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Semi-automatic MRI segmentation and volume quantification of intra-plaque hemorrhage

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Intra-plaque hemorrhage (IPH) is associated with plaque instability. Therefore, the presence and volume of IPH in carotid arteries may be relevant in predicting the progression of atherosclerotic disease and the occurrence of clinical events. The aim of our work was to develop and evaluate a method for semi-automatic IPH segmentation in T1-weighted (T1w)-magnetic resonance imaging (MRI).

Material and methods

IPH segmentation is performed by a regional level set method that models the intensity of the IPH and the background in T1w-MRI to be smoothly varying. The method only requires minimal user interaction, i.e., one or more mouse clicks inside the hemorrhage serve as initialization. The parameters of the method are optimized using a leave-one-out strategy by maximizing the Dice similarity coefficient (DSC) between manual and semi-automatic segmentations. We evaluated the IPH segmentation method on 22 carotid arteries; 10 of which were annotated by two observers and 12 were scanned twice within a 2 week period.

Results

We obtained a DSC of 0.52 between the manual and level set segmentations on all 22 carotids. The inter-observer DSC on 10 arteries is 0.57, which is comparable to the DSC between the method and the manual segmentation (0.55). The correlation between the IPH volumes extracted from the level set segmentation and the manual segmentation is 0.88, which is close to the inter-observer volume correlation of 0.92. The reproducibility after rescanning 12 carotids yield an IPH volume correlation of 0.97. The robustness with respect to the initialization by manually clicking two sets of seed points in these 12 carotid artery pairs yields a volume correlation of 0.99.

Conclusion

Semi-automatic segmentation and quantification of IPHs are feasible with an accuracy in the range of the inter-observer variability. The method has excellent reproducibility with respect to rescanning and manual initialization.

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Conflict of interest

Hui Tang, Mariana Selwaness, Reinhard Hameeteman, Anouk van Dijk, Aad van der Lugt, Jacqueline C Witteman, Wiro J Niessen, Lucas J van Vliet and Theo van Walsum declare that they have no conflict of interest. Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Biomedical Imaging Group Rotterdam, Department of Medical Informatics, Erasmus MC, P.O. Box 2040, 3000 CA , Rotterdam, The Netherlands

    Hui Tang, Reinhard Hameeteman, Wiro J. Niessen & Theo van Walsum

  2. Department of Radiology, Erasmus MC, P.O. Box 2040, 3000 CA , Rotterdam, The Netherlands

    Hui Tang, Mariana Selwaness, Reinhard Hameeteman, Anouk van Dijk, Aad van der Lugt, Wiro J. Niessen & Theo van Walsum

  3. Quantitative Imaging Group, Department of Imaging Physics, and Technology, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands

    Hui Tang, Wiro J. Niessen & Lucas J. van Vliet

  4. Department of Epidemiology, Erasmus MC, P.O. Box 2040, 3000 CA , Rotterdam, The Netherlands

    Mariana Selwaness, Anouk van Dijk & Jacqueline C. Witteman

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  1. Hui Tang
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  2. Mariana Selwaness
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Correspondence to Hui Tang.

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Tang, H., Selwaness, M., Hameeteman, R. et al. Semi-automatic MRI segmentation and volume quantification of intra-plaque hemorrhage. Int J CARS 10, 67–74 (2015). https://doi.org/10.1007/s11548-014-1010-3

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  • DOI: https://doi.org/10.1007/s11548-014-1010-3

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