Abstract

BackgroundCardiovascular magnetic resonance (CMR) sequences are commonly used to obtain a complete description of the function and structure of the heart, provided that accurate measurements are extracted from images. New methods of extraction of information are being developed, among them, deep neural networks are powerful tools that showed the ability to perform fast and accurate segmentation. Iq1n order to reduce the time spent by reading physicians to process data and minimize intra- and inter-observer variability, we propose a fully automatic multi-scan CMR image analysis pipeline.MethodsSequence specific U-Net 2D models were trained to perform the segmentation of the left ventricle (LV), right ventricle (RV) and aorta in cine short-axis, late gadolinium enhancement (LGE), native T1 map, post-contrast T1, native T2 map and aortic flow sequences depending on the need. The models were trained and tested on a set of data manually segmented by experts using semi-automatic and manual tools. A set of parameters were computed from the resulting segmentations such as the left ventricular and right ventricular ejection fraction (EF), LGE scar percentage, the mean T1, T1 post, T2 values within the myocardium, and aortic flow. The Dice similarity coefficient, Hausdorff distance, mean surface distance, and Pearson correlation coefficient R were used to assess and compare the results of the U-Net based pipeline with intra-observer variability. Additionally, the pipeline was validated on two clinical studies.ResultsThe sequence specific U-Net 2D models trained achieved fast (≤ 0.2 s/image on GPU) and precise segmentation over all the targeted region of interest with high Dice scores (= 0.91 for LV, = 0.92 for RV, = 0.93 for Aorta in average) comparable to intra-observer Dice scores (= 0.86 for LV, = 0.87 for RV, = 0.95 for aorta flow in average). The automatically and manually computed parameters were highly correlated (R = 0.91 in average) showing results superior to the intra-observer variability (R = 0.85 in average) for every sequence presented here.ConclusionThe proposed pipeline allows for fast and robust analysis of large CMR studies while guaranteeing reproducibility, hence potentially improving patient’s diagnosis as well as clinical studies outcome.

Highlights

  • Cardiovascular magnetic resonance (CMR) sequences are commonly used to obtain a complete description of the function and structure of the heart, provided that accurate measurements are extracted from images

  • Cardiac image segmentation is a challenging task for several reasons: (i) the acquisition requires the patient’s cooperation; (ii) image reconstruction is impacted by the cardiac rhythm or lack of rhythm; (iii) the blood flow surrounding the myocardium; (iv) high heterogeneity in the image due to standard acquisition made of many short-axis slices

  • Proposed fully automatic multi‐scan analysis pipeline Encouraged by the accuracy obtained in deep learning segmentation for cine CMR at the Automated Cardiac Diagnosis Challenge presented at STACOM workshop in 2017 [5], we intended to automatize all segmentation processes using convolutional neural networks (CNN)

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Summary

Introduction

Cardiovascular magnetic resonance (CMR) sequences are commonly used to obtain a complete description of the function and structure of the heart, provided that accurate measurements are extracted from images. Cardiovascular magnetic resonance (CMR) remains an active field of innovation with new sequences being developed to enrich the obtained measurements, or extracted information from the images. Fadil et al J Cardiovasc Magn Reson (2021) 23:47 scan, a complete description of the function and structure of the heart can be obtained, provided that accurate measurements can be extracted from the images. Segmentation is prone to observer-variability [4], especially in the contouring of the myocardium and the right ventricle (RV) This reproducibility issue, combined with the fact that current delineation methods are extremely time-consuming, makes the development of fast, robust, accurate and clinician-friendly tools a crucial element in improving clinician productivity and patient care

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