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Register a new userMulti-Atlas Segmentation with Joint Label Fusion of Osteoporotic Vertebral Compression Fractures on CT
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Added by
Yinong Wang
Publication date
2016
fields
Informatics Engineering
and research's language is
English
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The precise and accurate segmentation of the vertebral column is essential in the diagnosis and treatment of various orthopedic, neurological, and oncological traumas and pathologies. Segmentation is especially challenging in the presence of pathology such as vertebral compression fractures. In this paper, we propose a method to produce segmentations for osteoporotic compression fractured vertebrae by applying a multi-atlas joint label fusion technique for clinical CT images. A total of 170 thoracic and lumbar vertebrae were evaluated using atlases from five patients with varying degrees of spinal degeneration. In an osteoporotic cohort of bundled atlases, registration provided an average Dice coefficient and mean absolute surface distance of 2.7$pm$4.5% and 0.32$pm$0.13mm for osteoporotic vertebrae, respectively, and 90.9$pm$3.0% and 0.36$pm$0.11mm for compression fractured vertebrae.
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The presence of a vertebral compression fracture is highly indicative of osteoporosis and represents the single most robust predictor for development of a second osteoporotic fracture in the spine or elsewhere. Less than one third of vertebral compression fractures are diagnosed clinically. We present an automated method for detecting spine compression fractures in Computed Tomography (CT) scans. The algorithm is composed of three processes. First, the spinal column is segmented and sagittal patches are extracted. The patches are then binary classified using a Convolutional Neural Network (CNN). Finally a Recurrent Neural Network (RNN) is utilized to predict whether a vertebral fracture is present in the series of patches.
Classification of vertebral compression fractures (VCF) having osteoporotic or neoplastic origin is fundamental to the planning of treatment. We developed a fracture classification system by acquiring quantitative morphologic and bone density determinants of fracture progression through the use of automated measurements from longitudinal studies. A total of 250 CT studies were acquired for the task, each having previously identified VCFs with osteoporosis or neoplasm. Thirty-six features or each identified VCF were computed and classified using a committee of support vector machines. Ten-fold cross validation on 695 identified fractured vertebrae showed classification accuracies of 0.812, 0.665, and 0.820 for the measured, longitudinal, and combined feature sets respectively.
An osteoporosis-related fracture occurs every three seconds worldwide, affecting one in three women and one in five men aged over 50. The early detection of at-risk patients facilitates effective and well-evidenced preventative interventions, reducing the incidence of major osteoporotic fractures. In this study, we present an automatic system for identification of vertebral compression fractures on Computed Tomography images, which are often an undiagnosed precursor to major osteoporosis-related fractures. The system integrates a compact 3D representation of the spine, utilizing a Convolutional Neural Network (CNN) for spinal cord detection and a novel end-to-end sequence to sequence 3D architecture. We evaluate several model variants that exploit different representation and classification approaches and present a framework combining an ensemble of models that achieves state of the art results, validated on a large data set, with a patient-level fracture identification of 0.955 Area Under the Curve (AUC). The system proposed has the potential to support osteoporosis clinical management, improve treatment pathways, and to change the course of one of the most burdensome diseases of our generation.
Multi-atlas segmentation approach is one of the most widely-used image segmentation techniques in biomedical applications. There are two major challenges in this category of methods, i.e., atlas selection and label fusion. In this paper, we propose a novel multi-atlas segmentation method that formulates multi-atlas segmentation in a deep learning framework for better solving these challenges. The proposed method, dubbed deep fusion net (DFN), is a deep architecture that integrates a feature extraction subnet and a non-local patch-based label fusion (NL-PLF) subnet in a single network. The network parameters are learned by end-to-end training for automatically learning deep features that enable optimal performance in a NL-PLF framework. The learned deep features are further utilized in defining a similarity measure for atlas selection. By evaluating on two public cardiac MR datasets of SATA-13 and LV-09 for left ventricle segmentation, our approach achieved 0.833 in averaged Dice metric (ADM) on SATA-13 dataset and 0.95 in ADM for epicardium segmentation on LV-09 dataset, comparing favorably with the other automatic left ventricle segmentation methods. We also tested our approach on Cardiac Atlas Project (CAP) testing set of MICCAI 2013 SATA Segmentation Challenge, and our method achieved 0.815 in ADM, ranking highest at the time of writing.
Multi-atlas segmentation (MAS), first introduced and popularized by the pioneering work of Rohlfing, Brandt, Menzel and Maurer Jr (2004), Klein, Mensh, Ghosh, Tourville and Hirsch (2005), and Heckemann, Hajnal, Aljabar, Rueckert and Hammers (2006), is becoming one of the most widely-used and successful image segmentation techniques in biomedical applications. By manipulating and utilizing the entire dataset of atlases (training images that have been previously labeled, e.g., manually by an expert), rather than some model-based average representation, MAS has the flexibility to better capture anatomical variation, thus offering superior segmentation accuracy. This benefit, however, typically comes at a high computational cost. Recent advancements in computer hardware and image processing software have been instrumental in addressing this challenge and facilitated the wide adoption of MAS. Today, MAS has come a long way and the approach includes a wide array of sophisticated algorithms that employ ideas from machine learning, probabilistic modeling, optimization, and computer vision, among other fields. This paper presents a survey of published MAS algorithms and studies that have applied these methods to various biomedical problems. In writing this survey, we have three distinct aims. Our primary goal is to document how MAS was originally conceived, later evolved, and now relates to alternative methods. Second, this paper is intended to be a detailed reference of past research activity in MAS, which now spans over a decade (2003 - 2014) and entails novel methodological developments and application-specific solutions. Finally, our goal is to also present a perspective on the future of MAS, which, we believe, will be one of the dominant approaches in biomedical image segmentation.
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