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Pace DF, Contreras HTM, Romanowicz J, Ghelani S, Rahaman I, Zhang Y, Gao P, Jubair MI, Yeh T, Golland P, Geva T, Ghelani S, Powell AJ, Moghari MH. HVSMR-2.0: A 3D cardiovascular MR dataset for whole-heart segmentation in congenital heart disease. Sci Data 2024; 11:721. [PMID: 38956063 PMCID: PMC11219801 DOI: 10.1038/s41597-024-03469-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 06/04/2024] [Indexed: 07/04/2024] Open
Abstract
Patients with congenital heart disease often have cardiac anatomy that deviates significantly from normal, frequently requiring multiple heart surgeries. Image segmentation from a preoperative cardiovascular magnetic resonance (CMR) scan would enable creation of patient-specific 3D surface models of the heart, which have potential to improve surgical planning, enable surgical simulation, and allow automatic computation of quantitative metrics of heart function. However, there is no publicly available CMR dataset for whole-heart segmentation in patients with congenital heart disease. Here, we release the HVSMR-2.0 dataset, comprising 60 CMR scans alongside manual segmentation masks of the 4 cardiac chambers and 4 great vessels. The images showcase a wide range of heart defects and prior surgical interventions. The dataset also includes masks of required and optional extents of the great vessels, enabling fairer comparisons across algorithms. Detailed diagnoses for each subject are also provided. By releasing HVSMR-2.0, we aim to encourage development of robust segmentation algorithms and clinically relevant tools for congenital heart disease.
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Affiliation(s)
- Danielle F Pace
- A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA.
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | - Hannah T M Contreras
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA
- Pediatric Surgical Research Laboratories, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jennifer Romanowicz
- Department of Pediatrics, Section of Cardiology, Children's Hospital Colorado, Aurora, CO, USA
| | - Shruti Ghelani
- Department of Computer Science, University of Massachusetts Boston, Boston, MA, USA
| | - Imon Rahaman
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Yue Zhang
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Biochemistry and Molecular Genetics, Northwestern University, Chicago, IL, USA
- School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Patricia Gao
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - Tom Yeh
- Department of Computer Science, University of Colorado Boulder, Boulder, CO, USA
- Department of Psychology, Ewha Womans University, Seoul, South Korea
| | - Polina Golland
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Tal Geva
- Department of Cardiology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Sunil Ghelani
- Department of Cardiology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Andrew J Powell
- Department of Cardiology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Mehdi Hedjazi Moghari
- Department of Cardiology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- School of Medicine, The University of Colorado, Aurora, CO, USA
- Department of Radiology, Children's Hospital Colorado, Aurora, CO, USA
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Zagorchev L, Hyde DE, Li C, Wenzel F, Fläschner N, Ewald A, O'Donoghue S, Hancock K, Lim RX, Choi DC, Kelly E, Gupta S, Wilden J. Shape-constrained deformable brain segmentation: Methods and quantitative validation. Neuroimage 2024; 289:120542. [PMID: 38369167 DOI: 10.1016/j.neuroimage.2024.120542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 02/20/2024] Open
Abstract
MRI-guided neuro interventions require rapid, accurate, and reproducible segmentation of anatomical brain structures for identification of targets during surgical procedures and post-surgical evaluation of intervention efficiency. Segmentation algorithms must be validated and cleared for clinical use. This work introduces a methodology for shape-constrained deformable brain segmentation, describes the quantitative validation used for its clinical clearance, and presents a comparison with manual expert segmentation and FreeSurfer, an open source software for neuroimaging data analysis. ClearPoint Maestro is software for fully-automatic brain segmentation from T1-weighted MRI that combines a shape-constrained deformable brain model with voxel-wise tissue segmentation within the cerebral hemispheres and the cerebellum. The performance of the segmentation was validated in terms of accuracy and reproducibility. Segmentation accuracy was evaluated with respect to training data and independently traced ground truth. Segmentation reproducibility was quantified and compared with manual expert segmentation and FreeSurfer. Quantitative reproducibility analysis indicates superior performance compared to both manual expert segmentation and FreeSurfer. The shape-constrained methodology results in accurate and highly reproducible segmentation. Inherent point based-correspondence provides consistent target identification ideal for MRI-guided neuro interventions.
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Affiliation(s)
- Lyubomir Zagorchev
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA.
| | - Damon E Hyde
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Chen Li
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Fabian Wenzel
- Philips Research Hamburg, Medical Image Processing and Analytics, Röntgenstraße 24-26, Hamburg, 22335, Germany
| | - Nick Fläschner
- Philips Research Hamburg, Medical Image Processing and Analytics, Röntgenstraße 24-26, Hamburg, 22335, Germany
| | - Arne Ewald
- Philips Research Hamburg, Medical Image Processing and Analytics, Röntgenstraße 24-26, Hamburg, 22335, Germany
| | - Stefani O'Donoghue
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Kelli Hancock
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Ruo Xuan Lim
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Dennis C Choi
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Eddie Kelly
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Shruti Gupta
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Jessica Wilden
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
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Verstraeten S, Hoeijmakers M, Tonino P, Brüning J, Capelli C, van de Vosse F, Huberts W. Generation of synthetic aortic valve stenosis geometries for in silico trials. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2024; 40:e3778. [PMID: 37961993 DOI: 10.1002/cnm.3778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 09/01/2023] [Accepted: 09/17/2023] [Indexed: 11/15/2023]
Abstract
In silico trials are a promising way to increase the efficiency of the development, and the time to market of cardiovascular implantable devices. The development of transcatheter aortic valve implantation (TAVI) devices, could benefit from in silico trials to overcome frequently occurring complications such as paravalvular leakage and conduction problems. To be able to perform in silico TAVI trials virtual cohorts of TAVI patients are required. In a virtual cohort, individual patients are represented by computer models that usually require patient-specific aortic valve geometries. This study aimed to develop a virtual cohort generator that generates anatomically plausible, synthetic aortic valve stenosis geometries for in silico TAVI trials and allows for the selection of specific anatomical features that influence the occurrence of complications. To build the generator, a combination of non-parametrical statistical shape modeling and sampling from a copula distribution was used. The developed virtual cohort generator successfully generated synthetic aortic valve stenosis geometries that are comparable with a real cohort, and therefore, are considered as being anatomically plausible. Furthermore, we were able to select specific anatomical features with a sensitivity of around 90%. The virtual cohort generator has the potential to be used by TAVI manufacturers to test their devices. Future work will involve including calcifications to the synthetic geometries, and applying high-fidelity fluid-structure-interaction models to perform in silico trials.
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Affiliation(s)
- Sabine Verstraeten
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | | | - Pim Tonino
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| | - Jan Brüning
- Institute of Computer-assisted Cardiovascular Medicine, Charite Universitaetsmedizin, Berlin, Germany
| | - Claudio Capelli
- Institute of Cardiovascular Science, University College London, London, UK
| | - Frans van de Vosse
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Wouter Huberts
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
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Kahraman AT, Fröding T, Toumpanakis D, Sladoje N, Sjöblom T. Automated detection, segmentation and measurement of major vessels and the trachea in CT pulmonary angiography. Sci Rep 2023; 13:18407. [PMID: 37891213 PMCID: PMC10611811 DOI: 10.1038/s41598-023-45509-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
Mediastinal structure measurements are important for the radiologist's review of computed tomography pulmonary angiography (CTPA) examinations. In the reporting process, radiologists make measurements of diameters, volumes, and organ densities for image quality assessment and risk stratification. However, manual measurement of these features is time consuming. Here, we sought to develop a time-saving automated algorithm that can accurately detect, segment and measure mediastinal structures in routine clinical CTPA examinations. In this study, 700 CTPA examinations collected and annotated. Of these, a training set of 180 examinations were used to develop a fully automated deterministic algorithm. On the test set of 520 examinations, two radiologists validated the detection and segmentation performance quantitatively, and ground truth was annotated to validate the measurement performance. External validation was performed in 47 CTPAs from two independent datasets. The system had 86-100% detection and segmentation accuracy in the different tasks. The automatic measurements correlated well to those of the radiologist (Pearson's r 0.68-0.99). Taken together, the fully automated algorithm accurately detected, segmented, and measured mediastinal structures in routine CTPA examinations having an adequate representation of common artifacts and medical conditions.
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Affiliation(s)
- Ali T Kahraman
- Department of Immunology, Genetics and Pathology, Uppsala University, 751 85, Uppsala, Sweden
| | - Tomas Fröding
- Department of Radiology, Nyköping Hospital, 611 39, Nyköping, Sweden
| | - Dimitrios Toumpanakis
- Department of Radiology, Uppsala University Hospital, 751 85, Uppsala, Sweden
- Department of Surgical Sciences, Uppsala University, 751 85, Uppsala, Sweden
| | - Nataša Sladoje
- Centre for Image Analysis, Department of Information Technology, Uppsala University, 751 05, Uppsala, Sweden
| | - Tobias Sjöblom
- Department of Immunology, Genetics and Pathology, Uppsala University, 751 85, Uppsala, Sweden.
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Lyu Y, Tian X. MWG-UNet: Hybrid Deep Learning Framework for Lung Fields and Heart Segmentation in Chest X-ray Images. Bioengineering (Basel) 2023; 10:1091. [PMID: 37760193 PMCID: PMC10525798 DOI: 10.3390/bioengineering10091091] [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: 08/14/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Deep learning technology has achieved breakthrough research results in the fields of medical computer vision and image processing. Generative adversarial networks (GANs) have demonstrated a capacity for image generation and expression ability. This paper proposes a new method called MWG-UNet (multiple tasking Wasserstein generative adversarial network U-shape network) as a lung field and heart segmentation model, which takes advantages of the attention mechanism to enhance the segmentation accuracy of the generator so as to improve the performance. In particular, the Dice similarity, precision, and F1 score of the proposed method outperform other models, reaching 95.28%, 96.41%, and 95.90%, respectively, and the specificity surpasses the sub-optimal models by 0.28%, 0.90%, 0.24%, and 0.90%. However, the value of the IoU is inferior to the optimal model by 0.69%. The results show the proposed method has considerable ability in lung field segmentation. Our multi-organ segmentation results for the heart achieve Dice similarity and IoU values of 71.16% and 74.56%. The segmentation results on lung fields achieve Dice similarity and IoU values of 85.18% and 81.36%.
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Affiliation(s)
| | - Xiaolin Tian
- School of Computer Science and Engineering, Faculty of Innovation Engineering, Macau University of Science and Technology, Taipa, Macau 999078, China;
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Yang J, Li X, Cheng JZ, Xue Z, Shi F, Ji Y, Wang X, Yang F. Segment aorta and localize landmarks simultaneously on noncontrast CT using a multitask learning framework for patients without severe vascular disease. Comput Biol Med 2023; 160:107002. [PMID: 37187136 DOI: 10.1016/j.compbiomed.2023.107002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/29/2023] [Accepted: 05/02/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Non-contrast chest CT is widely used for lung cancer screening, and its images carry potential information of the thoracic aorta. The morphological assessment of the thoracic aorta may have potential value in the presymptomatic detection of thoracic aortic-related diseases and the risk prediction of future adverse events. However, due to low vasculature contrast in such images, visual assessment of aortic morphology is challenging and highly depends on physicians' experience. PURPOSE The main objective of this study is to propose a novel multi-task framework based on deep learning for simultaneous aortic segmentation and localization of key landmarks on unenhanced chest CT. The secondary objective is to use the algorithm to measure quantitative features of thoracic aorta morphology. METHODS The proposed network is composed of two subnets to carry out segmentation and landmark detection, respectively. The segmentation subnet aims to demarcate the aortic sinuses of the Valsalva, aortic trunk and aortic branches, whereas the detection subnet is devised to locate five landmarks on the aorta to facilitate morphology measures. The networks share a common encoder and run decoders in parallel, taking full advantage of the synergy of the segmentation and landmark detection tasks. Furthermore, the volume of interest (VOI) module and the squeeze-and-excitation (SE) block with attention mechanisms are incorporated to further boost the capability of feature learning. RESULTS Benefiting from the multitask framework, we achieved a mean Dice score of 0.95, average symmetric surface distance of 0.53 mm, Hausdorff distance of 2.13 mm for aortic segmentation, and mean square error (MSE) of 3.23 mm for landmark localization in 40 testing cases. CONCLUSION We proposed a multitask learning framework which can perform segmentation of the thoracic aorta and localization of landmarks simultaneously and achieved good results. It can support quantitative measurement of aortic morphology for further analysis of aortic diseases, such as hypertension.
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Affiliation(s)
- Jinrong Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Xiang Li
- Shanghai United Imaging Intelligence Co. Ltd., Shanghai, 201807, China
| | - Jie-Zhi Cheng
- Shanghai United Imaging Intelligence Co. Ltd., Shanghai, 201807, China
| | - Zhong Xue
- Shanghai United Imaging Intelligence Co. Ltd., Shanghai, 201807, China
| | - Feng Shi
- Shanghai United Imaging Intelligence Co. Ltd., Shanghai, 201807, China
| | - Yuqing Ji
- Shanghai United Imaging Intelligence Co. Ltd., Shanghai, 201807, China
| | - Xuechun Wang
- Shanghai United Imaging Intelligence Co. Ltd., Shanghai, 201807, China.
| | - Fan Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Stoks J, Hermans BJM, Boukens BJD, Holtackers RJ, Gommers S, Kaya YS, Vernooy K, Cluitmans MJM, Volders PGA, Ter Bekke RMA. High-resolution structural-functional substrate-trigger characterization: Future roadmap for catheter ablation of ventricular tachycardia. Front Cardiovasc Med 2023; 10:1112980. [PMID: 36873402 PMCID: PMC9978225 DOI: 10.3389/fcvm.2023.1112980] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/03/2023] [Indexed: 02/18/2023] Open
Abstract
Introduction Patients with ventricular tachyarrhythmias (VT) are at high risk of sudden cardiac death. When appropriate, catheter ablation is modestly effective, with relatively high VT recurrence and complication rates. Personalized models that incorporate imaging and computational approaches have advanced VT management. However, 3D patient-specific functional electrical information is typically not considered. We hypothesize that incorporating non-invasive 3D electrical and structural characterization in a patient-specific model improves VT-substrate recognition and ablation targeting. Materials and methods In a 53-year-old male with ischemic cardiomyopathy and recurrent monomorphic VT, we built a structural-functional model based on high-resolution 3D late-gadolinium enhancement (LGE) cardiac magnetic resonance imaging (3D-LGE CMR), multi-detector computed tomography (CT), and electrocardiographic imaging (ECGI). Invasive data from high-density contact and pace mapping obtained during endocardial VT-substrate modification were also incorporated. The integrated 3D electro-anatomic model was analyzed off-line. Results Merging the invasive voltage maps and 3D-LGE CMR endocardial geometry led to a mean Euclidean node-to-node distance of 5 ± 2 mm. Inferolateral and apical areas of low bipolar voltage (<1.5 mV) were associated with high 3D-LGE CMR signal intensity (>0.4) and with higher transmurality of fibrosis. Areas of functional conduction delay or block (evoked delayed potentials, EDPs) were in close proximity to 3D-LGE CMR-derived heterogeneous tissue corridors. ECGI pinpointed the epicardial VT exit at ∼10 mm from the endocardial site of origin, both juxtaposed to the distal ends of two heterogeneous tissue corridors in the inferobasal left ventricle. Radiofrequency ablation at the entrances of these corridors, eliminating all EDPs, and at the VT site of origin rendered the patient non-inducible and arrhythmia-free until the present day (20 months follow-up). Off-line analysis in our model uncovered dynamic electrical instability of the LV inferolateral heterogeneous scar region which set the stage for an evolving VT circuit. Discussion and conclusion We developed a personalized 3D model that integrates high-resolution structural and electrical information and allows the investigation of their dynamic interaction during arrhythmia formation. This model enhances our mechanistic understanding of scar-related VT and provides an advanced, non-invasive roadmap for catheter ablation.
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Affiliation(s)
- Job Stoks
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+, Maastricht, Netherlands.,Department of Advanced Computing Sciences, Maastricht University, Maastricht, Netherlands.,Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Ben J M Hermans
- Department of Physiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Bas J D Boukens
- Department of Physiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands.,Department of Medical Biology, Amsterdam University Medical Center (UMC), Amsterdam Medical Center (AMC), Amsterdam, Netherlands
| | - Robert J Holtackers
- Department of Radiology and Nuclear Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+, Maastricht, Netherlands
| | - Suzanne Gommers
- Department of Radiology and Nuclear Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+, Maastricht, Netherlands
| | - Yesim S Kaya
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+, Maastricht, Netherlands
| | - Kevin Vernooy
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+, Maastricht, Netherlands
| | - Matthijs J M Cluitmans
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+, Maastricht, Netherlands.,Philips Research, Eindhoven, Netherlands
| | - Paul G A Volders
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+, Maastricht, Netherlands
| | - Rachel M A Ter Bekke
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+, Maastricht, Netherlands
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Laumer F, Amrani M, Manduchi L, Beuret A, Rubi L, Dubatovka A, Matter CM, Buhmann JM. Weakly supervised inference of personalized heart meshes based on echocardiography videos. Med Image Anal 2023; 83:102653. [PMID: 36327655 DOI: 10.1016/j.media.2022.102653] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/27/2022] [Accepted: 10/08/2022] [Indexed: 12/12/2022]
Abstract
Echocardiography provides recordings of the heart chamber size and function and is a central tool for non-invasive diagnosis of heart diseases. It produces high-dimensional video data with substantial stochasticity in the measurements, which frequently prove difficult to interpret. To address this challenge, we propose an automated framework to enable the inference of a high resolution personalized 4D (3D plus time) surface mesh of the cardiac structures from 2D echocardiography video data. Inferring such shape models arises as a key step towards accurate personalized simulation that enables an automated assessment of the cardiac chamber morphology and function. The proposed method is trained using only unpaired echocardiography and heart mesh videos to find a mapping between these distinct visual domains in a self-supervised manner. The resulting model produces personalized 4D heart meshes, which exhibit a high correspondence with the input echocardiography videos. Furthermore, the 4D heart meshes enable the automatic extraction of echocardiographic variables, such as ejection fraction, myocardial muscle mass, and volumetric changes of chamber volumes over time with high temporal resolution.
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Affiliation(s)
- Fabian Laumer
- Institute for Machine Learning at ETH Zürich, Zürich, Switzerland.
| | - Mounir Amrani
- Institute for Machine Learning at ETH Zürich, Zürich, Switzerland
| | - Laura Manduchi
- Institute for Machine Learning at ETH Zürich, Zürich, Switzerland
| | - Ami Beuret
- Institute for Machine Learning at ETH Zürich, Zürich, Switzerland
| | - Lena Rubi
- Institute for Machine Learning at ETH Zürich, Zürich, Switzerland
| | - Alina Dubatovka
- Institute for Machine Learning at ETH Zürich, Zürich, Switzerland
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Pace DF, Dalca AV, Brosch T, Geva T, Powell AJ, Weese J, Moghari MH, Golland P. Learned iterative segmentation of highly variable anatomy from limited data: Applications to whole heart segmentation for congenital heart disease. Med Image Anal 2022; 80:102469. [PMID: 35640385 PMCID: PMC9617683 DOI: 10.1016/j.media.2022.102469] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 02/08/2023]
Abstract
Training deep learning models that segment an image in one step typically requires a large collection of manually annotated images that captures the anatomical variability in a cohort. This poses challenges when anatomical variability is extreme but training data is limited, as when segmenting cardiac structures in patients with congenital heart disease (CHD). In this paper, we propose an iterative segmentation model and show that it can be accurately learned from a small dataset. Implemented as a recurrent neural network, the model evolves a segmentation over multiple steps, from a single user click until reaching an automatically determined stopping point. We develop a novel loss function that evaluates the entire sequence of output segmentations, and use it to learn model parameters. Segmentations evolve predictably according to growth dynamics encapsulated by training data, which consists of images, partially completed segmentations, and the recommended next step. The user can easily refine the final segmentation by examining those that are earlier or later in the output sequence. Using a dataset of 3D cardiac MR scans from patients with a wide range of CHD types, we show that our iterative model offers better generalization to patients with the most severe heart malformations.
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Affiliation(s)
- Danielle F Pace
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA; A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Adrian V Dalca
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA; A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Tom Brosch
- Philips Research Laboratories, Hamburg, Germany
| | - Tal Geva
- Department of Cardiology, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Andrew J Powell
- Department of Cardiology, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | | | - Mehdi H Moghari
- Department of Cardiology, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Polina Golland
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA
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Assessing the Accuracy of an Artificial Intelligence-Based Segmentation Algorithm for the Thoracic Aorta in Computed Tomography Applications. Diagnostics (Basel) 2022; 12:diagnostics12081790. [PMID: 35892500 PMCID: PMC9330011 DOI: 10.3390/diagnostics12081790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/01/2022] [Accepted: 07/21/2022] [Indexed: 12/03/2022] Open
Abstract
The aim was to evaluate the accuracy of a prototypical artificial intelligence-based algorithm for automated segmentation and diameter measurement of the thoracic aorta (TA) using CT. One hundred twenty-two patients who underwent dual-source CT were retrospectively included. Ninety-three of these patients had been administered intravenous iodinated contrast. Images were evaluated using the prototypical algorithm, which segments the TA and determines the corresponding diameters at predefined anatomical locations based on the American Heart Association guidelines. The reference standard was established by two radiologists individually in a blinded, randomized fashion. Equivalency was tested and inter-reader agreement was assessed using intra-class correlation (ICC). In total, 99.2% of the parameters measured by the prototype were assessable. In nine patients, the prototype failed to determine one diameter along the vessel. Measurements along the TA did not differ between the algorithm and readers (p > 0.05), establishing equivalence. Inter-reader agreement between the algorithm and readers (ICC ≥ 0.961; 95% CI: 0.940−0.974), and between the readers was excellent (ICC ≥ 0.879; 95% CI: 0.818−0.92). The evaluated prototypical AI-based algorithm accurately measured TA diameters at each region of interest independent of the use of either contrast utilization or pathology. This indicates that the prototypical algorithm has substantial potential as a valuable tool in the rapid clinical evaluation of aortic pathology.
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Zhang Y, Liao Q, Ding L, Zhang J. Bridging 2D and 3D segmentation networks for computation-efficient volumetric medical image segmentation: An empirical study of 2.5D solutions. Comput Med Imaging Graph 2022; 99:102088. [DOI: 10.1016/j.compmedimag.2022.102088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 11/28/2022]
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Hoeijmakers MJMM, Morgenthaler V, Rutten MCM, van de Vosse FN. Scale-Resolving Simulations of Steady and Pulsatile Flow Through Healthy and Stenotic Heart Valves. J Biomech Eng 2022; 144:1119643. [PMID: 34529056 DOI: 10.1115/1.4052459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Indexed: 11/08/2022]
Abstract
Blood-flow downstream of stenotic and healthy aortic valves exhibits intermittent random fluctuations in the velocity field which are associated with turbulence. Such flows warrant the use of computationally demanding scale-resolving models. The aim of this work was to compute and quantify this turbulent flow in healthy and stenotic heart valves for steady and pulsatile flow conditions. Large eddy simulations (LESs) and Reynolds-averaged Navier-Stokes (RANS) simulations were used to compute the flow field at inlet Reynolds numbers of 2700 and 5400 for valves with an opening area of 70 mm2 and 175 mm2 and their projected orifice-plate type counterparts. Power spectra and turbulent kinetic energy were quantified on the centerline. Projected geometries exhibited an increased pressure-drop (>90%) and elevated turbulent kinetic energy levels (>147%). Turbulence production was an order of magnitude higher in stenotic heart valves compared to healthy valves. Pulsatile flow stabilizes flow in the acceleration phase, whereas onset of deceleration triggered (healthy valve) or amplified (stenotic valve) turbulence. Simplification of the aortic valve by projecting the orifice area should be avoided in computational fluid dynamics (CFD). RANS simulations may be used to predict the transvalvular pressure-drop, but scale-resolving models are recommended when detailed information of the flow field is required.
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Affiliation(s)
- M J M M Hoeijmakers
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven 5600 MB The Netherlands; Ansys Inc., Villeurbanne 69100, France
| | | | - M C M Rutten
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven 5600 MB, The Netherlands
| | - F N van de Vosse
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven 5600 MB, The Netherlands
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13
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Kong F, Wilson N, Shadden S. A deep-learning approach for direct whole-heart mesh reconstruction. Med Image Anal 2021; 74:102222. [PMID: 34543913 PMCID: PMC9503710 DOI: 10.1016/j.media.2021.102222] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 07/14/2021] [Accepted: 08/31/2021] [Indexed: 01/16/2023]
Abstract
Automated construction of surface geometries of cardiac structures from volumetric medical images is important for a number of clinical applications. While deep-learning-based approaches have demonstrated promising reconstruction precision, these approaches have mostly focused on voxel-wise segmentation followed by surface reconstruction and post-processing techniques. However, such approaches suffer from a number of limitations including disconnected regions or incorrect surface topology due to erroneous segmentation and stair-case artifacts due to limited segmentation resolution. We propose a novel deep-learning-based approach that directly predicts whole heart surface meshes from volumetric CT and MR image data. Our approach leverages a graph convolutional neural network to predict deformation on mesh vertices from a pre-defined mesh template to reconstruct multiple anatomical structures in a 3D image volume. Our method demonstrated promising performance of generating whole heart reconstructions with as good or better accuracy than prior deep-learning-based methods on both CT and MR data. Furthermore, by deforming a template mesh, our method can generate whole heart geometries with better anatomical consistency and produce high-resolution geometries from lower resolution input image data. Our method was also able to produce temporally-consistent surface mesh predictions for heart motion from CT or MR cine sequences, and therefore can potentially be applied for efficiently constructing 4D whole heart dynamics. Our code and pre-trained networks are available at https://github.com/fkong7/MeshDeformNet.
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Affiliation(s)
- Fanwei Kong
- Mechanical Engineering Department, University of California, Berkeley, Berkeley, CA 94709, United States.
| | - Nathan Wilson
- Open Source Medical Software Corporation, Santa Monica, CA, United States.
| | - Shawn Shadden
- Mechanical Engineering Department, University of California, Berkeley, Berkeley, CA 94709, United States.
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14
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Brosch T, Peters J, Groth A, Weber FM, Weese J. Model-based segmentation using neural network-based boundary detectors: Application to prostate and heart segmentation in MR images. MACHINE LEARNING WITH APPLICATIONS 2021. [DOI: 10.1016/j.mlwa.2021.100078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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15
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Hoeijmakers MJMM, Huberts W, Rutten MCM, van de Vosse FN. The impact of shape uncertainty on aortic-valve pressure-drop computations. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2021; 37:e3518. [PMID: 34350705 PMCID: PMC9286381 DOI: 10.1002/cnm.3518] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/17/2021] [Accepted: 07/04/2021] [Indexed: 06/13/2023]
Abstract
Patient-specific image-based computational fluid dynamics (CFD) is widely adopted in the cardiovascular research community to study hemodynamics, and will become increasingly important for personalized medicine. However, segmentation of the flow domain is not exact and geometric uncertainty can be expected which propagates through the computational model, leading to uncertainty in model output. Seventy-four aortic-valves were segmented from computed tomography images at peak systole. Statistical shape modeling was used to obtain an approximate parameterization of the original segmentations. This parameterization was used to train a meta-model that related the first five shape mode coefficients and flowrate to the CFD-computed transvalvular pressure-drop. Consequently, shape uncertainty in the order of 0.5 and 1.0 mm was emulated by introducing uncertainty in the shape mode coefficients. A global variance-based sensitivity analysis was performed to quantify output uncertainty and to determine relative importance of the shape modes. The first shape mode captured the opening/closing behavior of the valve and uncertainty in this mode coefficient accounted for more than 90% of the output variance. However, sensitivity to shape uncertainty is patient-specific, and the relative importance of the fourth shape mode coefficient tended to increase with increases in valvular area. These results show that geometric uncertainty in the order of image voxel size may lead to substantial uncertainty in CFD-computed transvalvular pressure-drops. Moreover, this illustrates that it is essential to assess the impact of geometric uncertainty on model output, and that this should be thoroughly quantified for applications that wish to use image-based CFD models.
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Affiliation(s)
- M. J. M. M. Hoeijmakers
- Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
- AnsysUtrechtThe Netherlands
| | - W. Huberts
- Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
- Department of Biomedical Engineering, School for Cardiovsacular DiseasesMaastricht UniversityMaastrichtThe Netherlands
| | - M. C. M. Rutten
- Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
| | - F. N. van de Vosse
- Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
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16
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Sieren MM, Widmann C, Weiss N, Moltz JH, Link F, Wegner F, Stahlberg E, Horn M, Oecherting TH, Goltz JP, Barkhausen J, Frydrychowicz A. Automated segmentation and quantification of the healthy and diseased aorta in CT angiographies using a dedicated deep learning approach. Eur Radiol 2021; 32:690-701. [PMID: 34170365 DOI: 10.1007/s00330-021-08130-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 03/26/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To develop and validate a deep learning-based algorithm for segmenting and quantifying the physiological and diseased aorta in computed tomography angiographies. METHODS CTA exams of the aorta of 191 patients (68.1 ± 14 years, 128 male), performed between 2015 and 2018, were retrospectively identified from our imaging archive and manually segmented by two investigators. A 3D U-Net model was trained on the data, which was divided into a training, a validation, and a test group at a ratio of 7:1:2. Cases in the test group (n = 41) were evaluated to compare manual and automatic segmentations. Dice similarity coefficient (DSC), mean surface distance (MSD), and Hausdorff surface distance (HSD) were extracted. Maximum diameter, effective diameter, and area were quantified and compared between both segmentations at eight anatomical landmarks, and at the maximum area of an aneurysms if present (n = 14). Statistics included error calculation, intraclass correlation coefficient, and Bland-Altman analysis. RESULTS A DSC of 0.95 [0.94; 0.95] and an MSD of 0.76 [0.06; 0.99] indicated close agreement between segmentations. HSD was 8.00 [4.47; 10.00]. The largest absolute errors were found in the ascending aorta with 0.8 ± 1.5 mm for maximum diameter and at the coeliac trunk with - 30.0 ± 81.6 mm2 for area. Results for absolute errors in aneurysms were - 0.5 ± 2.3 mm for maximum diameter, 0.3 ± 1.6 mm for effective diameter, and 64.9 ± 114.9 mm2 for area. ICC showed excellent agreement (> 0.9; p < 0.05) between quantitative measurements. CONCLUSIONS Automated segmentation of the aorta on CTA data using a deep learning algorithm is feasible and allows for accurate quantification of the aortic lumen even if the vascular architecture is altered by disease. KEY POINTS • A deep learning-based algorithm can automatically segment the aorta, mostly within acceptable margins of error, even if the vascular architecture is altered by disease. • Quantifications performed in the segmentations were mostly within clinically acceptable limits, even in pathologically altered segments of the aorta.
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Affiliation(s)
- Malte Maria Sieren
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - Cornelia Widmann
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Nick Weiss
- Fraunhofer Institute for Digital Medicine MEVIS, Lübeck/Bremen, Germany
| | - Jan Hendrik Moltz
- Fraunhofer Institute for Digital Medicine MEVIS, Lübeck/Bremen, Germany
| | - Florian Link
- Fraunhofer Institute for Digital Medicine MEVIS, Lübeck/Bremen, Germany
| | - Franz Wegner
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Erik Stahlberg
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Marco Horn
- Department for Vascular Surgery, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Thekla Helene Oecherting
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Jan Peter Goltz
- Institute for Diagnostic and Interventional Radiology/Neuroradiology, Sana Clinic, Lübeck, Germany
| | - Joerg Barkhausen
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Alex Frydrychowicz
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
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17
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Chen Z, Rigolli M, Vigneault DM, Kligerman S, Hahn L, Narezkina A, Craine A, Lowe K, Contijoch F. Automated cardiac volume assessment and cardiac long- and short-axis imaging plane prediction from electrocardiogram-gated computed tomography volumes enabled by deep learning. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2021; 2:311-322. [PMID: 34223176 PMCID: PMC8242184 DOI: 10.1093/ehjdh/ztab033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/01/2021] [Accepted: 03/19/2021] [Indexed: 01/29/2023]
Abstract
AIMS To develop an automated method for bloodpool segmentation and imaging plane re-slicing of cardiac computed tomography (CT) via deep learning (DL) for clinical use in coronary artery disease (CAD) wall motion assessment and reproducible longitudinal imaging. METHODS AND RESULTS One hundred patients who underwent clinically indicated cardiac CT scans with manually segmented left ventricle (LV) and left atrial (LA) chambers were used for training. For each patient, long-axis (LAX) and short-axis planes were manually defined by an imaging expert. A DL model was trained to predict bloodpool segmentations and imaging planes. Deep learning bloodpool segmentations showed close agreement with manual LV [median Dice: 0.91, Hausdorff distance (HD): 6.18 mm] and LA (Dice: 0.93, HD: 7.35 mm) segmentations and a strong correlation with manual ejection fraction (Pearson r: 0.95 LV, 0.92 LA). Predicted planes had low median location (6.96 mm) and angular orientation (7.96 ° ) errors which were comparable to inter-reader differences (P > 0.71). 84-97% of DL-prescribed LAX planes correctly intersected American Heart Association segments, which was comparable (P > 0.05) to manual slicing. In a test cohort of 144 patients, we evaluated the ability of the DL approach to provide diagnostic imaging planes. Visual scoring by two blinded experts determined ≥94% of DL-predicted planes to be diagnostically adequate. Further, DL-enabled visualization of LV wall motion abnormalities due to CAD and provided reproducible planes upon repeat imaging. CONCLUSION A volumetric, DL approach provides multiple chamber segmentations and can re-slice the imaging volume along standardized cardiac imaging planes for reproducible wall motion abnormality and functional assessment.
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Affiliation(s)
- Zhennong Chen
- Department of Bioengineering, UC San Diego School of Engineering, 9500 Gilman Drive, MC 0412, La Jolla, CA 92093, USA
| | - Marzia Rigolli
- Department of Bioengineering, UC San Diego School of Engineering, 9500 Gilman Drive, MC 0412, La Jolla, CA 92093, USA
| | - Davis Marc Vigneault
- Department of Internal Medicine, Scripps Mercy Hospital, 4077 Fifth Ave, San Diego, CA 92103, USA
| | - Seth Kligerman
- Department of Radiology, UC San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Lewis Hahn
- Department of Radiology, UC San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Anna Narezkina
- Department of Medicine, Division of Cardiology, UC San Diego School of Medicine, 9500 Gilman Dr, La Jolla, CA 92093, USA
| | - Amanda Craine
- Department of Bioengineering, UC San Diego School of Engineering, 9500 Gilman Drive, MC 0412, La Jolla, CA 92093, USA
| | - Katherine Lowe
- Department of Bioengineering, UC San Diego School of Engineering, 9500 Gilman Drive, MC 0412, La Jolla, CA 92093, USA
| | - Francisco Contijoch
- Department of Bioengineering, UC San Diego School of Engineering, 9500 Gilman Drive, MC 0412, La Jolla, CA 92093, USA
- Department of Radiology, UC San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093, USA
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18
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Kolesová H, Olejníčková V, Kvasilová A, Gregorovičová M, Sedmera D. Tissue clearing and imaging methods for cardiovascular development. iScience 2021; 24:102387. [PMID: 33981974 PMCID: PMC8086021 DOI: 10.1016/j.isci.2021.102387] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Tissue imaging in 3D using visible light is limited and various clearing techniques were developed to increase imaging depth, but none provides universal solution for all tissues at all developmental stages. In this review, we focus on different tissue clearing methods for 3D imaging of heart and vasculature, based on chemical composition (solvent-based, simple immersion, hyperhydration, and hydrogel embedding techniques). We discuss in detail compatibility of various tissue clearing techniques with visualization methods: fluorescence preservation, immunohistochemistry, nuclear staining, and fluorescent dyes vascular perfusion. We also discuss myocardium visualization using autofluorescence, tissue shrinking, and expansion. Then we overview imaging methods used to study cardiovascular system and live imaging. We discuss heart and vessels segmentation methods and image analysis. The review covers the whole process of cardiovascular system 3D imaging, starting from tissue clearing and its compatibility with various visualization methods to the types of imaging methods and resulting image analysis.
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Affiliation(s)
- Hana Kolesová
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Institute of Physiology, Czech Academy of Science, Prague, Czech Republic
| | - Veronika Olejníčková
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Institute of Physiology, Czech Academy of Science, Prague, Czech Republic
| | - Alena Kvasilová
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Martina Gregorovičová
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Institute of Physiology, Czech Academy of Science, Prague, Czech Republic
| | - David Sedmera
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Institute of Physiology, Czech Academy of Science, Prague, Czech Republic
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19
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Comelli A, Dahiya N, Stefano A, Benfante V, Gentile G, Agnese V, Raffa GM, Pilato M, Yezzi A, Petrucci G, Pasta S. Deep learning approach for the segmentation of aneurysmal ascending aorta. Biomed Eng Lett 2021; 11:15-24. [PMID: 33747600 PMCID: PMC7930147 DOI: 10.1007/s13534-020-00179-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/12/2020] [Accepted: 11/09/2020] [Indexed: 12/14/2022] Open
Abstract
Diagnosis of ascending thoracic aortic aneurysm (ATAA) is based on the measurement of the maximum aortic diameter, but size is not a good predictor of the risk of adverse events. There is growing interest in the development of novel image-derived risk strategies to improve patient risk management towards a highly individualized level. In this study, the feasibility and efficacy of deep learning for the automatic segmentation of ATAAs was investigated using UNet, ENet, and ERFNet techniques. Specifically, CT angiography done on 72 patients with ATAAs and different valve morphology (i.e., tricuspid aortic valve, TAV, and bicuspid aortic valve, BAV) were semi-automatically segmented with Mimics software (Materialize NV, Leuven, Belgium), and then used for training of the tested deep learning models. The segmentation performance in terms of accuracy and time inference were compared using several parameters. All deep learning models reported a dice score higher than 88%, suggesting a good agreement between predicted and manual ATAA segmentation. We found that the ENet and UNet are more accurate than ERFNet, with the ENet much faster than UNet. This study demonstrated that deep learning models can rapidly segment and quantify the 3D geometry of ATAAs with high accuracy, thereby facilitating the expansion into clinical workflow of personalized approach to the management of patients with ATAAs.
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Affiliation(s)
- Albert Comelli
- Ri.MED Foundation, Palermo, Italy
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Cefalù, Italy
| | - Navdeep Dahiya
- Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332 USA
| | - Alessandro Stefano
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Cefalù, Italy
| | - Viviana Benfante
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Cefalù, Italy
| | - Giovanni Gentile
- Department of Diagnostic and Therapeutic Services, Radiology Unit, IRCCS-ISMETT, Palermo, Italy
| | - Valentina Agnese
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
| | - Giuseppe M. Raffa
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
| | - Michele Pilato
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
| | - Anthony Yezzi
- Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332 USA
| | | | - Salvatore Pasta
- Department of Engineering, University of Palermo, Palermo, Italy
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20
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Zhang X, Noga M, Martin DG, Punithakumar K. Fully automated left atrium segmentation from anatomical cine long-axis MRI sequences using deep convolutional neural network with unscented Kalman filter. Med Image Anal 2020; 68:101916. [PMID: 33285484 DOI: 10.1016/j.media.2020.101916] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 11/20/2020] [Accepted: 11/21/2020] [Indexed: 11/26/2022]
Abstract
This study proposes a fully automated approach for the left atrial segmentation from routine cine long-axis cardiac magnetic resonance image sequences using deep convolutional neural networks and Bayesian filtering. The proposed approach consists of a classification network that automatically detects the type of long-axis sequence and three different convolutional neural network models followed by unscented Kalman filtering (UKF) that delineates the left atrium. Instead of training and predicting all long-axis sequence types together, the proposed approach first identifies the image sequence type as to 2, 3 and 4 chamber views, and then performs prediction based on neural nets trained for that particular sequence type. The datasets were acquired retrospectively and ground truth manual segmentation was provided by an expert radiologist. In addition to neural net based classification and segmentation, another neural net is trained and utilized to select image sequences for further processing using UKF to impose temporal consistency over cardiac cycle. A cyclic dynamic model with time-varying angular frequency is introduced in UKF to characterize the variations in cardiac motion during image scanning. The proposed approach was trained and evaluated separately with varying amount of training data with images acquired from 20, 40, 60 and 80 patients. Evaluations over 1515 images with equal number of images from each chamber group acquired from an additional 20 patients demonstrated that the proposed model outperformed state-of-the-art and yielded a mean Dice coefficient value of 94.1%, 93.7% and 90.1% for 2, 3 and 4-chamber sequences, respectively, when trained with datasets from 80 patients.
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Affiliation(s)
- Xiaoran Zhang
- Department of Electrical and Computer Engineering, University of California, Los Angeles, United States; Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada; Servier Virtual Cardiac Centre, Mazankowski Alberta Heart Institute, Edmonton, Canada.
| | - Michelle Noga
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada; Servier Virtual Cardiac Centre, Mazankowski Alberta Heart Institute, Edmonton, Canada
| | - David Glynn Martin
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada; Servier Virtual Cardiac Centre, Mazankowski Alberta Heart Institute, Edmonton, Canada
| | - Kumaradevan Punithakumar
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada; Servier Virtual Cardiac Centre, Mazankowski Alberta Heart Institute, Edmonton, Canada; Department of Computing Science, University of Alberta, Edmonton, Canada.
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Habijan M, Babin D, Galić I, Leventić H, Romić K, Velicki L, Pižurica A. Overview of the Whole Heart and Heart Chamber Segmentation Methods. Cardiovasc Eng Technol 2020; 11:725-747. [DOI: 10.1007/s13239-020-00494-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/06/2020] [Indexed: 12/13/2022]
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22
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Hoeijmakers MJMM, Waechter‐Stehle I, Weese J, Van de Vosse FN. Combining statistical shape modeling, CFD, and meta-modeling to approximate the patient-specific pressure-drop across the aortic valve in real-time. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2020; 36:e3387. [PMID: 32686898 PMCID: PMC7583374 DOI: 10.1002/cnm.3387] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/13/2020] [Accepted: 07/15/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Advances in medical imaging, segmentation techniques, and high performance computing have stimulated the use of complex, patient-specific, three-dimensional Computational Fluid Dynamics (CFD) simulations. Patient-specific, CFD-compatible geometries of the aortic valve are readily obtained. CFD can then be used to obtain the patient-specific pressure-flow relationship of the aortic valve. However, such CFD simulations are computationally expensive, and real-time alternatives are desired. AIM The aim of this work is to evaluate the performance of a meta-model with respect to high-fidelity, three-dimensional CFD simulations of the aortic valve. METHODS Principal component analysis was used to build a statistical shape model (SSM) from a population of 74 iso-topological meshes of the aortic valve. Synthetic meshes were created with the SSM, and steady-state CFD simulations at flow-rates between 50 and 650 mL/s were performed to build a meta-model. The meta-model related the statistical shape variance, and flow-rate to the pressure-drop. RESULTS Even though the first three shape modes account for only 46% of shape variance, the features relevant for the pressure-drop seem to be captured. The three-mode shape-model approximates the pressure-drop with an average error of 8.8% to 10.6% for aortic valves with a geometric orifice area below 150 mm2 . The proposed methodology was least accurate for aortic valve areas above 150 mm2 . Further reduction to a meta-model introduces an additional 3% error. CONCLUSIONS Statistical shape modeling can be used to capture shape variation of the aortic valve. Meta-models trained by SSM-based CFD simulations can provide an estimate of the pressure-flow relationship in real-time.
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Affiliation(s)
- M. J. M. M. Hoeijmakers
- Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
- ANSYS IncVilleurbanneFrance
| | | | | | - F. N. Van de Vosse
- Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
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23
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Franke B, Weese J, Waechter-Stehle I, Brüning J, Kuehne T, Goubergrits L. Towards improving the accuracy of aortic transvalvular pressure gradients: rethinking Bernoulli. Med Biol Eng Comput 2020; 58:1667-1679. [PMID: 32451697 PMCID: PMC7340661 DOI: 10.1007/s11517-020-02186-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 05/01/2020] [Indexed: 10/25/2022]
Abstract
The transvalvular pressure gradient (TPG) is commonly estimated using the Bernoulli equation. However, the method is known to be inaccurate. Therefore, an adjusted Bernoulli model for accurate TPG assessment was developed and evaluated. Numerical simulations were used to calculate TPGCFD in patient-specific geometries of aortic stenosis as ground truth. Geometries, aortic valve areas (AVA), and flow rates were derived from computed tomography scans. Simulations were divided in a training data set (135 cases) and a test data set (36 cases). The training data was used to fit an adjusted Bernoulli model as a function of AVA and flow rate. The model-predicted TPGModel was evaluated using the test data set and also compared against the common Bernoulli equation (TPGB). TPGB and TPGModel both correlated well with TPGCFD (r > 0.94), but significantly overestimated it. The average difference between TPGModel and TPGCFD was much lower: 3.3 mmHg vs. 17.3 mmHg between TPGB and TPGCFD. Also, the standard error of estimate was lower for the adjusted model: SEEModel = 5.3 mmHg vs. SEEB = 22.3 mmHg. The adjusted model's performance was more accurate than that of the conventional Bernoulli equation. The model might help to improve non-invasive assessment of TPG. Graphical abstract Processing pipeline for the definition of an adjusted Bernoulli model for the assessment of transvalvular pressure gradient. Using CT image data, the patient specific geometry of the stenosed AVs were reconstructed. Using this segmentation, the AVA as well as the volume flow rate was calculated and used for model definition. This novel model was compared against classical approaches on a test data set, which was not used for the model definition.
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Affiliation(s)
- Benedikt Franke
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - J Weese
- Philips Research Laboratories, Hamburg, Germany
| | | | - J Brüning
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - T Kuehne
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - L Goubergrits
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.,Einstein Center Digital Future, Berlin, Germany
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Koo HJ, Lee JG, Ko JY, Lee G, Kang JW, Kim YH, Yang DH. Automated Segmentation of Left Ventricular Myocardium on Cardiac Computed Tomography Using Deep Learning. Korean J Radiol 2020; 21:660-669. [PMID: 32410405 PMCID: PMC7231613 DOI: 10.3348/kjr.2019.0378] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/23/2020] [Accepted: 02/09/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To evaluate the accuracy of a deep learning-based automated segmentation of the left ventricle (LV) myocardium using cardiac CT. MATERIALS AND METHODS To develop a fully automated algorithm, 100 subjects with coronary artery disease were randomly selected as a development set (50 training / 20 validation / 30 internal test). An experienced cardiac radiologist generated the manual segmentation of the development set. The trained model was evaluated using 1000 validation set generated by an experienced technician. Visual assessment was performed to compare the manual and automatic segmentations. In a quantitative analysis, sensitivity and specificity were calculated according to the number of pixels where two three-dimensional masks of the manual and deep learning segmentations overlapped. Similarity indices, such as the Dice similarity coefficient (DSC), were used to evaluate the margin of each segmented masks. RESULTS The sensitivity and specificity of automated segmentation for each segment (1-16 segments) were high (85.5-100.0%). The DSC was 88.3 ± 6.2%. Among randomly selected 100 cases, all manual segmentation and deep learning masks for visual analysis were classified as very accurate to mostly accurate and there were no inaccurate cases (manual vs. deep learning: very accurate, 31 vs. 53; accurate, 64 vs. 39; mostly accurate, 15 vs. 8). The number of very accurate cases for deep learning masks was greater than that for manually segmented masks. CONCLUSION We present deep learning-based automatic segmentation of the LV myocardium and the results are comparable to manual segmentation data with high sensitivity, specificity, and high similarity scores.
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Affiliation(s)
- Hyun Jung Koo
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - June Goo Lee
- Biomedical Engineering Research Center, Asan Institute of Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yeon Ko
- Biomedical Engineering Research Center, Asan Institute of Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gaeun Lee
- Biomedical Engineering Research Center, Asan Institute of Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Won Kang
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Hak Kim
- Division of Cardiology, Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Hyun Yang
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Baskaran L, Al’Aref SJ, Maliakal G, Lee BC, Xu Z, Choi JW, Lee SE, Sung JM, Lin FY, Dunham S, Mosadegh B, Kim YJ, Gottlieb I, Lee BK, Chun EJ, Cademartiri F, Maffei E, Marques H, Shin S, Choi JH, Chinnaiyan K, Hadamitzky M, Conte E, Andreini D, Pontone G, Budoff MJ, Leipsic JA, Raff GL, Virmani R, Samady H, Stone PH, Berman DS, Narula J, Bax JJ, Chang HJ, Min JK, Shaw LJ. Automatic segmentation of multiple cardiovascular structures from cardiac computed tomography angiography images using deep learning. PLoS One 2020; 15:e0232573. [PMID: 32374784 PMCID: PMC7202628 DOI: 10.1371/journal.pone.0232573] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/23/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To develop, demonstrate and evaluate an automated deep learning method for multiple cardiovascular structure segmentation. BACKGROUND Segmentation of cardiovascular images is resource-intensive. We design an automated deep learning method for the segmentation of multiple structures from Coronary Computed Tomography Angiography (CCTA) images. METHODS Images from a multicenter registry of patients that underwent clinically-indicated CCTA were used. The proximal ascending and descending aorta (PAA, DA), superior and inferior vena cavae (SVC, IVC), pulmonary artery (PA), coronary sinus (CS), right ventricular wall (RVW) and left atrial wall (LAW) were annotated as ground truth. The U-net-derived deep learning model was trained, validated and tested in a 70:20:10 split. RESULTS The dataset comprised 206 patients, with 5.130 billion pixels. Mean age was 59.9 ± 9.4 yrs., and was 42.7% female. An overall median Dice score of 0.820 (0.782, 0.843) was achieved. Median Dice scores for PAA, DA, SVC, IVC, PA, CS, RVW and LAW were 0.969 (0.979, 0.988), 0.953 (0.955, 0.983), 0.937 (0.934, 0.965), 0.903 (0.897, 0.948), 0.775 (0.724, 0.925), 0.720 (0.642, 0.809), 0.685 (0.631, 0.761) and 0.625 (0.596, 0.749) respectively. Apart from the CS, there were no significant differences in performance between sexes or age groups. CONCLUSIONS An automated deep learning model demonstrated segmentation of multiple cardiovascular structures from CCTA images with reasonable overall accuracy when evaluated on a pixel level.
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Affiliation(s)
- Lohendran Baskaran
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York, United States of America
- Department of Cardiovascular Medicine, National Heart Centre, Singapore, Singapore
| | - Subhi J. Al’Aref
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York, United States of America
| | | | - Benjamin C. Lee
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
| | - Zhuoran Xu
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
| | - Jeong W. Choi
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
| | - Sang-Eun Lee
- Division of Cardiology, Severance Cardiovascular Hospital, Integrative Cardiovascular Imaging Center, Yonsei University College of Medicine, Seoul, South Korea
- Division of Cardiology, Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Ji Min Sung
- Division of Cardiology, Severance Cardiovascular Hospital, Integrative Cardiovascular Imaging Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Fay Y. Lin
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York, United States of America
| | - Simon Dunham
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
| | - Bobak Mosadegh
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
| | - Yong-Jin Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea
| | - Ilan Gottlieb
- Department of Radiology, Casa de Saude São Jose, Rio de Janeiro, Brazil
| | - Byoung Kwon Lee
- Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Ju Chun
- Department of Radiology, Seoul National University Bundang Hospital, Sungnam, South Korea
| | | | - Erica Maffei
- Department of Radiology, Area Vasta 1/ASUR Marche, Urbino, Italy
| | - Hugo Marques
- UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisboa, Portugal
| | - Sanghoon Shin
- Division of Cardiology, Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea
| | | | - Kavitha Chinnaiyan
- Department of Cardiology, William Beaumont Hospital, Royal Oak, Michigan, United States of America
| | - Martin Hadamitzky
- Department of Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany
| | | | | | | | - Matthew J. Budoff
- Department of Medicine, Los Angeles Biomedical Research Institute, Torrance, California, United States of America
| | - Jonathon A. Leipsic
- Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gilbert L. Raff
- Department of Cardiology, William Beaumont Hospital, Royal Oak, Michigan, United States of America
| | - Renu Virmani
- Department of Pathology, CVPath Institute, Gaithersburg, Maryland, United States of America
| | - Habib Samady
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Peter H. Stone
- Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Daniel S. Berman
- Department of Imaging and Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America
| | - Jagat Narula
- Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, Zena and Michael A. Wiener Cardiovascular Institute, and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, New York, New York, United States of America
| | - Jeroen J. Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Hyuk-Jae Chang
- Division of Cardiology, Severance Cardiovascular Hospital, Integrative Cardiovascular Imaging Center, Yonsei University College of Medicine, Seoul, South Korea
| | - James K. Min
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York, United States of America
| | - Leslee J. Shaw
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York, United States of America
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Niu Y, Qin L, Wang X. Structured graph regularized shape prior and cross-entropy induced active contour model for myocardium segmentation in CTA images. Neurocomputing 2019. [DOI: 10.1016/j.neucom.2019.04.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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27
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Estimation of valvular resistance of segmented aortic valves using computational fluid dynamics. J Biomech 2019; 94:49-58. [DOI: 10.1016/j.jbiomech.2019.07.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/18/2019] [Accepted: 07/09/2019] [Indexed: 12/29/2022]
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Itayem DA, Anzalone CL, White JR, Pallanch JF, O'Brien EK. Increased Accuracy, Confidence, and Efficiency in Anterior Ethmoidal Artery Identification with Segmented Image Guidance. Otolaryngol Head Neck Surg 2019; 160:818-821. [PMID: 30691346 DOI: 10.1177/0194599818825454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine whether using image guidance technology with 3-dimensional image segmentation increases the endoscopic surgeon's accuracy, efficiency, and confidence in identifying the anterior ethmoidal artery. METHODS This is a cross-sectional study of attending physicians and residents at an academic medical center. Because identification of the anterior ethmoidal artery during image-guided surgery can be challenging, we studied the effect of anterior ethmoidal artery image segmentation (ie, partitioning and coloring) on surgeon test performance. A computerized test was administered to 16 surgeons who were asked to identify the anterior ethmoidal artery on multiplanar computed tomographic images and to answer multiple-choice questions. Half the questions showed segmented images of the anterior ethmoidal artery, and half showed images without segmentation. Efficiency and accuracy of identification and subjective surgeon confidence were determined for each question. Descriptive statistics were used to compare test performance for identification of the anterior ethmoidal artery on images with or without segmentation. RESULTS Percentage of correct answers ( P < .001), efficiency ( P < .001), and confidence ( P < .001) in identification of the anterior ethmoidal artery were significantly better with segmented computed tomographic images. DISCUSSION We demonstrated that use of segmented images improves surgeons' accuracy, confidence, and efficiency for identification of the anterior ethmoidal artery. IMPLICATIONS FOR PRACTICE We describe how segmentation can allow surgeons to improve the surgical course by increasing their accuracy, confidence, and efficiency in identifying the anterior ethmoidal artery.
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Affiliation(s)
- Deeyar A Itayem
- 1 Mayo Clinic Alix School of Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA
| | - C Lane Anzalone
- 2 Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - James R White
- 2 Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - John F Pallanch
- 2 Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Erin K O'Brien
- 2 Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Sedghi Gamechi Z, Bons LR, Giordano M, Bos D, Budde RPJ, Kofoed KF, Pedersen JH, Roos-Hesselink JW, de Bruijne M. Automated 3D segmentation and diameter measurement of the thoracic aorta on non-contrast enhanced CT. Eur Radiol 2019; 29:4613-4623. [PMID: 30673817 PMCID: PMC6682850 DOI: 10.1007/s00330-018-5931-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 11/08/2018] [Accepted: 11/29/2018] [Indexed: 01/15/2023]
Abstract
Objectives To develop and evaluate a fully automatic method to measure diameters of the ascending and descending aorta on non-ECG-gated, non-contrast computed tomography (CT) scans. Material and methods The method combines multi-atlas registration to obtain seed points, aorta centerline extraction, and an optimal surface segmentation approach to extract the aorta surface around the centerline. From the extracted 3D aorta segmentation, the diameter of the ascending and descending aorta was calculated at cross-sectional slices perpendicular to the extracted centerline, at the level of the pulmonary artery bifurcation, and at 1-cm intervals up to 3 cm above and below this level. Agreement with manual annotations was evaluated by dice similarity coefficient (DSC) for segmentation overlap, mean surface distance (MSD), and intra-class correlation (ICC) of diameters on 100 CT scans from a lung cancer screening trial. Repeatability of the diameter measurements was evaluated on 617 baseline-one year follow-up CT scan pairs. Results The agreement between manual and automatic segmentations was good with 0.95 ± 0.01 DSC and 0.56 ± 0.08 mm MSD. ICC between the diameters derived from manual and from automatic segmentations was 0.97, with the per-level ICC ranging from 0.87 to 0.94. An ICC of 0.98 for all measurements and per-level ICC ranging from 0.91 to 0.96 were obtained for repeatability. Conclusion This fully automatic method can assess diameters in the thoracic aorta reliably even in non-ECG-gated, non-contrast CT scans. This could be a promising tool to assess aorta dilatation in screening and in clinical practice. Key Points • Fully automatic method to assess thoracic aorta diameters. • High agreement between fully automatic method and manual segmentations. • Method is suitable for non-ECG-gated CT and can therefore be used in screening. Electronic supplementary material The online version of this article (10.1007/s00330-018-5931-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zahra Sedghi Gamechi
- Biomedical Imaging Group Rotterdam, Departments of Radiology and Medical Informatics, Erasmus MC, Rotterdam, The Netherlands.
| | - Lidia R Bons
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Marco Giordano
- Biomedical Imaging Group Rotterdam, Departments of Radiology and Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
| | - Daniel Bos
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Ricardo P J Budde
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Klaus F Kofoed
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jesper Holst Pedersen
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - Marleen de Bruijne
- Biomedical Imaging Group Rotterdam, Departments of Radiology and Medical Informatics, Erasmus MC, Rotterdam, The Netherlands.,Machine Learning Section, Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
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Xie Q, Chen Z, Chen H, Lu X. Nonrigid registration of cardiac DSCT images by integrating intensity and point features. Biomed Signal Process Control 2019. [DOI: 10.1016/j.bspc.2018.08.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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31
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Morais P, Vilaça JL, Queirós S, Marchi A, Bourier F, Deisenhofer I, D'hooge J, Tavares JMRS. Automated segmentation of the atrial region and fossa ovalis towards computer-aided planning of inter-atrial wall interventions. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 161:73-84. [PMID: 29852969 DOI: 10.1016/j.cmpb.2018.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/29/2018] [Accepted: 04/17/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Image-fusion strategies have been applied to improve inter-atrial septal (IAS) wall minimally-invasive interventions. Hereto, several landmarks are initially identified on richly-detailed datasets throughout the planning stage and then combined with intra-operative images, enhancing the relevant structures and easing the procedure. Nevertheless, such planning is still performed manually, which is time-consuming and not necessarily reproducible, hampering its regular application. In this article, we present a novel automatic strategy to segment the atrial region (left/right atrium and aortic tract) and the fossa ovalis (FO). METHODS The method starts by initializing multiple 3D contours based on an atlas-based approach with global transforms only and refining them to the desired anatomy using a competitive segmentation strategy. The obtained contours are then applied to estimate the FO by evaluating both IAS wall thickness and the expected FO spatial location. RESULTS The proposed method was evaluated in 41 computed tomography datasets, by comparing the atrial region segmentation and FO estimation results against manually delineated contours. The automatic segmentation method presented a performance similar to the state-of-the-art techniques and a high feasibility, failing only in the segmentation of one aortic tract and of one right atrium. The FO estimation method presented an acceptable result in all the patients with a performance comparable to the inter-observer variability. Moreover, it was faster and fully user-interaction free. CONCLUSIONS Hence, the proposed method proved to be feasible to automatically segment the anatomical models for the planning of IAS wall interventions, making it exceptionally attractive for use in the clinical practice.
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Affiliation(s)
- Pedro Morais
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal; Instituto de Ciência e Inovação em Engenharia Mecânica e Engenharia Industrial, Faculdade de Engenharia, Universidade do Porto, Portugal; Lab on Cardiovascular Imaging & Dynamics, Department of Cardiovascular Sciences, KULeuven - University of Leuven, Leuven, Belgium.
| | - João L Vilaça
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal; 2Ai - Polytechnic Institute of Cávado and Ave, Barcelos, Portugal.
| | - Sandro Queirós
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal; Lab on Cardiovascular Imaging & Dynamics, Department of Cardiovascular Sciences, KULeuven - University of Leuven, Leuven, Belgium; Algoritmi Center, School of Engineering, University of Minho, Guimarães, Portugal.
| | - Alberto Marchi
- Cardiomyopathies Unit, Careggi University Hospital Florence, Italy
| | - Felix Bourier
- German Heart Center Munich, Technical University, Munich, Germany.
| | | | - Jan D'hooge
- Lab on Cardiovascular Imaging & Dynamics, Department of Cardiovascular Sciences, KULeuven - University of Leuven, Leuven, Belgium.
| | - João Manuel R S Tavares
- Instituto de Ciência e Inovação em Engenharia Mecânica e Engenharia Industrial, Faculdade de Engenharia, Universidade do Porto, Portugal.
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Rapid fully automatic segmentation of subcortical brain structures by shape-constrained surface adaptation. Med Image Anal 2018; 46:146-161. [DOI: 10.1016/j.media.2018.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 02/23/2018] [Accepted: 03/08/2018] [Indexed: 11/18/2022]
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Carminati M, Piazzese C, Pepi M, Tamborini G, Gripari P, Pontone G, Krause R, Auricchio A, Lang R, Caiani E. A statistical shape model of the left ventricle from real-time 3D echocardiography and its application to myocardial segmentation of cardiac magnetic resonance images. Comput Biol Med 2018; 96:241-251. [DOI: 10.1016/j.compbiomed.2018.03.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/21/2018] [Accepted: 03/21/2018] [Indexed: 10/17/2022]
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Danilov VV, Skirnevskiy IP, Gerget OM, Shelomentcev EE, Kolpashchikov DY, Vasilyev NV. Efficient workflow for automatic segmentation of the right heart based on 2D echocardiography. Int J Cardiovasc Imaging 2018; 34:1041-1055. [PMID: 29428969 DOI: 10.1007/s10554-018-1314-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 02/02/2018] [Indexed: 12/01/2022]
Abstract
The present study aimed to present a workflow algorithm for automatic processing of 2D echocardiography images. The workflow was based on several sequential steps. For each step, we compared different approaches. Epicardial 2D echocardiography datasets were acquired during various open-chest beating-heart surgical procedures in three porcine hearts. We proposed a metric called the global index that is a weighted average of several accuracy coefficients, indices and the mean processing time. This metric allows the estimation of the speed and accuracy for processing each image. The global index ranges from 0 to 1, which facilitates comparison between different approaches. The second step involved comparison among filtering, sharpening and segmentation techniques. During the noise reduction step, we compared the median filter, total variation filter, bilateral filter, curvature flow filter, non-local means filter and mean shift filter. To clarify the endocardium borders of the right heart, we used the linear sharpen. Lastly, we applied watershed segmentation, clusterisation, region-growing, morphological segmentation, image foresting segmentation and isoline delineation. We assessed all the techniques and identified the most appropriate workflow for echocardiography image segmentation of the right heart. For successful processing and segmentation of echocardiography images with minimal error, we found that the workflow should include the total variation filter/bilateral filter, linear sharpen technique, isoline delineation/region-growing segmentation and morphological post-processing. We presented an efficient and accurate workflow for the precise diagnosis of cardiovascular diseases. We introduced the global index metric for image pre-processing and segmentation estimation.
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Affiliation(s)
- Viacheslav V Danilov
- Medical Devices Design Laboratory, RASA Center in Tomsk, Tomsk Polytechnic University, Tomsk, Russia
| | - Igor P Skirnevskiy
- Medical Devices Design Laboratory, RASA Center in Tomsk, Tomsk Polytechnic University, Tomsk, Russia
| | - Olga M Gerget
- Medical Devices Design Laboratory, RASA Center in Tomsk, Tomsk Polytechnic University, Tomsk, Russia
| | - Egor E Shelomentcev
- Medical Devices Design Laboratory, RASA Center in Tomsk, Tomsk Polytechnic University, Tomsk, Russia
| | - Dmitrii Yu Kolpashchikov
- Medical Devices Design Laboratory, RASA Center in Tomsk, Tomsk Polytechnic University, Tomsk, Russia
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Morais P, Vilaça JL, Queirós S, Bourier F, Deisenhofer I, Tavares JMRS, D'hooge J. A competitive strategy for atrial and aortic tract segmentation based on deformable models. Med Image Anal 2017; 42:102-116. [PMID: 28780174 DOI: 10.1016/j.media.2017.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 06/30/2017] [Accepted: 07/26/2017] [Indexed: 01/27/2023]
Abstract
Multiple strategies have previously been described for atrial region (i.e. atrial bodies and aortic tract) segmentation. Although these techniques have proven their accuracy, inadequate results in the mid atrial walls are common, restricting their application for specific cardiac interventions. In this work, we introduce a novel competitive strategy to perform atrial region segmentation with correct delineation of the thin mid walls, and integrated it into the B-spline Explicit Active Surfaces framework. A double-stage segmentation process is used, which starts with a fast contour growing followed by a refinement stage with local descriptors. Independent functions are used to define each region, being afterward combined to compete for the optimal boundary. The competition locally constrains the surface evolution, prevents overlaps and allows refinement to the walls. Three different scenarios were used to demonstrate the advantages of the proposed approach, through the evaluation of its segmentation accuracy, and its performance for heterogeneous mid walls. Both computed tomography and magnetic resonance imaging datasets were used, presenting results similar to the state-of-the-art methods for both atria and aorta. The competitive strategy showed its superior performance with statistically significant differences against the traditional free-evolution approach in cases with bad image quality or missed atrial/aortic walls. Moreover, only the competitive approach was able to accurately segment the atrial/aortic wall. Overall, the proposed strategy showed to be suitable for atrial region segmentation with a correct segmentation of the mid thin walls, demonstrating its added value with respect to the traditional techniques.
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Affiliation(s)
- Pedro Morais
- Instituto de Ciência e Inovação em Engenharia Mecânica e Engenharia Industrial, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal; Lab on Cardiovascular Imaging & Dynamics, Department of Cardiovascular Sciences, KULeuven - University of Leuven, Leuven, Belgium.
| | - João L Vilaça
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal; DIGARC - Polytechnic Institute of Cávado and Ave, Barcelos, Portugal
| | - Sandro Queirós
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal; Lab on Cardiovascular Imaging & Dynamics, Department of Cardiovascular Sciences, KULeuven - University of Leuven, Leuven, Belgium; Algoritmi Center, School of Engineering, University of Minho, Guimarães, Portugal
| | - Felix Bourier
- Department of Electrophysiology, German Heart Center Munich, Technical University, Munich, Germany
| | - Isabel Deisenhofer
- Department of Electrophysiology, German Heart Center Munich, Technical University, Munich, Germany
| | - João Manuel R S Tavares
- Instituto de Ciência e Inovação em Engenharia Mecânica e Engenharia Industrial, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - Jan D'hooge
- Lab on Cardiovascular Imaging & Dynamics, Department of Cardiovascular Sciences, KULeuven - University of Leuven, Leuven, Belgium
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Weese J, Lungu A, Peters J, Weber FM, Waechter-Stehle I, Hose DR. CFD- and Bernoulli-based pressure drop estimates: A comparison using patient anatomies from heart and aortic valve segmentation of CT images. Med Phys 2017; 44:2281-2292. [DOI: 10.1002/mp.12203] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 02/09/2017] [Accepted: 02/15/2017] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jürgen Weese
- Philips Research Laboratories; Röntgenstrasse 24-26 D-22335 Hamburg Germany
| | - Angela Lungu
- Medical Physics Group; University of Sheffield, Medical School; Beech Hill Road Sheffield S10 2RX United Kingdom
| | - Jochen Peters
- Philips Research Laboratories; Röntgenstrasse 24-26 D-22335 Hamburg Germany
| | - Frank M. Weber
- Philips Research Laboratories; Röntgenstrasse 24-26 D-22335 Hamburg Germany
| | | | - D. Rodney Hose
- Medical Physics Group; University of Sheffield, Medical School; Beech Hill Road Sheffield S10 2RX United Kingdom
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Freiman M, Nickisch H, Prevrhal S, Schmitt H, Vembar M, Maurovich-Horvat P, Donnelly P, Goshen L. Improving CCTA-based lesions' hemodynamic significance assessment by accounting for partial volume modeling in automatic coronary lumen segmentation. Med Phys 2017; 44:1040-1049. [DOI: 10.1002/mp.12121] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 01/12/2017] [Accepted: 01/15/2017] [Indexed: 12/19/2022] Open
Affiliation(s)
- Moti Freiman
- Philips Medical Systems Technologies Ltd.; Advanced Technologies Center; Haifa 3100202 Israel
| | - Hannes Nickisch
- Philips Medical Systems Technologies Ltd.; Advanced Technologies Center; Haifa 3100202 Israel
| | - Sven Prevrhal
- Philips Medical Systems Technologies Ltd.; Advanced Technologies Center; Haifa 3100202 Israel
| | - Holger Schmitt
- Philips Medical Systems Technologies Ltd.; Advanced Technologies Center; Haifa 3100202 Israel
| | - Mani Vembar
- Philips Medical Systems Technologies Ltd.; Advanced Technologies Center; Haifa 3100202 Israel
| | - Pál Maurovich-Horvat
- Philips Medical Systems Technologies Ltd.; Advanced Technologies Center; Haifa 3100202 Israel
| | - Patrick Donnelly
- Philips Medical Systems Technologies Ltd.; Advanced Technologies Center; Haifa 3100202 Israel
| | - Liran Goshen
- Philips Medical Systems Technologies Ltd.; Advanced Technologies Center; Haifa 3100202 Israel
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Pereira F, Bueno A, Rodriguez A, Perrin D, Marx G, Cardinale M, Salgo I, Del Nido P. Automated detection of coarctation of aorta in neonates from two-dimensional echocardiograms. J Med Imaging (Bellingham) 2017; 4:014502. [PMID: 28149925 DOI: 10.1117/1.jmi.4.1.014502] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 12/20/2016] [Indexed: 11/14/2022] Open
Abstract
Coarctation of aorta (CoA) is a critical congenital heart defect (CCHD) that requires accurate and immediate diagnosis and treatment. Current newborn screening methods to detect CoA lack both in sensitivity and specificity, and when suspected in a newborn, it must be confirmed using specialized imaging and expert diagnosis, both of which are usually unavailable at tertiary birthing centers. We explore the feasibility of applying machine learning methods to reliably determine the presence of this difficult-to-diagnose cardiac abnormality from ultrasound image data. We propose a framework that uses deep learning-based machine learning methods for fully automated detection of CoA from two-dimensional ultrasound clinical data acquired in the parasternal long axis view, the apical four chamber view, and the suprasternal notch view. On a validation set consisting of 26 CoA and 64 normal patients our algorithm achieved a total error rate of 12.9% (11.5% false-negative error and 13.6% false-positive error) when combining decisions of classifiers over three standard echocardiographic view planes. This compares favorably with published results that combine clinical assessments with pulse oximetry to detect CoA (71% sensitivity).
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Affiliation(s)
- Franklin Pereira
- Philips Ultrasound Inc. , 3000 Minuteman Road, Andover, Massachusetts 02176, United States
| | - Alejandra Bueno
- Boston Children's Hospital , Department of Cardiovascular Surgery, 300 Longwood Avenue, Boston, Massachusetts 02115, United States
| | - Andrea Rodriguez
- Boston Children's Hospital , Department of Cardiovascular Surgery, 300 Longwood Avenue, Boston, Massachusetts 02115, United States
| | - Douglas Perrin
- Boston Children's Hospital , Department of Cardiovascular Surgery, 300 Longwood Avenue, Boston, Massachusetts 02115, United States
| | - Gerald Marx
- Boston Children's Hospital , Department of Cardiovascular Surgery, 300 Longwood Avenue, Boston, Massachusetts 02115, United States
| | - Michael Cardinale
- Philips Ultrasound Inc. , 3000 Minuteman Road, Andover, Massachusetts 02176, United States
| | - Ivan Salgo
- Philips Ultrasound Inc. , 3000 Minuteman Road, Andover, Massachusetts 02176, United States
| | - Pedro Del Nido
- Boston Children's Hospital , Department of Cardiovascular Surgery, 300 Longwood Avenue, Boston, Massachusetts 02115, United States
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Cai K, Yang R, Chen H, Li L, Zhou J, Ou S, Liu F. A framework combining window width-level adjustment and Gaussian filter-based multi-resolution for automatic whole heart segmentation. Neurocomputing 2017. [DOI: 10.1016/j.neucom.2016.03.106] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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40
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Assessment of Diastolic Function in Hypertrophic Cardiomyopathy by Computed Tomography–Derived Analysis of Left Ventricular Filling. J Comput Assist Tomogr 2017; 41:339-343. [DOI: 10.1097/rct.0000000000000533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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41
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Zhou R, Liao Z, Pan T, Milgrom SA, Pinnix CC, Shi A, Tang L, Yang J, Liu Y, Gomez D, Nguyen QN, Dabaja BS, Court L, Yang J. Cardiac atlas development and validation for automatic segmentation of cardiac substructures. Radiother Oncol 2016; 122:66-71. [PMID: 27939201 DOI: 10.1016/j.radonc.2016.11.016] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 11/16/2016] [Accepted: 11/21/2016] [Indexed: 12/25/2022]
Abstract
PURPOSE To develop and validate a set of atlases for auto-contouring cardiac substructures. METHODS Eight radiation oncologists manually and independently delineated 15 cardiac substructures from noncontrast CT images of 6 patients by referring to their respective fused contrast CT images. Individual contours were fused together for each structure, edited by 2 physicians, and became atlases to delineate other 6 patients. The auto-delineated contours of the 6 additional patients became templates for manual contouring. These 12 patients with well-defined contours composed the final atlases for multi-atlas segmentation. RESULTS The average time for manually contouring the 15 cardiac substructures was about 40min. Inter-observer variability was small for the heart, the chambers, and the aorta compared with that for other structures that were not clearly distinguishable in CT images. The mean dice similarity coefficient and mean surface distance of auto-segmented contours were within one standard deviation of expert contouring variability. Good agreement between auto-segmented and manual contours was observed for the heart, the chambers, and the great vessels. Independent validation on other 19 patients showed reasonable agreement for the heart chambers. CONCLUSIONS A set of cardiac atlases was created for auto-contouring from noncontrast CT images. The accuracy of auto-contouring for the heart, chambers, and great vessels was validated for potential clinical use.
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Affiliation(s)
- Rongrong Zhou
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Radiation Oncology, Xiangya Hospital, Central South University, Changsha, China
| | - Zhongxing Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Tinsu Pan
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Sarah A Milgrom
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Chelsea C Pinnix
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Anhui Shi
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Linglong Tang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Ju Yang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Ying Liu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Daniel Gomez
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Quynh-Nhu Nguyen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Bouthaina S Dabaja
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Laurence Court
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Jinzhong Yang
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USA.
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Veulemans V, Mollus S, Saalbach A, Pietsch M, Hellhammer K, Zeus T, Westenfeld R, Weese J, Kelm M, Balzer J. Optimal C-arm angulation during transcatheter aortic valve replacement: Accuracy of a rotational C-arm computed tomography based three dimensional heart model. World J Cardiol 2016; 8:606-614. [PMID: 27847562 PMCID: PMC5088367 DOI: 10.4330/wjc.v8.i10.606] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 07/10/2016] [Accepted: 08/31/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the accuracy of a rotational C-arm CT-based 3D heart model to predict an optimal C-arm configuration during transcatheter aortic valve replacement (TAVR).
METHODS Rotational C-arm CT (RCT) under rapid ventricular pacing was performed in 57 consecutive patients with severe aortic stenosis as part of the pre-procedural cardiac catheterization. With prototype software each RCT data set was segmented using a 3D heart model. From that the line of perpendicularity curve was obtained that generates a perpendicular view of the aortic annulus according to the right-cusp rule. To evaluate the accuracy of a model-based overlay we compared model- and expert-derived aortic root diameters.
RESULTS For all 57 patients in the RCT cohort diameter measurements were obtained from two independent operators and were compared to the model-based measurements. The inter-observer variability was measured to be in the range of 0°-12.96° of angular C-arm displacement for two independent operators. The model-to-operator agreement was 0°-13.82°. The model-based and expert measurements of aortic root diameters evaluated at the aortic annulus (r = 0.79, P < 0.01), the aortic sinus (r = 0.93, P < 0.01) and the sino-tubular junction (r = 0.92, P < 0.01) correlated on a high level and the Bland-Altman analysis showed good agreement. The interobserver measurements did not show a significant bias.
CONCLUSION Automatic segmentation of the aortic root using an anatomical model can accurately predict an optimal C-arm configuration, potentially simplifying current clinical workflows before and during TAVR.
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43
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Zhuang X, Shen J. Multi-scale patch and multi-modality atlases for whole heart segmentation of MRI. Med Image Anal 2016; 31:77-87. [PMID: 26999615 DOI: 10.1016/j.media.2016.02.006] [Citation(s) in RCA: 147] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 12/30/2015] [Accepted: 02/22/2016] [Indexed: 01/18/2023]
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Weese J, Lorenz C. Four challenges in medical image analysis from an industrial perspective. Med Image Anal 2016; 33:44-49. [PMID: 27344939 DOI: 10.1016/j.media.2016.06.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 12/12/2022]
Abstract
Today's medical imaging systems produce a huge amount of images containing a wealth of information. However, the information is hidden in the data and image analysis algorithms are needed to extract it, to make it readily available for medical decisions and to enable an efficient work flow. Advances in medical image analysis over the past 20 years mean there are now many algorithms and ideas available that allow to address medical image analysis tasks in commercial solutions with sufficient performance in terms of accuracy, reliability and speed. At the same time new challenges have arisen. Firstly, there is a need for more generic image analysis technologies that can be efficiently adapted for a specific clinical task. Secondly, efficient approaches for ground truth generation are needed to match the increasing demands regarding validation and machine learning. Thirdly, algorithms for analyzing heterogeneous image data are needed. Finally, anatomical and organ models play a crucial role in many applications, and algorithms to construct patient-specific models from medical images with a minimum of user interaction are needed. These challenges are complementary to the on-going need for more accurate, more reliable and faster algorithms, and dedicated algorithmic solutions for specific applications.
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Affiliation(s)
- Jürgen Weese
- Philips Research Hamburg, Röntgenstrasse 22 - 24, D-22335 Hamburg, Germany.
| | - Cristian Lorenz
- Philips Research Hamburg, Röntgenstrasse 22 - 24, D-22335 Hamburg, Germany.
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45
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Feng C, Zhang S, Zhao D, Li C. Simultaneous extraction of endocardial and epicardial contours of the left ventricle by distance regularized level sets. Med Phys 2016; 43:2741-2755. [DOI: 10.1118/1.4947126] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Chabiniok R, Wang VY, Hadjicharalambous M, Asner L, Lee J, Sermesant M, Kuhl E, Young AA, Moireau P, Nash MP, Chapelle D, Nordsletten DA. Multiphysics and multiscale modelling, data-model fusion and integration of organ physiology in the clinic: ventricular cardiac mechanics. Interface Focus 2016; 6:20150083. [PMID: 27051509 PMCID: PMC4759748 DOI: 10.1098/rsfs.2015.0083] [Citation(s) in RCA: 139] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
With heart and cardiovascular diseases continually challenging healthcare systems worldwide, translating basic research on cardiac (patho)physiology into clinical care is essential. Exacerbating this already extensive challenge is the complexity of the heart, relying on its hierarchical structure and function to maintain cardiovascular flow. Computational modelling has been proposed and actively pursued as a tool for accelerating research and translation. Allowing exploration of the relationships between physics, multiscale mechanisms and function, computational modelling provides a platform for improving our understanding of the heart. Further integration of experimental and clinical data through data assimilation and parameter estimation techniques is bringing computational models closer to use in routine clinical practice. This article reviews developments in computational cardiac modelling and how their integration with medical imaging data is providing new pathways for translational cardiac modelling.
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Affiliation(s)
- Radomir Chabiniok
- Division of Imaging Sciences and Biomedical Engineering, King's College London, St Thomas’ Hospital, London SE1 7EH, UK
- Inria and Paris-Saclay University, Bâtiment Alan Turing, 1 rue Honoré d'Estienne d'Orves, Campus de l'Ecole Polytechnique, Palaiseau 91120, France
| | - Vicky Y. Wang
- Auckland Bioengineering Institute, University of Auckland, 70 Symonds Street, Auckland, New Zealand
| | - Myrianthi Hadjicharalambous
- Division of Imaging Sciences and Biomedical Engineering, King's College London, St Thomas’ Hospital, London SE1 7EH, UK
| | - Liya Asner
- Division of Imaging Sciences and Biomedical Engineering, King's College London, St Thomas’ Hospital, London SE1 7EH, UK
| | - Jack Lee
- Division of Imaging Sciences and Biomedical Engineering, King's College London, St Thomas’ Hospital, London SE1 7EH, UK
| | - Maxime Sermesant
- Inria, Asclepios team, 2004 route des Lucioles BP 93, Sophia Antipolis Cedex 06902, France
| | - Ellen Kuhl
- Departments of Mechanical Engineering, Bioengineering, and Cardiothoracic Surgery, Stanford University, 496 Lomita Mall, Durand 217, Stanford, CA 94306, USA
| | - Alistair A. Young
- Auckland Bioengineering Institute, University of Auckland, 70 Symonds Street, Auckland, New Zealand
| | - Philippe Moireau
- Inria and Paris-Saclay University, Bâtiment Alan Turing, 1 rue Honoré d'Estienne d'Orves, Campus de l'Ecole Polytechnique, Palaiseau 91120, France
| | - Martyn P. Nash
- Auckland Bioengineering Institute, University of Auckland, 70 Symonds Street, Auckland, New Zealand
- Department of Engineering Science, University of Auckland, 70 Symonds Street, Auckland, New Zealand
| | - Dominique Chapelle
- Inria and Paris-Saclay University, Bâtiment Alan Turing, 1 rue Honoré d'Estienne d'Orves, Campus de l'Ecole Polytechnique, Palaiseau 91120, France
| | - David A. Nordsletten
- Division of Imaging Sciences and Biomedical Engineering, King's College London, St Thomas’ Hospital, London SE1 7EH, UK
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Pulmonary hypertension and right ventricular dysfunction in patients with left to right shunt coronary artery fistula: evaluation with cardiac CT. Int J Cardiovasc Imaging 2016; 32 Suppl 1:91-104. [PMID: 27016094 DOI: 10.1007/s10554-016-0868-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 03/02/2016] [Indexed: 10/22/2022]
Abstract
In this study, we aimed to evaluate whether patients with left to right shunt coronary artery fistula (LRSCAF) are predisposed to developing pulmonary hypertension and right ventricular dysfunction compared with healthy individuals. The value of cardiac CT findings in determining the necessity of intervention for these patients was investigated. We retrospectively studied 19 patients with LRSCAF and 19 healthy patients. Several parameters were observed on cardiac CT by two radiologists, including pulmonary trunk diameter (PA diameter), right ventricular diameter (RVD), left ventricular diameter (LVD), RVD/LVD ratio, septal bowing and CT score of right ventricular dysfunction (CSRVD). Data from both groups were compared. The inter- and intra-observer variabilities and correlations were examined. The disease group was further divided into intervention (n = 9) and non-intervention (n = 10) groups, and their data were compared. All cardiac CT findings showed significant intra- and inter-observer correlation without significant variability. Mann-Whitney U tests and χ(2) analysis showed that PA diameter, RVD/LVD ratio acquired from two observers, and CSRVD were higher in the disease group than in the control group (all P values < 0.05 for χ(2) and almost all P values < 0.05 for Mann-Whitney U). The RVD/LVD ratio and CSRVD were higher in the intervention group than in the non-intervention group (all P values < 0.05). Receiver operating curve analysis identified RVD/LVD = 1.036 and CSRVD = 3.5 as the best cut-off values to determine the necessity of further intervention. Patients with LRSCAF are more predisposed to pulmonary hypertension and right ventricular dysfunction compared with the normal population. RVD/LVD > 1.0 and CSRVD ≥ 4.0 may determine the necessity of intervention for patients with LRSCAF.
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Almeida N, Friboulet D, Sarvari SI, Bernard O, Barbosa D, Samset E, Dhooge J. Left-Atrial Segmentation From 3-D Ultrasound Using B-Spline Explicit Active Surfaces With Scale Uncoupling. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2016; 63:212-221. [PMID: 26685231 DOI: 10.1109/tuffc.2015.2507638] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Segmentation of the left atrium (LA) of the heart allows quantification of LA volume dynamics which can give insight into cardiac function. However, very little attention has been given to LA segmentation from three-dimensional (3-D) ultrasound (US), most efforts being focused on the segmentation of the left ventricle (LV). The B-spline explicit active surfaces (BEAS) framework has been shown to be a very robust and efficient methodology to perform LV segmentation. In this study, we propose an extension of the BEAS framework, introducing B-splines with uncoupled scaling. This formulation improves the shape support for less regular and more variable structures, by giving independent control over smoothness and number of control points. Semiautomatic segmentation of the LA endocardium using this framework was tested in a setup requiring little user input, on 20 volumetric sequences of echocardiographic data from healthy subjects. The segmentation results were evaluated against manual reference delineations of the LA. Relevant LA morphological and functional parameters were derived from the segmented surfaces, in order to assess the performance of the proposed method on its clinical usage. The results showed that the modified BEAS framework is capable of accurate semiautomatic LA segmentation in 3-D transthoracic US, providing reliable quantification of the LA morphology and function.
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Bruge S, Simon A, Lederlin M, Betancur J, Hernandez A, Donal E, Leclercq C, Garreau M. Multi-modal data fusion for Cardiac Resynchronization Therapy planning and assistance. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:2391-4. [PMID: 26736775 DOI: 10.1109/embc.2015.7318875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cardiac Resynchronization Therapy (CRT) has been validated as an efficient treatment for selected patients suffering from heart failure with cardiac dyssynchrony. In case of bi-ventricular stimulation, the response to the therapy may be improved by an optimal choice of the left ventricle (LV) pacing sites. The characterization of LV properties to select the best candidate sites and to precise their access modes would be useful for the clinician in pre- and per-operative stages. For that purpose, we propose a new pre-operative analysis solution integrating previously developed multi-modal data registration methods and a new segmentation process of their coronary venous access. Moreover, a novel visualization interface is proposed to help the clinician to visualize the most relevant pacing sites and their access during the implantation in the operating room. This work is illustrated on real CRT data patients.
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50
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Antunes S, Esposito A, Palmisano A, Colantoni C, Cerutti S, Rizzo G. Cardiac Multi-detector CT Segmentation Based on Multiscale Directional Edge Detector and 3D Level Set. Ann Biomed Eng 2015; 44:1487-501. [PMID: 26319010 DOI: 10.1007/s10439-015-1422-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 08/07/2015] [Indexed: 11/30/2022]
Abstract
Extraction of the cardiac surfaces of interest from multi-detector computed tomographic (MDCT) data is a pre-requisite step for cardiac analysis, as well as for image guidance procedures. Most of the existing methods need manual corrections, which is time-consuming. We present a fully automatic segmentation technique for the extraction of the right ventricle, left ventricular endocardium and epicardium from MDCT images. The method consists in a 3D level set surface evolution approach coupled to a new stopping function based on a multiscale directional second derivative Gaussian filter, which is able to stop propagation precisely on the real boundary of the structures of interest. We validated the segmentation method on 18 MDCT volumes from healthy and pathologic subjects using manual segmentation performed by a team of expert radiologists as gold standard. Segmentation errors were assessed for each structure resulting in a surface-to-surface mean error below 0.5 mm and a percentage of surface distance with errors less than 1 mm above 80%. Moreover, in comparison to other segmentation approaches, already proposed in previous work, our method presented an improved accuracy (with surface distance errors less than 1 mm increased of 8-20% for all structures). The obtained results suggest that our approach is accurate and effective for the segmentation of ventricular cavities and myocardium from MDCT images.
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Affiliation(s)
- Sofia Antunes
- Experimental Imaging Center, San Raffaele Scientific Institute, via olgettina 58, 20132, Milan, Italy. .,Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
| | - Antonio Esposito
- Experimental Imaging Center, San Raffaele Scientific Institute, via olgettina 58, 20132, Milan, Italy.,Department of Radiology, San Raffaele Scientific Institute, Milan, Italy
| | - Anna Palmisano
- Experimental Imaging Center, San Raffaele Scientific Institute, via olgettina 58, 20132, Milan, Italy.,Department of Radiology, San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Colantoni
- Experimental Imaging Center, San Raffaele Scientific Institute, via olgettina 58, 20132, Milan, Italy.,Department of Radiology, San Raffaele Scientific Institute, Milan, Italy
| | - Sergio Cerutti
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Giovanna Rizzo
- Institute of Molecular Bioimaging and Physiology CNR, Segrate, Italy
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