Style-invariant Cardiac Image Segmentation with Test-time Augmentation

Deep models often suffer from severe performance drop due to the appearance shift in the real clinical setting. Most of the existing learning-based methods rely on images from multiple sites/vendors or even corresponding labels. However, collecting enough unknown data to robustly model segmentation cannot always hold since the complex appearance shift caused by imaging factors in daily application. In this paper, we propose a novel style-invariant method for cardiac image segmentation. Based on the zero-shot style transfer to remove appearance shift and test-time augmentation to explore diverse underlying anatomy, our proposed method is effective in combating the appearance shift. Our contribution is three-fold. First, inspired by the spirit of universal style transfer, we develop a zero-shot stylization for content images to generate stylized images that appearance similarity to the style images. Second, we build up a robust cardiac segmentation model based on the U-Net structure. Our framework mainly consists of two networks during testing: the ST network for removing appearance shift and the segmentation network. Third, we investigate test-time augmentation to explore transformed versions of the stylized image for prediction and the results are merged. Notably, our proposed framework is fully test-time adaptation. Experiment results demonstrate that our methods are promising and generic for generalizing deep segmentation models.

FetusMap: Fetal Pose Estimation in 3D Ultrasound

The 3D ultrasound (US) entrance inspires a multitude of automated prenatal examinations. However, studies about the structuralized description of the whole fetus in 3D US are still rare. In this paper, we propose to estimate the 3D pose of fetus in US volumes to facilitate its quantitative analyses in global and local scales. Given the great challenges in 3D US, including the high volume dimension, poor image quality, symmetric ambiguity in anatomical structures and large variations of fetal pose, our contribution is three-fold. (i) This is the first work about 3D pose estimation of fetus in the literature. We aim to extract the skeleton of whole fetus and assign different segments/joints with correct torso/limb labels. (ii) We propose a self-supervised learning (SSL) framework to finetune the deep network to form visually plausible pose predictions. Specifically, we leverage the landmark-based registration to effectively encode case-adaptive anatomical priors and generate evolving label proxy for supervision. (iii) To enable our 3D network perceive better contextual cues with higher resolution input under limited computing resource, we further adopt the gradient check-pointing (GCP) strategy to save GPU memory and improve the prediction. Extensively validated on a large 3D US dataset, our method tackles varying fetal poses and achieves promising results. 3D pose estimation of fetus has potentials in serving as a map to provide navigation for many advanced studies.

Agent with Warm Start and Active Termination for Plane Localization in 3D Ultrasound

Standard plane localization is crucial for ultrasound (US) diagnosis. In prenatal US, dozens of standard planes are manually acquired with a 2D probe. It is time-consuming and operator-dependent. In comparison, 3D US containing multiple standard planes in one shot has the inherent advantages of less user-dependency and more efficiency. However, manual plane localization in US volume is challenging due to the huge search space and large fetal posture variation. In this study, we propose a novel reinforcement learning (RL) framework to automatically localize fetal brain standard planes in 3D US. Our contribution is two-fold. First, we equip the RL framework with a landmark-aware alignment module to provide warm start and strong spatial bounds for the agent actions, thus ensuring its effectiveness. Second, instead of passively and empirically terminating the agent inference, we propose a recurrent neural network based strategy for active termination of the agent's interaction procedure. This improves both the accuracy and efficiency of the localization system. Extensively validated on our in-house large dataset, our approach achieves the accuracy of 3.4mm/9.6{\deg} and 2.7mm/9.1{\deg} for the transcerebellar and transthalamic plane localization, respectively. Ourproposed RL framework is general and has the potential to improve the efficiency and standardization of US scanning.

Segmentation of Multimodal Myocardial Images Using Shape-Transfer GAN

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 shape preserved, and 2) learn to segment the myocardium of LGE images from these generated images. It's worth to note that no segmentation label of the LGE images is used during this procedure. We test our model on dataset from the Multi-sequence Cardiac MR Segmentation Challenge. The results show that the proposed Shape-Transfer GAN can achieve accurate myocardium masks of LGE images.

Cardiac Motion Scoring with Segment- and Subject-level Non-Local Modeling

Motion scoring of cardiac myocardium is of paramount importance for early detection and diagnosis of various cardiac disease. It aims at identifying regional wall motions into one of the four types including normal, hypokinetic, akinetic, and dyskinetic, and is extremely challenging due to the complex myocardium deformation and subtle inter-class difference of motion patterns. All existing work on automated motion analysis are focused on binary abnormality detection to avoid the much more demanding motion scoring, which is urgently required in real clinical practice yet has never been investigated before. In this work, we propose Cardiac-MOS, the first powerful method for cardiac motion scoring from cardiac MR sequences based on deep convolution neural network. Due to the locality of convolution, the relationship between distant non-local responses of the feature map cannot be explored, which is closely related to motion difference between segments. In Cardiac-MOS, such non-local relationship is modeled with non-local neural network within each segment and across all segments of one subject, i.e., segment- and subject-level non-local modeling, and lead to obvious performance improvement. Besides, Cardiac-MOS can effectively extract motion information from MR sequences of various lengths by interpolating the convolution kernel along the temporal dimension, therefore can be applied to MR sequences of multiple sources. Experiments on 1440 myocardium segments of 90 subjects from short axis MR sequences of multiple lengths prove that Cardiac-MOS achieves reliable performance, with correlation of 0.926 for motion score index estimation and accuracy of 77.4\% for motion scoring. Cardiac-MOS also outperforms all existing work for binary abnormality detection. As the first automatic motion scoring solution, Cardiac-MOS demonstrates great potential in future clinical application.

Full Quantification of Left Ventricle via Deep Multitask Learning Network Respecting Intra- and Inter-Task Relatedness

Cardiac left ventricle (LV) quantification is among the most clinically important tasks for identification and diagnosis of cardiac diseases, yet still a challenge due to the high variability of cardiac structure and the complexity of temporal dynamics. Full quantification, i.e., to simultaneously quantify all LV indices including two areas (cavity and myocardium), six regional wall thicknesses (RWT), three LV dimensions, and one cardiac phase, is even more challenging since the uncertain relatedness intra and inter each type of indices may hinder the learning procedure from better convergence and generalization. In this paper, we propose a newly-designed multitask learning network (FullLVNet), which is constituted by a deep convolution neural network (CNN) for expressive feature embedding of cardiac structure; two followed parallel recurrent neural network (RNN) modules for temporal dynamic modeling; and four linear models for the final estimation. During the final estimation, both intra- and inter-task relatedness are modeled to enforce improvement of generalization: 1) respecting intra-task relatedness, group lasso is applied to each of the regression tasks for sparse and common feature selection and consistent prediction; 2) respecting inter-task relatedness, three phase-guided constraints are proposed to penalize violation of the temporal behavior of the obtained LV indices. Experiments on MR sequences of 145 subjects show that FullLVNet achieves high accurate prediction with our intra- and inter-task relatedness, leading to MAE of 190mm$^2$, 1.41mm, 2.68mm for average areas, RWT, dimensions and error rate of 10.4\% for the phase classification. This endows our method a great potential in comprehensive clinical assessment of global, regional and dynamic cardiac function.

Direct Estimation of Regional Wall Thicknesses via Residual Recurrent Neural Network

Accurate estimation of regional wall thicknesses (RWT) of left ventricular (LV) myocardium from cardiac MR sequences is of significant importance for identification and diagnosis of cardiac disease. Existing RWT estimation still relies on segmentation of LV myocardium, which requires strong prior information and user interaction. No work has been devoted into direct estimation of RWT from cardiac MR images due to the diverse shapes and structures for various subjects and cardiac diseases, as well as the complex regional deformation of LV myocardium during the systole and diastole phases of the cardiac cycle. In this paper, we present a newly proposed Residual Recurrent Neural Network (ResRNN) that fully leverages the spatial and temporal dynamics of LV myocardium to achieve accurate frame-wise RWT estimation. Our ResRNN comprises two paths: 1) a feed forward convolution neural network (CNN) for effective and robust CNN embedding learning of various cardiac images and preliminary estimation of RWT from each frame itself independently, and 2) a recurrent neural network (RNN) for further improving the estimation by modeling spatial and temporal dynamics of LV myocardium. For the RNN path, we design for cardiac sequences a Circle-RNN to eliminate the effect of null hidden input for the first time-step. Our ResRNN is capable of obtaining accurate estimation of cardiac RWT with Mean Absolute Error of 1.44mm (less than 1-pixel error) when validated on cardiac MR sequences of 145 subjects, evidencing its great potential in clinical cardiac function assessment.

Direct Multitype Cardiac Indices Estimation via Joint Representation and Regression Learning

Cardiac indices estimation is of great importance during identification and diagnosis of cardiac disease in clinical routine. However, estimation of multitype cardiac indices with consistently reliable and high accuracy is still a great challenge due to the high variability of cardiac structures and complexity of temporal dynamics in cardiac MR sequences. While efforts have been devoted into cardiac volumes estimation through feature engineering followed by a independent regression model, these methods suffer from the vulnerable feature representation and incompatible regression model. In this paper, we propose a semi-automated method for multitype cardiac indices estimation. After manual labelling of two landmarks for ROI cropping, an integrated deep neural network Indices-Net is designed to jointly learn the representation and regression models. It comprises two tightly-coupled networks: a deep convolution autoencoder (DCAE) for cardiac image representation, and a multiple output convolution neural network (CNN) for indices regression. Joint learning of the two networks effectively enhances the expressiveness of image representation with respect to cardiac indices, and the compatibility between image representation and indices regression, thus leading to accurate and reliable estimations for all the cardiac indices. When applied with five-fold cross validation on MR images of 145 subjects, Indices-Net achieves consistently low estimation error for LV wall thicknesses (1.44$\pm$0.71mm) and areas of cavity and myocardium (204$\pm$133mm$^2$). It outperforms, with significant error reductions, segmentation method (55.1% and 17.4%) and two-phase direct volume-only methods (12.7% and 14.6%) for wall thicknesses and areas, respectively. These advantages endow the proposed method a great potential in clinical cardiac function assessment.

Learn to Evaluate Image Perceptual Quality Blindly from Statistics of Self-similarity

Among the various image quality assessment (IQA) tasks, blind IQA (BIQA) is particularly challenging due to the absence of knowledge about the reference image and distortion type. Features based on natural scene statistics (NSS) have been successfully used in BIQA, while the quality relevance of the feature plays an essential role to the quality prediction performance. Motivated by the fact that the early processing stage in human visual system aims to remove the signal redundancies for efficient visual coding, we propose a simple but very effective BIQA method by computing the statistics of self-similarity (SOS) in an image. Specifically, we calculate the inter-scale similarity and intra-scale similarity of the distorted image, extract the SOS features from these similarities, and learn a regression model to map the SOS features to the subjective quality score. Extensive experiments demonstrate very competitive quality prediction performance and generalization ability of the proposed SOS based BIQA method.

Gradient Magnitude Similarity Deviation: A Highly Efficient Perceptual Image Quality Index

It is an important task to faithfully evaluate the perceptual quality of output images in many applications such as image compression, image restoration and multimedia streaming. A good image quality assessment (IQA) model should not only deliver high quality prediction accuracy but also be computationally efficient. The efficiency of IQA metrics is becoming particularly important due to the increasing proliferation of high-volume visual data in high-speed networks. We present a new effective and efficient IQA model, called gradient magnitude similarity deviation (GMSD). The image gradients are sensitive to image distortions, while different local structures in a distorted image suffer different degrees of degradations. This motivates us to explore the use of global variation of gradient based local quality map for overall image quality prediction. We find that the pixel-wise gradient magnitude similarity (GMS) between the reference and distorted images combined with a novel pooling strategy the standard deviation of the GMS map can predict accurately perceptual image quality. The resulting GMSD algorithm is much faster than most state-of-the-art IQA methods, and delivers highly competitive prediction accuracy.