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.
Presents a new method for endocardial (inner) and epicardial (outer) contour estimation from sequences of echocardiographic images. The framework herein introduced is fine-tuned for parasternal short axis views at the papillary muscle level. The underlying model is probabilistic; it captures the relevant features of the image generation physical mechanisms and of the heart morphology. Contour sequences are assumed to be two-dimensional noncausal first-order Markov random processes; each variable has a spatial index and a temporal index. The image pixels are modeled as Rayleigh distributed random variables with means depending on their positions (inside endocardium, between endocardium and pericardium, or outside pericardium). The complete probabilistic model is built under the Bayesian framework. As estimation criterion the maximum a posteriori (MAP) is adopted. To solve the optimization problem, one is led to (joint estimation of contours and distributions' parameters), the authors introduce an algorithm herein named iterative multigrid dynamic programming (IMDP). It is a fully data-driven scheme with no ad-hoc parameters. The method is implemented on an ordinary workstation, leading to computation times compatible with operational use. Experiments with simulated and real images are presented. Abstract In this paper automatic detection of the boundary of left ventricle (LV) in a sequence of cardiac images has been proposed. The contour detection algorithm is formulated as a constrained optimization problem based on active contour model. The optimization problem has been solved using Genetic Algorithm (GA). The result obtained by the proposed GA based approach is compared with conventional nonlinear programming methods. Validation of the computer-generated boundaries is done after comparing them with manually outlined contours by expert observers. The performance of the algorithm is comparable to inter-observer anomalies. In this paper, we propose an automatic method for constructing an active shape model (ASM) to segment the complete cardiac left ventricle in 3D ultrasound (3DUS) images, which avoids costly manual landmarking. The automatic construction of the ASM has already been addressed in the literature; however, the direct application of these methods to 3DUS is hampered by a high level of noise and artefacts. Therefore, we propose to construct the ASM by fusing the multidetector computed tomography data, to learn the shape, with the artificially generated 3DUS, in order to learn the neighbourhood of the boundaries. Our artificial images were generated by two approaches: a faster one that does not take into account the geometry of the transducer, and a more comprehensive one, implemented in Field II toolbox. The segmentation accuracy of our ASM was evaluated on 20 patients with left-ventricular asynchrony, demonstrating plausibility of the approach. We present a new multiscale approach for deformable contour optimization. The method relies on a multigrid minimization method and a coarse-to-fine relaxation algorithm. This approach consists in minimizing a cascade of optimization problems of reduced and increasing complexity instead of considering the minimization problem on the full and original configuration space. Contrary to classical multiresolution algorithms, no reduction of image is applied. The family of defined energy functions are derived from the original (full resolution) objective function, ensuring that the same function is handled at each scale and that the energy decreases at each step of the deformable contour minimization process. The efficiency and the speed of this multiscale optimization strategy is demonstrated in the difficult context of the minimization of a region-based contour energy function ensuring the boundary detection of anatomical structures in ultrasound medical imagery. In this context, the proposed multiscale segmentation method is compared to other classical region-based segmentation approaches such as Maximum Likelihood or Markov Random Field-based segmentation techniques. We also extend this multiscale segmentation strategy to active contour models using a classical edge-based likelihood approach. Finally, time and performance analysis of this approach, compared to the (commonly used) dynamic programming-based optimization procedure, is given and allows to attest the accuracy and the speed of the proposed method. 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. Abstract In the automatic segmentation of echocardiographic images, a priori shape knowledge has been used to compensate for poor features in ultrasound images. This shape knowledge is often learned via an off-line training process, which requires tedious human effort and is highly expertise-dependent. More importantly, a learned shape template can only be used to segment a specific class of images with similar boundary shape. In this paper, we present a multi-scale level set framework for segmentation of endocardial boundaries at each frame in a multiframe echocardiographic image sequence. We point out that the intensity distribution of an ultrasound image at a very coarse scale can be approximately modeled by Gaussian. Then we combine region homogeneity and edge features in a level set approach to extract boundaries automatically at this coarse scale. At finer scale levels, these coarse boundaries are used to both initialize boundary detection and serve as an external constraint to guide contour evolution. This constraint functions similar to a traditional shape prior. Experimental results validate this combinative framework. Automatic delineation of the myocardium in real-time 3D echocardiography may be used to aid the diagnosis of heart problems such as ischaemia, by enabling quantification of wall thickening and wall motion abnormalities. Distinguishing between myocardial and non-myocardial tissue is, however, difficult due to low signal-to-noise ratio as well as the efficiency constraints imposed on any algorithmic solution by the large size of the data under consideration. In this paper, we take a machine learning approach treating this problem as a two-class 3D patch classification task. We demonstrate that solving such task using random forests , which are the discriminative classifiers developed recently in the machine learning community, allows to obtain accurate delineations in a matter of seconds (on a CPU) or even in real-time (on a GPU) for the entire 3D volume. In this paper we propose a novel segmentation technique for quantification of sparsely sampled single-beat 3D contrast enhanced echocardiographic data acquired with a Fast Rotating Ultrasound transducer (FRU). The method uses a 3D Active Shape Model of the Left Ventricle (LV) in combination with local appearance models as prior knowledge to steer the segmentation. From a set of semi-manually delineated contours, 3D meshes of the LV endocardium are constructed for different cardiac phases. Mesh surfaces are partitioned into a fixed number of regions, each of which is modeled by a local image appearance. During segmentation, model update points are generated based on similarity matches with these local appearance models in multiple curved 2D cross-sections, which are then propagated over a dense 3D mesh. The Active Shape Model effectively constrains the shape of the 3D mesh to a statistically plausible cardiac shape. Leave-one-out cross validation was carried out on single-beat contrast enhanced FRU data from 18 patients suffering from various cardiac pathologies. Experiments show that the proposed method generates segmentation results that agree with the ground truth contours with average Point to Point (P2P) error of 4.1±2.0 mm and average Point to Surface (P2S) error of 2.4±2.1mm. Convergence tests show that the proposed method is capable of producing acceptable segmentation results (with less than 1.5X error compared to favorable initialization) within the range of 18 22 mm of in-plane displacement and 12 14 degrees of long-axial orientation error. Automated left ventricle (LV) segmentation in 3D ultrasound (3D-US) remains a challenging research problem due to variable image quality and limited field-of-view. Modern segmentation approaches (shape, appearance and contour model based surface fitting) require an accurate initialization and good image boundary features to obtain reliable and consistent results. They are therefore not well suited for this problem. The proposed method overcomes those limitations with a novel and generic 3D-US image boundary representation technique: Probabilistic Edge Map (PEM). This new representation captures regularized and complete edge responses from standard 3D-US images. PEM is utilized in a multi-atlas LV segmentation framework to spatially align target and atlas images. Experiments on data from the MICCAI CETUS challenge show that the proposed approach is better suited for LV segmentation than the active contour, appearance and voxel classification approaches, achieving lower surface distance errors and better LV volume estimates.  Cardiac volume function assessment remains a critical step in daily cardiology, and 3-D ultrasound plays an increasingly important role. Though development of automatic endocardial segmentation methods has received much attention, the same cannot be said about epicardial segmentation, in spite of the importance of full myocardial segmentation. In this paper, different ways of coupling the endocardial and epicardial segmentations are contrasted and compared with uncoupled segmentation. For this purpose, the B-spline explicit active surfaces framework was used; 27 3-D echocardiographic images were used to validate the different coupling strategies, which were compared with manual contouring of the endocardial and epicardial borders performed by an expert. It is shown that an independent segmentation of the endocardium followed by an epicardial segmentation coupled to the endocardium is the most advantageous. In this way, a framework for fully automatic 3-D myocardial segmentation is proposed using a novel coupling strategy. A novel extension of active appearance models (AAMs) for automated border detection in echocardiographic image sequences is reported. The active appearance motion model (AAMM) technique allows fully automated robust and time-continuous delineation of left ventricular (LV) endocardial contours over the full heart cycle with good results. Nonlinear intensity normalization was developed and employed to accommodate ultrasound-specific intensity distributions. The method was trained and tested on 16-frame phase-normalized transthoracic four-chamber sequences of 129 unselected infarct patients, split randomly into a training set (n=65) and a test set (n=64). Borders were compared to expert drawn endocardial contours. On the test set, fully automated AAMM performed well in 97 of the cases (average distance between manual and automatic landmark points was 3.3 mm, comparable to human interobserver variabilities). The ultrasound-specific intensity normalization proved to be of great value for good results in echocardiograms. The AAMM was significantly more accurate than an equivalent set of two-dimensional AAMs. Fast segmentation of the left ventricular (LV) myocardium in 3D+time echocardiographic sequences can provide quantitative data of heart function that can aid in clinical diagnosis and disease assessment. We present an algorithm for automatic segmentation of the LV myocardium in 2D and 3D sequences which employs learning optical flow (OF) strategies. OF motion estimation is used to propagate single-frame segmentation results of the Random Forest classifier from one frame to the next. The best strategy for propagating between frames is learned on a per-frame basis. We demonstrate that our algorithm is fast and accurate. We also show that OF propagation increases the performance of the method with respect to the static baseline procedure, and that learning the best OF propagation strategy performs better than single-strategy OF propagation. Abstract We present a machine learning approach called shape regression machine (SRM) for efficient segmentation of an anatomic structure that exhibits a deformable shape in a medical image, e.g., left ventricle endocardial wall in an echocardiogram. The SRM achieves efficient segmentation via statistical learning of the interrelations among shape, appearance, and anatomy , which are exemplified by an annotated database. The SRM is a two-stage approach. In the first stage that estimates a rigid shape to solve an automatic initialization problem, it derives a regression solution to object detection that needs just one scan in principle and a sparse set of scans in practice, avoiding the exhaustive scanning required by the state-of-the-art classification-based detection approach while yielding comparable detection accuracy. In the second stage that estimates the nonrigid shape, it again learns a nonlinear regressor to directly associate nonrigid shape with image appearance. The underpinning of both stages is a novel image-based boosting ridge regression (IBRR) method that enables multivariate, nonlinear modeling and accommodates fast evaluation. We demonstrate the efficiency and effectiveness of the SRM using experiments on segmenting the left ventricle endocardium from a B-mode echocardiogram of apical four chamber view. The proposed algorithm is able to automatically detect and accurately segment the LV endocardial border in about 120 ms .  This paper presents a novel algorithm, aimed at automatic endocardial boundary (inner boundary) detection in myocardial opacification scenarios. The data acquisition protocol uses (on purpose) low mechanical index imaging (i.e., weak ultrasound signal), so that the acquired images are characterized by low signal-to-noise ratios. The proposed algorithm is based on converting the frames, given in Cartesian coordinates, into polar coordinates, and applying a set of filters in order to compute the initial estimation of the endocardial boundary. The final estimation of the endocardial boundary is produced by an error correction process, which uses both spatial and temporal filtering. The estimated boundaries are converted into Cartesian coordinates, for display. Our algorithm has been tested on nine cine-loops. The resulting myocardial outlines have been separately assessed by two clinicians, scoring each segment in each cine-loop on a scale between 5 (excellent) and 1 (completely unacceptable). The mean overall score is 3.8plusmn0.8, which seems adequate. The same clinicians have also manually drawn the contours of the endocardial boundary for the end-systolic and the end-diastolic frames of each cine-loop. The results show, that the mismatch between the automatically determined outlines and the manually drawn outlines is of the same order of magnitude as the interobserver variability. These results further support the validity of our method