Lateral Ventricle Segmentation of 3D Pre-term Neonates US Using Convex Optimization

Semi-supervised learning framework with shape encoding for neonatal ventricular segmentation from 3D ultrasound

BACKGROUND

Three-dimensional (3D) ultrasound (US) imaging has shown promise in non-invasive monitoring of changes in the lateral brain ventricles of neonates suffering from intraventricular hemorrhaging. Due to the poorly defined anatomical boundaries and low signal-to-noise ratio, fully supervised methods for segmentation of the lateral ventricles in 3D US images require a large dataset of annotated images by trained physicians, which is tedious, time-consuming, and expensive. Training fully supervised segmentation methods on a small dataset may lead to overfitting and hence reduce its generalizability. Semi-supervised learning (SSL) methods for 3D US segmentation may be able to address these challenges but most existing SSL methods have been developed for magnetic resonance or computed tomography (CT) images.

PURPOSE

To develop a fast, lightweight, and accurate SSL method, specifically for 3D US images, that will use unlabeled data towards improving segmentation performance.

METHODS

We propose an SSL framework that leverages the shape-encoding ability of an autoencoder network to enforce complex shape and size constraints on a 3D U-Net segmentation model. The autoencoder created pseudo-labels, based on the 3D U-Net predicted segmentations, that enforces shape constraints. An adversarial discriminator network then determined whether images came from the labeled or unlabeled data distributions. We used 887 3D US images, of which 87 had manually annotated labels and 800 images were unlabeled. Training/validation/testing sets of 25/12/50, 25/12/25 and 50/12/25 images were used for model experimentation. The Dice similarity coefficient (DSC), mean absolute surface distance (MAD), and absolute volumetric difference (VD) were used as metrics for comparing to other benchmarks. The baseline benchmark was the fully supervised vanilla 3D U-Net while dual task consistency, shape-aware semi-supervised network, correlation-aware mutual learning, and 3D U-Net Ensemble models were used as state-of-the-art benchmarks with DSC, MAD, and VD as comparison metrics. The Wilcoxon signed-rank test was used to test statistical significance between algorithms for DSC and VD with the threshold being p < 0.05 and corrected to p < 0.01 using the Bonferroni correction. The random-access memory (RAM) trace and number of trainable parameters were used to compare the computing efficiency between models.

RESULTS

Relative to the baseline 3D U-Net model, our shape-encoding SSL method reported a mean DSC improvement of 6.5%, 7.7%, and 4.1% with a 95% confidence interval of 4.2%, 5.7%, and 2.1% using image data splits of 25/12/50, 25/12/25, and 50/12/25, respectively. Our method only used a 1GB increase in RAM compared to the baseline 3D U-Net and required less than half the RAM and trainable parameters compared to the 3D U-Net ensemble method.

CONCLUSIONS

Based on our extensive literature survey, this is one of the first reported works to propose an SSL method designed for segmenting organs in 3D US images and specifically one that incorporates unlabeled data for segmenting neonatal cerebral lateral ventricles. When compared to the state-of-the-art SSL and fully supervised learning methods, our method yielded the highest DSC and lowest VD while being computationally efficient.

Automatic segmentation of ventricular volume by 3D ultrasonography in post haemorrhagic ventricular dilatation among preterm infants

To train, evaluate, and validate the application of a deep learning framework in three-dimensional ultrasound (3D US) for the automatic segmentation of ventricular volume in preterm infants with post haemorrhagic ventricular dilatation (PHVD). We trained a 2D convolutional neural network (CNN) for automatic segmentation ventricular volume from 3D US of preterm infants with PHVD. The method was validated with the Dice similarity coefficient (DSC) and the intra-class coefficient (ICC) compared to manual segmentation. The mean birth weight of the included patients was 1233.1 g (SD 309.4) and mean gestational age was 28.1 weeks (SD 1.6). A total of 152 serial 3D US from 10 preterm infants with PHVD were analysed. 230 ventricles were manually segmented. Of these, 108 were used for training a 2D CNN and 122 for validating the methodology for automatic segmentation. The global agreement for manual versus automated measures in the validation data (n = 122) was excellent with an ICC of 0.944 (0.874–0.971). The Dice similarity coefficient was 0.8 (± 0.01). 3D US based ventricular volume estimation through an automatic segmentation software developed through deep learning improves the accuracy and reduces the processing time needed for manual segmentation using VOCAL. 3D US should be considered a promising tool to help deepen our current understanding of the complex evolution of PHVD.

Longitudinal Analysis of Pre-Term Neonatal Cerebral Ventricles From 3D Ultrasound Images Using Spatial-Temporal Deformable Registration

Preterm neonates with a very low birth weight of less than 1,500 grams are at increased risk for developing intraventricular hemorrhage (IVH), which is a major cause of brain injury in preterm neonates. Quantitative measurements of ventricular dilatation or shrinkage play an important role in monitoring patients and evaluating treatment options. 3D ultrasound (US) has been developed to monitor ventricle volume as a biomarker for ventricular changes. However, ventricle volume as a global indicator does not allow for precise analysis of local ventricular changes, which could be linked to specific neurological problems often seen in the patient population later in life. In this work, a 3D+t spatial-temporal deformable registration approachis proposed, which is applied to the analysis of the detailed local changes of preterm IVH neonatal ventricles from 3D US images. In particular, a novel sequential convex/dual optimization algorithm is introduced to extract the optimal 3D+t spatial-temporal deformable field, which simultaneously optimizes the sequence of 3D deformation fieldswhile enjoying both efficiencyand simplicity in numerics. The developed registration technique was evaluated by comparing two manually extracted ventricle surfaces from the baseline and the registered follow-up images using the metrics of Dice similarity coefficient (DSC), mean absolute surface distance (MAD), and maximum absolute surface distance (MAXD). The performed experiments using 14 patients with 5 time-point images per patient show that the proposed 3D+t registration approach accurately recovered the longitudinal deformation of ventricle surfaces from 3D US images. The proposed approach may be potentially used to analyse the change pattern of cerebral ventricles of IVH patients, their response to different treatment options, and to elucidate the deficiencies that a patient could have later in life. To the best of our knowledge, this paper reports the first study on the longitudinalanalysis of neonatal ventricular system from 3D US images.

Three-dimensional segmentation of retroperitoneal masses using continuous convex relaxation and accumulated gradient distance for radiotherapy planning

An innovative algorithm has been developed for the segmentation of retroperitoneal tumors in 3D radiological images. This algorithm makes it possible for radiation oncologists and surgeons semiautomatically to select tumors for possible future radiation treatment and surgery. It is based on continuous convex relaxation methodology, the main novelty being the introduction of accumulated gradient distance, with intensity and gradient information being incorporated into the segmentation process. The algorithm was used to segment 26 CT image volumes. The results were compared with manual contouring of the same tumors. The proposed algorithm achieved 90 % sensitivity, 100 % specificity and 84 % positive predictive value, obtaining a mean distance to the closest point of 3.20 pixels. The algorithm's dependence on the initial manual contour was also analyzed, with results showing that the algorithm substantially reduced the variability of the manual segmentation carried out by different specialists. The algorithm was also compared with four benchmark algorithms (thresholding, edge-based level-set, region-based level-set and continuous max-flow with two labels). To the best of our knowledge, this is the first time the segmentation of retroperitoneal tumors for radiotherapy planning has been addressed.

User-guided segmentation of preterm neonate ventricular system from 3-D ultrasound images using convex optimization

A three-dimensional (3-D) ultrasound (US) system has been developed to monitor the intracranial ventricular system of preterm neonates with intraventricular hemorrhage (IVH) and the resultant dilation of the ventricles (ventriculomegaly). To measure ventricular volume from 3-D US images, a semi-automatic convex optimization-based approach is proposed for segmentation of the cerebral ventricular system in preterm neonates with IVH from 3-D US images. The proposed semi-automatic segmentation method makes use of the convex optimization technique supervised by user-initialized information. Experiments using 58 patient 3-D US images reveal that our proposed approach yielded a mean Dice similarity coefficient of 78.2% compared with the surfaces that were manually contoured, suggesting good agreement between these two segmentations. Additional metrics, the mean absolute distance of 0.65 mm and the maximum absolute distance of 3.2 mm, indicated small distance errors for a voxel spacing of 0.22 × 0.22 × 0.22 mm(3). The Pearson correlation coefficient (r = 0.97, p < 0.001) indicated a significant correlation of algorithm-generated ventricular system volume (VSV) with the manually generated VSV. The calculated minimal detectable difference in ventricular volume change indicated that the proposed segmentation approach with 3-D US images is capable of detecting a VSV difference of 6.5 cm(3) with 95% confidence, suggesting that this approach might be used for monitoring IVH patients' ventricular changes using 3-D US imaging. The mean segmentation times of the graphics processing unit (GPU)- and central processing unit-implemented algorithms were 50 ± 2 and 205 ± 5 s for one 3-D US image, respectively, in addition to 120 ± 10 s for initialization, less than the approximately 35 min required by manual segmentation. In addition, repeatability experiments indicated that the intra-observer variability ranges from 6.5% to 7.5%, and the inter-observer variability is 8.5% in terms of the coefficient of variation of the Dice similarity coefficient. The intra-class correlation coefficient for ventricular system volume measurements for each independent observer ranged from 0.988 to 0.996 and was 0.945 for three different observers. The coefficient of variation and intra-class correlation coefficient revealed that the intra- and inter-observer variability of the proposed approach introduced by the user initialization was small, indicating good reproducibility, independent of different users.