Deep learning-based segmentation of the placenta and uterus on MR images

Abstract. Purpose: Magnetic resonance imaging has been recently used to examine the abnormalities of the placenta during pregnancy. Segmentation of the placenta and uterine cavity allows quantitative measures and further analyses of the organs. The objective of this study is to develop a segmentation method with minimal user interaction. Approach: We developed a fully convolutional neural network (CNN) for simultaneous segmentation of the uterine cavity and placenta in three dimensions (3D) while a minimal operator interaction was incorporated for training and testing of the network. The user interaction guided the network to localize the placenta more accurately. In the experiments, we trained two CNNs, one using 70 normal training cases and the other using 129 training cases including normal cases as well as cases with suspected placenta accreta spectrum (PAS). We evaluated the performance of the segmentation algorithms on two test sets: one with 20 normal cases and the other with 50 images from both normal women and women with suspected PAS. Results: For the normal test data, the average Dice similarity coefficient (DSC) was 92% and 82% for the uterine cavity and placenta, respectively. For the combination of normal and abnormal cases, the DSC was 88% and 83% for the uterine cavity and placenta, respectively. The 3D segmentation algorithm estimated the volume of the normal and abnormal uterine cavity and placenta with average volume estimation errors of 4% and 9%, respectively. Conclusions: The deep learning-based segmentation method provides a useful tool for volume estimation and analysis of the placenta and uterus cavity in human placental imaging.

[1]  J. Balayla,et al.  Placenta accreta and the risk of adverse maternal and neonatal outcomes , 2013, Journal of perinatal medicine.

[2]  Klaus H. Maier-Hein,et al.  nnU-Net: Self-adapting Framework for U-Net-Based Medical Image Segmentation , 2018, Bildverarbeitung für die Medizin.

[3]  Diane M Twickler,et al.  Texture analysis of magnetic resonance images of the human placenta throughout gestation: A feasibility study , 2019, PloS one.

[4]  C. Limperopoulos,et al.  In vivo placental MRI shape and textural features predict fetal growth restriction and postnatal outcome , 2018, Journal of magnetic resonance imaging : JMRI.

[5]  Lanfen Lin,et al.  UNet 3+: A Full-Scale Connected UNet for Medical Image Segmentation , 2020, ICASSP 2020 - 2020 IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP).

[6]  N. Danısman,et al.  Emergency peripartum hysterectomy , 2011, Archives of Gynecology and Obstetrics.

[7]  E. Hafner,et al.  Triploidy in a twin pregnancy: small placenta volume as an early sonographical marker , 2003, Prenatal diagnosis.

[8]  W. Sepulveda,et al.  Perinatal Outcome After Prenatal Diagnosis of Placental Chorioangioma , 2003, Obstetrics and gynecology.

[9]  R. Gagnon Placental insufficiency and its consequences. , 2003, European journal of obstetrics, gynecology, and reproductive biology.

[10]  A. Reilly,et al.  Ultrasound assessment of placental function: the effectiveness of placental biometry in a low‐risk population as a predictor of a small for gestational age neonate , 2012, Prenatal diagnosis.

[11]  Sébastien Ourselin,et al.  Slic-Seg: A minimally interactive segmentation of the placenta from sparse and motion-corrupted fetal MRI in multiple views , 2016, Medical Image Anal..

[12]  Quyen N. Do,et al.  MRI of the Placenta Accreta Spectrum (PAS) Disorder: Radiomics Analysis Correlates With Surgical and Pathological Outcome , 2020, Journal of magnetic resonance imaging : JMRI.

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

[14]  J. Leyendecker,et al.  MRI of pregnancy-related issues: abnormal placentation. , 2012, AJR. American journal of roentgenology.

[15]  A. Guttmacher,et al.  The human placenta project: it's time for real time. , 2015, American journal of obstetrics and gynecology.

[16]  Yin Xi,et al.  Segmentation of uterus and placenta in MR images using a fully convolutional neural network , 2020, Medical Imaging.

[17]  E. Pajkrt,et al.  Development of placental abnormalities in location and anatomy , 2020, Acta obstetricia et gynecologica Scandinavica.

[18]  R. Naeye Abruptio Placentae and Placenta Previa: Frequency, Perinatal Mortality, and Cigarette Smoking , 1980, Obstetrics and gynecology.

[19]  Nima Tajbakhsh,et al.  UNet++: A Nested U-Net Architecture for Medical Image Segmentation , 2018, DLMIA/ML-CDS@MICCAI.

[20]  P. Bauer,et al.  Second‐trimester measurements of placental volume by three‐dimensional ultrasound to predict small‐for‐gestational‐age infants , 1998, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[21]  Yuan Yu,et al.  TensorFlow: A system for large-scale machine learning , 2016, OSDI.

[22]  Matthew D. Zeiler ADADELTA: An Adaptive Learning Rate Method , 2012, ArXiv.

[23]  J. Maldjian,et al.  MRI appearance of placenta percreta and placenta accreta. , 1999, Magnetic resonance imaging.

[24]  Konstantinos Kamnitsas,et al.  Fast Fully Automatic Segmentation of the Human Placenta from Motion Corrupted MRI , 2016, MICCAI.

[25]  Mizuho Nishio,et al.  Automatic segmentation of the uterus on MRI using a convolutional neural network , 2019, Comput. Biol. Medicine.

[26]  L. R. Dice Measures of the Amount of Ecologic Association Between Species , 1945 .

[27]  Marc-Emmanuel Bellemare,et al.  Uterus segmentation in dynamic MRI using LBP texture descriptors , 2014, Medical Imaging.