Enhanced detection of fetal pose in 3D MRI by Deep Reinforcement Learning with physical structure priors on anatomy.

Fetal MRI is heavily constrained by unpredictable and substantial fetal motion that causes image artifacts and limits the set of viable diagnostic image contrasts. Current mitigation of motion artifacts is predominantly performed by fast, single-shot MRI and retrospective motion correction. Estimation of fetal pose in real time during MRI stands to benefit prospective methods to detect and mitigate fetal motion artifacts where inferred fetal motion is combined with online slice prescription with low-latency decision making. Current developments of deep reinforcement learning (DRL), offer a novel approach for fetal landmarks detection. In this task 15 agents are deployed to detect 15 landmarks simultaneously by DRL. The optimization is challenging, and here we propose an improved DRL that incorporates priors on physical structure of the fetal body. First, we use graph communication layers to improve the communication among agents based on a graph where each node represents a fetal-body landmark. Further, additional reward based on the distance between agents and physical structures such as the fetal limbs is used to fully exploit physical structure. Evaluation of this method on a repository of 3-mm resolution in vivo data demonstrates a mean accuracy of landmark estimation within 10 mm of ground truth as 87.3%, and a mean error of 6.9 mm. The proposed DRL for fetal pose landmark search demonstrates a potential clinical utility for online detection of fetal motion that guides real-time mitigation of motion artifacts as well as health diagnosis during MRI of the pregnant mother.