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Register a new userMedical Image Analysis on Left Atrial LGE MRI for Atrial Fibrillation Studies: A Review
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Lei Li
Publication date
2021
fields
Informatics Engineering
and research's language is
English
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Late gadolinium enhancement magnetic resonance imaging (LGE MRI) is commonly used to visualize and quantify left atrial (LA) scars. The position and extent of scars provide important information of the pathophysiology and progression of atrial fibrillation (AF). Hence, LA scar segmentation and quantification from LGE MRI can be useful in computer-assisted diagnosis and treatment stratification of AF patients. Since manual delineation can be time-consuming and subject to intra- and inter-expert variability, automating this computing is highly desired, which nevertheless is still challenging and under-researched. This paper aims to provide a systematic review on computing methods for LA cavity, wall, scar and ablation gap segmentation and quantification from LGE MRI, and the related literature for AF studies. Specifically, we first summarize AF-related imaging techniques, particularly LGE MRI. Then, we review the methodologies of the four computing tasks in detail, and summarize the validation strategies applied in each task. Finally, the possible future developments are outlined, with a brief survey on the potential clinical applications of the aforementioned methods. The review shows that the research into this topic is still in early stages. Although several methods have been proposed, especially for LA segmentation, there is still large scope for further algorithmic developments due to performance issues related to the high variability of enhancement appearance and differences in image acquisition.
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Purpose: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is correlated with increased morbidity and mortality. It is associated with atrial fibrosis, which may be assessed non-invasively using late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI) where scar tissue is visualised as a region of signal enhancement. In this study, we proposed a novel fully automatic pipeline to achieve an accurate and objective atrial scarring segmentation and assessment of LGE MRI scans for the AF patients. Methods: Our fully automatic pipeline uniquely combined: (1) a multi-atlas based whole heart segmentation (MA-WHS) to determine the cardiac anatomy from an MRI Roadmap acquisition which is then mapped to LGE MRI, and (2) a super-pixel and supervised learning based approach to delineate the distribution and extent of atrial scarring in LGE MRI. Results: Both our MA-WHS and atrial scarring segmentation showed accurate delineations of cardiac anatomy (mean Dice = 89%) and atrial scarring (mean Dice =79%) respectively compared to the established ground truth from manual segmentation. Compared with previously studied methods with manual interventions, our innovative pipeline demonstrated comparable results, but was computed fully automatically. Conclusion: The proposed segmentation methods allow LGE MRI to be used as an objective assessment tool for localisation, visualisation and quantification of atrial scarring.
Left atrial (LA) segmentation from late gadolinium enhanced magnetic resonance imaging (LGE MRI) is a crucial step needed for planning the treatment of atrial fibrillation. However, automatic LA segmentation from LGE MRI is still challenging, due to the poor image quality, high variability in LA shapes, and unclear LA boundary. Though deep learning-based methods can provide promising LA segmentation results, they often generalize poorly to unseen domains, such as data from different scanners and/or sites. In this work, we collect 210 LGE MRIs from different centers with different levels of image quality. To evaluate the domain generalization ability of models on the LA segmentation task, we employ four commonly used semantic segmentation networks for the LA segmentation from multi-center LGE MRIs. Besides, we investigate three domain generalization strategies, i.e., histogram matching, mutual information based disentangled representation, and random style transfer, where a simple histogram matching is proved to be most effective.
Segmentation of the left atrial chamber and assessing its morphology, are essential for improving our understanding of atrial fibrillation, the most common type of cardiac arrhythmia. Automation of this process in 3D gadolinium enhanced-MRI (GE-MRI) data is desirable, as manual delineation is time-consuming, challenging and observer-dependent. Recently, deep convolutional neural networks (CNNs) have gained tremendous traction and achieved state-of-the-art results in medical image segmentation. However, it is difficult to incorporate local and global information without using contracting (pooling) layers, which in turn reduces segmentation accuracy for smaller structures. In this paper, we propose a 3D CNN for volumetric segmentation of the left atrial chamber in LGE-MRI. Our network is based on the well known U-Net architecture. We employ a 3D fully convolutional network, with dilated convolutions in the lowest level of the network, and residual connections between encoder blocks to incorporate local and global knowledge. The results show that including global context through the use of dilated convolutions, helps in domain adaptation, and the overall segmentation accuracy is improved in comparison to a 3D U-Net.
Transesophageal echocardiography (TEE) is widely used to detect left atrium (LA)/left atrial appendage (LAA) thrombi. In this paper, the local binary pattern variance (LBPV) features are extracted from region of interest (ROI). And the dynamic features are formed by using the information of its neighbor frames in the sequence. The sequence is viewed as a bag, and the images in the sequence are considered as the instances. Multiple-instance learning (MIL) method is employed to solve the LAA thrombi detection. The experimental results show that the proposed method can achieve better performance than that by using other methods.
Atrial Fibrillation (AF) is a common cardiac arrhythmia affecting a large number of people around the world. If left undetected, it will develop into chronic disability or even early mortality. However, patients who have this problem can barely feel its presence, especially in its early stage. A non-invasive, automatic, and effective detection method is therefore needed to help early detection so that medical intervention can be implemented in time to prevent its progression. Electrocardiogram (ECG), which records the electrical activities of the heart, has been widely used for detecting the presence of AF. However, due to the subtle patterns of AF, the performance of detection models have largely depended on complicated data pre-processing and expertly engineered features. In our work, we developed DenseECG, an end-to-end model based on 5 layers 1D densely connected convolutional neural network. We trained our model using the publicly available dataset from 2017 PhysioNet Computing in Cardiology(CinC) Challenge containing 8528 single-lead ECG recordings of short-term heart rhythms (9-61s). Our trained model was able to outperform the other state-of-the-art AF detection models on this dataset without complicated data pre-processing and expert-supervised feature engineering.
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