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Elias Grinias

Bio: Elias Grinias is an academic researcher from University of Crete. The author has contributed to research in topics: Region growing & Image segmentation. The author has an hindex of 4, co-authored 9 publications receiving 593 citations. Previous affiliations of Elias Grinias include Technological Educational Institute of Serres.

Papers
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Journal ArticleDOI
TL;DR: How far state-of-the-art deep learning methods can go at assessing CMRI, i.e., segmenting the myocardium and the two ventricles as well as classifying pathologies is measured, to open the door to highly accurate and fully automatic analysis of cardiac CMRI.
Abstract: Delineation of the left ventricular cavity, myocardium, and right ventricle from cardiac magnetic resonance images (multi-slice 2-D cine MRI) is a common clinical task to establish diagnosis. The automation of the corresponding tasks has thus been the subject of intense research over the past decades. In this paper, we introduce the “Automatic Cardiac Diagnosis Challenge” dataset (ACDC), the largest publicly available and fully annotated dataset for the purpose of cardiac MRI (CMR) assessment. The dataset contains data from 150 multi-equipments CMRI recordings with reference measurements and classification from two medical experts. The overarching objective of this paper is to measure how far state-of-the-art deep learning methods can go at assessing CMRI, i.e., segmenting the myocardium and the two ventricles as well as classifying pathologies. In the wake of the 2017 MICCAI-ACDC challenge, we report results from deep learning methods provided by nine research groups for the segmentation task and four groups for the classification task. Results show that the best methods faithfully reproduce the expert analysis, leading to a mean value of 0.97 correlation score for the automatic extraction of clinical indices and an accuracy of 0.96 for automatic diagnosis. These results clearly open the door to highly accurate and fully automatic analysis of cardiac CMRI. We also identify scenarios for which deep learning methods are still failing. Both the dataset and detailed results are publicly available online, while the platform will remain open for new submissions.

1,056 citations

Journal ArticleDOI
TL;DR: This paper uses a Markov Random Field model or a flooding algorithm to get the image segmentation by minimizing a min-max Bayesian criterion and reduces the problem of graph clustering to the simpler problem of point clustering.

63 citations

Book ChapterDOI
10 Sep 2017
TL;DR: A fast fully automatic method for cardiac segmentation in ED and ES short axis MRI that has obtained good results for LV and satisfactory for the RV and the myocardium on the ACDC 2017 datasets.
Abstract: We present a fast fully automatic method for cardiac segmentation in ED and ES short axis MRI. At first we extract a region where the whole heart is situated, using a new, time-based approach. Then, the segmentation in LV, myocardium and right ventricle (RV) is obtained for a slice in a basal ED slice where both cavities are well distinguished. The extracted regions are tracked for the whole slice sequence backwards and forwards in ED. In all cases the segmentation is based on MRF optimization in four classes, two for the blood areas, and one for the myocardium and the background. Subsequently the segmentation in the ES images is based on the result of ED segmentation. As the epicardium is not well delineated, a smoothing process based on spline curves is used for obtaining the final result. We consider that, with an unsupervised method, we have obtained good results for LV and satisfactory for the RV and the myocardium on the ACDC 2017 datasets.

34 citations

Journal ArticleDOI
TL;DR: The estimation of LV parameters with the new semiautomatic segmentation method is technically feasible, highly reproducible and time effective.
Abstract: The purpose of this study was to develop and evaluate a semiautomatic method for left ventricular (LV) segmentation on cine MR images and subsequent estimation of cardiac parameters. The study group comprised cardiac MR examinations of 18 consecutive patients with known or suspected coronary artery disease. The new method allowed the automatic detection of the LV endocardial and epicardial boundaries on each short-axis cine MR image using a Bayesian flooding segmentation algorithm and weighted least-squares B-splines minimization. Manual editing of the automatic contours could be performed for unsatisfactory segmentation results. The end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF) and LV mass estimated by the new method were compared with the reference values obtained by manually tracing the LV cavity borders. The reproducibility of the new method was determined using data from two independent observers. The mean number of endocardial and epicardial outlines not requiring any manual adjustment was more than 80% and 76% of the total contour number per study, respectively. The mean segmentation time including the required manual corrections was 2.3 ? 0.7 min per patient. LV volumes estimated by the semiautomatic method were significantly lower than those by manual tracing (P 0.05). LV indices estimated by the two methods were well correlated (r ? 0.80). The mean difference between manual and semiautomatic method for estimating EDV, ESV, EF and LV mass was 6.1 ? 7.2 ml, 3.0 ? 5.2 ml, ?0.6 ? 4.3% and ?6.2 ? 12.2 g, respectively. The intraobserver and interobserver variability associated with the semiautomatic determination of LV indices was 0.5?1.2% and 0.8?3.9%, respectively. The estimation of LV parameters with the new semiautomatic segmentation method is technically feasible, highly reproducible and time effective.

14 citations

Journal ArticleDOI
TL;DR: In this article, the authors conducted an unbiased evaluation and comparison of cardiac LV quantification methods that were submitted to the Left Ventricle Quantification (LVQuan) challenge, which was held in conjunction with the Statistical Atlases and Computational Modeling of the Heart (STACOM) workshop at the MICCAI 2018.
Abstract: Automatic quantification of the left ventricle (LV) from cardiac magnetic resonance (CMR) images plays an important role in making the diagnosis procedure efficient, reliable, and alleviating the laborious reading work for physicians. Considerable efforts have been devoted to LV quantification using different strategies that include segmentation-based (SG) methods and the recent direct regression (DR) methods. Although both SG and DR methods have obtained great success for the task, a systematic platform to benchmark them remains absent because of differences in label information during model learning. In this paper, we conducted an unbiased evaluation and comparison of cardiac LV quantification methods that were submitted to the Left Ventricle Quantification (LVQuan) challenge, which was held in conjunction with the Statistical Atlases and Computational Modeling of the Heart (STACOM) workshop at the MICCAI 2018. The challenge was targeted at the quantification of 1) areas of LV cavity and myocardium, 2) dimensions of the LV cavity, 3) regional wall thicknesses (RWT), and 4) the cardiac phase, from mid-ventricle short-axis CMR images. First, we constructed a public quantification dataset Cardiac-DIG with ground truth labels for both the myocardium mask and these quantification targets across the entire cardiac cycle. Then, the key techniques employed by each submission were described. Next, quantitative validation of these submissions were conducted with the constructed dataset. The evaluation results revealed that both SG and DR methods can offer good LV quantification performance, even though DR methods do not require densely labeled masks for supervision. Among the 12 submissions, the DR method LDAMT offered the best performance, with a mean estimation error of 301 mm $^2$ for the two areas, 2.15 mm for the cavity dimensions, 2.03 mm for RWTs, and a 9.5% error rate for the cardiac phase classification. Three of the SG methods also delivered comparable performances. Finally, we discussed the advantages and disadvantages of SG and DR methods, as well as the unsolved problems in automatic cardiac quantification for clinical practice applications.

6 citations


Cited by
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Journal ArticleDOI
TL;DR: nnU-Net as mentioned in this paper is a deep learning-based segmentation method that automatically configures itself, including preprocessing, network architecture, training and post-processing for any new task.
Abstract: Biomedical imaging is a driver of scientific discovery and a core component of medical care and is being stimulated by the field of deep learning. While semantic segmentation algorithms enable image analysis and quantification in many applications, the design of respective specialized solutions is non-trivial and highly dependent on dataset properties and hardware conditions. We developed nnU-Net, a deep learning-based segmentation method that automatically configures itself, including preprocessing, network architecture, training and post-processing for any new task. The key design choices in this process are modeled as a set of fixed parameters, interdependent rules and empirical decisions. Without manual intervention, nnU-Net surpasses most existing approaches, including highly specialized solutions on 23 public datasets used in international biomedical segmentation competitions. We make nnU-Net publicly available as an out-of-the-box tool, rendering state-of-the-art segmentation accessible to a broad audience by requiring neither expert knowledge nor computing resources beyond standard network training.

2,040 citations

Journal ArticleDOI
TL;DR: How far state-of-the-art deep learning methods can go at assessing CMRI, i.e., segmenting the myocardium and the two ventricles as well as classifying pathologies is measured, to open the door to highly accurate and fully automatic analysis of cardiac CMRI.
Abstract: Delineation of the left ventricular cavity, myocardium, and right ventricle from cardiac magnetic resonance images (multi-slice 2-D cine MRI) is a common clinical task to establish diagnosis. The automation of the corresponding tasks has thus been the subject of intense research over the past decades. In this paper, we introduce the “Automatic Cardiac Diagnosis Challenge” dataset (ACDC), the largest publicly available and fully annotated dataset for the purpose of cardiac MRI (CMR) assessment. The dataset contains data from 150 multi-equipments CMRI recordings with reference measurements and classification from two medical experts. The overarching objective of this paper is to measure how far state-of-the-art deep learning methods can go at assessing CMRI, i.e., segmenting the myocardium and the two ventricles as well as classifying pathologies. In the wake of the 2017 MICCAI-ACDC challenge, we report results from deep learning methods provided by nine research groups for the segmentation task and four groups for the classification task. Results show that the best methods faithfully reproduce the expert analysis, leading to a mean value of 0.97 correlation score for the automatic extraction of clinical indices and an accuracy of 0.96 for automatic diagnosis. These results clearly open the door to highly accurate and fully automatic analysis of cardiac CMRI. We also identify scenarios for which deep learning methods are still failing. Both the dataset and detailed results are publicly available online, while the platform will remain open for new submissions.

1,056 citations

Journal ArticleDOI
TL;DR: An automated analysis method based on a fully convolutional network achieves a performance on par with human experts in analysing CMR images and deriving clinically relevant measures.
Abstract: Cardiovascular resonance (CMR) imaging is a standard imaging modality for assessing cardiovascular diseases (CVDs), the leading cause of death globally. CMR enables accurate quantification of the cardiac chamber volume, ejection fraction and myocardial mass, providing information for diagnosis and monitoring of CVDs. However, for years, clinicians have been relying on manual approaches for CMR image analysis, which is time consuming and prone to subjective errors. It is a major clinical challenge to automatically derive quantitative and clinically relevant information from CMR images. Deep neural networks have shown a great potential in image pattern recognition and segmentation for a variety of tasks. Here we demonstrate an automated analysis method for CMR images, which is based on a fully convolutional network (FCN). The network is trained and evaluated on a large-scale dataset from the UK Biobank, consisting of 4,875 subjects with 93,500 pixelwise annotated images. The performance of the method has been evaluated using a number of technical metrics, including the Dice metric, mean contour distance and Hausdorff distance, as well as clinically relevant measures, including left ventricle (LV) end-diastolic volume (LVEDV) and end-systolic volume (LVESV), LV mass (LVM); right ventricle (RV) end-diastolic volume (RVEDV) and end-systolic volume (RVESV). By combining FCN with a large-scale annotated dataset, the proposed automated method achieves a high performance in segmenting the LV and RV on short-axis CMR images and the left atrium (LA) and right atrium (RA) on long-axis CMR images. On a short-axis image test set of 600 subjects, it achieves an average Dice metric of 0.94 for the LV cavity, 0.88 for the LV myocardium and 0.90 for the RV cavity. The mean absolute difference between automated measurement and manual measurement is 6.1 mL for LVEDV, 5.3 mL for LVESV, 6.9 gram for LVM, 8.5 mL for RVEDV and 7.2 mL for RVESV. On long-axis image test sets, the average Dice metric is 0.93 for the LA cavity (2-chamber view), 0.95 for the LA cavity (4-chamber view) and 0.96 for the RA cavity (4-chamber view). The performance is comparable to human inter-observer variability. We show that an automated method achieves a performance on par with human experts in analysing CMR images and deriving clinically relevant measures.

512 citations

Journal ArticleDOI
TL;DR: Without manual tuning, nnU-Net surpasses most specialised deep learning pipelines in 19 public international competitions and sets a new state of the art in the majority of the 49 tasks, demonstrating a vast hidden potential in the systematic adaptation of deep learning methods to different datasets.
Abstract: Biomedical imaging is a driver of scientific discovery and core component of medical care, currently stimulated by the field of deep learning. While semantic segmentation algorithms enable 3D image analysis and quantification in many applications, the design of respective specialised solutions is non-trivial and highly dependent on dataset properties and hardware conditions. We propose nnU-Net, a deep learning framework that condenses the current domain knowledge and autonomously takes the key decisions required to transfer a basic architecture to different datasets and segmentation tasks. Without manual tuning, nnU-Net surpasses most specialised deep learning pipelines in 19 public international competitions and sets a new state of the art in the majority of the 49 tasks. The results demonstrate a vast hidden potential in the systematic adaptation of deep learning methods to different datasets. We make nnU-Net publicly available as an open-source tool that can effectively be used out-of-the-box, rendering state of the art segmentation accessible to non-experts and catalyzing scientific progress as a framework for automated method design.

314 citations

Journal ArticleDOI
TL;DR: In this article, a review of deep learning-based segmentation methods for cardiac image segmentation is provided, which covers common imaging modalities including magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound.
Abstract: Deep learning has become the most widely used approach for cardiac image segmentation in recent years. In this paper, we provide a review of over 100 cardiac image segmentation papers using deep learning, which covers common imaging modalities including magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound (US) and major anatomical structures of interest (ventricles, atria and vessels). In addition, a summary of publicly available cardiac image datasets and code repositories are included to provide a base for encouraging reproducible research. Finally, we discuss the challenges and limitations with current deep learning-based approaches (scarcity of labels, model generalizability across different domains, interpretability) and suggest potential directions for future research.

254 citations