A global benchmark of algorithms for segmenting the left atrium from late gadolinium-enhanced cardiac magnetic resonance imaging

Zhaohan Xiong, Qing Xia, Zhiqiang Hu, Ning Huang, Cheng Bian, Yefeng Zheng, Sulaiman Vesal, Nishant Ravikumar, Andreas Maier, Xin Yang, Pheng Ann Heng, Dong Ni, Caizi Li, Qianqian Tong, Weixin Si, Elodie Puybareau, Younes Khoudli, Thierry Géraud, Chen Chen, Wenjia BaiDaniel Rueckert, Lingchao Xu, Xiahai Zhuang, Xinzhe Luo, Shuman Jia, Maxime Sermesant, Yashu Liu, Kuanquan Wang, Davide Borra, Alessandro Masci, Cristiana Corsi, Coen de Vente, Mitko Veta, Rashed Karim, Chandrakanth Jayachandran Preetha, Sandy Engelhardt, Menyun Qiao, Yuanyuan Wang, Qian Tao, Marta Nuñez-Garcia, Oscar Camara, Nicolo Savioli, Pablo Lamata, Jichao Zhao*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

166 Citations (Scopus)

Abstract

Segmentation of medical images, particularly late gadolinium-enhanced magnetic resonance imaging (LGE-MRI) used for visualizing diseased atrial structures, is a crucial first step for ablation treatment of atrial fibrillation. However, direct segmentation of LGE-MRIs is challenging due to the varying intensities caused by contrast agents. Since most clinical studies have relied on manual, labor-intensive approaches, automatic methods are of high interest, particularly optimized machine learning approaches. To address this, we organized the 2018 Left Atrium Segmentation Challenge using 154 3D LGE-MRIs, currently the world's largest atrial LGE-MRI dataset, and associated labels of the left atrium segmented by three medical experts, ultimately attracting the participation of 27 international teams. In this paper, extensive analysis of the submitted algorithms using technical and biological metrics was performed by undergoing subgroup analysis and conducting hyper-parameter analysis, offering an overall picture of the major design choices of convolutional neural networks (CNNs) and practical considerations for achieving state-of-the-art left atrium segmentation. Results show that the top method achieved a Dice score of 93.2% and a mean surface to surface distance of 0.7 mm, significantly outperforming prior state-of-the-art. Particularly, our analysis demonstrated that double sequentially used CNNs, in which a first CNN is used for automatic region-of-interest localization and a subsequent CNN is used for refined regional segmentation, achieved superior results than traditional methods and machine learning approaches containing single CNNs. This large-scale benchmarking study makes a significant step towards much-improved segmentation methods for atrial LGE-MRIs, and will serve as an important benchmark for evaluating and comparing the future works in the field. Furthermore, the findings from this study can potentially be extended to other imaging datasets and modalities, having an impact on the wider medical imaging community.

Original languageEnglish
Article number101832
JournalMedical Image Analysis
Volume67
DOIs
Publication statusPublished - Jan 2021

Keywords

  • Convolutional neural networks
  • Image segmentation
  • Late gadolinium-enhanced magnetic resonance imaging
  • Left atrium

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