Cardiovascular disease is a leading global cause of death, requiring accurate heart segmentation for diagnosis and surgical planning. Deep learning methods have been demonstrated to achieve superior performances in cardiac structures segmentation. However, there are still limitations in 3D whole heart segmentation, such as inadequate spatial context modeling, difficulty in capturing long-distance dependencies, high computational complexity, and limited representation of local high-level semantic information. To tackle the above problems, we propose a lightweight Pyramid Pooling Transformer-CNN (P2TC) network for accurate 3D whole heart segmentation. The proposed architecture comprises a dual encoder-decoder structure with a 3D pyramid pooling Transformer for multi-scale information fusion and a lightweight large-kernel Convolutional Neural Network (CNN) for local feature extraction. The decoder has two branches for precise segmentation and contextual residual handling. The first branch is used to generate segmentation masks for pixel-level classification based on the features extracted by the encoder to achieve accurate segmentation of cardiac structures. The second branch highlights contextual residuals across slices, enabling the network to better handle variations and boundaries. Extensive experimental results on the Multi-Modality Whole Heart Segmentation (MM-WHS) 2017 challenge dataset demonstrate that P2TC outperforms the most advanced methods, achieving the Dice scores of 92.6% and 88.1% in Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) modalities respectively, which surpasses the baseline model by 1.5% and 1.7%, and achieves state-of-the-art segmentation results.

Accurate myocardial segmentation is crucial in the diagnosis and treatment of myocardial infarction (MI), especially in Late Gadolinium Enhancement (LGE) cardiac magnetic resonance (CMR) images, where the infarcted myocardium exhibits a greater brightness. However, segmentation annotations for LGE images are usually not available. Although knowledge gained from CMR images of other modalities with ample annotations, such as balanced-Steady State Free Precession (bSSFP), can be transferred to the LGE images, the difference in image distribution between the two modalities (i.e., domain shift) usually results in a significant degradation in model performance. To alleviate this, an end-to-end Variational autoencoder based feature Alignment Module Combining Explicit and Implicit features (VAMCEI) is proposed. We first re-derive the Kullback-Leibler (KL) divergence between the posterior distributions of the two domains as a measure of the global distribution distance. Second, we calculate the prototype contrastive loss between the two domains, bringing closer the prototypes of the same category across domains and pushing away the prototypes of different categories within or across domains. Finally, a domain discriminator is added to the output space, which indirectly aligns the feature distribution and forces the extracted features to be more favorable for segmentation. In addition, by combining CycleGAN and VAMCEI, we propose a more refined multi-stage unsupervised domain adaptation (UDA) framework for myocardial structure segmentation. We conduct extensive experiments on the MSCMRSeg 2019, MyoPS 2020 and MM-WHS 2017 datasets. The experimental results demonstrate that our framework achieves superior performances than state-of-the-art methods.

Detailed information of substructures of the whole heart is usually vital in the diagnosis of cardiovascular diseases and in 3D modeling of the heart. Deep convolutional neural networks have been demonstrated to achieve state-of-the-art performance in 3D cardiac structures segmentation. However, when dealing with high-resolution 3D data, current methods employing tiling strategies usually degrade segmentation performances due to GPU memory constraints. This work develops a two-stage multi-modality whole heart segmentation strategy, which adopts an improved Combination of Faster R-CNN and 3D U-Net (CFUN+). More specifically, the bounding box of the heart is first detected by Faster R-CNN, and then the original Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) images of the heart aligned with the bounding box are input into 3D U-Net for segmentation. The proposed CFUN+ method redefines the bounding box loss function by replacing the previous Intersection over Union (IoU) loss with Complete Intersection over Union (CIoU) loss. Meanwhile, the integration of the edge loss makes the segmentation results more accurate, and also improves the convergence speed. The proposed method achieves an average Dice score of 91.1% on the Multi-Modality Whole Heart Segmentation (MM-WHS) 2017 challenge CT dataset, which is 5.2% higher than the baseline CFUN model, and achieves state-of-the-art segmentation results. In addition, the segmentation speed of a single heart has been dramatically improved from a few minutes to less than 6 seconds.