Vertebral body segmentation with prior shape constraints for accurate BMD measurements

Vertebrae, IVD and spinal canal boundary extraction on MRI, utilizing CT-trained active shape models

PURPOSE

Vertebrae, intervertebral disc (IVD) and spinal canal (SC) displacements are in the root of several spinal cord pathologies. The localization and boundary extraction of these structures, along with the quantification of their displacements, provide valuable clues for assessing each pathological condition. In this work, we propose a computational method for boundary extraction of vertebrae, IVD and SC in magnetic resonance images (MRI).

METHOD

Vertebrae shape priors derived from computed tomography (CT) images are used to guide vertebrae, IVD and SC boundary extraction in MRI. This strategy is dictated by three considerations: (1) CT is the modality of choice for highlighting solid structures such as vertebrae, (2) vertebrae boundaries indirectly impose constraints on the boundaries of neighbouring structures (IVD and SC), and (3) it can be observed that edges are similarly located in CT and MR images; therefore, gradient profiles and shape priors learned by active shape models (ASMs) from CT are also valid in MRI.

RESULTS

Experimental comparisons on two MR image datasets demonstrate that the proposed approach obtains segmentation results, which are comparable to the state of the art. Moreover, the adopted bimodal strategy is validated by demonstrating that CT-derived shape priors lead to more accurate boundary extraction than MRI-derived shape priors, even in the case of MR image applications.

CONCLUSION

Unlike existing bimodal methods, the proposed one is not dependent on the availability of CT/MR image pairs, which are not usually acquired from the same patient. In addition, unlike state-of-the-art deep learning-based methods, it is not dependent on large amounts of training data. The proposed method requires a limited amount of user intervention.

Bimodal CT/MRI-Based Segmentation Method for Intervertebral Disc Boundary Extraction

Intervertebral disc (IVD) localization and segmentation have triggered intensive research efforts in the medical image analysis community, since IVD abnormalities are strong indicators of various spinal cord-related pathologies. Despite the intensive research efforts to address IVD boundary extraction based on MR images, the potential of bimodal approaches, which benefit from complementary information derived from both magnetic resonance imaging (MRI) and computed tomography (CT), has not yet been fully realized. Furthermore, most existing approaches rely on manual intervention or on learning, although sufficiently large and labelled 3D datasets are not always available. In this light, this work introduces a bimodal segmentation method for vertebrae and IVD boundary extraction, which requires a limited amount of intervention and is not based on learning. The proposed method comprises various image processing and analysis stages, including CT/MRI registration, Otsu-based thresholding and Chan–Vese-based segmentation. The method was applied on 98 expert-annotated pairs of CT and MR spinal cord images with varying slice thicknesses and pixel sizes, which were obtained from 7 patients using different scanners. The experimental results had a Dice similarity coefficient equal to 94.77(%) for CT and 86.26(%) for MRI and a Hausdorff distance equal to 4.4 pixels for CT and 4.5 pixels for MRI. Experimental comparisons with state-of-the-art CT and MRI segmentation methods lead to the conclusion that the proposed method provides a reliable alternative for vertebrae and IVD boundary extraction. Moreover, the segmentation results are utilized to perform a bimodal visualization of the spine, which could potentially aid differential diagnosis with respect to several spine-related pathologies.

Evaluation and comparison of 3D intervertebral disc localization and segmentation methods for 3D T2 MR data: A grand challenge

The evaluation of changes in Intervertebral Discs (IVDs) with 3D Magnetic Resonance (MR) Imaging (MRI) can be of interest for many clinical applications. This paper presents the evaluation of both IVD localization and IVD segmentation methods submitted to the Automatic 3D MRI IVD Localization and Segmentation challenge, held at the 2015 International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI2015) with an on-site competition. With the construction of a manually annotated reference data set composed of 25 3D T2-weighted MR images acquired from two different studies and the establishment of a standard validation framework, quantitative evaluation was performed to compare the results of methods submitted to the challenge. Experimental results show that overall the best localization method achieves a mean localization distance of 0.8 mm and the best segmentation method achieves a mean Dice of 91.8%, a mean average absolute distance of 1.1 mm and a mean Hausdorff distance of 4.3 mm, respectively. The strengths and drawbacks of each method are discussed, which provides insights into the performance of different IVD localization and segmentation methods.

Fully Automatic Localization and Segmentation of 3D Vertebral Bodies from CT/MR Images via a Learning-Based Method

In this paper, we address the problems of fully automatic localization and segmentation of 3D vertebral bodies from CT/MR images. We propose a learning-based, unified random forest regression and classification framework to tackle these two problems. More specifically, in the first stage, the localization of 3D vertebral bodies is solved with random forest regression where we aggregate the votes from a set of randomly sampled image patches to get a probability map of the center of a target vertebral body in a given image. The resultant probability map is then further regularized by Hidden Markov Model (HMM) to eliminate potential ambiguity caused by the neighboring vertebral bodies. The output from the first stage allows us to define a region of interest (ROI) for the segmentation step, where we use random forest classification to estimate the likelihood of a voxel in the ROI being foreground or background. The estimated likelihood is combined with the prior probability, which is learned from a set of training data, to get the posterior probability of the voxel. The segmentation of the target vertebral body is then done by a binary thresholding of the estimated probability. We evaluated the present approach on two openly available datasets: 1) 3D T2-weighted spine MR images from 23 patients and 2) 3D spine CT images from 10 patients. Taking manual segmentation as the ground truth (each MR image contains at least 7 vertebral bodies from T11 to L5 and each CT image contains 5 vertebral bodies from L1 to L5), we evaluated the present approach with leave-one-out experiments. Specifically, for the T2-weighted MR images, we achieved for localization a mean error of 1.6 mm, and for segmentation a mean Dice metric of 88.7% and a mean surface distance of 1.5 mm, respectively. For the CT images we achieved for localization a mean error of 1.9 mm, and for segmentation a mean Dice metric of 91.0% and a mean surface distance of 0.9 mm, respectively.