No Arabic abstract
Patient-specific 3D printing of congenital heart anatomy demands an accurate segmentation of the thin tissue interfaces which characterise these diagnoses. Even when a label set has a high spatial overlap with the ground truth, inaccurate delineation of these interfaces can result in topological errors. These compromise the clinical utility of such models due to the anomalous appearance of defects. CNNs have achieved state-of-the-art performance in segmentation tasks. Whilst data augmentation has often played an important role, we show that conventional image resampling schemes used therein can introduce topological changes in the ground truth labelling of augmented samples. We present a novel pipeline to correct for these changes, using a fast-marching algorithm to enforce the topology of the ground truth labels within their augmented representations. In so doing, we invoke the idea of cardiac contiguous topology to describe an arbitrary combination of congenital heart defects and develop an associated, clinically meaningful metric to measure the topological correctness of segmentations. In a series of five-fold cross-validations, we demonstrate the performance gain produced by this pipeline and the relevance of topological considerations to the segmentation of congenital heart defects. We speculate as to the applicability of this approach to any segmentation task involving morphologically complex targets.
Congenital heart disease (CHD) is the most common type of birth defect, which occurs 1 in every 110 births in the United States. CHD usually comes with severe variations in heart structure and great artery connections that can be classified into many types. Thus highly specialized domain knowledge and the time-consuming human process is needed to analyze the associated medical images. On the other hand, due to the complexity of CHD and the lack of dataset, little has been explored on the automatic diagnosis (classification) of CHDs. In this paper, we present ImageCHD, the first medical image dataset for CHD classification. ImageCHD contains 110 3D Computed Tomography (CT) images covering most types of CHD, which is of decent size Classification of CHDs requires the identification of large structural changes without any local tissue changes, with limited data. It is an example of a larger class of problems that are quite difficult for current machine-learning-based vision methods to solve. To demonstrate this, we further present a baseline framework for the automatic classification of CHD, based on a state-of-the-art CHD segmentation method. Experimental results show that the baseline framework can only achieve a classification accuracy of 82.0% under a selective prediction scheme with 88.4% coverage, leaving big room for further improvement. We hope that ImageCHD can stimulate further research and lead to innovative and generic solutions that would have an impact in multiple domains. Our dataset is released to the public compared with existing medical imaging datasets.
3D printing has been widely adopted for clinical decision making and interventional planning of Congenital heart disease (CHD), while whole heart and great vessel segmentation is the most significant but time-consuming step in the model generation for 3D printing. While various automatic whole heart and great vessel segmentation frameworks have been developed in the literature, they are ineffective when applied to medical images in CHD, which have significant variations in heart structure and great vessel connections. To address the challenge, we leverage the power of deep learning in processing regular structures and that of graph algorithms in dealing with large variations and propose a framework that combines both for whole heart and great vessel segmentation in CHD. Particularly, we first use deep learning to segment the four chambers and myocardium followed by the blood pool, where variations are usually small. We then extract the connection information and apply graph matching to determine the categories of all the vessels. Experimental results using 683D CT images covering 14 types of CHD show that our method can increase Dice score by 11.9% on average compared with the state-of-the-art whole heart and great vessel segmentation method in normal anatomy. The segmentation results are also printed out using 3D printers for validation.
Multi-class segmentation of cardiac magnetic resonance (CMR) images seeks a separation of data into anatomical components with known structure and configuration. The most popular CNN-based methods are optimised using pixel wise loss functions, ignorant of the spatially extended features that characterise anatomy. Therefore, whilst sharing a high spatial overlap with the ground truth, inferred CNN-based segmentations can lack coherence, including spurious connected components, holes and voids. Such results are implausible, violating anticipated anatomical topology. In response, (single-class) persistent homology-based loss functions have been proposed to capture global anatomical features. Our work extends these approaches to the task of multi-class segmentation. Building an enriched topological description of all class labels and class label pairs, our loss functions make predictable and statistically significant improvements in segmentation topology using a CNN-based post-processing framework. We also present (and make available) a highly efficient implementation based on cubical complexes and parallel execution, enabling practical application within high resolution 3D data for the first time. We demonstrate our approach on 2D short axis and 3D whole heart CMR segmentation, advancing a detailed and faithful analysis of performance on two publicly available datasets.
The novel COVID-19 is a global pandemic disease overgrowing worldwide. Computer-aided screening tools with greater sensitivity is imperative for disease diagnosis and prognosis as early as possible. It also can be a helpful tool in triage for testing and clinical supervision of COVID-19 patients. However, designing such an automated tool from non-invasive radiographic images is challenging as many manually annotated datasets are not publicly available yet, which is the essential core requirement of supervised learning schemes. This article proposes a 3D Convolutional Neural Network (CNN)-based classification approach considering both the inter- and intra-slice spatial voxel information. The proposed system is trained in an end-to-end manner on the 3D patches from the whole volumetric CT images to enlarge the number of training samples, performing the ablation studies on patch size determination. We integrate progressive resizing, segmentation, augmentations, and class-rebalancing to our 3D network. The segmentation is a critical prerequisite step for COVID-19 diagnosis enabling the classifier to learn prominent lung features while excluding the outer lung regions of the CT scans. We evaluate all the extensive experiments on a publicly available dataset, named MosMed, having binary- and multi-class chest CT image partitions. Our experimental results are very encouraging, yielding areas under the ROC curve of 0.914 and 0.893 for the binary- and multi-class tasks, respectively, applying 5-fold cross-validations. Our methods promising results delegate it as a favorable aiding tool for clinical practitioners and radiologists to assess COVID-19.
One of the challenges in developing deep learning algorithms for medical image segmentation is the scarcity of annotated training data. To overcome this limitation, data augmentation and semi-supervised learning (SSL) methods have been developed. However, these methods have limited effectiveness as they either exploit the existing data set only (data augmentation) or risk negative impact by adding poor training examples (SSL). Segmentations are rarely the final product of medical image analysis - they are typically used in downstream tasks to infer higher-order patterns to evaluate diseases. Clinicians take into account a wealth of prior knowledge on biophysics and physiology when evaluating image analysis results. We have used these clinical assessments in previous works to create robust quality-control (QC) classifiers for automated cardiac magnetic resonance (CMR) analysis. In this paper, we propose a novel scheme that uses QC of the downstream task to identify high quality outputs of CMR segmentation networks, that are subsequently utilised for further network training. In essence, this provides quality-aware augmentation of training data in a variant of SSL for segmentation networks (semiQCSeg). We evaluate our approach in two CMR segmentation tasks (aortic and short axis cardiac volume segmentation) using UK Biobank data and two commonly used network architectures (U-net and a Fully Convolutional Network) and compare against supervised and SSL strategies. We show that semiQCSeg improves training of the segmentation networks. It decreases the need for labelled data, while outperforming the other methods in terms of Dice and clinical metrics. SemiQCSeg can be an efficient approach for training segmentation networks for medical image data when labelled datasets are scarce.