Kimberley M. Timmins

Kimberley M. Timmins, Maarten J. Kamphuis, Iris N. Vos et al.

The growth of unruptured intracranial aneurysms (UIAs) is a predictor of rupture. Therefore, for further imaging surveillance and treatment planning, it is important to be able to predict if an UIA is likely to grow based on an initial baseline Time-of-Flight MRA (TOF-MRA). It is known that the size and shape of UIAs are predictors of aneurysm growth and/or rupture. We perform a feasibility study of using a mesh convolutional neural network for future UIA growth prediction from baseline TOF-MRAs. We include 151 TOF-MRAs, with 169 UIAs where 49 UIAs were classified as growing and 120 as stable, based on the clinical definition of growth (>1 mm increase in size in follow-up scan). UIAs were segmented from TOF-MRAs and meshes were automatically generated. We investigate the input of both UIA mesh only and region-of-interest (ROI) meshes including UIA and surrounding parent vessels. We develop a classification model to predict UIAs that will grow or remain stable. The model consisted of a mesh convolutional neural network including additional novel input edge features of shape index and curvedness which describe the surface topology. It was investigated if input edge mid-point co-ordinates influenced the model performance. The model with highest AUC (63.8%) for growth prediction was using UIA meshes with input edge mid-point co-ordinate features (average F1 score = 62.3%, accuracy = 66.9%, sensitivity = 57.3%, specificity = 70.8%). We present a future UIA growth prediction model based on a mesh convolutional neural network with promising results.

V. de Vos, K. M. Timmins, I. C. van der Schaaf et al.

Deep learning approaches may help radiologists in the early diagnosis and timely treatment of cerebrovascular diseases. Accurate cerebral vessel segmentation of Time-of-Flight Magnetic Resonance Angiographs (TOF-MRAs) is an essential step in this process. This study investigates deep learning approaches for automatic, fast and accurate cerebrovascular segmentation for TOF-MRAs. The performance of several data augmentation and selection methods for training a 2D and 3D U-Net for vessel segmentation was investigated in five experiments: a) without augmentation, b) Gaussian blur, c) rotation and flipping, d) Gaussian blur, rotation and flipping and e) different input patch sizes. All experiments were performed by patch-training both a 2D and 3D U-Net and predicted on a test set of MRAs. Ground truth was manually defined using an interactive threshold and region growing method. The performance was evaluated using the Dice Similarity Coefficient (DSC), Modified Hausdorff Distance and Volumetric Similarity, between the predicted images and the interactively defined ground truth. The segmentation performance of all trained networks on the test set was found to be good, with DSC scores ranging from 0.72 to 0.83. Both the 2D and 3D U-Net had the best segmentation performance with Gaussian blur, rotation and flipping compared to other experiments without augmentation or only one of those augmentation techniques. Additionally, training on larger patches or slices gave optimal segmentation results. In conclusion, vessel segmentation can be optimally performed on TOF-MRAs using a trained 3D U-Net on larger patches, where data augmentation including Gaussian blur, rotation and flipping was performed on the training data.

Kimberley M. Timmins, Irene C. van der Schaaf, Ynte M. Ruigrok et al.

Time-of-Flight Magnetic Resonance Angiographs (TOF-MRAs) enable visualization and analysis of cerebral arteries. This analysis may indicate normal variation of the configuration of the cerebrovascular system or vessel abnormalities, such as aneurysms. A model would be useful to represent normal cerebrovascular structure and variabilities in a healthy population and to differentiate from abnormalities. Current anomaly detection using autoencoding convolutional neural networks usually use a voxelwise mean-error for optimization. We propose optimizing a variational-autoencoder (VAE) with structural similarity loss (SSIM) for TOF-MRA reconstruction. A patch-trained 2D fully-convolutional VAE was optimized for TOF-MRA reconstruction by comparing vessel segmentations of original and reconstructed MRAs. The method was trained and tested on two datasets: the IXI dataset, and a subset from the ADAM challenge. Both trained networks were tested on a dataset including subjects with aneurysms. We compared VAE optimization with L2-loss and SSIM-loss. Performance was evaluated between original and reconstructed MRAs using mean square error, mean-SSIM, peak-signal-to-noise-ratio and dice similarity index (DSI) of segmented vessels. The L2-optimized VAE outperforms SSIM, with improved reconstruction metrics and DSIs for both datasets. Optimization using SSIM performed best for visual image quality, but with discrepancy in quantitative reconstruction and vascular segmentation. The larger, more diverse IXI dataset had overall better performance. Reconstruction metrics, including SSIM, were lower for MRAs including aneurysms. A SSIM-optimized VAE improved the visual perceptive image quality of TOF-MRA reconstructions. A L2-optimized VAE performed best for TOF-MRA reconstruction, where the vascular segmentation is important. SSIM is a potential metric for anomaly detection of MRAs.