Deep Learning-based Prescription of Cardiac MRI Planes

Purpose: To develop and evaluate a system to prescribe imaging planes for cardiac MRI based on deep learning (DL)-based localization of key anatomic landmarks. Materials and Methods: Annotated landmarks on 892 long-axis (LAX) and 493 short-axis (SAX) cine steady-state free precession series from cardiac MR images were retrospectively collected between February 2012 and June 2017. U-Net-based heatmap regression was used for localization of cardiac landmarks, which were used to compute cardiac MRI planes. Performance was evaluated by comparing localization distances and plane angle differences between DL predictions and ground truth. The plane angulations from DL were compared with those prescribed by the technologist at the original time of acquisition. Data were split into 80% for training and 20% for testing, and results confirmed with fivefold cross-validation. Results: On LAX images, DL localized the apex within mean 12.56 mm +/- 19.11 (standard deviation) and the mitral valve (MV) within 7.68 mm +/- 6.91. On SAX images, DL localized the aortic valve within 5.78 mm +/- 5.68, MV within 5.90 mm +/- 5.24, pulmonary valve within 6.55 mm +/- 6.39, and tricuspid valve within 6.39 mm +/- 5.89. On the basis of these localizations, average angle bias and mean error of DL-predicted imaging planes relative to ground truth annotations were as follows: SAX, -1.27 degrees +/- 6.81 and 4.93 degrees +/- 4.86; four chambers, 0.38 degrees +/- 6.45 and 5.16 degrees +/- 3.80; three chambers, 0.13 degrees +/- 12.70 and 9.02 degrees +/- 8.83; and two chamber, 0.25 degrees +/- 9.08 and 6.53 degrees +/- 6.28, respectively. Conclusion: DL-based anatomic localization is a feasible strategy for planning cardiac MRI planes. This approach can produce imaging planes comparable to those defined by ground truth landmarks. Supplemental material is available for this article. (c) RSNA, 2019