Preserving Cardiac Integrity: A Topology-Infused Approach to Whole Heart Segmentation

Whole heart segmentation (WHS) supports cardiovascular disease (CVD) diagnosis, disease monitoring, treatment planning, and prognosis. Deep learning has become the most widely used method for WHS applications in recent years. However, segmentation of whole-heart structures faces numerous challenges including heart shape variability during the cardiac cycle, clinical artifacts like motion and poor contrast-to-noise ratio, domain shifts in multi-center data, and the distinct modalities of CT and MRI. To address these limitations and improve segmentation quality, this paper introduces a new topology-preserving module that is integrated into deep neural networks. The implementation achieves anatomically plausible segmentation by using learned topology-preserving fields, which are based entirely on 3D convolution and are therefore very effective for 3D voxel data. We incorporate natural constraints between structures into the end-to-end training and enrich the feature representation of the neural network. The effectiveness of the proposed method is validated on an open-source medical heart dataset, specifically using the WHS++ data. The results demonstrate that the architecture performs exceptionally well, achieving a Dice coefficient of 0.939 during testing. This indicates full topology preservation for individual structures and significantly outperforms other baselines in preserving the overall scene topology.