title: Myocardial Infarct Segmentation From Magnetic Resonance Images for Personalized Modeling of Cardiac Electrophysiology.
abstract: Accurate representation of myocardial infarct geometry is crucial to patient-specific computational modeling of the heart in ischemic cardiomyopathy. We have developed a methodology for segmentation of left ventricular (LV) infarct from clinically acquired, two-dimensional (2D), late-gadolinium enhanced cardiac magnetic resonance (LGE-CMR) images, for personalized modeling of ventricular electrophysiology. The infarct segmentation was expressed as a continuous min-cut optimization problem, which was solved using its dual formulation, the continuous max-flow (CMF). The optimization objective comprised of a smoothness term, and a data term that quantified the similarity between image intensity histograms of segmented regions and those of a set of training images. A manual segmentation of the LV myocardium was used to initialize and constrain the developed method. The three-dimensional geometry of infarct was reconstructed from its segmentation using an implicit, shape-based interpolation method. The proposed methodology was extensively evaluated using metrics based on geometry, and outcomes of individualized electrophysiological simulations of cardiac dys(function). Several existing LV infarct segmentation approaches were implemented, and compared with the proposed method. Our results demonstrated that the CMF method was more accurate than the existing approaches in reproducing expert manual LV infarct segmentations, and in electrophysiological simulations. The infarct segmentation method we have developed and comprehensively evaluated in this study constitutes an important step in advancing clinical applications of personalized simulations of cardiac electrophysiology.
authors.affiliation: Department of Biomedical Engineering, Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Eranga
authors.initials: E
authors.lastname: Ukwatta
authors.affiliation: Department of Biomedical Engineering, Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Hermenegild
authors.initials: H
authors.lastname: Arevalo
authors.affiliation: Department of Biomedical Engineering, Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Kristina
authors.initials: K
authors.lastname: Li
authors.affiliation: Robarts Research Institute, Western University, London, ON, Canada.
authors.forename: Jing
authors.initials: J
authors.lastname: Yuan
authors.affiliation: Robarts Research Institute, Western University, London, ON, Canada.
authors.forename: Wu
authors.initials: W
authors.lastname: Qiu
authors.affiliation: Department of Biomedical Engineering, Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Malamas
authors.affiliation: Division of Cardiology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Katherine C
authors.initials: KC
authors.lastname: Wu
authors.affiliation: Department of Biomedical Engineering, Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Natalia A
authors.initials: NA
authors.lastname: Trayanova
authors.affiliation: Department of Biomedical Engineering, Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Fijoy
authors.initials: F
authors.lastname: Vadakkumpadan
mesh_terms: D003198:Computer Simulation; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods*; D005682:Gadolinium / Q000627:therapeutic use; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008955:Models, Cardiovascular; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D066230:Patient-Specific Modeling
chemical_list: D005682:Gadolinium