An accurate whole heart segmentation (WHS) on medical images, including computed tomography (CT) and magnetic resonance (MR) images, plays a crucial role in many clinical applications, such as cardiovascular disease diagnosis, pre-surgical planning, and intraoperative treatment. Manual whole-heart segmentation is a time-consuming process, prone to subjectivity and error. Therefore, there is a need to develop a quick, automatic, and accurate whole heart segmentation systems. Nowadays, convolutional neural networks (CNNs) emerged as a robust approach for medical image segmentation. In this paper, we first introduce a novel connectivity structure of residual unit that we refer to as a feature merge residual unit (FM-Pre-ResNet). The proposed connectivity allows the creation of distinctly deep models without an increase in the number of parameters compared to the pre-activation residual units. Second, we propose a three-dimensional (3D) encoder–decoder based architecture that successfully incorporates FM-Pre-ResNet units and variational autoencoder (VAE). In an encoding stage, FM-Pre-ResNet units are used for learning a low-dimensional representation of the input. After that, the variational autoencoder (VAE) reconstructs the input image from the low-dimensional latent space to provide a strong regularization of all model weights, simultaneously preventing overfitting on the training data. Finally, the decoding stage creates the final whole heart segmentation. We evaluate our method on the 40 test subjects of the MICCAI Multi-Modality Whole Heart Segmentation (MM-WHS) Challenge. The average dice values of whole heart segmentation are 90.39% (CT images) and 89.50% (MRI images), which are both highly comparable to the state-of-the-art.
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