Automatic segmentation of multiple cardiovascular structures from cardiac computed tomography angiography images using deep learning

PLoS ONE, vol. 15, pp. e0232573

Abstract

OBJECTIVES: To develop, demonstrate and evaluate an automated deep learning method for multiple cardiovascular structure segmentation. BACKGROUND: Segmentation of cardiovascular images is resource-intensive. We design an automated deep learning method for the segmentation of multiple structures from Coronary Computed Tomography Angiography (CCTA) images. METHODS: Images from a multicenter registry of patients that underwent clinically-indicated CCTA were used. The proximal ascending and descending aorta (PAA, DA), superior and inferior vena cavae (SVC, IVC), pulmonary artery (PA), coronary sinus (CS), right ventricular wall (RVW) and left atrial wall (LAW) were annotated as ground truth. The U-net-derived deep learning model was trained, validated and tested in a 70:20:10 split. RESULTS: The dataset comprised 206 patients, with 5.130 billion pixels. Mean age was 59.9 ± 9.4 yrs., and was 42.7% female. An overall median Dice score of 0.820 (0.782, 0.843) was achieved. Median Dice scores for PAA, DA, SVC, IVC, PA, CS, RVW and LAW were 0.969 (0.979, 0.988), 0.953 (0.955, 0.983), 0.937 (0.934, 0.965), 0.903 (0.897, 0.948), 0.775 (0.724, 0.925), 0.720 (0.642, 0.809), 0.685 (0.631, 0.761) and 0.625 (0.596, 0.749) respectively. Apart from the CS, there were no significant differences in performance between sexes or age groups. CONCLUSIONS: An automated deep learning model demonstrated segmentation of multiple cardiovascular structures from CCTA images with reasonable overall accuracy when evaluated on a pixel level.

Authors 37

1. Lohendran Baskaran corresponding

   NewYork–Presbyterian Hospital · National Heart Centre Singapore · Weill Cornell Medicine

   Affiliation as printed

   Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America

   Department of Cardiovascular Medicine, National Heart Centre, Singapore, Singapore

   Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York, United States of America

2. Subhi Jamal Alaref

   NewYork–Presbyterian Hospital · Weill Cornell Medicine

   Affiliation as printed

   Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America

   Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York, United States of America

3. Gabriel Maliakal
   Affiliation as printed

   Cleerly, Inc, New York, New York, United States of America

4. Benjamin C. Lee

   Yonsei University · Gangnam Severance Hospital · Weill Cornell Medicine

   Affiliation as printed

   Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America

   Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

5. Zhuoran Xu

   Weill Cornell Medicine

   Affiliation as printed

   Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America

6. Jeong Won Choi

   Pusan National University Hospital · Weill Cornell Medicine

   Affiliation as printed

   Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America

   Pusan University Hospital, Busan, South Korea

7. Sang‐Eun Lee

   Ewha Womans University · Yonsei University · Severance Hospital · Yonsei University Health System · Ewha Womans University Seoul Hospital

   Affiliation as printed

   Division of Cardiology, Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea

   Division of Cardiology, Severance Cardiovascular Hospital, Integrative Cardiovascular Imaging Center, Yonsei University College of Medicine, Seoul, South Korea

8. Ji Min Sung

   Yonsei University · Severance Hospital · Yonsei University Health System

   Affiliation as printed

   Division of Cardiology, Severance Cardiovascular Hospital, Integrative Cardiovascular Imaging Center, Yonsei University College of Medicine, Seoul, South Korea

9. Fay Yu-Huei Lin

   NewYork–Presbyterian Hospital · Weill Cornell Medicine

   Affiliation as printed

   Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America

   Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York, United States of America

10. Simon N. Dunham

    Weill Cornell Medicine

    Affiliation as printed

    Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America

11. Bobak Mosadegh

    Weill Cornell Medicine

    Affiliation as printed

    Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America

12. Yong‐Jin Kim

    Seoul National University · Seoul National University Hospital

    Affiliation as printed

    Department of Internal Medicine, Seoul National University College of Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea

13. Ilan Gottlieb

    Fundação Saúde

    Affiliation as printed

    Department of Radiology, Casa de Saude São Jose, Rio de Janeiro, Brazil

14. Byoung Kwon Lee

    Yonsei University · Gangnam Severance Hospital · Weill Cornell Medicine

    Affiliation as printed

    Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America

    Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

15. Eun Ju Chun

    Seoul National University Bundang Hospital

    Affiliation as printed

    Department of Radiology, Seoul National University Bundang Hospital, Sungnam, South Korea

16. Filippo Cademartiri
    Affiliation as printed

    Cardiovascular Imaging Center, SDN IRCCS, Naples, Italy

17. Erica Maffei
    Affiliation as printed

    Department of Radiology, Area Vasta 1/ASUR Marche, Urbino, Italy

18. Hugo Marques

    Hospital da Luz

    Affiliation as printed

    UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisboa, Portugal

19. Sanghoon Shin

    Ewha Womans University · Ewha Womans University Seoul Hospital

    Affiliation as printed

    Division of Cardiology, Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea

20. Jung Hyun Choi

    Pusan National University Hospital · Weill Cornell Medicine

    Affiliation as printed

    Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America

    Pusan University Hospital, Busan, South Korea

21. Kavitha M. Chinnaiyan

    Beaumont Hospital, Royal Oak

    Affiliation as printed

    Department of Cardiology, William Beaumont Hospital, Royal Oak, Michigan, United States of America

22. Martin Hadamitzky

    Deutsches Herzzentrum München

    Affiliation as printed

    Department of Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany

23. Edoardo Conte

    Centro Cardiologico Monzino

    Affiliation as printed

    Centro Cardiologico Monzino, IRCCS, Milan, Italy

24. Daniele Andreini

    Centro Cardiologico Monzino

    Affiliation as printed

    Centro Cardiologico Monzino, IRCCS, Milan, Italy

25. Gianluca Pontone

    Centro Cardiologico Monzino

    Affiliation as printed

    Centro Cardiologico Monzino, IRCCS, Milan, Italy

26. Matthew Jay Budoff

    The Lundquist Institute

    Affiliation as printed

    Department of Medicine, Los Angeles Biomedical Research Institute, Torrance, California, United States of America

27. Jonathon A Leipsic

    University of British Columbia

    Affiliation as printed

    Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada

28. Gilbert L Raff

    Beaumont Hospital, Royal Oak

    Affiliation as printed

    Department of Cardiology, William Beaumont Hospital, Royal Oak, Michigan, United States of America

29. Renu Virmani

    CVPath Institute

    Affiliation as printed

    Department of Pathology, CVPath Institute, Gaithersburg, Maryland, United States of America

30. Habib Samady

    Emory University

    Affiliation as printed

    Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, United States of America

31. Peter Howard Stone

    Brigham and Women's Hospital · Harvard University

    Affiliation as printed

    Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America

32. Daniel S. Berman

    Cedars-Sinai Medical Center

    Affiliation as printed

    Department of Imaging and Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America

33. Jagat Narula

    Mount Sinai Hospital · Icahn School of Medicine at Mount Sinai

    Affiliation as printed

    Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, Zena and Michael A. Wiener Cardiovascular Institute, and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, New York, New York, United States of America

34. Jeroen Joost Bax Aachen Department of Cardiology, Leiden University Medical Center

    Leiden University Medical Center

    Affiliation as printed

    Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands

35. Hyuk‐Jae Chang

    Yonsei University · Severance Hospital · Yonsei University Health System

    Affiliation as printed

    Division of Cardiology, Severance Cardiovascular Hospital, Integrative Cardiovascular Imaging Center, Yonsei University College of Medicine, Seoul, South Korea

36. James K. Min

    NewYork–Presbyterian Hospital · Weill Cornell Medicine

    Affiliation as printed

    Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America

    Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York, United States of America

37. Leslee J. Shaw

    NewYork–Presbyterian Hospital · Weill Cornell Medicine

    Affiliation as printed

    Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America

    Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, New York, United States of America