Gerry P McCann

Shuihua Wang, Ahmed M. S. E. K Abdelaty, Kelly Parke et al.

A "heart attack" or myocardial infarction (MI), occurs when an artery supplying blood to the heart is abruptly occluded. The "gold standard" method for imaging MI is Cardiovascular Magnetic Resonance Imaging (MRI), with intravenously administered gadolinium-based contrast (late gadolinium enhancement). However, no "gold standard" fully automated method for the quantification of MI exists. In this work, we propose an end-to-end fully automatic system (MyI-Net) for the detection and quantification of MI in MRI images. This has the potential to reduce the uncertainty due to the technical variability across labs and inherent problems of the data and labels. Our system consists of four processing stages designed to maintain the flow of information across scales. First, features from raw MRI images are generated using feature extractors built on ResNet and MoblieNet architectures. This is followed by the Atrous Spatial Pyramid Pooling (ASPP) to produce spatial information at different scales to preserve more image context. High-level features from ASPP and initial low-level features are concatenated at the third stage and then passed to the fourth stage where spatial information is recovered via up-sampling to produce final image segmentation output into: i) background, ii) heart muscle, iii) blood and iv) scar areas. New models were compared with state-of-art models and manual quantification. Our models showed favorable performance in global segmentation and scar tissue detection relative to state-of-the-art work, including a four-fold better performance in matching scar pixels to contours produced by clinicians.

Tuan A. Bohoran, Polydoros N. Kampaktsis, Laura McLaughlin et al.

The right ventricular (RV) function deterioration strongly predicts clinical outcomes in numerous circumstances. To boost the clinical deployment of ensemble regression methods that quantify RV volumes using tabular data from the widely available two-dimensional echocardiography (2DE), we propose to complement the volume predictions with uncertainty scores. To this end, we employ an instance-based method which uses the learned tree structure to identify the nearest training samples to a target instance and then uses a number of distribution types to more flexibly model the output. The probabilistic and point-prediction performances of the proposed framework are evaluated on a relatively small-scale dataset, comprising 100 end-diastolic and end-systolic RV volumes. The reference values for point performance were obtained from MRI. The results demonstrate that our flexible approach yields improved probabilistic and point performances over other state-of-the-art methods. The appropriateness of the proposed framework is showcased by providing exemplar cases. The estimated uncertainty embodies both aleatoric and epistemic types. This work aligns with trustworthy artificial intelligence since it can be used to enhance the decision-making process and reduce risks. The feature importance scores of our framework can be exploited to reduce the number of required 2DE views which could enhance the proposed pipeline's clinical application.

Aida Moafi, Danial Moafi, Evgeny M. Mirkes et al.

The accurate segmentation of myocardial scars from cardiac MRI is essential for clinical assessment and treatment planning. In this study, we propose a robust deep-learning pipeline for fully automated myocardial scar detection and segmentation by fine-tuning state-of-the-art models. The method explicitly addresses challenges of label noise from semi-automatic annotations, data heterogeneity, and class imbalance through the use of Kullback-Leibler loss and extensive data augmentation. We evaluate the model's performance on both acute and chronic cases and demonstrate its ability to produce accurate and smooth segmentations despite noisy labels. In particular, our approach outperforms state-of-the-art models like nnU-Net and shows strong generalizability in an out-of-distribution test set, highlighting its robustness across various imaging conditions and clinical tasks. These results establish a reliable foundation for automated myocardial scar quantification and support the broader clinical adoption of deep learning in cardiac imaging.