the LV in CCTA scans
using voxel classification with convolutional neural networks is feasible.Comment: This work has been published as: Zreik, M., Leiner, T., de Vos, B.
D., van Hamersvelt, R. W., Viergever, M. A., I\v{s}gum, I. (2016, April).
Automatic segmentation of the left ventricle in cardiac CT angiography using
convolutional neural networks. In Biomedical Imaging (ISBI), 2016 IEEE 13th
International Symposium on (pp. 40-43). IEE
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
Automated cardiovascular magnetic resonance image analysis with fully convolutional networks
Background: Cardiovascular magnetic resonance (CMR) imaging is a standard imaging modality for assessing cardiovascular diseases (CVDs), the leading cause of death globally. CMR enables accurate quantification of the cardiac chamber volume, ejection fraction and myocardial mass, providing information for diagnosis and monitoring of CVDs. However, for years, clinicians have been relying on manual approaches for CMR image analysis, which is time consuming and prone to subjective errors. It is a major clinical challenge to automatically derive quantitative and clinically relevant information from CMR images.
Methods: Deep neural networks have shown a great potential in image pattern recognition and segmentation for a variety of tasks. Here we demonstrate an automated analysis method for CMR images, which is based on a fully convolutional network (FCN). The network is trained and evaluated on a large-scale dataset from the UK Biobank, consisting of 4,875 subjects with 93,500 pixelwise annotated images. The performance of the method has been evaluated using a number of technical metrics, including the Dice metric, mean contour distance and Hausdorff distance, as well as clinically relevant measures, including left ventricle (LV) end-diastolic volume (LVEDV) and end-systolic volume (LVESV), LV mass (LVM); right ventricle (RV) end-diastolic volume (RVEDV) and end-systolic volume (RVESV).
Results: By combining FCN with a large-scale annotated dataset, the proposed automated method achieves a high performance in segmenting the LV and RV on short-axis CMR images and the left atrium (LA) and right atrium (RA) on long-axis CMR images. On a short-axis image test set of 600 subjects, it achieves an average Dice metric of 0.94 for the LV cavity, 0.88 for the LV myocardium and 0.90 for the RV cavity. The mean absolute difference between automated measurement and manual measurement was 6.1 mL for LVEDV, 5.3 mL for LVESV, 6.9 gram for LVM, 8.5 mL for RVEDV and 7.2 mL for RVESV. On long-axis image test sets, the average Dice metric was 0.93 for the LA cavity (2-chamber view), 0.95 for the LA cavity (4-chamber view) and 0.96 for the RA cavity (4-chamber view). The performance is comparable to human inter-observer variability.
Conclusions: We show that an automated method achieves a performance on par with human experts in analysing CMR images and deriving clinically relevant measures
Deep learning cardiac motion analysis for human survival prediction
Motion analysis is used in computer vision to understand the behaviour of
moving objects in sequences of images. Optimising the interpretation of dynamic
biological systems requires accurate and precise motion tracking as well as
efficient representations of high-dimensional motion trajectories so that these
can be used for prediction tasks. Here we use image sequences of the heart,
acquired using cardiac magnetic resonance imaging, to create time-resolved
three-dimensional segmentations using a fully convolutional network trained on
anatomical shape priors. This dense motion model formed the input to a
supervised denoising autoencoder (4Dsurvival), which is a hybrid network
consisting of an autoencoder that learns a task-specific latent code
representation trained on observed outcome data, yielding a latent
representation optimised for survival prediction. To handle right-censored
survival outcomes, our network used a Cox partial likelihood loss function. In
a study of 302 patients the predictive accuracy (quantified by Harrell's
C-index) was significantly higher (p < .0001) for our model C=0.73 (95 CI:
0.68 - 0.78) than the human benchmark of C=0.59 (95 CI: 0.53 - 0.65). This
work demonstrates how a complex computer vision task using high-dimensional
medical image data can efficiently predict human survival
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