Myocardial contrast echocardiography (MCE) is an imaging technique that assesses left ventricle function and myocardial perfusion for the detection of coronary artery diseases. Automatic MCE perfusion quantification is challenging and requires accurate segmentation of the myocardium from noisy and time-varying images. Random forests (RF) have been successfully applied to many medical image segmentation tasks. However, the pixel-wise RF classifier ignores contextual relationships between label outputs of individual pixels. RF which only utilizes local appearance features is also susceptible to data suffering from large intensity variations. In this paper, we demonstrate how to overcome the above limitations of classic RF by presenting a fully automatic segmentation pipeline for myocardial segmentation in full-cycle 2-D MCE data. Specifically, a statistical shape model is used to provide shape prior information that guide the RF segmentation in two ways. First, a novel shape model (SM) feature is incorporated into the RF framework to generate a more accurate RF probability map. Second, the shape model is fitted to the RF probability map to refine and constrain the final segmentation to plausible myocardial shapes. We further improve the performance by introducing a bounding box detection algorithm as a preprocessing step in the segmentation pipeline. Our approach on 2-D image is further extended to 2-D+t sequences which ensures temporal consistency in the final sequence segmentations. When evaluated on clinical MCE data sets, our proposed method achieves notable improvement in segmentation accuracy and outperforms other state-of-the-art methods, including the classic RF and its variants, active shape model and image registration.
RF is well-suited for our MCE data because it effectively builds a non-linear appearance model based on local intensity regions. Therefore, it can better cope with the large intensity variations of the MCE data compared to the simple linear intensity model of ASM. However, the classic RF that utilizes only local appearance features have some limitations. First, the intensity information in MCE may be misleading and result in inaccurate segmentation. For instance, the RF can misclassify the papillary muscle as the myocardium because they have similar intensity. The epicardial boundary is also often difficult to identify based on intensity information alone. Second, the RF classifier assigns a class label to each pixel independently. Structural and contextual relationships between the pixel labels are ignored @cite_4 @cite_16 . This results in segmentation with inconsistent pixel labelling which leads to unsmooth boundaries, false detections in the background and holes in the regions of interests. Lastly, RF outputs an intermediate probability map which needs to be post-processed to obtain the final segmentation.
@cite_16 @cite_4
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We segment long-axis, four-chamber contrast enhanced echocardiography imagery using active shape models. The active shape model algorithm uses principal component analysis to model the shape variability found in a database of training shapes. Accurate segmentation from this model is accomplished by applying a specialized gradient vector flow field to guide the contours to the myocardial borders. The success of the proposed algorithm was verified by application to 65 patient myocardial contrast echocardiography (MCE) studies and through comparison with manually drawn contours. This approach improved accuracy over previously reported data, providing an average accuracy of 0.98, sensitivity of 0.84, specificity of 0.99, and RMSE of 3.3 pixels, when compared to ground truth. Error and variability from automatic segmentation were found to be less than those among multiple human observers. The approach also compares favorably against a standard active contour solution. A new generic model-based segmentation algorithm is presented, which can be trained from examples akin to the active shape model (ASM) approach in order to acquire knowledge about the shape to be segmented and about the gray-level appearance of the object in the image. Whereas ASM alternates between shape and intensity information during search, the proposed approach optimizes for shape and intensity characteristics simultaneously. Local gray-level appearance information at the landmark points extracted from feature images is used to automatically detect a number of plausible candidate locations for each landmark. The shape information is described by multiple landmark-specific statistical models that capture local dependencies between adjacent landmarks on the shape. The shape and intensity models are combined in a single cost function that is optimized noniteratively using dynamic programming, without the need for initialization. The algorithm was validated for segmentation of anatomical structures in chest and hand radiographs. In each experiment, the presented method had a significant higher performance when compared to the ASM schemes. As the method is highly effective, optimally suited for pathological cases and easy to implement, it is highly useful for many medical image segmentation tasks. We consider the task of pixel-wise semantic segmentation given a small set of labeled training images. Among two of the most popular techniques to address this task are Random Forests (RF) and Neural Networks (NN). The main contribution of this work is to explore the relationship between two special forms of these techniques: stacked RFs and deep Convolutional Neural Networks (CNN). We show that there exists a mapping from stacked RF to deep CNN, and an approximate mapping back. This insight gives two major practical benefits: Firstly, deep CNNs can be intelligently constructed and initialized, which is crucial when dealing with a limited amount of training data. Secondly, it can be utilized to create a new stacked RF with improved performance. Furthermore, this mapping yields a new CNN architecture, that is well suited for pixel-wise semantic labeling. We experimentally verify these practical benefits for two different application scenarios in computer vision and biology, where the layout of parts is important: Kinect-based body part labeling from depth images, and somite segmentation in microscopy images of developing zebrafish. This study investigated the use of artificial neural networks (ANN) for image segmentation and spatial temporal contour linking for the detection of endocardial contours on echocardiographic images. Using a backpropagation network, the system was trained with 279 sample regions obtained from eight training images to segment images into either tissue or blood pool region. The ANN system was then applied to parasternal short axis images of 38 patients. Spatial temporal contour linking was performed on the segmented images to extract endocardial boarders. Left ventricular areas (end-systolic and end-diastolic) determined with the automated system were calculated and compared to results obtained by manual contour tracing performed by two independent investigators. In addition, ejection fractions (EF) were derived using the area-length method and compared with radionuclide ventriculography. Image quality was classified as good in 12 (32 ), moderate in 13 (34 ) and poor in 13 (34 ) patients. The ANN system provided estimates of end-diastolic and end-systolic areas in 36 (89 ) of echocardiograms, which correlated well with those obtained by manual tracing (R = 0.99, SEE = 1.44). A good agreement was also found for the comparison of EF between the ANN system and Tc-radionuclide ventriculography (RNV, R = 0.93, SEE = 6.36). The ANN system also performed well in the subset of patients with poor image quality. Endocardial contour detection using artificial neural networks and spatial temporal contour linking allows accurate calculations of ventricular areas from transthoracic echocardiograms and performs well even in images with poor quality. This system could greatly enhance the feasibility, accuracy and reproducibility of calculating cardiac areas to derive left ventricular volumes and ejection fractions.