Foundation Model for Whole-Heart Segmentation: Leveraging Student-Teacher Learning in Multi-Modal Medical Imaging

Whole-heart segmentation from CT and MRI scans is crucial for cardiovascular disease analysis, yet existing methods struggle with modality-specific biases and the need for extensive labeled datasets. To address these challenges, we propose a foundation model for whole-heart segmentation using a self-supervised learning (SSL) framework based on a student-teacher architecture. Our model is pretrained on a large, unlabeled dataset of CT and MRI scans, leveraging the xLSTM backbone to capture long-range spatial dependencies and complex anatomical structures in 3D medical images. By incorporating multi-modal pretraining, our approach ensures strong generalization across both CT and MRI modalities, mitigating modality-specific variations and improving segmentation accuracy in diverse clinical settings. The use of large-scale unlabeled data significantly reduces the dependency on manual annotations, enabling robust performance even with limited labeled data. We further introduce an xLSTM-UNet-based architecture for downstream whole-heart segmentation tasks, demonstrating its effectiveness on few-label CT and MRI datasets. Our results validate the robustness and adaptability of the proposed model, highlighting its potential for advancing automated whole-heart segmentation in medical imaging.

SMILE-UHURA Challenge -- Small Vessel Segmentation at Mesoscopic Scale from Ultra-High Resolution 7T Magnetic Resonance Angiograms

The human brain receives nutrients and oxygen through an intricate network of blood vessels. Pathology affecting small vessels, at the mesoscopic scale, represents a critical vulnerability within the cerebral blood supply and can lead to severe conditions, such as Cerebral Small Vessel Diseases. The advent of 7 Tesla MRI systems has enabled the acquisition of higher spatial resolution images, making it possible to visualise such vessels in the brain. However, the lack of publicly available annotated datasets has impeded the development of robust, machine learning-driven segmentation algorithms. To address this, the SMILE-UHURA challenge was organised. This challenge, held in conjunction with the ISBI 2023, in Cartagena de Indias, Colombia, aimed to provide a platform for researchers working on related topics. The SMILE-UHURA challenge addresses the gap in publicly available annotated datasets by providing an annotated dataset of Time-of-Flight angiography acquired with 7T MRI. This dataset was created through a combination of automated pre-segmentation and extensive manual refinement. In this manuscript, sixteen submitted methods and two baseline methods are compared both quantitatively and qualitatively on two different datasets: held-out test MRAs from the same dataset as the training data (with labels kept secret) and a separate 7T ToF MRA dataset where both input volumes and labels are kept secret. The results demonstrate that most of the submitted deep learning methods, trained on the provided training dataset, achieved reliable segmentation performance. Dice scores reached up to 0.838 $\pm$ 0.066 and 0.716 $\pm$ 0.125 on the respective datasets, with an average performance of up to 0.804 $\pm$ 0.15.

Transforming Heart Chamber Imaging: Self-Supervised Learning for Whole Heart Reconstruction and Segmentation

Automated segmentation of Cardiac Magnetic Resonance (CMR) plays a pivotal role in efficiently assessing cardiac function, offering rapid clinical evaluations that benefit both healthcare practitioners and patients. While recent research has primarily focused on delineating structures in the short-axis orientation, less attention has been given to long-axis representations, mainly due to the complex nature of structures in this orientation. Performing pixel-wise segmentation of the left ventricular (LV) myocardium and the four cardiac chambers in 2-D steady-state free precession (SSFP) cine sequences is a crucial preprocessing stage for various analyses. However, the challenge lies in the significant variability in contrast, appearance, orientation, and positioning of the heart across different patients, clinical views, scanners, and imaging protocols. Consequently, achieving fully automatic semantic segmentation in this context is notoriously challenging. In recent years, several deep learning models have been proposed to accurately quantify and diagnose cardiac pathologies. These automated tools heavily rely on the accurate segmentation of cardiac structures in magnetic resonance images (MRI). Hence, there is a need for new methods to handle such structures' geometrical and textural complexities. We proposed 2D and 3D two-stage self-supervised deep learning segmentation hybrid transformer and CNN-based architectures for 4CH whole heart segmentation. Accurate segmentation of the ventricles and atria in 4CH views is crucial for analyzing heart health and reconstructing four-chamber meshes, which are essential for estimating various parameters to assess overall heart condition. Our proposed method outperformed state-of-the-art techniques, demonstrating superior performance in this domain.