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）
Neda Tavakoli, Amir Ali Rahsepar, Brandon C. Benefield, Daming Shen, Santiago López-Tapia, Florian Schiffers, Jeffrey J. Goldberger, Christine M. Albert, Edwin … 展开作者
Neda Tavakoli, Amir Ali Rahsepar, Brandon C. Benefield, Daming Shen, Santiago López-Tapia, Florian Schiffers, Jeffrey J. Goldberger, Christine M. Albert, Edwin Wu, Aggelos K. Katsaggelos, Daniel C. Lee, Daniel Kim
Background: Late Gadolinium Enhancement (LGE) imaging is the gold standard for assessing myocardial fibrosis and scarring, with left ventricular (LV) LGE extent predicting major adverse cardiac events (MACE). Despite its importance, routine LGE-based LV scar quantification is hindered by labor-intensive manual segmentation and inter-observer variability. Methods: We propose ScarNet, a hybrid model combining a transformer-based encoder from the Medical Segment Anything Model (MedSAM) with a convolution-based U-Net decoder, enhanced by tailored attention blocks. ScarNet was trained on 552 ischemic cardiomyopathy patients with expert segmentations of myocardial and scar boundaries and tested on 184 separate patients. Results: ScarNet achieved robust scar segmentation in 184 test patients, yielding a median Dice score of 0.912 (IQR: 0.863--0.944), significantly outperforming MedSAM (median Dice = 0.046, IQR: 0.043--0.047) and nnU-Net (median Dice = 0.638, IQR: 0.604--0.661). ScarNet demonstrated lower bias (-0.63%) and coefficient of variation (4.3%) compared to MedSAM (bias: -13.31%, CoV: 130.3%) and nnU-Net (bias: -2.46%, CoV: 20.3%). In Monte Carlo simulations with noise perturbations, ScarNet achieved significantly higher scar Dice (0.892 \pm 0.053, CoV = 5.9%) than MedSAM (0.048 \pm 0.112, CoV = 233.3%) and nnU-Net (0.615 \pm 0.537, CoV = 28.7%). Conclusion: ScarNet outperformed MedSAM and nnU-Net in accurately segmenting myocardial and scar boundaries in LGE images. The model exhibited robust performance across diverse image qualities and scar patterns.
CLAIM: Clinically-Guided LGE Augmentation for Realistic and Diverse Myocardial Scar Synthesis and Segmentation
Insigneo Institute for in-silico, Medicine, University of Sheffield, Sheffield, UK（Insigneo医学研究所（in-silico），谢菲尔德大学）；School of Computer Science, University of Sheffield, Sheffield, UK（谢菲尔德大学计算机科学学院）；Department of Cardiology, Nottingham University Hospitals NHS Trust, Nottingham, UK（诺丁汉大学医院心脏科）；School of Medicine, University of Nottingham, Nottingham, UK（诺丁汉大学医学院）
Contrast-Free Myocardial Scar Segmentation in Cine MRI using Motion and Texture Fusion
University of Oxford（牛津大学）；University of Southampton（南安普顿大学）；National University of Singapore（新加坡国立大学）；Fudan University（复旦大学）；Zhongshan Hospital, Fudan University（复旦大学附属中山医院）
University of Burgundy（勃艮第大学）；Technical University of Munich（慕尼黑工业大学）；icometrix；Casis company（Casis公司）；University Hospital of Dijon（第戎大学医院）
Significance: Late gadolinium enhanced magnetic resonance imaging (LGE-MRI) is the gold standard technique for myocardial viability assessment. Although the technique accurately reflects the damaged tissue, there is no clinical standard for quantifying myocardial infarction (MI), demanding most algorithms to be expert dependent. Objectives and Methods: In this work a new automatic method for MI quantification from LGE-MRI is proposed. Our novel segmentation approach is devised for accurately detecting not only hyper-enhanced lesions, but also microvascular-obstructed areas. Moreover, it includ…
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…
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）
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…
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…
School of Data Science, Fudan University（复旦大学数据科学学院）
Cardiac segmentation from late gadolinium enhancement MRI is an important task in clinics to identify and evaluate the infarction of myocardium. The automatic segmentation is however still challenging, due to the heterogeneous intensity distributions and indistinct boundaries in the images. In this paper, we propose a new method, based on deep neural networks (DNN), for fully automatic segmentation. The proposed network, referred to as SRSCN, comprises a shape reconstruction neural network (SRNN) and a spatial constraint network (SCN). SRNN aims to maintain a realistic shape of the resulting s…
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…
Fudan University（复旦大学）；Shanghai Jiao Tong University（上海交通大学）；Imperial College London（帝国理工学院）；Universitat de Barcelona（巴塞罗那大学）；Friedrich-Alexander-Universität Erlangen-Nürnberg（埃尔朗根-纽伦堡弗里德里希-亚历山大大学）；Harbin Institute of Technology（哈尔滨工业大学）；Southern University of Science and Technology（南方科技大学）；Technical University of Munich（慕尼黑工业大学）；INRIA（法国国家信息与自动化研究所）；Université Côte d’Azur（蔚蓝海岸大学）；NVIDIA（英伟达）；Xiamen University（厦门大学）；Sichuan University（四川大学）；Tencent AI Lab（腾讯人工智能实验室）
Accurate computing, analysis and modeling of the ventricles and myocardium from medical images are important, especially in the diagnosis and treatment management for patients suffering from myocardial infarction (MI). Late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) provides an important protocol to visualize MI. However, automated segmentation of LGE CMR is still challenging, due to the indistinguishable boundaries, heterogeneous intensity distribution and complex enhancement patterns of pathological myocardium from LGE CMR. Furthermore, compared with the other sequences LG…
Personalized 3D Myocardial Infarct Geometry Reconstruction from Cine MRI for Cardiac Digital Twins
Department of Biomedical Engineering, National University of Singapore（新加坡国立大学生物医学工程系）；Department of Medicine, National University of Singapore（新加坡国立大学医学系）；Department of Cardiology, National University Heart Centre Singapore（新加坡国立心脏中心心内科部）
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…
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 …
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 …
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…
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…
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）
In the clinical environment, myocardial infarction (MI) as one com-mon cardiovascular disease is mainly evaluated based on the late gadolinium enhancement (LGE) cardiac magnetic resonance images (CMRIs). The auto-matic segmentations of left ventricle (LV), right ventricle (RV), and left ven-tricular myocardium (LVM) in the LGE CMRIs are desired for the aided diag-nosis in clinic. To accomplish this segmentation task, this paper proposes a modified U-net architecture by combining multi-sequence CMRIs, including the cine, LGE, and T2-weighted CMRIs. The cine and T2-weighted CMRIs are used to ass…
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）
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 …
Friedrich-Alexander-Universität Erlangen-Nürnberg（埃尔朗根-纽伦堡弗里德里希-亚历山大大学）；University of Leeds（利兹大学）
Left ventricle segmentation and morphological assessment are essential for improving diagnosis and our understanding of cardiomyopathy, which in turn is imperative for reducing risk of myocardial infarctions in patients. Convolutional neural network (CNN) based methods for cardiac magnetic resonance (CMR) image segmentation rely on supervision with pixel-level annotations, and may not generalize well to images from a different domain. These methods are typically sensitive to variations in imaging protocols and data acquisition. Since annotating multi-sequence CMR images is tedious and subject …
