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Register a new userSimultaneous Left Atrium Anatomy and Scar Segmentations via Deep Learning in Multiview Information with Attention
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Three-dimensional late gadolinium enhanced (LGE) cardiac MR (CMR) of left atrial scar in patients with atrial fibrillation (AF) has recently emerged as a promising technique to stratify patients, to guide ablation therapy and to predict treatment success. This requires a segmentation of the high intensity scar tissue and also a segmentation of the left atrium (LA) anatomy, the latter usually being derived from a separate bright-blood acquisition. Performing both segmentations automatically from a single 3D LGE CMR acquisition would eliminate the need for an additional acquisition and avoid subsequent registration issues. In this paper, we propose a joint segmentation method based on multiview two-task (MVTT) recursive attention model working directly on 3D LGE CMR images to segment the LA (and proximal pulmonary veins) and to delineate the scar on the same dataset. Using our MVTT recursive attention model, both the LA anatomy and scar can be segmented accurately (mean Dice score of 93% for the LA anatomy and 87% for the scar segmentations) and efficiently (~0.27 seconds to simultaneously segment the LA anatomy and scars directly from the 3D LGE CMR dataset with 60-68 2D slices). Compared to conventional unsupervised learning and other state-of-the-art deep learning based methods, the proposed MVTT model achieved excellent results, leading to an automatic generation of a patient-specific anatomical model combined with scar segmentation for patients in AF.
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Automated and accurate segmentations of left atrium (LA) and atrial scars from late gadolinium-enhanced cardiac magnetic resonance (LGE CMR) images are in high demand for quantifying atrial scars. The previous quantification of atrial scars relies on a two-phase segmentation for LA and atrial scars due to their large volume difference (unbalanced atrial targets). In this paper, we propose an inter-cascade generative adversarial network, namely JAS-GAN, to segment the unbalanced atrial targets from LGE CMR images automatically and accurately in an end-to-end way. Firstly, JAS-GAN investigates an adaptive attention cascade to automatically correlate the segmentation tasks of the unbalanced atrial targets. The adaptive attention cascade mainly models the inclusion relationship of the two unbalanced atrial targets, where the estimated LA acts as the attention map to adaptively focus on the small atrial scars roughly. Then, an adversarial regularization is applied to the segmentation tasks of the unbalanced atrial targets for making a consistent optimization. It mainly forces the estimated joint distribution of LA and atrial scars to match the real ones. We evaluated the performance of our JAS-GAN on a 3D LGE CMR dataset with 192 scans. Compared with the state-of-the-art methods, our proposed approach yielded better segmentation performance (Average Dice Similarity Coefficient (DSC) values of 0.946 and 0.821 for LA and atrial scars, respectively), which indicated the effectiveness of our proposed approach for segmenting unbalanced atrial targets.
We propose an end-to-end deep neural network (DNN) which can simultaneously segment the left atrial (LA) cavity and quantify LA scars. The framework incorporates the continuous spatial information of the target by introducing a spatially encoded (SE) loss based on the distance transform map. Compared to conventional binary label based loss, the proposed SE loss can reduce noisy patches in the resulting segmentation, which is commonly seen for deep learning-based methods. To fully utilize the inherent spatial relationship between LA and LA scars, we further propose a shape attention (SA) mechanism through an explicit surface projection to build an end-to-end-trainable model. Specifically, the SA scheme is embedded into a two-task network to perform the joint LA segmentation and scar quantification. Moreover, the proposed method can alleviate the severe class-imbalance problem when detecting small and discrete targets like scars. We evaluated the proposed framework on 60 LGE MRI data from the MICCAI2018 LA challenge. For LA segmentation, the proposed method reduced the mean Hausdorff distance from 36.4 mm to 20.0 mm compared to the 3D basic U-Net using the binary cross-entropy loss. For scar quantification, the method was compared with the results or algorithms reported in the literature and demonstrated better performance.
Late Gadolinium Enhanced Cardiac MRI (LGE-CMRI) for detecting atrial scars in atrial fibrillation (AF) patients has recently emerged as a promising technique to stratify patients, guide ablation therapy and predict treatment success. Visualisation and quantification of scar tissues require a segmentation of both the left atrium (LA) and the high intensity scar regions from LGE-CMRI images. These two segmentation tasks are challenging due to the cancelling of healthy tissue signal, low signal-to-noise ratio and often limited image quality in these patients. Most approaches require manual supervision and/or a second bright-blood MRI acquisition for anatomical segmentation. Segmenting both the LA anatomy and the scar tissues automatically from a single LGE-CMRI acquisition is highly in demand. In this study, we proposed a novel fully automated multiview two-task (MVTT) recursive attention model working directly on LGE-CMRI images that combines a sequential learning and a dilated residual learning to segment the LA (including attached pulmonary veins) and delineate the atrial scars simultaneously via an innovative attention model. Compared to other state-of-the-art methods, the proposed MVTT achieves compelling improvement, enabling to generate a patient-specific anatomical and atrial scar assessment model.
Left atrial (LA) and atrial scar segmentation from late gadolinium enhanced magnetic resonance imaging (LGE MRI) is an important task in clinical practice. %, to guide ablation therapy and predict treatment results for atrial fibrillation (AF) patients. The automatic segmentation is however still challenging, due to the poor image quality, the various LA shapes, the thin wall, and the surrounding enhanced regions. Previous methods normally solved the two tasks independently and ignored the intrinsic spatial relationship between LA and scars. In this work, we develop a new framework, namely AtrialJSQnet, where LA segmentation, scar projection onto the LA surface, and scar quantification are performed simultaneously in an end-to-end style. We propose a mechanism of shape attention (SA) via an explicit surface projection, to utilize the inherent correlation between LA and LA scars. In specific, the SA scheme is embedded into a multi-task architecture to perform joint LA segmentation and scar quantification. Besides, a spatial encoding (SE) loss is introduced to incorporate continuous spatial information of the target, in order to reduce noisy patches in the predicted segmentation. We evaluated the proposed framework on 60 LGE MRIs from the MICCAI2018 LA challenge. Extensive experiments on a public dataset demonstrated the effect of the proposed AtrialJSQnet, which achieved competitive performance over the state-of-the-art. The relatedness between LA segmentation and scar quantification was explicitly explored and has shown significant performance improvements for both tasks. The code and results will be released publicly once the manuscript is accepted for publication via https://zmiclab.github.io/projects.html.
Congenital heart disease (CHD) is the most common congenital abnormality associated with birth defects in the United States. Despite training efforts and substantial advancement in ultrasound technology over the past years, CHD remains an abnormality that is frequently missed during prenatal ultrasonography. Therefore, computer-aided detection of CHD can play a critical role in prenatal care by improving screening and diagnosis. Since many CHDs involve structural abnormalities, automatic segmentation of anatomical structures is an important step in the analysis of fetal echocardiograms. While existing methods mainly focus on the four-chamber view with a small number of structures, here we present a more comprehensive deep learning segmentation framework covering 14 anatomical structures in both three-vessel trachea and four-chamber views. Specifically, our framework enhances the V-Net with spatial dropout, group normalization, and deep supervision to train a segmentation model that can be applied on both views regardless of abnormalities. By identifying the pitfall of using the Dice loss when some labels are unavailable in some images, this framework integrates information from multiple views and is robust to missing structures due to anatomical anomalies, achieving an average Dice score of 79%.
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