Multi-resolution convolutional neural networks for fully automated segmentation of acutely injured lungs in multiple species

Segmentation of lungs with acute respiratory distress syndrome (ARDS) is a challenging task due to diffuse opacification in dependent regions which results in little to no contrast at the lung boundary. For segmentation of severely injured lungs, local intensity and texture information, as well as global contextual information, are important factors for consistent inclusion of intrapulmonary structures. In this study, we propose a deep learning framework which uses a novel multi-resolution convolutional neural network (ConvNet) for automated segmentation of lungs in multiple mammalian species with injury models similar to ARDS. The multi-resolution model eliminates the need to tradeoff between high-resolution and global context by using a cascade of low-resolution to high-resolution networks. Transfer learning is used to accommodate the limited number of training datasets. The model was initially pre-trained on human CT images, and subsequently fine-tuned on canine, porcine, and ovine CT images with lung injuries similar to ARDS. The multi-resolution model was compared to both high-resolution and low-resolution networks alone. The multi-resolution model outperformed both the low- and high-resolution models, achieving an overall mean Jacaard index of 0.963 ± 0.025 compared to 0.919 ± 0.027 and 0.950 ± 0.036, respectively, for the animal dataset (N=287). The multi-resolution model achieves an overall average symmetric surface distance of 0.438 ± 0.315 mm, compared to 0.971 ± 0.368 mm and 0.657 ± 0.519 mm for the low-resolution and high-resolution models, respectively. We conclude that the multi-resolution model produces accurate segmentations in severely injured lungs, which is attributed to the inclusion of both local and global features.

[1]  Thomas Brox,et al.  U-Net: Convolutional Networks for Biomedical Image Segmentation , 2015, MICCAI.

[2]  Timo Kohlberger,et al.  Multi-stage Learning for Robust Lung Segmentation in Challenging CT Volumes , 2011, MICCAI.

[3]  Silvia Coppola,et al.  Lung Imaging in ARDS , 2017 .

[4]  Ronald M. Summers,et al.  Deep Convolutional Neural Networks for Computer-Aided Detection: CNN Architectures, Dataset Characteristics and Transfer Learning , 2016, IEEE Transactions on Medical Imaging.

[5]  Gary E. Christensen,et al.  Analysis of Regional Mechanics in Canine Lung Injury Using Forced Oscillations and 3D Image Registration , 2010, Annals of Biomedical Engineering.

[6]  E. Futier,et al.  High frequency percussive ventilation increases alveolar recruitment in early acute respiratory distress syndrome: an experimental, physiological and CT scan study , 2018, Critical Care.

[7]  Reinhard Beichel,et al.  Automated 3-D Segmentation of Lungs With Lung Cancer in CT Data Using a Novel Robust Active Shape Model Approach , 2012, IEEE Transactions on Medical Imaging.

[8]  Joseph M. Reinhardt,et al.  Smoothing lung segmentation surfaces in 3D x-ray CT images using anatomic guidance , 2004, SPIE Medical Imaging.

[9]  David W. Kaczka,et al.  Multifrequency Oscillatory Ventilation in the Premature Lung: Effects on Gas Exchange, Mechanics, and Ventilation Distribution , 2015, Anesthesiology.

[10]  Christian Igel,et al.  Deep Feature Learning for Knee Cartilage Segmentation Using a Triplanar Convolutional Neural Network , 2013, MICCAI.

[11]  Eric A. Hoffman,et al.  Quantifying Regional Lung Deformation Using Four-Dimensional Computed Tomography: A Comparison of Conventional and Oscillatory Ventilation , 2020, Frontiers in Physiology.

[12]  Ivan Laptev,et al.  Learning and Transferring Mid-level Image Representations Using Convolutional Neural Networks , 2014, 2014 IEEE Conference on Computer Vision and Pattern Recognition.

[13]  Gaetano Perchiazzi,et al.  Lung regional stress and strain as a function of posture and ventilatory mode. , 2011, Journal of applied physiology.

[14]  E. Regan,et al.  Genetic Epidemiology of COPD (COPDGene) Study Design , 2011, COPD.

[15]  Eric A. Hoffman,et al.  Frequency-Selective Computed Tomography: Applications During Periodic Thoracic Motion , 2017, IEEE Transactions on Medical Imaging.

[16]  James C. Gee,et al.  Visualizing the Propagation of Acute Lung Injury , 2016, Anesthesiology.

[17]  Lisa M LaVange,et al.  Design of the Subpopulations and Intermediate Outcomes in COPD Study (SPIROMICS) , 2013, Thorax.

[18]  Xiaodong Wu,et al.  Optimal Surface Segmentation in Volumetric Images-A Graph-Theoretic Approach , 2006, IEEE Transactions on Pattern Analysis and Machine Intelligence.

[19]  G J Kemerink,et al.  On segmentation of lung parenchyma in quantitative computed tomography of the lung. , 1998, Medical physics.

[20]  Marios Anthimopoulos,et al.  Lung Pattern Classification for Interstitial Lung Diseases Using a Deep Convolutional Neural Network , 2016, IEEE Transactions on Medical Imaging.

[21]  Joseph M. Reinhardt,et al.  Transfer Learning for Segmentation of Injured Lungs Using Coarse-to-Fine Convolutional Neural Networks , 2018, RAMBO+BIA+TIA@MICCAI.

[22]  Gaetano Perchiazzi,et al.  Regional distribution of lung compliance by image analysis of computed tomograms , 2014, Respiratory Physiology & Neurobiology.

[23]  Gang Song,et al.  Semiautomatic segmentation of longitudinal computed tomography images in a rat model of lung injury by surfactant depletion. , 2015, Journal of applied physiology.

[24]  Guillermo Bugedo,et al.  Lung recruitment in patients with the acute respiratory distress syndrome. , 2006, The New England journal of medicine.

[25]  L. W. Tsai,et al.  Impact of Positive End-Expiratory Pressure During Heterogeneous Lung Injury: Insights from Computed Tomographic Image Functional Modeling , 2008, Annals of Biomedical Engineering.

[26]  Anand Devaraj,et al.  Imaging of Acute Respiratory Distress Syndrome , 2012, Respiratory Care.

[27]  Jimmy Ba,et al.  Adam: A Method for Stochastic Optimization , 2014, ICLR.

[28]  Xiaogang Wang,et al.  Medical image classification with convolutional neural network , 2014, 2014 13th International Conference on Control Automation Robotics & Vision (ICARCV).

[29]  A HoffmanEric,et al.  COPD研究(SPIROMICS)における亜集団と中間結果のデザイン , 2014 .

[30]  D. Lynch,et al.  Idiopathic Pulmonary Fibrosis: The Association between the Adaptive Multiple Features Method and Fibrosis Outcomes , 2017, American journal of respiratory and critical care medicine.

[31]  David W. Kaczka,et al.  Imaging the Injured Lung: Mechanisms of Action and Clinical Use. , 2019, Anesthesiology.

[32]  Ayman El-Baz,et al.  Accurate Lungs Segmentation on CT Chest Images by Adaptive Appearance-Guided Shape Modeling , 2017, IEEE Transactions on Medical Imaging.

[33]  Wei Shen,et al.  Multi-scale Convolutional Neural Networks for Lung Nodule Classification , 2015, IPMI.

[34]  Kevin J Anstrom,et al.  Randomized trial of acetylcysteine in idiopathic pulmonary fibrosis. , 2014, The New England journal of medicine.

[35]  Milan Sonka,et al.  3D Slicer as an image computing platform for the Quantitative Imaging Network. , 2012, Magnetic resonance imaging.

[36]  James C Gee,et al.  Tidal changes on CT and progression of ARDS , 2017, Thorax.

[37]  B. van Ginneken,et al.  Automatic lung segmentation from thoracic computed tomography scans using a hybrid approach with error detection. , 2009, Medical physics.

[38]  Robert Paine,et al.  Clinical Significance of Symptoms in Smokers with Preserved Pulmonary Function. , 2016, The New England journal of medicine.

[39]  David Couper,et al.  SPIROMICS Protocol for Multicenter Quantitative Computed Tomography to Phenotype the Lungs. , 2016, American journal of respiratory and critical care medicine.

[40]  Bram van Ginneken,et al.  Toward automated segmentation of the pathological lung in CT , 2005, IEEE Transactions on Medical Imaging.

[41]  Matthew Fuld,et al.  Regional aeration and perfusion distribution in a sheep model of endotoxemic acute lung injury characterized by functional computed tomography imaging , 2009, Critical care medicine.

[42]  J. Alirezaie,et al.  An Automatic Wavelet-Based Approach for Lung Segmentation and Density Analysis in Dynamic CT , 2007, 2007 IEEE Symposium on Computational Intelligence in Image and Signal Processing.

[43]  B. Simon,et al.  Regional pulmonary inflammation in an endotoxemic ovine acute lung injury model , 2012, Respiratory Physiology & Neurobiology.

[44]  Gary E. Christensen,et al.  FissureNet: A Deep Learning Approach For Pulmonary Fissure Detection in CT Images , 2019, IEEE Transactions on Medical Imaging.

[45]  Eric A. Hoffman,et al.  Automatic lung segmentation for accurate quantitation of volumetric X-ray CT images , 2001, IEEE Transactions on Medical Imaging.

[46]  Michael F. McNitt-Gray,et al.  Method for segmenting chest CT image data using an anatomical model: preliminary results , 1997, IEEE Transactions on Medical Imaging.

[47]  Yoshua Bengio,et al.  Understanding the difficulty of training deep feedforward neural networks , 2010, AISTATS.

[48]  Eric A. Hoffman,et al.  Atlas-driven lung lobe segmentation in volumetric X-ray CT images , 2006, IEEE Transactions on Medical Imaging.

[49]  Kevin J Anstrom,et al.  Prednisone, azathioprine, and N-acetylcysteine for pulmonary fibrosis. , 2012, The New England journal of medicine.

[50]  Bram van Ginneken,et al.  A survey on deep learning in medical image analysis , 2017, Medical Image Anal..

[51]  Tilo Winkler,et al.  Regional tidal lung strain in mechanically ventilated normal lungs. , 2016, Journal of applied physiology.

[52]  Thea Koch,et al.  Ability of dynamic airway pressure curve profile and elastance for positive end-expiratory pressure titration , 2008, Intensive Care Medicine.

[53]  A. Carvalho,et al.  Automatic Lung Segmentation of Helical-CT Scans in Experimental Induced Lung Injury , 2009 .

[54]  L. Fasano,et al.  Overview of current lung imaging in acute respiratory distress syndrome , 2014, European Respiratory Review.

[55]  Sebastian Thrun,et al.  Dermatologist-level classification of skin cancer with deep neural networks , 2017, Nature.

[56]  L. Goodman,et al.  What has computed tomography taught us about the acute respiratory distress syndrome? , 2001, American journal of respiratory and critical care medicine.