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Register a new userAutomated Quality Control in Image Segmentation: Application to the UK Biobank Cardiac MR Imaging Study
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Added by
Robert Robinson
Publication date
2019
fields
Informatics Engineering
and research's language is
English
Authors
Robert Robinson
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Background: The trend towards large-scale studies including population imaging poses new challenges in terms of quality control (QC). This is a particular issue when automatic processing tools, e.g. image segmentation methods, are employed to derive quantitative measures or biomarkers for later analyses. Manual inspection and visual QC of each segmentation isnt feasible at large scale. However, its important to be able to automatically detect when a segmentation method fails so as to avoid inclusion of wrong measurements into subsequent analyses which could lead to incorrect conclusions. Methods: To overcome this challenge, we explore an approach for predicting segmentation quality based on Reverse Classification Accuracy, which enables us to discriminate between successful and failed segmentations on a per-cases basis. We validate this approach on a new, large-scale manually-annotated set of 4,800 cardiac magnetic resonance scans. We then apply our method to a large cohort of 7,250 cardiac MRI on which we have performed manual QC. Results: We report results used for predicting segmentation quality metrics including Dice Similarity Coefficient (DSC) and surface-distance measures. As initial validation, we present data for 400 scans demonstrating 99% accuracy for classifying low and high quality segmentations using predicted DSC scores. As further validation we show high correlation between real and predicted scores and 95% classification accuracy on 4,800 scans for which manual segmentations were available. We mimic real-world application of the method on 7,250 cardiac MRI where we show good agreement between predicted quality metrics and manual visual QC scores. Conclusions: We show that RCA has the potential for accurate and fully automatic segmentation QC on a per-case basis in the context of large-scale population imaging as in the UK Biobank Imaging Study.
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An end-to-end image analysis pipeline is presented for the abdominal MRI protocol used in the UK Biobank on the first 38,971 participants. Emphasis is on the processing steps necessary to ensure a high-level of data quality and consistency is produced in order to prepare the datasets for downstream quantitative analysis, such as segmentation and parameter estimation. Quality control procedures have been incorporated to detect and, where possible, correct issues in the raw data. Detection of fat-water swaps in the Dixon series is performed by a deep learning model and corrected automatically. Bone joints are predicted using a hybrid atlas-based registration and deep learning model for the shoulders, hips and knees. Simultaneous estimation of proton density fat fraction and transverse relaxivity (R2*) is performed using both the magnitude and phase information for the single-slice multiecho series. Approximately 98.1% of the two-point Dixon acquisitions were successfully processed and passed quality control, with 99.98% of the high-resolution T1-weighted 3D volumes succeeding. Approximately 99.98% of the single-slice multiecho acquisitions covering the liver were successfully processed and passed quality control, with 97.6% of the single-slice multiecho acquisitions covering the pancreas succeeding. At least one fat-water swap was detected in 1.8% of participants. With respect to the bone joints, approximately 3.3% of participants were missing at least one knee joint and 0.8% were missing at least one shoulder joint. For the participants who received both single-slice multiecho acquisition protocols for the liver a systematic difference between the two protocols was identified and modeled using multiple linear regression. The findings presented here will be invaluable for scientists who seek to use image-derived phenotypes from the abdominal MRI protocol.
The effectiveness of a cardiovascular magnetic resonance (CMR) scan depends on the ability of the operator to correctly tune the acquisition parameters to the subject being scanned and on the potential occurrence of imaging artefacts such as cardiac and respiratory motion. In the clinical practice, a quality control step is performed by visual assessment of the acquired images: however, this procedure is strongly operator-dependent, cumbersome and sometimes incompatible with the time constraints in clinical settings and large-scale studies. We propose a fast, fully-automated, learning-based quality control pipeline for CMR images, specifically for short-axis image stacks. Our pipeline performs three important quality checks: 1) heart coverage estimation, 2) inter-slice motion detection, 3) image contrast estimation in the cardiac region. The pipeline uses a hybrid decision forest method - integrating both regression and structured classification models - to extract landmarks as well as probabilistic segmentation maps from both long- and short-axis images as a basis to perform the quality checks. The technique was tested on up to 3000 cases from the UK Biobank as well as on 100 cases from the UK Digital Heart Project, and validated against manual annotations and visual inspections performed by expert interpreters. The results show the capability of the proposed pipeline to correctly detect incomplete or corrupted scans (e.g. on UK Biobank, sensitivity and specificity respectively 88% and 99% for heart coverage estimation, 85% and 95% for motion detection), allowing their exclusion from the analysed dataset or the triggering of a new acquisition.
Deep learning methods have reached state-of-the-art performance in cardiac image segmentation. Currently, the main bottleneck towards their effective translation into clinics requires assuring continuous high model performance and segmentation results. In this work, we present a novel learning framework to monitor the performance of heart segmentation models in the absence of ground truth. Formulated as an anomaly detection problem, the monitoring framework allows deriving surrogate quality measures for a segmentation and allows flagging suspicious results. We propose two different types of quality measures, a global score and a pixel-wise map. We demonstrate their use by reproducing the final rankings of a cardiac segmentation challenge in the absence of ground truth. Results show that our framework is accurate, fast, and scalable, confirming it is a viable option for quality control monitoring in clinical practice and large population studies.
We perform unsupervised analysis of image-derived shape and motion features extracted from 3822 cardiac 4D MRIs of the UK Biobank. First, with a feature extraction method previously published based on deep learning models, we extract from each case 9 feature values characterizing both the cardiac shape and motion. Second, a feature selection is performed to remove highly correlated feature pairs. Third, clustering is carried out using a Gaussian mixture model on the selected features. After analysis, we identify two small clusters which probably correspond to two pathological categories. Further confirmation using a trained classification model and dimensionality reduction tools is carried out to support this discovery. Moreover, we examine the differences between the other large clusters and compare our measures with the ground-truth.
Incorporation of prior knowledge about organ shape and location is key to improve performance of image analysis approaches. In particular, priors can be useful in cases where images are corrupted and contain artefacts due to limitations in image acquisition. The highly constrained nature of anatomical objects can be well captured with learning based techniques. However, in most recent and promising techniques such as CNN based segmentation it is not obvious how to incorporate such prior knowledge. State-of-the-art methods operate as pixel-wise classifiers where the training objectives do not incorporate the structure and inter-dependencies of the output. To overcome this limitation, we propose a generic training strategy that incorporates anatomical prior knowledge into CNNs through a new regularisation model, which is trained end-to-end. The new framework encourages models to follow the global anatomical properties of the underlying anatomy (e.g. shape, label structure) via learned non-linear representations of the shape. We show that the proposed approach can be easily adapted to different analysis tasks (e.g. image enhancement, segmentation) and improve the prediction accuracy of the state-of-the-art models. The applicability of our approach is shown on multi-modal cardiac datasets and public benchmarks. Additionally, we demonstrate how the learned deep models of 3D shapes can be interpreted and used as biomarkers for classification of cardiac pathologies.
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