Automated analysis and detection of abnormalities in transaxial anatomical cardiovascular magnetic resonance images: a proof of concept study with potential to optimize image acquisition.

Journal: The international journal of cardiovascular imaging
Published Date:

Abstract

The large number of available MRI sequences means patients cannot realistically undergo them all, so the range of sequences to be acquired during a scan are protocolled based on clinical details. Adapting this to unexpected findings identified early on in the scan requires experience and vigilance. We investigated whether deep learning of the images acquired in the first few minutes of a scan could provide an automated early alert of abnormal features. Anatomy sequences from 375 CMR scans were used as a training set. From these, we annotated 1500 individual slices and used these to train a convolutional neural network to perform automatic segmentation of the cardiac chambers, great vessels and any pleural effusions. 200 scans were used as a testing set. The system then assembled a 3D model of the thorax from which it made clinical measurements to identify important abnormalities. The system was successful in segmenting the anatomy slices (Dice 0.910) and identified multiple features which may guide further image acquisition. Diagnostic accuracy was 90.5% and 85.5% for left and right ventricular dilatation, 85% for left ventricular hypertrophy and 94.4% for ascending aorta dilatation. The area under ROC curve for diagnosing pleural effusions was 0.91. We present proof-of-concept that a neural network can segment and derive accurate clinical measurements from a 3D model of the thorax made from transaxial anatomy images acquired in the first few minutes of a scan. This early information could lead to dynamic adaptive scanning protocols, and by focusing scanner time appropriately and prioritizing cases for supervision and early reporting, improve patient experience and efficiency.

Authors

  • James P Howard
    Department of Cardiology, National Heart and Lung Institute, Imperial College London, London, United Kingdom. Electronic address: jphoward@doctors.org.uk.
  • Sameer Zaman
    Department of Computing, National Heart and Lung Institute, Imperial College London, Imperial College Healthcare NHS Trust, London, UK.
  • Aaraby Ragavan
    Department of Computing, National Heart and Lung Institute, Imperial College London, Imperial College Healthcare NHS Trust, London, UK.
  • Kerry Hall
    Department of Computing, National Heart and Lung Institute, Imperial College London, Imperial College Healthcare NHS Trust, London, UK.
  • Greg Leonard
    Department of Computing, National Heart and Lung Institute, Imperial College London, Imperial College Healthcare NHS Trust, London, UK.
  • Sharon Sutanto
    Department of Computing, National Heart and Lung Institute, Imperial College London, Imperial College Healthcare NHS Trust, London, UK.
  • Vijay Ramadoss
    Department of Computing, National Heart and Lung Institute, Imperial College London, Imperial College Healthcare NHS Trust, London, UK.
  • Yousuf Razvi
    Department of Computing, National Heart and Lung Institute, Imperial College London, Imperial College Healthcare NHS Trust, London, UK.
  • Nick F Linton
    Department of Computing, National Heart and Lung Institute, Imperial College London, Imperial College Healthcare NHS Trust, London, UK.
  • Anil Bharath
    Department of Computing, National Heart and Lung Institute, Imperial College London, Imperial College Healthcare NHS Trust, London, UK.
  • Matthew Shun-Shin
    Department of Computing, National Heart and Lung Institute, Imperial College London, Imperial College Healthcare NHS Trust, London, UK.
  • Daniel Rueckert
    Biomedical Image Analysis (BioMedIA) Group, Department of Computing, Imperial College London, UK. Electronic address: d.rueckert@imperial.ac.uk.
  • Darrel Francis
    Department of Computing, National Heart and Lung Institute, Imperial College London, Imperial College Healthcare NHS Trust, London, UK.
  • Graham Cole
    Department of Cardiovascular Imaging, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom