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Do QN, Lewis MA, Herrera CL, Owen D, Spong CY, Fei B, Lenkinski RE, Twickler DM, Xi Y. Magnetic Resonance Imaging-Based Radiomics of Axial and Sagittal Orientation in Pregnant Patients with Suspected Placenta Accreta Spectrum. Acad Radiol 2024:S1076-6332(24)00694-9. [PMID: 39366802 DOI: 10.1016/j.acra.2024.09.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 09/17/2024] [Accepted: 09/18/2024] [Indexed: 10/06/2024]
Abstract
RATIONALE AND OBJECTIVES Placenta accreta spectrum (PAS) is associated with significant morbidity and mortality. Current radiomic analysis of PAS magnetic resonance (MR) images is often performed on a single imaging plane. However, depending on the chosen imaging plane, radiomic features extracted from the same patient may vary due to the differing orientations and anatomical contexts, potentially leading to inconsistent results. In this study, we applied region of interest (ROI)-based radiomic analysis on axial and sagittal MR images in pregnant patients at high risk for PAS. Our objective was to compare MR textural features extracted from these imaging planes and to correlate these findings with surgical outcomes, aiming to enhance the accuracy of PAS diagnosis and treatment planning. MATERIALS AND METHODS This is a retrospective review of MR images of pregnancies with prenatally suspected PAS. Volumetric placental, uterus, and internal os of the cervix regions of interest (ROI) were manually segmented on axial and sagittal MR images for each patient. Radiomic features were extracted following the image biomarker standardization initiative guideline. Agreement in features extracted from axial and sagittal images were assessed using Spearman's rank correlation coefficient. RESULTS Of the 101 pregnant patients that met the study inclusion criteria, 65 underwent cesarean hysterectomy for PAS. 77 percent of the radiomics features had strong Spearman rank correlations (>0.8) between axial and sagittal images, indicating that these imaging planes provide similar radiomics information. The diagnostic performance of features extracted from axial and sagittal planes was quantified under the receiver operating characteristics curve (AUC). We found that axial and sagittal planes have similar performance for the prediction of hysterectomy. Shape elongation, Placental Location within the Uterus (PLU), and heterogeneity features were significant predictors for hysterectomy regardless of the imaging plane. CONCLUSION Our study found that radiomics features extracted from axial and sagittal MR image plane in the same patient have excellent agreement and strong correlation. We identified several features present in both axial and sagittal images that were predictive in detecting PAS-suspected patient who required hysterectomy. These features may represent the underlying placental pathophysiology.
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Affiliation(s)
- Quyen N Do
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA (Q.N.D., M.A.L., B.F., R.E.L., D.M.T., Y.X.).
| | - Matthew A Lewis
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA (Q.N.D., M.A.L., B.F., R.E.L., D.M.T., Y.X.)
| | - Christina L Herrera
- Department of Obstetrics & Gynecology, UT Southwestern Medical Center, Dallas, Texas, USA (C.L.H., D.O., C.Y.S., D.M.T.); Parkland Health and Hospital System, Dallas, Texas, USA (C.L.H., D.O., C.Y.S., D.M.T.)
| | - David Owen
- Department of Obstetrics & Gynecology, UT Southwestern Medical Center, Dallas, Texas, USA (C.L.H., D.O., C.Y.S., D.M.T.); Parkland Health and Hospital System, Dallas, Texas, USA (C.L.H., D.O., C.Y.S., D.M.T.)
| | - Catherine Y Spong
- Department of Obstetrics & Gynecology, UT Southwestern Medical Center, Dallas, Texas, USA (C.L.H., D.O., C.Y.S., D.M.T.); Parkland Health and Hospital System, Dallas, Texas, USA (C.L.H., D.O., C.Y.S., D.M.T.)
| | - Baowei Fei
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA (Q.N.D., M.A.L., B.F., R.E.L., D.M.T., Y.X.); Department of Bioengineering, The University of Texas at Dallas, Richardson, Texas, USA (B.F.); Center for Imaging and Surgical Innovation, The University of Texas at Dallas, Texas, USA (B.F.)
| | - Robert E Lenkinski
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA (Q.N.D., M.A.L., B.F., R.E.L., D.M.T., Y.X.)
| | - Diane M Twickler
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA (Q.N.D., M.A.L., B.F., R.E.L., D.M.T., Y.X.); Department of Obstetrics & Gynecology, UT Southwestern Medical Center, Dallas, Texas, USA (C.L.H., D.O., C.Y.S., D.M.T.); Parkland Health and Hospital System, Dallas, Texas, USA (C.L.H., D.O., C.Y.S., D.M.T.)
| | - Yin Xi
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA (Q.N.D., M.A.L., B.F., R.E.L., D.M.T., Y.X.)
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Yu Hung AL, Zheng H, Zhao K, Du X, Pang K, Miao Q, Raman SS, Terzopoulos D, Sung K. CSAM: A 2.5D Cross-Slice Attention Module for Anisotropic Volumetric Medical Image Segmentation. IEEE WINTER CONFERENCE ON APPLICATIONS OF COMPUTER VISION. IEEE WINTER CONFERENCE ON APPLICATIONS OF COMPUTER VISION 2024; 2024:5911-5920. [PMID: 39193208 PMCID: PMC11349312 DOI: 10.1109/wacv57701.2024.00582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
A large portion of volumetric medical data, especially magnetic resonance imaging (MRI) data, is anisotropic, as the through-plane resolution is typically much lower than the in-plane resolution. Both 3D and purely 2D deep learning-based segmentation methods are deficient in dealing with such volumetric data since the performance of 3D methods suffers when confronting anisotropic data, and 2D methods disregard crucial volumetric information. Insufficient work has been done on 2.5D methods, in which 2D convolution is mainly used in concert with volumetric information. These models focus on learning the relationship across slices, but typically have many parameters to train. We offer a Cross-Slice Attention Module (CSAM) with minimal trainable parameters, which captures information across all the slices in the volume by applying semantic, positional, and slice attention on deep feature maps at different scales. Our extensive experiments using different network architectures and tasks demonstrate the usefulness and generalizability of CSAM. Associated code is available at https://github.com/aL3x-O-o-Hung/CSAM.
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Affiliation(s)
| | | | - Kai Zhao
- University of California, Los Angeles
| | - Xiaoxi Du
- University of California, Los Angeles
| | | | - Qi Miao
- University of California, Los Angeles
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Osman YBM, Li C, Huang W, Wang S. Collaborative Learning for Annotation-Efficient Volumetric MR Image Segmentation. J Magn Reson Imaging 2023. [PMID: 38156427 DOI: 10.1002/jmri.29194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/05/2023] [Accepted: 12/05/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Deep learning has presented great potential in accurate MR image segmentation when enough labeled data are provided for network optimization. However, manually annotating three-dimensional (3D) MR images is tedious and time-consuming, requiring experts with rich domain knowledge and experience. PURPOSE To build a deep learning method exploring sparse annotations, namely only a single two-dimensional slice label for each 3D training MR image. STUDY TYPE Retrospective. POPULATION Three-dimensional MR images of 150 subjects from two publicly available datasets were included. Among them, 50 (1377 image slices) are for prostate segmentation. The other 100 (8800 image slices) are for left atrium segmentation. Five-fold cross-validation experiments were carried out utilizing the first dataset. For the second dataset, 80 subjects were used for training and 20 were used for testing. FIELD STRENGTH/SEQUENCE 1.5 T and 3.0 T; axial T2-weighted and late gadolinium-enhanced, 3D respiratory navigated, inversion recovery prepared gradient echo pulse sequence. ASSESSMENT A collaborative learning method by integrating the strengths of semi-supervised and self-supervised learning schemes was developed. The method was trained using labeled central slices and unlabeled noncentral slices. Segmentation performance on testing set was reported quantitatively and qualitatively. STATISTICAL TESTS Quantitative evaluation metrics including boundary intersection-over-union (B-IoU), Dice similarity coefficient, average symmetric surface distance, and relative absolute volume difference were calculated. Paired t test was performed, and P < 0.05 was considered statistically significant. RESULTS Compared to fully supervised training with only the labeled central slice, mean teacher, uncertainty-aware mean teacher, deep co-training, interpolation consistency training (ICT), and ambiguity-consensus mean teacher, the proposed method achieved a substantial improvement in segmentation accuracy, increasing the mean B-IoU significantly by more than 10.0% for prostate segmentation (proposed method B-IoU: 70.3% ± 7.6% vs. ICT B-IoU: 60.3% ± 11.2%) and by more than 6.0% for left atrium segmentation (proposed method B-IoU: 66.1% ± 6.8% vs. ICT B-IoU: 60.1% ± 7.1%). DATA CONCLUSIONS A collaborative learning method trained using sparse annotations can segment prostate and left atrium with high accuracy. LEVEL OF EVIDENCE 0 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Yousuf Babiker M Osman
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Cheng Li
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Weijian Huang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
- Peng Cheng Laboratory, Shenzhen, China
| | - Shanshan Wang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Peng Cheng Laboratory, Shenzhen, China
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Herrera CL, Kim MJ, Do QN, Owen DM, Fei B, Twickler DM, Spong CY. The human placenta project: Funded studies, imaging technologies, and future directions. Placenta 2023; 142:27-35. [PMID: 37634371 PMCID: PMC11257151 DOI: 10.1016/j.placenta.2023.08.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/16/2023] [Accepted: 08/19/2023] [Indexed: 08/29/2023]
Abstract
The placenta plays a critical role in fetal development. It serves as a multi-functional organ that protects and nurtures the fetus during pregnancy. However, despite its importance, the intricacies of placental structure and function in normal and diseased states have remained largely unexplored. Thus, in 2014, the National Institute of Child Health and Human Development launched the Human Placenta Project (HPP). As of May 2023, the HPP has awarded over $101 million in research funds, resulting in 41 funded studies and 459 publications. We conducted a comprehensive review of these studies and publications to identify areas of funded research, advances in those areas, limitations of current research, and continued areas of need. This paper will specifically review the funded studies by the HPP, followed by an in-depth discussion on advances and gaps within placental-focused imaging. We highlight the progress within magnetic reasonance imaging and ultrasound, including development of tools for the assessment of placental function and structure.
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Affiliation(s)
- Christina L Herrera
- Department of Obstetrics and Gynecology, UT Southwestern Medical Center, and Parkland Health Dallas, Texas, USA; Green Center for Reproductive Biology Sciences, UT Southwestern Medical Center, Dallas, TX, USA.
| | - Meredith J Kim
- University of Texas Southwestern Medical School, Dallas, TX, USA
| | - Quyen N Do
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - David M Owen
- Department of Obstetrics and Gynecology, UT Southwestern Medical Center, and Parkland Health Dallas, Texas, USA; Green Center for Reproductive Biology Sciences, UT Southwestern Medical Center, Dallas, TX, USA
| | - Baowei Fei
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA; Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA; Department of Bioengineering, University of Texas at Dallas, Dallas, TX, USA
| | - Diane M Twickler
- Department of Obstetrics and Gynecology, UT Southwestern Medical Center, and Parkland Health Dallas, Texas, USA; Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Catherine Y Spong
- Department of Obstetrics and Gynecology, UT Southwestern Medical Center, and Parkland Health Dallas, Texas, USA
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