James C. Moon

Wing Keung Cheung, Jeremy Kalindjian, Robert Bell et al.

Early detection and diagnosis of coronary artery disease (CAD) could save lives and reduce healthcare costs. The current clinical practice is to perform CAD diagnosis through analysing medical images from computed tomography coronary angiography (CTCA). Most current approaches utilise deep learning methods but require centerline extraction and multi-planar reconstruction. These indirect methods are not designed in a clinician-friendly manner, and they complicate the interventional procedure. Furthermore, the current deep learning methods do not provide exact explainability and limit the usefulness of these methods to be deployed in clinical settings. In this study, we first propose a 3D Resnet-50 deep learning model to directly classify normal subjects and CAD patients on CTCA images, then we demonstrate a 2D modified U-Net model can be subsequently employed to segment the coronary arteries. Our proposed approach outperforms the state-of-the-art models by 21.43% in terms of classification accuracy. The classification model with focal loss provides a better and more focused heat map, and the segmentation model provides better explainability than the classification-only model. The proposed holistic approach not only provides a simpler and clinician-friendly solution but also good classification accuracy and exact explainability for CAD diagnosis.

Hui Xue, Sarah M. Hooper, Iain Pierce et al.

To develop and evaluate a new deep learning MR denoising method that leverages quantitative noise distribution information from the reconstruction process to improve denoising performance and generalization. This retrospective study trained 14 different transformer and convolutional models with two backbone architectures on a large dataset of 2,885,236 images from 96,605 cardiac retro-gated cine complex series acquired at 3T. The proposed training scheme, termed SNRAware, leverages knowledge of the MRI reconstruction process to improve denoising performance by simulating large, high quality, and diverse synthetic datasets, and providing quantitative information about the noise distribution to the model. In-distribution testing was performed on a hold-out dataset of 3000 samples with performance measured using PSNR and SSIM, with ablation comparison without the noise augmentation. Out-of-distribution tests were conducted on cardiac real-time cine, first-pass cardiac perfusion, and neuro and spine MRI, all acquired at 1.5T, to test model generalization across imaging sequences, dynamically changing contrast, different anatomies, and field strengths. The best model found in the in-distribution test generalized well to out-of-distribution samples, delivering 6.5x and 2.9x CNR improvement for real-time cine and perfusion imaging, respectively. Further, a model trained with 100% cardiac cine data generalized well to a T1 MPRAGE neuro 3D scan and T2 TSE spine MRI.

Chen Chen, Wenjia Bai, Rhodri H. Davies et al.

Convolutional neural network (CNN) based segmentation methods provide an efficient and automated way for clinicians to assess the structure and function of the heart in cardiac MR images. While CNNs can generally perform the segmentation tasks with high accuracy when training and test images come from the same domain (e.g. same scanner or site), their performance often degrades dramatically on images from different scanners or clinical sites. We propose a simple yet effective way for improving the network generalization ability by carefully designing data normalization and augmentation strategies to accommodate common scenarios in multi-site, multi-scanner clinical imaging data sets. We demonstrate that a neural network trained on a single-site single-scanner dataset from the UK Biobank can be successfully applied to segmenting cardiac MR images across different sites and different scanners without substantial loss of accuracy. Specifically, the method was trained on a large set of 3,975 subjects from the UK Biobank. It was then directly tested on 600 different subjects from the UK Biobank for intra-domain testing and two other sets for cross-domain testing: the ACDC dataset (100 subjects, 1 site, 2 scanners) and the BSCMR-AS dataset (599 subjects, 6 sites, 9 scanners). The proposed method produces promising segmentation results on the UK Biobank test set which are comparable to previously reported values in the literature, while also performing well on cross-domain test sets, achieving a mean Dice metric of 0.90 for the left ventricle, 0.81 for the myocardium and 0.82 for the right ventricle on the ACDC dataset; and 0.89 for the left ventricle, 0.83 for the myocardium on the BSCMR-AS dataset. The proposed method offers a potential solution to improve CNN-based model generalizability for the cross-scanner and cross-site cardiac MR image segmentation task.