Automatic Segmentation and Disease Classification Using Cardiac Cine MR Images

Segmentation of the heart in cardiac cine MR is clinically used to quantify cardiac function. We propose a fully automatic method for segmentation and disease classification using cardiac cine MR images. A convolutional neural network (CNN) was designed to simultaneously segment the left ventricle (LV), right ventricle (RV) and myocardium in end-diastole (ED) and end-systole (ES) images. Features derived from the obtained segmentations were used in a Random Forest classifier to label patients as suffering from dilated cardiomyopathy, hypertrophic cardiomyopathy, heart failure following myocardial infarction, right ventricular abnormality, or no cardiac disease. The method was developed and evaluated using a balanced dataset containing images of 100 patients, which was provided in the MICCAI 2017 automated cardiac diagnosis challenge (ACDC). The segmentation and classification pipeline were evaluated in a four-fold stratified cross-validation. Average Dice scores between reference and automatically obtained segmentations were 0.94, 0.88 and 0.87 for the LV, RV and myocardium. The classifier assigned 91% of patients to the correct disease category. Segmentation and disease classification took 5 s per patient. The results of our study suggest that image-based diagnosis using cine MR cardiac scans can be performed automatically with high accuracy.Comment: Accepted in STACOM Automated Cardiac Diagnosis Challenge 201

Deep Learning-Based Carotid Artery Vessel Wall Segmentation in Black-Blood MRI Using Anatomical Priors

Carotid artery vessel wall thickness measurement is an essential step in the monitoring of patients with atherosclerosis. This requires accurate segmentation of the vessel wall, i.e., the region between an artery's lumen and outer wall, in black-blood magnetic resonance (MR) images. Commonly used convolutional neural networks (CNNs) for semantic segmentation are suboptimal for this task as their use does not guarantee a contiguous ring-shaped segmentation. Instead, in this work, we cast vessel wall segmentation as a multi-task regression problem in a polar coordinate system. For each carotid artery in each axial image slice, we aim to simultaneously find two non-intersecting nested contours that together delineate the vessel wall. CNNs applied to this problem enable an inductive bias that guarantees ring-shaped vessel walls. Moreover, we identify a problem-specific training data augmentation technique that substantially affects segmentation performance. We apply our method to segmentation of the internal and external carotid artery wall, and achieve top-ranking quantitative results in a public challenge, i.e., a median Dice similarity coefficient of 0.813 for the vessel wall and median Hausdorff distances of 0.552 mm and 0.776 mm for lumen and outer wall, respectively. Moreover, we show how the method improves over a conventional semantic segmentation approach. These results show that it is feasible to automatically obtain anatomically plausible segmentations of the carotid vessel wall with high accuracy.Comment: SPIE Medical Imaging 202

Local Implicit Neural Representations for Multi-Sequence MRI Translation

In radiological practice, multi-sequence MRI is routinely acquired to characterize anatomy and tissue. However, due to the heterogeneity of imaging protocols and contra-indications to contrast agents, some MRI sequences, e.g. contrast-enhanced T1-weighted image (T1ce), may not be acquired. This creates difficulties for large-scale clinical studies for which heterogeneous datasets are aggregated. Modern deep learning techniques have demonstrated the capability of synthesizing missing sequences from existing sequences, through learning from an extensive multi-sequence MRI dataset. In this paper, we propose a novel MR image translation solution based on local implicit neural representations. We split the available MRI sequences into local patches and assign to each patch a local multi-layer perceptron (MLP) that represents a patch in the T1ce. The parameters of these local MLPs are generated by a hypernetwork based on image features. Experimental results and ablation studies on the BraTS challenge dataset showed that the local MLPs are critical for recovering fine image and tumor details, as they allow for local specialization that is highly important for accurate image translation. Compared to a classical pix2pix model, the proposed method demonstrated visual improvement and significantly improved quantitative scores (MSE 0.86 x 10^-3 vs. 1.02 x 10^-3 and SSIM 94.9 vs 94.3

Coronary Artery Centerline Extraction in Cardiac CT Angiography Using a CNN-Based Orientation Classifier

Coronary artery centerline extraction in cardiac CT angiography (CCTA) images is a prerequisite for evaluation of stenoses and atherosclerotic plaque. We propose an algorithm that extracts coronary artery centerlines in CCTA using a convolutional neural network (CNN). A 3D dilated CNN is trained to predict the most likely direction and radius of an artery at any given point in a CCTA image based on a local image patch. Starting from a single seed point placed manually or automatically anywhere in a coronary artery, a tracker follows the vessel centerline in two directions using the predictions of the CNN. Tracking is terminated when no direction can be identified with high certainty. The CNN was trained using 32 manually annotated centerlines in a training set consisting of 8 CCTA images provided in the MICCAI 2008 Coronary Artery Tracking Challenge (CAT08). Evaluation using 24 test images of the CAT08 challenge showed that extracted centerlines had an average overlap of 93.7% with 96 manually annotated reference centerlines. Extracted centerline points were highly accurate, with an average distance of 0.21 mm to reference centerline points. In a second test set consisting of 50 CCTA scans, 5,448 markers in the coronary arteries were used as seed points to extract single centerlines. This showed strong correspondence between extracted centerlines and manually placed markers. In a third test set containing 36 CCTA scans, fully automatic seeding and centerline extraction led to extraction of on average 92% of clinically relevant coronary artery segments. The proposed method is able to accurately and efficiently determine the direction and radius of coronary arteries. The method can be trained with limited training data, and once trained allows fast automatic or interactive extraction of coronary artery trees from CCTA images.Comment: Accepted in Medical Image Analysi