Atrial fibrillation (AF) is the most prevalent form of cardiac arrhythmia and is associated with increased morbidity and mortality. The effectiveness of current clinical interventions for AF is often limited by an incomplete understanding of the atrial anatomical structures that sustain this arrhythmia. Late Gadolinium-Enhanced MRI (LGE-MRI) has emerged as a critical imaging modality for assessing atrial fibrosis and scarring, which are essential markers for predicting the success of ablation procedures in AF patients. The Multi-class Bi-Atrial Segmentation (MBAS) challenge at MICCAI 2024 aims to enhance the segmentation of both left and right atria and their walls using a comprehensive dataset of 200 multi-center 3D LGE-MRIs, labelled by experts. This work presents an ensemble approach that integrates multiple machine learning models, including Unet, ResNet, EfficientNet and VGG, to perform automatic bi-atrial segmentation from LGE-MRI data. The ensemble model was evaluated using the Dice Similarity Coefficient (DSC) and 95% Hausdorff distance (HD95) on the left & right atrium wall, right atrium cavity, and left atrium cavity. On the internal testing dataset, the model achieved a DSC of 88.41%, 98.48%, 98.45% and an HD95 of 1.07, 0.95, 0.64 respectively. This demonstrates the effectiveness of the ensemble model in improving segmentation accuracy. The approach contributes to advancing the understanding of AF and supports the development of more targeted and effective ablation strategies.
Fudan University（复旦大学）；Shanghai Jiao Tong University（上海交通大学）；Technical University of Munich（慕尼黑工业大学）；Helmholtz Center Munich（慕尼黑亥姆霍兹中心）
Late gadolinium enhancement magnetic resonance imaging (LGE MRI) is commonly used to visualize and quantify left atrial (LA) scars. The position and extent of scars provide important information of the pathophysiology and progression of atrial fibrillation (AF). Hence, LA scar segmentation and quantification from LGE MRI can be useful in computer-assisted diagnosis and treatment stratification of AF patients. Since manual delineation can be time-consuming and subject to intra- and inter-expert variability, automating this computing is highly desired, which nevertheless is still challenging and…
HAMIL-QA: Hierarchical Approach to Multiple Instance Learning for Atrial LGE MRI Quality Assessment
Kahlert School of Computing, University of Utah（犹他大学卡尔特计算机学院）；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）；Johns Hopkins（约翰斯·霍普金斯大学）；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影像研究所）
Royal Brompton Hospital（皇家布朗普顿医院）；National Heart and Lung Institute, Imperial College London（帝国理工学院国家心肺研究所）；Fudan University（复旦大学）；Shanghai Jiao Tong University（上海交通大学）；University of Lincoln（林肯大学）；City University London（伦敦城市大学）
Purpose: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is correlated with increased morbidity and mortality. It is associated with atrial fibrosis, which may be assessed non-invasively using late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI) where scar tissue is visualised as a region of signal enhancement. In this study, we proposed a novel fully automatic pipeline to achieve an accurate and objective atrial scarring segmentation and assessment of LGE MRI scans for the AF patients. Methods: Our fully automatic pipeline uniquely combined: (1) a multi-atlas bas…
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）
Scientific Computing and Imaging Institute, University of Utah（犹他大学科学计算与成像研究所）；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 Radiology and Imaging Sciences, University of Utah（犹他大学放射学与影像科学系）；Department of Biomedical Engineering, Johns Hopkins（约翰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）
Few-Shot Left Atrial Wall Segmentation in 3D LGE MRI via Meta-Learning
Department of Systems and Computer Engineering, Carleton University（系统与计算机工程系，卡尔顿大学）；Department of Radiology, Radiation Oncology, and Medical Physics, University of Ottawa（放射科、放射肿瘤学与医学物理系，渥太华大学）；Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute（心内科，医学系，渥太华心脏研究所）
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）
Left atrial (LA) segmentation from late gadolinium enhanced magnetic resonance imaging (LGE MRI) is a crucial step needed for planning the treatment of atrial fibrillation. However, automatic LA segmentation from LGE MRI is still challenging, due to the poor image quality, high variability in LA shapes, and unclear LA boundary. Though deep learning-based methods can provide promising LA segmentation results, they often generalize poorly to unseen domains, such as data from different scanners and/or sites. In this work, we collect 210 LGE MRIs from different centers with different levels of ima…
J. J. Strossmayer University of Osijek（奥西耶克J.J.斯特罗斯马耶大学）；Ghent University（根特大学）；imec（比利时微电子研究中心）
Atrial fibrillation (AF) is a cardiovascular disease identified as one of the main risk factors for stroke. The majority of strokes due to AF are caused by clots originating in the left atrial appendage (LAA). LAA occlusion is an effective procedure for reducing stroke risk. Planning the procedure using pre-procedural imaging and analysis has shown benefits. The analysis is commonly done by manually segmenting the appendage on 2D slices. Automatic LAA segmentation methods could save an expert's time and provide insightful 3D visualizations and accurate automatic measurements to aid in medical …
Segmentation of the left atrial chamber and assessing its morphology, are essential for improving our understanding of atrial fibrillation, the most common type of cardiac arrhythmia. Automation of this process in 3D gadolinium enhanced-MRI (GE-MRI) data is desirable, as manual delineation is time-consuming, challenging and observer-dependent. Recently, deep convolutional neural networks (CNNs) have gained tremendous traction and achieved state-of-the-art results in medical image segmentation. However, it is difficult to incorporate local and global information without using contracting (pooli…
Segmentation of the left atrium (LA) is crucial for assessing its anatomy in both pre-operative atrial fibrillation (AF) ablation planning and post-operative follow-up studies. In this paper, we present a fully automated framework for left atrial segmentation in gadolinium-enhanced magnetic resonance images (GE-MRI) based on deep learning. We propose a fully convolutional neural network and explore the benefits of multi-task learning for performing both atrial segmentation and pre/post ablation classification. Our results show that, by sharing features between related tasks, the network can ga…
Integrating Deep Learning in Cardiology: A Comprehensive Review of Atrial Fibrillation, Left Atrial Scar Segmentation, and the Frontiers of State-of-the-Art Techniques
University of Auckland（奥克兰大学）；Auckland Bioengineering Institute（奥克兰生物工程研究所）
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…
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…
Accurate cardiac computing, analysis and modeling from multi-modality images are important for the diagnosis and treatment of cardiac disease. Late gadolinium enhancement magnetic resonance imaging (LGE MRI) is a promising technique to visualize and quantify myocardial infarction (MI) and atrial scars. Automating quantification of MI and atrial scars can be challenging due to the low image quality and complex enhancement patterns of LGE MRI. Moreover, compared with the other sequences LGE MRIs with gold standard labels are particularly limited, which represents another obstacle for developing …
University of Oulu（奥卢大学）；Medical Research Center Oulu（奥卢医学研究中心）
Objective: We propose a non-contact approach for atrial fibrillation (AF) detection from face videos. Methods: Face videos, electrocardiography (ECG), and contact photoplethysmography (PPG) from 100 healthy subjects and 100 AF patients are recorded. Data recordings from healthy subjects are all labeled as healthy. Two cardiologists evaluated ECG recordings of patients and labeled each recording as AF, sinus rhythm (SR), or atrial flutter (AFL). We use the 3D convolutional neural network for remote PPG monitoring and propose a novel loss function (Wasserstein distance) to use the timing of syst…
Atrial fibrillation is a heart rhythm disorder that affects tens of millions people worldwide. The most effective treatment is catheter ablation. This involves irreversible heating of abnormal cardiac tissue facilitated by electroanatomical mapping. However, it is difficult to consistently identify the triggers and sources that may initiate or perpetuate atrial fibrillation due to its chaotic behavior. We developed a patient-specific computational heart model that can accurately reproduce the activation patterns to help in localizing these triggers and sources. Our model has high spatial resol…
Left atrial voltage maps are routinely acquired during electroanatomic mapping in patients undergoing catheter ablation for atrial fibrillation. For patients, who have prior catheter ablation when they are in sinus rhythm, the voltage map can be used to identify low voltage areas using a threshold of 0.2 - 0.45 mV. However, such a voltage threshold for maps acquired during atrial fibrillation has not been well established. A prerequisite for defining a voltage threshold is to maximize the topologically matched low voltage areas between the electroanatomic mapping acquired during atrial fibrill…
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…
Institute of Data Science, National University of Singapore（新加坡国立大学数据科学研究所）；School of Computing, National University of Singapore（新加坡国立大学计算学院）；National University of Singapore（新加坡国立大学）
Atrial Fibrillation (AF) is a common cardiac arrhythmia affecting a large number of people around the world. If left undetected, it will develop into chronic disability or even early mortality. However, patients who have this problem can barely feel its presence, especially in its early stage. A non-invasive, automatic, and effective detection method is therefore needed to help early detection so that medical intervention can be implemented in time to prevent its progression. Electrocardiogram (ECG), which records the electrical activities of the heart, has been widely used for detecting the p…
Indian Institute of Technology, Roorkee（鲁尔基印度理工学院）；Leicester Royal Infirmary（莱斯特皇家医院）；Glenfield Hospital（格伦菲尔德医院）
The incidences of atrial fibrillation (AFib) are increasing at a daunting rate worldwide. For the early detection of the risk of AFib, we have developed an automatic detection system based on deep neural networks. For achieving better classification, it is mandatory to have good pre-processing of physiological signals. Keeping this in mind, we have proposed a two-fold study. First, an end-to-end model is proposed to denoise the electrocardiogram signals using denoising autoencoders (DAE). To achieve denoising, we have used three networks including, convolutional neural network (CNN), dense neu…
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…
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）
We propose an end-to-end deep neural network (DNN) which can simultaneously segment the left atrial (LA) cavity and quantify LA scars. The framework incorporates the continuous spatial information of the target by introducing a spatially encoded (SE) loss based on the distance transform map. Compared to conventional binary label based loss, the proposed SE loss can reduce noisy patches in the resulting segmentation, which is commonly seen for deep learning-based methods. To fully utilize the inherent spatial relationship between LA and LA scars, we further propose a shape attention (SA) mechan…
Fuzhou University（福州大学）；College of Physics and Information Engineering, Fuzhou University（福州大学物理与信息工程学院）
Automatic segmentation of left atrial (LA) scars from late gadolinium enhanced CMR images is a crucial step for atrial fibrillation (AF) recurrence analysis. However, delineating LA scars is tedious and error-prone due to the variation of scar shapes. In this work, we propose a boundary-aware LA scar segmentation network, which is composed of two branches to segment LA and LA scars, respectively. We explore the inherent spatial relationship between LA and LA scars. By introducing a Sobel fusion module between the two segmentation branches, the spatial information of LA boundaries can be propag…
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, characterised by a rapid and irregular electrical activation of the atria. Treatments for AF are often ineffective and few atrial biomarkers exist to automatically characterise atrial function and aid in treatment selection for AF. Clinical metrics of left atrial (LA) function, such as ejection fraction (EF) and active atrial contraction ejection fraction (aEF), are promising, but have until now typically relied on volume estimations extrapolated from single-slice images. In this work, we study volumetric functional biom…
