A shape-constraint adversarial framework with instance-normalized spatio-temporal features for inter-fetal membrane segmentation.


Journal

Medical image analysis
ISSN: 1361-8423
Titre abrégé: Med Image Anal
Pays: Netherlands
ID NLM: 9713490

Informations de publication

Date de publication:
05 2021
Historique:
received: 27 06 2020
revised: 17 12 2020
accepted: 16 02 2021
pubmed: 2 3 2021
medline: 24 6 2021
entrez: 1 3 2021
Statut: ppublish

Résumé

During Twin-to-Twin Transfusion Syndrome (TTTS), abnormal vascular anastomoses in the monochorionic placenta can produce uneven blood flow between the fetuses. In the current practice, this syndrome is surgically treated by closing the abnormal connections using laser ablation. Surgeons commonly use the inter-fetal membrane as a reference. Limited field of view, low fetoscopic image quality and high inter-subject variability make the membrane identification a challenging task. However, currently available tools are not optimal for automatic membrane segmentation in fetoscopic videos, due to membrane texture homogeneity and high illumination variability. To tackle these challenges, we present a new deep-learning framework for inter-fetal membrane segmentation on in-vivo fetoscopic videos. The framework enhances existing architectures by (i) encoding a novel (instance-normalized) dense block, invariant to illumination changes, that extracts spatio-temporal features to enforce pixel connectivity in time, and (ii) relying on an adversarial training, which constrains macro appearance. We performed a comprehensive validation using 20 different videos (2000 frames) from 20 different surgeries, achieving a mean Dice Similarity Coefficient of 0.8780±0.1383. The proposed framework has great potential to positively impact the actual surgical practice for TTTS treatment, allowing the implementation of surgical guidance systems that can enhance context awareness and potentially lower the duration of the surgeries.

Sections du résumé

BACKGROUND AND OBJECTIVES
During Twin-to-Twin Transfusion Syndrome (TTTS), abnormal vascular anastomoses in the monochorionic placenta can produce uneven blood flow between the fetuses. In the current practice, this syndrome is surgically treated by closing the abnormal connections using laser ablation. Surgeons commonly use the inter-fetal membrane as a reference. Limited field of view, low fetoscopic image quality and high inter-subject variability make the membrane identification a challenging task. However, currently available tools are not optimal for automatic membrane segmentation in fetoscopic videos, due to membrane texture homogeneity and high illumination variability.
METHODS
To tackle these challenges, we present a new deep-learning framework for inter-fetal membrane segmentation on in-vivo fetoscopic videos. The framework enhances existing architectures by (i) encoding a novel (instance-normalized) dense block, invariant to illumination changes, that extracts spatio-temporal features to enforce pixel connectivity in time, and (ii) relying on an adversarial training, which constrains macro appearance.
RESULTS
We performed a comprehensive validation using 20 different videos (2000 frames) from 20 different surgeries, achieving a mean Dice Similarity Coefficient of 0.8780±0.1383.
CONCLUSIONS
The proposed framework has great potential to positively impact the actual surgical practice for TTTS treatment, allowing the implementation of surgical guidance systems that can enhance context awareness and potentially lower the duration of the surgeries.

Identifiants

pubmed: 33647785
pii: S1361-8415(21)00054-2
doi: 10.1016/j.media.2021.102008
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102008

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subjects of this manuscript.

Auteurs

Alessandro Casella (A)

Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy; Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy. Electronic address: alessandro.casella@iit.it.

Sara Moccia (S)

The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy; Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy.

Dario Paladini (D)

Department of Fetal and Perinatal Medicine, Istituto "Giannina Gaslini", Genoa, Italy.

Emanuele Frontoni (E)

Department of Information Engineering, Universitá Politecnica delle Marche, Ancona, Italy.

Elena De Momi (E)

Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.

Leonard S Mattos (LS)

Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy.

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Classifications MeSH