Landmark tracking in liver US images using cascade convolutional neural networks with long short-term memory

Accurate tracking of anatomic landmarks is critical for motion management in liver radiation therapy. Ultrasound (US) is a safe, low-cost technology that is broadly available and offer real-time imaging capability. This study proposed a deep learning-based tracking method for the US image-guided radiation therapy. The proposed cascade deep learning model is composed of an attention network, a mask region-based convolutional neural network (mask R-CNN), and a long short-term memory (LSTM) network. The attention network learns a mapping from an US image to a suspected area of landmark motion in order to reduce the search region. The mask R-CNN then produces multiple region-of-interest proposals in the reduced region and identifies the proposed landmark via three network heads: bounding box regression, proposal classification, and landmark segmentation. The LSTM network models the temporal relationship among the successive image frames for bounding box regression and proposal classification. To consolidate the final proposal, a selection method is designed according to the similarities between sequential frames. The proposed method was tested on the liver US tracking datasets used in the medical image computing and computer assisted interventions 2015 challenges, where the landmarks were annotated by three experienced observers to obtain their mean positions. Five-fold cross validation on the 24 given US sequences with ground truths shows that the mean tracking error for all landmarks is 0.65 ± 0.56 mm, and the errors of all landmarks are within 2 mm. We further tested the proposed model on 69 landmarks from the testing dataset that have the similar image pattern with the training pattern, resulting in a mean tracking error of 0.94 ± 0.83 mm. The proposed deep-learning model was implemented on a graphics processing unit (GPU), tracking 47-81 frames s⁻¹. Our experimental results have demonstrated the feasibility and accuracy of our proposed method in tracking liver anatomic landmarks using US images, providing a potential solution for real-time liver tracking for active motion management during radiation therapy.