3D Transesophageal Echocardiography is an excellent tool for evaluating the mitral valve and is also well suited for guiding cardiac interventions. We introduce a fully automatic method for mitral annulus segmentation in 3D Transesophageal Echocardiography, which requires no manual input. One hundred eleven multi-frame 3D transesophageal echocardiography recordings were split into training, validation, and test sets. Each 3D recording was decomposed into a set of 2D planes, exploiting the symmetry around the centerline of the left ventricle. A deep 2D convolutional neural network was trained to predict the mitral annulus coordinates, and the predictions from neighboring planes were regularized by enforcing continuity around the annulus. Applying the final model and postprocessing to the test set data gave a mean error of 2.0 mm-with a standard deviation of 1.9 mm. Fully automatic segmentation of the mitral annulus can alleviate the need for manual interaction in the quantification of an array of mitral annular parameters and has the potential to eliminate inter-observer variability.
Segmentation of the mitral annulus is often an important step in cardiac examinations. We propose a robust 3D method for predicting the anatomical orientation and segmentation of the mitral annulus in 3D transesophageal echocardiography. The method takes advantage of the circular anatomy of the annulus by utilizing cylinder coordinate samples and a 3D convolutional neural network with circular convolutions. Furthermore, the paper proposes new landmark detection loss functions based on the earth mover's distance. The method's effectiveness was demonstrated by training a HighRes3dNet model and evaluating its performance on a separate test set consisting of 135 frames from 19 examinations. The obtained coordinate prediction error was 1.96±1.62 mm, and the anatomical orientation prediction error was 9.7 • ±15.8 • . The robust and fully automatic mitral annulus segmentation and orientation prediction provided by the method can ease the workload of clinicians and provide time savings in clinics.
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