Xiahai Zhuang

A Registration-Based Propagation Framework for Automatic Whole Heart Segmentation of Cardiac MRI

Magnetic resonance (MR) imaging has become a routine modality for the determination of patient cardiac morphology. The extraction of this information can be important for the development of new clinical applications as well as the planning and guidance of cardiac interventional procedures. To avoid inter- and intra-observer variability of manual delineation, it is highly desirable to develop an automatic technique for whole heart segmentation of cardiac magnetic resonance images. However, automating this process is complicated by the limited quality of acquired images and large shape variation of the heart between subjects. In this paper, we propose a fully automatic whole heart segmentation framework based on two new image registration algorithms: the locally affine registration method (LARM) and the free-form deformations with adaptive control point status (ACPS FFDs). LARM provides the correspondence of anatomical substructures such as the four chambers and great vessels of the heart, while the registration using ACPS FFDs refines the local details using a constrained optimization scheme. We validated our proposed segmentation framework on 37 cardiac MR volumes on the end-diastolic phase, displaying a wide diversity of morphology and pathology, and achieved a mean accuracy of 2.14 ± 0.63 mm (rms surface distance) and a maximal error of 4.31 mm.

A Nonrigid Registration Framework Using Spatially Encoded Mutual Information and Free-Form Deformations

Mutual information (MI) registration including spatial information has been shown to perform better than the traditional MI measures for certain nonrigid registration tasks. In this work, we first provide new insight to problems of the MI-based registration and propose to use the spatially encoded mutual information (SEMI) to tackle these problems. To encode spatial information, we propose a hierarchical weighting scheme to differentiate the contribution of sample points to a set of entropy measures, which are associated to spatial variable values. By using free-form deformations (FFDs) as the transformation model, we can first define the spatial variable using the set of FFD control points, and then propose a local ascent optimization scheme for nonrigid SEMI registration. The proposed SEMI registration can improve the registration accuracy in the nonrigid cases where the traditional MI is challenged due to intensity distortion, contrast enhancement, or different imaging modalities. It also has a similar computation complexity to the registration using traditional MI measures, improving up to two orders of magnitude of computation time compared to the traditional schemes. We validate our algorithms using phantom brain MRI, simulated dynamic contrast enhanced mangetic resonance imaging (MRI) of the liver, and in vivo cardiac MRI. The results show that the SEMI registration significantly outperforms the traditional MI registration.

Benchmarking framework for myocardial tracking and deformation algorithms: An open access database

In this paper we present a benchmarking framework for the validation of cardiac motion analysis algorithms. The reported methods are the response to an open challenge that was issued to the medical imaging community through a MICCAI workshop. The database included magnetic resonance (MR) and 3D ultrasound (3DUS) datasets from a dynamic phantom and 15 healthy volunteers. Participants processed 3D tagged MR datasets (3DTAG), cine steady state free precession MR datasets (SSFP) and 3DUS datasets, amounting to 1158 image volumes. Ground-truth for motion tracking was based on 12 landmarks (4 walls at 3 ventricular levels). They were manually tracked by two observers in the 3DTAG data over the whole cardiac cycle, using an in-house application with 4D visualization capabilities. The median of the inter-observer variability was computed for the phantom dataset (0.77 mm) and for the volunteer datasets (0.84 mm). The ground-truth was registered to 3DUS coordinates using a point based similarity transform. Four institutions responded to the challenge by providing motion estimates for the data: Fraunhofer MEVIS (MEVIS), Bremen, Germany; Imperial College London - University College London (IUCL), UK; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Inria-Asclepios project (INRIA), France. Details on the implementation and evaluation of the four methodologies are presented in this manuscript. The manually tracked landmarks were used to evaluate tracking accuracy of all methodologies. For 3DTAG, median values were computed over all time frames for the phantom dataset (MEVIS=1.20mm, IUCL=0.73 mm, UPF=1.10mm, INRIA=1.09 mm) and for the volunteer datasets (MEVIS=1.33 mm, IUCL=1.52 mm, UPF=1.09 mm, INRIA=1.32 mm). For 3DUS, median values were computed at end diastole and end systole for the phantom dataset (MEVIS=4.40 mm, UPF=3.48 mm, INRIA=4.78 mm) and for the volunteer datasets (MEVIS=3.51 mm, UPF=3.71 mm, INRIA=4.07 mm). For SSFP, median values were computed at end diastole and end systole for the phantom dataset(UPF=6.18 mm, INRIA=3.93 mm) and for the volunteer datasets (UPF=3.09 mm, INRIA=4.78 mm). Finally, strain curves were generated and qualitatively compared. Good agreement was found between the different modalities and methodologies, except for radial strain that showed a high variability in cases of lower image quality.

The estimation of patient-specific cardiac diastolic functions from clinical measurements

An unresolved issue in patients with diastolic dysfunction is that the estimation of myocardial stiffness cannot be decoupled from diastolic residual active tension (AT) because of the impaired ventricular relaxation during diastole. To address this problem, this paper presents a method for estimating diastolic mechanical parameters of the left ventricle (LV) from cine and tagged MRI measurements and LV cavity pressure recordings, separating the passive myocardial constitutive properties and diastolic residual AT. Dynamic C1-continuous meshes are automatically built from the anatomy and deformation captured from dynamic MRI sequences. Diastolic deformation is simulated using a mechanical model that combines passive and active material properties. The problem of non-uniqueness of constitutive parameter estimation using the well known Guccione law is characterized by reformulation of this law. Using this reformulated form, and by constraining the constitutive parameters to be constant across time points during diastole, we separate the effects of passive constitutive properties and the residual AT during diastolic relaxation. Finally, the method is applied to two clinical cases and one control, demonstrating that increased residual AT during diastole provides a potential novel index for delineating healthy and pathological cases.

An Atlas-Based Segmentation Propagation Framework Using Locally Affine Registration --- Application to Automatic Whole Heart Segmentation

In this paper, we present a novel registration algorithm for locally affine registrations. This method preserves the anatomical and intensity class relationships between the local regions. A regularisation procedure is used to maintain a global diffeomorphic transformation. Combined with a novel generic method for accurately inverting the final deformation field, we include our techniques within an atlas-based segmentation propagation framework. We applied our method to automatically segment the whole heart from cardiac magnetic resonance images from a cohort of 18 volunteers (acquisition resolution 2 x 2 x 2 mm). The results show that the proposed method provides a robust initialisation for the atlas-based segmentation propagation framework refined with a fluid registration. We validated our approach against other registration strategies, and demonstrated that we improved the accuracy of the whole heart segmentations (1.8 +/- 0.42 mm).

Multi-scale patch and multi-modality atlases for whole heart segmentation of MRI

A whole heart segmentation (WHS) method is presented for cardiac MRI. This segmentation method employs multi-modality atlases from MRI and CT and adopts a new label fusion algorithm which is based on the proposed multi-scale patch (MSP) strategy and a new global atlas ranking scheme. MSP, developed from the scale-space theory, uses the information of multi-scale images and provides different levels of the structural information of images for multi-level local atlas ranking. Both the local and global atlas ranking steps use the information theoretic measures to compute the similarity between the target image and the atlases from multiple modalities. The proposed segmentation scheme was evaluated on a set of data involving 20 cardiac MRI and 20 CT images. Our proposed algorithm demonstrated a promising performance, yielding a mean WHS Dice score of 0.899 ± 0.0340, Jaccard index of 0.818 ± 0.0549, and surface distance error of 1.09 ± 1.11 mm for the 20 MRI data. The average runtime for the proposed label fusion was 12.58 min.

A Comprehensive Cardiac Motion Estimation Framework Using Both Untagged and 3-D Tagged MR Images Based on Nonrigid Registration

In this paper, we present a novel technique based on nonrigid image registration for myocardial motion estimation using both untagged and 3-D tagged MR images. The novel aspect of our technique is its simultaneous usage of complementary information from both untagged and 3-D tagged MR images. To estimate the motion within the myocardium, we register a sequence of tagged and untagged MR images during the cardiac cycle to a set of reference tagged and untagged MR images at end-diastole. The similarity measure is spatially weighted to maximize the utility of information from both images. In addition, the proposed approach integrates a valve plane tracker and adaptive incompressibility into the framework. We have evaluated the proposed approach on 12 subjects. Our results show a clear improvement in terms of accuracy compared to approaches that use either 3-D tagged or untagged MR image information alone. The relative error compared to manually tracked landmarks is less than 15% throughout the cardiac cycle. Finally, we demonstrate the automatic analysis of cardiac function from the myocardial deformation fields.

Challenges and Methodologies of Fully Automatic Whole Heart Segmentation: A Review

Whole heart segmentation from magnetic resonance imaging or computed tomography is a prerequisite for many clinical applications. Since manual delineation can be tedious and subject to bias, automating such segmentation becomes increasingly popular in the image computing field. However, fully automatic whole heart segmentation is challenging and only limited studies were reported in the literature. This article reviews the existing techniques and analyzes the challenges and methodologies. The techniques are classified in terms of the types of the prior models and the algorithms used to fit the model to unseen images. The prior models include the atlases and the deformable models, and the fitting algorithms are further decomposed into four key techniques including localization of the whole heart, initialization of substructures, refinement of boundary delineation, and regularization of shapes. Finally, the validation issues, challenges, and future directions are discussed.

Cardiac Image Super-Resolution with Global Correspondence Using Multi-Atlas PatchMatch

The accurate measurement of 3D cardiac function is an important task in the analysis of cardiac magnetic resonance (MR) images. However, short-axis image acquisitions with thick slices are commonly used in clinical practice due to constraints of acquisition time, signal-to-noise ratio and patient compliance. In this situation, the estimation of a high-resolution image can provide an approximation of the underlaying 3D measurements. In this paper, we develop a novel algorithm for the estimation of high-resolution cardiac MR images from single short-axis cardiac MR image stacks. First, we propose to use a novel approximate global search approach to find patch correspondence between the short-axis MR image and a set of atlases. Then, we propose an innovative super-resolution model which does not require explicit motion estimation. Finally, we build an expectation-maximization framework to optimize the model. We validate the proposed approach using images from 19 subjects with 200 atlases and show that the proposed algorithm significantly outperforms conventional interpolation such as linear or B-spline interpolation. In addition, we show that the super-resolved images can be used for the reproducible estimation of 3D cardiac functional indices.

Temporal sparse free-form deformations

FFD represent a widely used model for the non-rigid registration of medical images. The balance between robustness to noise and accuracy in modelling localised motion is typically controlled by the control point grid spacing and the amount of regularisation. More recently, TFFD have been proposed which extend the FFD approach in order to recover smooth motion from temporal image sequences. In this paper, we revisit the classic FFD approach and propose a sparse representation using the principles of compressed sensing. The sparse representation can model both global and local motion accurately and robustly. We view the registration as a deformation reconstruction problem. The deformation is reconstructed from a pair of images (or image sequences) with a sparsity constraint applied to the parametric space. Specifically, we introduce sparsity into the deformation via L1 regularisation, and apply a bending energy regularisation between neighbouring control points within each level to encourage a grouped sparse solution. We further extend the sparsity constraint to the temporal domain and propose a TSFFD which can capture fine local details such as motion discontinuities in both space and time without sacrificing robustness. We demonstrate the capabilities of the proposed framework to accurately estimate deformations in dynamic 2D and 3D image sequences. Compared to the classic FFD and TFFD approach, a significant increase in registration accuracy can be observed in natural images as well as in cardiac images.