Abstract

There is a growing demand for fast, accurate computation of clinical markers to improve renal function and anatomy assessment with a single study. However, conventional techniques have limitations leading to overestimations of kidney function or failure to provide sufficient spatial resolution to target the disease location. In contrast, the computer-aided analysis of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) could generate significant markers, including the glomerular filtration rate (GFR) and time–intensity curves of the cortex and medulla for determining obstruction in the urinary tract. This paper presents a dual-stage fully modular framework for automatic renal compartment segmentation in 4D DCE-MRI volumes. (1) Memory-efficient 3D deep learning is integrated to localise each kidney by harnessing residual convolutional neural networks for improved convergence; segmentation is performed by efficiently learning spatial–temporal information coupled with boundary-preserving fully convolutional dense nets. (2) Renal contextual information is enhanced via non-linear transformation to segment the cortex and medulla. The proposed framework is evaluated on a paediatric dataset containing 60 4D DCE-MRI volumes exhibiting varying conditions affecting kidney function. Our technique outperforms a state-of-the-art approach based on a GrabCut and support vector machine classifier in mean dice similarity (DSC) by 3.8% and demonstrates higher statistical stability with lower standard deviation by 12.4% and 15.7% for cortex and medulla segmentation, respectively.

Highlights

  • Kidney-related disorders are reportedly a growing global problem, with approximately 2 million people dying from acute kidney injury and an estimated 5 to 10 million people dying annually from kidney disease [1]

  • A recent study highlighted the detrimental impact of pain in patients with chronic kidney disease (CKD), where the occurrence of pain has been estimated at 50% to 70% in patients with advanced CKD [2]

  • A blood test provides an estimate of the glomerular filtration rate (GFR), which indicates the level of kidney function and determines the stage of kidney disease

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Summary

Introduction

Kidney-related disorders are reportedly a growing global problem, with approximately 2 million people dying from acute kidney injury and an estimated 5 to 10 million people dying annually from kidney disease [1]. Kidney damage leading to disease is caused by diabetes mellitus, hypertension and other chronic conditions. A recent study highlighted the detrimental impact of pain in patients with chronic kidney disease (CKD), where the occurrence of pain has been estimated at 50% to 70% in patients with advanced CKD [2]. There is a growing demand for methods that accurately monitor and stratify renal function [3,4] and, improve the assessment of disease prognosis, progression and treatment planning. A blood test provides an estimate of the glomerular filtration rate (GFR), which indicates the level of kidney function and determines the stage of kidney disease

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