A robust multi-variability model based liver segmentation algorithm for CT-scan and MRI modalities

Automated segmentation of liver and hepatic vessels on portal venous phase computed tomography images using a deep learning algorithm

BACKGROUND

CT-image segmentation for liver and hepatic vessels can facilitate liver surgical planning. However, time-consuming process and inter-observer variations of manual segmentation have limited wider application in clinical practice.

PURPOSE

Our study aimed to propose an automated deep learning (DL) segmentation algorithm for liver and hepatic vessels on portal venous phase CT images.

METHODS

This retrospective study was performed to develop a coarse-to-fine DL-based algorithm that was trained, validated, and tested using private 413, 52, and 50 portal venous phase CT images, respectively. Additionally, the performance of the DL algorithm was extensively evaluated and compared with manual segmentation using an independent clinical dataset of preoperative contrast-enhanced CT images from 44 patients with hepatic focal lesions. The accuracy of DL-based segmentation was quantitatively evaluated using the Dice Similarity Coefficient (DSC) and complementary metrics [Normalized Surface Dice (NSD) and Hausdorff distance_95 (HD95) for liver segmentation, Recall and Precision for hepatic vessel segmentation]. The processing time for DL and manual segmentation was also compared.

RESULTS

Our DL algorithm achieved accurate liver segmentation with DSC of 0.98, NSD of 0.92, and HD95 of 1.52 mm. DL-segmentation of hepatic veins, portal veins, and inferior vena cava attained DSC of 0.86, 0.89, and 0.94, respectively. Compared with the manual approach, the DL algorithm significantly outperformed with better segmentation results for both liver and hepatic vessels, with higher accuracy of liver and hepatic vessel segmentation (all p < 0.001) in independent 44 clinical data. In addition, the DL method significantly reduced the manual processing time of clinical postprocessing (p < 0.001).

CONCLUSIONS

The proposed DL algorithm potentially enabled accurate and rapid segmentation for liver and hepatic vessels using portal venous phase contrast CT images.

A deep learning framework for automated detection and quantitative assessment of liver trauma

Background

Both early detection and severity assessment of liver trauma are critical for optimal triage and management of trauma patients. Current trauma protocols utilize computed tomography (CT) assessment of injuries in a subjective and qualitative (v.s. quantitative) fashion, shortcomings which could both be addressed by automated computer-aided systems that are capable of generating real-time reproducible and quantitative information. This study outlines an end-to-end pipeline to calculate the percentage of the liver parenchyma disrupted by trauma, an important component of the American Association for the Surgery of Trauma (AAST) liver injury scale, the primary tool to assess liver trauma severity at CT.

Methods

This framework comprises deep convolutional neural networks that first generate initial masks of both liver parenchyma (including normal and affected liver) and regions affected by trauma using three dimensional contrast-enhanced CT scans. Next, during the post-processing step, human domain knowledge about the location and intensity distribution of liver trauma is integrated into the model to avoid false positive regions. After generating the liver parenchyma and trauma masks, the corresponding volumes are calculated. Liver parenchymal disruption is then computed as the volume of the liver parenchyma that is disrupted by trauma.

Results

The proposed model was trained and validated on an internal dataset from the University of Michigan Health System (UMHS) including 77 CT scans (34 with and 43 without liver parenchymal trauma). The Dice/recall/precision coefficients of the proposed segmentation models are 96.13/96.00/96.35% and 51.21/53.20/56.76%, respectively, in segmenting liver parenchyma and liver trauma regions. In volume-based severity analysis, the proposed model yields a linear regression relation of 0.95 in estimating the percentage of liver parenchyma disrupted by trauma. The model shows an accurate performance in avoiding false positives for patients without any liver parenchymal trauma. These results indicate that the model is generalizable on patients with pre-existing liver conditions, including fatty livers and congestive hepatopathy.

Conclusion

The proposed algorithms are able to accurately segment the liver and the regions affected by trauma. This pipeline demonstrates an accurate performance in estimating the percentage of liver parenchyma that is affected by trauma. Such a system can aid critical care medical personnel by providing a reproducible quantitative assessment of liver trauma as an alternative to the sometimes subjective AAST grading system that is used currently.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12880-022-00759-9.

Ontology-Driven Approach for Liver MRI Classification and HCC Detection

Reading and interpreting the medical image still remains the most challenging task in radiology. Through the important achievement of deep Convolutional Neural Networks (CNN) in the context of medical image classification, various clinical applications have been provided to detect lesions from Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans. In the diagnosis process for the liver cancer from Dynamic Contrast-Enhanced MRI (DCE-MRI), radiologists consider three phases during contrast injection: before injection, arterial phase, and portal phase for instance. Even if the contrast agent helps in enhancing the tumoral tissues, the diagnosis may be very difficult due to the possible low contrast and pathological tissues surrounding the tumors (cirrhosis). Alongside, in the medical field, ontologies have proven their effectiveness to solve several clinical problems such as offering shareable terminologies, vocabularies, and databases. In this article, we propose a multi-label CNN classification approach based on a parallel preprocessing algorithm. This algorithm is an extension of our previous work cited in the International Conference on Pattern Recognition and Artificial Intelligence (ICPRAI) 2020. The aim of our approach is to ameliorate the detection of HCC lesions and to extract more information about the detected tumor such as the stage, the localization, the size, and the type thanks to the use of ontologies. Moreover, the integration of such information has improved the detection process. In fact, experiments conducted by testing with real patient cases have shown that the proposed approach reached an accuracy of 93% using MRI patches of [Formula: see text] pixels, which is an improvement compared with our previous works.

Liver Segmentation in MRI Images using an Adaptive Water Flow Model

Background:

Identification and precise localization of the liver surface and its segments are essential for any surgical treatment. An algorithm of accurate liver segmentation simplifies the treatment planning for different types of liver diseases. Although liver segmentation turns researcher’s attention, it still has some challenging problems in computer-aided diagnosis.

Objective:

This study aimed to extract the potential liver regions by an adaptive water flow model and perform the final segmentation by the classification algorithm.

Material and Methods:

In this experimental study, an automatic liver segmentation algorithm was introduced. The proposed method designed the image by a transfer function based on the probability distribution function of the liver pixels to enhance the liver area. The enhanced image is then segmented using an adaptive water flow model in which the rainfall process is controlled by the liver location in the training images and the gray levels of pixels. The candidate liver segments are classified by a Multi-Layer Perception (MLP) neural network considering some texture, area, and gray level features.

Results:

The proposed algorithm efficiently distinguishes the liver region from its surrounding organs, resulting in perfect liver segmentation over 250 Magnetic Resonance Imaging (MRI) test images. The accuracy of 97% was obtained by quantitative evaluation over test images, which revealed the superiority of the proposed algorithm compared to some evaluated algorithms.

Conclusion:

Liver segmentation using an adaptive water flow algorithm and classifying the segmented area in MRI images yields more robust and reliable results in comparison with the classification of pixels.

Stability and Reproducibility of Radiomic Features Based Various Segmentation Technique on MR Images of Hepatocellular Carcinoma (HCC)

Hepatocellular carcinoma (HCC) is considered as a complex liver disease and ranked as the eighth-highest mortality rate with a prevalence of 2.4% in Malaysia. Magnetic resonance imaging (MRI) has been acknowledged for its advantages, a gold technique for diagnosing HCC, and yet the false-negative diagnosis from the examinations is inevitable. In this study, 30 MR images from patients diagnosed with HCC is used to evaluate the robustness of semi-automatic segmentation using the flood fill algorithm for quantitative features extraction. The relevant features were extracted from the segmented MR images of HCC. Four types of features extraction were used for this study, which are tumour intensity, shape feature, textural feature and wavelet feature. A total of 662 radiomic features were extracted from manual and semi-automatic segmentation and compared using intra-class relation coefficient (ICC). Radiomic features extracted using semi-automatic segmentation utilized flood filling algorithm from 3D-slicer had significantly higher reproducibility (average ICC = 0.952 ± 0.009, p < 0.05) compared with features extracted from manual segmentation (average ICC = 0.897 ± 0.011, p > 0.05). Moreover, features extracted from semi-automatic segmentation were more robust compared to manual segmentation. This study shows that semi-automatic segmentation from 3D-Slicer is a better alternative to the manual segmentation, as they can produce more robust and reproducible radiomic features.

Segmentation of Liver Anatomy by Combining 3D U-Net Approaches

Accurate liver vessel segmentation is of crucial importance for the clinical diagnosis and treatment of many hepatic diseases. Recent state-of-the-art methods for liver vessel reconstruction mostly utilize deep learning methods, namely, the U-Net model and its variants. However, to the best of our knowledge, no comparative evaluation has been proposed to compare these approaches in the liver vessel segmentation task. Moreover, most research works do not consider the liver volume segmentation as a preprocessing step, in order to keep only inner hepatic vessels, for Couinaud representation for instance. For these reasons, in this work, we propose using accurate Dense U-Net liver segmentation and conducting a comparison between 3D U-Net models inside the obtained volumes. More precisely, 3D U-Net, Dense U-Net, and MultiRes U-Net are pitted against each other in the vessel segmentation task on the IRCAD dataset. For each model, three alternative setups that allow adapting the selected CNN architectures to volumetric data are tested, namely, full 3D, slab-based, and box-based setups are considered. The results showed that the most accurate setup is the full 3D process, providing the highest Dice for most of the considered models. However, concerning the particular models, the slab-based MultiRes U-Net provided the best score. With our accurate vessel segmentations, several medical applications can be investigated, such as automatic and personalized Couinaud zoning of the liver.