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Purpose  Cardiac image segmentation is a critical process for generating personalized models of the heart and for quantifying cardiac performance parameters. Fully automatic segmentation of the left ventricle (LV), the right ventricle (RV), and the myocardium from cardiac cine MR images is challenging due to variability of the normal and abnormal anatomy, as well as the imaging protocols. This study proposes a multi‐task learning (MTL)‐based regularization of a convolutional neural network (CNN) to obtain accurate segmenation of the cardiac structures from cine MR images.    Methods  We train a CNN network to perform the main task of semantic segmentation, along with the simultaneous, auxiliary task of pixel‐wise distance map regression. The network also predicts uncertainties associated with both tasks, such that their losses are weighted by the inverse of their corresponding uncertainties. As a result, during training, the task featuring a higher uncertainty is weighted less and vice versa. The proposed distance map regularizer is a decoder network added to the bottleneck layer of an existing CNN architecture, facilitating the network to learn robust global features. The regularizer block is removed after training, so that the original number of network parameters does not change. The trained network outputs per‐pixel segmentation when a new patient cine MR image is provided as an input.    Results  We show that the proposed regularization method improves both binary and multi‐class segmentation performance over the corresponding state‐of‐the‐art CNN architectures. The evaluation was conducted on two publicly available cardiac cine MRI datasets, yielding average Dice coefficients of 0.84 ± 0.03 and 0.91 ± 0.04. We also demonstrate improved generalization performance of the distance map regularized network on cross‐dataset segmentation, showing as much as 42% improvement in myocardium Dice coefficient from 0.56 ± 0.28 to 0.80 ± 0.14.    Conclusions  We have presented a method for accurate segmentation of cardiac structures from cine MR images. Our experiments verify that the proposed method exceeds the segmentation performance of three existing state‐of‐the‐art methods. Furthermore, several cardiac indices that often serve as diagnostic biomarkers, specifically blood pool volume, myocardial mass, and ejection fraction, computed using our method are better correlated with the indices computed from the reference, ground truth segmentation. Hence, the proposed method has the potential to become a non‐invasive screening and diagnostic tool for the clinical assessment of various cardiac conditions, as well as a reliable aid for generating patient specific models of the cardiac anatomy for therapy planning, simulation, and guidance.

A distance map regularized CNN for cardiac cine MR image segmentation