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Optimising the analysis of cardiac structure and function requires accurate 3D representations of shape and motion. However, techniques such as cardiac magnetic resonance imaging are conventionally limited to acquiring contiguous cross-sectional slic es with low through-plane resolution and potential inter-slice spatial misalignment. Super-resolution in medical imaging aims to increase the resolution of images but is conventionally trained on features from low resolution datasets and does not super-resolve corresponding segmentations. Here we propose a semi-supervised multi-task generative adversarial network (Gemini-GAN) that performs joint super-resolution of the images and their labels using a ground truth of high resolution 3D cines and segmentations, while an unsupervised variational adversarial mixture autoencoder (V-AMA) is used for continuous domain adaptation. Our proposed approach is extensively evaluated on two transnational multi-ethnic populations of 1,331 and 205 adults respectively, delivering an improvement on state of the art methods in terms of Dice index, peak signal to noise ratio, and structural similarity index measure. This framework also exceeds the performance of state of the art generative domain adaptation models on external validation (Dice index 0.81 vs 0.74 for the left ventricle). This demonstrates how joint super-resolution and segmentation, trained on 3D ground-truth data with cross-domain generalization, enables robust precision phenotyping in diverse populations.
In cardiac magnetic resonance (CMR) imaging, a 3D high-resolution segmentation of the heart is essential for detailed description of its anatomical structures. However, due to the limit of acquisition duration and respiratory/cardiac motion, stacks o f multi-slice 2D images are acquired in clinical routine. The segmentation of these images provides a low-resolution representation of cardiac anatomy, which may contain artefacts caused by motion. Here we propose a novel latent optimisation framework that jointly performs motion correction and super resolution for cardiac image segmentations. Given a low-resolution segmentation as input, the framework accounts for inter-slice motion in cardiac MR imaging and super-resolves the input into a high-resolution segmentation consistent with input. A multi-view loss is incorporated to leverage information from both short-axis view and long-axis view of cardiac imaging. To solve the inverse problem, iterative optimisation is performed in a latent space, which ensures the anatomical plausibility. This alleviates the need of paired low-resolution and high-resolution images for supervised learning. Experiments on two cardiac MR datasets show that the proposed framework achieves high performance, comparable to state-of-the-art super-resolution approaches and with better cross-domain generalisability and anatomical plausibility.
The clinical management of several cardiovascular conditions, such as pulmonary hypertension, require the assessment of the right ventricular (RV) function. This work addresses the fully automatic and robust access to one of the key RV biomarkers, it s ejection fraction, from the gold standard imaging modality, MRI. The problem becomes the accurate segmentation of the RV blood pool from cine MRI sequences. This work proposes a solution based on Fully Convolutional Neural Networks (FCNN), where our first contribution is the optimal combination of three concepts (the convolution Gated Recurrent Units (GRU), the Generative Adversarial Networks (GAN), and the L1 loss function) that achieves an improvement of 0.05 and 3.49 mm in Dice Index and Hausdorff Distance respectively with respect to the baseline FCNN. This improvement is then doubled by our second contribution, the ROI-GAN, that sets two GANs to cooperate working at two fields of view of the image, its full resolution and the region of interest (ROI). Our rationale here is to better guide the FCNN learning by combining global (full resolution) and local Region Of Interest (ROI) features. The study is conducted in a large in-house dataset of $sim$ 23.000 segmented MRI slices, and its generality is verified in a publicly available dataset.
The segmentation of the left ventricle (LV) from CINE MRI images is essential to infer important clinical parameters. Typically, machine learning algorithms for automated LV segmentation use annotated contours from only two cardiac phases, diastole, and systole. In this work, we present an analysis work-flow for fully-automated LV segmentation that learns from images acquired through the cardiac cycle. The workflow consists of three components: first, for each image in the sequence, we perform an automated localization and subsequent cropping of the bounding box containing the cardiac silhouette. Second, we identify the LV contours using a Temporal Fully Convolutional Neural Network (T-FCNN), which extends Fully Convolutional Neural Networks (FCNN) through a recurrent mechanism enforcing temporal coherence across consecutive frames. Finally, we further defined the boundaries using either one of two components: fully-connected Conditional Random Fields (CRFs) with Gaussian edge potentials and Semantic Flow. Our initial experiments suggest that significant improvement in performance can potentially be achieved by using a recurrent neural network component that explicitly learns cardiac motion patterns whilst performing LV segmentation.
Atrial Fibrillation (AF) is a common electro-physiological cardiac disorder that causes changes in the anatomy of the atria. A better characterization of these changes is desirable for the definition of clinical biomarkers, furthermore, thus there is a need for its fully automatic segmentation from clinical images. In this work, we present an architecture based on 3D-convolution kernels, a Volumetric Fully Convolution Neural Network (V-FCNN), able to segment the entire volume in a one-shot, and consequently integrate the implicit spatial redundancy present in high-resolution images. A loss function based on the mixture of both Mean Square Error (MSE) and Dice Loss (DL) is used, in an attempt to combine the ability to capture the bulk shape as well as the reduction of local errors products by over-segmentation. Results demonstrate a reasonable performance in the middle region of the atria along with the impact of the challenges of capturing the variability of the pulmonary veins or the identification of the valve plane that separates the atria to the ventricle. A final dice of $92.5%$ in $54$ patients ($4752$ atria test slices in total) is shown.
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