Haben Berhane1, Michael Scott2, Joshua Robinson1, Cynthia Rigsby1, and Michael Markl2
1Lurie Childrens Hospital of Chicago, Chicago, IL, United States, 2Northwestern University, Chicago, IL, United States
Synopsis
We developed a 3D convolutional neural network for the
automatic segmentation of the thoracic aorta in 4D Flow-derived 3D PC-MRAs.
Using 100 testing datasets, we obtained an average dice score of 0.94±0.03 and
an average voxel-wise accuracy of 0.99. Additionally, our algorithm is robust
enough to accurately segment a wide array of aortic geometries and disease,
such as bicuspid aortic value, coarctation, and interrupted aortic arches.
Introduction
Studies have shown the potential of aortic 4D-Flow MRI for
the comprehensive characterization and quantification of changes on aortic hemodynamics
in common diseases such as aortic valve abnormalities, aneurysm, or dissection.
However, 4D-flow data analysis remains time intensive and complex, and despite
advances, no automated methods currently exist for advanced processing and quantification
across large cohorts. In addition, 4D-flow data analysis is often cumbersome
and requires manual interactions. Specifically, 3D segmentation of the aorta,
which is often required for subsequent analysis (e.g.3D-WSS), is one of the
most time-consuming pre-processing tasks, requiring both anatomic and technical
expertise for accurate and reproducible results. As such, a robust, automated
segmentation algorithm would accelerate the process of obtaining hemodynamic
quantification and improve flow analysis reliability. Previous attempts on automated
aortic 3D segmentation have focused on atlas registration and were performed on
either short-axis cine MRI or CT images[1-4]
from a homogeneous study cohort [5, 6].
However, in a practical clinical or research setting, the automated
segmentation algorithm should be 1)based on 4D-flow data alone, and 2)robust
across a wide array of aortic geometries and diseases (e.g., BAV, coarctation,
interrupted aortic arch). Recent developments in deep learning and
convolutional neural networks (CNN) have demonstrated excellent results in the
segmentation of MR images in cartilage and musculoskeletal tissue, knee joint
tissue, prostrate, and various other anatomical structures[7-9].
In this study, we built on these promising results to develop a 3D CNN for
automated 3D segmentation of the thoracic aorta directly from 4D-flow MRI data. Methods
This retrospective study used 210 (100 training, 10
validation, 100 testing) aortic 4D-flow scans (110 male, 13yrs on a 1.5T system (Aera, Siemens, spatial
resolution = 1.2-3.5mm3, temporal resolution=37-45ms,
venc=120-400cm/s). All 4D-flow datasets were pre-processed for eddy current
corrections and noise masking, using a software built in Matlab. 4D-flow derived
3D phase contrast (PC)-MRAs were generated from these data as a basis to
conduct a manual 3D segmentation of the thoracic aorta using commercial software
(Mimics, Materialise, Belgium). The 3D PC-MRA data were stacked into a 3D array
and used as the input for the CNN. The manually obtained 3D segmentations were
used as the ground-truth for training. The CNN utilized a 3D Unet architecture,
in which there is symmetrical encoder and decoder (Figure 1)[10, 11].
The encoding layers are formed by 2 sets of 3D-convolution, batch
normalization, and a linear rectified unit. Max-pooling was applied to half the
total number of features across the encoding layer, except in the slice number
direction, in order to enable a dynamic input range and promote segmentation
consistency across the slices. The decoder layers followed the same structure,
except the feature maps were up-sampled to double their dimensions.
Additionally, the decoding layer feature maps were concatenated with
corresponding encoding layer feature maps in order to retain as much
information from the early portions of the network. After the final convolution
layer, a sigmoid function was used to generate a probability map across all
voxels. A dice loss and a L2 loss function were used to account for the class
imbalance in the mask and limited dataset. Additionally, a dropout rate of 0.1
was applied after every convolution layer in order to prevent overfit and obtain
more generalizable features across the network. An Adam optimizer was used, and
the learning rate was kept constant at 0.0001. Training was performed for 300
epochs.Results
The CNN obtained an average dice score of 0.94±0.03 on the
testing dataset and an average dice score of 0.92±0.04 on the validation set. A
voxel-wise ROC can be seen in figure 3, with an AUC of 0.99 on the testing
dataset. Additionally, the average voxel-wise accuracy, at a decision threshold
of 0.5, was 0.99. Figure 2 displays
examples of the automated segmentation and the ground-truth for BAV,
coarctation, and interrupted aortic arch. The automated segmentation is in very
strong agreement with the ground-truth, with the only obvious difference being
a patch of the Aao that overlaps with the PA. The total computation on a single
dataset was 2 seconds (GPU:GTX 1080-Ti), and the total training time was 150
minutes.Discussion
Our algorithm demonstrated excellent accuracy and
robustness, with an average dice score of 0.94 ± 0.03, on par with the highest
reported dice score for MR images performed on controls (0.95±0.01) [5].
Future work will
progress towards whole heart segmentation and improved discrimination between vasculature,
for example our current CNN occasionally includes the SVC as a branch of the aortic,
particularly in datasets with more slices.Acknowledgements
No acknowledgement found.References
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