Multi-stage learning for segmentation of aortic dissections using a prior aortic anatomy simplification.

Aortic dissection (AD) is a life-threatening cardiovascular disease with a high mortality rate. The accurate and generalized 3-D reconstruction of AD from CT-angiography can effectively assist clinical procedures and surgery plans, however, is clinically unavaliable due to the lacking of efficient tools. In this study, we presented a novel multi-stage segmentation framework for type B AD to extract true lumen (TL), false lumen (FL) and all branches (BR) as different classes. Two cascaded neural networks were used to segment the aortic trunk and branches and to separate the dual lumen, respectively. An aortic straightening method was designed based on the prior vascular anatomy of AD, simplifying the curved aortic shape before the second network. The straightening-based method achieved the mean Dice scores of 0.96, 0.95 and 0.89 for TL, FL, and BR on a multi-center dataset involving 120 patients, outperforming the end-to-end multi-class methods and the multi-stage methods without straightening on the dual-lumen segmentation, even using different network architectures. Both the global volumetric features of the aorta and the local characteristics of the primary tear could be better identified and quantified based on the straightening. Comparing to previous deep learning methods dealing with AD segmentations, the proposed framework presented advantages in segmentation accuracy.

A Three-Dimensional Deep Convolutional Neural Network for Automatic Segmentation and Diameter Measurement of Type B Aortic Dissection.

OBJECTIVE: To provide an automatic method for segmentation and diameter measurement of type B aortic dissection (TBAD). MATERIALS AND METHODS: Aortic computed tomography angiographic images from 139 patients with TBAD were consecutively collected. We implemented a deep learning method based on a three-dimensional (3D) deep convolutional neural (CNN) network, which realizes automatic segmentation and measurement of the entire aorta (EA), true lumen (TL), and false lumen (FL). The accuracy, stability, and measurement time were compared between deep learning and manual methods. The intra- and inter-observer reproducibility of the manual method was also evaluated. RESULTS: The mean dice coefficient scores were 0.958, 0.961, and 0.932 for EA, TL, and FL, respectively. There was a linear relationship between the reference standard and measurement by the manual and deep learning method (r = 0.964 and 0.991, respectively). The average measurement error of the deep learning method was less than that of the manual method (EA, 1.64% vs. 4.13%; TL, 2.46% vs. 11.67%; FL, 2.50% vs. 8.02%). Bland-Altman plots revealed that the deviations of the diameters between the deep learning method and the reference standard were -0.042 mm (-3.412 to 3.330 mm), -0.376 mm (-3.328 to 2.577 mm), and 0.026 mm (-3.040 to 3.092 mm) for EA, TL, and FL, respectively. For the manual method, the corresponding deviations were -0.166 mm (-1.419 to 1.086 mm), -0.050 mm (-0.970 to 1.070 mm), and -0.085 mm (-1.010 to 0.084 mm). Intra- and inter-observer differences were found in measurements with the manual method, but not with the deep learning method. The measurement time with the deep learning method was markedly shorter than with the manual method (21.7 ± 1.1 vs. 82.5 ± 16.1 minutes, p < 0.001). CONCLUSION: The performance of efficient segmentation and diameter measurement of TBADs based on the 3D deep CNN was both accurate and stable. This method is promising for evaluating aortic morphology automatically and alleviating the workload of radiologists in the near future.

Rapid vessel segmentation and reconstruction of head and neck angiograms using 3D convolutional neural network.

The computed tomography angiography (CTA) postprocessing manually recognized by technologists is extremely labor intensive and error prone. We propose an artificial intelligence reconstruction system supported by an optimized physiological anatomical-based 3D convolutional neural network that can automatically achieve CTA reconstruction in healthcare services. This system is trained and tested with 18,766 head and neck CTA scans from 5 tertiary hospitals in China collected between June 2017 and November 2018. The overall reconstruction accuracy of the independent testing dataset is 0.931. It is clinically applicable due to its consistency with manually processed images, which achieves a qualification rate of 92.1%. This system reduces the time consumed from 14.22 ± 3.64 min to 4.94 ± 0.36 min, the number of clicks from 115.87 ± 25.9 to 4 and the labor force from 3 to 1 technologist after five months application. Thus, the system facilitates clinical workflows and provides an opportunity for clinical technologists to improve humanistic patient care.

Evaluate the Malignancy of Pulmonary Nodules Using the 3-D Deep Leaky Noisy-OR Network.

Automatic diagnosing lung cancer from computed tomography scans involves two steps: detect all suspicious lesions (pulmonary nodules) and evaluate the whole-lung/pulmonary malignancy. Currently, there are many studies about the first step, but few about the second step. Since the existence of nodule does not definitely indicate cancer, and the morphology of nodule has a complicated relationship with cancer, the diagnosis of lung cancer demands careful investigations on every suspicious nodule and integration of information of all nodules. We propose a 3-D deep neural network to solve this problem. The model consists of two modules. The first one is a 3-D region proposal network for nodule detection, which outputs all suspicious nodules for a subject. The second one selects the top five nodules based on the detection confidence, evaluates their cancer probabilities, and combines them with a leaky noisy-OR gate to obtain the probability of lung cancer for the subject. The two modules share the same backbone network, a modified U-net. The overfitting caused by the shortage of the training data is alleviated by training the two modules alternately. The proposed model won the first place in the Data Science Bowl 2017 competition.

Estimation of the Volume of the Left Ventricle From MRI Images Using Deep Neural Networks.

Segmenting human left ventricle (LV) in magnetic resonance imaging images and calculating its volume are important for diagnosing cardiac diseases. The latter task became the topic of the Second Annual Data Science Bowl organized by Kaggle. The dataset consisted of a large number of cases with only systole and diastole volume labels. We designed a system based on neural networks to solve this problem. It began with a detector to detect the regions of interest (ROI) containing LV chambers. Then a deep neural network named hypercolumns fully convolutional network was used to segment LV in ROI. The 2-D segmentation results were integrated across different images to estimate the volume. With ground-truth volume labels, this model was trained end-to-end. To improve the result, an additional dataset with only segmentation labels was used. The model was trained alternately on these two tasks. We also proposed a variance estimation method for the final prediction. Our algorithm ranked the fourth on the test set in this competition.

Somatostatin Neurons in the Basal Forebrain Promote High-Calorie Food Intake.

Obesity has become a global issue, and the overconsumption of food is thought to be a major contributor. However, the regulatory neural circuits that regulate palatable food consumption remain unclear. Here, we report that somatostatin (SOM) neurons and GABAergic (VGAT) neurons in the basal forebrain (BF) play specific roles in regulating feeding. Optogenetic stimulation of BF SOM neurons increased fat and sucrose intake within minutes and promoted anxiety-like behaviors. Furthermore, optogenetic stimulation of projections from BF SOM neurons to the lateral hypothalamic area (LHA) selectively resulted in fat intake. In addition, activation of BF VGAT neurons rapidly induced general food intake and gnawing behaviors. Whole-brain mapping of inputs and outputs showed that BF SOM neurons form bidirectional connections with several brain areas important in feeding and regulation of emotion. Collectively, these results suggest that BF SOM neurons play a selective role in hedonic feeding.