Automatic Localization of the Left Ventricle from Cardiac Cine Magnetic Resonance Imaging: A New Spectrum-Based Computer-Aided Tool

Traditionally, cardiac image analysis is done manually. Automatic image processing can help with the repetitive tasks, and also deal with huge amounts of data, a task which would be humanly tedious. This study aims to develop a spectrum-based computer-aided tool to locate the left ventricle using images obtained via cardiac magnetic resonance imaging. Discrete Fourier Transform was conducted pixelwise on the image sequence. Harmonic images of all frequencies were analyzed visually and quantitatively to determine different patterns of the left and right ventricles on spectrum. The first and fifth harmonic images were selected to perform an anisotropic weighted circle Hough detection. This tool was then tested in ten volunteers. Our tool was able to locate the left ventricle in all cases and had a significantly higher cropping ratio of 0.165 than did earlier studies. In conclusion, a new spectrum-based computer aided tool has been proposed and developed for automatic left ventricle localization. The development of this technique, which will enable the automatic location and further segmentation of the left ventricle, will have a significant impact in research and in diagnostic settings. We envisage that this automated method could be used by radiographers and cardiologists to diagnose and assess ventricular function in patients with diverse heart diseases.     

A hybrid graph-based approach for right ventricle segmentation in cardiac MRI by long axis information transition

Right ventricle segmentation is a challenging task in cardiac image analysis due to its complex anatomy and huge shape variations. In this paper, we proposed a semi-automatic approach by incorporating the right ventricle region and shape information into livewire framework and using one slice segmentation result for the segmentation of adjacent slices. The region term is created using our previously proposed region growing algorithm combined with the SUSAN edge detector while the shape prior is obtained by forming a signed distance function (SDF) from a set of binary masks of the right ventricle and applying PCA on them. Short axis slices are divided into two groups: primary and secondary slices. A primary slice is segmented by the proposed modified livewire and the livewire seeds are transited to a pre-processed version of upper and lower slices (secondary) to find new seed positions in these slices. The shortest path algorithm is applied on each pair of seeds for segmentation. This method is applied on 48 MR patients (from MICCAI’12 Right Ventricle Segmentation Challenge) and yielded an average Dice Metric of 0.937 ± 0.58 and the Hausdorff Distance of 5.16 ± 2.88 mm for endocardium segmentation. The correlation with the ground truth contours were measured as 0.99, 0.98, and 0.93 for EDV, ESV and EF respectively. The qualitative and quantitative results declare that the proposed method outperforms the state-of-the-art methods that uses the same dataset and the cardiac global functional parameters are calculated robustly by the proposed method.     

Variational Reconstruction of Left Cardiac Structure from CMR Images

Cardiovascular Disease (CVD), accounting for 17% of overall deaths in the USA, is the leading cause of death over the world. Advances in medical imaging techniques make the quantitative assessment of both the anatomy and function of heart possible. The cardiac modeling is an invariable prerequisite for quantitative analysis. In this study, a novel method is proposed to reconstruct the left cardiac structure from multi-planed cardiac magnetic resonance (CMR) images and contours. Routine CMR examination was performed to acquire both long axis and short axis images. Trained technologists delineated the endocardial contours. Multiple sets of two dimensional contours were projected into the three dimensional patient-based coordinate system and registered to each other. The union of the registered point sets was applied a variational surface reconstruction algorithm based on Delaunay triangulation and graph-cuts. The resulting triangulated surfaces were further post-processed. Quantitative evaluation on our method was performed via computing the overlapping ratio between the reconstructed model and the manually delineated long axis contours, which validates our method. We envisage that this method could be used by radiographers and cardiologists to diagnose and assess cardiac function in patients with diverse heart diseases.     

Semi-automatic algorithm for construction of the left ventricular area variation curve over a complete cardiac cycle

Background  

Two-dimensional echocardiography (2D-echo) allows the evaluation of cardiac structures and their movements. A wide range of clinical diagnoses are based on the performance of the left ventricle. The evaluation of myocardial function is typically performed by manual segmentation of the ventricular cavity in a series of dynamic images. This process is laborious and operator dependent. The automatic segmentation of the left ventricle in 4-chamber long-axis images during diastole is troublesome, because of the opening of the mitral valve.     

CTANet: Confidence-Based Threshold Adaption Network for Semi-Supervised Segmentation of Uterine Regions from MR Images for HIFU Treatment

ObjectivesThe accurate preoperative segmentation of the uterus and uterine fibroids from magnetic resonance images (MRI) is an essential step for diagnosis and real-time ultrasound guidance during high-intensity focused ultrasound (HIFU) surgery. Conventional supervised methods are effective techniques for image segmentation. Recently, semi-supervised segmentation approaches have been reported in the literature. One popular technique for semi-supervised methods is to use pseudo-labels to artificially annotate unlabeled data. However, many existing pseudo-label generations rely on a fixed threshold used to generate a confidence map, regardless of the proportion of unlabeled and labeled data.Materials and MethodsTo address this issue, we propose a novel semi-supervised framework called Confidence-based Threshold Adaptation Network (CTANet) to improve the quality of pseudo-labels. Specifically, we propose an online pseudo-labels method to automatically adjust the threshold, producing high-confident unlabeled annotations and boosting segmentation accuracy. To further improve the network's generalization to fit the diversity of different patients, we design a novel mixup strategy by regularizing the network on each layer in the decoder part and introducing a consistency regularization loss between the outputs of two sub-networks in CTANet.ResultsWe compare our method with several state-of-the-art semi-supervised segmentation methods on the same uterine fibroids dataset containing 297 patients. The performance is evaluated by the Dice similarity coefficient, the precision, and the recall. The results show that our method outperforms other semi-supervised learning methods. Moreover, for the same training set, our method approaches the segmentation performance of a fully supervised U-Net (100% annotated data) but using 4 times less annotated data (25% annotated data, 75% unannotated data).ConclusionExperimental results are provided to illustrate the effectiveness of the proposed semi-supervised approach. The proposed method can contribute to multi-class segmentation of uterine regions from MRI for HIFU treatment.     

Improved Estimation of Cardiac Function Parameters Using a Combination of Independent Automated Segmentation Results in Cardiovascular Magnetic Resonance Imaging

This work aimed at combining different segmentation approaches to produce a robust and accurate segmentation result. Three to five segmentation results of the left ventricle were combined using the STAPLE algorithm and the reliability of the resulting segmentation was evaluated in comparison with the result of each individual segmentation method. This comparison was performed using a supervised approach based on a reference method. Then, we used an unsupervised statistical evaluation, the extended Regression Without Truth (eRWT) that ranks different methods according to their accuracy in estimating a specific biomarker in a population. The segmentation accuracy was evaluated by estimating six cardiac function parameters resulting from the left ventricle contour delineation using a public cardiac cine MRI database. Eight different segmentation methods, including three expert delineations and five automated methods, were considered, and sixteen combinations of the automated methods using STAPLE were investigated. The supervised and unsupervised evaluations demonstrated that in most cases, STAPLE results provided better estimates than individual automated segmentation methods. Overall, combining different automated segmentation methods improved the reliability of the segmentation result compared to that obtained using an individual method and could achieve the accuracy of an expert.     

Evaluation of hypertrophic cardiomyopathy: new horizons for CMR?

Cardiac magnetic resonance imaging (CMR) is an accurate and reliable means of evaluating cardiac morphology, ventricular function, and myocardial perfusion, both for the left and the right ventricle thereby covering a whole spectrum of cardiac diseases. 1 CMR is therefore very well suited for identifying and characterising patients with various manifestations of left ventricular hypertrophy (LVH).     

An Active Contour Model for the Segmentation of Images with Intensity Inhomogeneities and Bias Field Estimation

Intensity inhomogeneity causes many difficulties in image segmentation and the understanding of magnetic resonance (MR) images. Bias correction is an important method for addressing the intensity inhomogeneity of MR images before quantitative analysis. In this paper, a modified model is developed for segmenting images with intensity inhomogeneity and estimating the bias field simultaneously. In the modified model, a clustering criterion energy function is defined by considering the difference between the measured image and estimated image in local region. By using this difference in local region, the modified method can obtain accurate segmentation results and an accurate estimation of the bias field. The energy function is incorporated into a level set formulation with a level set regularization term, and the energy minimization is conducted by a level set evolution process. The proposed model first appeared as a two-phase model and then extended to a multi-phase one. The experimental results demonstrate the advantages of our model in terms of accuracy and insensitivity to the location of the initial contours. In particular, our method has been applied to various synthetic and real images with desirable results.     

Automatic liver segmentation in MRI images using an iterative watershed algorithm and artificial neural network

Precise liver segmentation in abdominal MRI images is one of the most important steps for the computer-aided diagnosis of liver pathology. The first and essential step for diagnosis is automatic liver segmentation, and this process remains challenging. Extensive research has examined liver segmentation; however, it is challenging to distinguish which algorithm produces more precise segmentation results that are applicable to various medical imaging techniques. In this paper, we present a new automatic system for liver segmentation in abdominal MRI images. The system includes several successive steps. Preprocessing is applied to enhance the image (edge-preserved noise reduction) by using mathematical morphology. The proposed algorithm for liver region extraction is a combined algorithm that utilizes MLP neural networks and watershed algorithm. The traditional watershed transformation generally results in oversegmentation when directly applied to medical image segmentation. Therefore, we use trained neural networks to extract features of the liver region. The extracted features are used to monitor the quality of the segmentation using the watershed transform and adjust the required parameters automatically. The process of adjusting parameters is performed sequentially in several iterations. The proposed algorithm extracts liver region in one slice of the MRI images and the boundary tracking algorithm is suggested to extract the liver region in other slices, which is left as our future work. This system was applied to a series of test images to extract the liver region. Experimental results showed positive results for the proposed algorithm.     

An automatic segmentation and classification framework for anti-nuclear antibody images

Autoimmune disease is a disorder of immune system due to the over-reaction of lymphocytes against one's own body tissues. Anti-Nuclear Antibody (ANA) is an autoantibody produced by the immune system directed against the self body tissues or cells, which plays an important role in the diagnosis of autoimmune diseases. Indirect ImmunoFluorescence (IIF) method with HEp-2 cells provides the major screening method to detect ANA for the diagnosis of autoimmune diseases. Fluorescence patterns at present are usually examined laboriously by experienced physicians through manually inspecting the slides with the help of a microscope, which usually suffers from inter-observer variability that limits its reproducibility. Previous researches only provided simple segmentation methods and criterions for cell segmentation and recognition, but a fully automatic framework for the segmentation and recognition of HEp-2 cells had never been reported before. This study proposes a method based on the watershed algorithm to automatically detect the HEp-2 cells with different patterns. The experimental results show that the segmentation performance of the proposed method is satisfactory when evaluated with percent volume overlap (PVO: 89%). The classification performance using a SVM classifier designed based on the features calculated from the segmented cells achieves an average accuracy of 96.90%, which outperforms other methods presented in previous studies. The proposed method can be used to develop a computer-aided system to assist the physicians in the diagnosis of auto-immune diseases.     

Approche hybride combinant champs de Markov et modèle statistique de forme pour l’extraction des contours de la prostate en IRM

Recent progress in magnetic resonance imaging (MRI) has enabled new prostate cancer diagnosis techniques. The newest challenges in this field are to enhance image-based tumours detection. In such a context, the extraction of prostate's contours is a crucial step in the interpretation of MR images, and is usually carried out by an expert radiologist. This is though a tedious time consuming task, especially in 3D images (like CT and MRI). In addition, manual delineation is not reproducible because of differences between observers. In this paper, we introduce a novel method for automatic segmentation of prostate MRI that could help physicians in extracting 3D outlines of the gland. First a deformable shape model is used to obtain a first segmentation. The latter is refined using intensity information and Markov Random Fields modelling of regions. We use the Iterative Conditional Mode for optimising voxels’ labelling according to a Maximum A Posteriori criterion. Results from evaluation on patients’ data show that the method is satisfyingly accurate, fast and robust which makes it suitable for use in a clinical context. A multicentric validation and transfer to the industry would bring the contributions of this method to clinical routine and help improving diagnosis of prostate cancer.     

Patient oriented graph-based image segmentation

Despite increased image quality including medical imaging, image segmentation continues to represent a major bottleneck in practical applications due to noise and lack of contrast. In this paper, we present a new methodology to segment noisy, low contrast medical images, with a view to developing practical applications. Firstly, the contrast of the image is enhanced and then a modified graph-based method is followed. This paper has mainly two contributions: (1) a contrast enhancement stage performed by suitably utilizing the noise present in the medical data. This step is achieved through stochastic resonance theory applied in the wavelet domain and (2) a new weighting function is proposed for traditional graph-based approaches. Both qualitative (by our clinicians/radiologists) and quantitative evaluation performed on publicly available computed tomography (CT) (MICCAI 2007 Grand Challenge workshop database) and cardiac magnetic resonance (CMR) databases reflect the potential of the proposed method even in the presence of tumors/papillary muscles.     

An Automated Three-Dimensional Detection and Segmentation Method for Touching Cells by Integrating Concave Points Clustering and Random Walker Algorithm

Characterizing cytoarchitecture is crucial for understanding brain functions and neural diseases. In neuroanatomy, it is an important task to accurately extract cell populations'' centroids and contours. Recent advances have permitted imaging at single cell resolution for an entire mouse brain using the Nissl staining method. However, it is difficult to precisely segment numerous cells, especially those cells touching each other. As presented herein, we have developed an automated three-dimensional detection and segmentation method applied to the Nissl staining data, with the following two key steps: 1) concave points clustering to determine the seed points of touching cells; and 2) random walker segmentation to obtain cell contours. Also, we have evaluated the performance of our proposed method with several mouse brain datasets, which were captured with the micro-optical sectioning tomography imaging system, and the datasets include closely touching cells. Comparing with traditional detection and segmentation methods, our approach shows promising detection accuracy and high robustness.     

Breast mass segmentation using region-based and edge-based methods in a 4-stage multiscale system

Mass segmentation in mammograms is a challenging task due to problems such as low contrast, ill-defined, fuzzy or spiculated borders, and the presence of intensity inhomogeneities. These facts complicate the development of computer-aided diagnosis (CAD) systems to assist radiologists. In this paper, a novel mass segmentation algorithm for mammograms based on robust multiscale feature-fusion, and automatic estimation based maximum a posteriori (MAP) method is presented. The proposed segmentation technique consists of mainly four stages: a dynamic contrast improvement scheme applied to a selected region-of-interest (ROI), background-influence correction by template matching, detection of mass candidate points by prior and posterior probabilities based on robust multiscale feature-fusion, and final delineation of the mass region by a MAP scheme. This segmentation method is applied to 480 ROI masses that used ground truth from two radiologists. To compare its effectiveness with the state-of-the-art segmentation methods, three statistical metrics are employed. The experimental results indicate that the developed methods can reliably segment ill-defined or spiculated lesions when compared to other algorithms. Its integration in a CAD system may result in an improved aid to radiologists.     

Efficient liver segmentation in CT images based on graph cuts and bottleneck detection

Liver segmentation from abdominal computed tomography (CT) volumes is extremely important for computer-aided liver disease diagnosis and surgical planning of liver transplantation. Due to ambiguous edges, tissue adhesion, and variation in liver intensity and shape across patients, accurate liver segmentation is a challenging task. In this paper, we present an efficient semi-automatic method using intensity, local context, and spatial correlation of adjacent slices for the segmentation of healthy liver regions in CT volumes. An intensity model is combined with a principal component analysis (PCA) based appearance model to exclude complex background and highlight liver region. They are then integrated with location information from neighboring slices into graph cuts to segment the liver in each slice automatically. Finally, a boundary refinement method based on bottleneck detection is used to increase the segmentation accuracy. Our method does not require heavy training process or statistical model construction, and is capable of dealing with complicated shape and intensity variations. We apply the proposed method on XHCSU14 and SLIVER07 databases, and evaluate it by MICCAI criteria and Dice similarity coefficient. Experimental results show our method outperforms several existing methods on liver segmentation.     

A 3D Network Based Shape Prior for Automatic Myocardial Disease Segmentation in Delayed-Enhancement MRI

Objectives: In this work, a new deep learning model for relevant myocardial infarction segmentation from Late Gadolinium Enhancement (LGE)-MRI is proposed. Moreover, our novel segmentation method aims to detect microvascular-obstructed regions accurately. Material and methods: We first segment the anatomical structures, i.e., the left ventricular cavity and the myocardium, to achieve a preliminary segmentation. Then, a shape prior based framework that fuses the 3D U-Net architecture with 3D Autoencoder segmentation framework to constrain the segmentation process of pathological tissues is applied. Results: The proposed network reached outstanding myocardial segmentation compared with the human-level performance with the average Dice score of ‘0.9507’ for myocardium, ‘0.7656’ for scar, and ‘0.8377’ for MVO on the validation set consisting of 16 DE-MRI volumes selected from the training EMIDEC dataset. Conclusion: It is concluded that our approach's extensive validation and comprehensive comparison against existing state-of-the-art deep learning models on three annotated datasets, including healthy and diseased exams, make this proposal a reliable tool to enhance MI diagnosis.     

Automatic 4D Reconstruction of Patient-Specific Cardiac Mesh with 1-to-1 Vertex Correspondence from Segmented Contours Lines

We propose an automatic algorithm for the reconstruction of patient-specific cardiac mesh models with 1-to-1 vertex correspondence. In this framework, a series of 3D meshes depicting the endocardial surface of the heart at each time step is constructed, based on a set of border delineated magnetic resonance imaging (MRI) data of the whole cardiac cycle. The key contribution in this work involves a novel reconstruction technique to generate a 4D (i.e., spatial–temporal) model of the heart with 1-to-1 vertex mapping throughout the time frames. The reconstructed 3D model from the first time step is used as a base template model and then deformed to fit the segmented contours from the subsequent time steps. A method to determine a tree-based connectivity relationship is proposed to ensure robust mapping during mesh deformation. The novel feature is the ability to handle intra- and inter-frame 2D topology changes of the contours, which manifests as a series of merging and splitting of contours when the images are viewed either in a spatial or temporal sequence. Our algorithm has been tested on five acquisitions of cardiac MRI and can successfully reconstruct the full 4D heart model in around 30 minutes per subject. The generated 4D heart model conforms very well with the input segmented contours and the mesh element shape is of reasonably good quality. The work is important in the support of downstream computational simulation activities.     

Rough-Fuzzy Clustering and Unsupervised Feature Selection for Wavelet Based MR Image Segmentation

Image segmentation is an indispensable process in the visualization of human tissues, particularly during clinical analysis of brain magnetic resonance (MR) images. For many human experts, manual segmentation is a difficult and time consuming task, which makes an automated brain MR image segmentation method desirable. In this regard, this paper presents a new segmentation method for brain MR images, integrating judiciously the merits of rough-fuzzy computing and multiresolution image analysis technique. The proposed method assumes that the major brain tissues, namely, gray matter, white matter, and cerebrospinal fluid from the MR images are considered to have different textural properties. The dyadic wavelet analysis is used to extract the scale-space feature vector for each pixel, while the rough-fuzzy clustering is used to address the uncertainty problem of brain MR image segmentation. An unsupervised feature selection method is introduced, based on maximum relevance-maximum significance criterion, to select relevant and significant textural features for segmentation problem, while the mathematical morphology based skull stripping preprocessing step is proposed to remove the non-cerebral tissues like skull. The performance of the proposed method, along with a comparison with related approaches, is demonstrated on a set of synthetic and real brain MR images using standard validity indices.     

Comparative study on the performance of textural image features for active contour segmentation

We present a computerized method for the semi-automatic detection of contours in ultrasound images.The novelty of our study is the introduction of a fast and efficient image function relating to parametric active contour models.This new function is a combination of the gray-level information and first-order statistical features,called standard deviation parameters.In a comprehensive study,the developed algorithm and the efficiency of segmentation were first tested for synthetic images.Tests were also performed on breast and liver ultrasound images.The proposed method was compared with the watershed approach to show its efficiency.The performance of the segmentation was estimated using the area error rate.Using the standard deviation textural feature and a 5×5 kernel,our curve evolution was able to produce results close to the minimal area error rate(namely 8.88% for breast images and 10.82% for liver images).The image resolution was evaluated using the contrast-to-gradient method.The experiments showed promising segmentation results.