Temporal Training Strategies for Left Atrium and Left Atrial Appendage Segmentation in Dynamic Contrast 4DCT
Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid（马德里理工大学电信工程学院生物医学图像技术）；Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III（卡洛斯三世健康研究所生物工程、生物材料与纳米医学网络生物医学研究中心）；Department of Bioengineering, University of California San Diego（加州大学圣地亚哥分校生物工程系）；Division of Cardiovascular Medicine, University of California San Diego（加州大学圣地亚哥分校心血管医学部）；Department of Radiology, University of California San Diego（加州大学圣地亚哥分校放射学系）
David Montalvo-García, Lauren Severance, Elliot R. McVeigh, María J. Ledesma-Carbayo
Dynamic contrast-enhanced cardiac CT enables time-resolved analysis of contrast filling and washout in the left atrium (LA) and left atrial appendage (LAA), with potential applications for assessing blood stasis in atrial fibrillation (AF). Accurate segmentation across all frames is required for such analysis but is challenging due to large temporal contrast variations and the use of a single annotation per registered sequence. This creates a trade-off between training for robustness and limiting label noise. In this study, we investigate how temporal training-set design affects nnUNet-based segmentation of the LA and LAA in dynamic 4DCT. We compare training using a minimal two-frame dataset reflecting standard clinical practice, a physiologically selected subset of frames, and the full 27-frame sequence. We further evaluate the impact of foreground-based normalization. Training with all frames yielded the best performance in early low-contrast phases. However, the physiologically selected subset achieved comparable performance from the filling phase onward. Applying normalization parameters derived from the full dataset improved performance of reduced datasets in low-contrast frames, but did not fully close the gap. These findings highlight the importance of temporal diversity in training data for robust segmentation in dynamic CT, while indicating that carefully selected frame subsets may provide an effective trade-off between performance and efficiency for downstream applications.
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…
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 …
Inria（法国国家信息与自动化研究所）；IHU Liryc（利里克大学医院研究所）；University of Bordeaux（波尔多大学）
Radiological imaging offers effective measurement of anatomy, which is useful in disease diagnosis and assessment. Previous study has shown that the left atrial wall remodeling can provide information to predict treatment outcome in atrial fibrillation. Nevertheless, the segmentation of the left atrial structures from medical images is still very time-consuming. Current advances in neural network may help creating automatic segmentation models that reduce the workload for clinicians. In this preliminary study, we propose automated, two-stage, three-dimensional U-Nets with convolutional neural …
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…
Signed Distance Field based Segmentation and Statistical Shape Modelling of the Left Atrial Appendage
DTU Compute（DTU计算学院）；Technical University of Denmark（丹麦技术大学）；Physense（Physense公司）；Universitat Pompeu Fabra（庞培法布拉大学）；Department of Cardiology（心内科）；Rigshospitalet（哥本哈根 Rigshospitalet 医院）
Hankuk University of Foreign Studies（韩国外国语大学）；Seoul National University Bundang Hospital（首尔国立大学盆唐医院）
Left atrial appendage (LAA) closure (LAAC) is a minimally invasive implant-based method to prevent cardiovascular stroke in patients with non-valvular atrial fibrillation. Assessing the LAA orifice in preoperative CT angiography plays a crucial role in choosing an appropriate LAAC implant size and a proper C-arm angulation. However, accurate orifice localization is hard because of the high anatomic variation of LAA, and unclear position and orientation of the orifice in available CT views. Deep localization models also yield high error in localizing the orifice in CT image because of the tiny …
Radiomics-Informed Deep Learning for Classification of Atrial Fibrillation Sub-Types from Left-Atrium CT Volumes
The Hong Kong University of Science and Technology（香港科技大学）；Sun Yat-Sen University（中山大学）；Sun Yat-Sen Memorial Hospital（孙逸仙纪念医院）；Chinese Academy of Sciences（中国科学院）
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…
The segmentation of atrial scan images is of great significance for the three-dimensional reconstruction of the atrium and the surgical positioning. Most of the existing segmentation networks adopt a 2D structure and only take original images as input, ignoring the context information of 3D images and the role of prior information. In this paper, we propose an atrium segmentation network LGSANet with location guidance and siamese adjustment, which takes adjacent three slices of images as input and adopts an end-to-end approach to achieve coarse-to-fine atrial segmentation. The location guidanc…
Harbin Institute of Technology（哈尔滨工业大学）；Utah State University（犹他州立大学）；Fourth Affiliated Hospital of Harbin Medical University（哈尔滨医科大学附属第四医院）
Transesophageal echocardiography (TEE) is widely used to detect left atrium (LA)/left atrial appendage (LAA) thrombi. In this paper, the local binary pattern variance (LBPV) features are extracted from region of interest (ROI). And the dynamic features are formed by using the information of its neighbor frames in the sequence. The sequence is viewed as a bag, and the images in the sequence are considered as the instances. Multiple-instance learning (MIL) method is employed to solve the LAA thrombi detection. The experimental results show that the proposed method can achieve better performance …
Tencent YouTu Lab（腾讯优图实验室）；The Chinese University of Hong Kong（香港中文大学）；Beth Israel Deaconess Medical Center（贝斯以色列女执事医疗中心）；Harvard Medical School（哈佛医学院）
Accurately segmenting left atrium in MR volume can benefit the ablation procedure of atrial fibrillation. Traditional automated solutions often fail in relieving experts from the labor-intensive manual labeling. In this paper, we propose a deep neural network based solution for automated left atrium segmentation in gadolinium-enhanced MR volumes with promising performance. We firstly argue that, for this volumetric segmentation task, networks in 2D fashion can present great superiorities in time efficiency and segmentation accuracy than networks with 3D fashion. Considering the highly varying …
The Chinese University of Hong Kong（香港中文大学）；Shenzhen University（深圳大学）；Beth Israel Deaconess Medical Center（贝斯以色列女执事医疗中心）；Harvard Medical School（哈佛医学院）
Segmenting left atrium in MR volume holds great potentials in promoting the treatment of atrial fibrillation. However, the varying anatomies, artifacts and low contrasts among tissues hinder the advance of both manual and automated solutions. In this paper, we propose a fully-automated framework to segment left atrium in gadolinium-enhanced MR volumes. The region of left atrium is firstly automatically localized by a detection module. Our framework then originates with a customized 3D deep neural network to fully explore the spatial dependency in the region for segmentation. To alleviate the r…
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）
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…
University of Utah（犹他大学）；Scientific Computing and Imaging Institute（科学计算与成像研究所）；Comprehensive Arrhythmia Research and Management Center（综合心律失常研究与管理中心）
Difficult image segmentation problems, for instance left atrium MRI, can be addressed by incorporating shape priors to find solutions that are consistent with known objects. Nonetheless, a single multivariate Gaussian is not an adequate model in cases with significant nonlinear shape variation or where the prior distribution is multimodal. Nonparametric density estimation is more general, but has a ravenous appetite for training samples and poses serious challenges in optimization, especially in high dimensional spaces. Here, we propose a maximum-a-posteriori formulation that relies on a gener…
Technische Universität München（慕尼黑工业大学）；TOMTEC Imaging Systems GmbH（TOMTEC成像系统有限公司）；Whiting School of Engineering, Johns Hopkins University（约翰斯·霍普金斯大学怀廷工程学院）
Segmentation of the left atrium and deriving its size can help to predict and detect various cardiovascular conditions. Automation of this process in 3D Ultrasound image data is desirable, since manual delineations are time-consuming, challenging and observer-dependent. Convolutional neural networks have made improvements in computer vision and in medical image analysis. They have successfully been applied to segmentation tasks and were extended to work on volumetric data. In this paper we introduce a combined deep-learning based approach on volumetric segmentation in Ultrasound acquisitions w…
Shanghai Jiao Tong University（上海交通大学）；Fudan University（复旦大学）；National Heart and Lung Institute（国家心肺研究所）；Imperial College London（帝国理工学院）
Late Gadolinium Enhancement Magnetic Resonance Imaging (LGE MRI) emerged as a routine scan for patients with atrial fibrillation (AF). However, due to the low image quality automating the quantification and analysis of the atrial scars is challenging. In this study, we pro-posed a fully automated method based on the graph-cuts framework, where the potential of the graph is learned on a surface mesh of the left atrium (LA) using an equidistant projection and a Deep Neural Network (DNN). For validation, we employed 100 datasets with manual delineation. The results showed that the performance of …
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…
School of Biological Science and Medical Engineering, Beihang University（北京航空航天大学生物科学与医学工程学院）；School of Computer Science and Technology, Xidian University（西安电子科技大学计算机科学与技术学院）；Hefei Innovation Research Institute, Beihang University（北京航空航天大学合肥创新研究院）；Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University（北京航空航天大学生物医学工程高精尖创新中心）；Beijing Advanced Innovation Centre for Big Data-Based Precision Medicine, Beihang University（北京航空航天大学大数据精准医疗高精尖创新中心）
Consistency training has proven to be an advanced semi-supervised framework and achieved promising results in medical image segmentation tasks through enforcing an invariance of the predictions over different views of the inputs. However, with the iterative updating of model parameters, the models would tend to reach a coupled state and eventually lose the ability to exploit unlabeled data. To address the issue, we present a novel semi-supervised segmentation model based on parameter decoupling strategy to encourage consistent predictions from diverse views. Specifically, we first adopt a two-…
New York University（纽约大学）；University of Rochester（罗切斯特大学）；Siemens Healthineers（西门子医疗）
Using catheter ablation to treat atrial fibrillation increasingly relies on intracardiac echocardiography (ICE) for an anatomical delineation of the left atrium and the pulmonary veins that enter the atrium. However, it is a challenge to build an automatic contouring algorithm because ICE is noisy and provides only a limited 2D view of the 3D anatomy. This work provides the first automatic solution to segment the left atrium and the pulmonary veins from ICE. In this solution, we demonstrate the benefit of building a cross-modality framework that can leverage a database of diagnostic images to …
A Computational Pipeline for Advanced Analysis of 4D Flow MRI in the Left Atrium
PhySense, Department of Information and Communication Technologies, Universitat Pompeu Fabra（PhySense，信息与通信技术系，庞培法布拉大学）；Auckland Bioengineering Institute, University of Auckland（奥克兰生物工程研究所，奥克兰大学）；Faculty of Health and Environmental Sciences, Auckland University of Technology（健康与环境科学学院，奥克兰技术大学）；University Hospital Centre Zagreb（Zagreb大学医院中心）；Cardiovascular Institute, Hospital Clínic, Universitat de Barcelona（心血管研究所，医院临床，巴塞罗那大学）；Institut d’investigacions biomèdiques august pi i sunyer (IDIBAPS)（生物医学研究机构August Pi i Sunyer（IDIBAPS））；Institute for Medical Engineering and Science, Massachusetts Institute of Technology（医学工程与科学研究所，麻省理工学院）；Karolinska Institutet, Department of Molecular Medicine and Surgery（Karolinska研究所，分子医学与外科学系）
Scientific Computing and Imaging Institute（科学计算与成像研究所）；Comprehensive Arrhythmia Research and Management Center（综合性心律失常研究与管理中心）
Left atrium shape has been shown to be an independent predictor of recurrence after atrial fibrillation (AF) ablation. Shape-based representation is imperative to such an estimation process, where correspondence-based representation offers the most flexibility and ease-of-computation for population-level shape statistics. Nonetheless, population-level shape representations in the form of image segmentation and correspondence models derived from cardiac MRI require significant human resources with sufficient anatomy-specific expertise. In this paper, we propose a machine learning approach that …
University of California, Los Angeles（加州大学洛杉矶分校）；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）
This study proposes a fully automated approach for the left atrial segmentation from routine cine long-axis cardiac magnetic resonance image sequences using deep convolutional neural networks and Bayesian filtering. The proposed approach consists of a classification network that automatically detects the type of long-axis sequence and three different convolutional neural network models followed by unscented Kalman filtering (UKF) that delineates the left atrium. Instead of training and predicting all long-axis sequence types together, the proposed approach first identifies the image sequence t…
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）
High-Resolution Maps of Left Atrial Displacements and Strains Estimated with 3D Cine MRI using Online Learning Neural Networks
Imperial College London（帝国理工学院）；Spinoza Centre for Neuroimaging（斯宾诺莎神经成像中心）；University of Minho（米尼奥大学）；King’s College London（伦敦国王学院）；Royal Free Hospital（皇家自由医院）；UCL Queen Square Institute of Neurology（伦敦大学学院女王广场神经学研究所）；National Heart & Lung Institute（国家心肺研究所）
Spatio-temporal neural distance fields for conditional generative modeling of the heart
Technical University of Denmark（丹麦技术大学）；DTU Compute（DTU计算中心）；KardioMe；Rigshospitalet（哥本哈根 Rigshospitalet 医院）；Zealand University Hospital（西兰大学医院）；Universitat Pompeu Fabra（庞培法布拉大学）；Physense
