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James C Moon

Publications and source records attributed to James C Moon.

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A versatile foundation model for cine cardiac magnetic resonance image analysis tasks

Here we present a versatile foundation model that can perform a range of clinically-relevant image analysis tasks, including segmentation, landmark localisation, diagnosis, and prognostication. A multi-view convolution-transformer masked autoencoder, named as CineMA, was trained on 15 million cine images from 74,916 subjects. The model was validated on multiple image analysis tasks and compared to existing models on >4,500 images from eight independent datasets with diverse population characteristics, representing the largest benchmark study for cine CMR so far. CineMA consistently outperformed conventional convolutional neural networks (CNNs) in delineating ventricular boundaries and estimating ejection fraction, a key measure of cardiac function. The improved performance was preserved, even when the model only used half of fine-tuning data. CineMA also surpassed CNNs in disease detection and matched their performance in long-axis function measurement. Interestingly, we found that CineMA can also detect cardiac changes in systemic diseases, such as diabetes, hypertension and cancer, and can also predict mortality. Finally, we assessed model fairness and demonstrated consistent model performance across demographic subgroups. These findings highlight CineMA's accuracy, learning efficiency, adaptability, and fairness, underscoring its potential as a foundation model for automated cardiac image analysis to support clinical workflow and cardiovascular research. All training and inference code and models are made publicly available at https://github.com/mathpluscode/CineMA.

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Inline AI: Open-source Deep Learning Inference for Cardiac MR

Cardiac Magnetic Resonance (CMR) is established as a non-invasive imaging technique for evaluation of heart function, anatomy, and myocardial tissue characterization. Quantitative biomarkers are central for diagnosis and management of heart disease. Deep learning (DL) is playing an ever more important role in extracting these quantitative measures from CMR images. While many researchers have reported promising results in training and evaluating models, model deployment into the imaging workflow is less explored. A new imaging AI framework, the InlineAI, was developed and open-sourced. The main innovation is to enable the model inference inline as a part of imaging computation, instead of as an offline post-processing step and to allow users to plug in their models. We demonstrate the system capability on three applications: long-axis CMR cine landmark detection, short-axis CMR cine analysis of function and anatomy, and quantitative perfusion mapping. The InlineAI allowed models to be deployed into imaging workflow in a streaming manner directly on the scanner. The model was loaded and inference on incoming images were performed while the data acquisition was ongoing, and results were sent back to scanner. Several biomarkers were extracted from model outputs in the demonstrated applications and reported as curves and tabular values. All processes are full automated. the model inference was completed within 6-45s after the end of imaging data acquisition.

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Landmark detection in Cardiac Magnetic Resonance Imaging Using A Convolutional Neural Network

Purpose: To develop a convolutional neural network (CNN) solution for robust landmark detection in cardiac MR images. Methods: This retrospective study included cine, LGE and T1 mapping scans from two hospitals. The training set included 2,329 patients and 34,019 images. A hold-out test set included 531 patients and 7,723 images. CNN models were developed to detect two mitral valve plane and apical points on long-axis (LAX) images. On short-axis (SAX) images, anterior and posterior RV insertion points and LV center were detected. Model outputs were compared to manual labels by two operators for accuracy with a t-test for statistical significance. The trained model was deployed to MR scanners. Results: For the LAX images, success detection was 99.8% for cine, 99.4% for LGE. For the SAX, success rate was 96.6%, 97.6% and 98.9% for cine, LGE and T1-mapping. The L2 distances between model and manual labels were 2 to 3.5 mm, indicating close agreement between model landmarks to manual labels. No significant differences were found for the anterior RV insertion angle and LV length by the models and operators for all views and imaging sequences. Model inference on MR scanner took 610ms/5.6s on GPU/CPU, respectively, for a typical cardiac cine series. Conclusions: This study developed, validated and deployed a CNN solution for robust landmark detection in both long and short-axis CMR images for cine, LGE and T1 mapping sequences, with the accuracy comparable to the inter-operator variation.

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Automated Inline Analysis of Myocardial Perfusion MRI with Deep Learning

Recent development of quantitative myocardial blood flow (MBF) mapping allows direct evaluation of absolute myocardial perfusion, by computing pixel-wise flow maps. Clinical studies suggest quantitative evaluation would be more desirable for objectivity and efficiency. Objective assessment can be further facilitated by segmenting the myocardium and automatically generating reports following the AHA model. This will free user interaction for analysis and lead to a 'one-click' solution to improve workflow. This paper proposes a deep neural network based computational workflow for inline myocardial perfusion analysis. Adenosine stress and rest perfusion scans were acquired from three hospitals. Training set included N=1,825 perfusion series from 1,034 patients. Independent test set included 200 scans from 105 patients. Data were consecutively acquired at each site. A convolution neural net (CNN) model was trained to provide segmentation for LV cavity, myocardium and right ventricular by processing incoming 2D+T perfusion Gd series. Model outputs were compared to manual ground-truth for accuracy of segmentation and flow measures derived on global and per-sector basis. The trained models were integrated onto MR scanners for effective inference. Segmentation accuracy and myocardial flow measures were compared between CNN models and manual ground-truth. The mean Dice ratio of CNN derived myocardium was 0.93 +/- 0.04. Both global flow and per-sector values showed no significant difference, compared to manual results. The AHA 16 segment model was automatically generated and reported on the MR scanner. As a result, the fully automated analysis of perfusion flow mapping was achieved. This solution was integrated on the MR scanner, enabling 'one-click' analysis and reporting of myocardial blood flow.

q-bio.QM

Automatic In-line Quantitative Myocardial Perfusion Mapping: processing algorithm and implementation

Quantitative myocardial perfusion mapping has advantages over qualitative assessment, including the ability to detect global flow reduction. However, it is not clinically available and remains as a research tool. Building upon the previously described imaging sequence, this paper presents algorithm and implementation of an automated solution for inline perfusion flow mapping with step by step performance characterization. An inline perfusion flow mapping workflow is proposed and demonstrated on normal volunteers. Initial evaluation demonstrates the fully automated proposed solution for the respiratory motion correction, AIF LV mask detection and pixel-wise mapping, from free-breathing myocardial perfusion imaging.

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