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]

Hough Forest-based Corner Detection for Cervical Spine Radiographs

The cervical spine (neck region) is highly sensitive to trauma related injuries, which must be analysed carefully by emergency physicians. In this work, we propose a Hough Forest-based corner detection method for cervical spine radiographs, as a first step towards a computer-aided diagnostic tool. We propose a novel patch-based model based on two-stage supervised learning (classification and regression) to estimate the corners of cervical vertebral bodies. Our method is evaluated using 106 cervical x-ray images consisting of 530 vertebrae and 2120 corners, which have been demarcated manually by an expert radiographer. The results show promising performance of the proposed algorithm, with a lowest median error of 1.98 m

Probabilistic Spatial Regression using a Deep Fully Convolutional Neural Network

Probabilistic predictions are often preferred in computer vision problems because they can provide a confidence of the predicted value. The recent dominant model for computer vision problems, the convolutional neural network, produces probabilistic output for classification and segmentation problems. But probabilistic regression using neural networks is not well defined. In this work, we present a novel fully convolutional neural network capable of producing a spatial probabilistic distribution for localizing image landmarks. We have introduced a new network layer and a novel loss function for the network to produce a two-dimensional probability map. The proposed network has been used in a novel framework to localize vertebral corners for lateral cervical Xray images. The framework has been evaluated on a dataset of 172 images consisting 797 vertebrae and 3,188 vertebral corners. The proposed framework has demonstrated promising performance in localizing vertebral corners, with a relative improvement of 38% over the previous state-of-the-art

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

Fully automatic cervical vertebrae segmentation framework for X-ray images

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.The cervical spine is a highly flexible anatomy and therefore vulnerable to injuries. Unfortunately, a large number of injuries in lateral cervical X-ray images remain undiagnosed due to human errors. Computer-aided injury detection has the potential to reduce the risk of misdiagnosis. Towards building an automatic injury detection system, in this paper, we propose a deep learning-based fully automatic framework for segmentation of cervical vertebrae in X-ray images. The framework first localizes the spinal region in the image using a deep fully convolutional neural network. Then vertebra centers are localized using a novel deep probabilistic spatial regression network. Finally, a novel shape-aware deep segmentation network is used to segment the vertebrae in the image. The framework can take an X-ray image and produce a vertebrae segmentation result without any manual intervention. Each block of the fully automatic framework has been trained on a set of 124 X-ray images and tested on another 172 images, all collected from real-life hospital emergency rooms. A Dice similarity coefficient of 0.84 and a shape error of 1.69 mm have been achieved

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

Fully automatic image analysis framework for cervical vertebra in X-ray images

Despite the advancement in imaging technologies, a fifth of the injuries in the cervical spine remain unnoticed in the X-ray radiological exam. About a two-third of the subjects with unnoticed injuries suffer tragic consequences. Based on the success of computer-aided systems in several medical image modalities to enhance clinical interpretation, we have proposed a fully automatic image analysis framework for cervical vertebrae in X-ray images. The framework takes an X-ray image as input and highlights different vertebral features at the output. To the best of our knowledge, this is the first fully automatic system in the literature for the analysis of the cervical vertebrae. The complete framework has been built by cascading specialized modules, each of which addresses a specific computer vision problem. This dissertation explores data-driven supervised machine learning solutions to these problems. Given an input X-ray image, the first module localizes the spinal region. The second module predicts vertebral centers from the spinal region which are then used to generate vertebral image patches. These patches are then passed through machine learning modules that detect vertebral corners, highlight vertebral boundaries, segment vertebral body and predict vertebral shapes. In the process of building the complete framework, we have proposed and compared different solutions to the problems addressed by each of the modules. A novel region-aware dense classification deep neural network has been proposed for the first module to address the spine localization problem. The proposed network outperformed the standard dense classification network and random forestbased methods. Location of the vertebral centers and corners vary based on human interpretation and thus are better represented by probability maps than single points. To learn the mapping between the vertebral image patches and the probability maps, a novel neural network capable of predicting a spatially distributed probabilistic distribution has been proposed. The network achieved expert-level performance in localizing vertebral centers and outperform the Harris corner detector and Hough forest-based methods for corner localization. The proposed network has also shown its capability for detecting vertebral boundaries and produced visually better results than the dense classification network-based boundary detectors. Segmentation of the vertebral body is a crucial part of the proposed framework. A new shapeaware loss function has been proposed for training a segmentation network to encourage prediction of vertebra-like structures. The segmentation performance improved significantly, however, the pixel-wise nature of proposed loss function was not able to constrain the predictions adequately. To solve the problem a novel neural network was proposed which predicts vertebral shapes and trains on a loss function defined in the shape space. The proposed shape predictor network was capable of learning better topological information about the vertebra than the shape-aware segmentation network. The methods proposed in this dissertation have been trained and tested on a challenging dataset of X-ray images collected from medical emergency rooms. The proposed, first-of-its-kind, fully automatic framework produces state-of-the-art results both quantitatively and qualitatively

Automatic Segmentation and Identification of Spinous Processes on Sagittal X-Rays Based on Random Forest Classification and Dedicated Contextual Features

X-ray based quantitative analysis of spine parameters is required in routine diagnosis or treatment planning. Existing tools commonly require manual intervention. Attempts towards automation of the whole procedure have mainly focused on vertebral bodies, whereas other regions such as the posterior arch also bear considerable amount of useful information. In this study, we combine a specific design of contextual visual features with a multi-class Random Forest classifier to perform pixel-wise segmentation and identification of all cervical spine spinous processes, on sagittal radiographs. Segmentations were evaluated on 62 radiographs, comparing to manual tracing. Correct identification was obtained for all subjects, and segmentation returned mean SD values of: Dice coefficient =88 8%; Hausdorff distance =2.1 1.4 mm and; mean surface distance =0.6 0.4 mm. The derived geometric parameters can be used to reduce the amount of manual intervention needed for spine modeling or to measure clinical indices

Semi-automatic Tracking of the Hyoid bone and the Epiglottis Movements in Digital Videofluoroscopic Images

Swallowing is a process that happens hundreds of times per day during eating, drinking, or swallowing saliva. Dysphagia is an abnormality in any stage of the swallowing process. It can cause serious problems such as dehydration and respiratory infection. In order to help dysphasic patients, radiologists need to evaluate the patient’s swallowing ability, usually using Video Fluoroscopic Swallowing Study (VFSS). During the assessment, several measurements are taken and evaluated, such as the displacement of the hyoid bone and epiglottis. Usually radiologists perform evaluation by means of visual inspection, which is a time consuming process that produces subjective results. Previous research has made strides automating swallowing measurements in order to produce objective results, but there is no study that automatically tracks the movement of the epiglottis. This thesis presents a design and implementation of a Computer Aided Diagnosis (CAD) system that can automatically track the movement of the hyoid bone and the epiglottis using minimal user input. The correlation between these two movements will be studied. With the aid of this system, radiologists can more reliably and efficiently take measurements and evaluate the health of the swallowing process