心房颤动（AF）是最常见的心律失常。准确分割左心房（LA）和 LA 瘢痕可为预测 AF 的治疗结果提供有价值的信息。本文提出利用晚期钆增强磁共振成像（LGE-MRI）自动分割 LA 腔并量化 LA 瘢痕。我们采用 nnU-Net 作为基线模型，并利用 TopK 损失作为损失函数来挖掘 LA 边界特征的重要性。具体而言，在训练过程中实现了对 LA 边界像素的聚焦，从而提供更准确的边界预测。另一方面，将预测的 LA 边界的距离图变换视为 LA 瘢痕预测的额外输入，为瘢痕位置提供边缘约束。我们进一步设计了一种新颖的不确定性感知模块（UAM），以为高不确定性预测生成更好的结果。在 LAScarQS 2022 数据集上的实验证明了我们的模型在 LA 腔和 LA 瘢痕分割上的优越性能。具体而言，我们在 LA 腔和瘢痕分割上分别取得了 88.98% 和 64.08% 的 Dice 系数。我们将在 https://github.com/level6626/Boundary-focused-nnU-Net 上公开实现代码。
英文摘要：
Atrial fibrillation (AF) is the most common cardiac arrhythmia. Accurate segmentation of the left atrial (LA) and LA scars can provide valuable information to predict treatment outcomes in AF. In this paper, we proposed to automatically segment LA cavity and quantify LA scars with late gadolinium enhancement Magnetic Resonance Imagings (LGE-MRIs). We adopted nnU-Net as the baseline model and exploited the importance of LA boundary characteristics with the TopK loss as the loss function. Specifically, a focus on LA boundary pixels is achieved during training, which provides a more accurate boundary prediction. On the other hand, a distance map transformation of the predicted LA boundary is regarded as an additional input for the LA scar prediction, which provides marginal constraint on scar locations. We further designed a novel uncertainty-aware module (UAM) to produce better results for predictions with high uncertainty. Experiments on the LAScarQS 2022 dataset demonstrated our model's superior performance on the LA cavity and LA scar segmentation. Specifically, we achieved 88.98\% and 64.08\% Dice coefficient for LA cavity and scar segmentation, respectively. We will make our implementation code public available at https://github.com/level6626/Boundary-focused-nnU-Net.
ScarNet: A Novel Foundation Model for Automated Myocardial Scar Quantification from LGE in Cardiac MRI
Northwestern University（西北大学）；Feinberg School of Medicine（费林伯格医学院）；University of Miami Miller School of Medicine（迈阿密大学米勒医学院）；Cedars-Sinai Medical Center（西达赛奈医疗中心）
Two-Stage Deep Learning Framework for Quality Assessment of Left Atrial Late Gadolinium Enhanced MRI Images
Kahlert School of Computing, University of Utah（犹他大学卡勒特计算学院）；Department of Biomedical Engineering, University of Utah（犹他大学生物医学工程系）；Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah（犹他大学诺拉·埃克尔斯·哈里森心血管研究与培训研究所）；Department of Biomedical Engineering, Johns Hopkins（约翰斯·霍普金斯大学生物医学工程系）；Division of Cardiology, University of Utah（犹他大学心脏病学系）；Department of Radiology and Imaging Sciences, University of Utah（犹他大学放射学与影像科学系）；Scientific Computing and Imaging Institute, University of Utah（犹他大学科学计算与成像研究所）
Anhui University（安徽大学）；Royal Brompton Hospital（皇家布朗普顿医院）；National Heart & Lung Institute, Imperial College London（帝国理工学院国家心肺研究所）；Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences（中国科学院深圳先进技术研究院）；University College London（伦敦大学学院）；Alan Turing Institute（艾伦·图灵研究所）；Imperial College London（帝国理工学院）
Late Gadolinium Enhanced Cardiac MRI (LGE-CMRI) for detecting atrial scars in atrial fibrillation (AF) patients has recently emerged as a promising technique to stratify patients, guide ablation therapy and predict treatment success. Visualisation and quantification of scar tissues require a segmentation of both the left atrium (LA) and the high intensity scar regions from LGE-CMRI images. These two segmentation tasks are challenging due to the cancelling of healthy tissue signal, low signal-to-noise ratio and often limited image quality in these patients. Most approaches require manual superv…
Cardiovascular Research Centre, Royal Brompton Hospital（皇家布朗普顿医院心血管研究中心）；National Heart and Lung Institute, Imperial College London（帝国理工学院国家心肺研究所）；Anhui University（安徽大学）；Western University（西安大略大学）；University College London（伦敦大学学院）；Alan Turing Institute（阿兰·图灵研究所）；NIHR Imperial Biomedical Research Centre（NIHR帝国生物医学研究中心）；Beijing Anzhen Hospital, Capital Medical University（首都医科大学附属北京安贞医院）；School of Biomedical Engineering, Sun Yat-Sen University（中山大学医学院生物医学工程学院）
Three-dimensional late gadolinium enhanced (LGE) cardiac MR (CMR) of left atrial scar in patients with atrial fibrillation (AF) has recently emerged as a promising technique to stratify patients, to guide ablation therapy and to predict treatment success. This requires a segmentation of the high intensity scar tissue and also a segmentation of the left atrium (LA) anatomy, the latter usually being derived from a separate bright-blood acquisition. Performing both segmentations automatically from a single 3D LGE CMR acquisition would eliminate the need for an additional acquisition and avoid sub…
Sun Yat-sen University（中山大学）；Royal Brompton Hospital（皇家布朗普顿医院）；Imperial College London（帝国理工学院）
Automated and accurate segmentations of left atrium (LA) and atrial scars from late gadolinium-enhanced cardiac magnetic resonance (LGE CMR) images are in high demand for quantifying atrial scars. The previous quantification of atrial scars relies on a two-phase segmentation for LA and atrial scars due to their large volume difference (unbalanced atrial targets). In this paper, we propose an inter-cascade generative adversarial network, namely JAS-GAN, to segment the unbalanced atrial targets from LGE CMR images automatically and accurately in an end-to-end way. Firstly, JAS-GAN investigates a…
Fudan University（复旦大学）；Shanghai Jiao Tong University（上海交通大学）；King’s College London（伦敦国王学院）；Technical University Munich（慕尼黑工业大学）；Helmholtz Center Munich（慕尼黑亥姆霍兹中心）
Left atrial (LA) and atrial scar segmentation from late gadolinium enhanced magnetic resonance imaging (LGE MRI) is an important task in clinical practice. %, to guide ablation therapy and predict treatment results for atrial fibrillation (AF) patients. The automatic segmentation is however still challenging, due to the poor image quality, the various LA shapes, the thin wall, and the surrounding enhanced regions. Previous methods normally solved the two tasks independently and ignored the intrinsic spatial relationship between LA and scars. In this work, we develop a new framework, namely Atr…
Auckland Bioengineering Institute, University of Auckland（奥克兰大学生物工程研究所）；Beihang University（北京航空航天大学）；Peking University（北京大学）；SenseTime Inc（商汤科技）；Tencent Jarvis Laboratory（腾讯Jarvis实验室）；Friedrich-Alexander-Universität Erlangen-Nürnberg（埃尔朗根-纽伦堡弗里德里希-亚历山大大学）；The Chinese University of Hong Kong（香港中文大学）；Shenzhen University（深圳大学）；Wuhan University（武汉大学）；Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences（中国科学院深圳先进技术研究院）；EPITA Research and Development Laboratory（EPITA研发实验室）；Imperial College London（伦敦帝国学院）；Shanghai Jiao Tong University（上海交通大学）；Fudan University（复旦大学）；Harbin Institute of Technology（哈尔滨工业大学）；University of Bologna（博洛尼亚大学）；Eindhoven University of Technology（埃因霍温理工大学）；Kings College London（伦敦国王学院）；University of Magdeburg（马格德堡大学）；Heidelberg University Hospital（海德堡大学医院）；Leiden University Medical Center（莱顿大学医学中心）；Universitat Pompeu Fabra（庞培法布拉大学）；Physense（Physense机构）
Segmentation of cardiac images, particularly late gadolinium-enhanced magnetic resonance imaging (LGE-MRI) widely used for visualizing diseased cardiac structures, is a crucial first step for clinical diagnosis and treatment. However, direct segmentation of LGE-MRIs is challenging due to its attenuated contrast. Since most clinical studies have relied on manual and labor-intensive approaches, automatic methods are of high interest, particularly optimized machine learning approaches. To address this, we organized the "2018 Left Atrium Segmentation Challenge" using 154 3D LGE-MRIs, currently the…
Sun Yat-sen University（中山大学）；Royal Brompton Hospital（皇家布朗普顿医院）；Imperial College London（帝国理工学院）
Semi-supervised learning provides great significance in left atrium (LA) segmentation model learning with insufficient labelled data. Generalising semi-supervised learning to cross-domain data is of high importance to further improve model robustness. However, the widely existing distribution difference and sample mismatch between different data domains hinder the generalisation of semi-supervised learning. In this study, we alleviate these problems by proposing an Adaptive Hierarchical Dual Consistency (AHDC) for the semi-supervised LA segmentation on cross-domain data. The AHDC mainly consis…
LA-CaRe-CNN: Cascading Refinement CNN for Left Atrial Scar Segmentation
Gottfried Schatz Research Center: Medical Physics and Biophysics（戈特弗里德·施蔡茨研究所以及生物物理学）；Medical University of Graz（格拉茨医科大学）；Institute of Computer Graphics and Vision（计算机图形学与视觉研究所）；Graz University of Technology（格拉茨理工大学）；AVL List GmbH；Institute for Medical Informatics, Statistics and Documentation（医学信息学、统计学与文档研究所）
