Segmentation of Lumbar Spine MRI Images for Stenosis Detection using Patch-based Pixel Classification Neural Network

This paper addresses the central problem of automatic segmentation of lumbar spine Magnetic Resonance Imaging (MRI) images to delineate boundaries between the anterior arch and posterior arch of the lumbar spine. This is necessary to efficiently detect the occurrence of lumbar spinal stenosis as a leading cause of Chronic Lower Back Pain. A patch-based classification neural network consisting of convolutional and fully connected layers is used to classify and label pixels in MRI images. The classifier is trained using overlapping patches of size 25x25 pixels taken from a set of cropped axial-view T2-weighted MRI images of the bottom three intervertebral discs. A set of experiment is conducted to measure the performance of the classification network in segmenting the images when either all or each of the discs separately is used. Using pixel accuracy, mean accuracy, mean Intersection over Union (IoU), and frequency weighted IoU as the performance metrics we have shown that our approach produces better segmentation results than eleven other pixel classifiers. Furthermore, our experiment result also indicates that our approach produces more accurate delineation of all important boundaries and making it best suited for the subsequent stage of lumbar spinal stenosis detection

A Machine Learning and Computer Assisted Methodology for Diagnosing Chronic Lower Back Pain on Lumbar Spine Magnetic Resonance Images

Chronic Lower Back Pain (CLBP) is one of the major types of pain that affects many people around the world. It is estimated that 28.1% of US adults suffer from this illness and 2.5 million of the UK population experience this type of pain every day. Most CLBP cases do not happen overnight and it is usually developed from a less serious but acute variant of lower back pain. An acute type of lower back pain can develop into a chronic one if the underlying cause is serious and left untreated. The longer a person is disabled by back pain, the less chance he or she returns to work and the more health care cost he or she will require. It is therefore important to identify the cause of back pains as early as possible in order to improve the chance of patient rehabilitation. The speediness of early diagnosis can depend on many factors including referral time from a general practitioner to the hospital, waiting time for a specialist appointment, time for a Magnetic Resonance Imaging (MRI) scan and time for the analysis result to come out. Currently diagnosing the lower back pain is done by visual observation and analysis of the lumbar spine MRI images by radiologists and clinicians and this process could take up much of their time and effort. This, therefore, rationalizes the need for a new method to increase the efficiency and effectiveness of the imaging diagnostic process. This thesis details a novel methodology to automatically aid clinicians in performing diagnosis of CLBP on lumbar spine MRI images. The methodology is based on the current accepted medical practice of manual inspection of the MRI scans of the patient’s lumbar spine as advised by several practitioners in this field. The main methodology is divided into three sub-methods the first sub-method is disc herniation detection using disc segmentation and centroid distance function. While the second sub-method is lumbar spinal stenosis detection via segmentation of area between anterior and posterior (AAP) Elements. Whereas, the last sub-method is the use of deep learning to perform semantic segmentation to identify regions in the MRI images that are relevant to the diagnosis process. The method then performs boundary delineation between these regions, identifies key points along the boundaries and measures distances between these points that can be used as an indication to the health of the lumbar spine. Due to a limitation in the size and suitability of the currently existing open-access lumbar spine dataset necessary to train and test any good classification algorithms, a dataset consisting of 48,345 MRI slices from a complete clinical lumbar MRI study of 515 symptomatic back pain patients from several specialty hospitals around the world has been created. Each MRI study is annotated by expert radiologists with notes regarding the observed characteristics, condition of the lumbar spine, or presence of diseases. The ground-truth dataset containing manually labelled segmented images has also been developed. To complement this ground-truth dataset, a novel method of constructing and evaluating the suitability of ground truth data for lumbar spine MRI image segmentation has been developed. A subset of the dataset, which includes the data for 101 patients, is used in a set of experiments that have been conducted using a variety of algorithms to conclude with using SegNet as the image segmentation algorithm. The network consists of VGG16 layers pre-trained using a subset of non-medical images from the ImageNet database and fine-tuned using the training portion of the ground-truth dataset. The results of these experiments show the accurate delineation of important boundaries of regions in lumbar spine MRI. The experiments also show very close agreement between the expert radiologists’ notes on the condition of a lumbar spine and the conclusion of the system about the lumbar spine in the majority of cases

Development of Ground Truth Data for Automatic Lumbar Spine MRI Image Segmentation

Artificial Intelligence through supervised machine learning remains an attractive and popular research area in medical image processing. The objective of such research is often tied to the development of an intelligent computer aided diagnostic system whose aim is to assist physicians in their task of diagnosing diseases. The quality of the resulting system depends largely on the availability of good data for the machine learning algorithm to train on. Training data of a supervised learning process needs to include ground truth, i.e., data that have been correctly annotated by experts. Due to the complex nature of most medical images, human error, experience, and perception play a strong role in the quality of the ground truth. In this paper, we present the results of annotating lumbar spine Magnetic Resonance Imaging images for automatic image segmentation and propose confidence and consistency metrics to measure the quality and variability of the resulting ground truth data, respectively

MRI-SegFlow: a novel unsupervised deep learning pipeline enabling accurate vertebral segmentation of MRI images.

Most deep learning based vertebral segmentation methods require laborious manual labelling tasks. We aim to establish an unsupervised deep learning pipeline for vertebral segmentation of MR images. We integrate the sub-optimal segmentation results produced by a rule-based method with a unique voting mechanism to provide supervision in the training process for the deep learning model. Preliminary validation shows a high segmentation accuracy achieved by our method without relying on any manual labelling.The clinical relevance of this study is that it provides an efficient vertebral segmentation method with high accuracy. Potential applications are in automated pathology detection and vertebral 3D reconstructions for biomechanical simulations and 3D printing, facilitating clinical decision making, surgical planning and tissue engineering

Classification of Sagittal Lumbar Spine MRI for Lumbar Spinal Stenosis Detection using Transfer Learning of a Deep Convolutional Neural Network

Analysis of sagittal lumbar spine MRI images remains an important step in automated detection and diagnosis of lumbar spinal stenosis. There are nu-merous algorithms proposed in the literature that can measure the condition of lumbar intervertebral discs through analysis of the lumbar spine in the sagittal view. However, these algorithms rely on using suitable sagittal im-ages as their inputs. Since an MRI data repository contains more than just these specific images, it is, therefore, necessary to employ an algorithm that can automatically select such images from the entire repository. In this pa-per, we demonstrate the application of an image classification method using deep convolutional neural networks for this purpose. Specifically, we use a pre-trained Inception-ResNet-v2 model and retrain it using two sets of T1-weighted and T2-weighted images. Through our experiment, we can con-clude that this method can reach a performance level of 0.91 and 0.93 on the T1 and T2 datasets, respectively when measured using the accuracy, preci-sion, recall, and f1-score metrics. We also show that the difference in per-formance between using the two modalities is statistically significant and us-ing T2-weighted images is preferred over using T1-weighted images

Automatic Semantic Segmentation of the Lumbar Spine: Clinical Applicability in a Multi-parametric and Multi-centre Study on Magnetic Resonance Images

One of the major difficulties in medical image segmentation is the high variability of these images, which is caused by their origin (multi-centre), the acquisition protocols (multi-parametric), as well as the variability of human anatomy, the severity of the illness, the effect of age and gender, among others. The problem addressed in this work is the automatic semantic segmentation of lumbar spine Magnetic Resonance images using convolutional neural networks. The purpose is to assign a class label to each pixel of an image. Classes were defined by radiologists and correspond to different structural elements like vertebrae, intervertebral discs, nerves, blood vessels, and other tissues. The proposed network topologies are variants of the U-Net architecture. Several complementary blocks were used to define the variants: Three types of convolutional blocks, spatial attention models, deep supervision and multilevel feature extractor. This document describes the topologies and analyses the results of the neural network designs that obtained the most accurate segmentations. Several of the proposed designs outperform the standard U-Net used as baseline, especially when used in ensembles where the output of multiple neural networks is combined according to different strategies.Comment: 19 pages, 9 Figures, 8 Tables; Supplementary Material: 6 pages, 8 Table

Deep Reinforcement Learning in Medical Object Detection and Segmentation

Medical object detection and segmentation are crucial pre-processing steps in the clinical workflow for diagnosis and therapy planning. Although deep learning methods have achieved considerable performance in this field, they impose several shortcomings, such as computational limitations, sub-optimal parameter optimization, and weak generalization. Deep reinforcement learning as the newest artificial intelligence algorithm has great potential to address the limitation of traditional deep learning methods, as well as obtaining accurate detection and segmentation results. Deep reinforcement learning has a cognitive-like process to propose the area of desirable objects, thereby facilitating accurate object detection and segmentation. In this thesis, we deploy deep reinforcement learning into two challenging and representative medical object detection and segmentation tasks: 1) Sequential-Conditional Reinforcement Learning (SCRL) for vertebral body detection and segmentation by modeling the spine anatomy with deep reinforcement learning; 2) Weakly-Supervised Teacher-Student network (WSTS) for liver tumor segmentation from the non-enhanced image by transferring tumor knowledge from the enhanced image with deep reinforcement learning. The experiment indicates our methods are effective and outperform state-of-art deep learning methods. Therefore, this thesis improves object detection and segmentation accuracy and offers researchers a novel approach based on deep reinforcement learning in medical image analysis

Medical Image Segmentation with Deep Learning

Medical imaging is the technique and process of creating visual representations of the body of a patient for clinical analysis and medical intervention. Healthcare professionals rely heavily on medical images and image documentation for proper diagnosis and treatment. However, manual interpretation and analysis of medical images is time-consuming, and inaccurate when the interpreter is not well-trained. Fully automatic segmentation of the region of interest from medical images have been researched for years to enhance the efficiency and accuracy of understanding such images. With the advance of deep learning, various neural network models have gained great success in semantic segmentation and spark research interests in medical image segmentation using deep learning. We propose two convolutional frameworks to segment tissues from different types of medical images. Comprehensive experiments and analyses are conducted on various segmentation neural networks to demonstrate the effectiveness of our methods. Furthermore, datasets built for training our networks and full implementations are published