# Fully Automatic Segmentation and Objective Assessment of Atrial Scars for Longstanding Persistent Atrial Fibrillation Patients Using Late Gadolinium-Enhanced MRI

## TL;DR

This paper introduces a fully automatic pipeline for segmenting and assessing atrial scars in LGE MRI scans of atrial fibrillation patients, combining multi-atlas segmentation and supervised learning, achieving high accuracy without manual intervention.

## Contribution

The study presents a novel fully automatic method that accurately segments atrial scars in LGE MRI, improving objectivity and efficiency over manual approaches.

## Key findings

- Achieved mean Dice of 89% for cardiac anatomy segmentation.
- Achieved mean Dice of 79% for atrial scar delineation.
- Demonstrated comparable accuracy to manual methods with full automation.

## Abstract

Purpose: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is correlated with increased morbidity and mortality. It is associated with atrial fibrosis, which may be assessed non-invasively using late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI) where scar tissue is visualised as a region of signal enhancement. In this study, we proposed a novel fully automatic pipeline to achieve an accurate and objective atrial scarring segmentation and assessment of LGE MRI scans for the AF patients. Methods: Our fully automatic pipeline uniquely combined: (1) a multi-atlas based whole heart segmentation (MA-WHS) to determine the cardiac anatomy from an MRI Roadmap acquisition which is then mapped to LGE MRI, and (2) a super-pixel and supervised learning based approach to delineate the distribution and extent of atrial scarring in LGE MRI. Results: Both our MA-WHS and atrial scarring segmentation showed accurate delineations of cardiac anatomy (mean Dice = 89%) and atrial scarring (mean Dice =79%) respectively compared to the established ground truth from manual segmentation. Compared with previously studied methods with manual interventions, our innovative pipeline demonstrated comparable results, but was computed fully automatically. Conclusion: The proposed segmentation methods allow LGE MRI to be used as an objective assessment tool for localisation, visualisation and quantification of atrial scarring.

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Source: https://tomesphere.com/paper/1705.09529