Fully automated contour detection of the ascending aorta in cardiac 2D phase-contrast MRI

Purpose In this study we proposed a fully automated method for localizing and segmenting the ascending aortic lumen with phase-contrast magnetic resonance imaging (PC-MRI). Material and methods Twenty-five phase-contrast series were randomly selected out of a large population dataset of patients whose cardiac MRI examination, performed from September 2008 to October 2013, was unremarkable. The local Ethical Committee approved this retrospective study. The ascending aorta was automatically identified on each phase of the cardiac cycle using a priori knowledge of aortic geometry. The frame that maximized the area, eccentricity, and solidity parameters was chosen for unsupervised initialization. Aortic segmentation was performed on each frame using active contouring without edges techniques. The entire algorithm was developed using Matlab R2016b. To validate the proposed method, the manual segmentation performed by a highly experienced operator was used. Dice similarity coefficient, Bland-Altman analysis, and Pearson's correlation coefficient were used as performance metrics. Results Comparing automated and manual segmentation of the aortic lumen on 714 images, Bland-Altman analysis showed a bias of − 6.68 mm2, a coefficient of repeatability of 91.22 mm2, a mean area measurement of 581.40 mm2, and a reproducibility of 85%. Automated and manual segmentation were highly correlated (R = 0.98). The Dice similarity coefficient versus the manual reference standard was 94.6 ± 2.1% (mean ± standard deviation). Conclusion A fully automated and robust method for identification and segmentation of ascending aorta on PC-MRI was developed. Its application on patients with a variety of pathologic conditions is advisable.