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Register a new userDetecting Hypo-plastic Left Heart Syndrome in Fetal Ultrasound via Disease-specific Atlas Maps
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Fetal ultrasound screening during pregnancy plays a vital role in the early detection of fetal malformations which have potential long-term health impacts. The level of skill required to diagnose such malformations from live ultrasound during examination is high and resources for screening are often limited. We present an interpretable, atlas-learning segmentation method for automatic diagnosis of Hypo-plastic Left Heart Syndrome (HLHS) from a single `4 Chamber Heart view image. We propose to extend the recently introduced Image-and-Spatial Transformer Networks (Atlas-ISTN) into a framework that enables sensitising atlas generation to disease. In this framework we can jointly learn image segmentation, registration, atlas construction and disease prediction while providing a maximum level of clinical interpretability compared to direct image classification methods. As a result our segmentation allows diagnoses competitive with expert-derived manual diagnosis and yields an AUC-ROC of 0.978 (1043 cases for training, 260 for validation and 325 for testing).
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Prenatal screening with ultrasound can lower neonatal mortality significantly for selected cardiac abnormalities. However, the need for human expertise, coupled with the high volume of screening cases, limits the practically achievable detection rates. In this paper we discuss the potential for deep learning techniques to aid in the detection of congenital heart disease (CHD) in fetal ultrasound. We propose a pipeline for automated data curation and classification. During both training and inference, we exploit an auxiliary view classification task to bias features toward relevant cardiac structures. This bias helps to improve in F1-scores from 0.72 and 0.77 to 0.87 and 0.85 for healthy and CHD classes respectively.
Congenital heart disease is considered as one the most common groups of congenital malformations which affects $6-11$ per $1000$ newborns. In this work, an automated framework for detection of cardiac anomalies during ultrasound screening is proposed and evaluated on the example of Hypoplastic Left Heart Syndrome (HLHS), a sub-category of congenital heart disease. We propose an unsupervised approach that learns healthy anatomy exclusively from clinically confirmed normal control patients. We evaluate a number of known anomaly detection frameworks together with a model architecture based on the $alpha$-GAN network and find evidence that the proposed model performs significantly better than the state-of-the-art in image-based anomaly detection, yielding average $0.81$ AUC emph{and} a better robustness towards initialisation compared to previous works.
Fetal brain magnetic resonance imaging (MRI) offers exquisite images of the developing brain but is not suitable for second-trimester anomaly screening, for which ultrasound (US) is employed. Although expert sonographers are adept at reading US images, MR images which closely resemble anatomical images are much easier for non-experts to interpret. Thus in this paper we propose to generate MR-like images directly from clinical US images. In medical image analysis such a capability is potentially useful as well, for instance for automatic US-MRI registration and fusion. The proposed model is end-to-end trainable and self-supervised without any external annotations. Specifically, based on an assumption that the US and MRI data share a similar anatomical latent space, we first utilise a network to extract the shared latent features, which are then used for MRI synthesis. Since paired data is unavailable for our study (and rare in practice), pixel-level constraints are infeasible to apply. We instead propose to enforce the distributions to be statistically indistinguishable, by adversarial learning in both the image domain and feature space. To regularise the anatomical structures between US and MRI during synthesis, we further propose an adversarial structural constraint. A new cross-modal attention technique is proposed to utilise non-local spatial information, by encouraging multi-modal knowledge fusion and propagation. We extend the approach to consider the case where 3D auxiliary information (e.g., 3D neighbours and a 3D location index) from volumetric data is also available, and show that this improves image synthesis. The proposed approach is evaluated quantitatively and qualitatively with comparison to real fetal MR images and other approaches to synthesis, demonstrating its feasibility of synthesising realistic MR images.
Two-dimensional echocardiography (2DE) measurements of left ventricle (LV) dimensions are highly significant markers of several cardiovascular diseases. These measurements are often used in clinical care despite suffering from large variability between observers. This variability is due to the challenging nature of accurately finding the correct temporal and spatial location of measurement endpoints in ultrasound images. These images often contain fuzzy boundaries and varying reflection patterns between frames. In this work, we present a convolutional neural network (CNN) based approach to automate 2DE LV measurements. Treating the problem as a landmark detection problem, we propose a modified U-Net CNN architecture to generate heatmaps of likely coordinate locations. To improve the network performance we use anatomically meaningful heatmaps as labels and train with a multi-component loss function. Our network achieves 13.4%, 6%, and 10.8% mean percent error on intraventricular septum (IVS), LV internal dimension (LVID), and LV posterior wall (LVPW) measurements respectively. The design outperforms other networks and matches or approaches intra-analyser expert error.
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.
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