Multi-stage learning for segmentation of aortic dissections using a prior aortic anatomy simplification

Duanduan Chen, Xuyang Zhang, Yuqian Mei, Fangzhou Liao, Huanming Xu, Zhenfeng Li, Qianjiang Xiao, Wei Guo, Hongkun Zhang, Tianyi Yan, Jiang Xiong, Yiannis Ventikos

Research output: Contribution to journalArticleResearchpeer-review

38 Citations (Scopus)

Abstract

Aortic dissection (AD) is a life-threatening cardiovascular disease with a high mortality rate. The accurate and generalized 3-D reconstruction of AD from CT-angiography can effectively assist clinical procedures and surgery plans, however, is clinically unavaliable due to the lacking of efficient tools. In this study, we presented a novel multi-stage segmentation framework for type B AD to extract true lumen (TL), false lumen (FL) and all branches (BR) as different classes. Two cascaded neural networks were used to segment the aortic trunk and branches and to separate the dual lumen, respectively. An aortic straightening method was designed based on the prior vascular anatomy of AD, simplifying the curved aortic shape before the second network. The straightening-based method achieved the mean Dice scores of 0.96, 0.95 and 0.89 for TL, FL, and BR on a multi-center dataset involving 120 patients, outperforming the end-to-end multi-class methods and the multi-stage methods without straightening on the dual-lumen segmentation, even using different network architectures. Both the global volumetric features of the aorta and the local characteristics of the primary tear could be better identified and quantified based on the straightening. Comparing to previous deep learning methods dealing with AD segmentations, the proposed framework presented advantages in segmentation accuracy.

Original languageEnglish
Article number101931
Number of pages12
JournalMedical Image Analysis
Volume69
DOIs
Publication statusPublished - Apr 2021
Externally publishedYes

Keywords

  • Aortic dissection
  • CT-angiography
  • Deep learning
  • Prior anatomy simplification
  • Segmentation

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