Automated segmentation of haematoma and perihaematomal oedema in MRI of acute spontaneous intracerebral haemorrhage

Pszczolkowski, Stefan; Law, Zhe K.; Gallagher, Rebecca G.; Meng, Dewen; Swienton, David J.; Morgan, Paul S.; Bath, Philip M.; Sprigg, Nikola; Dineen, Rob A.

Abstract

Background
Spontaneous intracerebral haemorrhage (SICH) is a common condition with high morbidity and mortality. Segmentation of haematoma and perihaematoma oedema on medical images provides quantitative outcome measures for clinical trials and may provide important markers of prognosis in people with SICH.

Methods
We take advantage of improved contrast seen on magnetic resonance (MR) images of patients with acute and early subacute SICH and introduce an automated algorithm for haematoma and oedema segmentation from these images. To our knowledge, there is no previously proposed segmentation technique for SICH that utilises MR images directly. The method is based on shape and intensity analysis for haematoma segmentation and voxel-wise dynamic thresholding of hyper-intensities for oedema segmentation.

Results
Using Dice scores to measure segmentation overlaps between labellings yielded by the proposed algorithm and five different expert raters on 18 patients, we observe that our technique achieves overlap scores that are very similar to those obtained by pairwise expert rater comparison. A further comparison between the proposed method and a state-of-the-art Deep Learning segmentation on a separate set of 32 manually annotated subjects confirms the proposed method can achieve comparable results with very mild computational burden and in a completely training-free and unsupervised way.

Conclusion
Our technique can be a computationally light and effective way to automatically delineate haematoma and oedema extent directly from MR images. Thus, with increasing use of MR images clinically after intracerebral haemorrhage this technique has the potential to inform clinical practice in the future.

Citation

Pszczolkowski, S., Law, Z. K., Gallagher, R. G., Meng, D., Swienton, D. J., Morgan, P. S., …Dineen, R. A. (2019). Automated segmentation of haematoma and perihaematomal oedema in MRI of acute spontaneous intracerebral haemorrhage. Computers in Biology and Medicine, 106, 126-139. https://doi.org/10.1016/j.compbiomed.2019.01.022

• Journal Article Type: Article
• Acceptance Date: Jan 24, 2019
• Online Publication Date: Jan 29, 2019
• Publication Date: Mar 1, 2019
• Deposit Date: Feb 6, 2019
• Publicly Available Date: Feb 6, 2019
• Journal: Computers in Biology and Medicine
• Print ISSN: 0010-4825
• Electronic ISSN: 1879-0534
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 106
• Pages: 126-139
• DOI: https://doi.org/10.1016/j.compbiomed.2019.01.022
• Keywords: Brain MRI; Image segmentation; Spontaneous intracerebral haemorrhage; Stroke
• Public URL: https://nottingham-repository.worktribe.com/output/1522939
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0010482519300289#ack0010
• Additional Information: This article is maintained by: Elsevier; Article Title: Automated segmentation of haematoma and perihaematomal oedema in MRI of acute spontaneous intracerebral haemorrhage; Journal Title: Computers in Biology and Medicine; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.compbiomed.2019.01.022; Content Type: article; Copyright: © 2019 The Authors. Published by Elsevier Ltd.