Patch-based Corner Detection for Cervical Vertebrae in X-ray Images

Corners hold vital information about size, shape and morphology of a vertebra in an x-ray image, and recent literature [1, 2] has shown promising performance for detecting vertebral corners using a Hough forest-based architecture. To provide spatial context, this method generates a set of 12 patches around a vertebra and uses a machine learning approach to predict corners of a vertebral body through a voting process. In this paper, we extend this framework in terms of patch generation and prediction methods. During patch generation, the square region of interest has been replaced with data-driven rectangular and trapezoidal region of interest which better aligns the patches to the vertebral body geometry, resulting in more discriminative feature vectors. The corner estimation or the prediction stage has been improved by utilising more efficient voting process using a single kernel density estimation. In addition, advanced and more complex feature vectors are introduced. We also present a thorough evaluation of the framework with different patch generation methods, forest training mechanisms and prediction methods. In order to compare the performance of this framework with a more general method, a novel multi-scale Harris corner detector-based approach is introduced that incorporates a spatial prior through a naive Bayes method. All these methods have been tested on a dataset of 90 X-ray images and achieved an average corner localization error of 2.01 mm, representing a 33% improvement in localisation accuracy compared to the previous state-of-the-art method [2]

Global Localization and Orientation of the Cervical Spine in X-ray Imaging

Injuries in cervical spine X-ray images are often missed by emergency physicians. Many of these missing injuries cause further complications. Automated analysis of the images has the potential to reduce the chance of missing injuries. Towards this goal, this paper proposes an automatic localization of the spinal column in cervical spine X-ray images. The framework employs a random classification forest algorithm with a kernel density estimation-based voting accumulation method to localize the spinal column and to detect the orientation. The algorithm has been evaluated with 90 emergency room X-ray images and has achieved an average detection accuracy of 91% and an orientation error of 3.6◦. The framework can be used to narrow the search area for other advanced injury detection systems

Development of ultrasound to measure deformation of functional spinal units in cervical spine

Neck pain is a pervasive problem in the general population, especially in those working in vibrating environments, e.g. military troops and truck drivers. Previous studies showed neck pain was strongly associated with the degeneration of intervertebral disc, which is commonly caused by repetitive loading in the work place. Currently, there is no existing method to measure the in-vivo displacement and loading condition of cervical spine on the site. Therefore, there is little knowledge about the alternation of cervical spine functionality and biomechanics in dynamic environments. In this thesis, a portable ultrasound system was explored as a tool to measure the vertebral motion and functional spinal unit deformation. It is hypothesized that the time sequences of ultrasound imaging signals can be used to characterize the deformation of cervical spine functional spinal units in response to applied displacements and loading. Specifically, a multi-frame tracking algorithm is developed to measure the dynamic movement of vertebrae, which is validated in ex-vivo models. The planar kinematics of the functional spinal units is derived from a dual ultrasound system, which applies two ultrasound systems to image C-spine anteriorly and posteriorly. The kinematics is reconstructed from the results of the multi-frame movement tracking algorithm and a method to co-register ultrasound vertebrae images to MRI scan. Using the dual ultrasound, it is shown that the dynamic deformation of functional spinal unit is affected by the biomechanics properties of intervertebral disc ex-vivo and different applied loading in activities in-vivo. It is concluded that ultrasound is capable of measuring functional spinal units motion, which allows rapid in-vivo evaluation of C-spine in dynamic environments where X-Ray, CT or MRI cannot be used.2020-02-20T00:00:00

Cervical Vertebral Corner Detection using Haar-like Features and Modified Hough Forest

The neck (cervical spine) is a flexible part of the human body and is particularly vulnerable to injury. Patients suspected of cervical spine injuries are often imaged using lateral view radiographs. Incorrect diagnosis based on these images may lead to serious long-term consequences. Our overarching goal is to develop a computer-aided detection system to help an emergency room physician correctly diagnose a patient's injury. In this paper, we present a method to localize the corners of cervical vertebrae in a set of 90 lateral cervical radiographs. Haar-like features are computed using intensity and gradient image patches, each of which votes for possible corner position using a modified Hough forest regression technique. Votes are aggregated using two dimensional kernel density estimation, to find the location of the corner. Our method demonstrates promising results, identifying corners with an average median error of 2.08 mm

X-ray Image Segmentation and An Internet-based Tool for Medical Validation

Segmentation of vertebrae in X-ray images is a difficult task that requires an effective segmentation procedure. Noise, poor image contrast, occlusions and shape variability are some of the challenges in many of the spine X-ray images archived at the U.S. National Library of Medicine (NLM). In this thesis, we propose a curvature-based corner matching approach, which exploits the posterior corners of the vertebra to estimate the location and orientation of the vertebrae. The key advantage of the proposed approach is execution time, roughly about one-fifth of the previous approach that uses the generalized Hough transform when tested on a sizeable set of cervical spine images. This thesis also presents the first ever effort to develop a prototype internet-based medical image segmentation and pathology validation tool, which enables radiologists to validate computer generated image segmentations, modify existing or create new segmentation in addition to identifying pertinent pathology data

Live Wire Segmentation Tool for Osteophyte Detection in Lumbar Spine X-Ray Images

Computer-assisted vertebra segmentation in x-ray images is a challenging problem. Inter-subject variability and the generally poor contrast of digitized radiograph images contribute to the segmentation difficulty. In this paper, a semi-automated live wire approach is investigated for vertebrae segmentation. The live wire approach integrates initially selected user points with dynamic programming to generate a closed vertebra boundary. In order to assess the degree to which vertebra features are conserved using the live wire technique, convex hull-based features to characterize anterior osteophytes in lumbar vertebrae are determined for live wire and manually segmented vertebrae. Anterior osteophyte discrimination was performed over 405 lumbar vertebrae, 204 abnormal vertebrae with anterior osteophytes and 201 normal vertebrae. A leave-one-out standard back propagation neural network was used for vertebrae segmentation. Experimental results show that manual segmentation yielded slightly better discrimination results than the live wire technique

Automatic segmentation of the spine by means of a probabilistic atlas with a special focus on ribs suppression

[EN] Purpose: The development of automatic and reliable algorithms for the detection and segmentation of the vertebrae are of great importance prior to any diagnostic task. However, an important problem found to accurately segment the vertebrae is the presence of the ribs in the thoracic region. To overcome this problem, a probabilistic atlas of the spine has been developed dealing with the proximity of other structures, with a special focus on ribs suppression. Methods: The data sets used consist of Computed Tomography images corresponding to 21 patients suffering from spinal metastases. Two methods have been combined to obtain the final result: firstly, an initial segmentation is performed using a fully automatic level-set method; secondly, to refine the initial segmentation, a 3D volume indicating the probability of each voxel of belonging to the spine has been developed. In this way, a probability map is generated and deformed to be adapted to each testing case. Results: To validate the improvement obtained after applying the atlas, the Dice coefficient (DSC), the Hausdorff distance (HD), and the mean surface-to-surface distance (MSD) were used. The results showed up an average of 10 mm of improvement accuracy in terms of HD, obtaining an overall final average of 15.51 2.74 mm. Also, a global value of 91.01 3.18% in terms of DSC and a MSD of 0.66 0.25 mm were obtained. The major improvement using the atlas was achieved in the thoracic region, as ribs were almost perfectly suppressed. Conclusion: The study demonstrated that the atlas is able to detect and appropriately eliminate the ribs while improving the segmentation accuracy.The authors thank the financial support of the Spanish Ministerio de Economia y Competitividad (MINECO) and FEDER funds under Grants TEC2012-33778 and BFU2015-64380-C2-2-R (D.M.) and DPI2013-4572-R (J.D., E.D.)Ruiz-España, S.; Domingo, J.; Díaz-Parra, A.; Dura, E.; D'ocon-Alcaniz, V.; Arana, E.; Moratal, D. (2017). 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Deformable Multisurface Segmentation of the Spine for Orthopedic Surgery Planning and Simulation

Purpose: We describe a shape-aware multisurface simplex deformable model for the segmentation of healthy as well as pathological lumbar spine in medical image data. Approach: This model provides an accurate and robust segmentation scheme for the identification of intervertebral disc pathologies to enable the minimally supervised planning and patient-specific simulation of spine surgery, in a manner that combines multisurface and shape statistics-based variants of the deformable simplex model. Statistical shape variation within the dataset has been captured by application of principal component analysis and incorporated during the segmentation process to refine results. In the case where shape statistics hinder detection of the pathological region, user assistance is allowed to disable the prior shape influence during deformation. Results: Results demonstrate validation against user-assisted expert segmentation, showing excellent boundary agreement and prevention of spatial overlap between neighboring surfaces. This section also plots the characteristics of the statistical shape model, such as compactness, generalizability and specificity, as a function of the number of modes used to represent the family of shapes. Final results demonstrate a proof-of-concept deformation application based on the open-source surgery simulation Simulation Open Framework Architecture toolkit. Conclusions: To summarize, we present a deformable multisurface model that embeds a shape statistics force, with applications to surgery planning and simulation

Shape/image registration for medical imaging : novel algorithms and applications.

This dissertation looks at two different categories of the registration approaches: Shape registration, and Image registration. It also considers the applications of these approaches into the medical imaging field. Shape registration is an important problem in computer vision, computer graphics and medical imaging. It has been handled in different manners in many applications like shapebased segmentation, shape recognition, and tracking. Image registration is the process of overlaying two or more images of the same scene taken at different times, from different viewpoints, and/or by different sensors. Many image processing applications like remote sensing, fusion of medical images, and computer-aided surgery need image registration. This study deals with two different applications in the field of medical image analysis. The first one is related to shape-based segmentation of the human vertebral bodies (VBs). The vertebra consists of the VB, spinous, and other anatomical regions. Spinous pedicles, and ribs should not be included in the bone mineral density (BMD) measurements. The VB segmentation is not an easy task since the ribs have similar gray level information. This dissertation investigates two different segmentation approaches. Both of them are obeying the variational shape-based segmentation frameworks. The first approach deals with two dimensional (2D) case. This segmentation approach starts with obtaining the initial segmentation using the intensity/spatial interaction models. Then, shape model is registered to the image domain. Finally, the optimal segmentation is obtained using the optimization of an energy functional which integrating the shape model with the intensity information. The second one is a 3D simultaneous segmentation and registration approach. The information of the intensity is handled by embedding a Willmore flow into the level set segmentation framework. Then the shape variations are estimated using a new distance probabilistic model. The experimental results show that the segmentation accuracy of the framework are much higher than other alternatives. Applications on BMD measurements of vertebral body are given to illustrate the accuracy of the proposed segmentation approach. The second application is related to the field of computer-aided surgery, specifically on ankle fusion surgery. The long-term goal of this work is to apply this technique to ankle fusion surgery to determine the proper size and orientation of the screws that are used for fusing the bones together. In addition, we try to localize the best bone region to fix these screws. To achieve these goals, the 2D-3D registration is introduced. The role of 2D-3D registration is to enhance the quality of the surgical procedure in terms of time and accuracy, and would greatly reduce the need for repeated surgeries; thus, saving the patients time, expense, and trauma