A Multi-Scale Spatial Transformer U-Net for Simultaneously Automatic Reorientation and Segmentation of 3D Nuclear Cardiac Images

Accurate reorientation and segmentation of the left ventricular (LV) is essential for the quantitative analysis of myocardial perfusion imaging (MPI), in which one critical step is to reorient the reconstructed transaxial nuclear cardiac images into standard short-axis slices for subsequent image processing. Small-scale LV myocardium (LV-MY) region detection and the diverse cardiac structures of individual patients pose challenges to LV segmentation operation. To mitigate these issues, we propose an end-to-end model, named as multi-scale spatial transformer UNet (MS-ST-UNet), that involves the multi-scale spatial transformer network (MSSTN) and multi-scale UNet (MSUNet) modules to perform simultaneous reorientation and segmentation of LV region from nuclear cardiac images. The proposed method is trained and tested using two different nuclear cardiac image modalities: 13N-ammonia PET and 99mTc-sestamibi SPECT. We use a multi-scale strategy to generate and extract image features with different scales. Our experimental results demonstrate that the proposed method significantly improves the reorientation and segmentation performance. This joint learning framework promotes mutual enhancement between reorientation and segmentation tasks, leading to cutting edge performance and an efficient image processing workflow. The proposed end-to-end deep network has the potential to reduce the burden of manual delineation for cardiac images, thereby providing multimodal quantitative analysis assistance for physicists.