Instrument segmentation plays a vital role in 3D ultrasound (US) guided cardiac intervention. Efficient and accurate segmentation during the operation is highly desired since it can facilitate the operation, reduce the operational complexity, and therefore improve the outcome. Nevertheless, current image-based instrument segmentation methods are not efficient nor accurate enough for clinical usage. Lately, fully convolutional neural networks (FCNs), including 2D and 3D FCNs, have been used in different volumetric segmentation tasks. However, 2D FCN cannot exploit the 3D contextual information in the volumetric data, while 3D FCN requires high computation cost and a large amount of training data. Moreover, with limited computation resources, 3D FCN is commonly applied with a patch-based strategy, which is therefore not efficient for clinical applications. To address these, we propose a POI-FuseNet, which consists of a patch-of-interest (POI) selector and a FuseNet. The POI selector can efficiently select the interested regions containing the instrument, while FuseNet can make use of 2D and 3D FCN features to hierarchically exploit contextual information. Furthermore, we propose a hybrid loss function, which consists of a contextual loss and a class-balanced focal loss, to improve the segmentation performance of the network. With the collected challenging ex-vivo dataset on RF-ablation catheter, our method achieved a Dice score of 70.5%, superior to the state-of-the-art methods. In addition, based on the pre-trained model from ex-vivo dataset, our method can be adapted to the in-vivo dataset on guidewire and achieves a Dice score of 66.5% for a different cardiac operation. More crucially, with POI-based strategy, segmentation efficiency is reduced to around 1.3 seconds per volume, which shows the proposed method is promising for clinical use.

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http://dx.doi.org/10.1016/j.media.2020.101842DOI Listing

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