A deep learning approach for the segmentation of myocardial diseases

Cardiac left ventricular (LV) segmentation is a paramount essential step for both diagnosis and treatment of cardiac pathologies such as ischemia, myocardial infarction, arrhythmia and myocarditis. However, this segmentation is challenging due to high variability across patients and the potential lack of contrast between structures. In this work, we propose and evaluate a (2.5D) SegU-Net model based on the fusion of two deep learning segmentation techniques (U-Net and Seg-Net) for automated LGE-MRI (Late gadolinium enhanced magnetic resonance imaging) myocardial disease (infarct core and no-reflow region) quantification in a new multifield expert annotated dataset. Given that the scar tissue represents a small part of the whole MRI slices, we focused on myocardium area. Segmentation results show that this preprocessing step facilitate the learning procedure. In order to solve the class imbalance problem, we propose to apply the Jaccard loss and the Focal Loss as optimization loss function and to integrate a class weights strategy into the objective function. Late combination has been used to merge the output of the best trained models on a different set of hyperparameters. The final network segmentation performances will be useful for future comparison of new methods to the current related work for this task. A total number of 2237 of slices (320 cases) were used for training/validation and 210 slices (35 cases) were used for testing. Experiments on our proposed dataset, using several evaluation metrics such Jaccard distance (IOU), Accuracy and Dice similarity coefficient (DSC), demonstrate efficiency performance in quantifying different zones of myocardium infarction across various patients. As compared to the second intra-observer study, our testing results showed that the SegU-Net prediction model leads to these average Dice coefficients over all segmented tissue classes, respectively: `Back-ground': 0.99999, `Myocardium': 0.99434, `Infarctus': 0.95587, `Noreflow': 0.78187 outperforming seven previously proposed methods.