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Register a new userHardware-aware Real-time Myocardial Segmentation Quality Control in Contrast Echocardiography
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Automatic myocardial segmentation of contrast echocardiography has shown great potential in the quantification of myocardial perfusion parameters. Segmentation quality control is an important step to ensure the accuracy of segmentation results for quality research as well as its clinical application. Usually, the segmentation quality control happens after the data acquisition. At the data acquisition time, the operator could not know the quality of the segmentation results. On-the-fly segmentation quality control could help the operator to adjust the ultrasound probe or retake data if the quality is unsatisfied, which can greatly reduce the effort of time-consuming manual correction. However, it is infeasible to deploy state-of-the-art DNN-based models because the segmentation module and quality control module must fit in the limited hardware resource on the ultrasound machine while satisfying strict latency constraints. In this paper, we propose a hardware-aware neural architecture search framework for automatic myocardial segmentation and quality control of contrast echocardiography. We explicitly incorporate the hardware latency as a regularization term into the loss function during training. The proposed method searches the best neural network architecture for the segmentation module and quality prediction module with strict latency.
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Myocardial infarction (MI), or commonly known as heart attack, is a life-threatening health problem worldwide from which 32.4 million people suffer each year. Early diagnosis and treatment of MI are crucial to prevent further heart tissue damages or death. The earliest and most reliable sign of ischemia is regional wall motion abnormality (RWMA) of the affected part of the ventricular muscle. Echocardiography can easily, inexpensively, and non-invasively exhibit the RWMA. In this article, we introduce a three-phase approach for early MI detection in low-quality echocardiography: 1) segmentation of the entire left ventricle (LV) wall using a state-of-the-art deep learning model, 2) analysis of the segmented LV wall by feature engineering, and 3) early MI detection. The main contributions of this study are highly accurate segmentation of the LV wall from low-quality echocardiography, pseudo labeling approach for ground-truth formation of the unannotated LV wall, and the first public echocardiographic dataset (HMC-QU)* for MI detection. Furthermore, the outputs of the proposed approach can significantly help cardiologists for a better assessment of the LV wall characteristics. The proposed approach has achieved 95.72% sensitivity and 99.58% specificity for the LV wall segmentation, and 85.97% sensitivity, 74.03% specificity, and 86.85% precision for MI detection on the HMC-QU dataset. *The benchmark HMC-QU dataset is publicly shared at the repository https://www.kaggle.com/aysendegerli/hmcqu-dataset
Real-time cardiac magnetic resonance imaging (MRI) plays an increasingly important role in guiding various cardiac interventions. In order to provide better visual assistance, the cine MRI frames need to be segmented on-the-fly to avoid noticeable visual lag. In addition, considering reliability and patient data privacy, the computation is preferably done on local hardware. State-of-the-art MRI segmentation methods mostly focus on accuracy only, and can hardly be adopted for real-time application or on local hardware. In this work, we present the first hardware-aware multi-scale neural architecture search (NAS) framework for real-time 3D cardiac cine MRI segmentation. The proposed framework incorporates a latency regularization term into the loss function to handle real-time constraints, with the consideration of underlying hardware. In addition, the formulation is fully differentiable with respect to the architecture parameters, so that stochastic gradient descent (SGD) can be used for optimization to reduce the computation cost while maintaining optimization quality. Experimental results on ACDC MICCAI 2017 dataset demonstrate that our hardware-aware multi-scale NAS framework can reduce the latency by up to 3.5 times and satisfy the real-time constraints, while still achieving competitive segmentation accuracy, compared with the state-of-the-art NAS segmentation framework.
Tissue characterisation with CMR parametric mapping has the potential to detect and quantify both focal and diffuse alterations in myocardial structure not assessable by late gadolinium enhancement. Native T1 mapping in particular has shown promise as a useful biomarker to support diagnostic, therapeutic and prognostic decision-making in ischaemic and non-ischaemic cardiomyopathies. Convolutional neural networks with Bayesian inference are a category of artificial neural networks which model the uncertainty of the network output. This study presents an automated framework for tissue characterisation from native ShMOLLI T1 mapping at 1.5T using a Probabilistic Hierarchical Segmentation (PHiSeg) network. In addition, we use the uncertainty information provided by the PHiSeg network in a novel automated quality control (QC) step to identify uncertain T1 values. The PHiSeg network and QC were validated against manual analysis on a cohort of the UK Biobank containing healthy subjects and chronic cardiomyopathy patients. We used the proposed method to obtain reference T1 ranges for the left ventricular myocardium in healthy subjects as well as common clinical cardiac conditions. T1 values computed from automatic and manual segmentations were highly correlated (r=0.97). Bland-Altman analysis showed good agreement between the automated and manual measurements. The average Dice metric was 0.84 for the left ventricular myocardium. The sensitivity of detection of erroneous outputs was 91%. Finally, T1 values were automatically derived from 14,683 CMR exams from the UK Biobank. The proposed pipeline allows for automatic analysis of myocardial native T1 mapping and includes a QC process to detect potentially erroneous results. T1 reference values were presented for healthy subjects and common clinical cardiac conditions from the largest cohort to date using T1-mapping images.
Most existing deep learning-based frameworks for image segmentation assume that a unique ground truth is known and can be used for performance evaluation. This is true for many applications, but not all. Myocardial segmentation of Myocardial Contrast Echocardiography (MCE), a critical task in automatic myocardial perfusion analysis, is an example. Due to the low resolution and serious artifacts in MCE data, annotations from different cardiologists can vary significantly, and it is hard to tell which one is the best. In this case, how can we find a good way to evaluate segmentation performance and how do we train the neural network? In this paper, we address the first problem by proposing a new extended Dice to effectively evaluate the segmentation performance when multiple accepted ground truth is available. Then based on our proposed metric, we solve the second problem by further incorporating the new metric into a loss function that enables neural networks to flexibly learn general features of myocardium. Experiment results on our clinical MCE data set demonstrate that the neural network trained with the proposed loss function outperforms those existing ones that try to obtain a unique ground truth from multiple annotations, both quantitatively and qualitatively. Finally, our grading study shows that using extended Dice as an evaluation metric can better identify segmentation results that need manual correction compared with using Dice.
Cardiac imaging known as echocardiography is a non-invasive tool utilized to produce data including images and videos, which cardiologists use to diagnose cardiac abnormalities in general and myocardial infarction (MI) in particular. Echocardiography machines can deliver abundant amounts of data that need to be quickly analyzed by cardiologists to help them make a diagnosis and treat cardiac conditions. However, the acquired data quality varies depending on the acquisition conditions and the patients responsiveness to the setup instructions. These constraints are challenging to doctors especially when patients are facing MI and their lives are at stake. In this paper, we propose an innovative real-time end-to-end fully automated model based on convolutional neural networks (CNN) to detect MI depending on regional wall motion abnormalities (RWMA) of the left ventricle (LV) from videos produced by echocardiography. Our model is implemented as a pipeline consisting of a 2D CNN that performs data preprocessing by segmenting the LV chamber from the apical four-chamber (A4C) view, followed by a 3D CNN that performs a binary classification to detect if the segmented echocardiography shows signs of MI. We trained both CNNs on a dataset composed of 165 echocardiography videos each acquired from a distinct patient. The 2D CNN achieved an accuracy of 97.18% on data segmentation while the 3D CNN achieved 90.9% of accuracy, 100% of precision and 95% of recall on MI detection. Our results demonstrate that creating a fully automated system for MI detection is feasible and propitious.
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