Automatic detection of myocardial ischaemia using generalisable spatio-temporal hierarchical Bayesian modelling of DCE-MRI

Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI) can be used as a non-invasive method for the assessment of myocardial perfusion. The acquired images can be utilised to analyse the spatial extent and severity of myocardial ischaemia (regions with impaired microvascular blood flow). In the present paper, we propose a novel generalisable spatio-temporal hierarchical Bayesian model (GST-HBM) to automate the detection of ischaemic lesions and improve the in silico prediction accuracy by systematically integrating spatio-temporal context information. We present a computational inference procedure with an adequate tradeoff between accuracy and computational efficiency, whereby model parameters are sampled from the posterior distribution with Gibbs sampling, while lower -level hyperparameters are selected using model selection strategies based on the Watanabe Akaike information criterion (WAIC). We have assessed our method on both synthetic (in silico) data with known gold -standard and 12 sets of clinical first -pass myocardial perfusion DCE-MRI datasets. We have also carried out a comparative performance evaluation with four established alternative methods: Gaussian mixture model (GMM), opening and closing operations based on Gaussian mixture model (GMMmax C&O), Markov random field constrained Gaussian mixture model (GMM-MRF) and modelbased hierarchical Bayesian model (M-HBM). Our results show that the proposed GST-HBM method achieves much higher in silico prediction accuracy than the established alternative methods. Furthermore, this method appears to provide a more robust delineation of ischaemic lesions in datasets affected by spatially variant noise.