Abstract

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-refined 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, a refinement step is designed to explicitly impose shape prior knowledge 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 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 presence of artefacts in input CMR volumes.

Highlights

  • C ARDIAC magnetic resonance (CMR) imaging is the gold standard for assessing cardiac chamber volume and mass for a wide range of cardiovascular diseases [1]

  • We are aware of only one deep learning segmentation method [11] that takes into account different cardiac artifacts, but the method was tested on only simulated images of the left ventricle (LV), whose anatomy is less complex than bi-ventricular anatomy

  • For landmark localization in a CMR volume, the primary challenge is the extreme imbalance between the proportion of voxels belonging to landmark regions and the proportion belonging to non-landmark regions (the 6 landmarks are represented by 6 voxels, while all the remaining voxels represent background)

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Summary

INTRODUCTION

C ARDIAC magnetic resonance (CMR) imaging is the gold standard for assessing cardiac chamber volume and mass for a wide range of cardiovascular diseases [1]. We are aware of only one deep learning segmentation method [11] that takes into account different cardiac artifacts, but the method was tested on only simulated images of the LV, whose anatomy is less complex than bi-ventricular anatomy It is thereby still an open problem as to how to build an artifact-free and smooth bi-ventricular segmentation model from real artifact-corrupted CMR volumes with novel image segmentation methods. We thoroughly assess the effectiveness and robustness of the proposed pipeline using a large-scale dataset, comprising 2480 short-axis CMR volumetric images for training and testing. To our knowledge, this is one of the first CMR segmentation studies utilizing a volumetric dataset of this size, and the technique introduced is the first automatic approach capable of producing a full high-resolution bi-ventricular model in 3D

Overview
Learning Segmentation Labels and Landmark Locations
Introducing Anatomical Shape Prior Knowledge
EXPERIMENTS
Preprocessing and Augmentation
Segmentation of High-Resolution Volumes
Landmark Localization
Impact of Landmarks
Experiments on Simulated Low-Resolution Volumes
Experiments on Pathological Low-Resolution Volumes
Findings
DISCUSSION AND CONCLUSION
Full Text
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