Automatic pericardium segmentation and quantification of epicardial fat from computed tomography angiography

J Med Imaging (Bellingham). 2016 Jul;3(3):034003. doi: 10.1117/1.JMI.3.3.034003. Epub 2016 Sep 15.


Recent findings indicate a strong correlation between the risk of future heart disease and the volume of adipose tissue inside of the pericardium. So far, large-scale studies have been hindered by the fact that manual delineation of the pericardium is extremely time-consuming and that existing methods for automatic delineation lack accuracy. An efficient and fully automatic approach to pericardium segmentation and epicardial fat volume (EFV) estimation is presented, based on a variant of multi-atlas segmentation for spatial initialization and a random forest classifier for accurate pericardium detection. Experimental validation on a set of 30 manually delineated computer tomography angiography volumes shows a significant improvement on state-of-the-art in terms of EFV estimation [mean absolute EFV difference: 3.8 ml (4.7%), Pearson correlation: 0.99] with run times suitable for large-scale studies (52 s). Further, the results compare favorably with interobserver variability measured on 10 volumes.

Keywords: computed tomography angiography; epicardial fat quantification; machine learning; pericardium; segmentation.