Automated cardiac MR image segmentation: theory and measurement evaluation.

We present a new approach to magnetic resonance image segmentation with a Gradient-Vector-Flow-based snake applied to selective smoothing filtered images. The system also allows automated image segmentation in the presence of grey scale inhomogeneity, as in cardiac Magnetic Resonance imaging. Removal of such inhomogeneities is a difficult task, but we proved that using non-linear anisotropic diffusion filtering, myocardium edges are selectively preserved. The approach allowed medical data to be automatically segmented in order to track not only endocardium, which is usually a less difficult task, but also epicardium in anatomic and perfusion studies with Magnetic Resonance. The method developed proceeds in three distinct phases: (a) an anisotropic diffusion filtering tool is used to reduce grey scale inhomogeneity and to selectively preserve edges; (b) a Gradient-Vector-Flow-based snake is applied on filtered images to allow capturing a snake from a long range and to move into concave boundary regions; and (c) an automatic procedure based on a snake is used to fit both endocardium and epicardium borders in a multiphase, multislice examination. A good agreement (P<0.001) between manual and automatic data analysis, based on the mean difference+/-SD, was assessed in a pool of 907 cardiac function and perfusion images.