In this paper, we propose a convolutional neural network-based method to automatically retrieve missing or noisy cardiac acquisition plane information from magnetic resonance imaging and predict the five most common cardiac views. We fine-tune a convolutional neural network (CNN) initially trained on a large natural image recognition data-set (Imagenet ILSVRC2012) and transfer the learnt feature representations to cardiac view recognition. We contrast this approach with a previously introduced method using classification forests and an augmented set of image miniatures, with prediction using off the shelf CNN features, and with CNNs learnt from scratch. We validate this algorithm on two different cardiac studies with 200 patients and 15 healthy volunteers, respectively. We show that there is value in fine-tuning a model trained for natural images to transfer it to medical images. Our approach achieves an average F1 score of 97.66% and significantly improves the state-of-the-art of image-based cardiac view recognition. This is an important building block to organise and filter large collections of cardiac data prior to further analysis. It allows us to merge studies from multiple centres, to perform smarter image filtering, to select the most appropriate image processing algorithm, and to enhance visualisation of cardiac data-sets in content-based image retrieval.

The robust delineation of the cochlea and its inner structures combined with the detection of the electrode of a cochlear implant within these structures is essential for envisaging a safer, more individualized, routine image-guided cochlear implant therapy. We present Nautilus—a web-based research platform for automated pre- and post-implantation cochlear analysis. Nautilus delineates cochlear structures from pre-operative clinical CT images by combining deep learning and Bayesian inference approaches. It enables the extraction of electrode locations from a post-operative CT image using convolutional neural networks and geometrical inference. By fusing pre- and post-operative images, Nautilus is able to provide a set of personalized pre- and post-operative metrics that can serve the exploration of clinically relevant questions in cochlear implantation therapy. In addition, Nautilus embeds a self-assessment module providing a confidence rating on the outputs of its pipeline. We present a detailed accuracy and robustness analyses of the tool on a carefully designed dataset. The results of these analyses provide legitimate grounds for envisaging the implementation of image-guided cochlear implant practices into routine clinical workflows.

Understanding cochlear anatomy is crucial for developing less traumatic electrode arrays and insertion guidance for cochlear implantation. The human cochlea shows considerable variability in size and morphology. This study analyses 1000+ clinical temporal bone CT images using a web-based image analysis tool. Cochlear size and shape parameters were obtained to determine population statistics and perform regression and correlation analysis. The analysis revealed that cochlear morphology follows Gaussian distribution, while cochlear dimensions A and B are not well-correlated to each other. Additionally, dimension B is more correlated to duct lengths, the wrapping factor and volume than dimension A. The scala tympani size varies considerably among the population, with the size generally decreasing along insertion depth with dimensional jumps through the trajectory. The mean scala tympani radius was 0.32 mm near the 720° insertion angle. Inter-individual variability was four times that of intra-individual variation. On average, the dimensions of both ears are similar. However, statistically significant differences in clinical dimensions were observed between ears of the same patient, suggesting that size and shape are not the same. Harnessing deep learning-based, automated image analysis tools, our results yielded important insights into cochlear morphology and implant development, helping to reduce insertion trauma and preserving residual hearing.