Left atrial appendage segmentation and quantification in 3D and 4D cardiac ultrasound
Systems and methods for real time three-dimensional left atrial appendage (LAA) quantification. Deep learning is used to perform LAA segmentation, tracking and live quantification on critical measurement in 4D ultrasound sequences. The collected information may be used for device selection and anomaly detection to assist early-phase disease finding.
1 . A method for real time three-dimensional left atrial appendage quantification, the method comprising:
acquiring a real time three-dimensional ultrasound sequence of a patient;
selecting a seed location of the left atrial appendage in a frame of the real time three-dimensional ultrasound sequence;
cropping the frame to a region of interest based on the seed location;
generating an initial three-dimensional left atrial appendage segmentation from the region of interest;
extracting one or more landmarks from the three-dimensional left atrial appendage segmentation;
slicing the initial three-dimensional left atrial appendage segmentation into a plurality of two-dimensional slices, wherein the plurality of two-dimensional slices each include a portion of a contour of the left atrial appendage;
tracking the contour of the left atrial appendage in the plurality of two-dimensional slices for a plurality of subsequent frames of the real time three-dimensional ultrasound sequence and tracking the one or more landmarks in the real time three-dimensional ultrasound sequence;
generating a real time three-dimensional left atrial appendage segmentation for each of the plurality of subsequent frames by aggregating the tracked contours from the two-dimensional slices for each respective subsequent frame; and
quantifying at least one morphological metric from the tracked contour and/or the tracked one or more landmarks, wherein the at least one morphological metric comprises a diameter of the left atrial appendage over time, wherein the quantified diameter is used to determine a property of a device in a left atrial appendage closure procedure.
2 . The method of claim 1 , wherein selecting the seed location comprises:
freezing the real time three-dimensional ultrasound sequence; and
clicking, by a user, on the seed location inside the left atrial appendage in a frame of the frozen real time three-dimensional ultrasound sequence;
wherein the real time three-dimensional ultrasound sequence is unfrozen after selecting the seed location.
3 . The method of claim 1 , wherein cropping comprises:
calculating an estimated shape and size of the left atrial appendage from a collected dataset of images of left atrial appendages of a plurality of patients; and
centering the region of interest around the seed location based on the estimated shape and size.
4 . The method of claim 1 , wherein the three-dimensional left atrial appendage segmentation is generated using a machine trained network.
5 . The method of claim 1 , wherein the one or more landmarks comprises at least one of ostium and neck landmarks that determine diameters of the ostium and neck area of the left atrial appendage.
6 . The method of claim 1 , wherein the contour and the one or more landmarks are tracked in real time using respective neural networks trained using a cycle-consistency loss.
7 . The method of claim 1 , wherein the diameter of the left atrial appendage is used to determine and select properties of the device in the left atrial appendage closure procedure that matches characteristics of the patient's left atrial appendage.
8 . The method of claim 1 , wherein the real time three-dimensional ultrasound sequence is provided by an ultrasound system configured for Intracardiac Echocardiography.
9 . A system for real time three-dimensional left atrial appendage segmentation, the system comprising:
an ultrasound imaging system configured to acquire a 4D ultrasound sequence of patient; and
a processor configured to:
select a seed location of the left atrial appendage in a frame of the 4D ultrasound sequence,
crop the frame to a region of interest based on the seed location,
generate an initial three-dimensional left atrial appendage segmentation from the region of interest,
extract one or more landmarks from the initial three-dimensional left atrial appendage segmentation,
slice the initial three-dimensional left atrial appendage segmentation into a plurality of two-dimensional slices, wherein the plurality of two-dimensional slices each include a portion of a contour of the left atrial appendage,
track the contour in the plurality of two-dimensional slices over time and the one or more landmarks in the 4D ultrasound sequence,
generate a real time three-dimensional left atrial appendage segmentation for each of the plurality of subsequent frames by aggregating the tracked contours from the two-dimensional slices for each respective subsequent frame,
quantify at least one morphological metric from the tracked contour and/or the tracked one or more landmarks, wherein the at least one morphological metric comprises a diameter of the left atrial appendage over time, and
cause a display to present the quantified diameter for use in determining a property of a device in a left atrial appendage closure procedure.
10 . The system of claim 9 , wherein cropping comprises:
calculating an estimated shape and size of the left atrial appendage from a collected dataset of images of left atrial appendages of a plurality of patients; and
centering the region of interest around the seed location based on the estimated shape and size.
11 . The system of claim 9 , wherein the processor is configured to generate the three-dimensional left atrial appendage segmentation using a machine trained network.
12 . The system of claim 9 , wherein the one or more landmarks comprises at least one of ostium and neck landmarks that determine diameters of the ostium and neck area of the left atrial appendage.
13 . The system of claim 9 , wherein the processor is configured to track the contour and the one or more landmarks in real time using respective neural networks trained using a cycle-consistency loss.
14 . The system of claim 9 , wherein the diameter of the left atrial appendage is used to determine and select properties of the device in the left atrial appendage closure procedure that matches characteristics of the patient's left atrial appendage.
15 . The system of claim 9 , wherein the ultrasound imaging system is configured for Intracardiac Echocardiography.
16 . A system comprising:
an ultrasound imaging system configured to acquire a 4D ultrasound sequence of patient;
a display configured to display the 4D ultrasound sequence;
an input device configured to identify a seed location for a left atrial appendage in a frame of the 4D ultrasound sequence; and
a processor configured to:
crop the frame to a region of interest based on the seed location,
generate an initial three-dimensional left atrial appendage segmentation from the region of interest,
slice the initial three-dimensional left atrial appendage segmentation into a plurality of two-dimensional slices, wherein the plurality of two-dimensional slices each include a portion of a contour of the left atrial appendage,
track the contour in the plurality of two-dimensional slices in real time,
generate a real time three-dimensional left atrial appendage segmentation for each of the plurality of subsequent frames by aggregating the tracked contours from the two-dimensional slices for each respective subsequent frame,
identify one or more landmarks in the three-dimensional left atrial appendage segmentation and track the one or more landmarks over time in the 4D ultrasound sequence, and
quantify at least one metric from the real time three-dimensional left atrial appendage segmentation and/or the tracked one or more landmarks.