This work evaluates deep learning-based myocardial infarction (MI) quantification using Segment cardiovascular magnetic resonance (CMR) software. Segment CMR software incorporates the expectation-maximization, weighted intensity, a priori information (EWA) algorithm used to generate the infarct scar volume, infarct scar percentage, and microvascular obstruction percentage. Here, Segment CMR software segmentation algorithm is updated with semantic segmentation with U-net to achieve and evaluate fully automated or deep learning-based MI quantification. The direct observation of graphs and the number of infarcted and contoured myocardium are two options used to estimate the relationship between deep learning-based MI quantification and medical expert-based results.
University of Leicester（莱斯特大学）；NIHR Leicester Biomedical Research Centre（NIHR莱斯特生物医学研究中心）；Glenfield Hospital（格伦菲尔德医院）；Norwegian University of Science and Technology (NTNU)（挪威科技大学）；Saint-Petersburg State Electrotechnical University（圣彼得堡国立电工大学）
A "heart attack" or myocardial infarction (MI), occurs when an artery supplying blood to the heart is abruptly occluded. The "gold standard" method for imaging MI is Cardiovascular Magnetic Resonance Imaging (MRI), with intravenously administered gadolinium-based contrast (late gadolinium enhancement). However, no "gold standard" fully automated method for the quantification of MI exists. In this work, we propose an end-to-end fully automatic system (MyI-Net) for the detection and quantification of MI in MRI images. This has the potential to reduce the uncertainty due to the technical variabil…
The University of Hong Kong（香港大学）；Imperial College London（伦敦帝国理工学院）；Royal Brompton Hospital（皇家布朗普顿医院）
Myocardial Velocity Mapping Cardiac MR (MVM-CMR) can be used to measure global and regional myocardial velocities with proved reproducibility. Accurate left ventricle delineation is a prerequisite for robust and reproducible myocardial velocity estimation. Conventional manual segmentation on this dataset can be time-consuming and subjective, and an effective fully automated delineation method is highly in demand. By leveraging recently proposed deep learning-based semantic segmentation approaches, in this study, we propose a novel fully automated framework incorporating a 3D-UNet backbone arch…
Automatic segmentation of myocardial contours and relevant areas like infraction and no-reflow is an important step for the quantitative evaluation of myocardial infarction. In this work, we propose a cascaded convolutional neural network for automatic myocardial infarction segmentation from delayed-enhancement cardiac MRI. We first use a 2D U-Net to focus on the intra-slice information to perform a preliminary segmentation. After that, we use a 3D U-Net to utilize the volumetric spatial information for a subtle segmentation. Our method is evaluated on the MICCAI 2020 EMIDEC challenge dataset …
Multi-Source and Multi-Sequence Myocardial Pathology Segmentation Using a Cascading Refinement CNN
Institute of Computer Graphics and Vision, Graz University of Technology（格拉茨工业大学计算机图形学与视觉研究所）；AVL List GmbH（AVL List 有限公司）；Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz（格拉茨医科大学医学信息学、统计学与文献学研究所）
ImViA Laboratory, University of Burgundy（勃艮第大学ImViA实验室）；CHU Dijon（第戎大学医院）；CGFL；Institut Curie（居里研究所）
In this paper, we propose a new deep learning framework for an automatic myocardial infarction evaluation from clinical information and delayed enhancement-MRI (DE-MRI). The proposed framework addresses two tasks. The first task is automatic detection of myocardial contours, the infarcted area, the no-reflow area, and the left ventricular cavity from a short-axis DE-MRI series. It employs two segmentation neural networks. The first network is used to segment the anatomical structures such as the myocardium and left ventricular cavity. The second network is used to segment the pathological area…
Nanjing University of Science and Technology（南京理工大学）
Automatic evaluation of myocardium and pathology plays an important role in the quantitative analysis of patients suffering from myocardial infarction. In this paper, we present a cascaded convolutional neural network framework for myocardial infarction segmentation and classification in delayed-enhancement cardiac MRI. Specifically, we first use a 2D U-Net to segment the whole heart, including the left ventricle and the myocardium. Then, we crop the whole heart as a region of interest (ROI). Finally, a new 2D U-Net is used to segment the infraction and no-reflow areas in the whole heart ROI. …
In this report, I investigate the use of end-to-end deep residual learning with dilated convolutions for myocardial infarction (MI) detection and localization from electrocardiogram (ECG) signals. Although deep residual learning has already been applied to MI detection and localization, I propose a more accurate system that distinguishes among a higher number (i.e., six) of MI locations. Inspired by speech waveform processing with neural networks, I found a more robust front-end than directly arranging the multi-lead ECG signal into an input matrix consisting of the use of a single one-dimensi…
Southeast University（东南大学）；Shenzhen University（深圳大学）；Fudan University（复旦大学）；Shanghai Jiao Tong University（上海交通大学）；Kings College London（伦敦国王学院）；Affiliated Drum Tower Hospital of Nanjing University Medical School（南京大学医学院附属鼓楼医院）
Multi-sequence cardiac magnetic resonance (CMR) provides essential pathology information (scar and edema) to diagnose myocardial infarction. However, automatic pathology segmentation can be challenging due to the difficulty of effectively exploring the underlying information from the multi-sequence CMR data. This paper aims to tackle the scar and edema segmentation from multi-sequence CMR with a novel auto-weighted supervision framework, where the interactions among different supervised layers are explored under a task-specific objective using reinforcement learning. Furthermore, we design a c…
Fuzhou University（福州大学）；University of Oxford（牛津大学）；Fudan University（复旦大学）；Zhongshan Hospital, Fudan University（复旦大学附属中山医院）；Shanghai Medical School, Fudan University（复旦大学上海医学院）；Shanghai Institute of Medical Imaging（上海医学影像研究所）
Myocardial pathology segmentation (MyoPS) is critical for the risk stratification and treatment planning of myocardial infarction (MI). Multi-sequence cardiac magnetic resonance (MS-CMR) images can provide valuable information. For instance, balanced steady-state free precession cine sequences present clear anatomical boundaries, while late gadolinium enhancement and T2-weighted CMR sequences visualize myocardial scar and edema of MI, respectively. Existing methods usually fuse anatomical and pathological information from different CMR sequences for MyoPS, but assume that these images have bee…
The University of Winnipeg（温尼伯大学）；Qatar University（卡塔尔大学）；Hamad Medical Corporation（哈马德医疗公司）
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 patient's responsiveness to the setup instructions. These constraints are challenging to doctors especi…
Fudan University（复旦大学）；University of Oxford（牛津大学）；Zhongshan Hospital, Fudan University（复旦大学附属中山医院）；Shanghai Medical School, Fudan University（复旦大学上海医学院）；Shanghai Institute of Medical Imaging（上海医学影像研究所）
Myocardial pathology segmentation (MyoPS) can be a prerequisite for the accurate diagnosis and treatment planning of myocardial infarction. However, achieving this segmentation is challenging, mainly due to the inadequate and indistinct information from an image. In this work, we develop an end-to-end deep neural network, referred to as MyoPS-Net, to flexibly combine five-sequence cardiac magnetic resonance (CMR) images for MyoPS. To extract precise and adequate information, we design an effective yet flexible architecture to extract and fuse cross-modal features. This architecture can tackle …
National University of Singapore（新加坡国立大学）；National University Heart Centre（新加坡国立大学心脏中心）
Automatic segmentation of myocardium in Late Gadolinium Enhanced (LGE) Cardiac MR (CMR) images is often difficult due to the intensity heterogeneity resulting from accumulation of contrast agent in infarcted areas. In this paper, we propose an automatic segmentation framework that fully utilizes shared information between corresponding cine and LGE images of a same patient. Given myocardial contours in cine CMR images, the proposed framework achieves accurate segmentation of LGE CMR images in a coarse-to-fine manner. Affine registration is first performed between the corresponding cine and LGE…
Tampere University（坦佩雷大学）；Qatar University（卡塔尔大学）；Hamad Medical Corporation（哈马德医疗公司）
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) segmentatio…
Imperial College London（帝国理工学院）；Technical University Munich（慕尼黑工业大学）；University of Edinburgh（爱丁堡大学）；MRC London Institute of Medical Sciences（MRC伦敦医学科学研究所）
Recovering the 3D motion of the heart from cine cardiac magnetic resonance (CMR) imaging enables the assessment of regional myocardial function and is important for understanding and analyzing cardiovascular disease. However, 3D cardiac motion estimation is challenging because the acquired cine CMR images are usually 2D slices which limit the accurate estimation of through-plane motion. To address this problem, we propose a novel multi-view motion estimation network (MulViMotion), which integrates 2D cine CMR images acquired in short-axis and long-axis planes to learn a consistent 3D motion fi…
National Heart & Lung Institute, Imperial College London（伦敦帝国理工学院国家心肺研究所）；Royal Brompton Hospital（皇家布朗普顿医院）
Four-dimensional (4D) left ventricular myocardial velocity mapping (MVM) is a cardiac magnetic resonance (CMR) technique that allows assessment of cardiac motion in three orthogonal directions. Accurate and reproducible delineation of the myocardium is crucial for accurate analysis of peak systolic and diastolic myocardial velocities. In addition to the conventionally available magnitude CMR data, 4D MVM also acquires three velocity-encoded phase datasets which are used to generate velocity maps. These can be used to facilitate and improve myocardial delineation. Based on the success of deep l…
Delayed-enhancement cardiac magnetic resonance (DE-CMR)provides important diagnostic and prognostic information on myocardial viability. The presence and extent of late gadolinium enhancement (LGE)in DE-CMR is negatively associated with the probability of improvement in left ventricular function after revascularization. Moreover, LGE findings can support the diagnosis of several other cardiomyopathies, but their absence does not rule them out, making disease classification by visual assessment difficult. In this work, we propose deep learning neural networks that can automatically predict myoc…
The American University in Cairo（开罗美国大学）；Aswan Heart Centre（阿斯旺心脏中心）
In this paper, we propose an enhanced 3D myocardial strain estimation procedure, which combines complementary displacement information from multiple orientations of a single imaging modality (untagged CMR SSFP images). To estimate myocardial strain across the left ventricle, we register the sets of short-axis, four-chamber and two-chamber views via a 2D non-rigid registration algorithm implemented in a commercial software (Segment, Medviso). We then create a series of interpolating functions for the three orthogonal directions of motion and use them to deform a tetrahedral mesh representation …
Predicting Lethal Outcome (Cause) And Understanding Key Biomarkers Linked With Acute Myocardial Infarction Using Deep Artificial Neural Network And Ensemble Of Machine Learning Methodologies
CineMyoPS: Segmenting Myocardial Pathologies from Cine Cardiac MR
School of Medical Imaging, Fujian Medical University（福建医科大学医学影像学院）；College of Physics and Information Engineering, Fuzhou University（福州大学物理与信息工程学院）；Department of Biomedical Engineering, National University of Singapore（新加坡国立大学生物医学工程系）；School of Data Science, Fudan University（复旦大学数据科学学院）；Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University（上海交通大学医学院仁济医院放射科）
University of Auckland（奥克兰大学）；Queen Mary University of London（伦敦玛丽女王大学）；University of Oxford（牛津大学）
Purpose: To demonstrate the feasibility and performance of a fully automated deep learning framework to estimate myocardial strain from short-axis cardiac magnetic resonance tagged images. Methods and Materials: In this retrospective cross-sectional study, 4508 cases from the UK Biobank were split randomly into 3244 training and 812 validation cases, and 452 test cases. Ground truth myocardial landmarks were defined and tracked by manual initialization and correction of deformable image registration using previously validated software with five readers. The fully automatic framework consisted …
Improve Myocardial Strain Estimation based on Deformable Groupwise Registration with a Locally Low-Rank Dissimilarity Metric
Shanghai Jiao Tong University（上海交通大学）；School of Biomedical Engineering（生物医学工程学院）；National Engineering Research Center of Advanced Magnetic Resonance Technologies for Diagnosis and Therapy（国家医学诊疗先进磁共振技术工程研究中心）；Renji Hospital, School of Medicine, Shanghai Jiao Tong University（上海交通大学医学院附属仁济医院）
National University of Singapore（新加坡国立大学）；National University Heart Centre（新加坡国立大学心脏中心）；National University Hospital（新加坡国立大学医院）
Automatic segmentation of the left ventricle (LV) in late gadolinium enhanced (LGE) cardiac MR (CMR) images is difficult due to the intensity heterogeneity arising from accumulation of contrast agent in infarcted myocardium. In this paper, we present a comprehensive framework for automatic 3D segmentation of the LV in LGE CMR images. Given myocardial contours in cine images as a priori knowledge, the framework initially propagates the a priori segmentation from cine to LGE images via 2D translational registration. Two meshes representing respectively endocardial and epicardial surfaces are the…
University of Bourgogne Franche-Comté（勃艮第-弗朗什孔泰大学）；University Hospital of Dijon（第戎大学医院）；CASIS company（CASIS公司）
Cardiac left ventricular (LV) segmentation from short-axis MRI acquired 10 minutes after the injection of a contrast agent (LGE-MRI) is a necessary step in the processing allowing the identification and diagnosis of cardiac diseases such as myocardial infarction. However, this segmentation is challenging due to high variability across subjects and the potential lack of contrast between structures. Then, the main objective of this work is to develop an accurate automatic segmentation method based on deep learning models for the myocardial borders on LGE-MRI. To this end, 2.5 D residual neural n…
Lund University（隆德大学）；Skåne University Hospital（斯科讷大学医院）
In this work, the best size for late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) images in the training dataset was determined to optimize deep learning training outcomes. Non-extra pixel and extra pixel interpolation algorithms were used to determine the new size of the LGE-MRI images. A novel strategy was introduced to handle interpolation masks and remove extra class labels in interpolated ground truth (GT) segmentation masks. The expectation maximization, weighted intensity, a priori information (EWA) algorithm was used for quantification of myocardial infarction (MI) in …
Fudan University（复旦大学）；Shanghai Jiao Tong University（上海交通大学）；Universitat de Barcelona（巴塞罗那大学）；Universitat Autònoma de Barcelona（巴塞罗那自治大学）；University of Electronic Science and Technology of China（电子科技大学）；Northwestern Polytechnical University（西北工业大学）；Hunan University（湖南大学）；National Engineering Laboratory for Robot Visual Perception and Control Technology（机器人视觉感知与控制技术国家工程实验室）；Fuzhou University（福州大学）；Comprehensive Heart Failure Center（综合心力衰竭中心）
Assessment of myocardial viability is essential in diagnosis and treatment management of patients suffering from myocardial infarction, and classification of pathology on myocardium is the key to this assessment. This work defines a new task of medical image analysis, i.e., to perform myocardial pathology segmentation (MyoPS) combining three-sequence cardiac magnetic resonance (CMR) images, which was first proposed in the MyoPS challenge, in conjunction with MICCAI 2020. The challenge provided 45 paired and pre-aligned CMR images, allowing algorithms to combine the complementary information fr…
Coronary artery disease (CAD) remains the world's leading cause of mortality and the disease burden is continually expanding as the population ages. Recently, the MR-INFORM randomised trial has demonstrated that the management of patients with stable CAD can be guided by stress perfusion cardiovascular magnetic resonance (CMR) imaging and it is non-inferior to the using the invasive reference standard of fractional flow reserve. The benefits of using stress perfusion CMR include that it is non-invasive and significantly reduces the number of unnecessary coronary revascularisations. As compared…
University of Virginia（弗吉尼亚大学）；University of Virginia Health System（弗吉尼亚大学卫生系统）
Automated identification of myocardial scar from late gadolinium enhancement cardiac magnetic resonance images (LGE-CMR) is limited by image noise and artifacts such as those related to motion and partial volume effect. This paper presents a novel joint deep learning (JDL) framework that improves such tasks by utilizing simultaneously learned myocardium segmentations to eliminate negative effects from non-region-of-interest areas. In contrast to previous approaches treating scar detection and myocardium segmentation as separate or parallel tasks, our proposed method introduces a message passin…
University of Burgundy（勃艮第大学）；University Hospital of Dijon（第戎大学医院）；University of Franche-Comté（弗朗什-孔泰大学）；CASIS Company（CASIS公司）；University of Sousse（苏塞大学）；University of Monastir（莫纳斯提尔大学）；Erasmus MC（伊拉斯姆斯大学医学中心）
A key factor for assessing the state of the heart after myocardial infarction (MI) is to measure whether the myocardium segment is viable after reperfusion or revascularization therapy. Delayed enhancement-MRI or DE-MRI, which is performed several minutes after injection of the contrast agent, provides high contrast between viable and nonviable myocardium and is therefore a method of choice to evaluate the extent of MI. To automatically assess myocardial status, the results of the EMIDEC challenge that focused on this task are presented in this paper. The challenge's main objectives were twofo…
University of Alberta（阿尔伯塔大学）；Mazankowski Alberta Heart Institute（马赞科夫斯基阿尔伯塔心脏研究所）
Myocardial characterization is essential for patients with myocardial infarction and other myocardial diseases, and the assessment is often performed using cardiac magnetic resonance (CMR) sequences. In this study, we propose a fully automated approach using deep convolutional neural networks (CNN) for cardiac pathology segmentation, including left ventricular (LV) blood pool, right ventricular blood pool, LV normal myocardium, LV myocardial edema (ME) and LV myocardial scars (MS). The input to the network consists of three CMR sequences, namely, late gadolinium enhancement (LGE), T2 and balan…
Myocardium segmentation of late gadolinium enhancement (LGE) Cardiac MR images is important for evaluation of infarction regions in clinical practice. The pathological myocardium in LGE images presents distinctive brightness and textures compared with the healthy tissues, making it much more challenging to be segment. Instead, the balanced-Steady State Free Precession (bSSFP) cine images show clearly boundaries and can be easily segmented. Given this fact, we propose a novel shape-transfer GAN for LGE images, which can 1) learn to generate realistic LGE images from bSSFP with the anatomical sh…
The MYOSAIQ Challenge: Myocardial Segmentation with Automated Infarct Quantification
INSA-Lyon, Universite Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1294（里昂国立应用科学学院、里昂第一大学克洛德·贝尔纳大学、圣艾蒂安大学、法国国家科学研究中心、法国国家健康与医学研究院、CREATIS联合研究机构）；Institut Universitaire de France (IUF)（法兰西大学研究院）；University of Sherbrooke（谢布鲁克大学）；Huazhong University of Science and Technology（华中科技大学）；Sunnybrook Research Institute, University of Toronto（多伦多大学桑尼布鲁克研究所）；Imperial College London（伦敦帝国理工学院）；University College London（伦敦大学学院）；Fudan University（复旦大学）；Medical University of Graz（格拉茨医科大学）；Graz University of Technology（格拉茨技术大学）；Universidad de Zaragoza（萨拉戈萨大学）；Instituto de Investigación Sanitaria de Aragón (IIS Aragón)（阿拉贡卫生研究所）；Centre Hospitalier Annecy Genevois（阿讷西日内瓦中心医院）；Hôpital Universitaire Cardiologique Louis Pradel（路易·普拉德尔大学心脏病医院）
University of Minnesota（明尼苏达大学）；Center for Magnetic Resonance Research, University of Minnesota（明尼苏达大学磁共振研究中心）；Beth Israel Deaconess Medical Center, Harvard Medical School（哈佛医学院贝斯以色列女执事医疗中心）
Late gadolinium enhancement (LGE) cardiac MRI (CMR) is the clinical standard for diagnosis of myocardial scar. 3D isotropic LGE CMR provides improved coverage and resolution compared to 2D imaging. However, image acceleration is required due to long scan times and contrast washout. Physics-guided deep learning (PG-DL) approaches have recently emerged as an improved accelerated MRI strategy. Training of PG-DL methods is typically performed in supervised manner requiring fully-sampled data as reference, which is challenging in 3D LGE CMR. Recently, a self-supervised learning approach was propose…
King’s College London（伦敦国王学院）；Guy’s and St Thomas’ NHS Foundation Trust（盖伊和圣托马斯国民保健服务基金会信托）；ETH Zürich（苏黎世联邦理工学院）；Imperial College London（伦敦帝国理工学院）
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 characteri…
National Heart and Lung Institute, Imperial College London（帝国理工学院国家心肺研究所）；Royal Brompton Hospital（皇家布朗普顿医院）；University of the Basque Country UPV/EHU（巴斯克大学）；TECNALIA, Basque Research and Technology Alliance（巴斯克研究与技术联盟TECNALIA）；Beihang University（北京航空航天大学）；Shenzhen Second People’s Hospital（深圳市第二人民医院）
Synthetic digital twins based on medical data accelerate the acquisition, labelling and decision making procedure in digital healthcare. A core part of digital healthcare twins is model-based data synthesis, which permits the generation of realistic medical signals without requiring to cope with the modelling complexity of anatomical and biochemical phenomena producing them in reality. Unfortunately, algorithms for cardiac data synthesis have been so far scarcely studied in the literature. An important imaging modality in the cardiac examination is three-directional CINE multi-slice myocardial…
Personalized 3D Myocardial Infarct Geometry Reconstruction from Cine MRI with Explicit Cardiac Motion Modeling
Department of Biomedical Engineering, National University of Singapore, Singapore（新加坡国立大学生物医学工程系）；Department of Computer Science, National University of Singapore, Singapore（新加坡国立大学计算机科学系）；Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand（奥克兰大学生物工程研究所）；School of Biomedical Engineering and Imaging Sciences, King’s College London, UK（伦敦国王学院生物医学工程与成像科学学校）；Department of Medicine, National University of Singapore, Singapore（新加坡国立大学医学系）；Department of Cardiology, National University Heart Centre Singapore, Singapore（新加坡国立心脏中心心血管科）
Universidad de Valladolid（巴利亚多利德大学）；King’s College London（伦敦国王学院）；Instituto Superior Técnico, Universidade de Lisboa（里斯本大学高等技术学院）；Centre for Marine Sciences - CCMAR（海洋科学中心（CCMAR））
First-pass perfusion cardiac magnetic resonance (FPP-CMR) is becoming an essential non-invasive imaging method for detecting deficits of myocardial blood flow, allowing the assessment of coronary heart disease. Nevertheless, acquisitions suffer from relatively low spatial resolution and limited heart coverage. Compressed sensing (CS) methods have been proposed to accelerate FPP-CMR and achieve higher spatial resolution. However, the long reconstruction times have limited the widespread clinical use of CS in FPP-CMR. Deep learning techniques based on supervised learning have emerged as alternat…
University of Leeds（利兹大学）；University of Oxford（牛津大学）；Queen Mary University of London（伦敦玛丽女王大学）；Barts Health NHS Trust（巴茨健康国民保健制度信托基金）
Large prospective epidemiological studies acquire cardiovascular magnetic resonance (CMR) images for pre-symptomatic populations and follow these over time. To support this approach, fully automatic large-scale 3D analysis is essential. In this work, we propose a novel deep neural network using both CMR images and patient metadata to directly predict cardiac shape parameters. The proposed method uses the promising ability of statistical shape models to simplify shape complexity and variability together with the advantages of convolutional neural networks for the extraction of solid visual feat…
