Abstract

Segmentation of the placenta from fetal MRI is challenging due to sparse acquisition, inter-slice motion, and the widely varying position and shape of the placenta between pregnant women. We propose a minimally interactive framework that combines multiple volumes acquired in different views to obtain accurate segmentation of the placenta. In the first phase, a minimally interactive slice-by-slice propagation method called Slic-Seg is used to obtain an initial segmentation from a single motion-corrupted sparse volume image. It combines high-level features, online Random Forests and Conditional Random Fields, and only needs user interactions in a single slice. In the second phase, to take advantage of the complementary resolution in multiple volumes acquired in different views, we further propose a probability-based 4D Graph Cuts method to refine the initial segmentations using inter-slice and inter-image consistency. We used our minimally interactive framework to examine the placentas of 16 mid-gestation patients from MRI acquired in axial and sagittal views respectively. The results show the proposed method has 1) a good performance even in cases where sparse scribbles provided by the user lead to poor results with the competitive propagation approaches; 2) a good interactivity with low intra- and inter-operator variability; 3) higher accuracy than state-of-the-art interactive segmentation methods; and 4) an improved accuracy due to the co-segmentation based refinement, which outperforms single volume or intensity-based Graph Cuts.

Highlights

  • The placenta plays a critical role in the growth and development of the fetus during pregnancy

  • We have shown that our automatic refinement leveraging multiple volumes and relying on 4D Graph Cuts can reduce errors related to the initial propagation

  • We presented an interactive, learning-based method for the segmentation of the placenta from motion corrupted fetal magnetic resonance imaging (MRI) in multiple views

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Summary

Introduction

The placenta plays a critical role in the growth and development of the fetus during pregnancy. Placental abnormalities are a cause of poor maternal and fetal outcome. Placental attachment disorders (Mazouni et al, 2007) such as placenta accreta are due to an abnormally adherent placenta invading the myometrium, and are associated with life-threatening postpartum hemorrhage. Image-based diagnosis of placenta accreta allows for multidisciplinary planning in an attempt to minimize risks during the delivery. Twin-totwin transfusion syndrome (TTTS) (Deprest et al, 2010) can result in unequal blood distribution and severe birth defects for one or both twins.

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