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

Pathogenicity locus, core genome, and accessory gene contributions to Clostridium difficile virulence

Clostridium difficile is a spore-forming anaerobic bacterium that causes colitis in patients with disrupted colonic microbiota. While some individuals are asymptomatic C. difficile carriers, symptomatic disease ranges from mild diarrhea to potentially lethal toxic megacolon. The wide disease spectrum has been attributed to the infected host’s age, underlying diseases, immune status, and microbiome composition. However, strain-specific differences in C. difficile virulence have also been implicated in determining colitis severity. Because patients infected with C. difficile are unique in terms of medical history, microbiome composition, and immune competence, determining the relative contribution of C. difficile virulence to disease severity has been challenging, and conclusions regarding the virulence of specific strains have been inconsistent. To address this, we used a mouse model to test 33 clinical C. difficile strains isolated from patients with disease severities ranging from asymptomatic carriage to severe colitis, and we determined their relative in vivo virulence in genetically identical, antibiotic-pretreated mice. We found that murine infections with C. difficile clade 2 strains (including multilocus sequence type 1/ribotype 027) were associated with higher lethality and that C. difficile strains associated with greater human disease severity caused more severe disease in mice. While toxin production was not strongly correlated with in vivo colonic pathology, the ability of C. difficile strains to grow in the presence of secondary bile acids was associated with greater disease severity. Whole-genome sequencing and identification of core and accessory genes identified a subset of accessory genes that distinguish high-virulence from lower-virulence C. difficile strains

The Whole Heliosphere Interval in the Context of a Long and Structured Solar Minimum: An Overview from Sun to Earth

Throughout months of extremely low solar activity during the recent extended solar-cycle minimum, structural evolution continued to be observed from the Sun through the solar wind and to the Earth. In 2008, the presence of long-lived and large low-latitude coronal holes meant that geospace was periodically impacted by high-speed streams, even though solar irradiance, activity, and interplanetary magnetic fields had reached levels as low as, or lower than, observed in past minima. This time period, which includes the first Whole Heliosphere Interval (WHI 1: Carrington Rotation (CR) 2068), illustrates the effects of fast solar-wind streams on the Earth in an otherwise quiet heliosphere. By the end of 2008, sunspots and solar irradiance had reached their lowest levels for this minimum (e.g., WHI 2: CR 2078), and continued solar magnetic-flux evolution had led to a flattening of the heliospheric current sheet and the decay of the low-latitude coronal holes and associated Earth-intersecting high-speed solar-wind streams. As the new solar cycle slowly began, solar-wind and geospace observables stayed low or continued to decline, reaching very low levels by June – July 2009. At this point (e.g., WHI 3: CR 2085) the Sun–Earth system, taken as a whole, was at its quietest. In this article we present an overview of observations that span the period 2008 – 2009, with highlighted discussion of CRs 2068, 2078, and 2085. We show side-by-side observables from the Sun’s interior through its surface and atmosphere, through the solar wind and heliosphere and to the Earth’s space environment and upper atmosphere, and reference detailed studies of these various regimes within this topical issue and elsewhere

CNN-based Landmark Detection in Cardiac CTA Scans

Fast and accurate anatomical landmark detection can benefit many medical image analysis methods. Here, we propose a method to automatically detect anatomical landmarks in medical images. Automatic landmark detection is performed with a patch-based fully convolutional neural network (FCNN) that combines regression and classification. For any given image patch, regression is used to predict the 3D displacement vector from the image patch to the landmark. Simultaneously, classification is used to identify patches that contain the landmark. Under the assumption that patches close to a landmark can determine the landmark location more precisely than patches farther from it, only those patches that contain the landmark according to classification are used to determine the landmark location. The landmark location is obtained by calculating the average landmark location using the computed 3D displacement vectors. The method is evaluated using detection of six clinically relevant landmarks in coronary CT angiography (CCTA) scans: the right and left ostium, the bifurcation of the left main coronary artery (LM) into the left anterior descending and the left circumflex artery, and the origin of the right, non-coronary, and left aortic valve commissure. The proposed method achieved an average Euclidean distance error of 2.19 mm and 2.88 mm for the right and left ostium respectively, 3.78 mm for the bifurcation of the LM, and 1.82 mm, 2.10 mm and 1.89 mm for the origin of the right, non-coronary, and left aortic valve commissure respectively, demonstrating accurate performance. The proposed combination of regression and classification can be used to accurately detect landmarks in CCTA scans.Comment: This work was submitted to MIDL 2018 Conferenc