A Novel 4D Semi-Automated Algorithm for Volumetric Segmentation in Echocardiography

Segmentation of the left ventricle (LV) in temporal 3D echocardiography sequences poses a challenge. However, it is an essential component in generating quantitative clinical measurements for the diagnosis and treatment of various cardiac diseases. Identifying the endocardial borders of the left ventricle can be difficult due to the inherent properties of ultrasound. This study proposes a 4D segmentation algorithm that segments over temporal 3D volumes that has minimal user interaction and is based on a diffeomorphic registration approach. In contrast to several existing algorithms, the proposed method does not depend on training data or make any geometrical assumptions. The algorithm was evaluated on seven patients obtained from the Mazankowski Alberta Heart Institute, Edmonton, Canada in comparison to expert manual segmentation. The proposed approach yielded Dice scores of 0.94 (0.01), 0.91 (0.03) and 0.92 (0.02) at end diastole, at end systole and over the entire cardiac cycle, respectively. The corresponding Hausdorff distance values were 4.49 (1.01) mm, 4.94 (1.41) mm, and 5.05 (0.85) mm, respectively. These results demonstrate that the proposed 4D segmentation approach for the left ventricle is robust and can potentially be used in clinical practice.