Machine learning for the automatic assessment of aortic rotational flow and wall shear stress from 4D flow cardiac magnetic resonance imaging.

Objective: Three-dimensional (3D) time-resolved phase-contrast cardiac magnetic resonance (4D flow CMR) allows for unparalleled quantification of blood velocity. Despite established potential in aortic diseases, the analysis is time-consuming and requires expert knowledge, hindering clinical applica...

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Publicado en:European Radiology Vol. 32; no. 10; pp. 7117 - 7128
Autores principales: Garrido-Oliver, Juan, Aviles, Jordina, Córdova, Marcos Mejía, Dux-Santoy, Lydia, Ruiz-Muñoz, Aroa, Teixido-Tura, Gisela, Maso Talou, Gonzalo D., Morales Ferez, Xabier, Jiménez, Guillermo, Evangelista, Arturo, Ferreira-González, Ignacio, Rodriguez-Palomares, Jose, Camara, Oscar, Guala, Andrea
Formato: diagnostic images pictorial research tables/charts Journal Article
Publicado: Springer Nature Oct2022
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Machine learning for the automatic assessment of aortic rotational flow and wall shear stress from 4D flow cardiac magnetic resonance imaging.
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        au:
          Garrido-Oliver, Juan
          Aviles, Jordina
          Córdova, Marcos Mejía
          Dux-Santoy, Lydia
          Ruiz-Muñoz, Aroa
          Teixido-Tura, Gisela
          Maso Talou, Gonzalo D.
          Morales Ferez, Xabier
          Jiménez, Guillermo
          Evangelista, Arturo
          Ferreira-González, Ignacio
          Rodriguez-Palomares, Jose
          Camara, Oscar
          Guala, Andrea
        affil: Vall d'Hebron Institute of Research, Barcelona, Spain
      sug:
        subj:
          Magnetic Resonance Imaging Methods
          Aorta
          Blood Flow Velocity
          Aortic Valve
          Scales
          Funding Source
      ab: Objective: Three-dimensional (3D) time-resolved phase-contrast cardiac magnetic resonance (4D flow CMR) allows for unparalleled quantification of blood velocity. Despite established potential in aortic diseases, the analysis is time-consuming and requires expert knowledge, hindering clinical application. The present research aimed to develop and test a fully automatic machine learning-based pipeline for aortic 4D flow CMR analysis.Methods: Four hundred and four subjects were prospectively included. Ground-truth to train the algorithms was generated by experts. The cohort was divided into training (323 patients) and testing (81) sets and used to train and test a 3D nnU-Net for segmentation and a Deep Q-Network algorithm for landmark detection. In-plane (IRF) and through-plane (SFRR) rotational flow descriptors and axial and circumferential wall shear stress (WSS) were computed at ten planes covering the ascending aorta and arch.Results: Automatic aortic segmentation resulted in a median Dice score (DS) of 0.949 and average symmetric surface distance of 0.839 (0.632-1.071) mm, comparable with the state of the art. Aortic landmarks were located with a precision comparable with experts in the sinotubular junction and first and third supra-aortic vessels (p = 0.513, 0.592 and 0.905, respectively) but with lower precision in the pulmonary bifurcation (p = 0.028), resulting in precise localisation of analysis planes. Automatic flow assessment showed excellent (ICC > 0.9) agreement with manual quantification of SFRR and good-to-excellent agreement (ICC > 0.75) in the measurement of IRF and axial and circumferential WSS.Conclusion: Fully automatic analysis of complex aortic flow dynamics from 4D flow CMR is feasible. Its implementation could foster the clinical use of 4D flow CMR.Key Points: • 4D flow CMR allows for unparalleled aortic blood flow analysis but requires aortic segmentation and anatomical landmark identification, which are time-consuming, limiting 4D flow CMR widespread use. • A fully automatic machine learning pipeline for aortic 4D flow CMR analysis was trained with data of 323 patients and tested in 81 patients, ensuring a balanced distribution of aneurysm aetiologies. • Automatic assessment of complex flow characteristics such as rotational flow and wall shear stress showed good-to-excellent agreement with manual quantification.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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