Cardiac CT (CCT) is of vital importance in heart disease diagnosis but is conventionally limited by its complex workflow that requires dedicated phase and bolus monitoring devices [e.g., electrocardiogram (ECG) gating]. Our previous work has demonstrated the possibility of replacing ECG devices with deep learning (DL)-based monitoring of continuously acquired pulsed mode projections (PMPs, i.e., only a few sparsely sampled projections per gantry rotation). In this work, we report the development of a new projection domain DL-based cardiac phase estimation method that uses ensemble learning [i.e., training multiple convolution neural network (CNN) in parallel] to estimate and reduce DL uncertainty. The estimated DL uncertainty information was then used drive an analytical regularizer in a principled time-dependent manner (i.e., stronger regularization when DL uncertainty is higher). Combined with our previous work on PMP-based bolus curve estimation, the proposed method could potentially be used to achieve autonomous cardiac scanning in a robust (i.e., reduced uncertainty) manner without ECG and bolus timing devices.
Cardiac CT plays an important role in diagnosing heart diseases but is conventionally limited by its complex workflow that requires dedicated phase and bolus tracking [e.g., electrocardiogram (ECG) gating]. This work reports initial progress towards robust and autonomous cardiac CT exams through deep learning (DL) analysis of pulsed-mode projections (PMPs). To this end, cardiac phase and its uncertainty were simultaneously estimated using a novel projection domain cardiac phase estimation network (PhaseNet), which utilizes a sliding-window multi-channel feature extraction approach and a long short-term memory (LSTM) block to extract temporal correlation between time-distributed PMPs. Monte-Carlo dropout layers were utilized to predict the uncertainty of deep learning-based cardiac phase prediction. The performance of the proposed phase estimation pipeline was evaluated using accurate physics-based emulated data.
PhaseNet demonstrated improved phase estimation accuracy compared to more standard methods in terms of RMSE (~43% improvement vs. a standard CNN-LSTM; ~17% improvement vs. a multi-channel residual network [ResNet]), achieving accurate phase estimation with <8% RMSE in cardiac phase (phase ranges from 0-100%). These findings suggest that the cardiac phase can be accurately estimated with the proposed projection domain approach. Combined with our previous work on PMP-based bolus curve estimation, the proposed method could potentially be used to achieve autonomous cardiac CT scanning without ECG device or expert-in-the-loop bolus timing.
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