RESUMEN
Renal segmentation on contrast-enhanced computed tomography (CT) provides distinct spatial context and morphology. Current studies for renal segmentations are highly dependent on manual efforts, which are time-consuming and tedious. Hence, developing an automatic framework for the segmentation of renal cortex, medulla and pelvicalyceal system is an important quantitative assessment of renal morphometry. Recent innovations in deep methods have driven performance toward levels for which clinical translation is appealing. However, the segmentation of renal structures can be challenging due to the limited field-of-view (FOV) and variability among patients. In this paper, we propose a method to automatically label the renal cortex, the medulla and pelvicalyceal system. First, we retrieved 45 clinically-acquired deidentified arterial phase CT scans (45 patients, 90 kidneys) without diagnosis codes (ICD-9) involving kidney abnormalities. Second, an interpreter performed manual segmentation to pelvis, medulla and cortex slice-by-slice on all retrieved subjects under expert supervision. Finally, we proposed a patch-based deep neural networks to automatically segment renal structures. Compared to the automatic baseline algorithm (3D U-Net) and conventional hierarchical method (3D U-Net Hierarchy), our proposed method achieves improvement of 0.7968 to 0.6749 (3D U-Net), 0.7482 (3D U-Net Hierarchy) in terms of mean Dice scores across three classes (p-value < 0.001, paired t-tests between our method and 3D U-Net Hierarchy). In summary, the proposed algorithm provides a precise and efficient method for labeling renal structures.
RESUMEN
PURPOSE: Dynamic contrast-enhanced computed tomography (CT) is widely used to provide dynamic tissue contrast for diagnostic investigation and vascular identification. However, the phase information of contrast injection is typically recorded manually by technicians, which introduces missing or mislabeling. Hence, imaging-based contrast phase identification is appealing, but challenging, due to large variations among different contrast protocols, vascular dynamics, and metabolism, especially for clinically acquired CT scans. The purpose of this study is to perform imaging-based phase identification for dynamic abdominal CT using a proposed adversarial learning framework across five representative contrast phases. METHODS: A generative adversarial network (GAN) is proposed as a disentangled representation learning model. To explicitly model different contrast phases, a low dimensional common representation and a class specific code are fused in the hidden layer. Then, the low dimensional features are reconstructed following a discriminator and classifier. 36 350 slices of CT scans from 400 subjects are used to evaluate the proposed method with fivefold cross-validation with splits on subjects. Then, 2216 slices images from 20 independent subjects are employed as independent testing data, which are evaluated using multiclass normalized confusion matrix. RESULTS: The proposed network significantly improved correspondence (0.93) over VGG, ResNet50, StarGAN, and 3DSE with accuracy scores 0.59, 0.62, 0.72, and 0.90, respectively (P < 0.001 Stuart-Maxwell test for normalized multiclass confusion matrix). CONCLUSION: We show that adversarial learning for discriminator can be benefit for capturing contrast information among phases. The proposed discriminator from the disentangled network achieves promising results.
